HomeMy WebLinkAbout01-07-13BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
INHERITANCE TAX
RECORD ADJUSTMENT
RECORD~~? Vii. ~'C~ C~
REGIS i ~~ 0~ `:_',~~~_f.S
CLERK 0~=
BRIDGET M WHITLEY ES ORPHANS' CCJRT
FL 6 C~BERLAhlD CO., ?,~
17 S 2ND ST
HARRISBURG PA 17101-2053
~ pennsylvania
DEPARTMENT OF REVENUE
REV-1593 EX AFP (12-12)
DATE 12-17-2012
ESTATE OF ETSHIED JANICE W
DATE OF DEATH 08-21-2011
FILE NUMBER 21 11-0992
COUNTY CUMBERLAND
ACN 101
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
NOTE: To ensure proper credit to your account, submit the upper portion of this form with your tax payment.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
----------------------------------------------------------------------------------------------------------------
REV-1593 EX AFP C12-12~ ** INHERITANCE TAX RECORD ADJUSTMENT **
ESTATE OF: ETSHIED JANICE W FILE N0.:21 11-0992 ACN: 101 DATE: 12-17-2012
ADJUSTMENT BASED oN: ADMINISTRATIVE CORRECTION
VALUE OF ESTATE: -
1. Real Estate (Schedule A) C1) 95, 000.00
2. Stocks and Bonds (Schedule B) c2) .00
3. Closely Held Stock/Partnership Interest (Schedule C) C3) .00
4. Mortgages/Notes Receivable (Schedule D) C4) .00
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 4 7,136.0 0
6. Jointly Owned Property (Schedule F) C6) .00
7. Transfers (Schedule G) C7) 28.100.00
8. Total Assets C8)
170,236.00
DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Administrative Costs/
Miscellaneous Expenses (Schedule H) C9) 21 , 053.00
10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) 142,592.00
11. Total Deductions C11) 163,645.00
12. Net Value of Tax Return C12) 6,591.00
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Sche dule J) (13) .00
14. Net Value of Estate Subject to Tax C14) 6,591.00
TAX:
15. Amount of Line 14 at Spousal rate
(15) .00X.00 = .00
16. Amount of Line 14 taxable at Lineal/Class A rate C16)
2$,100.00x.045= 1,264.50
17. Amount of Line 14 at Sibling rate C17)
, 00x.12 . 00
18. Amount of Line 14 taxable at Collateral/Class B rate (18)
,0 0x.15 = .00
19. Principal Tax Due
TAX CREDITS: C19) 1 , 264.50
AYMENT RECEIPT DISCOUNT (+)
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
05-21-2012 CD016005 .00 1,265.00
TOTAL TAX PAYMENT 1,265.00
ALANCE OF TAX DUE .50C
INTEREST AND PEN. .00
TOTAL DUE .50C
* IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE r
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) i\