HomeMy WebLinkAbout05-14-15 NOTICE OF INHERITANCE TAX pennsylvania
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
BUREAU (QFC (1 �((v7V N.0y-AW,E OF OF DEDUCTIONS AND ASSESSMENT OF TAX
INHERITA A DI`�I�IOr REV-1547 EX AFP (11-14)
PO BOX 28 `� 4" �. WILLS
HARRISBURPA 77128-1601
?01[ F!Ry 19 �� 12 19 DATE 05-11-2015
!3 ESTATE OF STASYSZYN CARL J
CLE DATE OF DEATH 05-31-2014
0RPHAs.J, i= - FILE NUMBER 21 14-0618
COUNTY CUMBERLAND
qg . $�bWICZ JOHN, C ACN 101
104 S HANOVER ST APPEAL DATE: 07-10-2015
CARLISLE PA 17013-3420 (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
REV 1547 EX AFP (11-14) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: STASYSZYN CARL JFILE NO. :21 14-0618 ACN: 101 DATE: 05-11-2015
TAX RETURN WAS: ( X) ACCEPTED AS FILED C ) CHANGED
APPRAISED VALUE OF RETURN BASED ON- ORIGINAL RETURN
1. Real Estate (Schedule A) (1) •00 NOTE: To ensure proper
2. Stocks and Bonds (Schedule B) (2) .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) 15,308.08
6. Jointly Owned Property (Schedule F) (6) .00
7. Transfers CSchedule G) C7) .00
S. Total Assets (8) 15,308.08
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) C9) 12,102.41
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 18,664.23
11. Total Deductions (11) 30,766.64
12. Net Value of Tax Return (12) 15,458.56-
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00
14. Net Value of Estate Subject to Tax C14) 15,458.56-
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 C16) n 0 x 045 = .00
17. Amount of Line 14 at sibling rate (17) nn 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 (+)
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.