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NOTICE OF INHERITANCE TAX pennsyLvarna 11'
suREau of INDIVIDUAL TAXES MAN- ~ OWANCE OR DISALLOWANCE
.jpT,t DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION p r►¢{i~G ~N AND ASSESSMENT OF TAX
PO BOX 280601 ( REV-1547 IX AFP (12-11)
HARRISBURG PA 17128-0601
=%~A~ ~3 pi ~2 DATE 08-06-2012
Ph ESTATE OF EPPLEMAN CATHRYNE L
DATE OF DEATH 01-21-2012
" FILE NUMBER 21 12-0118
COUNTY CUMBERLAND
IVO V OTTO III CUMBERAD CO, pA ACN 101
10 E HIGH ST APPEAL DATE: 10-05-2012
CARLISLE PA 17013-3015 (See reverse side under Objections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG - THIS - LINE RETAIN LOWER PORTION FOR YOUR RECORDS F-
REV-1547 EX AFP (12-11) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: EPPLEMAN CATHRYNE LFILE NO.:21 12-0118 ACN: 101 DATE: 08-06-2012
TAX RETURN WAS: CX) 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,
3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 submit the upper portion
of this form with your
4. Mortgages/Notes Receivable (Schedule D) (4) 51,605.31 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 5,6 20.30
6. Jointly Owned Property (Schedule F) (6) 338.55
7. Transfers CSchedule G) (7) .00
8. Total Assets (8) _ 57,564.16
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 4,458.32
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 1,400. 00
11. Total Deductions (11) 5,858.32
12. Net Value of Tax Return (12) 51,705.84
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts CSchedule J) (13) .00
14. Net Value of Estate Subject to Tax C14) 51,705 .84
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 (15) .00 X 00 = .00
16. Amount of Line 14 taxable at Lineal/Class A rate (16) 51 .705.84 x 045 = 2,326.76
17. Amount of Line 14 at Sibling rate C17) n0 X 12 = .00
18. Amount of Line 14 taxable at Collateral/Class B rate (18) .00 X 15 = .00
19. Principal Tax Due (19)= 2,326.76
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT C+)
AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID
04-20-2012 CDO15875 116.34 2,210.42
TOTAL TAX PAYMENT 2,326.76
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
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.