HomeMy WebLinkAbout08-24-12ppr~ (.~ ~, ,ter-`fit rr~~11CC NOTICE OF INHERITANCE TAX pennsylvania ~
BUREAU of INDkWd?t1 A'~n_'7~x~'sr. ~,h 1 CryAPPRAISEMEN 7, ALLOWANCE OR DISALLOWANCE
INHERITANCE TAX OI.IL~, `. y;,~ ~ ,J OF DEDUCTIONS AND ASSESSMENT OF TAX DEPARTMENT OF REVENUE
PU BOX 280601 ~~I ,,, LLLIII~~I ,,, LLLIII REV-3547 EX AFP (12 -11)
HARRISBURG PA 1]128-0601
1'x!12 AUG 24 AFB I1 ~ 3,
R I C HhR~p'~~C-' SyyEL'-gA~'RPR
77 WEST MAIN ST
MECHANICSBURG PA 17055
DATE 08-20-2012
ESTATE OF BLACK SAMUEL H
DATE OF DEATH 11-11-2011
FILE NUMBER 21 11-1224
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 10-19-2012
(See reverse side under Objections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
GUT ALONG THIS LINE ~-1--RETAIN LOWER PORTION FOR YOUR RECORDS F
------------------------ ------'------------
REV-1547 EX AFP (12-11) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
"'---------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: BLACK SAMUEL HFILE N0.:21 11-1224 ACN: 101 DATE: OB-20-2012
TAX RETURN WAS: (X ) ACCEPTED AS FILED ( 7 CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1) .00
NOTE: To ensure proper
2. Stocks and Bonds (Schetlule B7 (2) 2.86 cre tlit Yo your account,
3. Closely Held Stock/Partners hlp Interest (Schetlule C) (37 .00 submit the upper portion
4. Mortgages/Notes Receivable (Schetlule D7 of this form with your
(4) .00 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (51 83,425.90
6. Jointly Owned Property (Schedule F) (6) .00
7. Transfers (Schetlule G) (7) .00
e. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS: (el - 83.428 76
9. Funeral Expanses/Atlm. Costs/Misc. Expenses (Schetlule H7 (97_ 77.44n 1R
10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) 9.124.58
11. Total Detluctions
12.
Net Value of Tax Return al) 21,564.76
13.
Charitable/Gover
t (12) 61,864.00
nmen
al Bequests; Non-elected 9113 Trusts (Sched
l
J
14
Net V
l u
e
) C13)
00
. a
ue of Estate Subject to Tax
(141 61.864.00
NOTE: If an assessment was issued previously, lines 14, 15 and/or 16
17
reflect figures that
include the total
of ALL
t ,
, 18 and 19 will
ASSESS
MENT OF TAX: re
urns asses sed to date.
15. Amount of Line 14 aY Spousal rate (15J .00 00 =
16.
Amount of Line 14 t
bl x .00
axa
e at Lineal/Class A rate C16) 61
R6
17.
Amount of Line 14 at Sibling
rate .
4 n0 X 045 =
2,7$3.88
u7) ~n x 12 = 00
18. Amount of Line 14 taxable at Collateral/Class B rate (18) .00 15 = .
19.
Principal Tax Due x .00
TAX CREDITS: (197= 2,783.88
PAYMENT RECEIPT DISCOUNT (+)
DATE
02-06-2012 NUMBER
CD015549 INTEREST/PEN PAID (-)
139.19 AMOUNT PAID
2,800.00
:u:wL :w)c raYMENT 2,939.19
tALANCE OF TAX DUE 155.31CR
INTEREST AND PEN. .00
TOTAL DUE 155.31CR
x IF PAID AFTER GATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A '•CREDIT'• CCR), YOU MAY
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTI