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NOTICE OF INHERITANCE TAX . pennsylvania
BUREAU OF INDIVIDUAL TAXES APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 EX AFP (12-12)
PO BOX 280601
HARRISBURG PA 17128-0601 r,~
DATE 12-17-2012
ESTATE OF ZIEGLER REYNOLD K
DATE OF DEATH 02-02-2012
Cu.l ` 21 - 173,
FILE NUMBER 21 12-0279
COUNTY CUMBERLAND
RICHARD E FEHR CLLE 0 ~ ACN 101
1 SPOTTS LN ;-r ¢ N, ` = APPEAL DATE: 02- 15-2013
S C H U Y L K I L L HA 7 K Z'- 9 9 (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 (12-12) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: ZIEGLER REYNOLD KFILE NO.:21 12-0279 ACN: 101 DATE: 12-17-2012
TAX RETURN WAS: (X) ACCEPTED AS FILED C ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1) 107,500.00 NOTE: To ensure proper
2. Stocks and Bonds (Schedule B) (2) 62,380 .88 credit to your account,
.0 0 submit the upper portion
3. Closely Held Stock/Partnership Interest (Schedule C) (3) 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) 5,326.37
6. Jointly Owned Property (Schedule F) (6) .0 0
7. Transfers (Schedule G) C7) 23, 068.70
8. Total Assets (8) 198,275.95
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) C9) 5,494, 17
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 78,593.97
11. Total Deductions C11) 84, 088.15
12. Net Value of Tax Return C12) 114, 187.80
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) 500. 00
14. Net Value of Estate Subject to Tax (14) 113,687 .80
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 C16) 113, 687.80 X 045 = 5,115.95
17. Amount of Line 14 at Sibling rate (17) .011, X 12 = .00
18. Amount of Line 14 taxable at Collateral/Class B rate (18) .00 X 15 = .00
19. Principal Tax Due (19)= 5,115.95
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID C-)
09-10-2012 CDO16488 .00 5,115.95
TOTAL TAX PAYMENT 5,115.95
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 DU
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. v1