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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
fAfi'f!'~I~EMENT, ALLOWANCE OR DISALLOWANCE
',-,;t:-df;':-'Dl;DUCTIONS AND ASSESSMENT OF TAX
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 2B0601
HARRISBURG PA 1712B-0601
REV-15~7 EX AFP (06-05)
DATE 06-25-2007
ESTATE OF CASE JOYCE G
DATE OF DEATH 10-17-2005
FILE NUMBER 21 05-11 02
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 08-24-2007
( See reverse side under Objections)
Amount 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 CASE JOYCE G FILE NO. 21 05-1102 ACN 101 DATE 06-25-2007
ZOOl JUN 25 PM 3: 55
CLERK OF
DOUGLAS C YOHE ESQRPH.AN'S COURT
STE 140 CU~/FT~: r~:), p,~
1700 BENT CREEK BLVD
MECHANICSBURG PA 17050
TAX 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) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Stock/Partnership Interest (Schedule C) (3)
4. Mortgages/Notes Receivable (Schedule D) (4)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5)
6. Jointly Owned Property (Schedule F) (6)
7. Transfers (Schedule G) (7)
8.
Total Assets
131,000.00
2,842.22
.00
.00
1,242.54
12,019.53
.00
(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
13.
14.
(9)
CIa)
32,782.71
93,690.75
CI1)
CI2)
CI3)
CI4)
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:
NOTE:
CIS) .00 X 00
CI6) 20,630.83 X 045 =
CI7) .00 X 12
CI8) .00 X 15
CI9)=
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
147,104.29
1;:>6.473.46
20,630.83
.00
20,630.83
.00
928.39
.00
.00
928.39
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
01-12-2006 CD006204 46.42 3,750.00
TOTAL TAX CREDIT 3,796.42
BALANCE OF TAX DUE 2,868.03CR
INTEREST AND PEN. .00
TOTAL DUE 2,868.03CR
* IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. '6
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)