HomeMy WebLinkAbout07-10-12 (2)BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 2BOfi 01
HARRISBURG PA 1]128-0601
RANDALL K MILLER
125 STE 102
1255 S MARKET ST
ELIZABETHTOWN
NO ~ CE TAX
APPRAISEM DISALLOWANCE Pennsylvania ~_
OF DEDU 5.~~ S$MENT OF TAX DEPARTMENT OF REVENUE
REV-154] EX AFP (12-ill ~
2D12JUL 10 PMT; ~~
T o7-BZ-zolz
ESTATE OF PETERSON
(~~w{L~:~=rptr~. ..r~~~ D~A.TE OF DEATH 06-23-2011 DOLORES F
"'~'•S ~V1.F17LE NUMBER 21 11-0846
ESq ~ ~O~IITY CUMBERLAND
ACN 101
APPEAL. DATE: 08-31-2012
(See reverse side under Objections
PA 17022-2903
Amount Remitt:etl
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SpUARE
CARLISLE PA 17013
CU7-gLON6 THIS LIN _ y --RETAIN-LOWER PORTION FOR YOUR RF'C ORDS (-~
REV-1547 EX AFP (1~-11) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: PETERSO' DOLORES FFILE N0.:21 11-0846
TAX RETURN WAS: (X) ACCEPTED AS FILED ( 7 CI1ANGfiD 101 DATE: 07-02-2012
APPRAISED VALUE OF ETURN BASED ON: ORIGINAL RETUpu
1. Real Estate (SCNedule A)
2. Stocks and Bond; (Schedule B)
3. Closely Held Stolck/Partnership Interest (S<hetlule C)
4. Mortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposiks/Misc. Personal Property (S ehetlule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (SChetl~le G)
8. Total Assets
APPROVED DEDUCTIONS ',AND EXEMPTIONS:
9. Funeral ExpensesifAtlm. Costs/Misc. Expenses CSched ule H)
10. Debts/Mortgage L~'a bilities/Liens (S<hetlule I7
11. Total Deductions
12- Net Value of Tax Return
13. Charitable/Govern~ne nt ].
(17 ~ UO
(2) .00
(3) ~U
C4)
(5) 24,2_ p=
(6) .00
(]) .00
NOTE: Tp ensure proper
cre tlit to your account,
submit the upper portion
of this farm with your
tax payment.
(B) 24 209.90
(9) 7.3 F 69
no) 1.611.15
a Bequests; Non-aleetetl 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
NOTE: If an assessBlent was issu d
(117 3,966.84
(12) 20,243.06
(137 .00
(14) 20 243.06
reflec t fieuryes that e Previously,
includ lines 14, 15 and./or 16
17
1
ASSESSMENT OF
TAX: '
e the total
of ALL
returns ,
,
8 and 19 will
15. gmount of
Line 14 'at Spousal assessed to date.
16. Amount of
Line 14 'taxable at rate
Lineal/Clas
(151
- ,QO X
00 =
17. Amount of Line 14 at Sibling s A rate
rate (16) ~n ~~~ X 045 -- -
18. Amount of
19 Line 14
Itaxabla at
Collateral/Cl (177 _
~~ X -
12 0.94
. Principal
Tax Due ass B rat a
C18)
~
.00 -
15 - -
TAX CREDITS: ~
g ~00
PAYMENT
RECE PT (197~
= 1 0~91f
DATE
...... _I__ DISCOUNT (+)
INTEREST/PEN PAID (-)
* IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
AMOUNT PAID
TOTAL TAX PAYMENT
BALAN TAX DUE
INTE D PEN.
~_
roraL Dtl)E
10.
00
00
Bo
IF TOTAL DUE IS REFLECTED AS q ^CREDI T" (CR), yp
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.