HomeMy WebLinkAbout07-30-12NOTICE OF INHERITANCE TAX
BUREAU OF INDIVIDUAL-,~rp 1~ ~ , SEMENT, ALLOWANCE OR DISALLOWANCE
INHERITANCE TAX OIVISION~1C:l~Vi ~~~-~' ~~ DEDUCTIONS AND ASSESSMENT OF TAX
PO BOX 280601 ([,;[[+~~(•"!"CRR (;~_ ~,, +~'
HARRISBURG PA 17126-0601 ilC~7i~~ij ~~ °~`'"~"~~
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90 SALEM CHURCH RD
MECHANICSBURG PA 17050-5281
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DEPARTMENT OF REVENUE
REV-1547 EX AFP (12-11)
DATE 07-23-2012
ESTATE OF SAMPSON MARY D
DATE OF DEATH 03-02-2011
FILE NUMBER 21 11-0525
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 09-21-2012
(See reverse side under Objections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALON_6 THIS LINE _ ~ R_ETA_IN LOWER POR_TION_ FOR YOUR RECORDS E-- _
REV-1547 EX AFP C12-11) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: SAMPSON MARY DFILE N0.:21 11-0525 ACN: 101 _____________
OR
DATE: 07-23-2012
TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) C1) .00
NOTE: To ensure proper
2. Stocks and Bonds (Schedule B) C2) .00 credit to your account,
3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 submit the upper portion
of this form with your
4. Mortgages/Notes Receivable (Schedule D) C4) .00 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) C5) 3,500.00
6. Jointly Owned Property (Schedule F) C6) 98 5.0 9
7. Transfers (Schedule G) C7) .00
e. Total Assets (8) 4.485.09
APPROV ED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) Cg)_ 1.34 5.04
L0. Debts/Mortgage Liabilities/Liens (Schedule I) ( 10) 841.84
11. Total Deductions (11) 2, 186.88
12. Net Value of Tax Return C12) 2,298.21
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00
14. Net Value of Estate Subject to Tax C14) 2,298.21
NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 a nd 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) .00 X 00 - .00
16. Amount of Line 14 taxable at Lineal/Class A rate C16) 7.79f~_?1 x 045 = 103.42
17. Amount of Line 14 at Sibling rate (17) _OD X 12 = .00
18. Amount of Line 14 taxable at Collateral/Class B ra te C18) :Ob X 15 - .00
19. Principal Tax Due C19)= 10 3.4 2
TAX CREDITS:
rnrncni Ktcttrl DISCOUNT C+) I AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
04 04-2012 CD015792 .00 51.70
INTEREST IS CHARGED THROUGH 08-07-2012
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
* IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
TOTAL TAX PAYMENT 51.70
BALANCE OF TAX DUE 51.72
INTEREST AND PEN. 1.58
TOTAL DUE 53.30
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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