HomeMy WebLinkAbout11-30-12NOTICE OF INHERITANCE TAX ~ Pennsylvania
BUREAU DF INDIVIDUAL TAXES APPRAISEMENT, .ALLOWANCE OR DISALLOWANCE
INHERITANCE TAX DIVISION OF DEDUCTIONS AND ASSESSMENT OF TAX DEPARTMENT OF REVENUE
PO BOX 280601 REC O ~~~~ nC th REV-1547 Ex AFP (09-12)
HARRISBURG PA 17128-0607 V!'~7VE /Sr
REGISTER pF ~-~~ ~S DATE 11
Z~~1 ~iOU 30 Rl~ 1 ~ ~~
c~.ERK o~=
LISA MARIE COYNE EsQQRpNANS' COURT
3901 MARKET ST ~BERE~~;~p CO., pA
CAMP HILL PA 17011-
-26-2012
ESTATE OF SHUGHART HELEN P
DATE OF DEATH 12-30-2011
FILE NUMBER 21 12-0153
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 01-25-2013
(See reverse side under Objections
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE ---- ~ RETAIN LOWER PORTION FOR YOUR
-------------------- ------------- RECORDS F
REV-15
----------
47 EX AFP C12-11~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE _
____________
OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: SHUGHART HELEN PFILE N0.:21 12-0153 ACN: 101 DATE: 11-26-2012
TAX RETURN WAS: (X) ACCEPTED AS FILED C ) CHANGED
APPRAI SED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) ~1) 110,000
00
2.
Stocks and Bonds (Schedule B) C2) .
.0 0 NOTE: To ensure proper
credit to your account,
3. Closely Held Stock/Partnership Interest (Schedule C) (3) .0 0 submit the upper portion
4.
Mortgages/Notes Receivable (Schedule D) C4)
.0 0 of this form with your
5.
Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5)
2,54 5.7 7 tax payment.
6. Jointly Owned Property (Schedule F) C6) .0 0
7. Transfers (Schedule 6) C7) .0 0
8. Total Assets
APPROV
ED DEDUCTIONS AND EXEMPTIONS: cs) - 1_ 1 2 , 545.77
9. Funeral Expenses/Ads. Costs/Misc. Expenses (Schedule H) Cg) 38.99 0.6 6
10. Debts/Mortgage Liabilities/Liens (Schedule I) alp) 3 9,8 0. 8
11. Total Deductions
tll) 78,810.94
12. Net value of Tax Return 33
734
83
13. Charitable/Governsental Bequests; Non-elected 9113 Trusts (Schedule J) (12) ,
.
0 0
14.
Net Value of Estate Subject to Tax C13) .
X14) __ 33,734.83
NOTE: If an assessment was issued previously, Lines 14, 15, 16, 17, 18 and/or 19 will
reflect fi0ures that include the total of all returns assessed to date
ASSESSMENT OF
TAX: .
15. Amount of Line 14 at spousal rate (15) 00 0 0 =
16 .
X .0 0
. Amount of Line 14 taxable at lineal rate (16) ;; • 734 _ R3 X 045 = 1 , 518
07
17. Amount of Line 14 at sibling rate C17) -~~ X 1 2 = .
18
Amount
f
L .0 0
.
o ine 14 taxable at collateral rate (18) 0 0 x 15 =
19. Principal
Tax Due . .0 0
TAX CREDITS: (19)=
1,518.D7
PAYMENT RECEIPT DISCOUNT (+)
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
08-20-2012 CD016416
.00 1,518.07
TOTAL TAX PAYMENT 1,518.07
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 (CR), YOU MAY BE DUE
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE FOR INSTRUCTIONS.
- _