HomeMy WebLinkAbout05-22-12C nrnr <-,h4QT,I~C~~. OF INHERITANCE TAX Pennsylvania ~' , ~
BUREAU OF INDIVIDUAL raxES ;f~~`~~5'E~~`%' ALLOWANCE OR DISALLOWANCE
INHERITANCE TAX DIVISION ~-~'1i' ~w DEPARTMENT OF REVENUE
PD Box 2BO6B1 ~ •-•.., ~ ~; : D~D~~Ct~ONS AND ASSESSMENT OF TAX REV-1547 EX AFP <1z-11)
HARRISBURG PA 17128-0601
- ._ ~i r'4 f i I ' aJ ~
JORDAN D CUNNINGHAFI~~~`'~1't~'y~ t'+~., FH,
2320 N 2ND ST
HARRISBURG PA 17110-1008
DATE 05-14-2012
ESTATE OF FRITZ JEFFREY A
DATE OF DEATH 02-26-2011
FILE NUMBER 21 11-0316
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 17013
CUT ALONG THIS LINE --• RETAIN LOWER PORTION FOR YDUR
------------------------------------- RECORDS F~
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REV-1547 EX AFP C12-11) NOTICE OF INHERITANCE TAX - _
APPRAISEMENT
ALLOWANCE
-----------------
O
DISALLOWANCE OF DEDUCTIONS
AND ASSESS ,
MENT OF TAX R
ESTATE OF: FRITZ JEFFREY AFILE N0.:21 11-0316 ACN: 101 DA
TE: 05-14-2012
TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED
APPRAISED VALU
E OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B) (1) .00
NOTE: To ensure proper
3. Closely Held Stock/Partnership Interest (Schedule C) (2)
(3) .00
.00 credit to your account,
submit the upper portion
4. Mortgages/Notes Receivable (Schedule D)
(4)
' DO of this form with your
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5)
8,307.4 3 tax payment.
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G) (6) .00
(7) 5, 210.06
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS: ($) 13.517 49
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) ~ 4 9 7L•
10. Debts/Mortgage Liabilities/Liens (Schedule I)
(lo) 3,781.00
11. Total Deductions
12• Net Value of Tax Return (11) 15,330.24
13. Charitable/Governmental Bequests; Non-elected 9113 Tru
t 1,812.75-
14. Net Value of Estate Subject to Tax s
s (Schedule J) (13) .00
NOTE:
If an assessment was issued previously
li (14)
1 1,812 75-
,
reflect figures that include the tot
l nes 4, 15 and/or 16, 17, 18 and 19 will
a
ASSESSMENT OF TAX: of ALL returns assessed to date.
15. Amount of Line 14 at Spousal rate
16. Amount of Line 14 taxable at Lineal/Class A rate '00 X 00 = .00
17. Amount of Line 14 at Sibling rate (16) ~ X 045 = .00
18.
Amount of Line 14 taxable at Collateral/Class B (ln_ nn x 12 = .00
19. ra
Principal Tax Due te (18)
• 00 X 15 =
. 00
TAX CREDITS: (19)= .00
- I ----" ~ 1r1J000NT C+)
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
TOTAL TAX PAYMENT
.00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
* IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
TOTAL DUE I .00
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ~/
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