HomeMy WebLinkAbout12-19-14 NOTICE OF INHERITANCE TAX pennsyLvarna
BUREAU OF INDIVIDUAL TAXES
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
OF DEDUCTIONS AND ASSESSMENT OF TAX
INHERITANCE TAX OFFICE OF REV-1547 EX AFP (11-14)
Pa BOX 280 f�((jjjj LL77
HARRISBURG OF 171%YtR 'WILLS
RG VI 1 1+7 DATE 12-22-2014
201' DSC 19y{{ I� 1 ( ESTATE OF KAUFFMAN RANDY R
U DATE OF DEATH 11-15-2013
CLERK OF FILE NUMBER 21 13-1316
GAL0MV4A, R COUNTY CUMBERLAND
101
5406"ff .L „[D CDA1 , Yf ACN APPEAL DATE: 02-20-2015
MECHANICSBURG PA 17055-3851 (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 C11-14� NDTICE OF INHERITANCE TAX APPRAI SEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: KAUFFMAN RANDY RFILE NO. :21 13-1316 ACN: 101 DATE: 12-22-2014
TAX RETURN WAS: (X) ACCEPTED AS FILED C ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1) 75,000.00 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 portionof this form with your
4. Mortgages/Notes Receivable (Schedule D) (4) .Q0 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 53,074.01
6. Jointly Owned Property (Schedule F) (6) .00
7. Transfers (Schedule G) (7) .00
8. Total Assets (8) 128,074.01
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 19,624.08
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 13,643.49
11. Total Deductions (11) 33,267.57
12. Net Value of Tax Return (12) 94,806.44
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00
14. Net Value of Estate Subject to Tax (14) 94,806.44
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) 44.8R6-44 x 045 = 4,266.29
17. Amount of Line 14 at sibling rate (17) -00 X 12 = 0 0
18. Amount of Line 14 taxable at collateral rate (18) .00 X 15 = 00
19. Principal Tax Due (19)= 4,266.29
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT {+)
AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
08-12-2014 CDO19529 .00 4,266.29
TOTAL TAX PAYMENT 4,266,29
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 1
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE FOR INSTRUCTIONS.