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BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO lOX 280&01
HARRISIURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
'*
REV-1547 EX AFP (06-05)
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DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
06-05-2007
LEVIN
01-01-2007
21 07-0021
CUMBERLAND
101
APPEAL DATE: 08-04-2007
( See reverse side under Objections )
A.ount Re.lttedl I
MAKE CHECK PAYABLE AND REMIT PAYMENT
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
JEFFREY
S
GREG M LEVIN
APT 1206
10050 GREAT
AUSTI N
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TO:
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 LEVIN JEFFREY S FILE NO. 21 07-0021 ACN 101 DATE 06-05-2007
TAX RETURN WAS: (X) ACCEPTED AS FILED
) 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. Mort;a;es/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)
U)
(7)
.00
.00
.00
.00
NOTE: To insure proper
credit to your account,
sub.it the upper portion
of this forM with your
tax payment.
15,857.00
.00
.00
(8)
15,857.00
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mort;a;e 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)
7,163.00
8.824.00
(11)
(12)
(13)
(14)
11;.987.00
130.00-
.00
130.00-
NOTE:
If an assess.ent was Issued preViously, lines
reflect figures that Include the total of ~
ASSESSMENT OF TAX:
15. Amount of Line 14
16. Amount of Line 14
17. AMount of Line 14
18. A.ount of Line 14
19. Pr1ncipal Tax Due
14, 15 and/or 1', 17, 18 and 19 will
returns assessed to date.
.00 X 00 ..
.00 X 045..
.00 X 12 _
.00 X 15 ..
(19)-
.00
.00
.00
.00
.00
at Spousal
taxable at
at Sibl1n;
taxable at
rate
(15)
(16)
(17)
(18)
Lineal/Class A rate
rate
Collateral/Class B rate
DATE
NUMBER
+
INTEREST/PEN PAID (-)
AMOUNT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
.00
.00
.00
.00
* IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN t1, 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.)