HomeMy WebLinkAbout07-13-15 NOTICE OF INHERITANCE TAX Pennsylvania
BUREAU OF INDIVIDUAL raxEs "APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION OF DEDUCTIONS AND ASSESSMENT OF TAX - REV-1547 EX AFP C11-14>
PO BOX HARRISBURG 6PA-1T19BQRP E D OFFICE O F
REGISTER OF 'WILLS
DATE 07-13-2015
HIS AIL 13 PM 12 Q9 ESTATE OF CLEGG JEAN A
DATE OF DEATH 05-25-2014
FILE NUMBER 21 14-0778
�� �� COUNTY CUMBERLAND
MOYAORPHA S' C. MY-' M'. ACN 101
APPEAL DATE: 09-11-2015
HARRISBURG PA 1/109-4522 (See reverse side under Objections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
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REV-1547 EX AFP (11-14) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: CLEGG JEAN AFILE NO. :21 14-0778 ACN: 101 DATE: 07-13-2015
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
3. Closely Held Stock/Partnership Interest (Schedule C) C3) of this form with your
4. Mortgages/Notes Receivable CSchedule D) C4) .00 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property CSchedule E) (5) .0 0
6. Jointly Owned Property (Schedule F) (6) .00
7. Transfers (Schedule G) (7) 270,800.87
8. Total Assets C8) 270,800.87
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 2,8 96.92
10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) 599.00
11. Total Deductions (11) 3,495.92
12. Net Value of Tax Return (12) 267,304.95
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts CSchedule J) C13) .00
14. Net Value of Estate Subject to Tax (14) 267,304.95
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) 25,788.00 X 00 = .00
16. Amount of Line 14 taxable at lineal rate (16) 741 •ril A-95i X 045 = 10,868.26
17. Amount of Line 14 at sibling rate (17) On X 12 = .00
18. Amount of Line 14 taxable at collateral rate (18) .00 X 15 = .00
19. Principal Tax Due (19)= 10,868.26
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT C+)
AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID C-)
08-19-2014 CDO19570 492.47 9,357.01
02-23-2015 CD020282 .00 1,018.77
07-06-2015 SBADJUST .00 .01
TOTAL TAX PAYMENT 10,868.26
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.