HomeMy WebLinkAbout04-29-15 REV-1162 EX0 1-96)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT.280601
HARRISBURG,PA 1 7 1 28-0601 PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT NO. CD 020589
SALZMANN HUGHES PC
354 ALEXANDER SPRING RD
SUITE 1
CARLISLE, PA 17015
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
----------
-------- fold
101 $21 ,095.66
ESTATE INFORMATION: SSN:
FILE NUMBER: 2113-0027
DECEDENT NAME: BRASHEAR WALTER J
DATE OF PAYMENT: 04/29/2015
POSTMARK DATE: 04/29/2015
COUNTY: CUMBERLAND fi
DATE OF DEATH: 10/11/2012
TOTAL AMOUNT PAID: $21 ,095.66
REMARKS: RCPT TO ATTY
CHECK# 8028
INITIALS: D131
SEAL RECEIVED BY: LISA M. GRAYSON, ESQ.
REGISTER OF WILLS
REGISTER OF WILLS
pennsyLvania
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX Qb "
INHERITANCE TAX DIVISION OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 EX AFP (11-14)
PO BOX 280601
HARRISBURG PA 17128-0601
DATE 02-09-2015
ESTATE OF BRASHEAR WALTER i
DATE OF DEATH 10-11-2012
FILE NUMBER 21 13-0027
COUNTY CUMBERLAND
DOUGLAS III ESQGEORGE F ACN 101
354 ALEXANDER SPRING RD APPEAL DATE: 04-10-2015
CARLISLE PA 17015-7451 (See reverse side under Objections)
Amount Remittedl 19, ;,1 ,095.6
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
I COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE -1► RETAIN LOWER PORTION FOR YOUR RECORDS 4—
R �__i4---i---Fi---i---��_K---------i---;i---i---il�---;--- ---6i-----------------
1 7 E AF C11-243 TI OF INHE ITA F TAX A RAI EME , AL OW CE
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: BRASHEAR WALTER JFILE NO. :21 13-0027 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) 223,191.84 NOTE: To ensure proper
2. Stocks and Bonds (Schedule B) (2) 12,277.00 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) 14,574.34
6. Jointly Owned Property (Schedule F) (6) _-Do *;;3
7. Transfers (Schedule G) (7) 8'78 3 :;0
M 0
0
8. Total AssetsC0., 8 - 0— 258.829.01
APPROVED DEDUCTIONS AND EXEMPTIONS:
cl -0 A
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) C9) �,n CA C)
10. Debts/Mortgage Liabilities/Liens (Schedule 1) (10)
11. Total Deductions -TA 21,485.66
12. Net Value of Tax Return C-� C> _037,343.35
C:)
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule JJ
14, Net Value of Estate Subject to Tax
(14)ri FU) JA7,343.35
NOTE: If an assessment was issued previously, Lines 14, 15, 1z, 17, land/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) -0-0 x 045 = .00
17. Amount of Line 14 at sibling rate (17) 197,786. 10 x 12 = 23,734.33
18. Amount of Line 14 taxable at collateral rate (18) 39,557.25 x 15 = 5,933.59
19. Principal Tax Due C19)= 29,667.92
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID
10-01-2014 CDO19738 .00 10,000.00
INTEREST IS CHARGED THROUGH 02-24-2015 TOTAL TAX PAYMENT 10,000.00
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 19,667.92
REVERSE SIDE OF THIS FORM INTEREST AND PEN. 1,322.91
TOTAL DUE 20,990.83
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.