HomeMy WebLinkAbout08-06-12AP w^~~r~°~HERITANCE TAX Pennsylvania ~
BUREAU OF INDIVIDUAL TAXES Wn ANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
INHERITANCE 7AX DIVISION ~~O~Z~D ASSESSMENT OF TAX
PO BOX 280601 REV-1547 EX AFP (12-11)
HARRISBURG PA 17128-0601
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~yOMR~PHAN`S (;O~RT
CHARLES E SHIELDS III wmD~`AN~ ~'•
6 CLOUSER RD
MECHANICSBURG PA 17055-9751
DATE 07-30-2012
ESTATE OF TREASTER ARLENE M
DATE OF DEATH 05-15-2011
FILE NUMBER 21 11-0615
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 RECORDS ~
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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: TREASTER ARLENE MFILE N0.:21 11-0615 ACN: 101 DATE: 07-30-2012
TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED
APPRAISED V
ALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) C1) 00
2.
Stocks and Bonds (Schedule B)
C2) .
,00 NOTE: To ensure proper
credit to your account,
3. Closely Heid Stock/Partnership Interest (Schedule C) (3) .00 submit the upper portion
4. Mortgages/Notes Receivable (Schedule D)
C4)
00 of this form with your
5.
Cash/Bank Deposits/Misc. Personal Property (Schedule E)
(5) .
165,09 7.4 2 tax payment.
6. Jointly Owned Property (Schedule F) C6) .00
7. Transfers (Schedule G) C7) 33, 149.17
8. Total Assets
ca) 198 , 246.59
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) fig) 6.00
10. Debts/Mortgage Liabilities/Liens (Schedule I) cl0) •372.40
11. Total Deductions
12.
Net Value of Tax Return C11) 22,898.40
13
Ch
it
bl C12) 175,348.19
. ar
a
e/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C13) 157.813.37
14. Net Value of Estate Subject to Tax
(14) 17,534.82
NOTE: If an assessment was issued previously, lines 14, 15 and/or 16
17 18
reflect figures that include the total
of ALL ,
,
returns assessed to d and 19 will
ate
ASSESSMENT OF TAX: .
15. Amount of Line 14 at Spousal rate c15) 157,813.37 X 00 = 00
16. Amount of Line 14 taxable at Lineal/Class A rate (16) 17.~~4
A7 x 045 = .
17
Amount of Li
1 - 789.07
. ne
4 at Sibling rate C17)
00 X 12 =
.00
18. Amount of Line 14 taxable at Collateral/Class B ra te C18) .00 X 15 = 00
19. Principal Tax Due .
TAX CREDITS: (19)=
789.07
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
08-05-2011 CD014809 5
00
02-08-2012
CD01556b .
00 95.00
04-11-2012
CD015841 .
06- 675.00
07-23-2012
REFUND .
00 15.97
. 1.84-
TOTAL TAX PAYMENT 789.07
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .0.0
* 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.