HomeMy WebLinkAbout09-29-15 COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE REV-1162 EX�11-96)
BUREAU OF INDIVIDUAL TAXES
DEPT.280601
HARRISBURG,PA 1712g-O607
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 021308
SOBOLEWSKI WILLIAM GRANT
186 LONGSTREET DR
GETTYSBURG, PA 17325
ACN
ASSESSMENT AMOUNT
CONTROL
'--'---- fold N U M B E R
_____""' '___"__
101 � 581 .11
ESTATE INFORMATION: sstv: 4oi-32-67s� I
FILE NUMBER: 2114-0792 I
DECEDENT NAME: SOBOLEWSKI ELOISE D I
DATE OF PAYMENT: 09/30/201 5 I
POSTMARK DATE: 09/29/2015 I
couNTY: CUMBERLAND I
DATE OF DEATH: 08/01/201 4 I
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TOTAL AMOUNT PAID: 581 .1 1
REMARKS:
CHECK# 256
INITIALS: HMW
SEAL RECEIVED BY: LISA M. GRAYSON, ESQ.
REGISTER OF WILLS
REGISTER OF WILLS
�EP 2 f 2015
AAPRATSEM�NTE ALLOWANCETORCDISAlLQWANCE ' �� pennSY�Van�a
BUREAW QF INDIYIDUAL TAXES p� DgbUCTTONS AND i1SSESSMENT OF TAX
IMHERITANC� TAX DIVISION DEPAR7MENT OF REVEPtUE
AO a0X 280601
' HARRIS811R6 PA 17226-0601 REV-1547 EX pFp (11-14)
DATE 09-15-2015
ESTATE OF SpBOLEWSKI ELOISE D
DATE OF' DEATH D8-01-2014
FILE NUMBER 21 I4-0792
SAIDIS ROBERT C COUNTY CUMBERLAND ;_,,,
26 W HIGN ST ACN Tpl c7 ;._,' ;,�
CARLISLE ApPEAL DATE: �_�_20�5�'�' ��r� r�rt
PA 17013-2922 (Seereversesideunde���eetions)�� � ��
, Amouht Fte�itted , . . y ='�
� T4AKE CHECK PAYABLE AND R�MIT'PA �
REGISTER OF WILLS Y1�NT TQi;
I COUR7HOEJSE SQUARE '
. --t,
, CARLISLE PA 1701$ .=:� �
' CUT AL.ONG THIS LINE r :>
= --------___,._.__ �i RETAIN LUWER PORTTON FOR YOUR RECORDS f-• -�' t:s
� REY-I5Ce7 EX AFP C11-147 N�TICE OF�IFtkE�2ITANCF�TqX APPRAISEMENTr ALL04lANCE UR r�T�� ��T���"�
DiSALLOWANCE UF DE"DUiTgdN'S ANi7 ASSESSMENT OF TAX � ���
ESTATE OF: SOBOLEWSKI ELOISE DFILE NO. :
21 14-0792 ACN: 101 DA7Es 04-15-2015
TAX RE7URN WAS: C ) ACCEPTED AS F3LED ( X) CHANGED SEE ATTACHED NOTICE
APPR;4ISED VALUE DF RETURN $ASED ON: DRIGINAI. RETURN
1. Real Estate CSchsduls A)
2. Stocks and Bonds CSchedule B) «� 180 i 000.00 NOTE: To ensure
Proper
3. Closely Held 5tock/Partnership interest (Schedule C) C2� •�0 credit to your account,
C3) ,fl 0 submit the upper portio�
4. Mortgages/Notes Receivable CSchedule D) of this Porm with your
[4) .00 tax payment.
6. Cash/Dank Deposits/MAsc, Persohal Property CSchedule E) (5) 3,7 31..00
d, ,ioirtily OWned Aroperty CScheduie F) ,��
' CJ)
, 7. Transfers [Schedule 6) X2,904.61
tl. Total Assets
C7)
APPROVED DEDUCTIDNS AND EXEMPTIONS: C8� — 196.b35 62
9. Funaral Expenses/Adm. Costs/Misc. Expensas CScAedule H) �g� ] 7 0 �
10. Debts/Mortgage Liabi23ties/Liens CSchedule I)
, cio) 4.749 87
11. Tota�. Deduct�ons
12. NoY Value of Tax Return �11) 22,460.18
; 13, Charitable/Governn�ental Bequests; Non-elected 9113 Trusts CSchedule Jl C12� �74�175.4 3
14. Net Valus of Estate Subject to Tax �13) 00
ci4� 174,7.75.43
ti�rE: If an assessment was issued pheviousJ.y, Lines 14, 15, 16, 17, 18 andlor 19 will
refl,ect f�igures that include the total of all refiurns 8ssessed to date.
ASSESSMENT OF TAXs
: 15. Amount of Line 14 at spousal rate (lg� .00 -
16. Amount of Line 14 taxabYe at lineal rate X 00 - ��
cis�- ��4.t 75 �3 X 045 = 7,837.89
, 17. Amourlt� of Line 14 at sibling rats
(17� _ .�0 X 12 - .00
18. Amount of Line 14 taxable at eollateral rate
C18� .00 X 15 .00
Z9. Principal 7ax Due , -
7AX CREDI7S: C9�` 7,837.89
PAYMENT RECEIPT AISCOUN7 (+)
DATE NUMBER INTERES7/PEN PAID (-) AMOUNT PAID i
04-28-2Q15 CD02Q582 .00 .
7,757.78 �
INTER�ST IS CHARGED THROUGH 09-30-2015 TOTAL TAX PAYMEMT '
AT THE RATES APPLICABLE AS OUTLINED ON 7HE BALANCE OF TAX DUE 7'757.78 �
80. LI '
REVERSE SIDE OF THIS FORM �
INTEREST AND PEN. 1.00 I
TOTAL DUE 81.11 �
� IF PAIU AFTER llq7E INDICATEb, SEE REYERSE IF T4TA1. DUE IS REFLEC7ED AS A CREDIT CCR), YOtI MAY BE DUE �
FOR CALCULATION OF ADDITIONAL LNTEREST. A REFUND. SEE REVERSE SIDE FOR INS7RUC7'IONS,
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•ia�u�c�ot-�o�
P pennsytvania lNHERITANCE TAX
DEPARTMENT OF REVENUE EXPI..ANATI�N
BUREAU OF JNDIVIDUAL TAXES OF CHANGES
PO Box 280801
R IS g �
DEGEpENT'S NAME
Eloise Sobolewski FILE NUM$ER
REVIEWED BY '
2114-a�s2
Tracell Agent#93 ACN
. . 101
ITEM
SCMEDULE �Q, EXPLANATION OF CHANGES
F Atl Tho value af fhe accounts have been reduced to zero as they were previously assessed,
accepted and paid under various ACN's.
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ORIGINAL P8g8 1