HomeMy WebLinkAbout06-12-12NOTICE OF INHERITANCE TAX
BUREAU OF INDIVIDUAL raxES ALLOWANCE OR DISALLOWANCE
INHERITANCE TAX DIVISION ~ ~ IONS AND ASSESSMENT OF TAX
PO BOX 260601 {~ ~'~
HARRISBURG PA 17128-0601 RE.I.~~,' C. L`~ ~ ~ ~~
is i 2 JU~I i 2 AP1 I!~ 3 4
THOMAS A CAPPER
2303 MARKET ST
CAMP HILL
r ~;:
Ci_~~`~
~~yyo~R~c~'I~~~~~~~s~~('c~~,~yu~~T
trtllV+L71~I16rY`u/ VlJ•, f !'~
PA 17011-4627
Pennsylvania ~
DEPARTMENT OF REVENUE
REV-1547 EX AFP C12-11)
DATE 06-05-2012
ESTATE OF BLACK MARTHA E
DATE OF DEATH 08-28-2010
FILE NUMBER 21 11-1119
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 08-04-2012
(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~
-------------------- ----------------------------------------------------------------
REV-1547 EX AFP C12-11~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: BLACK MARTHA EFILE N0.:21 11-1119 ACN: InI nerF. nt_n~_~ni~
TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
C1) .00 NOTE: To ensure proper
C2) .00 credit to your account,
(3) .00 submit the upper portion
of this form with your
C4) .00 tax payment.
C5) 8,529.48
C6) .00
C7) .00
CB) 8,529.48
Cg) 1 . 19 0
clo)_ 76,946.11
11. Total Deductions C11) 78, 141 .61
12. Net Value of Tax Return C12) 69,612.13-
13. Charitable/Governmental Bequests; Non-elected 4113 Trusts (Schedule J) C13) .00
14. Net Value of Estate Subject to Tax C14) 69,612.13-
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 (15) .0 0 X 00 - .00
16. Amount of Line 14 taxable at Lineal/Class A rate (16) .nn x 04 5 = .00
17. Amount of Line 14 at Sibling rate C17) ~~ X 12 = .00
18. Amount of Line 14 taxable at Collateral/Class B rate C18) .00 X 15 - .00
19. Principal Tax Due C19)= .00
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT C+)
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" CCR), YOU MAY BE DUE
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.