HomeMy WebLinkAbout06-07-13 REC(���Op�ptl�}��TANCE TAX �j pennsylvania
pppf�l(i(��1�a1�'¢�(�(L�$wl+li�E OR DISALLOWANCE ■ �� DEPARTMENTOFREVENUE
BUREAU OF INDIVIDUAL TAXES p�'D� O�tT !CS IIwTtA,SESSMENT OF TAX fi�
INHERITANCE TA% DIVISION REV-I54] FX AFP (03-13)
HARRISBURG6PR 17128-0601 1�13 JUN 1 I 1 1 1 �,�}
DATE 06-10-2013
CLERK Gi� esrArE OF BRICKER CLARENCE A
ORPHANS� GCiURT DATE OF DEATH os-iz-zoio
CUMBERLAND CU.. PQI�E 'NUnBER zi 12-1155
COUNTY CUMBERLAND
MARK A MATEYA p�N 101
55 W CHURCH AVE APPEAL DATE: 08-09-2013
CARLISLE PA 17013-3202 (SeereversesideuederObjecHonsJ
A�ount Re�itted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
. 1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALON6 THIS LINE --► RETAIN LOWER PORTION FOR YOUR RECORDS �
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REV-1547 EX AFP CO2-13) NOTICE OF INHERITANCE TAX APPRAISEMENT. ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: BRICKER CLARENCE AFILE N0. :21 12-1155 ACN: lUl DATE: 06-10-2013
TAX RETURN WAS: ( JO ACCEPTED AS FILED O CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (S<hedulo A) (1) .00 NOTE: To •nsure proper
� 2. Stocks anC Bontls (SChetlula B) �p� .00 cre01t to your account,
.o0 SubmSY tlle uppe!' pOrt3on
3. Closaly Held Stock/Partnars�3p InYarest (SChedul• C) C3) cf this form with your
4. MortBa9es/NOtes Reeeivable CSehetlule D) (4) •�� tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (SChetlule E) (57 341.93
6. Jointly Owned Property (SChetlule F) C6) '��
7. TrensFers CSchetlule G) ��� 125�377.86
e. Total AsseYS (e) 125.719.79
APPROVED DEDUCTIDNS AND EXEMPTIONS:
9. Funerol Ezpenses/Adm. Costs/Misc. Expenses (SChetlula H7 �g� .00
10. Debts/Mortga9e �1ah113t1es/Liens (SChedule I) (30) .00
11. Total Detluctions (117 .00
12. NeY Value of Ta• Return �yZ� 125�719.�9
13. Charitable/Governmenial Bequests; Non-elecfed 9113 Trusis CSch¢tlule J) �13� •��
14. Net Value of Estate Sub7eet to Tax (14) 125.719.79
NOTE: If an assess�ent was issued previously. Lines 14. 15. 16, 17, 18 and/or 19 will
reflact fiyures that include the total of all returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at soousal rate c15) 341.93 X 00 = .00
16. Amount of Line 14 taxable aY lineal rete (16) »�'•;»-R� X 045 = 5�642.00
17. Amount of Line 14 at siblinp rate (177 -�� X 12 = .0�
18. Amount of LSne 14 taxable at <ollataral rate (18) .00 X 15 .00
19. Princi�al Tax Dua �19�= 5.642.00
TAX CREDITS:
PAYMENT RECEIPi DISCOUNT (+) qMOUNT PAID
DATE NUMBER INTEHEST/PEN PAID C-)
04-19-2013 CD017475 .00 5,642.00
BALANCE OF UNPAID INTEREST/PENALTY AS OF 04-20-2013 TOTAL TAX PAYMENT 5,642.U0
BALANCE OF TAX DUE .00
INTEREST AND PEN. 327.55
TOTAL DUE 327.55 `
� IF PAID AFTER DATE INDICATED. SEE REVERSE IF TOTRL DUE IS REFLECTED AS A CREDIT CCR). YOU MRY BE DUE (�,�' \
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUNO. SEE REVERSE SIDE FOR INSTRUCTIONS. � �a
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