HomeMy WebLinkAbout07-28-14 NOTICE OF INHERITANCE TAX %7pennsytvania
INHERITANCE TAX DIVISION
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL
TAXES OF DEDUCTIONS AND ASSESSMENT OF TAX PO BOX 280601 REV-1547 a APP (08-13)
HARRISBURG PA 17128-0601
DATE 07-28-2014
ESTATE OF BURGOON JOHN R
DATE OF DEATH 06-15-2013
FILE NUMBER 21 13-0678
COUNTY CUMBERLAND
HALBRUNER ESQ MARK E ACN 101
2109 MARKET ST APPEAL DATE: 09-26-2014
CAMP HILL PA 17011-4723 (See reverse side under Objections)
Amount RemittedE---�
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--
REV-1547 EX AFP (08-133 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: BURGOON JOHN RFILE NO. :21 13-0678 ACN: 101 DATE: 07-28-2014
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 (Schedule B) (2) .00 credit to your account,
S. Closely Held Stock/Partnership Interest (Schedule C) (3) . 00 submit the upper portion
4. Mortgages/Notes Receivable (Schedule D) of this form with your
(4) .00 tax payment.
S. Cash/Bank Deposits/Mist. Personal Property (Schedule E) (5) 36,258.76
6. Jointly Owned Property (Schedule F) (6) .00
7. Transfers (Schedule G) (7) 34,199. 05
8. Total Assets (8) 70.457.81
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Mist. Expenses (Schedule H) (9)_ 6,607.57
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 803.45
11. Total Deductions - (11) 7,411 .02
12. Net Value of Tax Return (12) 63,046.79
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) . 00
14. Net Value of Estate Subject to Tax (14) 63,046.79
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) 63-Q46 Rn X 045 = 2.,837. 11
17. Amount of Line 14 at sibling rate (17). - nn X 12 n= `'' .00
18. Amount of Line 14 taxable at collateral rate (18) .00 X 15�?j�-'+ ,j�Jj,'T1
19. Principal Tax Due C1(Ra=L
TAX CREDITS: �);L L
PAYMENT ^') `
RECEIPT DISCOUNT (+) U-.' 00
PAID PAID
' I'•
DATE NUMBER INTEREST/PEN PAID (-) [;')� `-�;.,
09-09-2013 CD018138 141 .86 3,100. 00 C__' ;
- PI
TOTAL TAX PAYMENT 3,241 .86
BALANCE OF TAX DUE 404.75CR
INTEREST AND PEN. . 00
TOTAL DUE 404.75CR 1
+ IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A CREDIT (CR), YOU MAY BE DUE \�` 1
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE FOR INSTRUCTIONS. (\RJR/