HomeMy WebLinkAbout09-29-15 COMMONWEALTH OF PENNSYLVANIA REV-1162 EX0 1-96)
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT.280601
HARRISBURG,PA 17128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
N0. CD 021303
SHAW ANDREW H
200 SOUTH SPRING GARDEN STREET
CARLISLE, PA 17013
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
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__________ --------
101 $29.08
ESTATE INFORMATION:
FILE NUMBER: 2114-0774
DECEDENT NAME: HADDEN MARJORIE H
DATE OF PAYMENT: 09/29/2015
POSTMARK DATE: 09/29/2015
COUNTY: CUMBERLAND
DATE OF DEATH: 08/07/2014
TOTAL AMOUNT PAID: $29.08
REMARKS: RECEIPT TO ATTY
CHECK# 2243
INITIALS: WZ
SEAL RECEIVED BY: LISA M. GRAYSON, ESQ.
REGISTER OF WILLS
REGISTER OF WILLS
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)
PO BOX 280601
HARRISBURG PA 17128-0601
DATE 09-15-2015
ESTATE OF HADDEN MARJORIE H
DATE OF DEATH 08-07-2014
FILE NUMBER 21 14-0774
COUNTY CUMBERLAND
SHAW ES'Q ANDREW H ACN 101
STE 11 APPEAL DATE: 11-14-2015
200 S S.PRING GARDEN S (See reverse side under Objections)
CARLISLE PA 17013-2578 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---- ----7--7-----------
-Ri-V---Ii-4i--Ei-i-F�-iil-lZ)-N5TIiE-Oi-iN�iRiTiNii-iAX APPRAISEMENT., ALLOWANCE OR.
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: HADDEN MARJORIE HFILE NO. :21 14-0774 ACN: 181 DATE: 09-15-2015
TAX RETURN WAS: CX) ACCEPTED AS FILED C CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1) 194,900.00 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 portion
of this form with your
4. Mortgages/Notes Receivable (Schedule D) (4) .00 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (S) 8,219.49
6. Jointly Owned Property (Schedule F) (6) 5,936.27
7. Transfers (Schedule G) (7) .00
B. Total Assets (8) 209,055.76
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 23,068.13
10. Debts/Mortgage Liabilities/L'iens (Schedule 1) (10) 97,077.93
11. Total Deductions (11) 120,146.06
12. Net Value of Tax Return (12) 88,909.70
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00
14. Net Value of Estate Subject to Tax C14) 88,909.70
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 .00 X 00 = .1)0
16. Amount of Line 14 taxable at lineal rate C16) RA.9n9.7n x 045 = 4,000.94
17. Amount of Line 14 at sibling rate (17) on , X 12 = .00
18. Amount of Line 14 taxable at collateral rate (18) .00 X 15 = .00
19. Principal Tax Due C19)= 4,000.94
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID C-)
11-05-2014 CD019879 189.47 3,600.00
05-06-2015 CD020630 .00 182.73
INTEREST IS CHARGED THROUGH 09-30-2015 TOTAL TAX PAYMENT 3,972.20
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 28.74
REVERSE SIDE OF THIS FORM INTEREST AND PEN. .34
TOTAL DUE 29.08
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.