HomeMy WebLinkAbout09-08-15 INHERITANCE TAX �`° Pennsylvania
BUREAU OF INDIVIDUAL TAXES RECORD ADJUSTMENT DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION REV-1593 EX AFP (12-14)
PO BOX 280601
HARRISBURG PA 17128-0601
RECORDED OFFICE Or' DATE 08-27-2015
REGIST ; t= Y"ILLS ESTATE OF FLESHER CLARICE E
DATE OF DEATH 11-03-2010
�� �� 2 ul FILE NUMBER 21 12-1033
COUNTY CUMBERLAND
r ACN 101
LYONS ATTOR JOHN " Amount Remitted
OSI F`
112 WALNUT STREET u ME`I
HARRISBURG P� 17101 MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
NOTE: To ensure proper credit to your account, submit the upper portion of this form with your tax payment.
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REV-1593 EX AFP (12-14) ** INHERITANCE TAX RECORD ADJUSTMENT **
ESTATE OF: FLESHER CLARICE E FILE NO. :21 12-1033 ACN: 101 DATE: 08-27-2015
ADJUSTMENT BASED ON: PROTEST BOARD DECISION
VALUE OF ESTATE:
1. Real Estate (Schedule A) (1) 138,987.50
2. Stocks and Bonds (Schedule B) (2) .00
3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00
4. Mortgages/Notes Receivable (Schedule D) (4) .00
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 1100 0.00
6. Jointly Owned Property (Schedule F) (6) .00
7. Transfers (Schedule G) C7) .00
8. Total Assets (8)
139,987.50
DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Administrative Costs/
Miscellaneous Expenses (Schedule H) (9) .00
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) .00
11. Total Deductions (11) .00
12. Net Value of Tax Return C12) 139,987.50
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts '(Schedule• J) (13) .0 0
14. Net Value of Estate Subject to Tax (14) 139,987.50
TAX:
15. Amount of Line 14 at Spousal rate C15) 00 X.00 = .00
16. Amount of Line 14 taxable at Lineal/Class A rate (16) 139,987.50x.045= 6,299.44
17. Amount of Line 14 at Sibling rate (17) .00x.12 = .00
18. Amount of Line 14 taxable at Collateral/Class B rate (18) 00 x.15 = .00
19. Principal Tax Due (19)
TAX CREDITS: 6,299.44
PAYMENT RECEIPT DISCOUNT (+)
DATE NUMBER INTEREST/PEN PAID C-) AMOUNT PAID
02-20-2014 CDO18786 .00 45.00
07-31-2015 CD021050 .00 5,729.05
INTEREST IS CHARGED THROUGH 09-11-2015* TOTAL TAX PAYMENT 5,774.05
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 525.39
REVERSE SIDE OF THIS FORM INTEREST AND PEN. 753.01
TOTAL DUE 1,278.40
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 OF THIS FORM FOR INSTRUCTIONS.