HomeMy WebLinkAbout09-08-15 NOTICE OF INHERITANCE TAX pennsyLvarna
BUREAU OF INDIVIDUAL TAXES APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION OF DEDUCTIONS AND ASSESSMENT OF TAX _..__._v
PO BOX 280601 Rg(�(tf� �[) �FFICE OF REV-1547 EX AFP C11-14)
HARRISBURG PA 1 1 `��j��jji` _ [ !
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DATE 08-31-2015
nis s�() n� i'") L,� ESTATE OF SJOBERG MONICA
1J II DATE OF DEATH 08-08-2014
GLEr FILE NUMBER 21 14-0916
KOPECKIQQ;;`,'; JOHNNA� J COUNTY CUMBERLAND
ACN 101
120 T ,�T' `; APPEAL DATE: 10-30-2015
HARRISBURG PA 17101-1210 (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: SJOBERG MONICA FILE NO. :21 14-0916 ACN: 101 DATE: 08-31-2015
TAX RETURN WAS: C X) ACCEPTED AS FILED ( ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) Cl) 178,739.76 NOTE: To ensure proper
2. Stocks and Bonds (Schedule B) (2) .00 credit to your account,
S. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 submit the upper portionof this form with your
4. Mortgages/Notes Receivable (Schedule D) (4) 0 0 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) C5) 6,487.00
6. Jointly Owned Property (Schedule F) (6) .00
7. Transfers CSchedule G) (7) 19,492.76
8. Total Assets (8) 204,718.76
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 14,0 25.78
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 36,351.00
11. Total Deductions (11) 50,376.78
12. Net Value of Tax Return (12) 154,341 .98
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00
14. Net Value of Estate Subject to Tax (14) 154,341 .98
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) I r,4.141 -98, X 045 = 6,945.39
17. Amount of Line 14 at sibling rate (17) . 00 1 X 12 = .00
18. Amount of Line 14 taxable at collateral rate (18) .00 X 15 = .00
19. Principal Tax Due C19)= 6,945.39
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT C+)
AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
INTEREST IS CHARGED THROUGH 09-15-2015 TOTAL TAX PAYMENT .00
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 6,945.39
REVERSE SIDE OF THIS FORM INTEREST AND PEN. 74.04
TOTAL DUE 7,019.43
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. \1`lJ