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NOTICE OF INHERITANCE 7AX � pennsytvania
APP NT, ALLOWANCE OR DISALLOWANCE ■
BUREAU OF INDIVIDUAL r � �,��' DEPARTMENT OFREVENUE
INXERITANCE TAX DIVISION���'"�';-�� � � � `� TIDNS AND ASSESSMENT OF TAX `���� REV-154] IX �FP (03-13)
PO BOX 280601 r ��. "�"'I� ��` ' � �
HARRISlIIRG PA 17128-0601 Y�i�-!�- , 1-i �1 •� � ,.'�'J
]�'i';� i����i_ � FI I 1 J� DATE 07-01-2013
ESTATE OF CASHION JERRY
����i� �;- DATE OP DEATH 11-02-2012
Q��}{,q�4$� �U�1�1 FILE NUMBER 21 12-1198
GEORGE F D COUNTY CUMBERLAND
���ER��af��ac^.. Pa Acn �o�
354 ALEXAND SPRING R� APPEAL DATE: OS-30-2013
CARLISLE PA 1 7 0 15-7451 (SeereversesideunderObjecdons)
A�ount Re�itted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALOH6 THIS LINE ____ 1 R TAIN LOWER PORTION FOR YOUR RECORDS �
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REV-1547 EX AFP CO2-13) NOTICE F INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOW, NCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: CASHION JE:RR�IY FILE N0. :21 12-1198 ACN: 101 DATE: 07-01-2013
TAX RETURNIWAS: (JO 11CCEPTED AS FILED ( J CHANGEO
APPRAISED VALUE OF RETURN BASED'�� ON: ORIGINAL RETURN
1. Raal Estate (SChetlule A) � (1) •00 NOTE: To ensure proper
2. Stocks and BonCS CS<hetlule B) �Z� .00 cretllY to your eccaunt.
.00 submit the uppar oortion
3. Closely HelO Stock/Partnership Interest CSchedula C7 C3) of this form with your
4. Mortgapas/NOtes Receivabl• CSchetlule D) C4) •00 tax payment.
5. Cash/Bank Deposits/Mise. Parsonal Praparty (Sehadule E) (5) 14.023. 18
6. Jointly Owned Property (SChetlule F) �6� Zr193.59
7. Transfars CSchedula G) ��� 147�200.00
fl. iotai Assets . ca7 163.416.77
APPROVED DEDUCTIONS AND EXEMPTIbNS:
9. Funeral Expenses/Atlm. Cosls/Mise. Exoo�sas (Sehadula H) �q� 3.450.66
10. Debts/MOrt9�90 Liabilities/Liens (Schadule I7 (10) 47.230.00
ii. ratai DeducYions a1� 50,680.66
12. Net Value of Tax Return �ly� 112.736.11
13. ChariYaDla/Gavernmental BequesY�s; Non-elected 9113 Trusts (Sthedule J7 �1;� .00
14. Net Value of Estate SuDject to Tax �ly� 112,736.11
NOTE: If an assess�ent was is$uetl prsviously, Lines 14, 15. 16. 17. 18 and/or 19 will
reflect fiDUres that intlude the total of all returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Lfne 14 aY spousal raY• C157 13.998.00 X 00 � .00
16. AmounY of Line 14 taxable at 19nea1 rate (167 QA-�;R- > > X U45 = 4�443.21
17. Amount of LSne 14 at siblln9 r8te C17) -�� X 12 - .00
18. Amount of Line 14 taxable at collateral rate C18) .00 X 15 = .DO
19. Printipal Tax Due �19�° 4,443.21
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) pMOUNT PAID
DATE NUMHER INTEREST/PEN PAID (-)
01-2 -20 3 CD017089 �, 222.16 4,883.00
TOTAL TAX PAYMENT 5.105.16
' BALANCE OF TAX DUE 661 .95CR
� INTEREST AND PEN. .00
TOTAL DUE 661.95CR
t IF PAID AFTER DATE 2NDICATED, SEE RENEBSE IF TOTAL DUE IS REFLECTED AS A CREDIT CCR), YDII MAV BE DUE �/�� �
FOR CALCULATION DF qDUITIONAL INTffRE6T. A REFUND. SEE REVERSE SSDE FOR INSTRUCTIONS. �����
`�V
RESERVATION: Estates of de�de�fs dyinp on or before Dec. 12,1982-if any firture iMerest in the esiate is transterced in possession or
enjoyment ro aoMateral berrefipiaries of ttre decedent after the expiradan of any�N�for Nfe or�years;the Commom�veekh
hereby expreealy r�erve5 Me right to appraise and asaess transfer inher8ance taxes at Me lavvlui coNateral rate on any such
fuNre interest.
PAYMENT: Detach the top por6on of tldc notice and submit with your payment to the Registe�o(Wills In�cated on the front of the rrotice.
Make check or money order payable to:REGISTER OF WILL,AGENT.
REFUND(CR): A refund of a tax credit not requesled on the taz retum may be requasted by completlnp an AppNCation for Refund ot
Pennsylvania lnheritance and Estate Tax(REV-1313). Applfcatans are available hom the departmenPs web site at
www.revem -�any.Hepister of Wflls or Revenue di�triatC)Iflce,or from the deper6nent's 24-hour torms ordering
service:1-8(10-�,s�,senrices for taxpayers with Specii8l haerinp atKYor speekirq needa:1•800-447-302f1(fT only).
Please albw 4-6 weeks from Me date a retund was graMed�to arrive.
OBJECTIONS: Any party in interest not satlsTied with the appraisement,albwance or disaHOwance of deductions,or agsessment of tax
(includfng discount or iMerest)as shown on this raNce may objec[whhin BD days of the date of receipt of this rw8ce by:
A) Filing an appeal onlina at � on or bafore the appeal date identified on the front W this rrotica.
Or sendinp a written proteat M:PA DepartmeM of Revenue,Bogrd of Appeals,PO BOX 281201, Harrisburg PA 17128-1021;
B) HaWnp the�mattee detetmined at audit of tlre MxouMOf fie peia+,5na+repre5ea�tive;or
C) C�ppaeArg ro thB O�phans'Court.
ADMINISTRATIVE Errors discovered on this a5sessment shoukl be addressed in writinfl to:PA Department of flevenue,Bureau of Individual
CORRECTIONS: Tazes,ATTN:Post ABCaeamentReview UnR,�PO BOX 280601,Hamsbury PA, 1712&1021;Phone(71�787-6505: See pape 4
Instructions for InherRance Tax R9tum for a HesideM Decedent(REV-1507)fpr an explanation of atkninistratively correctable
ercors.
DISCOUNT: If any Wu due is paid within thrae calendar months af[er the decedent's death,a five percent discount ot the tax peid is albwable.
� INTEREST: Intarest is charged bepinninp willi first day of delirpuency,or nine months and one date Nom date of death,to the date of
payment. Mnual iMeeest rates are available on Form REV-1871,eveil8ble at www.revenue.atate.oa.us,or upon rquegt by
calling t-888-728-2937.
Interest is caiculated as folbws:
INTEREST=BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
Any Notice issued after the tau becomes delinquant will reflect an intereat calculation to 75 days beyord tha date of the
assessment If paymeM is made after the iMereat ca�ulatlon date show on the Notice,additional iMerest must be ca�ulated.