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NOTICE OF INHERITANCE TAX � pennsylvania
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENTOFREVENUE
BUREAU oF INDIVIDUAL TAXES OF DEDUCTIONS AND ASSESSMENT OF TAX
INHERITANCE TAX DIVISION REV-1547 IX AFP (09-12)
PO BOX 280601
HARRISBURG PA 17128-�$Q�j��`'������ ��`#::.��� ��
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(�� �,yfa��� DATE 03-25-2013
ESTATE OF SCHWARTZ JEANNE L
.'i';�;� ��(� ;�� �� 1 �� DATE OF DEATH 04-14-2012
FILE NUMBER 21 12-0536
�"' (�,��' COUNTY CUMBERLAND
C I NDY L �j� C �� _ESQ ACN 101
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875 MARKE'T'S� APPEAL DATE: 05-24 2013
L E M 0 Y N�+U�B E�L A P�1{�1,�,Q r� (See reverse side under Objections)
Amount Remitted
MAKE CNECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SqUARE
CARLISLE PA 17013
CUT AL�NG THIS LINE_ -� __RETAIN_LOWER_PORTION FOR YOUR_RECORDS_ f- ___________________
REV-1547 EX AFP C12-11� NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: SCHWARTZ JEANNE LFILE NU. :21 12-0536 ACN: 101 DATE: 03-25-2013
TAX RETURN WAS: C ) ACCEPTED AS FILED C X) CHANGED SEE ATTACHED NOTICE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate CSchedule A) [1) •�� NOTE: To ensure proper
2. Stocks and Bonds CSchedule B) �2� .0 0 credit to your account,
.0 0 submit the upper portion
3. Closely Held Stock/Partnership Interest CSchedule C) C3) of this form with your
4. Mortgages/Notes Receivable (Schedule D) [4) •0 0 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property CSchedule E) (5) 5,741.21
6. Jointly Owned Property CSchedule F� C6)
65,000.00
7. Transfers CSchedule G) ��� 89,878.48
8. Total Assets cs) 160,619.69
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses CSchedule H) C9� 2 0,5 3 3.5 9
10. Debts/Mortgage Liabilities/Liens CSchedule I) �lp� .0 0
11. Total Deductions (11) 20,533.59
12. Net Value of Tax Return �12� 140,086.10
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts CSchedule J) C13� .0 0
14. Net Value of Estate Subject to Tax C14� 140,086.10
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) .0 0 X 0 0 = .0 0
16. Amount of Line 14 taxable at lineal rate C16) -�� X 0 4 5 = .0 0
17. Amount of Line 14 at sibling rate C17) -0 0 X 12 = .0 0
18. Amount of Line 14 taxable at collateral rate C 18) 140,086.10 X 15 = 21,012.92
19. Principal Tax Due C19�- 21,012.92
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT t+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID C-)
07-13-2012 CD016254 15.79 300.00
INTEREST IS CHARGED THROUGH 04-09-2013 TOTAL TAX PAYMENT 315.79
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 20,697.13
REVERSE SIDE OF THIS FORM INTEREST AND PEN. 144.26
TOTAL DUE 20,841 .39
* IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A CREDIT CCR), YOU MAY BE DUE�
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE FOR INSTRUCTIONS.
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� � ennsylvania
p INHERITANCE TAX
DEPARTMENT OF REVENUE
EXPLANATION
BUREAU OF INDIVIDUAL TAXES OF CHANGES
BUREAU OF INDIVIDUAL TAXES Y
DEPT.280601
HARRISBURG,PA 17128-0601
DECEDENT'S NAME FILE NUMBER
Jeanne Schwartz 2112-0536
REVIEWED BY ACN
Tamika Washington 101
ITEM
SCHEDULE Np, EXPLANATION OF CHANGES
Total on Schedule F was not correctly carried forward to recapitulation page.
G 1 The IRA is fully taxable as the decedent is the primary owner and the transferee is a
beneficiary not a joint owner.
Row Paae 1