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HomeMy WebLinkAbout01-04-13 COMMONWEALTH OF PENNSYLVANIA REV-1 162 EX(1 1-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 01 7010 SHUMAN WILLIAM LEE 260 CREEK RD CAMP HILL, PA 17011 ACN ASSESSMENT AMOUNT CONTROL NUMBER fold 101 $155.55 ESTATE INFORMATION: SSN: 193-12-9612 FILE NUMBER: 2111-1036 DECEDENT NAME: SHUMAN WILLIAM R DATE OF PAYMENT: 01 /04/201 3 POSTMARK DATE: 01 /04/201 3 COUNTY: CUMBERLAND DATE OF DEATH: 09/21/2011 TOTAL AMOUNT PAID: $155.55 REMARKS: RECEIPT TO ATTY CHECK#915 INITIALS: CJ SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS NOTICE OF INHERITANCE TAX s~ 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) PO BOX 280601 HARRISBURG PA 17128-0601 RECORDED O+ _ 1CE OF DATE 12-24-2012 REGIS € Es OF ESTATE OF SHUMAN WILLIAM R DATE OF DEATH 09-21-2011 2613 J N ! i t ~ 7 FILE NUMBER 21 11-1036 COUNTY CUMBERLAND BRUCE D FOREMAN 101 FL 6 CLERK O ACN APPEAL DATE: 02-22-2013 112 MARKET ST ORPHANS' COURT (See reverse side under Objections) HARRISBURG PUNBMW CO., PA Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT-ALONG-THIS-LINE - - RETAIN LOWER PORTION FOR YOUR RECORDS 4-- - REV-1547 EX AFP (12-12) NOTICE OF INHERITANCE TAX APPRAISEMENT,-ALLOWANCE-OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF: SHUMAN WILLIAM RFILE NO.:21 11-1036 ACN: 101 DATE: 12-24-2012 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 190,000.00 NOTE: To ensure proper 2. Stocks and Bonds CSchedule B) (2) .00 credit to your account, 3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 submit the upper portion of this form with your 4. Mortgages/Notes Receivable CSchedule D) (4) 2,874. 97 tax payment. 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 503,840.77 6. Jointly Owned Property (Schedule F) C6) .00 7. Transfers (Schedule G) C7) .00 8. Total Assets (8) 696,715.74 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses CSchedule H) (9) 3,680.50 10. Debts/Mortgage Liabilities/Liens (Schedule I) C10)_ 1,9 71.76 11. Total Deductions (11) 5,652.26 12. Net Value of Tax Return (12) 691,063.48 T3. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C13) .00 14. Net Value of Estate Subject to Tax C14) 691,063.48 NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate C15) .00 X 00 = .00 16. Amount of Line 14 taxable at Lineal/ Class A rate (16)_ 991.n.43-4R X 045 = 31,097.86 17. Amount of Line 14 at Sibling rate (17) nn X 12 = .00 18. Amount of Line 14 taxable at Collateral/Class B rate (18) 00 X 15 = .00 19. Principal Tax Due C19)= 31,097.86 TAX CREDITS: PAYMENT RECEIPT DISCOUNT DATE NUMBER INTEREST/PEN PAID C-) AMOUNT PAID 08-21-2012 CD016417 .00 31,097.86 BALANCE OF UNPAID INTEREST/PENALTY AS OF 08-22-2012 TOTAL TAX PAYMENT 31,097.86 BALANCE OF TAX DUE .00 INTEREST AND PEN. 155.55 TOTAL DUE 155.55 * IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.