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NOTICE OF INHERITANCE TAX pennsyLvarna 4
BUREAU OF INDIVIDUAL TAXES RA~I$EMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE ?
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INHERITANCE TAX DIVISION Et1f D,f 0_-pyNS AND ASSESSMENT OF TAX REV-1547 EX AFP (12-11)
PO BOX 280601 1r
HARRISBURG PA 17128-0601 f q
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~~~+'r DATE 08-06-2012
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uU ~t 12: 2~ ESTATE OF HENCH PATRICIA
DATE OF DEATH 09-11-2011
FILE NUMBER 21 12-0473
ORPHAN ~ l i A3 COUNTY CUMBERLAND
WAY NE F SHADE E BE D Co,,pA ACN 101
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53 W POMFRET ST APPEAL DATE: 10-05-2012
CARLISLE PA 17013-3217 (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
REV-1547 EX AFP (12-11) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: HENCH PATRICIA FILE NO.:21 12-0473 ACN: 101 DATE: 08-06-2012
TAX RETURN WAS: (X) ACCEPTED AS FILED C ) CHANGED
APPRAISED VALUE OF RETURN BASED ON. ORIGINAL RETURN
1. Real Estate CSchedule A) (1) .00 NOTE: To ensure proper
00 credit to your account,
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Stock/Partnership Interest (Schedule C) (3) 00 submit the upper portion
of this form with your
4. Mortgages/Notes Receivable CSchedule D) C4) .00. tax payment.
5. Cash/Bank Deposits/Misc. Personal Property CSchedule E) (5) .00
6. Jointly Owned Property (Schedule F) (6) .00
7. Transfers (Schedule G) (7) .00
8. Total Assets (8) .00
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) C9) .00
10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) 00
11. Total Deductions (11) .00
12. Net Value of Tax Return (12) .00
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00
14. Net Value of Estate Subject to Tax (14) .00
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) 00 x 045 = .00
17. Amount of Line 14 at Sibling rate C17) An x 12 = .00
18. Amount of Line 14 taxable at Collateral/Class B rate C18) .00 X 15 = .00
19. Principal Tax Due (19)= .00
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT C+)
DATE NUMBER INTEREST/PEN PAID C-) 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" (CR), YOU MAY BE E
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.