HomeMy WebLinkAbout11-08-12COMMONWEALTH OF PENNSYLVANIA REV-1162 EX111-961
DEPARTMENT OP REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 016752
ANDES SAMUEL L
525 NORTH 12TH STREET
PO BOX 168
LEMOYNE, PA 17043
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
fold
ESTATE INFORMATION: ss-v:
FILE NUMBER: 211 1-1043
DECEDENT NAME: COLDREN DANIEL R
DATE OF PAYMENT: 1 1 /08/201 2
POSTMARK DATE: 1 1 /08/201 2
COUNTY: CUMBERLAND
DATE OF DEATH: 09/16/201 1
TOTAL AMOUNT PAID:
101 ~ 534.68
REMARKS:
534.68
CHECK# 8903
INITIALS: DMB
SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
~ r~; ~ ~~ OF INHERITANCE TAX Pennsylvania ~
~AP~J4~I8~ ALLOWANCE OR DISALLOWANCE
BUREAU OF INDIVIDUAL TAXES L n. - „ DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION I ~ ,'i „i ~F D,~D,.`~~C~ONS AND ASSESSMENT OF TAX REV-1547 EX AFP C12-11)
PO BOX 280601
HARRISBURG PA 17128-0601
~'~l~4~k~'cJ P~i ~~ 27
DATE 10-08-2012
ESTATE OF COLDREN DANIEL R
DATE OF DEATH 09-16-2011
C~~i~t-~,~l`'v~v ~!~Jhr FILE NUMBER 21 11-1043
GUMBERLAND CO.
PA. COUNTY CUMBERLAND
,
SAMUEL L ANDES ACN 101
525 N 12TH ST APPEAL DATE: 12-07-2012
LEMOYNE PA 17043-1245 (See reverse side under Objections)
Amount Remitted 3tr.6
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT AL
------ ONG THIS LINE -_-- -• RETAIN LOWER PORTION FOR YOUR RECORDS ~-
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REV-15 ------
47 EX AFP C12-11) NOTICE OF INHERITANCE ---------------------------------------------
TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: COLDREN DANIEL RFILE N0 .:21 11-1043 ACN: 101 DATE: 10-08-2012
TAX RETURN WAS: C X) ACCEPTE D AS FILED ( ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1) 139,500.00 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) .0 0 submit the upper portion
4.
Mortgages/Notes Receivable (Schedule D) of this form with your
(4) 32,200.00 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 26 9,139.07
6. Jointly Owned Property (Schedule F) (6) .00
7. Transfers (Schedule G) (7) 29,424.30
8. Total Assets c8) 470.263.37
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (g) 41. 1
10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) 48 5.26
11. Total Deductions C11) 41,697.58
12. Net Value of Tax Return (12) 428,565.79
13. Charitable/Governmental Bequests; Non-elected 9113 Tr usts (Schedule J) (13) .00
14. Net Value of Estate Subject to Tax C14) 428,565.79
NOTE: If an assessment was issued previously, li nes 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 C15) .00 X 00 - .00
16. Amount of Line 14 taxable at Lineal/Class A rate (16) _00 x 04 5 = .00
17. Amount of Line 14 at Sibling rate C17) .00 X 12 = .0 0
18. Amount of Line 14 taxable at Collateral/Class B rate (18) 428,565.79 X 15 - 64,284.87
19. Principal Tax Due (19)= 64,284.87
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT C+)
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
12-05-2011 CD015295 2,368.42 45,000
00
07-11-2012 CD016240 .00 .
16,916.45
BALANCE OF UNPAID INTEREST/PENALTY AS OF 07-12-2012 TOTAL TAX PAYMENT 64,284.87
BALANCE OF TAX DUE .00
INTEREST AND PEN. 34.68
TOTAL DUE 34.68
* IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.