HomeMy WebLinkAbout07-03-06
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
SHIELDS CHARLES EDWARD III ESQ
SIX CLOUSER ROAD
MECHANICSBURG, PA 17013
un__n fold
ESTATE INFORMATION: SSN: 002-03-8280
FILE NUMBER: 2105-0640
DECEDENT NAME: LAVERTUE ERNESTINE A
DA TE OF PAYMENT: 07/03/2006
POSTMARK DATE: 06/30/2006
COUNTY: CUMBERLAND
DATE OF DEATH: 06/12/2005
NO. CD 006914
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $86,93
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$86.93
REMARKS: DAVID & RICHARD LA VERTUE
CHECK#122
SEAL
INITIALS: WZ
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
06-19-2006
LAVERTUE
06-12-2005
21 05-0640
CUMBERLAND
101
APPEAL DATE: 08-18-2006
( 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
9Yr_~~p~~_r~~~_~~~~------~---~~!~!~-~Q~~~-~Q~!!Q~-~Q~-YQY~_~~9Q~P~__~____________________
REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ERNESTINE A FILE NO. 21 05-0640 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
....cr'.^,'-;.-QY', J)'EIJ(jq~oNS AND ASSESSMENT OF TAX
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DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
CHARLES E SHIELDS II I ,y~
6 CLOUSER RD
MECHANICSBURG
PA 17055
ESTATE OF
LAVERTUE
REV-1547 EX AFP (06-05)
ERNESTINE A
TAX RETURN WAS: (X) ACCEPTED AS FILED
CHANGED
DATE 06-19-2006
NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
re~lec~ 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
201,220.01 X 045 " 9,054.90
.00 X 12 " .00
.00 X 15 " .00
(19)" 9,054.90
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)
190,000.00
6,335.00
.00
.00
28.334.23
.00
.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)
21,142.11
2.307.11
(11)
(12)
(13)
(14)
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
224,669.23
23.449 22
201, 220.01
.00
201,220.01
,,~-~~. . (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
05-01-2006 CD006642 .00 9,054.90
BALANCE OF UNPAID INTEREST/PENALTY AS OF 05-02-2006 TOTAL TAX CREDIT 9,054.90
BALANCE OF TAX DUE .00
INTEREST AND PEN. 86.93
TOTAL DUE 86.93
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
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