HomeMy WebLinkAbout03-28-14 NOTICE OF INHERITANCE TAX ] pennsylvania
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE yER\�' DEPARTMENT OF REVENUE
BUREAU of INDIVIDUAL TAXES YOF DEDUCTIONS AND ASSESSMENT OF TAX
INHERITANCE TAX DIVISION REV-154] EX AFP (08-13)
PO BOX 280601 °
HARRISBURG PA 17128-0601
RECORDED OFFICE GATE 03-31-2014
REGISTER OF WILLOTATE' OF HENRY CLEO F
DATE OF DEATH 09-05-2013
2014 MR 28 flM 11 %E NUMBER 21 13-0969
COUNTY CUMBERLAND
ROGERS ESQ ELYSE E CLERK OF ACN 101
STE 400 ORPHANS' COURT APPEAL DATE: 05-30-2014
635 N 12TH ST (!�� p� (See reverse side under Objections)
LEMOYNE PA 170&-T�RLAND CO., PAmount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE —I- RETAIN LOWER PORTION FOR YOUR-RECORDS-_4---------------------
R-E-V:-1-5-4-7 EX AFP COS-13) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: HENRY CLEO FFILE NO. :21 13-0969 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) (1) .00 NOTE: To ensure Proper
2. Stocks and Bonds CSChedule B) C2) .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) 24,489.48
6. Jointly Owned Property (Schedule F) (6) 82,819.10
7. Transfers (Schedule G) (7) 54,216.76
B. Total Assets (e) 161 .525.34
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) C9) 9,974.67
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 2,028.23
11. Total Deductions (11) 12,002.90
12. Net Value of Tax Return (12) 149,522.44
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00
14. Net Value of Estate Subject to Tax (14) 149,522.44
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 C17) .00 X 12 = .00
le. Amount of Line 14 taxable at collateral rate (18) 149,522.44 X 15 = 22,428.37
19. Principal Tax Due (19)= 22,428.37
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
11-26-2013 CD018453 1 ,121 .42 21,306.95
TOTAL TAX PAYMENT 22,428.37
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. ��'