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BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
."_,,,..NOTICE OF INHERITANCE TAX
\APP~Jl.ISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
*'
REV-1547 EX AFP (06-05)
DATE 03-19-2007
ESTATE OF HODGE SR JACOB R
DATE OF DEATH 10-25-2005
FILE NUMBER 21 06-0030
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 05-18-2007
( 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 (03-05J NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF HODGE SR JACOB R FILE NO. 21 06-0030 ACN 101 DATE 03-19-2007
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Op:'ll
GEORGE F DOUGLUJl'II
SAlOIS ETAL
26 W HIGH ST
CARLISLE PA 17013
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
(1)
(2)
(3)
(4)
(5)
(6)
(7)
129,990.00
.00
.00
.00
2.000.00
.00
.00
(8)
NOTE: To insure proper
credit to your account.
submit the upper portion
of this form with your
tax payment.
131,990.00
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)
ClO)
3,040.00
131.586.29
Cl1)
Cl2)
Cl3)
Cl4)
134.r.?r..?9
2,636.29-
.00
2,636.29-
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 Cl5) .00 X 00 .00
16. Amount of Line 14 taxable at Lineal/Class A rate Cl6) .00 X 045 = .00
17. Amount of Line 14 at Sibling rate Cl7) .00 X 12 = .00
18. Amount of Line 14 taxable at Collateral/Class B rate Cl8) .00 X 15 = .00
19. Principal Tax Due Cl9)= .00
TAX CREDITS:
PAYMI:NI RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
TOTAL TAX CREDIT .00
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.)