HomeMy WebLinkAbout12-17-12BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
NOTICE OF INHERITANCE TAX
APOFADEDULTIONSLANDAASSESSMENTAOFOTAXCE
RECORDED DsE1CE OF
2L'12 DEC 17 flCl ii `i9
DAVID W REAGER
2331 MARKET SICLERK 0~
CAMP HILL ORPHAN' CfblR~4642
Gk1MBERLAND CO., PA
( 7 CHANGED
RETAIN LOWER PORTION FOR YDUR RECORDS E~ _________________
CUT ALONG THIS LINE '~'~ _______ ___ _ _ ___ ___ _ _ _____ ___ _ _ _ __
REV-1547 EX AFP (12-11~DISALLOWANCENOFRDEDUCTIONS ANDRASSESSMENTAOF TAXCE OR
ACN: 101 DATE: 11-12-2012
nr.rr nr. roerv CLARE GFILE N0.:21 11-0731
TAX RETURN WAS: (X) ACCEPTED AS FILED
ORIGINAL RETURN
APPRAISED VALUE OF RETURN BASED ON:
1. Real Estate (Schedule A)
2. Stocks antl Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schetlule C)
4. Mortgages/Notes Reeeiva6le (SChetlule D]
5. Cash/Bank Deposits/Misc. Personal Property (SChetlule E)
6. Jointly Owned Property (Schedule F7
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)
11
12
13
14
00
(17 ~~
(2)
.00
(3)
.00
(4)
12,915.35
(5)
(6)
.00
(»~ ---
~ Pennsylvania
DEPARTMENT OF REVENDE
REV-1547 EX AFP (09 -12)
NOTE: Tq ensure proper
cretlit to Your account,
submit the upper po rt ian
of this form with your
tax payment.
(g) 22.817.75
(9)
(lo) 996.84
Total Deductions
Net Value of Tax Return
Charitable/Governmental Bequests; Non-elected 9113 Trusts (SChetlule J)
Net Value of Estate Sub]eck to Tax
(11) 10,552.55
12,265.20
(12 ) ~~--~
(13)
(14) 12,265.20
Lines 14, 15, 16. 17, 18 and/or 19 will
of all returns assessed to date.
NOTE: If an assessment was issued previously,
reflect figures that include the total
ASSESSMENT OF TAX:
15. Amount of Line 14 at spousal rate
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 at sibling rata
18. Amount of Line 14 Taxable at collateral rate
19. PrSncipal Tax Due
TAX CREDITS: _____,,,,_ „~
.00 x 00 = .00
C15)
)
~-96r;.20_x
045=
551.93
(ls) .nD x 12 = .00
c177 00 x 15 = .00
(le) . (19)= 551.93
AMOUNT PAID
DATE I NUMBER I INTEREST/PEN PAID (-)
n
TOTAL TAX PAYMENT 21,838.60
lALANCE OF TAX DUE 21,286.67CR
INTEREST AND PEN. .00
TOTAL DUE 21,286.67CR
DATE 11-12-2012
ESTATE OF TRACY CLARE G
DATE OF DEATH 05-27-2011
FILE NUMBER 21 11-0731
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 01-11-2013
(See reverse side under 06jections)
Amount Remitted
MAKE REGISTER OF WI A SD REMIT PAYMENT TO:
1 COURTHOUSE SQUARE
CARLISLE PA 17013
~ IF PAID AFTER DATE INDICATED. SEE REVERSE IF TOTAL DUE IS REFLECTED AS A CREDIT (CR]. YOU MAY BE
FOR CALCULATION OF ADO IT IONAL INTEREST. A REFUND. SEE REVERSE SIDE FOR INSTRUCTIONS.