HomeMy WebLinkAbout03-22-13 �i��'i���}�� ����;�C��F INHERITANCE TAX � pennsylvania
/�E ��A��E�� ,� ALLOWANCE �R DISALLOWANCE DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES ���sta� FD S AND ASSESSMENT OF TAX
INHERITANCE TAX DIVISION REV-1547 IX AFP C09-12)
PO BOX 280601
HARRISBURG PA 17128-0601 i��� (Z"�A� �/3 D� � ��
t ��I C. i
DATE 03-25-2013
CLERK �� ESTATE OF HOLICEK MARGARET A
Q��H '�N�' ����-�- DATE OF DEATH 05-08-2012
G:�l�lBERLA�� G�., pA FILE NUMBER 21 13-0089
COUNTY CUMBERLAND
CHRISTOPHER LILIENTHAL
ACN 101
327 CHARLES RD APPEAL DATE: 05-24-2013
M E C HA N I C S B U R G P A 17 0 5 0-3 0 0 6 (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_LUWER PORTIUN FOR YOUR RECORDS E-
REV-1547 EX AFP C12-11� NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: HOLICEK MARGARET AFILE N0. :21 13-0089 ACN: 101 DATE: 03-25-2013
TAX RETURN WAS: C X) ACCEPTED AS FILED O CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) C1� .0 0 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) (3) of this form with your
4. Mortgages/Notes Receivable CSchedule D) (4) •0� tax payment.
5. Cash/Bank Deposits/Misc. Personal Property CSchedule E) C5) 4,5 7 5.35
6. Jointly Owned Property CSchedule F) C6� 7 6 5.34
7. Transfers CSchedule G) ��� .0 0
8. Total Assets (8) 5.340.69
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses CSchedule H) �q� 3.0 7 4.91
10. Debts/Mortgage Liabilities/Liens CSchedule I) �ip� 619.8 7
11. Total Deductions C11� 3,694.78
12. Net Value of Tax Return C12� 1,645.91
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C13� .0 0
14. Net Value of Estate Subject to Tax C14� 1,b45.91
NUTE: 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) .0 0 X 0 0 = .0 0
16. Amount of Line 14 taxable at lineal rate C16) � •�4�-91 x 045 = 74.07
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)= 74.07
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID C-)
. 01-22-2013 CD017088 .00 74.07
TOTAL TAX PAYMENT 74.07
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.