HomeMy WebLinkAbout05-20-05
BUREAU OF INDIVI~fAil~s'
INHERITANCE TAX DIVISI~~ ~
PO BOX 280601
HARRISBURG PA 17128-0601'
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
DF DEDUCTIONS AND ASSESSHENT DF TAX
ZOGS ~lAY 20 Pi'112: 39
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
05-23-2005
MOVER
12-30-1998
21 05-0241
CUMBERLAND
101
AltOUnt R..ltiad
CLERr\ OF
ORPHIWS COURT
KEITH JC~J!\lWUSE' ", 'f)
816 CENTER ST
ASHLAND PA 17921
*'
REY-1547 EX AFP (03-05)
KEITH
R
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
lt~r-"M.r:"Yf.m.'l"ft!'ll!'.'lMm!I!.'W.!wtAWIM.T.m.lWltlTftMMr~.'lrCtWIM.T.lITr.............. ...
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF MOVER KEITH R FILE NO. 21 05-0241 ACN 101 DATE 05-23-2005
TAX RETURN WAS: I X I ACCEPTED AS FILED
CHANGED
I~ an assess.ent was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
r~lect ~igures that include the total o~ ALL returns assessed to date.
ASSESSMENT OF TAX:
IS. AMount of Line 14 at Spousal rat. (15)
16. '-aunt of Line 14 taxable at Lineal/Class A rat. (16)
17. AMount of line 14 at Sibling rat. (17)
18. Amount of Lin. 14 taxable at Coll.teral/Class Brat. (18J
19. Principal Tax Due
TAX CREDITS'
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule CJ
4. Mortgages/Notes Raceiv.ble (Schedule D)
S. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. .Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
III
121
131
141
151
161
171
20,055.60
.00
.00
.00
.00
.00
.00
181
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Ad.. Costs/Misc. Expenses (Schedule H) (9)
10. Debts/Hortgage Liabilities/Liens (Schedule I) (10)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governnental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Est.t. Subiect to Tex
.00
.00
1111
1121
1131
1141
NOTE:
20,055.60 X 00 =
.00 X 06 =
.00 X 00 =
.00 X 15 =
NOTE: To insure proper
credit to your accountl
sub.it the upper portion
of this for. with your
tax PlQllent.
20,055.60
00
20,055.60
.00
20,055.60
1191=
.00
.00
.00
.00
.00
.
"J AHOUNT PAID
DATE NUHBER INTEREST/PEN PAID I-I
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
~
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS THAN '1, NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YOU HAY 8E DUE
A REFUND. SEE REVERSE SIDE OF THIS FOHN FOR INSTRUCTIONS. I