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r~rr;HUTT~'~?'~''rI RITANCE TAX Pennsylvania ~
BUREAU OF INDIVIDUAL TAXES APPRAf"~~S~M~N-T~.,~I~'~,~CE OR DISALLOWANCE DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION OF ~~trU~'TI`~NS+''J4ND ASSESSMENT OF TAX REV-1547 IX AFP C12-11)
PO BOX 280601
HARRISBURG PA 17126-0601 .,t„ ,~«~,~
t ~`"~ ~' ~ DATE 04-02-2012
ESTATE OF SHEAFFER LOIS L
~ ..~
`_'' ~'~h ~- DATE OF DEATH 07-26-2011
^~R1`.~,FS',,~~',,`~r, FILE NUMBER 21 11-1068
~~J., P,~ COUNTY CUMBERLAND
CHRISTA M APLIN ACN 101
STE 12 APPEAL DATE: 06-01-2012
845 SIR THOMAS CT (See reverse side under Objections)
HARRISBURG PA 17109-4843 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 APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: SHEAFFER LOIS LFILE N0.:21 11-1068 ACN: 101 DATE: 04-02-2012
TAX RETURN WAS: (X) ACCEPTED AS FILED C ) CHANGED
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) ~2) .00 credit to your account,
submit the upper portion
3. Closely Held Stock/Partnership Interest (Schedule C) (3) '00 of this form with your
4. Mortgages/Notes Receivable (Schedule D) C4) •00 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 592.19
6. Jointly Owned Property (Schedule F) (6) .00
7. Transfers (Schedule G) ~7) 144,397.08
8. Total Assets cs) 144 , 989.27
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) ~q) 4.4 35.54
10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) 4,158.6 2
11. Total Deductions X11) 8,594.16
12. Net Value of Tax Return (12) 136,395.11
13. Charitabl e/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00
14. Net Value of Estate Subject to Tax (14) 136,395.11
NOTE: If an assessment was issued previously, li nes 14, 15 and/or 16, 17, 18 and 19 will
reflec t 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 C16) 1 36.395. l 1 x 045 = 6, 137.78
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) •00 X 15 - .00
19. Principal Tax Due (19)= 6, 137.78
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+)
AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID C-)
10-11-2011 CD015052 306.89 5,830.89
TOTAL TAX PAYMENT 6,137.78
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" CCR), YOU MAY BE DUE
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.