HomeMy WebLinkAbout09-14-15 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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REG I s� -,, ' F V!ILLS DATE 09-07-2015
n r-,m Ili '312 ESTATE OF WERTZ SR JAMES R
DATE OF DEATH 04-07-2014
FILE NUMBER 21 14-0476
C LC COUNTY CUMBERLAND
o iWES SAMUEL L ACN 101
,N .12TH ST APPEAL DATE: 11-06-2015
C0 E PA 17043-1245 (See reverse side under Objections)
Amount Remitted-
MAKE
emitted IMAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE 1� RETAIN LOWER PORTION FOR YOUR RECORDS +-
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DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: WERTZ SR JAMES RFILE NO. :21 14-0476 ACN: 101 DATE: 09-07-2015
TAX RETURN WAS: C X) ACCEPTED AS FILED CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate CSchedule A) (1) 63,000.00 NOTE: To ensure proper
2. Stocks and Bonds (Schedule B) (2) .00 credit to your account,
00 submit the upper portion
3. Closely Held Stock/Partnership Interest (Schedule C) (3) .
of this form with your
4. Mortgages/Notes Receivable (Schedule D) (4) .00 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 986.82
6. Jointly Owned Property CSchedule F) (6) 7,233.29
7. Transfers (Schedule G) (7) .00
8. Total Assets 71,220.11
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 9,165.5 3
10. Debts/Mortgage Liabilities/Liens (Schedule 1) (10) 16,843. 12
11. Total Deductions (11) 26,008.65
12. Net Value of Tax Return (12) 45,211.46
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00
14. Net Value of Estate Subject to Tax (14) 45,211.46
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) 45,211 -46 x 045 = 2,034.52
17. Amount of Line 14 at sibling rate (17) .00 'x 12 = .00
18. Amount of Line 14 taxable at collateral rate (18) .00 X 15 = .00
19. Principal Tax Due (19)= 2,034.52
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID
06-02-2014 CDO19235 101 .73 31000.00
TOTAL TAX PAYMENT 3,101.73
BALANCE OF TAX DUE 1,067.21CR
INTEREST AND PEN. .00
TOTAL DUE 1 ,067.21CR
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.