HomeMy WebLinkAbout12-19-11NOTICE OF INHERITANCE TAX pe1111S~/~Va1118 "~ ~~ ~ ~ ,
BUREAU OF INDIVIDUAL TAXES ~~ "ARPRA~S-EM~EPF ~, ALLOWANCE OR DISALLOWANCE •7
INHERITANCE TAX DIVISION OF DEl'iUD~IONS AND ASSESSMENT OF TAX DEPARTMENT OF REVENUE
PO BOX 260601 REV-1547 IX AFP (12-10)
HARRISBURG PA 17128-0601 ~~~~ ._:_ ;
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MARIELLE F HAZE~~~f,4Q -,~ ~ - ., OA
STE 202
2000 LINGLESTOWN RD
HARRISBURG PA 17110-9347
DATE 12-12-2011
ESTATE OF GORDON ANN W
DATE OF DEATH 11-05-2010
FILE NUMBER 21 11-0079
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 02-10-2012
(See reverse side under Objections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER Of= WILLS
1 COURTHOUSE SQUARE
CARLISLE F'A 17013
CUT ALONG THIS LINE ~-"l--RETAIN LOWER PORTION FOR YOUR
REV-1547 RECORDS F
EX AFP C12-10) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE
DISALLOWANCE
--------------
OR
OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: GORDON
ANN WFILE N0.:21 11-0079 ACN: 101 DATE: 12-12-2011
TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
(1)
2. Stocks and Bonds (Schedule B) '00 NOTE: To ensure proper
3. Closely Held Stock/Partnership Interest (Schedule C) C2) .00 credit to your account,
submit t
(3)
4. Mortgages/Notes Receivable (Schedule D) .00 he upper portion
of this form with you
5. Cash/Bank Deposits/Misc. Personal Property (Schedul
E)
l
! r
tax payment.
e
(5)
6. Jointly Owned Property (Schedule F) E
,679.96
7. Transfers (Schedule G) (6) .0 0
cn 13,421.32
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS: (B) 31,026 58
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
(9)-
10. Debts/Mortgage Liabilities/Liens (Schedule I) T.6 8 ~R
clo)_ 14,039 61
11. Total Deductions
12• Net Value of Tax Return (11) 21,677.99
13. Charitable/Governmental Bequests; Non-elected 9113 Tr
t (12) 9,348.5 9
us
s (Schedule
14. Net Value of Estate Subject to Tax J)
(13) .00
(14)
NOTE: If an assessment was issued previously, lines 14
i5 9,348 59
,
a
reflect figures that include the total
f nd/or 16, 17,
and 19 will
o
ALL returns
ASSESSMENT OF TAX: assessed to d to
15. Amount of Line 14 at Spousal rate
(15)
16. Amount of Line 14 taxable at Lineal/Class A rat '00 X 00 = .00
e
17. Amount of Line 14 at Sibling rate (16)_ 9. 3GR rq x 045 = 420.69
cln
18. Amount of Line 14 taxable at Collateral/Class B rate (18)
1 nn x 12 =
UO .00
9. Principal Tax Due °'
X 15 = . 00
TAX CREDITS: (19)= 420.69
PAYMENT RECEIPT DISCOUNT (+)
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
08-02-2011 CD014798
• 00 ~:9n ~n
TOTAL TAX PAYMENT
420.69
BALANCE OF 'TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
* IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF' THIS FORM FOR INSTRUCTIONS.