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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
J, ~ . I j-' "_-..,
I " 'r-.i (,:Til"'ltT,lCE OF INHERITANCE TAX
-APPRAtSEKEHT~ ALLOWANCE OR DISALLOWANCE
"o~ DE,bucnONS AND ASSESSMENT OF TAX
*'
DATE 02-12-2007
ESTATE OF OCONNOR EDNA M
DATE OF DEATH 10-21-2006
FILE NUMBER 21 06-0940
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 04-13-2007
( See reverse side under Objections)
A.ount Remittedl 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 +-
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REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF OCONNOR EDNA M FILE NO. 21 06-0940 ACN 101 DATE 02-12-2007
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
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T PETER VANDERCOY III
1114 MUSKET LN
MECHANICSBURG PA 17050
REV-1547 EX AFP (06-05)
T AX RETURN WAS: (X) ACCEPTED AS F I LED
) CHANGED
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
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
(1)
(2)
(3)
(4)
(5)
(6)
(7)
.00
.00
.00
.00
10.305.62
.00
.00
(8)
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
10,305.62
(9)
(10)
1,922.88
2.156.00
(11)
(12)
(13)
(14)
4.078.88
6,226.74
.00
6,226.74
NOTE: If an assess.ent 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) .00 X 00 .00
16. Amount of Line 14 taxable at Lineal/Class A rate (16) 6,226.74 X 045 = 280.20
17. Amount of Line 14 at Sibling rate (17) .00 X 12 = .00
18. Amount of Line 14 taxable at Collateral/Class B rate (18) .00 X 15 = .00
19. Principal Tax Due (19)= 280.20
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
11-24-2006 CD007485 13.97 265.46
02-05-2007 SBADJUST .00 .77
TOTAL TAX CREDIT 280.20
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.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE ~_
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) 1Y-