HomeMy WebLinkAbout02-24-12BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
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A`J~I~ ~; ~"xl",.„~'OWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
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PATRICIA A LEWIS
3 SANTA MARIA AVE
CAMP HILL PA 17011-7320
DATE 02-20-2012
ESTATE OF RILEY DORIS A
DATE OF DEATH 09-20-2009
FILE NUMBER 21 11-0939
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 04-20-2012
(See reverse side under Objections)
Amount Remitted-
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE S4UARE
CARLISLE PA 17013
CUT ALONG THIS LINE ~--) RETAIN LOWER PORTION FOR YOUR RECORDS E'-- _ _______________
REV-1547 EX AFP C12-11~
R
R
N AOFOTAXCE OR
DEDUCTIONS AND
OF
DISALLOWANCE ASSESSMENT
ESTATE OF: RILEY DORIS AFILE N0.:21 11-0939 ACN: 101 DATE: 02-20-2012
TAX RETURN WAS: C X) ACCEPTED AS FILED ( ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
00
roper
C1) • NOTE: To ensure p
1. Real Estate (Schedule A) .00 credit to your account,
2. Stocks and Bonds (Schedule B) C2)
00 submit the upper portion
Closely Held Stock/Partnership interest (Schedule C)
3 C3)
.
of this form with your
.
Mortgages/Notes Receivable (Schedule D)
4 C4) .00 tax payment.
.
Cash/Bank Deposits/Misc. Personal Property (Schedule E)
5 90
C5) 6.60
.
6. Jointly Owned Property (Schedule F)
(6) ,00
00
7 Transfers (Schedule G)
C7)
.
' ~$) 906.60
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) Cg) 770.50
.00
10 Debts/Mortgage Liabilities/Liens (Schedule I) (10)
770.50
c11)
11. Total Deductions
C12) 136.10
12. Net Value of Tax Return
J) (13) .00
13. Charitable/Governmental Bequests; Nonelected 9113 Trusts (Schedule 10
136
14. Net Value of Estate Subject to Tax C14) .
NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX: .00 x Op = .00
15. Amount of Line 14 at Spousal rate (15)
1~6 10 x 04 5 =
6.12
16 Amount of Line 14 taxable at Lineal/Class A rate C16)
. c17) . DO x 12 = . 00
17. Amount of Line 14 at Sibling rate
00
) .00 X 15 = .
18. Amount of Line 14 taxable at Collateral/Class B rate (18 (19)= 6.12
19. Principal Tax Due
TAX CR EDITS:
PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID C-)
09-02-2011 (0014929 .25- 20.00
TOTAL TAX PAYMENT 19.75
BALANCE OF TAX DUE 13.63CR
INTEREST AND PEN. .00
TOTAL DUE 13.63CR
* IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.