HomeMy WebLinkAbout03-20-80
REV.483 (8-78)
COMMONWEALTH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
INHERITANCE TAX SECTION
OFFICIAL NOTICE OF DETERMINATION
AND ASSESSMENT OF PENNSYLVANIA
ESTATE TAX
TO:
DATE:
ESTATE OF:
FILE NO:
COUNTY OF:
DATE OF DEAlll:
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A. DETERMINATION:
1. Taxable estate based upon:
The United States Estate Tax Return (Form 706)
~I,e communication from the Federal Government
confinning the acceptance of or changes to the
Federal Estate Tax Return
2. Amount of credit far State death taxes (as verified)
3. Pennsylvania inheritance tax assessed
(excluding any discount and/or interest)
4. Nonna) inheritance tax paid to other States or
Territories of the United States (excluding
any discount and/or interest)
5. Total inheritance tax credits (line item 3 plus line item 4)
6. Total liability for Pennsylvania estate tox (line item 2
minus line item 5)
$ /</7;).3:1. Y7
$ :3 77. K 7
$ /t~;l6/.3/
$ - .::--
$ I.? ;2b/3 J
$ _r..>-
NOTE: Complete line items 7 and 8 ONL Y when determination
is based on Federal Closing Letter
7.
A.mount of Pennsylvania estate tax assessed on determination
dated /0 - 3/-79
Addition (reduction) to Pennsylvania estate tax (line item 6
minus line item 7)
$
CJ
8.
Detennination prepared by:
Date:
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B. ASSESSMENT:
1. Pennsylvania Estate Tax reflected on:
I ine item A (6)
line item A (8) $
2. Less credits:
DATE OF PAYMENT
AMOUNT PAID
INTEREST
($ )
($ )
($ )
CREDIT
=
=
=
3. Balance of Pennsylvania estate tax due
$
Interest is due at the rate of six (6) percent per annum from
to the date of payment.
A.ssessment prepared by:
AGENT FOR THE COMMONWEAL TH
Date:
SEE REVERSE SIDE FOR INSTRUCTIONS