HomeMy WebLinkAbout06-21-11COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 260801
HARRISBURG, PA 17128-0801
RECEIVED FROM:
CABA SHARON L
2520 LAMBS GAP RD
ENOLA, PA 17025
Boa
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1162 EX111-961
N0. CD 014613
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
ESTATE INFORMATION: sSN: 2o9-t2-9645
FILE NUMBER: 211 1-0480
DECEDENT NAME: HERNJAK MARY JANE
DATE OF PAYMENT: 06/21/2011
POSTMARK DATE: 06/20/201 1
COUNTY: CUMBERLAND
DATE OF DEATH: 03/26/201 1
REMARKS: SHARON CABA
CHECK#1002
SEAL
101 ~ $6,125.00
TOTAL AMOUNT PAID:
INITIALS: WZ
RECEIVED BY:
56,125.00
GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
~S T i +h~4- I ~~
155610105
REV-1500 EX Decedent's Social Security Number
209-12-9645
D®cedent's Name: HERNJAK, MARY JANE
RECAPITULATION
1. Real Estate (Schedule A) ............................................ . 1.
2. Stocks and Bonds (Schedule B) ......................................
2.
.
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) .... . 3.
4.
.....
Mortgages and Notes Receivable (Schedule D) .................... .
. 4.
2,500.00
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)..... .. 5.
4,182.36
6. Jointly Owned Property (Schedule F) O Separate Billing Requested ..... .. 6.
7 Inter-Vivos Transfers & Miscellaneous Non-Probate Property
7 109,312.52
. (Schedule G) O Separate Billing Requested...... ..
.
6 115,994.88
8.
.
Total Gross Assets (total lines 1 through 7) ............... .
.
9.
...
Funeral Expenses and Administrative Gosts (Schedule H) ..... .
.. 9.
8,541.03
10. Debts of Decedent, Mortgage liabilities, and Liens (Schedule I) ............ .. 10.
11 8,541.03
11. Total Deductions (total Lines 9 and 10) ............................... .
..
12 107,453.85
12. Net Value of Estate (Line 8 minus Line 11) ............................
.
.
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
13 350.00
an election to tax has not been made (Schedule J) ...................... ..
.
14.
... , ....
Net Value Subject to Tax (Line 12 minus Line 13) .......... .
.. 1a.
107,103.85
TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116 15
(a)(1.2) X .0_
16. Amount of Line 14 taxable 107,103.85
at lineal rate X .0 6
__.. 16. 6,424.23
17. Amount of Line 14 taxable 17
at sibling rate X .12
18. Amount of Line 14 taxable 18
at collaterel rate X .15
6,426.02
19. TAX DUE ...................................................... ...19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O
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