HomeMy WebLinkAbout03-05-12BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
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NOTICE OF INHERITANCE TAX Pennsylvania E ~
AP '~JpT~- NCE OR DISALLOWANCE DEPARTMENT OF REVENUE
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0~~ ~fS}~G;TI01~$, ~/kND ASSESSMENT OF TAX REV-1547 EX AFP <IZ-11)
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CLERK 0~
ORPHAN'S Ci?URT
CIJ~APFPI.a~Ji ;',~. PA,
CHARLES E SHIELDS III
6 CLOUSER RD
MECHANICSBURG PA 17055-9751
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
02-28-2012
MARTIN JOHN W
12-13-2010
21 10-1237
CUMBERLAND
101
APPEAL DATE: 04-28-2012
(See reverse side under Objections)
Amount Remitted~-
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALON_6 THIS LINE _ ~1 R_ETA_IN LOWER POR_TION_ FOR YOUR RECORDS ~ _ _______________
REV-1547 EX AFP C12-11) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: MARTIN JOHN WFILE N0.:21 to-7737 ACNe lnl nerF. n~_~a_~ni~
TAX RETURN WAS: C X) ACCEPTED AS FILED C ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
C1) .00
cz) 6,617.31
c3) .00
c4) .00
~5) 16,784.10
c6) .00
C7) 130, 195.35
NOTE: To ensure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
c8) 153,596.76
C9) 36.822.17
clo) 10.992.61
11. Total Deductions C11) 47,814.78
12. Net Value of Tax Return C12) 105,781.98
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C13) .00
14. Net Value of Estate Subject to Tax (14) 105,781.98
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 d ate.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate C15) .00 X 00 - .00
16. Amount of Line 14 taxable at Lineal/Class A rate C16) 10~.781.9R x 045 = 4,760.19
17. Amount of Line 14 at Sibling rate (17) .00 X 12 = .00
18. Amount of Line 14 taxable at Collateral/Class B ra te C18) .00 X 15 - .00
19. Principal Tax Due C19)= 4, 760.19
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT C+)
DATE
NUMBER
INTEREST/PEN PAID
C-) AMDUNT PAID
-09-2011
, , v u .
TOTAL TAX PAYMENT 4,760.19
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" (CR), YOU MAY BE
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.