HomeMy WebLinkAbout08-17-15 NOTICE OF INHERITANCE TAX pennsylvania
BUREAU OF INDIVIDUAL TAXES APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION OF DEDUCTIONS AND ASSESSMENT OF TAX --- - REV-1547 EX AFP (11-14)
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HARRISBURG601 PA 171Wdaa R D E D OFFICE 0F-REGISTER OF WILLS DATE 08-10-2015
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�� ESTATE OF KEENE CLYO E
U . n 12 %39 DATE OF DEATH 07-09-2014
FILE NUMBER 21 14-0726
CLE!t,� OF COUNTY CUMBERLAND
FLOWER ORPHAN,(�THOMAS_ E ACN 101
10 W�� rSTL4s1R
I-St 4 APPEAL DATE: 10-09-2015
CARL PA •17013-2922 (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
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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: KEENE CLYO EFILE NO. :21 14-0726 ACN: 101 DATE: 08-10-2015
TAX RETURN WAS: ( X) ACCEPTED AS FILED ( ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) Cl) 75,000.00 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) 16,219.37
6. Jointly Owned Property (Schedule F) (6) .00
7. Transfers (Schedule G) (7) .00
8. Total Assets (8) 91 ,219.37
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 42,464.78
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 919.61
11. Total Deductions (11) 43,384.39
12. Net Value of Tax Return (12) 47,834.98
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) 10 ,762.8 7
14. Net Value of Estate Subject to Tax (14) 37,072.11
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 1 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) n X 12 = .00
18. Amount of Line 14 taxable at collateral rate (18) 37,072. 11 X 15 = 5,560.82
19. Principal Tax Due (19)= 5,560.82
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+)
AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID C-)
INTEREST IS CHARGED THROUGH 08-25-2015 TOTAL TAX PAYMENT .00
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 5,560.82
REVERSE SIDE OF THIS FORM INTEREST AND PEN. 62.93
TOTAL DUE 5,623.75
* 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.