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HomeMy WebLinkAbout03-04-13 COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT.280601 HARRISBURG, PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 017262 WILEY JAN M THE WILEY GROUP 130 W CHURCH ST STE 100 DILLSBURG, PA 17019 ACN ASSESSMENT AMOUNT CONTROL NUMBER fold 101 $56.54 ESTATE INFORMATION: SSN: 193-24-1204 FILE NUMBER: 2111-1021 DECEDENT NAME: HINER MARY JANE DATE OF PAYMENT: 03/04/2013 POSTMARK DATE: 02/20/2013 COUNTY: CUMBERLAND DATE OF DEATH: 09/15/2011 TOTAL AMOUNT PAID: $56.54 REMARKS: CHECK#11284 INITIALS: CJ SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS NOTICE OF INHERITANCE TAX a pennsyLvarna _HU 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 REv DATE 01-21-2013 ra i i_' ESTATE OF HINER MARY J DATE OF DEATH 09-15-2011 L'i3 FIB 12 FILE NUMBER 21 11-1021 09 COUNTY CUMBERLAND DAVID J LENOX ACN 101 3 N BALTIMORE S-CLERK APPEAL DATE: 03-22-2013 DILLSBURG QR HRIW7(9-~9~°•-F~i787 (See reverse side under Objections) CUMBERLAND C0,, A Amount Remitted 1 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 REV-1547 EX AFP (12-12) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF: HINER MARY JFILE N0.:21 11-1021 ACN: 101 DATE: 01-21-2013 TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate CSchedule A) Cl) 119,809.27 NOTE: To ensure proper 2. Stocks and Bonds CSchedule B) (2) 16,736.30 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) •00 tax payment. 5. Cash/Bank Deposits/Misc. Personal Property CSchedule E) (5) 43,091 .40 6. Jointly Owned Property CSchedule F) (6) .00 7. Transfers (Schedule G) (7) .00 8. Total Assets (8) 179,636.97 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 90,422.12 10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) 290.28 11. Total Deductions (11) 90,712.40 12. Net Value of Tax Return (12) 88,924.57 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts CSchedule J) C13) 55,127.21 14. Net Value of Estate Subject to Tax C14) _ 33,797.36 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 1.6. Amount of Line 14 taxable at Lineal/Class A rate C16) -00 X 045 = .00 17. Amount of Line 14 at Sibling rate (17) _00 X 12 = .00 18. Amount of Line 14 taxable at Collateral/Class B rate C18) 33, 797.36 X 15 = 5,069.60 19. Principal Tax Due C19)= 5,069.60 TAX CREDITS: PAYMENT RECEIPT DISCOUNT AMOUNT PAID DATE NUMBER INTEREST/PEN PAID 10-29-2012 CDO16718 .00 5,069.60 BALANCE OF UNPAID INTEREST/PENALTY AS OF 10-30-2012 TOTAL TAX PAYMENT 5,069.60 BALANCE OF TAX DUE .00 INTEREST AND PEN. 56.54 TOTAL DUE 56.54 * IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. x oW _z o ~U D~ w^~ o~ w~ I.3 i't t e ..t _ C tr' oc rJ p' rJ ~ T dd -00" ONVIUIESNnO o Z `310 • N (1,01,111M AO CO .1h. ° m co D C) Ao