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BUREAU OF INDIVIDUAL TAXES APPRAISEMENTP ALLOWANCE OR DISALLOWANCE 1V DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 EX AFP (11-14)
PO BOX 280601
HARRISBURG PA 17128-0601 Rr-CORDED OFFICE OF
-
REGISTER OF WILLS DATE 12-15-2014
ESTATE OF KINER DIANNE L
2014 OEC 15 PM 12 12 DATE OF DEATH 01-20-2013
FILE NUMBER 21 13-0619
CLEFK OF COUNTY CUMBERLAND
SMITH 0R' MA N S' MU R T ACN 101
200 OLDTOWN 6%Br:�L A r"� -- - % APPEAL DATE: 02-13-2015
GARDNERS 'P f� 4L 90tt" (See reverse side under Objections)
Amount Remittedi
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE -0, RETAIN LOWER PORTION FOR YOUR RECORDS 4-
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REV-1547 --------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: KINER DIANNE LFILE NO. :21 13-0619 ACN: 101 DATE: 12-15-2014
TAX RETURN WAS: C X) ACCEPTED AS FILED CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) Cl) .00 NOTE: To ensure proper
2. Stocks and Bonds (Schedule B) (2) .00 credit to your account,
00 submit the upper portion
3. Closely Held Stock/Partnership Interest (Schedule C) (5) .
of this form with your
4. Mortgages/Notes Receivable (Schedule D) (4) .00 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) CS) .00
6. Jointly Owned Property (Schedule F) (6) .00
7. Transfers (Schedule G) (7)- .00
8, Total Assets (8) .00
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 10,000.00
10. Debts/Mortgage Liabilities/Liens (Schedule 1) (10) 00
11. Total Deductions (11) 10,000.00
12. Net Value of Tax Return (12) 10,000.00-
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00
14. Net Value of Estate Subject to Tax (14) 10,000.00-
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) -nn x 045 = .00
17. Amount of Line 14 at sibling rate C17) .nn x 12 = .00
18. Amount of Line 14 taxable at collateral rate Cis) .00 X 15 = .00
19. Principal Tax Due (19)= .00
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID
TOTAL TAX PAYMENT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
■ 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.