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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 2B0601
HARRISBURG PA 1712B-0601
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
REV-1547 EX AFP (06-05)
DATE 06-11-2007
ESTATE OF HORNER THEDA J
DATE OF DEATH 12-27-2006
FILE NUMBER 21 07-0002
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 08-10-2007
( See reverse side under Objections)
Amount Remi t t ed I ::J
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 +--
-------------------------------------------------------------------------..-----------------
REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF HORNER THEDA J FILE NO. 21 07-0002 ACN 101 DATE 06-11-2007
JOHN MEAKIN
MARKET SQ BL.DG
MECHANICSBURG
PA 17055
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)
Cl)
(2)
(3)
(4)
(5)
(6)
(7)
213,600.00
204,567.02
.00
.00
105,782.18
.00
.00
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
8.
Total Assets
(8)
523,949.20
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
(9)
Cl 0)
10,918.00
.00
Cll)
Cl2)
Cl3)
11 .
12.
13.
14.
Total Deductions
Net Value of Tax Return
Net Value of Estate Subject to Tax
Cl4)
10.918 nn
513,031.20
.00
513,031.20
Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
NOTE:
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
Cl5)
513,031.20 X 00
-
.00 X 045 =
.00 X 12
-
.00 X 15
( 19);'
.00
.00
.00
.00
.00
Cl6)
17. Amount of Line 14 at Sibling
18. Amount of Line 14 taxable at
19. Principal Tax Due
TAX CREDITS:
PAYMENT RECEIPT
DATE NUMBER
rate
Collateral/Class B rate
Cl7>
Cl8)
DISCOUNT (+)
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.
l,
IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. '
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DU~)
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)