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BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
NOTICE OF INHERITANCE TAX Pennsylvania ~~.
APP~~l~1`,~S,~E~17'{,~-~A~L~4li4NCE OR DISALLOWANCE
~ ,, ~{{,,"" ~.. DEPARTMENT OF REVENUE
Q~"~tiwCTI-ONSG AND ASSESSMENT OF TAX REV-1547 EX AFP c12-11)
CLERK C= {-~
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MARIELLE F HAZEN ESQ ~~~i^vt~,iEriL,^11i v`~~, PA
STE 202
2000 LINGLESTOWN RD
HARRISBURG PA 17110
DATE 03-12-2012
ESTATE OF EDGIN ARTHUR F
DATE OF DEATH 12-23-2010
FILE NUMBER 21 11-0039
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 05-11-2012
(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 ~-~'
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REV-1547 EX AFP C12-11~ NOTICE OF INHERITANCE TAX APPR
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AISEME
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NT, ALLOWANCE ___
-
OR
DISALLOWANCE OF DEDUCTIONS AND ASSESS MENT OF TAX
ESTATE OF: EDGIN ARTHUR FFILE N0.:21 11-0039 ACN: 101 DATE: 03-12-2012
TAX RETURN WAS: C ) ACCEPTED AS FILED C X) CHANGED $EE ATTACHED NOTICE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1) .00 NOTE: To ensure proper
2. Stocks and Bonds (Schedule B) C2) ,QO credit to your account,
3. Closely Held Stock/Partnership Interest (Schedule C) C3) .00 submit the upper portion
4.
Mortgages/Notes Receivable (Schedule D)
(4)
00 of this form with your
. tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 35 7,607.72
6. Jointly Owned Property (Schedule F) C6) .00
7. Transfers (Schedule G) C7) 102, 109.69
8. Total Assets cs) 459.717.41
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) ~q)_ ?5 0 0
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 4 00.20
11. Total Deductions C11) 25,602.21
12• Net Value of Tax Return C12) 434,115.20
13. Charitable/Governmental Bequests; Non-elected 9113 Tr usts (Schedule J) C13) 293.320.19
14. Net Value of Estate Subject to Tax C14) 140,795.01
NOTE: If an assessment was issued previously, li nes 14, 15 and/or 16, 17, 18 and 19 will
reflect figures that include the total of ALL returns assessed to d ate.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate C15) 47,685.76 X 00 = .00
16. Amount of Line 14 taxable at Lineal/Class A rate (16) 9 . 109.7F: x 045 = 4, 189.92
17. Amount of Line 14 at Sibling rate C17) .00 X 12 = .00
18. Amount of Line 14 taxable at Collateral/Class B rate (18) .00 X 15 - .00
19. Principal Tax Due C19)= 4, 189
92
TAX CREDITS: .
PAYMENT RECEIPT DISCOUNT C+)
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
09-21-2011 CD014989 .00 4,189.92
TOTAL TAX PAYMENT 4,189.92
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
~ IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.
REV-1470 EX (01-10)~
~ pennsylvan~a INHERITANCE TAX
DEPARTMENT OF REVENUE EXPLANATION
BUREAU OF INDIVIDUAL TAXES OF CHANGES
PO Box 280601
DECEDENT'S NAME FILE NUMBER
EDGIN, ARTHUR F 21 11-0039
REVIEWED BY ACN
H. Moore 101
ITEM
SCHEDULE NO, EXPLANATION OF CHANGES
1500 Amounts passing intrust for the surviving spouse, for which an election to tax was not
made, have been moved to Line 13 of the return.
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