HomeMy WebLinkAbout09-16-13 COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96)
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT,280601
HARRISBURG,PA 17128-0801
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
N0. CD 01 $145
BUSCEMI NANCY M
754 MANOR ROAD
CAMP HILL, PA 17011
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
101 ( $2,179.68
ESTATE INFORMATION: SSN:
FILE NUMBER: 2113-0323
DECEDENT NAME: COMA BESSIE G
DATE OF PAYMENT: 09/16/2013
POSTMARK DATE: 09112/2013
COUNTY: CUMBERLAND
DATE OF DEATH: 03/02/2013
TOTAL AMOUNT PAID: $2,179.68
REMARKS:
CHECK# 108
INITIALS: HMW
SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
NOTICE OF INHERITANCE TAX 7Rl�Md pennsylvania
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES OF DEDUCTIONS AND ASSESSMENT OF TAX
INHERITANCE TAX DIVISION REV-1547 EX AFP (03-13)
PO BOX 280601
HARRISBURG PA 17128-0601
(;7' DATE 09-10-2013
ESTATE OF COMA BESSIE G
DATE OF DEATH 03-02-2013
,J} €tV ! �,i L47 FILE NUMBER 21 13-0323
E11 COUNTY CUMBERLAND
TINTER LEONARD ACN 101
315 N FRONT ST ��. :.�� �S APPEAL DATE: 11.09-2013
HARRISBURG 0RflhfAst7ib W-gT2o3 (See reverse side under Objections)
CUMBERLANID CO,, PA Amount Remittedr R 1 r1% �V-
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE —H RETAIN LOWER PORTION FOR YOUR RECORDS (--
--"-------'---- "'-—------------------------------------------
REV-1547 EX AFP t02-13) NOTICE OF INHERITANCE TAX APPRAZS£MENT, ALLOWANCE OR
_
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OFz COMA BESSIE GFILE NO. :21 13-0323 ACN: 101 DATE: 09-10-2013
TAX RETURN WAS: C ) ACCEPTED AS FILED C X) CHANGED SEE ATTACHED NOTICE
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) C2) 400 credit to your account,
DD submit the upper portion
3. Closely Held Stock/Partnership Interest (Schedule C) B) of this form with your
4. Mortgages/Notes Receivable CSchedule D) C4) •00 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property CSchedule E) (5) 1 ,151 .53
6, Jointly Owned Property (Schedule F) (6) 234,193.24
7. Transfers CSchedule G) C7) ' 00
8. Total Assets (8) , 235,344.77
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm, Costs/Misc. Expenses (Schedule H) C9) 22,377. 14
10. Debts/Mortgage Liabilities/Lions (Schedule I) 110) 2,516.73
11. Total Deductions 111) 24,893.87
12. Net Value of Tax Return (12) 210,450,90
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) Cis) .00
I4. Net Value of Estate Subject to Tax C14) 210,450.90
NOTE: If an assessment was issued previously, Lines 14, 15, 16, 17, IS 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) 400 X 00 = .00
16. Amount of Line 14 taxable at lineal rate (16) -nn X 045 = .DD
17. Amount of Line 14 at sibling rate (17) 21D .45(L 90 X 12 = 25,254.11
18. Amount of Line 14 taxable at collateral rate (As) .00 X 15 = .00
19. Principal Tax Due {141= 25,254.11
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
05-03-2013 CDO17 44 1,105.26 21,000.00
06-26-2013 CDO17797 .00 969. 17
PAYMENT MUST BE MADE BY 12-02-2013* . TOTAL TAX PAYMENT 23,074.43
BALANCE OF TAX DUE 2, 179.68
INTEREST AND PEN. .00
TOTAL DUE 2, 179.68
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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