HomeMy WebLinkAbout06-17-15 rNO�T,11C r INHERITANCE TAX DEPARTMENT OF REVENUE
OF` DEI)UtTJ�QJ�S AND ASSESSMENT OF TAX
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BUREAU OF INDIVIDUAL TAXES RENA RAI'9&04T, ALLOWANCE OR DISALLOWANCE 'd
INHERITANCE TAX DIVISION REV-1547 EX AFP (11-14)
PO BOX 280601
HARRISBURG PA 17128-0601
?GIS JUN 17 FR F1 11 2 DATE 06-15-2015
C L OF ESTATE OF WILSON LEMA
DATE OF DEATH 04-16-2008
0 rtj P HA N'S' C C,IJ RT FILE NUMBER 21 15-0096
COUNTY CUMBERLAND
SUTHERLEN DONALD L ACN 101
1409 FROST RD APPEAL DATE: 08-14-2015
MECHANICSBURG PA 17055-5136 (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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DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: WILSON LEMA FILE NO. :21 15-0096 ACN: 101 DATE: 06-15-2015
TAX RETURN WAS: C X) 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) C2) .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) .0 0
6. Jointly Owned Property (Schedule F) (6) 23,750.00
7. Transfers (Schedule G) C7)- .00
B. Total Assets 23,750.00
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 12,957.69
10. Debts/Mortgage Liabilities/Liens (Schedule 1) (10) .0 0
11. Total Deductions (11) 12,957.69
12. Net Value of Tax Return (12) 10,792.31
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00
14. Net Value of Estate Subject to Tax (14) 10,792.31
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) 10,792.31 X 00 .00
16. Amount of Line 14 taxable at lineal rate (16) -00 x 045 = .00
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)= 00
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT C+) 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.