HomeMy WebLinkAbout02-06-13BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
NOTICE OF INHERITANCE TAX `~~-~w pennsy~Van~a
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1x47 Ex AFP clz-lz)
RECORDFC OFI-ICE OF
REGISTER OF ~-]L.LS
1013 FEB ~ P(~ 1 `~2
EDMUND G MYERS CLERK OF
301 MARKET ST
PO Box l09 ORPHANS' COURT
LEMOYNE C'~~i18~A~,l~
DATE 01-29-2013
ESTATE OF FORTNEY SR LEE E
DATE OF DEATH 01-23-2012
FILE NUMBER 21 12-0133
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 03-30-2013
(See reverse side under Objections
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE ----~--> RETAIN LOWER PORTION FOR YOUR RECORDS
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REV-1547 EX AFP C12-12~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALL
OWANCE _ __
OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: FORTNEY SR LEE EFILE N0.:21 12-0133 ACN: 101 DATE: 01-29-2013
TAX RETURN WAS: C x) ACCEPTED AS FILED C ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) C1) .00 NOTE: To
2. Stocks and Bonds (Schedule B) ~2)
,00 ensure proper
credit to your account,
3. Closely Held Stock/Partnership Interest (Schedule C) C3) .0 0 submit the upper portion
4. Mortgages/Notes Receivable (Schedule D) (4)
O 0 of this form with your
. tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) C5) 15,50 0.00
6. Jointly Owned Property (Schedule F) C6) .0 0
7. Transfers (Schedule G) ~7) .0 0
8. Total Assets
c8) _ 15.500.00
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) C9) 4.36 8. 7
L0. Debts/Mortgage Liabilities/Liens (Schedule I) (10) .0 D
11. Total Deductions C11) 4,368.57
12. Net Value of Tax Return C12) 11,131.43
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) 20 0.00
14. Net Value of Estate Subject to Tax (14) 10,931.43
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) .0 0 X 00 = .0 0
16. Amount of Line 14 taxable at Lineal/Class A rate ( 16) 7 n .931. L•; x 045 = 491.91
17. Amount of Line 14 at Sibling rate (17) n n x 12 =
18. Amount of Line 14 taxable at Collateral/Class B rate (18) .00
X 15 .0 0
= .0 0
19. Principal Tax Due
TAX CREDITS: C19) = 491.91
PAYMENT RECEIPT DISCOUNT C+)
DATE NUMBER INTEREST/PEN PAID C-) AMOUNT PAID
10-23-2012 CD016682 00
. 491 .91
TOTAL TAX PAYMENT 491.91
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
* 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 FDRM FOR INSTRUCTIONS.
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