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NOTICE OF INHERITANCE TAX " pennsyLvarna
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE
INHERITANCE TAX D FED r`r DEDUCTIONS AND ASSESSMENT OF TAX ._.__..._J
PO BOX 280601i°�J�:J`J 1 S 4 r REV-1547 EX AFP (11-14)
HARRISBURG PA 17128�- (r1 r -_-
DATE 06-08-2015
Nis v�,l� S ESTATE OF BRENNEMAN MARY J
DATE OF DEATH 05-12-2014
(n� C LES' r FILE NUMBER 21 15-0161
BRENNEMANRPIti`E LYNN K COUNTY CUMBERLAND
301
180 TE�C�1 C RD ACN APPEAL DATE: 08-07-2015
MECHANICSBURG PA 17050 (See reverse side under Objections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE RETAIN LOWER PORTION FOR YOUR RECORDS
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REV 1547 EX AFP (11-14) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: BRENNEMAN MARY JFILE NO. :21 15-0161 ACN: 301 DATE: 06-08-2015
TAX RETURN WAS: C ) ACCEPTED AS FILED C X) CHANGED SEE ATTACHED NOTICE
APPRAISED VALUE OF RETURN BASED ON: TRANSFEREE RETURN
1. Real Estate (Schedule A) (1) •00 NOTE: To ensure proper
2. Stocks and Bonds (Schedule B) (2) .00 credit to your account,
3. Closely Held Stock/Partnership Interest (Schedule C) (3) 00 submit the upper portionof this form with your
4. Mortgages/Notes Receivable (Schedule D) (4) . 0 0, tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) .00
6. Jointly Owned Property (Schedule F) (6) .00
7. Transfers (Schedule G) (7) 2,155,757.88
8. Total Assets (8) 2,155,757.88
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) .0 0
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) .00
11. Total Deductions (11) .00
12. Net Value of Tax Return (12) 2,155,757.88
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00
14. Net Value of Estate Subject to Tax (14) 2,155,757.88
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) P•1 1;9;.7q7_RR X 045 = 97,009. 11
17. Amount of Line 14 at sibling rate (17) 00 X 12 = .00
18. Amount of Line 14 taxable at collateral rate (18) .00 X 15 = . 00
19. Principal Tax Due (19)= 97,009. 11
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+)
AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
02-12-2015 CD020238 .00 16,950.77
INTEREST IS CHARGED THROUGH 06-23-2015 TOTAL TAX PAYMENT 16,950.77
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 80,058.34
REVERSE SIDE OF THIS FORM INTEREST AND PEN. .00
TOTAL DUE 80,058.34
* IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A CREDIT (CR), YOU MAY BE DUE
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE FOR INSTRUCTIONS. lv\1jJv/1
REV•147L cX(01.10)
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pennsylvania INHERITANCE TAX
.i DEPARTMENT OF REVENUE EXPLANATION
BUREAU OF INDIVIDUAL TAXES OF CHANGES
PO Box 280601
HARRISBURG,PA 1
7128-0601
DECEDENT'S NAME FILE NUMBER
Mary J. Brenneman 2115-0161
REVIEWED BY ACN
y C. Moyer 301
ITEM
SCHEDULE NO, EXPLANATION OF CHANGES
G 2 The agricultural use exemption has been disallowed for these parcels per the definition
of a qualified transferee.
The deductions on the return have been disallowed.
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