HomeMy WebLinkAbout09-07-12G~~jyy NOTICE OF INHERITANCE TAX
BUREAU OF INDIVIDUAL TAXLi'l~lt~U~"~APP ~ENT, ALLOWANCE OR DISALLOWANCE
INHERITANCE TAX DIVISION ~i -~ ~...r _b~~~~~DE'DUCTIONS AND ASSESSMENT OF TAX
PO BOX 280601 !'~~~j,Lk , ,~- ~,;;~~ ~ C
HARRISBURG PA 17128-0601 `~ .~'J
!(~ i' ~ SEP - 7 Pei ~~: 3
~~~~O~`R2Pf G;,if`~ ~,v`'lJti!
SUSAN L HIR~I~M~R(.~1(p ~ ~A
151 YELLOW BREECHES DR
CAMP HILL PA 17011-8342
Pennsylvania ~
DEPARTMENT OF REVENUE
REV-1547 EX AFP C12-11)
DATE 09-03-2012
ESTATE OF BELCHER LEWIS E
DATE OF DEATH 03-08-2012
FILE NUMBER 21 12-0318
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 11-02-2012
(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 _ -- R_ETA_IN LOWER POR_TION_ FOR YOUR RECORDS E- _ _______________
REV-1547 EX AFP C12-11) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: BELCHER LEWIS EFILE N0.:21 12-0318 ACN: 101 DATE: 09-03-2012
TAX RETURN WAS: C X) ACCEPTED AS FILED C ) CHANGED
APPRAI SED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1) 100,000.00 NOTE: To ensure proper
2. Stocks and Bonds (Schedule B) (2) 5 0,521.66 credit to your account,
3. Closely Held Stock/Partnership Interest (Schedule C) C3) .00 submit the upper portion
of this form with your
4. Mortgages/Notes Receivable (Schedule D) (4) .00 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 4 27,008.54
6. Jointly Owned Property (Schedule F) (6) .00
7. Transfers (Schedule G) (7) 42, 112.92
s. Total Assets (e) 619.643.12
APPROV ED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (q) 13.230.24
10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) 2.117.62
11. Total Deductions (11) 15,348.86
12. Net Value of Tax Return (12) 604,295.26
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C13) .00
14. Net Value of Estate Subject to Tax (14) 604,295.26
NOTE: If an assessment was issued previously,
reflect figures that include the total
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate
16. Amount of Line 14 taxable at Lineal/Class A rate
17. Amount of Line 14 at Sibling rate
18. Amount of Line 14 taxable at Collateral/Class B rate
19. Principal Tax Due
TAX CREDITS:
lines 14, 15 and/or 16, 17, 18 and 19 will
of ALL returns assessed to date.
c15) .00 X 00 - .00
c16) 604.29.26 x 045 = 27,193.29
(la) .00 x 15 = .00
(19)= 27, 193.29
PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID C-)
05-31-2012 CD016041 1,359.66 25,833.63
TOTAL TAX PAYMENT 27,193.29
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" (CR), YOU MAY BE DUE
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS., (L