HomeMy WebLinkAbout07-10-12Buaeau DF INDIVIDUAL rgxss RG I Y16~ OF INHERITANCE TAX
INHERITANCE TAX DIVISION ~I}T{~~PP + ALLOWANCE OR DISALLOWANCE
PD Box zeacal (1L~7!S~~~E~,~,$IONS AND ASSESSMENT OF TAX
HARRISB ORG PA 1]128-0601
2Q 12 ,lUL I 0 P~€121 ! 0
CL.E!~!< Gr
(yORPf-I~N`S COURT
LISA MARIE COYNE~~CO•,PA
3901 MARKET ST
CAMP HILL PA 17011-4227
Pennsylvania ~
DEPARTMENT OF REVEN UE
REV-154]EX AFP (12-11)
DATE 07-02-2012
ESTATE OF GIFFIN
DATE OF DEATH 08-20-2008 DONALD C
FILE NUMBER 21 08-0922
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 08-31-2012
(See reverse side under Objections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT 70:
REGISTER OF~ WILLS
1 COURTHOUSE SQUARE
CARLISLE F'A 17013
CUT-ALONG THIS LINE _ y --RETAIN LOWER PORTION FOR YOUR RECORDS F
REV-1547 EX AFP (12-11) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: GIFFIN
DONALD CFILE N0.:21 08-0922
TAX RETURN WpS: (X) ACCEPTED AS FILED ( ) CHANGED 101 DATE: 07-02-2012
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks antl Bonds (Schedule B)
3. Closely Held Stack/Partnership Interest (SChatlule C)
4. Mortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (SChetlule G)
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/gtlm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
(1) 17~7,6G=~
(z) .00
(3)- ~~OU
(4) ~~OU
(5)
,~ 1
g,53
(6) .00
(r) .00
(9)- 12 ~9R
NOTE: To ensure proper
ere tlit to your account,
submit the upper portion
of this form with your
tax payment.
ce) 197 182.99
il. Total Deductions I10) 2~ 92- 3 32
12. Net Value of Tax Return
13. Charl table/Gover (11] 40,421.72
nmental Bequests; Non-eleetetl 9113 Tr
14. Net Value of Estate S usts I12)
(Schatlul
J 156,761.27
ubject to Tax e
)
(13) .00
NOTE: If an assessment was issued previousl 14 156 761.27
reflect figures that
ASSESSMENT y, li
include the total nes 14, 15 antl/or 16,
17, 18 and 19
OF TAX:
15
A
of
ALL
returns assessed to
date will
.
mount of Line 14 at Spousal
16 rate .
. Amount of Line 14 taxable at Lineal/Clas (15)
~-~-_.• 0 0 X 0 0
17. Amount of Line 14 at Sibling s A rate
rate (16) _ )r'~ A'~- ~ x 045 =
18. Amount of Line 14 taxable at
19 Collateral/Cl =
--~~ x 12 7,054.26
. Principal Tax Due ass B rate Og) 00 )
15
TAX CREDITS: -
( ~
;00
PAYMENT RECEIPT _
(19)- ~•?6
DATE
02 23 2012 NUMBER DISCOUNT (+)
INTEREST/PEN PAID ( )
AMOUNT PpIII I
00015620
i i i
mum vA
r I
~-
BALANCE OF UNPAID INTEREST/PENALTY AS OF 02-24-2012 TOTAL TAX PAYMENT
BALANCE OF TAX DUE 7'054.26
.INTEREST AND PEN, •00
234.09
* IF PgID AFTER DATE INDICATED, SEE REVERSE TOTAL DUE 234.09
FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A ~~CREDI7~~
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR)INSiRUCTI0N5.~