HomeMy WebLinkAbout11-30-12BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
NOTICE OF INHERITANCE TAX
APPRAISEMENT,_ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
RECQRGEC ~tc~tr~~ OF
REGISTER CI: ~~'~~5
tUi~ I~l, ~~ 30 ~~~ i -. L ~.J
CLERK Gr
JOHN C OSZUSTOWICZ ~RPNAAIS. ~t~
104 S HANOVER ST (~f' R p~
CARLISLE 'P}(~7~1`3~p~~•' '4`~
cl) .00
C2) 599.00
c3) . 00
C4) . 00
c5) .00
C6) .00
c7) .00
CUT ALONG THIS LINE ---- ~ R_ETA_IN LOWER POR_TION_ FOR YOUR RECORDS 4- _
REV-1547 EX AFP C12-11) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: FOX MARTHA MFILE N0.:21 05-0618 ACN: 101 DATE: 12-03-2012
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 (09-12)
NOTE: To ensure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
C8) X99.00
C9) 8 , 033.70
clo) .00
11. Total Deductions C11) 8,033.70
12. Net Value of Tax Return C12) 7,434.70-
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C13) .00
14. Net Value of Estate Subject to Tax 7
434
70-
C14) __ ,
.
NOTE: If an assessment was issued previously, Lines 14, 15, 16, 17, 18 and/or 19 will
reflect figures that
ASSESSMENT OF TAX: include the total of all returns assessed to date.
15. Amount of Line 14 at spousal rate (15) .0 0 X 00 - .00
16. Amount of Line 14 taxable at lineal rate (16]- -~ ~ X 04 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 rate C18) .0 0 x 15 = .DO
19. Principal Tax Due C19?= .0 0
TAX CREDITS:
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID C-)
ANDUNT PAID
~ IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST_
TOTAL TAX PAYMENT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
IF TOTAL DUE IS REFLECTED AS A CREDIT CCR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE FOR INSTRUCTIONS.
l
DATE 12-03-2012
ESTATE OF FOX MARTHA M
DATE DF DEATH 01-04-2005
FILE NUMBER 21 05-0618
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 02-01-2013
(See reverse side under Objections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013