HomeMy WebLinkAbout07-28-14 (2) COMMONWEALTH OF PENNSYLVANIA REV-1162 EXI11-96)
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT.280601
HARRISBURG,PA 17128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 019478
MOTTER ANN M
211 FIREHOUSE ROAD
SHIPPENSBURG, PA 17257
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
_""'__ fold ""'_'_"
101 � S 12,699.88
ESTATE INFORMATION: ssrv: �
FILE NUMBER: 21 1 3-1 068 �
DECEDENT NAME: MILLER ROY LEON �
DATE OF PAYMENT: 07/28/2014 I
POSTMARK DATE: 07/28/2014 (
COUNTY: CUMBERLAND �
DATE OF DEATH: 1 O/01/201 3 �
�
TOTAL AMOUNT PAID: S 12,699.88
REMARKS: RECEIPT TO ATTY
CHECK# 114
INITIALS: HMW
SEAL RECEIVED BY: LISA M. GRAYSON, ESQ.
REGISTER OF WILLS
REGISTER OF WILLS
NOTICE OF IMHERITAN�E TAX ,tt j pennsylvania
APPRAISEMENT, ALLOWANCE OR AISALLOWANCE �
BUREAU OF INDIVIDUA� TAXES OF DEDUCTIONS AND ASSESSMENT OF TAX j DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION � � REV-1547 IX AFP (OS-13)
PO BOX 280601
HARRISBURG PA 17128-0601
DATE 07-28-201G
E$TATE QF MIL�ER ROY L
DATE OF DEATH 10-01-2013
FILE NUMBER 21 13-1068
VERNEY ESQ JACQUELINM COUNTY CUMBERLAND
44 S HANOVER ST ACM 10�.
APPEAL DATE: 09-26-2014
CA R L I S L E P A 17 013 (See reverse side under Objections)
Amount Remitted�-
� MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
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tla ---� •• REGISTER OF WIILS
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�_ -_:.. „� � 1 COURTHOUSE SQUARE
��,• . � ,7U CARLISLE PA 17013
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,C�}J�":_11L01� THIS ,t E --� RETAIN LOWER PORTION FOR YOUR RECORDS F-
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�EY-��1547�EX q�ff 8-13) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
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L��, � '.,�u,, DISALLOWANCE OF -DEDUCTIONS AND- dSSESSMENT �OF�T?iX -
��fATE _!}F: MI�� ROY LFILE N0. :21 13-1068 ACN: 101 DATE: 07-28-2014
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' � TAX RETURN WAS: C ) ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate CSChedule A) ��� 186,000.00 NOTE: To ensure proper
2. Stocks and Bonds CSchedule B) C2� ,QQ credit to your account,
3. Closely Held Stock/Partnership Interest CSchedule C) C3� ,pp submit the upper portion
of this form with your
4. Mortgages/Notes Receivable CSchedule D) C4� .00 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) C5) 21,803.4 7
6. Jointly Owned Property CSchedule F) �6� .00
7. Transfers CSchedule G) �j� 281,595.88
8. Total Assets (8) 489.399.35
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses CSchedule H) �q�._ 14,221 . 18
10. Debts/Mortgage Liabilities/Liens (Schedule I) �ip� 225.96
11. Total Deductions C11� 14,447. 14
12. Net Value of Tax Return �lz� 474,952.21
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts CSchedule J) �lg� .00
14. Net Value of Estate Subject to Tax C14� 474,952.21
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 C15) .00 X 00 - .00
16. Amount of Line 14 taxable at lineal rate C16� 4�4•9F�-77 X 045 = 21,372.85
17. Amount of Line 14 at sibling rate (17� . 0� X 12 = .00
18. Amount of Line 14 taxable at collateral rate C18) .00 X 15 = .00
19. Principal Tax Due C19�= 21,372.85
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT C+)
AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID C-)
03-18-2014 CD018899 .00 8,701.03
INTEREST IS CHARGED THROUGH 08-12-2014 TOTAL TAX PAYMENT 8,701 .03
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 12,671 .82
REVERSE SIDE OF TNIS FpRM INTEREST AND PEN. 43.64
TOTAL DUE 12,715.46
� IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A CREDIT (CR), YOU MAY BE DUE
FOR CAt,CULATION OF ADDITIONAL INTEREST. A REFUNA. SEE REVERSE SIDE FOR INSTRUCTIONS.