HomeMy WebLinkAbout01-12-15 NOTICE OF INHERITANCE TAX pennsylvania
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES OF DEDUCTIONS AND ASSESSMENT OF TAX
INHERITANCE TAX DIVISION REV-1547 EX AFP (11-I4)
PO BOX 280601
HARRISBURG PA 17128-0601
DATE 01-12-2015
ESTATE OF BEDNARIK PATTI S
DATE OF DEATH 10-26-2013
FILE NUMBER 21 13-1261
COUNTY CUMBERLAND
HATCH ESQ CRAIG A ACN 101
2109 MARKET ST APPEAL DATE: 03-13-2015
CAMP HILL PA 17011-4723 (See reverse side under Objections)
Amount Remitted I I
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
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REV-1547 EX AFP C11-141 NOTICE O-F INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: BEDNARIK PATTI SFILE NO. :21 13-1261 ACN: 101 DATE: 01-12-2015
TAX RETURN WAS: C 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) (2) .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) .00
6. Jointly Owned Property (Schedule F) (6) .00
7. Transfers (Schedule G) (7) 479,265.96
8. Total Assets (a) 479,265.96
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses CSchedule H) (9) .00
10. Debts/Mortgage Liabilities/Liens CSchedule I) (10) .00
11. Total Deductions (11) .90
12. Net Value of Tax Return (12) 479,265.96
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts CSchedule J) (13) .0 0
14. Net Value of Estate Subject to Tax (14) 479,265.96
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)
479,265.96 x 00 = .00
16. Amount of Line 14 taxable at lineal rate (16) -0 0 x 045 = .00
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)= o -00
TAX CREDITS: C `'' m M
PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID p C?
DATE NUMBER INTEREST/PEN PAID C-) rTI CJS X
r,
-11:3 r7-1
TOTAL TAX PAYMENTS W i= r1-00
BALANCE OF TAX�IbUE F-► Cn 0
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.