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NOTICE OF INHERITANCE TAX Pennsylvania
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TA ~i>]~'RIA~MENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
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BUREAU OF INDIVIDUAL
INHERITANCE TAX Drv1s1oN - ~
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NS AND ASSESSMENT OF TAX
REV-1547 EX AFP C12-09)
PO BOX 280601 ~ii~.~iJ 3 ~~, , 1r, ..
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HARRISBURG PA 17128-0601
2QI~SEP 17 AA~/ C
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DATE 09-14-
2010
ESTATE OF BROWN JEANNETTE R
DATE OF DEATH 03-20-2010
C~-~~~~~ FILE NUMBER 21 10-0376
ORPHANS C+QURT COUNTY CUMBERLAND
JOHN D SHE~,~~,~`~ C~~„ f~A ACN 101
STE 201 APPEAL DATE: 11-13-2010
2080 L I NGLESTOWN RD (See reverse side under Objections)
HARRISBURG PA 17110 Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
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REV-1547 EX AFP C12-09~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: BROWN JEANNETTE RFILE N0.:21 10-0376 ACN: 101
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OR
DATE: 09-14-2010
TAX RETURN WAS: C X) ACCEPTED AS FILED C ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1) •0 0 NOTE: To ensure proper
2. Stocks and Bonds (Schedule B) (2) ,00 credit to your account,
00 submit the upper portion
3. Closely Held Stock/Partnership Interest (Schedule C) C3) . of this form with your
4. Mortgages/Notes Receivable (Schedule D) C4] •0 0 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 5,700.00
6. Jointly Owned Property (Schedule F) (6) .00
7. Transfers (Schedule G) (7) 728,948.00
8. Total Assets (8) 734 , 648.00
APPROV ED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 58.88 2.00
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 714.00
11. Total Deductions (11) 59,596.00
12. Net Value of Tax Return (12) 675, 052.00
13. Charitable/Governmental Bequests; Non-elected 9113 Tr usts (Schedu le J) C13) .00
14. Net Value of Estate Subject to Tax (14) 675, 052.00
NOTE: If an assessment 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 C15) .00 X 00 = .00
16. Amount of Line 14 taxable at Lineal/Class A rate (16) 67~i.~~i?.00 x 045 = 30,377.00
17. Amount of Line 14 at Sibling rate (17) .DO X 12 = .00
18. Amount of Line 14 taxable at Collateral/Class B rate (18) •00 X 15 = .00
19. Principal Tax Due C19)= 30,377.00
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID C-)
05-25-2010 CD012796 1,518.84 28,858.00
09-07-2010 SBADJUST .00 .16
TOTAL TAX PAYMENT 30,377.00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
+ IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.
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