HomeMy WebLinkAbout09-24-12BUREAU OF INDIyIDU (~
INHERITANCE 7AX AL Tq ~F~,,~~ OTICE OF
PO BOX 280601 D1VISION _ ENT INHERITgNC
HARRISBURG p Ott^,~T~"'r ~g ALLONJ QR E TAX
A 1 7128-0601 ~~" ~" ~ f-'' ~~.~ DUC ~ E
~ TIOMS ANC DISALLOWANCE Penns
AND ASSESSMENT OF TA)C YIV=
~~ t ~ n~~ ~~ ~( DEPARTMENT pp RED
1 J ~tl ~ • ~~ REV-1547 IX AFP CI2-
Dq TE
~.;L.~:i~~', ~ i- ESTATE Op 09-24-2012
ROBERT p ~~,~ S.•O~,Jt'{r DATE OF DEATH 08ITSCH JR EDWARD
714 BRIDGELI~(~(.>~~ C~., P/Q FILE NUMBER 06-2011
ST COUNTY 21 11"0896
PO BOX 461 ACM CUMBERLAND
NEW CUMBERLAND Pq 17070-0461 (Seereyerse U1 11-23-20
ATE:
side under pb ec • 12
Anount Remitted J hoes)
MAKE CHECK PAY
REGIST ABLE AND REMIT
1 COURTR OF WILLS PAYMENT T0:
REV-1547 EX AFPLCIE_---- y _RETAIN CARLISLEO pA SQ~oRE
2 11) NOTIC LOWER PORTION 3
ESTATE OF; DISALL WANCENHERITgNCE TAX- FOR YOUR RE_C_OR_DS
KLITSCH JR OF DEDUCTIONS APPRAISEMENT --" ~-______
EDWARD AND ASSESSMENTApFOTAANCE
AFILE MO,: OR --'--
APPRAISED VALUE pF rqx REruRN was: C 21 11-0896 ACN: "' -
1 • Real RETURN X ) ACCEPTED qS FILED 101 DATE:
Estate [schedule A) BASED ON: ORIGINAL C
2• Stocks RETURN ) CHANGED 09-24"2012
3• Close and Bonds [Schedule g)
lY Held Stock/Par CI) 177
4• Mortgages/ tnershiP Int , 700.00
Notes Rec Brest CSche C2) 46,893,32 NOTE: To
5• Cash/ eivable dule C) ensure proper
Bank Deposits/ [Schedule D) C3) credit to
6, Jo- MYsc. Pers .QO submit Your account
lntly Owned Pro onal ProPert C4) the upper '
~• Tr Perty CSc Y CSchedu •00 of this portion
ansfers [Schedule G) hedule F) le E) C5) form with
157, 999.48 tax payment, your
8• Total Assets C6)
APPROVED DEDU c7) •00
CTIONS AND EXEMPT 27,426.28
9• Funeral Expenses/ IONS:
10. Debts/Mort Adm• Costs/Misc.
gage Liabilities/Lie Expenses C8) 410
[Schedule N) 019, Og
11. Total Deductions ns [Schedule I) C9)
12. Net Value C10)
13. Charitab of Tax Return 703. Qg
le/Governmental Beque$ts;
14. Net Value of Estate C11)
:OTE: subject to T Non-elected 9113 Trusts [12) 41,561.62
If an ax [Schedule J) 368,457.46
assessbent was issue C13)
SSESSNENTfOFct flgu~es that d previously, lines C14) •00
TqX: include the total 14' 15 368 457.46
ls. Amount of of ALL and/or 16, 17,
Line 14 at Spousa -~ -'eturns 18 and
16. amount of Line 1 rate asses 19 will
17• Amount op 14 taxable at Line Sed to date,
Line al/Class A rate C15)
14 at Sibling rate ' 00 X 00
18. Amount of Line lG C16) _
19, principal T taxable at Collateral/C C17j X 045 = •00
'- [RED ax Due lass 16,580.59
ITS: B rate c1B) X 12 -
PAYMENT • 00
DATE RECEIPT • 00 X 15 -
NUMBER DISCOUNT C+J C19)= •00
- 03 - 2011 INTEREST/P 1 6' S80.59
CD015171 EN PgID C_) AMOUNT
829.03 pAID
16,000.On
TOTAL TAX PAYMENT
BALANCE OF TAX DUE 16'829.03
PAID AFTER INTEREST AMD PEN. 248.44CR
CALCULATIONAOF INDICATED, SEE
ADDITIONAL REVERSE TOTAL DUE • 00
INTEREST. IF TOTAL DUE IS 248.44CR
A REFUND. REFLECTED qg A •~
SEE REVERSE SIDE OF CREDIT~~ CCR),
THIS FORM FOR INSTRUCT ONS•DUE
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