HomeMy WebLinkAbout11-13-12NOTICE OF INHERITANCE TAX
.+~ ~P~~'1,~,,$F,.~ENT, ALLOWANCE OR DISALLOWANCE
BUREAU OF INDIVIDUAL TAx~`~!~j~.~r~i~`~~, ~~ TIONS AND ASSESSMENT OF TAX
INHERITANCE TAX DIVISION ' - ~'~ ~'-~
PO BOX 280601 ~ ~ "' ~ `s)'! ~ <+
HARRISBURG PA 17128-0601 ~',-~ ~ ~. .....4.~J
~ Pennsylvania
DEPARTMENT OF REVENUE
REV-1547 EX AFP C09-12)
DATE 11-05-2012
~~ ~ ~ ` '~~~ ~ ~ ~~ ~ ~ ~ Q ESTATE OF ORLOUSKY MADLYN G
DATE OF DEATH 04-28-2012
_ FILE NUMBER 21 12-0527
SUSAN J HART ~~~~,~ ,tom ~"~(J~~ COUNTY CUMBERLAND
1 IRVINE ROW~~~` ~`rtv[~ ~'~" P~ ACN 101
APPEAL DATE: 01-04-2013
C A R L I S L E P A 17 013 - 3 019 (See reverse side under Objections )
Awount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALON_6 THIS LINE ---- -~ R_ETA_IN LOWER POR_TION_ FOR YOUR RECORDS F-
REV-1547 EX AFP C12-11) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: ORLOUSKY MADLYN GFILE N0.:21 12-0527 ACN: 101 _ ___
OR
DATE: 11-05-2012
TAX RETURN WAS: C X) ACCEPTED AS FILED ( ) CHANGED
APPRAI SED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) C1) .0 0
NOTE: To ensure proper
2. Stocks and Bonds (Schedule B) C2) ,Q D credit to your account,
3. Closely Held Stock/Partnership Interest (Schedule C) C3) .00 submit the upper portion
4.
Mortgages/Notes Receivable (Schedule D) C4)
207,520.56 of this form with your
tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) C5) .0 0
6. Jointly Owned Property (Schedule F) C6) .00
7. Transfers (Schedule G) C7) .0 0
8. Total Assets
C8) 07. 0. 6
APPROV ED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) Cg)_ 4.8 5 2.2 6
10. Debts/Mortgage Liabilities/Liens (Schedule I) Clp) 9.8 4 0. b
11. Total Deductions C11) 14,692.52
12. Net Value of Tax Return C12) 192,828.04
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) DO
14. Net Value of Estate Subject to Tax (13) .
192
828
C14) - ,
.04
NOTE: If an assesssent was issued previously, Lines 14, 15, 16, 17, 18 and/or 19 will
reflect figures that include the total of all returns assessed to date
ASSESSMENT OF TAX: .
15. Amount of Line 14 at spousal rate C15) .00 X 0 0 - .DO
16. Amount of Line 14 taxable at lineal rate C16) 7 97 . R7R n X 045 = 8, 677.26
17. Amount of Line 14 at sibling rate (17]_ _0 D X 12 = .0 0
18. Amount of Line 14 taxable at collateral rate C18) .0 0 X 15 = .00
19. Principal Tax Due (19) =
TAX CREDITS: 8,677.26
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT (+)
INTEREST/PEN PAID (-)
AMOUNT PAID
06-27-2012 CD016182 421.05 8
000
00
08-03-2012 CD016345 00 ,
.
. 256.22
~ IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
TOTAL TAX PAYMENT 8,677.27
BALANCE OF TAX DUE .O1CR
INTEREST AND PEN. .00
TOTAL DUE .O1CR
IF TOTAL DUE IS REFLECTED AS A CREDIT (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE FOR INSTRUCTIONS.
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