HomeMy WebLinkAbout09-28-12~._'--"'-Vj
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BO% 280601
HARRIS BNRG PA 17128-0601
NOTICE OF INHERITANCE TAX
6C1N\!7IpIH1~~ , ALLOWANCE OR DISALLOWANCE
(~[/~(,~i-AFrpD~ IONS AND ASSESSMENT OF TAX
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CHARLES E SHIELVyn:Lx.~LAND ~.,
6 CLOUSER RD
MECHANICSBURG PA 17055
pennsylvania ~
DEPARTMENT OF REVENUE
REV-1547 IX AFP (12-11]
DATE 09-24-2012
ESTATE OF CLOUSER RICHARD E
DATE OF DEATH 05-28-2010
FILE NUMBER 21 10-0589
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 11-23-2012
(See reverse side under Objeeteons)
Anount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE ~i __RETAIN_LOWER_PORTIDN_FOR_YOUR-RECORDS
REV-1547 EX AFP (12-11)DISALLOWANCENOFRDEDUCTIONS ANDRASSESSMENTAOF
ESTATE OF: CLOUSER RICHARD EFILE N0.:21 10-0589 ACN:
TAX RETURN WAS: C ) ACCEPTED AS FILED C X) CHANGED
APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN N0. 02
1. Real Estate (S<hetlule A)
2. Stocks and Bonds (Schedule B)
3. Closely Heltl Stock/Partnership Inters sk (Schedule C7
4. Mortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Ownetl Property (Schedule F)
7. Transfers (Schedule G)
NOTE: To ensure proper
credit to your account,
submit the upper portion
of this Form with your
tax Payment.
(B) 802.67
e. Total Assets
APPROV ED DEDUCTIONS AND EXEMPTIONS:
86
0
9 Funeral Expenses/Adm. Costs/MSSe. Expenses (Schedule H) (97 .
8,84
.
10
Debts/Morkgaga Liabilities/Liens (Schedule I)
(10) ,00
. 8,840.86
(n)
11. Total Deductions (12) 8,038.19-
12. Net Value of Tax Return
J) (13) .00
13 itable/Governmental Bequests; Non-elected 9113
Ch Trusts (Schedule
. ar
(14) 49.810.03
14. Net Value of Estate Subject to Tax
If an assessnent was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
NOTE: reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX: .00 x 00 = .00
15. Amount of Line 14 at Spousal rate (15)
49
03
x 045
810
2,241.45
16 Amount of LSne 14 taxable at Lineal/Class A rate (16) .
_
.
. cn) .nn x 12 = .00
17 Amount of Line 14 at Sibling rate
.
.00 x 15 = .00
18 . Amount of Line 14 taxable at Collateral/Class B ra ke (18) (19)= 2,241.45
19 . Principal Tax Due
fA)( GK GIJl Ia:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
08-13-2010 CD013210 112.07 2,992.50
49-
519
07-05-2012 REFUND .00 .
1WANCE OR
TAX
101 DATE: 09-24-2012
SEE ATTACHED NOTICE
a) .00
c2) .00
(3) .00
(4) .00
(5) 802.67
c6) .00
(7) .00
TOTAL TAX PAYMENT 2,585.08
BALANCE OF TAX DUE 343.63CR
INTEREST AND PEN. .00
TOTAL DUE 343.63CR
v LF PAID AFTER DATE INDICATED, SEE REVERSE AFREFUND.DSEEIREVERSECSIDEpOFATHISEF ORM FOR)INSORU CTIONSIUE
FOR CALCULATION OF ADDITIONAL INTEREST. '~
INHERITANCE TAX
EXPLANATION
OF CHANGES
Clouser, Richard E.
Daniel Heck
2110-0589
101
ITEM
SCHEDULE NO.
EXPLANATION OF CHANGES
A I 1 I Forwarded to Post Assessment Review Unit in reference to the reduction to the real
estate.
E I I Accepted additional assets.
H ~ ~ Accepted additional expenses.
ROW
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