HomeMy WebLinkAbout09-24-12BUREAU OF INDIVIDUq~ TAXE
INHERITANCE ~~~~,~~R
PO BDX 280601 N IC
TAX DIVISIO 0. E OF INHERIT
HARRISBURG Pq 17128_
.^-~-. r, aNc
0601 ~EC!~t~? !~~l~CTIO SL A DA AS3ES3M I ALLOWANCE Aenns/~~~/// ,,''
ENT OF TAX DEPARTMENT~~`Eb
~.!2 SEP 24 pM l: 36
R~-1547 EX AFP C12-1
DATE
~" , `, ~ ~'. ESTATE OF 09-24 -2012
WILLIAM ~~~~+~~ ~iJi~CIT DATE OF CLAY JR
R KAUBER(,~D `(,Q, FILE DEATH 04-27-2011 JAMES
STE B pn NUMBER F
940 CENTURY DR ~ COUNTY 21 11-0551
MECHANICSBURG ACN 101BERLAND
PA 17055-4376 APPEgL DATE;
(See reverse side under 1- 23 - 2012
Aar o u n t Remitted ObJectioas~
MAKE CHECK P
REGISTER OFBLE AND REMIT
REV 154j6'rHIS-LINE __ ~! 1 COURTHOUSE WILLS PAYMENT T0:
EX AFP C12-11~ RETgIN LO CARL IS PA SQUgRE
LE 17013
ESTATE OF: D SALLO OF IMHERITR' PORTION_ _ FOR_ Y_0
CLAY JR WANCE OF DEDUCTIpAX RAIS UR'RECORDS_ ~_
JAMES NS qN~ EMENT, gLLO
FFILE N0.:21 ASSESSMENT OF WANCE ~R'---_______-
APPRAISED VALUE U TAX RETURN wqS: 11 -0551 TAX
1 • Real Estate F RETURN BASEL) c X) ACCEPT ACN;
(Schedule q) 0Mc ORj ED AS FILED 101
2. stocks GINAL RETURN c ) CHANGED DATE' 09-24-2012
3• Closely and Bonds (Schedule B)
Held Stock/p
4. artnersh C1)
Mortgages/Notes ip Int
5. Cash/Bank DePOS.Receivable CScheduere5t [Schedule C) C2) •00 NO
6, Jo its/Misc. per le D) C3) •00 cred' To ensure Pr
7• Transfers wCS he rOPerty (Schedule F) rOperty [Schedule C4) •0 0 ofbmit they~pPe~ccOUnt,
B Total dule G) E) C5) •0 0 to this form with YO~~°n
wpp Assets , 00 x payment.
ROVED cs)
DEDUCT C7) 00
9• Funeral Expenses/ 616, 016, 82
l0. Debts/ ONS A ~D EXEMPTIONS:
Mortgage Liab Costs/Misc.
11. ilities/ Expenses CSche CS)
Total De Liens CSche Jule H) 616 016, 82
12 ductions dole I) C9)
Net Value of Tax Return
13. Charitable/ C10)
Governmental • 00
rE14• NIf Vanu ~ of Estate SubJect to Tax NOn-elected 9113 Tru C11)
Ssessment was Sts [schedule ~) C12) 6 4875.50
E5S Amount0of TAXi9ures that in ludep the1pUS1Y, lines 14 C14) 11' 141:00
is. Amount ~lne 14 total 15 and/°~ 611
at Spousal 141.32
of line 14 rate °f A~ returns 16• 17, 18 and
17. Amount taxable assessed
of Line 14 at ~lneal/C C15j t° date. 19 will
,9' Pmincipal Tax Due t xable lat Collater lass A rate C17) 611,141.32 X 00 _
=REDITS: al/Class B r X 045 = • 00
YMENT ate C1B) X 12 = • 00
SATE RECEIPT .0p X 15 .00
NUMBER DISCOUNT
INTE C+) C19)_ • 00
REST/PEN P • 00
AID C_) AMOUNT PAID
TOTgL TqX PAYMENT
AFTER IN ENCE OF TAX DUE .00
"~~ArroNAOF INDrcar REST AND PEN,
ADDITIONq SEE REVERSE •00
INTEREST. TOTAL DUE • 00
IF TOTq~ DUE
.Op
A REFUND. SEE REVERSE 3IDEAOFATHISEFORM FCR)' YOU MAY g
OR INSTRUCTIONS,D~