HomeMy WebLinkAbout02-10-12BUREAU DF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 28D601
HARRISBURG PA 17128-0601
SUSAN H CONFAIR
2331 MARKET ST
CAMP HILL
INHERITANCE TAX
~~~~~~~~~~, ,-~r*-R~C~D ADJUSTMENT
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Pennsylvania ~~ ~"
DEPARTMENT OF REVENUE
REY-1543 EX AFP (12-11)
~~~j ~ ~, ~~ ~ ~ ~i''' ~~: ~ Z DATE O1 -27-2012
ESTATE OF ASHMORE MARY J
CL~~K~,~ DATE OF DEATH 10-22-2009
ORPHANS C{}l..iR' FILE NUMBER 21 09-1071
Cit)Pb~F~~ ~~~~,, i rt PA COUNTY CUMBERLAND
ACN 101
Amount Remitted
PA 17011 MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
NOTE: To ensure proper credit to your account, submit the upper portion of this form with your tax payment.
CUT ALONG THIS LINE -- RETAIN LOWER PORTION FOR YOUR RECORDS E-
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REV-1593 EX AFP C12-11~ *~ INHERITANCE TAX RECORD ADJUSTMENT **
ESTATE OF:ASHMORE MARY J FILE NO.:21 09-1071 ACN: 101 DATE: 01-27-2012
ADJUSTMENT BASED oN: BOARD OF APPEALS REFUND
VALUE OF ESTATE:
1. Real Estate (Schedule A) (1} 161,411.61
2. Stocks and Bonds (Schedule B) C2) 661 , 717 .23
3. Closely Held Stock/Partnership Interest (Schedule C) C3) ,00
4. Mortgages/Notes Receivable (Schedule D) C4) .00
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) C5) 118.720.4 6
6. Jointly Owned Property (Schedule F} C6) .00
7. Transfers (Schedule G) C7) .00
8. Total Assets C8)
941,849.30
DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Administrative Costs/
Miscellaneous Expenses (Schedule H) C9) 50,557.29
10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) 4 5,4 00.40
11. Total Deductions C11) 95,957.69
12. Net Value of Tax Return C12) 845,891.61
13. Charitable/Governmental Bequests; Non-elected 9113 Tru sts (Schedule J) C13) 864,777.5 3
14. Net Value of Estate Subject to Tax C14) 18,885.92-
TAX:
15. Amount of Line 14 at Spousal rate (15) .00X.00 = .00
16. Amount of Line 14 taxable at Lineal/Class A rate C16)
,00X.04 5= .00
17. Amount of Line 14 at Sibling rate C17) =
, 00X. 12 .00
18. Amount of Line 14 taxable at CollaterallClass B rate C18)
12,297.53Y.15 = .00
19. Principal Tax Due
C19) 00
TAX CREDITS: .
PAYMENT RECEIPT DISCOUNT C+)
DATE NUMBER INTEREST/PEN PAID C-) AMOUNT PAID
01-20-2010 I CD012259 ~ .00 285.00
~ IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
TOTAL TAX PAYMENT 285.00
ALANCE OF TAX DUE 285.0001
INTEREST AND PEN. .00
TOTAL DUE 285.0001
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR}, YOU MAY BE DUE n
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.} `^~l~/