HomeMy WebLinkAbout08-17-15 NOTICE OF INHERITANCE TAX pennsyLvarna
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES OF DEDUCTIONS AND ASSESSMENT OF TAX
INHERITANCE TAX Dffft�l R D EE n OFFICE OF-
HARRISBURG � ����� REV-1547 EX AFP (11-14)
PO BOX 280601 UU LL''
PA 17128-0601
REGISTER GF ",'ILLS
DATE 08-10-2015
NIS AUG 17 PM 12 v9 ESTATE OF STORBECK DOROTHY E
DATE OF DEATH 02-13-2013
CLEI�'\ OF FILE NUMBER 21 13-0234
STORBEC0RRI]A,','ht HARD J COUNTY CUMBERLAND
ACN 101
2830 �IIF�tDR;,"' 7'', APPEAL DATE: 10-09-2015
CAMP HILL P A 17011-1631 (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
REV 1547 EX AFP (11-14) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: STORBECK DOROTHY EFILE NO. :21 13-0234 ACN: 101 DATE: ,08-10-2015
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) (2) .00 credit to your account,
3. Closely Held Stock/Partnership Interest (Schedule C) (3) 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) 4,377.76
6. Jointly Owned Property CSchedule F) (6) .0 0
7. Transfers (Schedule G) (7) .00
8. Total Assets (8) 4,377.76
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 1 ,555.93
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 2,821 .83
11. Total Deductions (11) 4,377.76
12. Net Value of Tax Return C12) .00
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) 00
14. Net Value of Estate Subject to Tax (14) 00
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) - r)n 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 (+)
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.