HomeMy WebLinkAbout01-25-06
COMMONWEALTH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1 162 EX(1 1-961
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
SEIBERT JEAN D ESQUIRE
109 LOCUST STREET
HARRISBURG, PA 17101
___h___ fold
ESTATE INFORMATION: SSN: 172-01-9525
FILE NUMBER: 2105-0126
DECEDENT NAME: BLACK ALICE W
DATE OF PAYMENT: 01/25/2006
POSTMARK DATE: 01/24/2006
COUNTY: CUMBERLAND
DATE OF DEATH: 01/28/2005
NO. CD 006240
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $1,317.96
I
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I
TOTAL AMOUNT PAID:
REMARKS:
WION, ZULLI & SEIBERT
CHECK# 1025 / 7394
SEAL
INITIALS: RSK
RECEIVED BY:
REGISTER OF WILLS
$1,317.96
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
12-12-2D05
BLACK
01-Z8-2005
21 05-0126
CUMBERLAND
101
APPEAL DATE: 02-10-2006
(Se~ rtn'ertle side under Objections)
Amourrt Remi't'ted[ ~''317. ~/r; I
MAKE CHECK PAYABLE AND REM T PAYMENT TO;
REGISTER OF WILLS
CUMBERLAND CD COURT HOUSE
CARLISLE~ PA 17013
~Y!_~~9~~_!~~~_~1~i____~_~___~~!~I~_~~~~!_~g~!!~~_EQ~_~Qy~~!!g~~p~__~____________________
REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRA%SEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF BLACK ALICE W FILE NO. 21 05-01Z6 ACN 101 DATE 12-12-2005
"fAX RETURN WAS: ( ) ACCEPTED AS FlLED ( Xl CHANGED SEE ATTACHED NOTICE
BUREAU OF INDIVIDUAL TAXES
INHERITAMCE TAX DIVISION
PO BOX Zl10601
HARRISBURG I'A l1UII-06U1
COMMONW~LTH OF PENNSYLVAN%A
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAIseMENT~ ALLOWANCE OR OISAlLOWAMCE
RECCGC<:!5" ~~~ AND AsseSSMENT Of TAX
: ~~.':,':;lr:~."'-~~>;, :".\.-' .,.\l:!.. :..':':
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
2Q~5 [.~' C - 9
Fi'i 3: 09
JEAN D SEIBERT
WION ETAl
109 LOCUST 5T
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PA 17101
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REV-1547 E~ AFP (06-05)
ALICE
W
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Ada. Coats/Misc. Ex~nsas (S~dule H) (,)
10. Oebb/MoJ'igage Lbbil1U.s/liens (Schedule 1) {to) 1,697 .L31
11. Total Daduc~lo"s (11)
12. Ne1: V~lue of Tex Ratul'1\ (2)
13. Charit.blI!1/Gove~n.ental Bequasts; Non-elected 9113 Trusts (Sehedule J) (1~).
14. Net Valu. of Estate Subject tD Tax Clct}
NOTE; I~ an assessment was issued previous1y_ 1ines 14, 15 and/or 16, 17, 18 and
r~1ect ~igures tha~ 1nc1uae the total D~ AL~ returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate (lS)
16. AmoUnt Df Line l~ taxeble at Lln..l/Cless A rate (16)
17. Aaount of Line 14 .t Sibling rate (17)
18. Amount of line 14 ~.xab1e at Collateral/Class 8 rate (18)
19. Prin~ipal Tax Due
D S.
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Raa1 Est.te (Schedule A)
2. Stocks ~ Bonds (Sc:heclule IU
3. Clos.l~ Held stock/P.rtne~ship Int.rest (Schedul. C)
4. nortgagaslNotes Receivable (Schedule OJ
5. Cash/Bank Deposits/Misc. Personal PrDpe~ty (Schedule E)
6. Jointly Owned PrDPerty ($chedula F)
7. Trans~Brs (Schedule G)
8. Total Assets
(1)
(Z)
(3)
(4J
Oil
(6)~
(7)
,DO
147.15Z.~
.00
.00
112 . 437 .33
.00
84,633.72
(8)
21.731. 75
.00 X
.00 X
.00 )(
297.382.72 X
AI'IOUNT PAID
40,500.00
675.78
DATE NUMBER
04-ZZ-2005 CDOOSZ41
07-21-2005 ~\ CDOOS607
INTEREST/PEN PAID (-)
2~131.58
.00
INTEREST IS CHAR6ED THROUGH 12-27-2005
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
· IF PAID AFtER DATE INDICATED, SEE ftEVERSE
FOR CALCUlATION OF ADDITIONAL INTEREST.
NOTE: To insure proper
credit to your account~
submit the upper porUon
of this form with Your
t.x paynant.
344.ZZ3.89
2:3.429 0';
320.794.83
23~412.11
297,382.72
19 will
00 0:;
045 _
12 ~
15 '"
(19)'"
.00
.00
.00
44.607.41
44,607.41
43,307.36
1,300.05
10.69
1,310.74
pJ.
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLEctED AS A "CREDIr' (CR). YOU KAY BE DUE
A REFUND. seE REVERSE Sloe OF THIS FORM FOR INSTRUCTIONS,)
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