HomeMy WebLinkAbout03-22-13 NOTICE OF INHERITANCE TAX � pennsylvania
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENTOFREVENUE
BUREAU oF INDIVIDUAL TAXES OF DEDUCTIONS AND ASSESSMENT OF TAX
INHERITANCE TAX DIVISION REV-1547 DC AFP C09-12)
PO BOX 280601
HARRISBURG PA 17128-0601 �������� ������ ��
DATE 03-25-2013
�������� a� ���°��� ESTATE OF JACOBS HAROLD 0
`��� ���i �� �f t j �� FILE NUMBERTH 21 12-0292
COUMTY CUMBERLAND
MICHAEL CHEREWKA ESQ C�.E�K �� ACN 101
624 N FRONT ST Q���A�c�• ���R-�- APPEAL DATE: 05-24-2013
WO R M L E YS B U R G P l������Q� ��.' �Q (See reverse side under Objections)
�t t't 1�
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 C12-11� NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE UF: JACOBS HAROLD OFILE N0. :21 12-0292 ACN: 101 DATE: 03-25-2013
TAX RETURN WAS: (X) ACCEPTED AS FILED C ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) �1� 172,200.00 NOTE: To ensure proper
2. Stocks and Bonds CSchedule B) C2� .0 0 credit to your account,
.0 0 submit the upper portion
3. Closely Held Stock/Partnership Interest CSchedule C) C3) of this form with your
4. Mortgages/Notes Receivable CSchedule D) C4) •�� tax payment.
5. Cash/Bank Deposits/Misc. Personal Property CSchedule E) (5) 3,6 0 0.0 0
6. Jointly Owned Property tSchedule .F) �6� 33,042.05
7. Transfers CSchedule G) ��� .0 0
s. Total Assets cs� 208.842.05
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses CSchedule H) C9� 13.941.12
10. Debts/Mortgage Liabilities/Liens CSchedule I) �lp� 42,641.96
11. Total Deductions C11) 56,583.08
12. Net Value of Tax Return C12� 152,258.97
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts CSchedule J) C13� .0 0
14. Net Value of Estate Subject to Tax C14? 152,258.08
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 C15) 152,258.08 X 00 = .00
16. Amount of Line 14 taxable at lineal rate C16) -�� x 0 4 5 = .0 0
17. Amount of Line 14 at sibling rate C17) -0 0 X 12 = .0 0
18. Amount of Line 14 taxable at collateral rate C18) .0 0 X 15 = .0 0
19. Principal Tax Due C19�- .0 0
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID C-)
TOTAL TAX PAYMENT .00
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 FOR INSTRUCTIONS.