HomeMy WebLinkAbout12-19-14 NOTICE OF INHERITANCE TAX pennsyLvania
BUREAU OF INDIVIDUAL TA APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
INHERITANCE TAXF M DE bFFICE OOF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 EX AFP (11-14)
PO BOX 2BO601 6"
HARRISBURG PA 171REE%61rSTER OF VIRIS
DATE 12-22-2014
zo 19 fin 17 ESTATE OF FORNEY RAY K
DATE OF DEATH 12-18-2013
E R,\ FILE NUMBER 21 14-0005
FORNEY ORPHANS' COURIT pp� COUNTY CUMBERLAND
1 ACN 101
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ItA - APPEAL DATE: 02-20-2015
WASHINGTON DC 20006-1682 (See reverse side under Objections)
Amount Remitted I I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
I COURTHOUSE SQUARE
CARLISLE PA 17013
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DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: FORNEY RAY KFILE NO. :21 14-0005 ACN: 101 DATE: 12-22-2014
TAX RETURN WAS: ( X) ACCEPTED AS FILED CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) Cl) 195,000.00 NOTE: To ensure proper
2. Stocks and Bonds (Schedule B) (2) .00 credit to your account,
00 submit the upper portion
3. Closely Held Stock/Partnership Interest (Schedule C) (3) .
of this form with your
4. Mortgages/Notes Receivable (Schedule D) C4) .00 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 84,851. 18
6. Jointly Owned Property (Schedule F) (6) .00
7. Transfers (Schedule G) (7) 25,437.53
8. Total Assets (8) 305,288.71
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses CSchedule H) (9) 44,448. 10
10. Debts/Mortgage Liabilities/Liens (Schedule 1) (10) 164,000.87
11. Total Deductions (11) 208,448.97
12. Net Value of Tax Return (12) 96,839.74
13. Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (13) .00--
14.
0014. Net Value of Estate Subject to Tax (14) 96,839.74
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 1 X 00 = .00
16. Amount of Line 14 taxable at lineal rate (16) 9A.R39_74 X 045 = 4,357.79
17. Amount of Line 14 at sibling rate C17) On x 12 = .00
18. Amount of Line 14 taxable at collateral rate (18) .00 x 15 = .00
19. Principal Tax Due (19)= 4,357.79
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID C-)
03-11-2014 CDO18884 115.79 2,200.00
08-11-2014 CDO19521 .00 2,047.79
TOTAL TAX PAYMENT 4,363.58
BALANCE OF TAX DUE 5.79CR
INTEREST AND PEN. .00
TOTAL DUE 5.79CR
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.