HomeMy WebLinkAbout03-22-13 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
N0. CD 017361
O'ROURKE LORI V
418 PINE ROAD
MT HOLLY SPRINGS, PA 17065
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
-------- fold
__________ ________
101 $2,190.00
ESTATE INFORMATION: SSN:
FILE NUMBER: 2111 -0944
DECEDENT NAME: O'ROURKE ROBERT
DATE OF PAYMENT: 03/22/2013
POSTMARK DATE: 03/21/2013
COUNTY: CUMBERLAND
DATE OF DEATH: 08/21/2011
TOTAL AMOUNT PAID: $2,190.00
REMARKS: RECEIPT TO ATTY
CHECK# 167
INITIALS: DMB
SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
NOTICE OF INHERITANCE TAX pennsyLvania
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES OF DEDUCTIJ9.11A-AND ASSESSMENT OF TAX
INHERITANCE TAX DIVISION REV-154,7 EX AFP (09-12)
PO BOX 280601 R EC 0 P1 I C E 0 F
HARRISBURG PA 17128-0601 of:. 'Vil I S
RE" DATE 03-11-2013
*3 MR 22 PM I 5'JI ESTATE OF OROURKE ROBERT
DATE OF DEATH 08-21-2011
CLERK C : FILE NUMBER 21 11-0944
CHARLES E SHIELDS III OFATHANS' 1'.')U,r,T COUNTY CUMBERLAND
101
6 CLOUSER RD CUMBERLAN') PA ACN APPEAL DATE: 05-10-2013
MECHANICSBURG PA 17055-9751 (See reverse side under Objections)
Amount Remitted 1 -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 4-
ii-v:i--4-7-i-X--A-FP--(-12:-1-1-)--N-O-Ti-C-E--Oi--I-NH-E-R-ITi-N-C-E-i-A-X-i-P-P-Riii-E-Mi-N-T-,-i-L-L5i-A-N-C---O_R---------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF- OROURKE ROBERT FILE NO. :21 11-0944 ACH: 101 DATE: 03-11-2013
TAX RETURN WAS. ( X) ACCEPTED-AS FILED C CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1) .00 NOTE: To ensure proper
2. Stocks and Bonds (Schedule B) (2) .00 credit to your account,
3, Closely Held Stock/Partnership Interest (Schedule C) (5) .00 submit the upper portior
of this form with your
4. Mortgages/Notes Receivable (Schedule D) (4) .00 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 34,002.71
6. Jointly Owned Property (Schedule F) (6) 14,231.71
7. Transfers (Schedule G) (7) 109,008.03
8. Total Assets (8) 157,242.45
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 12,837.32
10. Debts/Mortgage Liabilities/Liens (Schedule 1) (10) 430.00
11. Total Deductions (11) 13,267.32
12. Net Value of Tax Return (12) 143,975. 13
13. Charitable/Governmental Requests; Non-elected 9113 Trusts (Schedule J) (13) .0 0
14. Not Value of Estate Subject to Tax (14) 143,975. 13
NOTE: If an assessment was issued previously, Lines 14, 15, 16, 17, 18 and/or 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 CIS) .00 X 00 = .00
16. Amount of Line 14 taxable at lineal rate (16) 1 4A.971;„I A X 045 = 6,478.88
17. Amount of Line 14 at sibling rate (17) .00 x 12 = .00
18. Amount of Line 14 taxable at collateral rate (18) .00 x 15 = .00
19. Principal Tax Due C19)= 6,478.88
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
07-17-2012 CDO16264 .00 4,358.01
INTEREST IS CHARGED THROUGH 03-26-2013 _TOTAL TAX PAYMENT 4,358.01
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 2,120.87
REVERSE SIDE OF THIS FORM INTEREST AND PEN. 74.11
TOTAL DUE 2,194.98
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 FOR INSTRUCTIONL
E M -
CHARLES E. SHIELDS, III
ATTORNEY-AT-LAW
6 CLOUSER ROAD
Corner of Trindle and Clouser Roads
MECHANICSBURG,PA 17055
GEORGE M.HOUCK TELEPHONE (717) 766-0209
(1912-1991) FAX (717) 795-7473
March 21, 2013
Register of Wills
Cumberland County Court House
1 Courthouse Square
Carlisle, PA 17013
Re: Estate of Robert O'Rourke
No.21-11-0944
' Dear Register of Wills:
Please find enclosed Check No. 167 in the amount of$2,194.98 for the Inheritance Tax
due as per the attached Notice of Inheritance Tax Appraisement, Allowance or Disallowance of
Deductions and Assessment of Tax.
Thank you for your kind attention to this matter.
Very truly yours,
Charles E. Shields, III
Attorney-At-Law
CES/mjj.
Enclosures