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BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
'A'PPRAfSEIo(a1T, ALLOWANCE OR DISALLOWANCE
OF DEDUCTloNS AND ASSESSMENT OF TAX
*
REV-1547 EX AFP (06-05)
DATE 10-16-2007
ESTATE OF RAGER CAMREN M
DATE OF DEATH 07-30-2006
FILE NUMBER 21 06-0997
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 12-15-2007
( See reverse side under Objections)
A.ount Re.i tted [ ]
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 of--
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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 RAGER CAMREN M FILE NO. 21 06-0997 ACN 101 DATE 10-16-2007
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DAVID W REAGER
REAGER & ADLER
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CAMP HILL
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PA 17DlI
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.
Total Assets
(l)
(2)
(3)
(4)
(5)
(6)
(n
.00
.00
.00
.00
.00
.00
.00
(8)
NOTE: To insure proper
credit to your account,
submit the Upper portion
of this form with your
tax payment.
Stocks and Bonds (Schedule B)
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)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9.
10.
11.
12.
13.
14.
Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9)
DebtS/Mortgage Liabilities/Liens (Schedule I) (10)
Total Deductions
Net Value of Tax Return
Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
Net Value of Estate SUbject to Tax
.00
.00
NOTE:
.00
(ll)
ClZ}
Cl3}
Cl4}
.nn
.00
.00
.00
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
CIS}
(I6)
Cl7}
Cl8}
.00 X DO .00
.00 X 045 = .00
.00 X 12 = .00
.00 X 15 = .00
Cl9}= .00
AMOUNT PAID
T
R C IPT
NUMBER
(-)
* IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
.00
.00
.00
.00
( IF TOTAL DUE IS LESS THAN *1, NO PAYMENT IS REQUIRED. I'J
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DU~
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)