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N4TICE OF INHERITdNCE TAX � pennsylvania
HUREAU OF ZNDIVZDUAt TAXES APPRAISHMENTi ALLUWANCE OR DISALtOWANCE DEPApTMENTOFqEVENUE
INNERITANCE TAX DIVISION �F �EDUGTIONS AND ASSESSMENT OF TAX ���1
REY-7547 IX AFP {b3-23)
A4 BD7C 2EOb61
HARRISpURG Pa 1]128-tl601
DATE D7-P9-2013
ESTATE OF S7RUZKA JR ANDREW M
DATE 4F DEA7N 12-15-2012
FI�E NUM9ER 21 13-045Q
FIOWER TNOMAS E COUNTY CUMBERLAND
ACN lql
FlOWER lAW LLC APPEAL DATE: 09-27-2013
10 W M I6H ST (See reverse sid¢und�r Qbj�etions}
CARLISLE PA 17D13-2922 Apount Resitted'-� �
MAKE CHECK PAYABIE AND REMIt PAYMENT T6:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17�13
CUT ALON6 TNIS 4INE ___ �-�► RETAIN LdWER P4RTION FOR YOUR RECOkIIS E�
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REV-1547 EX AFP CO2-13) N4TICE OF INHERITANCE TAX APPRAISENEMT, ALLOWAMCE 4R
� DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: STRUZKA JR ANDREW MFILE N0. :21 13-0450 ACN: 101 DATE: 07-24-2U13
. TAX RETURN WASS Cj(7 ACCEpTED AS FILED C ) CHAN6ED
APPRAISED VALUE OF RETURN BASED QN: ORIGINAL RETURN
I. Real Extate CSChodulm A3 C1) •0� NOTE: To ensure proper
2. Stacks and Hontls CSchedula B} �g� 15r217.06 credit to your account,
Dp sabmit tha upper pot^tion
3. Closaly Hsid Stack/PaKpsrship Into�est CSOhadui• C) C33 04 this form wikh your
4. Mortyages/Natas Raceiveble {SChaduie D3 t4) •�� tax peyment.
5. CashBank Deposits/Misc. Ps�sonal Proparty f5chadula E) {g} 2>793.25
6. JolnYly Ownatl Propprty CSchatlule F> {�? .DO
7. Transfers (SChadula G7 t7) .00
e. 7ota1 Assets � �g} 18.,Qj,0.31
APPROVED DEUUCTIpNS pND EXENPTIONSs
9. Funeral Ezpenses/Adm. Costs/Mlsc. Expansss CSChedule H) �y� 14,734.00
10. De6tsJMOrk9age tiabilSties/Lions CSChoqule I} C10) •00
11. Tvtal DeAU<tlons Cil? 14�734.00
12. Nat Yalue of Tax Raturn �yp� 3.276.31
1S. Charitablel�orsrnmanta2 Baquasts; Mon-electatl 9113 Trusts CSChadula J3 �y;� •00
14. Net Yalua of Estatg Subioct to Tax t143 �'�7b.31
N6TE: If an assess�ent ras Sssued Previous3Y, i.fnes 14. 15, 16,cX7, 18 a��}/o�=;'li9y wi11
rsflect fiQUres that inc2ude tha total of a1S returns assp�sl2d to dete; ;{ `''
ASSESSMEN7 OF 7AX: c�3 - "� " � �� <<
c;;
15. Amount of Line 14 at spousal rate C15)��276 �_;X �''� �y�„00
16. Amount af Lina 14 #axaDle at lineal ra#e C16) -�'�-X i��15 �� �� _ .00
27. Amou�t of tina 24 at s361inffi rate t17)_T-��52 ��2 --� i.::� .OQ
78. Amouni of Li�a 14 taxaDle at collateral nta t18) .QD c� 1� �`� ��!�0�
19. Principa2 Tax Dua �:> i„' '"�a��° -- -�-� pQ
TAX CREDI7S: `�' �' ����+
PAYMENT RECELPT DiSCOUNT (+) (—. C:'i �-�
ANOUNT PAL� —;y
�ATE NUMBER IN7ERES7/PEN PAID (J C-�
TOTAL TAX PAYMENT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAt DUE .00
* TF PAID AFTER DAiE INDICATED, SEE REVERSE IF 70TAL DUE IS REFLECTED AS A CREDIT (CR). YOU MAY &E DUE ��
PqR CALCULATSqN OF ADDZTI�NAL INTERES7. A REFUNA. SEE REYERSE SIpE FDR IN$TRUCTIONS.
RESERVATION: Estate&of dececknts dyiuqvn or 6efore Dec. 12,1982-if any tuWre interest in fheastale iatvansferced in poesdssion or
en' yment to GWlqtiara{be�efiCianes of ihq decedent afier the expireHottof argr � �pf�,ar yeaFS;tlie,GO�t+onweaith
K� �
hersbp expresBly�reserves the rigltt ta appraise a�asseas hanafer inhe�tance tazes at the lawtvl collateral�raEe on arry such
future interest.
PAYMENT: Detxh the top porUon of this notiae and submitwlth your payment to the Register of Wiils IrWicated on the hoM of tlre notiqe.
Make check or mnney order payaMe ro:�REGiSTER OF WIL�,AGENT.
� REFUND(Cft): A refund of a teu credit not requested on the tax return may be requested by.., _r���atiwn f4c ftefuMnf
Pennsyivania inharipnce and Estate Tax jREV-1313}. �tio�are R irom CIV�ertrfrenYB+i�di gqs aY
' ��aNt.Hapkstar of Wills or Re+reraae L�Ck6a4 tx tram�tlredeparhMMS 2Mkow7foi,rrm�adering
service:t-BOq;362•2a60;servicea for tarzpayers with rrpeCia�haatyp arM/or speaking riaeds:i-&d0�347-3W20(7T.only}.
Piease aiiow 4•6"we&ks firom tfie t�a re6und was graMed ta arrfve. �
OBJECTfpNS; Any parly in inierest npt satisfied witir the appraisemeM,aibwar�s or d�salWwarus of de�aCtipnst�pr a�se§eR�arrt pf�
(inciud��c�sc�unt or interest}as shown on this rwtir�may object witlun 6Q tlays of�the datg�bt YeCeipt ol fliiS�by:
Aj Fiiing an appeai on8na at on or be#�re Uae 8pppat d��:idenb'fied.��the;froMa¢g�is�wtice.
� B) HavNp t�Me mat1B�dete�mii�ired�taudt o�f H�re@�eccount of tlre��p9nqns��re{xssen�$e�o X 281201,Harristiutg PA 17128-1021;
c) c7t+�rc,ar��o ma o�,ar�s•coun.
ADMItJISTRATIVE Errors dscov�red on�fiis aSSessmeM shquid be addtessed in wriSng to:PA Department of Reverwe,Butearu pf IrK6v�tai
- C{}FSAECTIONS: Ta�ces.ATTN:-PaM � . . oY Reriew.U��.PO BOX 2806tlt,NarHstiurg PA;�1712&-7029�-,�Phaae�171T}787-85fi5. See��pepe 4
� Inshuctions for InheAtance Tax�Retum for a ReaideM Decederrt(RfV-4501)for an explenadon of adminisUaUvety twrrectable
errors.
DI$COUNT: If any tan due is paid�Nritliin three calendar mo�rths after the decedent's���teaih,a five percent d'+scoum af the ta�c paid is�aNOwable.
. INTEREST: Interost is charped bepinninp with first day of delinquancY,or nine months and one date from date of death,to the daig of
payment. Annuai iMerest rates are avaiiabia on Form REV•161 t,avaiiabia at www.r�vnq��g,�tp.aa.��s,or uport ripiest 6y
cailing t-8f3@-72fi-2937.
IntBreSt is Caicuiat6d as foibws:
� INTEREST=BALANCE OF TAX UNPAIp X NUMBER QF DAYS 6ELINaIIENT X DAILY INTEREST FACTOR
. Any Natice issued after the ta�c becomes tlelinquant will reflec[an inierest cakuiaBon to 15 daya beyond the dffie of the
asses6ment. If paymeM is made after Cre iniere5t ca�utatian date show on tfie Notice,addttianai inierest must be catCUiated.