HomeMy WebLinkAbout10-30-13 COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96)
DEPARTMENT OFREVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT.280601
HARRISBURG,PA 17128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 418342
KUYKENDALLROXANNA RAE
1348 ZIMMERMAN ROAD
CARLISLE, PA 17015
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
-....- ---- --------
101 i $146.57
ESTATE INFORMATION: SSN:
FILE NUMBER: 2112-0258
DECEDENT NAME: BROZACK BARBARA A
DATE OF PAYMENT: 10/30/2013
POSTMARK DATE: 10/29/2013
COUNTY: CUMBERLAND
DATE OF DEATH: 12/29/2011
TOTAL AMOUNT PAID: $146.57
REMARKS: RECEIPT TO ATTY
CHECK# 95
INITIALS: WZ
SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
- INHERITANCE TAX pennsylvania
BUREAU OF INDIVIDUAL TAXES
RECORD ADJUSTMENT DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION REV-1593 IX AFP (12-12)
PO BOX 260601
HARRISBURG PA 17126-0601
RECORDED OFFICE OF DATE 09-25-2013
REGISTER O !,";L LS ESTATE;''-,O F7 4°''B 0 02AC Kam, BARBARA ,, A
)f p DATE-OF DEATH 12-29-2011
3Q pfI GO COUNTYUMB ER CUMBERLAND
CLERK (Cr ACN 101
KEITH 0 BRENNEMAN ESGRPHANS' COURT Amount Remitted
44 W MAIN ST CUMBERLAND CO., PA
PO BOX 318 MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
MECHANICSBURG PA 17055-0318
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
NOTE: To ensure proper credit to your account, submit the upper portion of this form with your tax payment.
CUT ALONG THIS LINE ���� � RETAIN LOWER PORTION FOR YOUR RECORDS 4-
...
............. ........-- _ .____________________........................------------------....."""""
REV-1593 EX AFP (12-12) xx INHERITANCE TAX RECORD ADJUSTMENT xx
ESTATE OF: BROZACK BARBARA A FILE NO. :21 12-0258 ACN: 101 DATE: 09-25-2013
ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION
VALUE OF ESTATE:
1. Real Estate (Schedule A) ✓(1) 125,508.25
2. Stocks and Bonds (Schedule B) (2) .00
S. Closely Held Stock/Partnership Interest (Schedule C) (3) .00
4. Mortgages/Notes Receivable (Schedule D) (4) .00
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) V(5) 28,037.17
6. Jointly Owned Property (Schedule F) (6) .00
7. Transfers (Schedule G) i(7) 9.376.63
8. Total Assets (8)
DEDUCTIONS AND EXEMPTIONS: 162,922.05 61L
9. Funeral Expenses/Administrative Costs/
Miscellaneous Expenses (Schedule H) (9) 15,506.96 0%
10. Debts/Mortgage Liabilities/Liens (Schedule I) AID) 14,026.20
11. Total Deductions (11) 29,533.160tL'
12. Net Value of Tax Return (12) 133,388.89 ✓
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00
14. Net Value of Estate Sub3ect to Tax (14) 133,388.89 ✓
TAX:
15. Amount of Line 14 at Spousal rate (15) .00X.00 = .00
16. Amount of Line 14 taxable at Lineal/Class A rate (16) 133,388.89X.045= 6 r 002.50
17. Amount of Line 14 at Sibling rate (17)
.00X. 12 = .00
18. Amount of Line 14 taxable at Collateral/Class B rate (lg) .00 v.15. _ .00
19. Principal Tax Due (19) 6,002.50
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
06-12-2013 CDO17728 .00 5,982.13
INTEREST IS CHARGED THROUGH 10-10-2013* TOTAL TAX PAYMENT 5,982. 13
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE _ 20.37
REVERSE SIDE OF THIS FORM INTEREST AND PEN. ,. 126.20
-•-., ;TOTAL DUE `s,= r,,� ir•.,+- ::. :146:5.
\
\ 2
,
co
\% .
1wo y \
. y :
U ®
. &
lo
§
\ �
to
\ \ _