HomeMy WebLinkAbout05-26-15 NOTICE OF INHERITANCE TAX pennsyLvania
BUREAU OF INDIVIDUAL TAXES APPRAISEMENT, ALLOWANCE OR DISALLOWANCE 117 DEPARTMENT OF REVENUE
INHERIT N AXPiVff-S-IO?CFF10E OF OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 EX AFP (11-14)
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DATE 05-25-2015
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!J DATE 26 cM 12 50 ESTATE OF KOUMPIAS MADELINE G
DATE OF DEATH 09-30-2014
FILE NUMBER 21 14-1016
CCOUNTY CUMBERLAND
F AR R LIS` DIANE ACN 101
(��4�C§fgP*HENS XING - APPEAL DATE: 07-24-2015
MECHANICSBURG PA 17050 (See reverse side under Objections)
Amount Remittedi
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
I COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS 4-
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DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: KOUMPIAS MADELINE GFILE NO. :21 14-1016 ACN: 101 DATE: 05-25-2015
TAX RETURN WAS: CX) ACCEPTED AS FILED 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) 43,458.02 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 CSchedule F) (6) 684.15
7. Transfers (Schedule G) (7)- .00
8. Total Assets (8) 44,142.17
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 2,472.60
10. Debts/Mortgage Liabilities/Liens (Schedule 1) (10) •00
11. Total Deductions (11) 2,472.60
12. Net Value of Tax Return (12) 41,669.57
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00
14. Net Value of Estate Subject to Tax (14) 41,669.57
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) 41 ,449-57 x 045 = 1,875. 13
17. Amount of Line 14 at sibling rate (17) nO x 12 = .00
18. Amount of Line 14 taxable at collateral rate (18) .00 x 15 = .00
19. Principal Tax Due (19)= 1,875.13
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID
10-24-2014 CDO19837 1.54 29.33
12-26-2014 CD020073 92.21 1,752.04
05-18-2015 SBADJUST .00 .01
TOTAL TAX PAYMENT 1,875.13
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. vv