HomeMy WebLinkAbout07-06-15 NOTICE OF INHERITANCE TAX pennsyLvarna
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES OF DEDUCTIONS AND ASSESSMENT OF TAX
INHERITANCE TAX DIVISION REV-1547 EX AFP (11-14)
Pd BOX 280601
URG
HARRISBURG PA PAREftQUED OFFICE OF
REGISTER OF WILLS DATE 07-06-2015
LEB
?015 JUL 6 3 1,L DATETOFODEATH 11-24-2014 SAMUEL L
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FILE NUMBER 21 14-1188
CLERK OF COUNTY CUMBERLAND
JAME�oPRA S' CMRT L ACN 101
13�' Y_R_E ND CO , PA, APPEAL DATE: 09-04-2015
FEt {See reverse side under Objections)
HUMMELSTOWN PA 17036-9162 Amount Remittedr�
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-
REV-1547 EX AFP C11-14) NOTICE O-F INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: LEIB SAMUEL LFILE NO. :21 14-1188 ACN: 101 DATE: 07-06-2015
TAX RETURN WAS: ( 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) (2) .00 credit to your account,
00 submit the upper portion
S. Closely Held Stock/Partnership Interest (Schedule C) (3) of this form with your
4. Mortgages/Notes Receivable (Schedule D) (4) .Q0 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 115,859.56
6. Jointly Owned Property (Schedule F) (6) .00
7. Transfers (Schedule G) (7) .00
8. Total Assets (8) 115,859.56
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 6,9 58.92
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 197.70
11. Total Deductions (11) 7,156.62
12. Net Value of Tax Return (12) 108,702.94
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) 2,000.00
14. Net Value of Estate Subject to Tax (14) 106,702.94
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) -nn x 045 = .00
17. Amount of Line 14 at sibling rate (17) 26,675.74 X 12 = 3,201.09
18. Amount of Line 14 taxable at collateral rate (18) 80,027.20 x 15 = 12,004.08
19. Principal Tax Due (19)= 15,205.17
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID C-)
02-20-2015 CD020256 760.26 14,444.91
TOTAL TAX PAYMENT 15,205,17
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. ��//