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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
DATE 04-30-2007
ESTATE OF MILLER HELENA M
DATE OF DEATH 05-25-2006
FILE NUMBER 21 06-0500
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 06-29-2007
( See reverse side under Objections)
Amount Re.ittedl 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 +--
REY:i547-Ex-AFP-C03:05j-NoTlcE-OF-INHERITANCE-TAX-APPRAISEMENT:-ALLowANCE-OR---------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF MILLER HELENA M FILE NO. 21 06-0500 ACN 101 DATE 04-30-2007
BUREAU OF INDIVI~ij~l TAxe~
INHERITANCE TAX DIVISIQM
PO BOX 280601 , '
HARRISBURG PA 17128-0601
t ~.~.Y - -I
p~ ~ t ~: /,',0
j'tl j \. .
OP::;I '
JOHN M(SMITH
GINGRICH' ETAL
PO BOX 267
ELIZABETHTOWN
PA 17022
*'
REV-15~7 EX AFP (06-05)
TAX RETURN WAS: (X) ACCEPTED AS FILED
) CHANGED
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
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)
.00
17.740.00
.00
.00
.00
395.987.12
788,492.44
(8)
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
1,202,219.56
?1'i.8~9 9?
1,176,379.64
.00
1,176,379.64
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 !b!... 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) 1,176,379.64 X 045 = 52,937.08
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)= 52,937.08
(9)
ClO)
22,968.29
TAX CRl=nITS: I
PAYMENT RECEIPT 7 DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
08-21-2006 CDOO7132,..1 2,636.84 50,100.00
02-06-2007 CDOO7785 .00 200.24
TOTAL TAX CREDIT 52,937.08
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
* IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
2.871.63
Cl1)
Cl2)
Cl3)
Cl4)
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. ,
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE ~UE 11
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