HomeMy WebLinkAbout02-26-15 nMONwEPLirv OF aEurvSVLVPNIP Rn/ t l82 E%C 1-861
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M1..FFG9VRG PP P�28-O601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
N0. CD 020287
GATES SAMUEL A
250 YORK ST
HANOVER, PA 17337
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
----- __-
101 � 53,112.30
ESTATE INFORMATION: SSN: �
Fi�E NunneER: 2114-0535 �
oeCEDeNT Name SHANK DAVID D I
DATEOFPAYMENT: OZ/26/2015 I
POSTMARK DATE: 02/24/2015 �
COUNrv: CUMBERLAND I
DATEOFDEATH: �5/12/2014 I
TOTAL AMOUNT PAID: 53,112.30
REMARKS:
CHECK# 2051
INITIALS: CJ
sea� RECENED BY: LISA M. GRAYSON, ESQ.
REGISTER OF WILLS
REGISTER OFWILLS
NOTICE OF INNERITANCE 7AX � ,��.�� pennsylvania
�� RPPRAISEMENT. ALLOWAN[E OR OISALLOWANCE
BUREAU DF INOSVIDONL TAXES OEPAFTMENTOFFEVENUE
�xxeailnxc[ inx orvaxor� EOU[TIONS AND ASSESSMENT OF TA% REvasm �e nw ui-i4�
��INRRISGVR66PA 1]129-0601 R���1V����: .� . .. . ..
FE� 2 '� Z�jS�..� ...- � �� �.. bATE 02-16-2015
(y1yy� o �r�TATE OF SHANK OAVIO �
SAr� `EB CO I � 1 lp�pTE OF DEATM 05-12-2014
FILE NUMBER 21 14-0535
�'--� � � COUNTV CUMBERLANO
GATES SAMUEL ADF;�;�,,, � � � � ' A�N 101
250 VORK ST (`, .,_. . APPEAL OATE: 04-1]-2015
HANOVER PA 17351�"-�SZ37 � (SeereversesideunQerObjections)
� Amount Reoittetl�
MAKE CHELK PAYABLE AND REMIT PAVMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE_____ y RETAIN LOWEk PORTION FOR Y011k kECORDS H
"""'"""'"_ """"""""""""'"""""'__'"""""'""'__""'"'"'""""
REV-1547 EX AFP Q1-I4J NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCt OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: SHANK �AVID DFILE N0. :21 14-0535 ACN: 101 DATE: 02-16-2015
TA% RETURN WAS: ( ) ACCEPTEO AS FILEO O(l LHANGEO SEE ATTACHED NOTICE
APPRAISED VAWE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate [Sc�eEule A) �1) 169.900.00 ryOTE: To e sure vroper
2. Stocks antl Bontls (Sc�eEule Bl <2> �00 reEit to your a un[,
. �0 sucmat tna uaaer�earuon
3. Clasely Heltl Stock/Pa�tne�s�ip Sn[e�es< (SCFeEula C) (3) of t�is fo�m vSfM1 you�
4. Mort9+9as/Notas RawivaCL CSc�etlule O) (4) '�� [ax oayment.
5. Cas�/6ank Oepas3[s/Misc. pa�sonal P�ape�tY (Sc�etlule E) (5) 9•��5�83
6. Ja3n[ly Ovnatl G�apa�tY (Sc�eUule F) (6l •�0
v. rran:ra�s t5�neaule c) p� 292,803.54
e. Total nssets ca� 4�2.479.3�
APPROVED OEDUCTIONS ANO EXEMPTIONS:
9. Fune�al Expenses/AOm. Casts/Misc. Ezpanses (ScbeEula H] �9) 5�.983.98
io. �eetsinortaaea �iaeilities/�ians <scneaula [� ao> 86,490.3]
11. Total Deau<tions ��ll 144,474.35
t2. Nat Value af Taz aeturn �i1� 328,005.02
L3. CM1aritable/Gavernmental Beqoes[s; Non-elec[e0 9113 Trus[s (SCM1eJule A <1;� .�0
L4. Nat Value af Es[afe SUEjeck fo Tax ��y� 328,005.02
NOTE: If an assess�ent vas issued prevlously. Lines 14, 15, 16, 17. 18 antl/or 19 will
reflect flgures that include the total of all returns assessetl to dake.
ASSESSMENT OF TR%:
15. Amowt o£ Lina 14 a[ spousal rate (15l ��� X DO - .00
15. nmount ot �ine lc cazmie at 11nea1 rate u5� ��� ���� �� % 045 = 10 .404.91
I]. Amowt of Line 14 at 5i01in9 �a<e (I]) � II❑ % ]$ - .00
1e. amaun[ or una ia x�x+ela aa caiia[erai raxe ue� 96,784.86 x 15 ' 14.51].]3
19. PHnclpal Tax Oue [39)= 24i922.64
TAX CREOITS:
PAYMENT RECEIPT OISCOUNT (♦) pMOUNT PAID
pATE NUMBER INTEREST/PEN PAIO (J
08-29-2014 CD019618 .00 21�815.18
INTEREST IS CHARGED THROUGH 03-03-2015 TOTAL TAX PAVMENT 21,615.18
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANLE OF TAX DOE 3,10].46
REVERSE SIOE OF THIS FORM INTEREST ANU PEN. 4.64
TOTAL DUE 3,112.30
i IF PRIO AFTER DATE INOICRTED� SEE REVERSE IF TOTAL OUE IS REFLECTEO AS A CREOIT (CR)� Y011 MAY 8E �UE
FOR CALCIILATION OF AO�IiIONNL INiEREST. A REFUN�. SEE REVERSE SIDE F00. INSTROCi[�NS.
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