HomeMy WebLinkAbout01-07-13NOTICE OF INHERITANCE TAX ~ Pennsylvania
BUREAU OF INDIVIDUAL TAXES APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 EX AFP (12-12)
HARRISBURG6PA 17128-0601 a ~ C ~ ~ ~ ' ~ ~ `'_{j i a
REG'~S i ~ (~' ~`~:~'~P S DATE 01-07
?ili3 JFi~J ? F'f~ ~ ~2
CLERK C~=
DOUGLAS G MILLER ORPHANS' ~L't~RT
60 W POMFRET ST
CARLISLE ~B~~~d3~L4'S•, ~h~
-2013
ESTATE OF SHANNON RICHARD C
DATE OF DEATH 05-20-2012
FILE NUMBER 21 12-0589
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 03-08-2013
(See reverse side under Objections)
Amount ReBaitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE _ ~1 R_ETA_IN LOWER POR_TION_ FOR YOUR RECORDS ~ _ _____________
REV-1547 EX AFP C12-12~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: SHANNON RICHARD (FILE N0.:21 12-0589 ACN: tnt DeTF: nl_n~_~ntz
TAX RETURN WAS: C X) ACCEPTED AS FILED ( ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) C1) 178, 900.00 NOTE: To ensure proper
2. Stocks and Bonds (Schedule B) (2) 205,576.61 credit to your account,
3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 submit the upper portion
4. Mortgages/Notes Receivable (Schedule D]
(4)
.0 0 of this form with your
tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 173,533.55
6. Jointly Owned Property (Schedule F) ((,) .0 0
7. Transfers (Schedule G) (7) 13, 299.90
8. Total Assets (8) 571 , 310.06
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (q) 32.37 4.6 9
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 7.8 98.4 8
11. Total Deductions (11) 40,273.17
12. Net Value of Tax Return (12) 531 , 036.89
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00
14. Net Value of Estate Subject to Tax (14) 531,036.89
NOTE: If an assesssent was issued previously, lines 14, 15 and/or 16, 17 , 18 and 19 will
reflect figures that include the total of ALL ret urns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate C15) .00 X 0 0 - .0 0
16. Amount of Line 14 taxable at Lineal/Class A rate (16) S31 .0;6 89 x 045 = 23,896.66
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 rate C18) .0 0 X 15 - .00
19. Principal Tax Due (19)= 23,896.66
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT C+)
DATE NUMBER INTEREST/PEN PAID (-) AMDUNT PAID
08-13-2012 CD016381 973.68 18,500.00
10-12-2012 CD016633 .00 4,319.22
PAYMENT MUST BE MADE BY 02-20-2013*.
TOTAL TAX PAYMENT 23,792.90
BALANCE OF TAX DUE 103.76
INTEREST AND PEN. .00
TOTAL DUE 103.76
~ IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DU
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. _~