HomeMy WebLinkAbout02-09-15 I-FIX r
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NOTICE OF INHERITANCE TAX Pennsylvania
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES OF DEDUCTIONS AND ASSESSMENT OF TAX ILI
INHERITANCE TAX DIVISION REV-1547 EX AFP (11-14)
PO B -F- 11CE OF
BOX
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HARRIS
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R DATE 02-09-2015
7ESTATE OF BOYAGODA UPALI N
IEB 9 FM DATE OF DEATH 02-18-2013
C j7 FILE NUMBER 21 14-0104
COUNTY CUMBERLAND
CdE{
ACN 101
62� NwFFRONT-, ST, APPEAL DATE: 04-10-2015
C P1, , .
W6 ktvSBURG PA 17043-1022 (See reverse side under Objections)
Amount Remittedl
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 +-
RiV:-1-54-7--Ei--AFP--C-1-1--i-4-)-NOTICE--O-F-INHERITANCE-TAX--A-PP-R-A-Iii-M-E-Ni-,--ALLOWANCE-5i---------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: BOYAGODA UPALI NFILE NO. :21 14-0104 ACN: 101 DATE: 02-09-2015
TAX RETURN WAS: ( X) ACCEPTED AS FILED 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,
3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 submit the upper portion
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) 2,500.00
6. Jointly Owned Property (Schedule F) (6) 180,100.00
7. Transfers (Schedule G) (7) .00
8. Total Assets (8) 182,600.00
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 3,431.67
10. Debts/Mortgage Liabilities/Liens (Schedule 1) (10) 120,259.02
11. Total Deductions (11) 123,690.69
12. Net Value of Tax Return (12) 58,909.31
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts CSchedule J) (13) .0 0
14. Net Value of Estate Subject to Tax (14) 58,909.31
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) 58,909.31 x 00 = .00
16. Amount of Line 14 taxable at lineal rate (16) -n n x 045 = .00
17. Amount of Line 14 at sibling rate (17) .()01 x 12 = .00
18. Amount of Line 14 taxable at collateral rate Cis) .00 x 15 = .00
19. Principal Tax Due C19)= .00
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID
TOTAL TAX PAYMENT .00
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 CCR), YOU MAY BE DUE
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE FOR INSTRUCTIONS.