HomeMy WebLinkAbout07-06-15 NOTICE OF INHERITANCE TAX Pennsylvania
BUREAU OF INDIVIDUAL raxEs
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
OF DEDUCTIONS AND ASSESSMENT OF TAX
INHERITANCE TAX DIVIE]I@W�O R p E D OFFICE OF,
�` REV-1547 EX AFP C11-14)
PO BOX 280601 (\Gtr
HARRISBURG PA 17128-ORLGISTER OF WILLS
DATE 06-29-2015
?015 JUL 6 Phi 3 12 ESTATE OF MCCOMBS BEATRICE H
DATE OF DEATH 09-06-2014
CLERK OF FILE NUMBER 21 14-0928
KERWIN ORPHANVE"RQENb1Ti COUNTY CUMBERLAND
ACN 101
4245 sffA*B& t_rgj� T,`, t rt APPEAL DATE: 08-28-2015
ELIZABETHVILLE PA 17023-8433 (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 F- -------------------
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REV-1547 EX AFP C11-14) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: MCCOMBS BEATRICE HFILE NO. :21 14-0928 ACN: 101 DATE: 06-29-2015
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,
0 0 submit the upper portion
3. Closely Held Stock/Partnership Interest (Schedule C) (3) . of this form with your
4. Mortgages/Notes Receivable CSchedule D) C4) .00 tax payment.
S. Cash/Bank Deposits/Misc. Personal Property (Schedule E) C5) 22,870.12
6. Jointly Owned Property (Schedule F) (6) .0 0
7. Transfers (Schedule G) (7) .00
8. Total Assets (8) 22,870.12
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 4,728.37
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 00
11. Total Deductions (11) 4,728.37
12. Net Value of Tax Return (12) 18,141 .75
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) 16,698.25
14. Net Value of Estate Subject to Tax (14) 1,443.50
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) -(in 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) 1 ,443.50 X 15 = 216.53
19. Principal Tax Due C19)= 216.53
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT C+)
AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
02-17-2015 CD020250 .00 216.53
TOTAL TAX PAYMENT 216.53
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.