HomeMy WebLinkAbout08-06-12{} ~p~ OTICE OF INHERITANCE TAX Pennsylvania ~
BUREAU OF INDIVIDUAL T~(, ~~LU ~~' t^tu~."'~MENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION ~~'ti~'~ r',r `~gr_~~EDUCTIONS AND ASSESSMENT OF TAX
PO BOX 280601 ~ a.~ ~-'~+~, REV-1547 EX AFP C12-lll
HARRISBURG PA 17128-0601
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,'O~PHHN'S C~liRj
BARBARA R M~~~M~~~~`'"'o ~.,
323 N 27TH ST
CAMP HILL PA 17011-3629
DATE 07-30-2012
ESTATE OF ROMBERGER RALPH L
DATE OF DEATH 04-23-2010
FILE NUMBER 21 10-0493
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 09-28-2012
(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
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REV-1547 EX AFP C12-11~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE ____
______
OR
DISALLOWANCE OF DEDUCTIONS AND ASSESS MENT OF TAX
ESTATE OF: ROMBERGER RALPH LFILE N0.:21 10-0493 ACN: 101 DATE: 07-30-2012
TAX RETURN WAS: C X) ACCEPTED AS FILED ( ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) C1) 00
2. Stocks and Bonds (Schedule B)
C2) .
461,520.00 NOTE: To ensure proper
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)
C4)
00 of this form with your
. tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) C5) .00
6. Jointly Owned Property (Schedule F) (6) 53,290.00
7. Transfers (Schedule G) ~7) .0 0
e. Total Assets
APPROVED DEDUC c8) 514,810.00
TIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) fig) 6,000.00
10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) .00
11. Total Deductions C11) 6, 000.00
12. Net Value of Tax Return C12) 508,810.00
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00
14. Net Value of Estate Subject to Tax (14) 508,810.00
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 d ate
ASSESSMENT OF TAX: .
15. Amount of Line 14 at Spousal rate c15) 508,810.00 X 00 = .00
16. Amount of Line 14 taxable at Lineal/Class A rate C16) .00 x 04 5 =
17
A
t .0 0
. moun
of Line 14 at Sibling rate C17) ~0 X 12 =
_ .00
18. Amount of Line 14 taxable at Collateral/Class B ra te (18) .00 X 15 = 00
19. Principal Tax Due .
TAX CREDITS: (19)= .00
r,arntni I RECEIPT DISCOUNT (+)
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.
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