HomeMy WebLinkAbout03-16-15 NOTICE OF INHERITANCE TAX IV
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APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES OF DEDUCTIONS AND ASSESSMENT OF TAX
INHERITANCE TAX DIVISION REV-1547 EX AFP (11-14)
PO BOX 280601 R E C 0 PA FC I- r'F
HARRISBURG PA 17128-0601
REGI`
DATE 03-16-2015
(�rl� 1 C 7 12 +,'9 ESTATE OF PERRY MADISON J
' iil liJ DATE OF DEATH 01-10-2013
FILE NUMBER 21 13-1039
COUNTY CUMBERLAND
MELLINGER ACN 101
3513 N F�mNTnSTf APPEAL DATE: 05-15-2015
HARRISBURG PA 17110-1438 (See reverse side under Objections)
Amount Remitted
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 (11-14) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: PERRY MADISON JFILE NO. :21 13-1039 ACN: 101 DATE: 03-16-2015
TAX RETURN WAS: ( X) ACCEPTED AS FILED C ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) Cl) •00 NOTE: To ensure proper
2. Stocks and Bonds (Schedule B) C2) .00 credit to your account,
S. Closely Held Stock/Partnership Interest (Schedule C) C3) 00 submit the upper portionof this form with your
4. Mortgages/Notes Receivable (Schedule D) C4) .00 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) .0 0
6. Jointly Owned Property (Schedule F) C6) .00
7. Transfers CSchedule G) C7) .00
8. Total Assets (8) .00
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 8,8 39.94
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 10 ,901 .59
11. Total Deductions (11) 19,741 .53
12. Net Value of Tax Return (12) 19,741 .53-
13.
9,741 .53-
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00
14. Net Value of Estate Subject to Tax (14) 19,741 .53-
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) -00 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)= .00
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT C+)
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 (CR), YOU MAY BE DUE \
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE FOR INSTRUCTIONS