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- _ NOTICE OF INHERITANCE TAX pennsy van~a ~ -
APPRkI~I'EMENT, ALLOWANCE OR DISALLOWANCE
BUREAU OF INDIVIDUAL TARE S - DEPARTMENT OF REVENUE
POHBOXT280601~ °IV1s1oN OF DEDUCTIONS AND ASSESSMENT OF TAX
REV-1547 EX AFP C12-10)
HARRISBURG PA 17128-0601
DATE 03-01-2011
ESTATE OF WARD EDNA M
DATE OF DEATH 11-22-2010
~~ FILE NUMBER 21 10-1221
-. -_ COUNTY CUMBERLAND
JAN L BROWN ~" ACN 101
STE 12 APPEAL DATE: 04-30-2011
8 4 5 S I R T H O M A S C T ( See reverse side under Objections )
HARRISBURG PA 17109 Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 1.7013
CUT ALONG THIS LINE --- --~ R_ETA_IN LOWER POR_TION_ FOR YOUR RECORDS ~
REV-1547 EX AFP C12-10~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: WARD EDNA MFILE N0.:21 10-1221 ACN: 101 _ _____
OR
DATE: 03-01-2011
TAX RETURN WAS: C X) ACCEPTED AS FILED ( ) CHANGED
APPRAI SED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) C1) .0 0 NOTE: To ensure proper
2. Stocks and Bonds (Schedule B) C2) ,0 0 credit to your account,
3. Closely Held Stock/Partnership Interest (Schedule C) C3) .0 0 submit the upper portion
4.
Mortgages/Notes Receivable (Schedule D)
C4)
0 0 of this form with your
. tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) C5) 14 3.0 0
6. Jointly Owned Property (Schedule F) C6) 57, 662.52
7. Transfers (Schedule G) C7) .0 0
8. Total Assets C8) 57,805.52
APPROV ED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/,Adm. Costs/Misc. Expenses (Schedule H) C9) 1,54 4.4
10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) .0 0
11. Total Deductions C11) 1,544.42
12. Net Value of Tax Return C12) 56, 261.10
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .0 0
14. Net Value of Estate Subject to Tax C14) 56,261.10
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) .0 0 X 0 0 = .0 0
16. Amount of Line 14 taxable at Lineal/Class A rate C16) Sb ,?6l . ] 0 x 045 = 2,531 .75
17. Amount of Line 14 at Sibling rate C17) _ 00 X 12 = . 00
18. Amount of Line 14 taxable at Collateral/Class B rate C18) .0 0 X 15 = .0 0
19. Principal Tax Due C19)= 2,531.75
TAX CREDITS:
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID C-)
AMOUNT PAID
12-10-2010 CD013779 126.59 2,405.17
* IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
TOTAL TAX PAYMENT 2,531.76
BALANCE OF TAX DUE .O1CR
INTEREST AND PEN. .00
TOTAL DUE .O1CR
IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.
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