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~v~1 IOJPP~ir[i~MENT E ALLOWANCE TOR DISALLOWANCE Pennsylvania ~
BUREAU OF INDIVIDUAL T DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION `r,„~`'~~~+ ~t' ' ~ SEDUCTIONS AND ASSESSMENT OF TAX
PO BOX 280601 Uiai " `~~ '~" REV-1547 EX AFP C12-11)
HARRISBURG PA 17128-0601
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BETH L MAR KCUMBERE.AND CC}., PA
304 BERKSHIRE RD
MECHANICSBURG PA 17055-5511
DATE 09-17-2012
ESTATE OF HOSTETLER LELA M
DATE OF DEATH 02-08-2012
FILE NUMBER 21 12-0204
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 11-16-2012
(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 F- __
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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: HOSTETLER LELA MFILE N0.:21 12-0204 ACN: lnl DATES no_i~_~n
TAX RETURN WAS: CX) ACCEPTED AS FILED ( ) CHANGED
APPRAI SED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) C1) .00 NOTE: To e
2.
Stocks and Bonds (Schedule B)
C2)
,Op nsure proper
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) .00
6. Jointly Owned Property (Schedule F) (6) .00
7. Transfers (Schedule G) C7) .00
8. Total Assets C8) .00
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) Cg)_ 7.4 77. 7
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) .00
11. Total Deductions C11) 7,477.27
12. Net Value of Tax Return (12) 7,477.27-
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00
14. Net Value of Estate Subject to Tax C14) 7,477.27-
NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 a nd 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 (15) .00 X 00 - .00
16. Amount of Line 14 taxable at Lineal/Class A rate (16) .On x 04 5 = .00
17. Amount of Line 14 at Sibling rate (17) .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)=
TAX .00
CREDITS:
PAYMENT RECEIPT DISCOUNT C+)
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
TOTAL TAX PAYMENT .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" CCR), YOU MAY BE DUE/~
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. rlh