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BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
:::;C('(\:Jr"T,Np;r-li~Ii-.o~ 1 NHERITANCE TAX
i Ic_l.A'j;lIpltAiISEltSNlI\...{~LL:OWANCE OR DISALLOWANCE
r:rF:-:~r!D-eQU(:TiI'~NS :::AND ASSESSMENT OF TAX
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REV-1547 EX AFP C06-05)
DATE 07-30-2007
ESTATE OF HUMBERSTON DEBORAH J
DATE OF DEATH 11-11-2006
FILE NUMBER 21 06-1069
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 09-28-2007
( 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 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 HUMBERSTON DEBORAH J FILE NO. 21 06-1069 ACN 101 DATE 07-30-2007
2007 AUG -3 PH 14: 22
HUBERT X GILROY
MARTSON LAW OFFICES
10 E HIGH ST
CARLISLE
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PA 17013
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. 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)
8. Total Assets
(1)
(2)
(3)
(4)
(5)
(6)
(7)
.00
11 , 131 . 24
.00
.00
16.516.64
.00
.00
(8)
NOTE: To insure proper
credit to your account.
submit the upper portion
of this form with your
tax payment.
APPROVED DEDUCTIONS AND EXEMPTIONS:
27,647.88
9.
10.
11.
12.
13.
14.
Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
Debts/Mortgage Liabilities/Liens (Schedule I)
Total Deductions
Net Value of Tax Return
Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
Net Value of Estate Subject to Tax
(9)
ClO)
15,267.14
2.992.97
NOTE:
(11)
Cl2)
Cl3)
Cl4)
18.?1;0.11
9,387.77
.00
9,387.77
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 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. Tax Due
C
A M N
DATE
05-31-2007
Cl5)
Cl6)
Cl7)
Cl8)
.00
.00
9,387.77
.00
X 00
X 045 =
X 12 =
X 15 =
(19)=
.00
.00
1,126.53
.00
1,126.53
C +)
INTEREST/PEN PAID (-)
.00
AMOUNT PAID
1,126.53
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
1,126.53
.00
.00
.00
* 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.)