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NOTICE OF INHERITANCE TAX , pennsy vania
BUREAU OF INDIVIDUAL TAXES APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION ~O.F~ UDUCTLO,,Y AND ASSESSMENT OF TAX REV-1547 EX AFP (12-12)
PO BOX 280601 R i~E v C +L R=` ~
HARRISBURG PA 17128-0601
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DATE 12-24-2012
C~ revs t f i-~ ESTATE OF ALLISON DONALD H i_ L
DATE OF DEATH 01-31-2012
F°T FILE NUMBER 21 12-0249
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JOHN D SHERIDAN EAFPTHNS' 1~ COUNTY CUMBERLAND
ACN 101
STE 201 C U M 3 E R L A, a' APPEAL DATE: 02-22-2013
2080 L I N G L E S T O W N RD (See reverse side under Objections)
HARRISBURG PA 17110-9670 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 (12-12) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: ALLISON DONALD HFILE NO.:21 12-0249 ACN: 101 DATE: 12-24-2012
TAX RETURN WAS: C X) ACCEPTED AS FILED C ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1) 185,525.00 NOTE: To ensure proper
2. Stocks and Bonds (Schedule B) (2) 108, 184. 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) (4) .00 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 101,494.00
6. Jointly Owned Property (Schedule F) (6) .0 0
7. Transfers (Schedule G) (7) 16,638.00
8. Total Assets (8) 411,841.00
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 61,119.0 0
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 1,982. 00
11. Total Deductions (11) 63, 101.00
12. Net Value of Tax Return (12) 348,740.00
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .0 0
14. Net Value of Estate Subject to Tax (14) 348, 740.00
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) 348 , 741. 00 X 045 = 15, 693.00
17. Amount of Line 14 at Sibling rate (17) 00 X 12 = .00
18. Amount of Line 14 taxable at Collateral/Class B rate (18) .00 X 15 = .00
19. Principal Tax Due (19)= 15, 693.00
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID
04-26-2012 CDO15892 784.65 16,500.00
TOTAL TAX PAYMENT 17,284.65
BALANCE OF TAX DUE 1,591.65CR
INTEREST AND PEN. .00
TOTAL DUE 1,591.65C
* IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DU
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.
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