HomeMy WebLinkAbout07-10-12~:~~E,p,~~RITANCE TAX Pennsylvania ~
BUREAU OF INDIVIDUAL TAXES APPR ,f CE OR DISALLOWANCE DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION DF ~1 (}~$~'lyq~p ASSESSMENT DF TAX REV-1547 EX AFP (12-ill
PO BOX 280601 •~uv
HARRISBURG PA 17128-0601
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ESTATE OF WAGONER JACK D
(~~~~"i~; ,~;' DATE OF DEATH 06-09-2011
'~tK.ftJ~T FILE NUMBER 21 11-0804
~0 ~ ~~ COUNTY CUMBERLAND
SUSAN H CONFAIR ACN 101
2331 MARKET ST APPEAL DATE: 08-31-2012
CAMP HILL PA 17011-4642 (See reverse side under Objections)
Amount Remitted -~
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
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REV-1547 EX AFP (12-11) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: WAGONER JACK DFILE N0.:21 11-0804 ACN: 101 DATE: 07-02-2012
_. TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED
APPRAISED VALUE OF RETURN BASED ON• ORIGINAL RETURN
1. Real Estate (Schedule A) (1J .00
2. Stocks and Bonds (Schedule B) (y .00
3. Closely Held Stock/Partnarshlp Interest (Schetlule C) (3) .00
4. Mortgages/Notes Receivable (Schetlule D7 (4) .00
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E] (57 7,247.36
6. Jointly Owned Property (Schedule F7 (6) .00
7. Transfers (Schedul¢ G) (7) 365,618.50
NOTE: To ensure proper
credit Yo your account,
submit the upper portion
of this form with your
tax payment.
e. Total Assets (el 372.865.86
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedu le H) (9) 10.636. Ci0
30. Debts/Mortgage Liabilities/Liens (Schedule I7 (30)... 8.910.80
11. Total Deductions (11) 19,547.30
12. Net Value of Tax Return (12) 353,318.56
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (131 .00
14. NeY Value of Estate Subj¢<t to Tax (14) 353.318.56
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 d ate.
ASSESS MENT OF TAX:
15. Amount of Lin¢ 14 at Spousal rate (15) .00 X 00 - .00
16. Amounk of Line 14 taxable at Lineal/Class A rate (16) 3g3.31R-r.A X 045 = 15,899.34
17. Amount of Lina 14 at Sibling rate (17) - DO X 12 ° .00
18. Amount of Line 14 taxable at Collateral/Class B ra te (18) .00 X 15 - .DO
19. Principal Tax Due (19)= 15,899.34
TAX CR EDITS:
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT (+)
INTEREST/PEN PAID C-) AMOUNT PAID
09-02-2011 (0014933 700.00 13,300.00
03-08-2012 (0015680 .00 1.899.36
TOTAL TAX PAYMENT 15,899.36
BALANCE OF TAX DUE .02CR
INTEREST AND PEN. .00
TOTAL DUE .02CR
~ IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), VOU MAY BE OUE
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.