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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
r-'" ,","",r ry !:!.9.n.,CE OF INHERITANCE TAX
~:::,_C1i.':A&~~."~Ji!.EIH, ALLOWANCE OR DISALLOWANCE
Of -DEDUqIoNS AND ASSESSMENT OF TAX
:'; i ' .",r" I 'I
DATE 06-18-2007
ESTATE OF MOORE MARY H
DATE OF DEATH 07-10-2006
FILE NUMBER 21 06-0661
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 08-17-2007
( See reverse side under Objections)
Amount Remittedl ~
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 MOORE MARY H FILE NO. 21 06-0661 ACN 101 DATE 06-18-2007
2007 JUN 25 PH 3: 57
ROBERT L MARKS
MARKS HAL
PO BOX 179
DANVILLE
CLERK OF
ORPWH,I'S ("'('\!JeT
. j hi--l,,! II \. \'~j\j~,! I
ESQCll~ ,.,'. ,',~. D~
jl'/,,~ I I,) :-h
PA 17821
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) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Stock/Partnership Interest (Schedule C) (3)
4. Mortgages/Notes Receivable (Schedule D) (4)
s. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (s)
6. Jointly Owned Property (Schedule F) (6)
7. Transfers (Schedule G) (7)
8.
Total Assets
.00
.00
.00
.00
20,939.95
.00
1,284,773.26
(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
101,207.02
2,093.27
Cll}
Cl2}
Cl3}
Cl4}
(9)
ClO}
13.
14.
Net Value of Estate Subject to Tax
Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
If an assessment 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
16. Amount of Line 14 taxable at Lineal/Class A rate
17. Amount of Line 14 at Sibling rate
18. Amount of Line 14 taxable at Collateral/Class B rate
19. Principal Tax Due
TAX CREDITS:
PAYMENT
DATE
10-10-2006
NOTE:
Cls}
Cl6}
Cl7}
Cl8}
.00 X
75,000.00 X
1l,033.00 X
699,827.96 X
RECEIPT
NUMBER
CD007296
DISCOUNT (+)
INTEREST/PEN PAID (-)
5,483.66
132,237.72
AMOUNT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
REV-1547 EX AFP (06-05)
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
1,305,713.21
ln3.30n_~9
1,202,412.92
416,551.96
785,860.96
00 =
045 _
12 =
15 =
.00
3,375.00
1,323.96
104,974.19
109,673.15
Cl9}-
137,721.38
28,048.23CR
.00
28,048.23CR
\
!...L
'j"
"
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.)