HomeMy WebLinkAbout10-06-14 NOTICE OF INHERITANCE TAX pennsylvarna
BUREAU OF INDIVIDUAL TAXES APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 EX AFP (08-13)
PO BOX 280601
HARRISBURG PA 17128-0601
DATE 10-06-2014
ESTATE OF HAIN CLARENCE E
DATE OF DEATH 06-28-2013
FILE NUMBER 21 13-0792
COUNTY CUMBERLAND
HAZEN ESQ MARIELLE F ACN 101
STE 202 APPEAL DATE: 12-05-2014
2000 LINGLESTOWN RD (See reverse side under Objections)
HARRISBURG PA 17110-9347 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 COS-13� NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: HAIN CLARENCE EFILE NO. :21 13-0792 ACN: 101 DATE: 10-06-2014
TAX RETURN WAS: ( X) ACCEPTED AS FILED C ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1) 150,000.00 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) 00 submit the upper portionof this form with your
4. Mortgages/Notes Receivable (Schedule D) (4) •00 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 30,695.03
6. Jointly Owned Property (Schedule F) (6) 24,959.99
7. Transfers (Schedule G) C7) 'q0
8. Total Assets C8) 205,655.02
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) C9) 4 0,08 5.08
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 687.89
11. Total Deductions (11) 40,772.97
12. Net Value of Tax Return (12) 164,882.05
13, Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00
14. Net Value of Estate Subject to Tax (14) !164,8".05
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NOTE: If an assessment was issued previously, Lines 14, 15, 16, 17=,- L§ and7or 15ti"ll
reflect figures that include the total of all returns asses Ad7to dam 2
ASSESSMENT OF TAX: M = c-) (y)
15. Amount of Line 14 at spousal rate (15) 00 9.0 r= m IT1.00
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16. Amount of Line 14 taxable at lineal rate (16) 1 r'4,8R7-D5 `X f4, 5-= 7-7,4 .69
17. Amount of Line 14 at sibling rate (17) on A( 12' = �� r�.00
18. Amount of Line 14 taxable at collateral rate (18) 00 ,X00
19. Principal Tax Due '(49)= 7c 69
TAX CREDITS: O
PAYMENT RECEIPT DISCOUNT (+)
AMOUNT PAID .0
DATE NUMBER INTEREST/PEN PAID C-)
09-26-2013 CDO18185 357.89 6,800.00
06-04-2014 CDO19251 .00 261.80
09-29-2014 SBADJUST .00 1 .46
TOTAL TAX PAYMENT 7,419.69
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 CCR), YOU MAY BE DUE 1)�
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE FOR INSTRUCTIONS.