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NOTILE OF INHERITANCE TAX � pennsylvania
BUREAU OF INDIVIDUAL TAXES APPRAISEMENT. ALLOWANCE OR DISALLOWANCE DEPARTMENTOFREVENUE
INHERSTANCE TAX OIVISION OF DEDUCTIONS AN➢ ASSESSMENT OF TAX REV-]547 IX AFP coa-ii�
PO BO% 280601
NARRISBURG PA ]7/28-0601 k E C 0 R D E D 0 r r IC E 0 F
REGISTER OF �'i�i.�S DATE 07-OS-2013
ESTA7E OF ZOCK THOMAS M
�O(3 ���, i2 P(� 2 23 FILE NUMBERTH 21 07-0319
COUNTY CUMBERLAND
ANDREW W BARBIN PC CLERK OF pCN 101
STE lU2 ORPHANS� COURT APPEAL DATE: 09-06-2013
5 KACEY CT ��M����ND CO., pQ (Seer¢nersesideunderOhjections)
MECHANICSBURG PA Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TD:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALON6 THIS LINE ____ �-► RETAIN LOWER PORTION FOR YOUR RECORDS f�
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REV-1547 EX AFP (02-13) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: 20CK THOMAS MFILE N0. :21 07-0319 ACN: 101 DATE: 07-OS-2013
TAX RETURN WAS: ( > ACCEPTED AS FILED ( X] CHANGEU SEE ATTACHED NOTICE
APPRAISED VALUE OF RE7URN BASED ON: aRIGINAL RETURN
1. Real Estate (SCheAUl¢ A) (1) 1�1 .0�0.�0 N�TE: Ta ensure prop¢r
2. Stocks and Bonds cSCheEule B) �Z� •00 <reCit to your account,
. �� submlt the upper portion
i. L1ose3Y Heltl Stock/Partnership Tnterost (Schedule C) �3) of ihis form with your
4. Mort9aeeslNotes ReceSvaDle (ScheOUle D> (4) •00 ia• paymenf.
5. Cash/Bank Deposits/Misc. Personal Property (SChetlule E) (5) 886.45
6. Jo1nt1Y Ownetl Property (Schodul¢ F7 (6) .�0
7. Transfers (Schedule G) �7� . 00
e. 7ota1 Asseis cg) 171 .886.45
APPROYED UEDUCTIONS AND EXEMPTIONS:
9. Funeral Exponses/Adm. Costs/MSsc. Ezpanses CScAeEule M) �g� 9.640.00
10. Dobts/MOrtgaBe LSa0113ties/Llons CSch¢tlule I) (lp) .00
11. Total �etluctions �11� 9rb40.OD
12. Net Value of Tas Raturn �127 162�246.45
l3. CharitaGle/6overnmenta3 Bequasts; Non-e3ecSed 9113 Trusts (Schodule J) �13� -00
14. Net Value of Estata Sub�ect to Taz �14� 162.246.45
NOTE: If an assessment was Sssued Previously. Lines 14. 15, 16. 17. 18 and/or 19 will
reflect fi9ures that include the tolal of all returns assessed to date.
ASSESSMENT OF TAX:
15. Amounf of Lin¢ 14 at sp0usal rate (15) •Ofl X 00 - .00
16. Amount of Line 14 taxable at llneal raFe (16) ���•�G6 -45 X 045 ° 7�301 .09
17. Amount of LSne 14 at siblin9 rate (177 -00 X 12 ' .00
18. Amounf of Lfno 14 taxable at collateral rate (18) . 00 X 15 .00
19. PrSnc10a1 Tax Due �19�= 7,301 .09
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) qryOUNT PAID
DATE NUMBER INTEftEST/PEN PAID (-)
03-22-2011 CD014165 393.91- 7,695.00
BALANCE OF UNPAID INTEREST/PENALTY AS OF 03-23-2011 TOTAL TAX PAYMENT 7.301 .09
BALANCE OF TAX UUE , pp
INTEREST AND PEN. 837.07
TDTAL DUE 837.07
+ IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A CREDIT (CR), VDU MAY BE DUE /�1�
FOR CALCULATION OF ADOITIONAL INTEREST. A REFUND. SEE REVERSE SIDE FOR INSTRUCTIONS. �jY
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RESERVATION: Estates of decedents dying on or before Dec.12,1982-if any tuture interest in the estate is transferred in possession or
enjoyment to collateral beneficiaries of[he decedent after the ezpiration of any estate for life or years;the Commorn+ealth
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 ot the notice.
Make check or money order payable to:REGISTER OF W ILL,AGENT.
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 lnheritance and Estate Tax(REV-1313). Applications are available from the departmenCs web site at
www.revenue state.o�.us,any Register of Wills or Revenue District OHice,or from the departmenYs 24-hour forms ordering
service: 1-800-362-2050;services for ta�payers with special hearing and/or speaking needs: 1-800-4473020(TT only).
Please allow 4-6 weeks from the date a refund was granied to arrive.
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[his notice may object within 60 days of the date of receipt of this notice by:
A) Filing an appeal online at www boardofaooeals state oa us on or before the appeal date identifed on the front of this notice.
Or sending a written protest to:PA Department of Revenue,Board of Appeals,PO BOX 281201,Harrisburg PA 7 71 28-1 021;
B) Having the matter determined at audit of the account of the personal represen[ative;or
C) C)Appealing to the Orphans'Court. �
ADMINISTRATIVE Errors discovered on this assessmen[should be addressed in writing to:PA Department of Revenue,Bureau of Individual
CORRECTIONS: Taxes,ATTN:Pos[Assessment Review Unit,PO BOX 280601,Harrisburg PA, 17128-1021,Phone(71�)787-6505. See page 4
Instructions for Inheritance Tax Return for a Resident Decedent(REV-7501)for an explanation of administraiively correctable
errors.
DISCOUNT: If any tax due is paid wi[hin three calendar months after the decedenYs death,a five percent discount of the tax paid is allowable.
INTEREST: Interest is charged beginning with first day of delinquency,or nine months and one date from date of deaih,to the date of
payment. Annual interest rates are available on Form REV-1611,available at www revenue state oa us,or upon rquest 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 interes[calculation to 15 days beyond the date of the
assessment. If payment is made after the interest calculation date show on the Notice,additional interest must be calculated.
W , ;.
��`' � �� pCI�I1�$�(�Ya�"Ila INHERITANCE TAX
�� DEPARTMENT OFREVENUE -
EXPLANATION
BUREAU OFINDIVIDUALTAXE$ OF CHANGES
BUREAU OF INDIVIDUAL TAXES �
DEPT.280601
HARRISBURG,PA 17128-0601 .
DECEDENT'S NAME � FILE NUMBER
Thomas M Zock 2107-0319
REVIEWED BY qCN
Tamika Washington 107
ITEM
SCHEDULE NO. EXPLANATION OF CHANGES �
Original Inheritance tax return has been adjusted to reflect the additions/changes as
indicated from the correspondence sent to the department.
rtow Paqe 1