HomeMy WebLinkAbout01-17-12NOTICE OF INHERITANCE TAX
BUREAU OF INDIVIDUAL TAXES ~;; I '~hPPRAIS~'pl~' ALLOWANCE OR DISALLOWANCE
INHERITANCE TAX DIVISION OF DEIUU~TIONS AND ASSESSMENT OF T,AX
PO BOX 280601
HARRISBURG PA 17128-0601 -`
pennsylvarna r~~ ~
DEPARTMENT OF REVENUE
REV-1547 EX AFP C12-11)
" ~~ '~~ ~ ~ i~' ~j: ~ ,} DATE 01-03-2012
ESTATE OF IMAJERCHIK NICHOLDS J
CLCR~~ ;,J~: DATE OF DEATH 05-25-2011
~~~',-~ ~,'t ;~.r FILE NUMBER .?1 11-0657
~ Jx.;1 i'
TIM HOLMES n~ ~~°•~' ~ il~ COUNTY (:UMBERLAND
122 S 16TH ST ACN ]'.O1
CAMP HILL APPEAL DATE: 03-03-2012
PA 17011- 5505 (See reverse side under Objections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT-ALONG THIS LINE ~-'~ --RETAIN-LOWER PORTION
FOR YOUR
REV-1547 EX AFP C12- RECGRDS ~
_
11~
N
R ----
ALLOWANCE
DISALLOWANCE
DEDUCTIONS ANDRAISEMENT,
OF
ESTATE OF: MAJERCHIK ASSESSMENI' OF TAX -"'""""-------
OR
NICHOLDS JFILE N0.:21 11-0657 ACN: 101 DATE
TAX RETURN WAS : 01-03-2012
: (X) ACCEPTED AS FILED
C )
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN CHANGED
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B) ~1) .00 NOTE: To ensure proper
C2)
3. Closely Held Stock/Partnership Interest (Sched
l .00 credit to your account,
u
e C)
fig)
4. Mortgages/Notes Receivable (Schedule D) •~~ submit the upper portion
of thi
(4)
5. Cash/Bank Deposits/Misc. Personal Propert
(S s form with
Your
tax payment.
y
chedule E) C5)
6. Jointly Owned Property (Schedule F) 13 0,5 38.70
7. Transfers (Schedule G) (6) .00
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12• Net Value of Tax Return
13. Charitable/Governmental Bequests;
14. Net Value of Estate Subject to Tax
cli) 4,407.07
c12) 126, 131.63
cii) .00
c14) 126, 131 63
Non-elected 9113 Trusts (Schedule J)
NOTE: If an assessment was issued previously, lines 14, 15
reflect figures that include the total of ALL return
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate
16. Amount of Line 14 taxable at Lineal/Class A rate
17. Amount of Line 14 at Sibling rate
18. Amount of Line 14 taxable at Collateral/Class B rate
19. Principal Tax Due
TAX CREDITS:
"''°^' RECEIPT DISCOUNT (+)
DATE NUMBER INTEREST/PEN PAID (-)
~ IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
and/or 16, 17, 18 and 19 will
s assessed to date.
cls) 126, 131.63 X
ci6)_ nn X
c17)_ nn X
cls) . DO X
c7) .00
ca) 130 , 538 70
C9) 4 407 07
clo) .00
AMOUNT PAID
00 = .00
045 = .00
12 = .00
15 = .00
c19)= .00
TOTAL TAX PAYMENT
.00
BALANCE OF TAX DUE
.00
INTEREST AND PEN. .00
TOTAL DUE .00
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE D~
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.