HomeMy WebLinkAbout12-19-14 NOTICE OF INHERITANCE TAX pennsyLvania
BUREAU OF INDIVIDUAL TAXES APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 EX AFP (11-14)
PO BX
HARRIOSBURG280601 PA 17128-0601 RECORDED OFFICE OF
REGISTER OF WILLS DATE 12-22-2014
ESTATE OF EVERTTS JEAN G
?019 OEC 19 AF, 1118 DATE OF DEATH 11-18-2013
FILE NUMBER 21 14-0374
CLERK OF COUNTY CUMBERLAND
DETHLEFS ESQ OR ANL C5UR1 ACN 101
2132 MARKETAPPEAL DATE: 02-20-2015
CAMP HILL C&'BEPktl:71�,Cl h_ PA (See reverse side under Objections)
Amount Remitted)
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: EVERTTS JEAN GFILE NO. :21 14-0374 ACN: 101 DATE: 12-22-2014
TAX RETURN WAS: C ) ACCEPTED AS FILED C X) CHANGED SEE ATTACHED NOTICE
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) C2) .00 credit to your account,
00 submit the upper portion
3. Closely Held Stock/Partnership Interest (Schedule C) C3) .
of this form with your
4. Mortgages/Notes Receivable (Schedule D) (4) .00 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 12,532. 12
6. Jointly Owned Property (Schedule F) C6) .0 1 0
7. Transfers (Schedule G) (7) 830,969.00
8. Total Assets (8) 843,501.12
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 14,714. 12
10. Debts/Mortgage Liabilities/Liens (Schedule 1) (10) .00
11. Total Deductions (11) 14,714.12
12. Net Value of Tax Return (12) 828,787.00
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) 599 396.00
14. Net Value of Estate Subject to Tax (14) 229,391.00
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) 156,255.00 x 00 = .00
16. Amount of Line 14 taxable at lineal rate (16) 71.136-nn x 045 = 3,291.12
17. Amount of Line 14 at sibling rate (17) .00 X 12 = .00
18. Amount of Line 14 taxable at collateral rate (18) .00 x 15 = .00
19. Principal Tax Due (19)= 3,291 . 12
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID
04-17-2014 CDO19042 .00 31192.93
INTEREST IS CHARGED THROUGH 01-06-2015 TOTAL TAX PAYMENT 3,192.93
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 98.19
REVERSE SIDE OF THIS FORM INTEREST AND PEN. 1.14
TOTAL DUE 99.33
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.
REV-1470_�X(01-10)
' pennsytvanla INHERITANCE TAX
V+ DEPARTMENT OF REVENUE EXPLANATION
BUREAU OF INDIVIDUAL TAXES OF CHANGES
PO BOX 280601
0
DECEDENT'S NAME FILE NUMBER
Jean Evertts 2114-0374
REVIEWED BY ACN
Heidi Schultz 101
ITEM
SCHEDULE NO, EXPLANATION OF CHANGES
Amounts passing in Trust for which an election to tax has not been made have been
moved to Line 13 of the Return.
Line 16 has been adjusted to reflect amount indicated on Schedule G item 2.
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