HomeMy WebLinkAbout03-28-14 NOTICE OF INHERITANCE TAX pennsylvania
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES , [OVffEbI(�NS_pµp ASSESSMENT OF TAX Iff
INHERITANCE TAX DIVISION ff�t �j f(�tC UU I'I'���V tt ��JJ�r REV-1547 IX AFP (OB-13)
PO BOX 280601
HARRISBURG PA 17128-0601 REGISTER OF WILLS
ppmm
DATE 03-31-2014
2014 N 28 AM 11 32STATE OF SHIVELY GEORGE R
DATE OF DEATH 06-18-2011
CLERK OF FILE NUMBER 21 13-0939
ORPHANS- COURT COUNTY CUMBERLAND
HATCH ESQ CELA CRAIG CUMBERLAND AACN 101
2109 MARKET ST CO.,, APPEAL DATE: 05-30-2014
CAMP HILL PA 17011-4723 (See reverse side under Objections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE RETAIN LOWER-PORTION-FOR-YOUR-RECORDS l-
------------------------------------------ ------- --- -SEMN--_-_ ---------""" """'- -
REV-1547 EX AFP C08-13) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: SHIVELY GEORGE RFILE NO. :21 13-0939 ACN: 101 DATE: 03-31-2014
TAX RETURN WAS: ( X) ACCEPTED AS FILED ( ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) Cl) .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 C) (3) . of this form with your
4. Mortgages/Notes Receivable (Schedule D) (4) .00 tax Payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 74,500.00
6. Jointly Owned Property (Schedule F) (6) .00
7. Transfers (Schedule G) (7) .00
8. Total Assets (8) 74.500.00
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 3,000.00
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) .00
11. Total Deductions (11) 31000.00
12. Net Value of Tax Return (12) 71,500. 00
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00
14. Net Value of Estate Subject to Tax (14) 71,500 .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) 71 ,500.00 X 00 = .00
16. Amount of Line 14 taxable at lineal rate (16) -00 X 045 = .00
17. Amount of Line 14 at sibling rate (17) .110 X 12 = . 00
18. Amount of Line 14 taxable at collateral rate (18) .00 X 15 = 100
19. Principal Tax Due (19)= .00
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
TOTAL TAX PAYMENT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE 900
* 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. `;