HomeMy WebLinkAbout06-19-79
RCC-84
(8-77)
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.- 4
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION
OFFICIAL NOTICE OF
INHERITANCE TAX
ASSESSMENT
TO:
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DATE
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ESTATE OF/-It, -' /
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FILE NO.
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COUNTY OF (',
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For County Information purposes only
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COUNTY FILE NO: J'
DATE OF DEATH
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-------------------------------- -- -- -_._- -- -- ---- - ----- ---- -- - -- - -- - - --
Appraised Value of Estate:
Real Estate
Personal Property
Jointly Held Property/Transfers
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$
j.Z:,7" /1':_
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Total Gross Estate
$
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Total Approved Deductions
i /f (/f
Clear Value of Estate
$
JI/i/llf
,
Less: Approved Charitable Exemptions
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Clear Value of Estate Subject to Tax
$
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Amount Taxable @ 6% Rate
$
tax due
$
Amount Taxable @ 15% Rate
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tax due
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TOTAL PENNSYLVANIA INHERITANCE TAX DUE
$
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Less Credits:
DATE OF PAYMENT
AMOUNT PAID
DISCOUNT
INTEREST
TAX CREDIT
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$ ,j / l, ( (
+ $~;': ( "~, -
$
=
$ /i ,,:/, I. ..'
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=
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BALANCE OF PENNSYLVANIA INHERITANCE TAX DUE
$
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Interest will accrue at the
Inheritance tax from
rate of six (6) percent per annum on the unpaid balance of
to the date of payment.
Assessed by:
Agent for the Commonwealth
SEE REVERSE SIDE FOR INSTRUCTIONS
REGISTER OF WILL'S COPY
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RCC- 3 (1-691
APPLICATION FOR CHARITABLE EXEMPTION
FROM PENNSYLVtNIA T~ANSFER INHERITANCE TAX
. r.....
(Act of May 28, 1956, P.L. 1757, and Act of June 15, 1961,
P.L. 373, as amended)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
Application is hereby filed for the approval
of on exemption from Pennsylvania Transfer
Inheritance Tax on the transfer of the property
described below:
1- Bureau File # n Ht 557
2. Date of Death Oetober 10 1919
3. Date of Approva I ~--,_.
4. Nome of Decedent
5. The Commonwealth's appraised value of the property for which on exemption is claimed is $ 15 814.16
(Note: Where the property is other than a specified amount of cash, the exemption cannot be approved unti I the value of
the property has been established by appraisal by the Commonwealth, except in those cases where the amount of the gift
or bequest represents a stated fractional or percentage portion of the entire estate or the entire residue. In those cases
enter such fractional or percenta~ amount above).
Ji'lot"flllCe V. S.l1'>
6. Check the manner in which the transfer was effected and submit a copy of the document authorizing the transfer, unless
such material has been previously filed.
WILL 0;
DEED 0;
TRUST INDENTURE V;
SURVIVORSHIP 0;
OTHER 0;
(If other, explain)
7. Correct Business Name and Address.,2f Charitable Orga'li zg,tion reco.eivinll prqpert.Y: 'IOL.... U..... .._..I ~",'et\...^d:t..t.
The llenG'ft)lent !l0l!lt$ J"Uftd of Central. t'ennaYLvaau t;e'Rf'e-t"ePCe. .\.U~ u..<io_ _ U... ..
NAME Church J.t~JUlY Vf.ll.age
ADDRESS
325 We.lev Drive. Neehanteabun l"onn.,'lvan14 I1n55
8. I certify that the information contained herein is, to the best of my knowledge and belief, true and correct.
CQ'fi:' B~ R. A. ~;xec\ator of E.~at. of P'loraecG V.
3y c;d1ir.lJ (% /'}djf/~-I5h)
Poet Office Box 30$
Self)
Signature of Appl icant
Address of Applicant
Official Title
Truae Of fleer
Date
,,1m..", 1 1'79
/
This form must be completed in triplicate and all three copies delivered to the Register of Wills for the County in which the decedent
resided, or in which letters were issued for a non-resident decedent's estate. If the decedent was a nan-resident of Pennsylvania and
letters were not issued by a Pennsylvania Register of Wi lis, deliver all three copies to the Director, Bureau of County Collections,
Penna. Department of Revenue, 26 S. 4th Street, Harrisburg, Pa.
Do not write below this line - For Official Use Only
Approved: F,or the secretar~ of Revenue Referred to Bureau Headquarters
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(Signature of Register of Wills) (Initials of Register of Wills)
Approved 0
For Secretory of Revenue
Denied* 0
(Authorized Signature)
(County)
Rfi:;:i~~L'; c;.;" 'If
C~;~'l;S':':~':J',;J (J, : Y
(County)
(Title)
(Date of Approval)
(Date of Referral)
(Date of Action)
* See reverse side for reasons
U-(S-'71
MUST BE FILED IN TRIPLlCA TE
This section will be compl eted by Bureau Headquarters only when the application for exemption has been de~!..~:"
Date:
The application for exemption contained on the face of this form has been denied because
Note: Any party in interest, including the Commonwealth, aggrieved by this action may within sixty (60) days after
the date of this notice exercise their rights of Protest, Notice, or Appeal in accordance with the provisions of applicable
Pennsylvania Inheritance and Estate Tax Acts.
Trinity 'i.fnit..d:'1etho~1st Church
'Fourth $. 'e'l1{IRft Sn:..ts
New Cumberland Petln.ylvafti8 1101f,