HomeMy WebLinkAbout05-05-14 NOTICE OF INHERITANCE TAX 5 pennsylvania
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL Tnxes OF DEDUCTIONS AND ASSESSMENT OF TAX RFV-1547 EX AFP (08-15)
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
DATE 05-05-2014
ESTATE OF CLIFFORD LOIS J
DATE OF DEATH 05-23-2013
C FILE NUMBER 21 13-0876
FFICF�Of COUNTY CUMBERLAND
SEIBERT RECORDSAAA ACN 101
3631 N Ff�V9lV1� TI'RR OF V'A 1I- S APPEAL DATE: 07-04-2014
HARRISBURG CPA 17110-�d3 (See reverse side under Objections)
2014 0 'i �, , - Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
CLERK OF REGISTER OF WILLS
ORPHANS' COURT 1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUMBERLAND CO., PA
CUT ALONG THIS LINE RETAIN LOWER PORTION FOR-YOUR-RECORDS t-
REV-1547 EX AFP (08-13) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: CLIFFORD LOIS JFILE NO. :21 13-0876 ACN: 101 DATE: 05-05-2014
TAX RETURN WAS: ( X) ACCEPTED AS FILED ( ) CHANGED
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) (2) .00 credit to your account,
00 Submit the upper portion
3. Closely Held Stock/Partnership Interest (Schedule L) (3) . of this form with your
4. Mortgages/Notes Receivable (Schedule D) (4) •00 tax payment.
S. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 113, 193.87
6. Jointly Owned Property (Schedule F) (6) . 00
7. Transfers (Schedule G) (7) .00
8. Total Assets IS) 113. 193.87
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 5.941 .42
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 826.50
11. Total Deductions (11) 6,767.92
12. Net Value of Tax Return (12) 106,425.95
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) 96 .425.95
14. Net Value of Estate Subject to Tax (14) 10,000.00
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) -nn X 045 = .00
17. Amount of Line 14 at sibling rate (17) .00 X 12 = .00
18. Amount of Line 14 taxable at collateral rate (18) 10,000. 00 X 15 = 1,500.00
19. Principal Tax Due (19)= 1,500 .00
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID C-)
08-19-2013 CDO18042 75.00 1,425.00
TOTAL TAX PAYMENT 1,500 .00
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 (CR), YOU MAY BE DUE
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE FOR INSTRUCTIONS.
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