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NOTICE OF INHERITANCE TAX pennsyLvarna
BUREAU OF INDIVIDUAL TAXES A FI (jWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE r
INHERITANCE TAX DIVISION ( -bqC IR. ►ND ASSESSMENT OF TAX REV-1547 EX AFP (12-11)
PO BOX 280601 ~f! ; J
HARRISBURG PA 17128-0601
t~2 OCT -9 P9 3~ 31 DATE 10-08-2012
ESTATE OF KROH PATRICIA L
DATE OF DEATH 02-27-2011
FILE NUMBER 21 11-0747
ORPRLL,`TG GCILPI COUNTY CUMBERLAND
THOMAS D GOULD CUMBCRLMD G0., PA ACN 101
STE 203 APPEAL DATE: 12-07-2012
5006 E T R I N D L E RD (See reverse side under Objections)
MECHANICSBURG PA 17050-3651 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: KROH PATRICIA LFILE NO.:21 11-0747 ACN: 101 DATE: 10-08-2012
TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1) 133,200.00 NOTE: To ensure proper
00 credit to your account,
2. Stocks and Bonds (Schedule B) (2)
submit the upper portion
3. Closely Held Stock/Partnership Interest (Schedule C) 00 C3) 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) 6,000.00
6. Jointly Owned Property (Schedule F) (6) .00
7. Transfers (Schedule G) (7) .00
8. Total Assets (8) 139,200.00
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 13,4 26.9 2
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 1,395.72
11. Total Deductions (11) 14,822.64
12. Net Value of Tax Return (12) 124, 377.36
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00
14. Net Value of Estate Subject to Tax (14) 124,377.36
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) 35,208.10 X 00 = .00
16. Amount of Line 14 taxable at Lineal/Class A rate (16) 89. 1 69.26 x 045 = 4,012.62
17. Amount of Line 14 at Sibling rate (17) _00 X 12 = .00
18. Amount of Line 14 taxable at Collateral/Class B rate (18) .00 X 15 = .00
19. Principal Tax Due (19)= 4,012.62
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT
DATE NUMBER INTEREST/PEN PAID AMOUNT PAID
06-29-2012 CDO16188 .00 4,012.62
BALANCE OF UNPAID INTEREST/PENALTY AS OF 06-30-2012 TOTAL TAX PAYMENT 4,012.62
BALANCE OF TAX DUE .00
INTEREST AND PEN. 70.74
TOTAL DUE 70.74
* IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE D E
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.