HomeMy WebLinkAbout05-11-12~' "'~`N`41'ThC,~ ~r ERITANCE TAX Pennsylvania ~
BUREAU OF INDIVIDUAL TAXES ~ P~ ~
INHERITANCE TAX DIVISION AP OF~'--~ ~~N'f, ~1~.~NCE OR DISALLOWANCE DEPARTMENT OF REVENUE
C'~EON~ ~AN~ ASSESSMENT OF TAX REV-1547 EX AFP (lz-u)
PO BOX 280601
HARRISBURG PA 17128-0601
a.:- 7r,Y I i ~~.,`+ 11; J7 DATE 05-07-2012
ESTATE OF ROBERTS JACQUELYN A
.-r. DATE OF DEATH 10-07-2010
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VFi~'f-tr,~a... ~..~.;Ii~ FILE NUMBER 21 10-1165
CUMBEFL,~~[) ~U, PA COUNTY CUMBERLAND
LINDA J LUNDBREG AVP ACN 101
4242 CARLISLE PIKE APPEAL DATE: 07-06-2012
P O B O X 3 0 8 ( See reverse side under Objections )
CAMP HILL PA 17001-0308 Amount Remitted C
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 •-
REV-1547 EX AFP (12-11) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: ROBERTS JACQUELYN AFILE N0.:21 10-1165 ACN: 101 DATE: 05-07-2012
TAX RETURN WAS: C X) ACCEPTED AS FILED ( ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1) 430,000.00
2. Stocks and Bonds (Schedule B) (2) .00
3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00
4. Mortgages/Notes Receivable (Schedule D) (4) .00
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 431 , 254.51
6. Jointly Owned Property (Schedule F) (6) .00
7. Transfers (Schedule G) (7) .00
NOTE: To ensure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
8. Total Assets (8) 861.254.51
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 111.661.03
L0. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 323,063.29
11. Total Deductions (11) 434,724.32
12. Net Value of Tax Return (12) 426,530.19
13. Charitable/Governmental Bequests; Non-elected 9113 Tr usts (Schedule J) (13) 4 26,5 30.19
14. Net Value of Estate Subject to Tax (14) .0 0
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 (16) .OD x 045 = .00
17. Amount of Line 14 at Sibling rate (17) D D X 12 = .00
18. Amount of Line 14 taxable at Collateral/Class B rate (18) .00 X 15 - .00
19. Principal Tax Due (19)= .00
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+)
DATE
NUMBER
INTEREST/PEN PAID (-) 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. ~~
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