HomeMy WebLinkAbout04-02-12rrr~nr ~~ 1~9+F OF INHERITANCE TAX +~=
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BUREAU OF INDIVIDUAL TAXES r~-in"F~RA~SfMx~ T~ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION ~ IE~'., ~.AF `D~DIiIG'~ N$ AND ASSESSMENT OF TAX
PO BOX 280601 REV-1547 EX AFP (12-11)
HARRISBURG PA 17128-0601
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DAVID M WATTS JR ESQ
100 PINE ST
PO BOX 1166
HARRISBURG PA 17108-1166
DATE 03-26-2012
ESTATE OF BARISKI JAMES L
DATE OF DEATH 12-20-2007
FILE NUMBER 21 10-0222
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 05-25-2012
(See reverse side under Objections)
Amount Remitted-
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE ---- --~ RETAIN LOWER PORTION FOR YOUR RECORDS E-- _ _____
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REV-1547 EX AFP C12-11) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: BARISKI JAMES LFILE N0.:21 10-0222 ACN: 101 DATE: n~-7~-~nl~
TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED
APPRAI SED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1) 00
2.
Stocks and Bonds (Schedule B)
(2) .
,00 NOTE: To ensure proper
credit to your account,
3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 submit the upper portion
4.
Mortgages/Notes Receivable (Schedule D)
(4)
00 of this form with your
. tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 301.89
6. Jointly Owned Property (Schedule F) (6) .00
7. Transfers (Schedule G) (7) .00
8. Total Assets
APPROV
D (8) 301.89
E DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (g)_ r~7 ,~0
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 8 2 39.19
11. Total Deductions (11) 8,810.69
12• Net Value of Tax Return (12) 8,508.80-
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00
14. Net Value of Estate Subject to Tax (14) 8,508.80-
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: .
15. Amount of Line 14 at Spousal rate C15) .00 X 00 - .00
16. Amount of Line 14 taxable at Lineal/Class A rate (16)_ 00 x 045 =
17 _ .0 0
. Amount of Line 14 at Sibling rate (17) [10 =
X 12 .00
18. Amount of Line 14 taxable at Collateral/Class B ra te C18) .00 X 15 = .00
19. Principal Tax Due
TAX CREDITS (19)= .00
:
PAYMENT RECEIPT DISCOUNT C+)
DATE NUMBER INTEREST/PEN PAID C-) AMOUNT PAID
TOTAL TAX PAYMENT .00
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 DUE
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. n
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