HomeMy WebLinkAbout05-28-80
'\V_483 (8-78)
C MMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
UREAU OF FIELD OPERATIONS
INHERITANCE TAX SECTION
"
\
...
OFFICIAL NOTICE OF DETERMINATION
AND ASSESSMENT OF PENNSYLVANIA
ESTATE TAX
TO:
DATE:
EST ATE OF:
FILE NO:
COUNTY OF:
DATE OF DEATH:
L-:- .J J -- "rtJ
./i/-/;~/l e, r//I,- v
. ;;L/- 7d?-yj",;-- /
~A'-?d Ii ,C'-A / ~_ ,/
r-,<'o,,-r /, 7cP
------ -- -- ---- ----- ---- ---- -- -,- ------ ----- ----- --------- -- --- - --- ---- -- - -- ---------- --- ---
$
~~"//A<<
. C!~:~
Determination prepared by: _::..- f.2J
Date: / ~ /-0 d
/
j. DETERMINATION:
Taxable estate based upon:
The United States Estate Tax Return (Form 706)
~ communication from the Federal Government
/ confirming the acceptance of or changes to the
Federal Estate Tax Return
Amount of credit for State death taxes (as verified)
Pennsylvania inheritance tax assessed
(excluding any discount and/or interest)
Normal inheritance tax paid to other States or
Territories of the United States (excluding
any di scount and/or interest)
Total inheritance tax credits (line item 3 plus line item 4)
Total liability for Pennsylvania estate tax (line item 2
minus line item 5)
1.
:?.
C)
.J.
1.
5.
I.
NOTE: Complete line items 7 and 8 ONLY when determination
is based on Federal Closing Letter
;:.
'-'.
Amount of Pennsylvania ist~~lax assessed on determination
dated ~ - J - 0(/
Addition (reduction) to Pennsylvania estate tax (line item 6
minus line item 7)
$
$
/q#~~
I ~
$ / ~ h '/'1 y,}.-
- c~,-
$
/0 t y y, Y;2-
$
c
$
,..
-- - ---- -- --- - ----- --- --------------- -- -- ----- ---- -- ---- --- - -- ----- ---- ---- -- -- ------- ------
B. ASSESSMENT:
.. Pennsylvania Estate Tax reflected on:
line item A (6)
line item A (8)
2. Less credits:
DATE OF PAYMENT
AMOUNT PAID
INTEREST
($ )
($ )
($ )
3. Balance of Pennsylvania estate tax due
Interest is due at the rate of six (6) percent per annum from
$
CREDIT
=
=
=
$
to the date of payment.
Assessment prepared by:
AGENT FOR THE COMMONWEAI..TH
Date:
SEE REVERSE SIDE FOR INSTRUCTIONS