HomeMy WebLinkAbout05-04-15 NOTICE OF INHERITANCE TAX pennsyLvarna
BUREAU OF INDIVIDUAL TAXES APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION OF DEDUCTIONS AND ASSESSMENT OF TAX
PO BOX 28CRCCORDED OFFICE OF REV-1547 EX AFP C11-14)
HARRISBURG PA 17128-0601
REGI�ZT (; OF WILLS
DATE 05-04-2015
?01S Pfd 12 15 ESTATE OF FORNEY RAY K
DATE OF DEATH 12-18-2013
CLE nF FILE NUMBER 21 14-0005
�lfCuC'3�\VID L COUNTY CUMBERLAND
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ACN 101
^ ,ES;Lt-P APPEAL DATE: 07-03-2015
1601 K ST NW (See reverse side under Objections)
WASHINGTON DC 20006 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 F-
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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: FORNEY RAY KFILE NO. :21 14-0005 ACN: 101 DATE: 05-04-2015
TAX RETURN WAS: ( ) ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE
APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN NO. 01
1. Real Estate (Schedule A) (1) •00 NOTE: To ensure proper
2. Stocks and Bonds (Schedule B) (2) .00 credit to your account,
S. 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.
S. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) .00
6. Jointly Owned Property (Schedule F) C6) .00
7. Transfers (Schedule G) (7) .00
8. Total Assets (8) .00
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) .00
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) .00
11. Total Deductions (11) 00
12. Net Value of Tax Return C12) 00
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) 00
14. Net Value of Estate Subject to Tax (14) 96,839.74
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 1 X 00 = .00
16. Amount of Line 14 taxable at lineal rate (16) 9A.R39_74 X 045 = 4,357.79
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 C19)= 4,357.79
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+)
AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
03-11-2014 CDO18884 115.79 2,200.00
08-11-2014 CDO19521 .00 2,047.79
12-15-2014 CD020036 .00 337.50
TOTAL TAX PAYMENT 4,701 .08
BALANCE OF TAX DUE 343.29CR
INTEREST AND PEN. .00
TOTAL DUE 343.29CR
* IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A CREDIT (CR), YOU MAY BE DUE \t\\
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE FOR INSTRUCTIONS. �ev�J
REV-1470 EX(01.10) r
pennsytvania INHERITANCE TAX
DEPARTMENT OF REVENUE EXPLANATION
-- - DLN: 15001511
BUREAU OF INDIVIDUAL TAXES OF CHANGES
PO Box 280601
HARRIOURG,PA 10
DECEDENT'S NAME FILE NUMBER
Ray K Forney 2114-0005
REVIEWED BY ACN
Jason Kreiser 101
ITEM
SCHEDULE NO. EXPLANATION OF CHANGES
I
H (B) 1 Forwarded to Post Assessment Review Unit in reference to the reduction to the personal
representative commission.
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