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DATE 07-23-2007
ESTATE OF HORNBERGER EMMA C
DATE OF DEATH 08-27-2006
FILE NUMBER 21 06-0783
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 09-21-2007
( 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-lS47 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF HORNBERGER EMMA C FILE NO. 21 06-0783 ACN 101 DATE 07-23-2007
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX OIVISION
PO BOX 2B0601
HARRISBURG PA 1712B-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
'APp~A~~EH~'T;'ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
2007 JUL 30 Pr! I: 23
RONALD P SIEG
3647 DERRY ST
HBG
ALP:( o,e
V _11(, I
ORDHh\i':~ ('(\1 lOT
II I. ".;_'"_h,l f
CI}/"'--
PA 17111
--
*
REV-1547 EX AFP (06-05)
TAX RETURN WAS: (X) ACCEPTED AS F I LED
) CHANGED
NOTE: If an assesslDent 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 CIS) .00 X DO .00
16. Amount of Line 14 taxable at Lineal/Class A rate Cl6) .00 X 045 = .00
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) 302,166.90 X 15 = 45,325.04
19. Principal Tax Due (19)= 45,325.04
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (_)
11-21-2006 CD007461 2,266.25 43,165.00
TOTAL TAX CREDIT 45,431.25
BALANCE OF TAX DUE 106.21CR
INTEREST AND PEN. .00
TOTAL DUE 106.21CR ~
* IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN *1, NO PAYMENT IS REQUIRED.
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2.
3.
4.
5.
6.
7.
8.
CI)
(2)
(3)
(4)
(5)
(6)
(7)
Stocks and Bonds (Schedule B)
.00
.00
.00
.00
308.756.12
.00
.00
(8)
Closely Held Stock/Partnership Interest (Schedule C)
Mortgages/Notes Receivable (Schedule D)
Cash/Bank Deposits/Misc. Personal Property (Schedule E)
Jointly OWned Property (Schedule F)
Transfers (Schedule G)
Total Assets
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
(9)
ClO)
5,563.02
1.026.20
Cl1>
(12)
(13)
Cl4)
FOR CALCULATION OF ADDITIONAL INTEREST.
NOTE: To insure proper
credit to your account,
submit the Upper portion
of this form with your
tax payment.
308,756.12
6.1;119.""
302,166.90
.00
302,166.90
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)