HomeMy WebLinkAbout04-06-15 NOTICE OF INHERITANCE TAX Pennsylvania
A_PPRAISEMENT, ALLOWANCE OR DISALLOWANCE
BUREAU OF INDTVI'DUAL TAXES OF DEDUCTIONS AND ASSESSMENT OF TAX DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION REV-1547 EX AFP (11-14)
PO BOX 260601 p� C OFFICE
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HARRISBURG PA REODRD E D 0 F F I C E O F
REGISTER OF WILLS DATE 04-06-2015
ESTATE OF BERTOLETTE JACK E
! ( C7 f DATE OF DEATH 03-03-2014
_ FILE NUMBER 21 14-0228
CLERK Gr COUNTY CUMBERLAND
BANGS ¢� J. �C i7+AL L ACN 101
429 S UA&N ��'„ „ . - % APPEAL DATE: 06-05-2015
CAMP+MN'Ert_r,°,D `PA'17611-5902 (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 4- --------------
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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: BERTOLETTE JACK EFILE N0. :21 14-0228 ACN: 101 DATE: 04-06-2015
TAX RETURN WAS: ( X) ACCEPTED AS FILED ( ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1) 34 5,613.67 NOTE: To ensure proper
2. Stocks and Bonds (Schedule B) (2) 3,410.83 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) .00
6. Jointly Owned Property (Schedule F) (6) .00
7. Transfers (Schedule G) C7) .00
8. Total Assets (8) 349,024.50
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 38,123. 12
10. Debts/Mortgage Liabilities/Liens (Schedule I) CIO) 232,752.34
11. Total Deductions (11) 270,875.46
12. Net Value of Tax Return (12) 78,149.04
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .0 0
14. Net Value of Estate Subject to Tax (14) 78,149.04
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) 0 0 X 00 = .00
16. Amount of Line 14 taxable at lineal rate (16) 78.149- 04 X 045 = 3,516.71
17. Amount of Line 14 at sibling rate (17) .0 0 I X 12 = .00
18. Amount of Line 14 taxable at collateral rate (18) .00 X 15 = .00
19. Principal Tax Due (19)= 3,516.71
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+)
AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
11-25-2014 CDO19970 .00 3,516.71
TOTAL TAX PAYMENT 3,516.71
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.