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BUREAU OF INDIVIDUAL TAXES AP~RA_ISL~IENfi', A-L~LBrWANCE 0R DISALLOWANCE DEPARTMENT OF REVENUE r'
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INHERITANCE TAX DIVISION O~~',~€~~l~L~-oN' _..A,ND ASSESSMENT OF TAX REV-1547 Ex AFP (12-09)
PO BOX 280601
HARRISBURG PA 17128-0601 ii
~~i~ ®L, 1 _ ~ ~~~ i~' ~~ DATE 09-27-2010
ESTATE OF LIBBY LUCILLE C
(~~~~'~( (y;l-` DATE OF DEATH 09-29-2009
' ~ FILE NUMBER 21 09-0982
d~PH~~I ~'~ ~`.~~..~RT
(~~~;~^~;F~'? /~,''~i_.! ~ ;(1 . ~~, COUNTY CUMBERLAND
JOSEPH C MICHETTI JR ACN 101
921 MARKET ST APPEAL DATE: 11-26-2010
T R E V O R T O N P A 17 8 81 (See reverse side under Objections )
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-~E- -------------------
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REV-1547 EX AFP C12-09~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: LIBBY LUCILLE (FILE N0.:21 09-0982 ACN: 101 DATE: 09-27-2010
TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) 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) 2,8 7 6.9 8 credit to your account,
.0 0 submit the upper portion
3. Closely Held Stock/Partnership Interest (Schedule C) (3) of this form with your
4. Mortgages/Notes Receivable (Schedule D) (4) •0 0 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 125, 319.91
6. Jointly Owned Property (Schedule F) (6) 20,944.25
7. Transfers (Schedule G) (7) ~ .0 0
8. Total Assets C8) 149 , 141.14
APPROV ED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) C9) 31.2 6 1.5 0
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) .0 0
11. Total Deductions (11) 31,261.50
12. Net Value of Tax Return (12) 117,879.64
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C13) .0 0
14. Net Value of Estate Subject to Tax (14) 117,879.64
NOTE: If an assessment was issued previously, lines 14, 15 and/or lb, 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) .0 0 X 0 0 = .0 0
16. Amount of Line 14 taxable at Lineal/Class A rate (16) 69 .411.94 X 045 = 3, 123.54
17. Amount of Line 14 at Sibling rate (17) _0 0 X 12 = .0 0
18. Amount of Line 14 taxable at Collateral/Class B rate (18) 4$,467.70 X 15 = 7,270.16
19. Principal Tax Due C 19?= 1 0 , 393.70
TAX CREDITS:
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT (+)
INTEREST/PEN PAID (-)
AMOUNT PAID
06-23-2010 CD012970 .00 10,393.70
TOTAL TAX PAYMENT 10,393.70
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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