HomeMy WebLinkAbout01-30-12BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX
INHERITANCE TAX DIVISION APP
PD sox zaocol O U.. CE OR DISALLOWANCE
HARRISBURG PA 1 7128-06 01 `^~ f'9_ ASSESSMENT OF TAX
(~~ t r'' ! .. ~ ~'
Pennsylvania -'
DEPARTMENT OF REVENUE
REV-1547 EX AFP (12-I1)
'~~~~ J~~I ~~ ~~ ~2~ ~ :3DATE 01-30-2012
ESTATE OF EVANS
CLERK Q~ DATE OF DEATH 06-03-2011 HORACE
GERALD J SHEKLETSKI ESQ COUNTYUMBER 21 11-0663
414 BRIDGE ST C<~~`S ifCUAj
~~ ~n . PA ACN CUMBERLAND
PO BOX E 101
NEW CUMBERLAND ~ APPEAL DATE: p3_30-2012
PA 17 0 7 0 -19 2 7 (S'ee reverse side under Objections
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CUT-ALONG THIS LINE CARLISLE 1'A 17013
REV-1547 EX AFP ----' ~ __RETAIN-LOWER POR_TION__F__OR YOUR
C12-11~ NOTICE OF INHERITANCE TAX -' RECORDS ~.~.
ESTATE OF: DISALLOWANCE OF DEDUCTIONS AND RASSESSMENTAOFOTAXCE OR
EVANS HORACE ----
FILE NO.:21 11-0663
APPRAISED VALUE OF Tax RETURN was: ( ACN: 101 DATE:
X) ACCEPTED AS FILED O1 -30 -2012
1 • Real Estate [SchRedu eRA) BASED ON: ORIGINAL ( ) CHANGED
RETURN
2• Stocks and Bonds (Schedule B) _
3. Closely Held Stock/Partnershi C1) ~ ~ NOTE:
P Interest To ensure proper
4• Mortgages/Notes Receivable (Schedule D) (Schedule C) C2)~~~ ~ credit to your account,
5. Cash/Bank (3)----~~~ OQ submit the
Deposits/ upper portion
6• Jointl Misc. Personal Propert (4) of this form with
y Owned Propert y (Schedule E) C5) -~'~~ tax payment. Y°ur
y (Schedule F) ~1 ,~ 069.2(
7. Transfers (Schedule G)
$• Total Assets (6)= 8 0
APPROVED DEDUCTIONS C7)~~-~00
AND EXEMPTIONS:
9. Funeral Expenses/Adm. (B) 161
l0. Costs/Misc. Expenses 870.46
Debts/Mortgage Liabilities/Liens (Schedule H)
(Schedule I) C9)- ~~ ZQg 7
11. Total Deductions (10)-- 00
12. Net Value of Tax Return -~
13. Charitable/Governmental Be nests; (11)
14. Net Value of v Non-elected 9113 Trusts (Schedule J) 14'388.12
Estate Subject to Tax (12) 147,482.34
NOTE: If an (13) 1 000.00
assessment was issued previously,
reflect fi (14) 146 482.34
ASSESSMENT OF gures that include lines 14, 15 and/or
TAX: the total of A~ returns 16' 17' 18 and 19
15. Amount of Line 14 assessed to date, will
16. Amount of Line 14 at Spousal rate
taxable at Lineal/Class (15)
17• Amount of Line 14 A rate '0~~ X 00 -
at Sibling rate C16) ~ ?~ 4R9 zi~ . 00
18. Amount of Line 14 taxable at Collateral/Class g ~; X 04 5 =
(17) Io non ne 6,141.71
19. Principal Tax Due X 12 -
TAX CREDITS: rate (lg) 1 ~ 200.00
.00 1
DATE
0909_p~
09-02-2011
01-23-2012
NUMBER
CD014924
SBADJUST
INTE~PEN PAID (-)
* IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
363.82
.00
_ x 5 -
(19)= ' ~~
-~-_- 7,341.71
AMOUNT PAID
6,912.60
.O1
TOTAL TAX PA MY ENT
BALANCE OF 7 341.71
TAX DUE
INTEREST AND PEN, •00
TOTAL DUE •00
IF TOTAL DUE IS REFLECTED AS ~ .00
A REFUND. SEE REVERSE SIDE OFA •CREDIT" (CR),
THI:i FORM FOR INSTRUCTIONS,DUE
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