HomeMy WebLinkAbout06-19-06
06-12-2006
JACOBSEN
07-28-2005
21 05-0702
CUMBERLAND
101
APPEAL DATE: o8-11-2oo6
( See reverse side under Objections)
Amount Remitted I 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-(03-05l NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
, DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF JACOBSEN CLARENCE FILE NO. 21 05-0702 ACN 101
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
ANDREA C JACOBSEN
355 E BALTIMORE ST
C~ISLE PA 17013
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
I"
("
,"
REV-1547 EX AFP (06-05)
CLARENCE
TAX RETURN WAS: [X) ACCEPTED AS FILED
CHANGED
DATE 06-12-2006
NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect figures that include the total of 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.
.00 X 00 = .00
225,065.55 X 045 = 10,127.95
.00 X 12 = .00
.00 X 15 = .00
(19)= 10,127.95
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate [Schedule A)
2. Stocks and Bonds [Schedule B)
3. Closely Held Stock/Partnership Interest [Schedule C)
4. Mortgages/Notes Receivable [Schedule D)
5. Cash/Bank Deposits/Misc. Personal Property [Schedule E)
6. Jointly Owned Property [Schedule F)
7. Transfers [Schedule G)
8. Total Assets
(1)
(2)
(3)
(4)
(5)
(6)
(7)
105,000.00
.00
.00
.00
132.095.77
2,261.57
.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses [Schedule H)
10. Debts/Mortgage 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)
12,526.94
1.764.85
(11)
(12)
(13)
(14)
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
239,357.34
14.291 79
225,065.55
.00
225,065.55
.
/ NUMBER l+J AMOUNT PAID
DATE INTEREST/PEN PAID [-)
10-25-2005 V CDo05932 495.00 9,405.00
04-28-2006 CDo0662o .00 227.95
TOTAL TAX CREDIT 10,127.95
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
[ IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. {lJ
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DU
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.),