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NOTICE OF INHERITANCE TAX ; pennsyLvania
BUREAU OF INDIVIDUAL TAXES APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
OF DEDUCTIONS AND ASSESSMENT OF TAX
INHERITANCE TAX DIVISION REV-1547 IX AFP (09-12)
PO BOX 280601
HARRISBURG PA 17128-0601
RECORDED O ICE OF DATE 12-10-2012
REGISTER, OF V.111-IS ESTATE OF BURDICK MARIAN W
Ail DATE OF DEATH 07-20-2011
LIM DEC 1~7 1 Ail 11 50 FILE NUMBER 21 11-0848
COUNTY CUMBERLAND
ROBERT G FREY CLERIC 01ACN 101
5 S HANOVER ST 9 , r11„ APPEAL DATE: 02-08-2013
CARLISLE P 1 AU 3 'i ~ (See reverse side under Objections)
CUMBERLAND CO., PA 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 E-
REV-1547 EX AFP (12-11)-NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE-OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: BURDICK MARIAN WFILE NO.:21 11-0848 ACN: 101 DATE: 12-10-2012
TAX RETURN WAS: C X) ACCEPTED AS FILED ( ) CHANGED
APPRAISED VALUE OF RETURN BASED ON- ORIGINAL RETURN
1. Real Estate (Schedule A) (1) 30 0,00 0.00 NOTE: To ensure proper
2. Stocks and Bonds (Schedule B) (2) 14 2,799.51 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) 00 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property CSchedule E) (5) 1,652.00
6. Jointly Owned Property (Schedule F) (6) 9,710.50
7. Transfers (Schedule G) C7) 260,488.00
8. Total Assets (8) 714,650.01
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) C9)- 33,025.00
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 6,123.00
11. Total Deductions CII) 39, 148.00
12. Net Value of Tax Return (12) 675,502.01
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C13) .00
14. Net Value of Estate Subject to Tax (14) 675,502.01
NOTE: If an assessment was issued previously, Lines 14, 15, 16, 17, 18 and/or 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 rate (16) 67fi.Sn9 nl X 045 = 30,397.59
17. Amount of Line 14 at sibling rate (17) -00 X 12 = .00
18. Amount of Line 14 taxable at collateral rate (18) .00 X 15 = .00
19. Principal Tax Due C19)= 30,397.59
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT C+)
AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID
10-18-2012 CDO16662 .00 26,500.00
INTEREST IS CHARGED THROUGH 12-25-2012 TOTAL TAX PAYMENT 26,500.00
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 3,897.59
REVERSE SIDE OF THIS FORM INTEREST AND PEN. 472.89
TOTAL DUE 4,370.48
* IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A CREDIT CCR), YOU MAY BE DUET"
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE FOR INSTRUCTIONS. 4
APPRAISEMENT: Efforts to obtain an inheritance tax return have been exhausted for the estate referenced. Therefore, the filling
requirements have been waived. The department, however, reserves the right to assess any assets that may be
recovered at a future time.
RESERVATION: Estates of decedents dying on or before Dec. 12, 1982 - if any future interest in the estate is transferred in possession or
enjoyment to collateral beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth
hereby expressly reserves the right to appraise and assess transfer inheritance taxes at the lawful collateral rate on any such
future interest.
PAYMENT: Detach the top portion of this notice and submit with your payment to the Register of Wills indicated on the front of the notice.
Make check or money order payable to: REGISTER OF WILLS, AGENT.
Failure to pay the tax, interest, and penalty due may result in the filing of a lien or the issuance of an Orphan's Court citation.
REFUND (CR): A refund of a tax credit not requested on the tax return may be requested by completing an Application for Refund of
Pennsylvania Inheritance and Estate Tax (REV-1313). Applications are available from the department's web site at
www.revenue.state.pa.us, any Register of Wills or Revenue District Office, or from the department's 24-hour forms ordering
service: 1-800-362-2050; services for taxpayers with special hearing and/or speaking needs: 1-800-447-3020 (TT only).
OBJECTIONS: Any party in interest not satisfied with the appraisement, allowance or disallowance of deductions, or assessment of tax
(including discount or interest) as shown on this notice may object within 60 days of the date of receipt of this notice by:
A) Filing an appeal online at www.boardofappeals.state.pa.us on or before the appeal date identified on the front of this notice.
Or sending a written protest to: PA Department of Revenue, Board of Appeals, PO BOX 281021, Harrisburg PA 17128-1021;
B) Having the matter determined at audit of the account of the personal representative; or
C) Appealing to the Orphans' Court.
ADMINISTRATIVE
CORRECTIONS: Errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual
Taxes, ATTN: Post Assessment Review Unit, PO BOX 280601, Harrisburg PA 17128-0601, Phone (717) 787-6505. See page 4
Instructions for Inheritance Tax Return for a Resident Decedent (REV-1501) for an explanation of administratively correctable
errors.
DISCOUNT: If any tax due is paid within three calendar months after the decedent's death a five percent discount of the tax paid is allowed.
INTEREST: Interest is charged beginning with first day of delinquency, or nine months and one day from date of death, to the date of
payment. Annual interest rates are available on Form REV-1611, available at www revenue.state.pa.us, or upon request by
calling 1-888-728-2937.
Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
Any Notice issued after the tax becomes delinquent will reflect an interest calculation to 15 days beyond the date of the
assessment. If payment is made after the interest calculation date shown on the Notice, additional interest must be calculated.