HomeMy WebLinkAbout01-31-06
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
KARPOVICH ANN M
1 33 ROOSEVELT DRIVE
MAHONOY CITY, PA 17948
n_nn_ fold
ESTATE INFORMATION: SSN: 174-20-7495
FILE NUMBER: 2105-0523
DECEDENT NAME: FLURIE JESSE L
DA TE OF PAYMENT: 01/31/2006
POSTMARK DATE: 01/30/2006
COUNTY: CUMBERLAND
DATE OF DEATH: 06/07/2005
NO. CD 006256
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $319.33
I
I
I
I
,
I
I
I
TOTAL AMOUNT PAID:
REMARKS:
ANN KARPOVICH
CHECK# 31
SEAL
INITIALS: RSK
RECEIVED BY:
REGISTER OF WILLS
$319.33
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
01-24-2006
FLURIE
06-07-2005
21 05-0523
CUMBERLAND
101
APPEAL DATE: 03-25-2006
( See reverse side under Objections)
Amount Remitted I 3/1.33 I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE~ PA 17013
CUT ALONG THIS LINE --. RETAIN LOWER PORTION FOR YOUR RECORDS +-
-------------------------------------------------------------------------------------------
REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
JESSE. L FILE NO. 21 05-0523 ACN 101 DATE 01-24-2006
TAX RETURN WAS: ( ) ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEHENT~ ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
CHARLES F CHENOT III ESQ
PO BOX 250
NEW BLOOMFIElD
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
PA 17068
ESTATE OF
FLURIE
REV-1547 EX AFP (06-05)
JESSE
L
I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
re~lect Tigures that include the total o~ ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate (15)
16. Amount of Line 14 taxable at Lineal/Class A rate (16)
17. Amount of Line 14 at Sibling rate (17)
18. Amount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
TAX CREDITS:
rAY"!:1'I1 "........., . T+J AHOUNT PAID
DATE NUHBER INTEREST/PEN PAID (-)
09-02-2005 CD005766 1~736.84 33~000.00
11-09-2005 CD005988 .00 723.46
PAYMENT MUST BE MADE BY 03-07-2006~. TOTAL TAX CREDIT 35~460.30
BALANCE OF TAX DUE 319.33
INTEREST AND PEN. .00
TOTAL DUE 319.33
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED O~: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Hald Stock/Partnership Interest (Schedule C)
4. Hortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
(1)
(2)
(3)
(4)
(5)
(6)
(7)
.00
311.929.42
.00
.00
17.941.37
.00
107~900.52
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Hisc. Expenses (Schedule H)
10. Debts/Hortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
(10)
31~177.37
8.768.75
(11)
(12)
(13)
(14)
NOTE:
.00
144~962.34
107~900.52
108~721.75
X 00 =
X 045 =
X 12 =
X 15 =
(19)=
· IF PAID AFTER DATE INDICATED~ SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
NOTE: To insure proper
credit to your account~
submit the upper portion
of this form with your
tax payment.
437~771.31
39.946 1')
397~825.19
36~240.58
361~584.61
.00
6~523.31
12~948.06
16~308.26
35~779.63
IF TOTAL DUE IS LESS THAN $l~ NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR)~ YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
r~~----~-
...:.
", I
C'
{.~t.
(,.I
.....
J',i
I;')
C)
(..,.
-......
-.....
-.....
=.--.;::
-.
-..
-'
-..
-'
::.:::
-....
-....
...
:;;.::
-.....
~r:>.~
'. ~~
~.F~ ~
~ C)
'- ~
~~
~ ;.:..
o
~~~
~~~
~~~,
...~.:
~')'~~
~~~:
..........
~
~. ~.
,~
)
~I!
"
.W J:
o ~
w ;1J
)::. 7J
~ "'01
h (f) '"
t'..,) rn
o C
c ;;0
Vi ,G1
,,::2 "
.s. P
(;, ~.
....i
~ ~
f