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BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
r,~-,~ NOTICE OF INHERITANCE TAX
',: ,)APff~~I.s~"'r,ALLOWANCE OR DISALLOWANCE
,'ilf:DE'DUtil'iOlolS AND ASSESSMENT OF TAX
'*
DATE 09-03-2007
ESTATE OF ACRI MICHAEL A
DATE OF DEATH 01-25-2007
FILE NUMBER 21 07-0116
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 11-02-2007
( See reverse side under Objections)
Amount Re.ittedl 1
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 ACRI MICHAEL A FILE NO. 21 07-0116 ACN 101 DATE 09-03-2007
20117 AUG 31 PN 3: 58
REV-1547 EX AFP (06-05)
LISA MARIE COYNE
COYNE & COYNE
3901 MARKET ST
CAMP HILL
CLERK OF
QoP/ "'!' -"
CU.'~' ~I.~" ~-i:~~ \J '>~.~"Q~)r:?T
, ~,' 'I' ,
PA 17011
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
.00
.00
.00
.00
6,387.74
.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:
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 Bequestsj Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
6,387.74
(9)
ClO)
1,253.02
2.319.74
NOTE: 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 (15) .00 X DO .00
16. Amount of Line 14 taxable at Lineal/Class A rate (16) 2,814.98 X 045 = 126.67
17. Amount of Line 14 at Sibling rate Cl7) .00 X 12 = .00
18. Amount of Line 14 taxable at Collateral/Class B rate (18) .00 X 15 = .00
19. Principal Tax Due Cl9)= 126.67
(11)
Cl2)
(13)
(14)
3.~7?7~
2,814.98
.00
2,814.98
TAX I :s :
PAYMENT DnCOONT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (_)
04-25-2007 CD008077 6.33 160.00
08-27-2007 REFUND .00 39.66-
TOTAL TAX CREDIT 126.67
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
( IF TOTAL DUE IS LESS THAN *1, NO PAYMENT IS REQUIRED. C-6
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DU
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
* IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.