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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
pC00pn:::f\ n:::C\rH-i~Y-iCE OF INHERITANCE TAX
. ':::~ ~.:;:~'::::A~~~~'(fE"~NT, ALLOWANCE OR DISALLOWANCE
Hcb~:.; i Li: ;vQF;~Eb.llCTIONS AND ASSESSMENT OF TAX
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
2001 JUN 29 PM I: I 2
'*
REV-1547 EX AFP (06-05)
DATE D6-25-2DD7
ESTATE OF HENNES DONALD J
DATE OF DEATH Dl-28-2DD7
FILE NUMBER 21 D7-D395
COUNTY CUMBERLAND
ACN lDl
APPEAL DATE: D8-24-2DD7
( See reverse side under Objections)
A.ount Re.ittedl I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17D13
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 HENNES DONALD J FILE NO. 21 07-0395 ACN lDl DATE D6-25-2D07
CLERK OF
ORPHAN'S COURT
CU~ 11"',-,-,1 " l.!I\ ('" DA
ROGER B IRWIN ESQ 1\':' ,,' .' -' '",' , ' .,
IRWIN & MCKNIGHT
6D W POMFRET ST
CARLISLE PA 17D13
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.
3.
4.
5.
6.
7.
8.
Stocks and Bonds (Schedule B)
(1)
(2)
(3)
(4)
(5)
(6)
(7)
.DD
1,319,384.D4
.DD
.DD
72,811.38
.DD
72,DDD.DD
(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
If an assess.ent was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect figures that include the total of ~ 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
TS:
NOTE:
(9)
(10)
13,747.91
19.874.DD
(11)
(12)
(13)
(14)
(15)
(16)
(17)
(18)
. DD X
1,43D,573.51 X
. DD X
. DD X
AMOUNT PAID
61,157.D2
IP
NUMBER
CDDD8D69
A
DATE
D4-23-2DD7
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
NOTE: To insure proper
credit to your account.
submit the upper portion
of this form with your
tax payment.
1,464,195.42
33.~?1 91
1,43D,573.51
.DD
1,43D,573.51
DD
D45 =
12 =
15 =
.DD
64,375.81
.DD
.DD
64,375.81
(19) =
64,375.81
.DD
.DD
.DD
* 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.)