HomeMy WebLinkAbout05-22-12NOTICE OF INHERITANCE TAX
BUREAU OF INDIVIDUAL TaxESrir_f; ~~API~~t/k~M~iT, ALLOWANCE OR DISALLOWANCE
INHERITANCE TAX DIVISION ~ ~ sOF.. D~pl9,'CTIONS AND ASSESSMENT OF TAX
PO BDX 280601 ~~~~~~~~ - ~ _ 'r~~----~-
HARRISBURG PA 17128-0601
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H ANTHONY ADAMS'~~~'~~~~~ ~~~-~~'~tilJ ~' ,1 , PA
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49 W ORANGE ST
SHIPPENSBURG PA 17257-1813
Pennsylvania ~~~
DEPARTMENT OF REVENUE
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REV-1547 EX AFP (12-11)
DATE 05-14-2012
ESTATE OF BLACK SARA E
DATE OF DEATH 07-18-2011
FILE NUMBER 21 11-0870
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 07-13-2012
(See reverse side under Objections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17D13
CUT ALONG THIS LINE -~ RETAIN LOWER PORTION FOR YOUR RECORDS E'-
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REV-1547 EX AFP (12-11~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: BLACK SARA EFILE N0.:21 11-0870 ACN: ]O] DATE: n~-74-~n
TAX RETURN WAS: C X) ACCEPTED AS FILED ( ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) C1) 50,000.00 NOTE: To ensure proper
2. Stocks and Bonds [Schedule B) C2) .OD credit to your account,
3.
Closely Held Stock/Partnership Interest (Schedule C)
C3)
'00 submit the upper portion
of this form with your
4. Mortgages/Notes Receivable (Schedule D) (4) •00 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 8,4 67.74
6. Jointly Owned Property (Schedule F) (b) .00
7. Transfers (Schedule G) (7) .00
s. Total Assets c8) 58,467.74
APPROV ED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) Cq) 1,106.50
10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) 30 , 045.64
11. Total Deductions C11) 31,152.14
12. Net Value of Tax Return (12) 27,315.60
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C13) .00
14. Net Value of Estate Subject to Tax (14) 27,315.60
NOTE: If an assessment was issuedpreviously,
reflec t figures that include the total
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate
lb. Amount of line 14 taxable at Lineal/Class A rate
17. Amount of Line 14 at Sibling rate
lines 14, 15 and/or 16, 17, 18 and 19 will
of ALL returns assessed to date.
18. Amount of Line 14 taxable at Collateral/Class B rate
19. Principal Tax Due
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT C+)
DATE NUMBER INTEREST/PEN PAID C-)
X11-30-2011 ~ CD015266 .00
c15) . 00 X
C16) ~ 7,31~.60 X
(17) .00 X
Cls) . DO x
AMOUNT PAID
1,
00 - .00
045 = 1,229.20
12 = .00
15 = .00
C19)= 1 , 229.20
TOTAL TAX PAYMENT 1,229.20
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" CCR), YOU MAY BE DUE
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.
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