HomeMy WebLinkAbout02-15-13BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIY [SION
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HARRISBURG PA 17128-0601
KEITH 0 BRENNEMAN
44 W MAIN ST
MECHANICSBURG
INHERITANCE TAX
RECORD ADJUSTMENT
RECORDED Q'F1CE~0P
REGISTER OF .=~.__S
~ia.3 FEB 19 ~~ 1i 3Q
CLERK O~
ORPHANS' COURT
CUMBERLAND CO•. PA
PA 17055-6249
~' pennsylvania
DEPARTMENT OF REVENUE
REY -1593 EX AFP (12-I Z)
DATE 02-07-2013
ESTATE OF MCLANE ROZELLA M
DATE OF DEATH 08-05-2011
FILE NUMBER 21 11-0902
COUNTY CUMBERLAND
ACN 101
Amount Remittetl
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SgUARE
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 l--
REY-1593 EX AFP C12-12~ ~~ INHERITANCE TAX RECORD ADJUSTMENT ^x
ESTATE OF: MCLANE ROZELLA M FILE N0.:21 11-0902 ACN: 101 pATE: 02-07-2013
ADJUSTMENT BASED oN: ADMINISTRATIVE CORRECTION
VALUE OF ESTATE:
1. Real Estate (Schedule A) (1) .00
2. Stocks and Bonds (Schedule B) (2) .00
3. Closely Held Stack/Partnership Interest (Schedule C) (3) .00
4. Mortgages/Notes Receivable (Schedule D) (47 .OO
5. Cash/Bank Deposits/Misc. Personal Property (S<hetlule E) C57 5,757.41
6. Jpincly Owned Property (Schedule F) (b) 2.977.89
7. Transfers (Schedule G) (7) 1 71.996.61
s. Total Assets (B) 180,031.91
DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Administrative Costs/
Miscellaneous Expenses (schedule H) (9) 13.396.59
10. Debts/Mortgage Liabilities/Liens (Schedule I) (107 10.636.67
li. Total Deductions (11) 24,033.26
12. Net Yalue of Tax Return (12) 155,99$.65
13. Charitable/Governmental BeQUe sts; Non-elected 9113 Trusts CSchetlule J) (13) 6,000.00
14. N¢Y Value of Estate SubSect to Tax (14) 149,998.65
TAX:
15. Amount of Line 14 at Spousal rate (15) .00)( .00 ~ .00
16. Amount of line 14 taxable at Lineal/Class A rata (363 ,00x .045= .00
17. Amount of Line 14 at Sibling rate (17) ,00x .12 .00
18. Amount of Lins 14 taxable at Collateral/Class B rate (183 149,998.65x .15 22,499.80
19. Principal Tax Due (19)
22,499.80
TAX CR EDITS:
DATE NUMBER INTEREST/PEN PAID (-7 AMOUNT PAID
05-07-2012 (0015937 3.69- 22,584.74
08-20-2012 SBADJUST .00 3.70
TOTAL TAX PAYMENT ~ 22,584.7
1
+ 2F PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED pS A "CREDIT'' (CR). VDU MAV BE
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
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DEPARTMENT OF REVENUE
BUREAU OF INDIV[DUA~TAXES
PO Box 280601
INHERITANCE TAX
EXPLANATION
OF CHANGES
/~.,~/~,.~ ~,.,,,Y,~ Rozella M. McLane I~ ~~~,...,.,/~~~ 2111-0902
ILL V ILYYI/ / 1
James Russell 101
ITEM
SCHEDULE NO, EXPLANATION OF CHANGES
2 Citizens Bank joint accounts were transferred to Schedule F Jointly Owned Property.
Additional asset of $665.21 from Highmark insurance premium was placed on E. Sapphire
ring and jewelry listed on E were adjusted to the correct value of $1,718. On Schedule 1
debts that should not have been claimed were taken off which included Highmark Blue
Shield -net payment on account of $30.94/Refund of S.S. for Aug. 2011 $975.60/Capital
Area Health Associates -payment on account of $89.82
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