HomeMy WebLinkAbout07-21-14 NOTICE OF INHERITANCE TAX pennsylvani r
BUREAU OF INDIVIDUAL razes
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
OF DEDUCTIONS AND ASSESSMENT OF TAX
INHERITANCE TAX DIVISION REV-1547 EX AFP (08-13)
PO BOX 280601
HARRISBURG PA 17128-0601
DATE 07-14-2014
ESTATE OF BURKHOLDER HELEN M
DATE OF DEATH 10-30-2013
FILE NUMBER 21 14-0214
COUNTY CUMBERLAND
BOLLINGER JUSTIN J ACN 101
PO BOX 16 APPEAL DATE: 09-12-2014
LITITZ PA 17543-0016 (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 4-
-
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REV-1547 EX AFP (08-13) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: BURKHOLDER HELEN MFILE NO. :21 14-0214 ACM: 101 DATE: 07-14-2014
TAX RETURN WAS: IX) 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 CSchedule B) C2) . 00 credit to your account,
3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 submit the upper portiot
of this form with your
4. Mortgages/Notes Receivable (Schedule D) (4) . 00 tax payment.
5. Cash/Bank Deposits/Mist. Personal Property (Schedule E) (5) 7,815.62
6. Jointly Owned Property (Schedule F) C6) .00
7. Transfers (Schedule G) C7J . 00
8. Total Assets (8) 7,815.62
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Mist. Expenses (Schedule H) (q) 2.428.46
10. Debts/Mortgage Liabilities/Liens (Schedule I) CIO) 129.325.66
11. Total Deductions (11) 131,754. 12
12. Net Value of Tax Return (12) 123,938.50-
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) _ . 00
14. Net Value of Estate Subject to Tax C14) 123,938.50-
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 DO = .00
16. Amount of Line 14 taxable at lineal rate (I6) nn X 045 = . 00
17. Amount of Line 14 at sibling rate C17) - nn X 12 = . 00
18. Amount of Line 14 taxable at collateral rate (18) . 00 X �0
19. Principal Tax Due _
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) C r- "Tv
AMfPAID -D - -:C-�
DATE NUMBER INTEREST/PEN PAID (-) r >rr f`.J
C-),` c?
C)
D
--n
TOTAL TAX PAYMENT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
x 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.