HomeMy WebLinkAbout07-28-14 NOTICE OF INHERITANCE TAX pennsylvania
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
BUREAU OF INDIVIDUAL TAXES OF DEDUCTIONS AND ASSESSMENT OF TAX DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION
PO BOX 280601 REV-1547 IX AFP (08-13)
HARRISBURG PA 17128-0601
DATE 07-28-2014
ESTATE OF JESSICK SHIRLEY M
DATE OF DEATH 12-26-2012
FILE NUMBER 21 13-0558
COUNTY CUMBERLAND
COYNE ESQ LISA M
3901 MARKET ST ACN 101 APPEAL DATE: 09-26-2014
CAMP HILL PA 17011-4227 (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 � _
REV-1547 EX AFP (08-13) NOTICE OF INHERITANCE TAX APPRAISEMENT. ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: JESSICK SHIRLEY MFILE NO. :21 13-0558 ACN: 101 DATE: 07-28-2014
TAX RETURN WAS: C X) ACCEPTED AS FILED C ) 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,
3. Closely Held Stock/Partnership Interest (Schedule C) (3) X00 submit the upper portion
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) 500.00
6. Jointly Owned Property (Schedule F) (6) 1,000. 00
7. Transfers (Schedule G) (7) .00
8. Total Assets (8) 1 .500. DO
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Mist. Expenses (Schedule H) C9) 5.894.95
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) .00
11. Total Deductions (11) 5,894.95
12. Net Value of Tax Return (12) 4,394.95-
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00
14. Net Value of Estate Subject to Tax C14) 4,394.95-
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
17.17. Amount of Line 14 at sibling rate (17) 00 X 1 '-- . DO-,,
18. Amount of Line 14 taxable at collateral rate (lg) L - r0_3
19. Principal Tax Due . 00 X 1 ^C,T=-
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) .?'=
AMOUNT PAID "'
DATE NUMBER INTEREST/PEN PAID C-) d ir^
D
TOTAL TAX PAYMENT .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.