HomeMy WebLinkAbout08-03-15 NOTICE OF INHERITANCE TAX pennsytvarna
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION OF DEDUCTIONS AND ASSESSMENT OF TAX
� �� REV-1547 EX AFP (11-14)
PO BOX gORDED OFFICE OF
HARRISBURGURG PPA 1712 -
A
REGISTEs CF WILLS DATE 08-03-2015
1r AUGC ESTATE OF BERGMAN JOAN L
HIS U 3 PM 12 05 DATE OF DEATH 06-16-2014
FILE NUMBER 21 15-0087
CLED", C1- COUNTY CUMBERLAND
WINEKA EORPHAflJILLIj M ACN 101
17RCCEL� 8�,±,HALLER .t APPEAL DATE: 10-02-2015
�� (See reverse side under Objections)
HARRISBURG PA 17102-2392 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
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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: BERGMAN JOAN LFILE NO. :21 15-0087 ACN: 101 DATE: 08-03-2015
TAX RETURN WAS: C 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 CSchedule B) C2) .00 credit to your account,
3. Closely Held Stock/Partnership Interest (Schedule C) C3) 00 submit the upper portionof this form with your
4. Mortgages/Notes Receivable (Schedule D) (4) .00 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 1 ,358.60
6. Jointly Owned Property CSchedule F) (6) .00
7. Transfers (Schedule G) (7) 505.93
8. Total Assets C8) 1 ,864.53
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) C9) 4,74 2.70
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 1 ,06 3.26
11. Total Deductions (11) 5,805.96
12. Net Value of Tax Return (12) 3,941 .43-
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C13) .00
14. Net Value of Estate Subject to Tax (14) 3,941.43-
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) .0 0, 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) -nn X 12 = .00
18. Amount of Line 14 taxable at collateral rate (18) .00 X 15 = .00
19. Principal Tax Due (19)= 00
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT C+)
AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID C-)
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. \�n