HomeMy WebLinkAbout03-11-80
REV-483 (8-78)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF FIE LD OPE RA TIONS
INHERITANCE TAX SECTION
OFFICIAL NOTICE OF DETERMINATION
AND ASSESSMENT OF PENNSYLVANIA
ESTATE TAX
TO:
~~;:~E OF: /YJ!,~- ~~ -~ez--
~~EN~~'OF' '^zJ~
DATE OF DEATH: ____
-----------------------------------------------------------------------------------------
A. DETERMINATION:
1. Taxable estate based upon:
~The United States Estate Tax Return (Form 706)
The communication from the Federal Government
confirming the acceptance of or changes to the
Federal Estate Tax Return
2. Amount of credit for State death taxes (as verified)
3. Pennsylvania inheritance tax assessed
(excluding any discount and/or interest)
4. Normal inheritance tax paid to other States or
Territories of the United States (excluding
any di scount and! or interest)
5. Total inheritance tax credits (line item 3 plus line item 4)
6. Total liability for Pennsylvania estate tax (line item 2
minus line item 5)
$ SZ9C:.'l. 91
$ -6-
$ ~9st7,~-
$ ---, CJ -
$ J.9r/7,9C
$ -0-
NOTE: Complete line items 7 and 8 ONLY when determination
is based on Federal Closing Letter
7.
Amount of Pennsylvania estate tax assessed on determination
dated
Addition (reduction) to Pennsylvania estate tax (line item 6
minus line item 7)
$
8.
Determination prepared by:
Date:
B. ASSESSMENT:
1. Pennsylvania Estate Tax reflected on:
line item A (6)
line item A (8)
2. Less credits:
DATE OF PAYMENT AMOUNT PAID
$
INT EREST
($ )
($ )
($ )
CREDIT
=
=
=
$
3. Balance of Pennsylvania estate tax due
Interest is due at the rate of six (6) percent per annum from
ta the date of payment.
Assessment prepared by:
AGENT FOR THE COMMONWEAL TH
Date:
SEE REVERSE SIDE FOR INSTRUCTIONS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF EXAMINATION
OFFICIAL NOTICE OF
INHERITANCE TAX
ASSESSMENT
COUNTY FILE NO:
- n ,\ ' .I I, "")
TO: 6~J0f'-t) .,.J"'- ~,) -t /U::~"rn (j~ M.
(/,> Vy,(kok \!- \,J , )~l~ . CJtf
Ilr r.f-'- fJ-' t
C'- '\__\/"-("'" (4 ,-<', ll'Q l.
;' ~ ,i ~
/. II " , ("
/~-h,/UC) -)'<'/''1 ,~J,\:--v.:.. \ \ (' I '-J d -5 '7
Appraised Value' f E tate:
Real Estate
.-J, ) ,- r) ;;..
<--"\ ( ,'t-
If '-'71-
DATE
:--"111 CVL Lt- I (,i ,YO
f /,
ESTATE-"\'(l(l/\ 'l'o.~' r ':~/II2Y/Vy:tI.r.,_
~ I - "..
-- I 'J r ~ (', ~
~L:(
DATE OF DEATH C~ q 197rf'
FILE NO.
COUNTY
Personal Property
S
+ 5'1. '-III Sf:5'
'--
Jointly Held Property /Transfers
+
Total Gross Estate
s 59' LfJI_ ~5
"
- I 0 , 0d,), tD
,
Total Approved Deductions
Clear Value of Estate
s I./-f;:, ? () o. r;:;
-_..
Less: Approved Charitable Exemptions
Amount Taxable @ 6% Rate
slfl( ?~j().
1/-4 c l-,.r
S ,71(3, /::::>
95
Clear Value of Estate Subject to Tax
tax due
s
aq c) ? (/-5'
Amount Taxable @ 15% Rate
tax due
* * * * * *
,; J TOTAL PENNSYLVANIA1;;INHERITANCE TAX DUE
I, . j/\ fa' h(; l-o."C.u
"IV (\ ,-O~ (. -,< - I ~' ~I ..,-
A five' percent d'isc u~ totaling S
Inheritance Tax is paid by
s ~ 9 ~? Lic5 dl.
I ) 7 / () v...,w..
-- ---
30 V~,. 5..S
will be granted if the
Less Credits:
DATE OF PAYMENT
AMOUNT PAID
DISCOUNT
INTEREST
TAX CREDIT
/ - 6,,,,- [ u
$ 3 0 'I y.,. t;~5 + $
s
= $..~6L/4 (;;'5
+
=
+
=
Interest accrues at the rate of six (6) percent per annum
on the unpaid balance of InheritanCI! Tax from
to date of payment. Interest due if paid by
is
r;.--' I, ' li
$ \r;1', l\%.. ~-AJ "
BALANCE OF PENNSYLVANIA INHERITANCE TAX OlJ,E
"
'-
Assessed by:
S~ '""'roM;"" ~ R__ Sid_ u:'\w1::: .~~~~ ,I, ~) Jb I
,''l~ \\ ~
-