HomeMy WebLinkAbout09-06-13 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 018118
THOMAS R MARK
101 S MARKET ST
MECHANICSBURG, PA 17055
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
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101 $119.90
ESTATE INFORMATION: SSN:
FILE NUMBER: 2112-0056
DECEDENT NAME: CLARK DEANE D
DATE OF PAYMENT: 09/06/2013
POSTMARK DATE: 09/04/2013
COUNTY: CUMBERLAND
DATE OF DEATH: 12/28/2011
TOTAL AMOUNT PAID: $119.90
REMARKS:
CHECK# 3303
INITIALS: HMW
SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
NOTICE OF INHERITANCE TAX ne`jjf pennsylvania
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
BUREAU OF INDIVIDUAL TAXES OF DEDUCTIONS AND ASSESSMENT OF TAX DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION REV-154? EX AFP (03-13)
PO BOX 280601
HARRISBURG PA 17128-0601 RECORDED O FF1�/�c O F
RECls,eq OF DATE 08-I2-2013
c vEiIM-E OF CLARK DEANE D
DATE OF SAP S PI �In F,hk,)ff UMBERTH 21 12-0056
COUNTY CUMBERLAND
THOMAS ESQ R M CLERK OFACN 101
101 S MARKET ST ORPHANS' COURr APPEAL DATE: 10-11-2013
MECHANICSBURG PA 17055_0500BERLAND COAR,Mt(RemittedI// ?0 Objections)I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
I COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE --__ �--/ RETAIN LOWER PORTION FOR YOUR RECORDS f--
__---1-5-4-7-____-_-____ ________________________________________________________________
REV-1547 EX AFP {02-13? NOTICE Of INHERITANCE TAX APPRAISEMENT, ALLOWANCE 4R
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: CLARK DEANE DFILE NO. :21 12-0056 ACN: 101 DATE: 08-12-2013
TAX RETURN WAS: ( X) ACCEPTED AS FILED { } CHANGED
APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN NO. 01
1. Real Estate (Schedule A) (1) • 00 NOTE: To ensure proper
2. Stocks and Bonds (Schedule B) (2) 36,460.03 credit to your account,
S. Closely Hold Stock/Partnership Interest (Schedule C) (3) 00 submit the upper Portior of this form with your
4. Mortgages/Notes Receivable (Schedule D) (4) •00 tax payment.
5. Cash/Bank Doposits/Mist. Personal Property (Schedule E) (5) .00
6. Jointly Owned Property (Schedule F) (61 .00
7. Transfers (Schedule G) (7) .00
8. Total Assets (8) 36,460,D3
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Mist. Expenses (Schedule N) (9) 621 .97
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) - .00
11. Total Deductions (11) 621.97
12, Net Value of Tax Return (I2) 35,838.06
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00
14. Net Value of Estate Subdect to Tax (14) 199,898.76
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 (15) .00 X 00 = .00
16. Amount of Line 14 taxable at lineal rate (16) -On X 045 = .00
17. Amount of Line 14 at sibling rate (17) .nn X 12 .00
18. Amount of Lino 14 taxable at collateral rate (1$) 199,898.76 X 15 = 29,984.82
19. Principal Tax Due t24)= 29,984.82
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT f+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
09-25-2012 CDO16556 .00 24,609.11
06-27-2013 CDO17805 - .00 5,375471
BALANCE OF UNPAID INTEREST/PENALTY AS OF 06-28-2013 TOTAL TAX PAYMENT 29,984,82
BALANCE OF TAX DUE .tl0
INTEREST AND PEN. 119.90
TOTAL DUE 119.90
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.
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