HomeMy WebLinkAbout09-04-12F., ,~{# ; ,_, ,.-,~~ICE OF INHERITANCE TAX
~~'--` ~ ''~~P'~R~S~ T, ALLOWANCE OR DISALLOWANCE
BUREAU OF INDIVIDUAL TAXES ,-
INHERITANCE TAX DIVISION ~5~ , ;_ D:F ,.~!~~b4~CTI0NS AND ASSESSMENT OF TAX
PO BOX 280601 ` ' -~
HARRISBURG PA 17128-0601
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JAMES A MILLER~~M~~"~~"~ ~~~~ ~~'
4 S 17TH ST
CAMP HILL PA 17011-4805
~1) 120, 000.00
C2) .00
C3) .00
C4) .00
C5) 6 , 811 .87
C6) .00
c7) .00
CUT ALONG THIS LINE ---- -~ R_ETA_IN LOWER POR_TION_ FOR YOUR RECORDS f- _ _____
REV-1547 EX AFP C12-11~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: FAILOR MIRIAM (FILE N0.:21 11-0935 ACN: lfll ^ATFr nst_~~_~ni~
TAX RETURN WAS: C X) ACCEPTED AS FILED C ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
pennsylvania~ - ~
DEPARTMENT OF REVENUE
REV-1547 EX AFP C12-11)
NOTE: To ensure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
C8) 12b , 811.87
C9) 13 , 020. 4
Clo) 311 , 951.83
11. Total Deductions C11) 324,972.25
12. Net Value of Tax Return C12) 198, 160 . 38-
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C13) .0 0
14. Net Value of Estate Subject to Tax C14) 198, 160 .38-
NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect figures that include the total of ALL returns assessed to d ate.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate C15) .0 0 X 0 0 = .0 0
16. Amount of Line 14 taxable at Lineal/Class A rate C16) _0 0 x 0 4 5 = .0 0
17. Amount of Line 14 at Sibling rate C17) .0 0 X 12 = .0 0
18. Amount of Line 14 taxable at Collateral/Class B ra te (18) .0 0 X 15 = .0 0
19. Principal Tax Due C19)= .0 0
TAX CREDITS:
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID C-)
AMOUNT PAID
DATE 08-27-2012
ESTATE OF FAILOR MIRIAM C
DATE OF DEATH 04-15-2010
FILE NUMBER 21 11-0935
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 10-26-2012
(See reverse side under Objections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
TOTAL TAX PAYMENT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
* IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.