HomeMy WebLinkAbout12-29-14 NOTICE OF INHERITANCE TAX �f pennsyLvania
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DEPARTMENT OF REVENUE
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INHERITANC AVV_4DWAL OF DEDUCTIONS AND ASSESSMENT OF TAX IVIREV-1547 EX AFP (11-14)
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12-29-2014
L ESTATE OF CARBAUGH JANET H
CLETt"," OF DATE OF DEATH 12-02-2013
0 R P H AN.S' Co 1�1R T FILE NUMBER 21 14-0703
COUNTY CUMBERLAND
'J'O'EL' R ACN 101
STE 200 APPEAL DATE: 02-27-2015
14 N MAIN ST (See reverse side under Objections)
CHAMBERSBURG PA 17201-1814 Amount Remittedi
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE -0, RETAIN LOWER PORTION FOR YOUR RECORDS 4-
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DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: CARBAUGH JANET HFILE NO. :21 14-0703 ACN: 101 DATE: 12-29-2014
TAX RETURN WAS: ( X) ACCEPTED AS FILED C 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) C2) .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) (4) .00 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 7,336. 10
6. Jointly Owned Property (Schedule F) (6) .00
7. Transfers (Schedule G) (7)_ .00
8. Total Assets (8) 7,336.10
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 690.00
10. Debts/Mortgage Liabilities/Liens (Schedule 1) (10) 3.116.28
11. Total Deductions (11) 3,806.28
12. Net Value of Tax Return (12) 3,529.82
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00
14. Net Value of Estate Subject to Tax (14) 3,529.82
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 3-529-A7 x 045 = 158.84
17. Amount of Line 14 at sibling rate (17) nO X 12 = .00
18. Amount of Line 14 taxable at collateral rate (18) .00 x 15 = .00
19. Principal Tax Due (19)= 158.84
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID C-)
07-23-2014 CD61-9-479, .00 158.84
TOTAL TAX PAYMENT 158.84
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
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE FOR INSTRUCTIONS.