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RECORD ADJUSTMENT DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES -94
INHERITANCE TAX DIVISION REV-1593 EX AFP (12-14)
PO BOX 280601 t ECORDED OFFICE OF
HARRISBURG PA 17128-060
REGIS REGISTER OF WILLS DATE 06-26-2015
ESTATE OF REBER GERALD J
2015 JUL 6 PM 3 12 DATE OF DEATH 03-30-2014
_ FILE NUMBER 21 14-0338
CLERK OF COUNTY CUMBERLAND
ORPHANS' ('/01-JkT ACN 101
.
PROCTOR RUMQERa4EV `'t Amount Remitted
STE 202
35 E HIGH ST MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
CARLISLE PA 17013-3052
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
NOTE: To ensure proper credit to your account, submit the upper portion of this form with your tax payment.
CUT ALONG THIS LINE -� RETAIN LOWER PORTION FOR YOUR RECORDS E-
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REV-1593 EX AFP C12-14) ** INHERITANCE TAX RECORD ADJUSTMENT **
ESTATE OF: REBER GERALD J FILE NO. :21 14-0338 ACN: 101 DATE: 06-26-2015
ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION
VALUE OF ESTATE:
1. Real Estate (Schedule A) (1) .00
2. Stocks and Bonds (Schedule B) (2) .00
S. Closely Held Stock/Partnership Interest (Schedule C) (3) .00
4. Mortgages/Notes Receivable (Schedule D) C4) .00
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 365,845.11
6. Jointly Owned Property CSchedule F) (6) .00
7. Transfers (Schedule G) (7) .00
8. Total Assets C8)
365,845.11
DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Administrative Costs/
Miscellaneous Expenses (Schedule H) (9) 9,478.01 '
10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) 4,7 30.70
11. Total Deductions (11) 14,208.71
12. Net Value of Tax Return C12) 351,636.40
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00
14. Net Value of Estate Subject to Tax (14) 351,636.40
TAX:
15. Amount of Line 14 at Spousal rate (15) 00X.00 = .00
16. Amount of Line 14 taxable at Lineal/Class A rate (16) 351,636.40 .045= 15,823.64
17. Amount of Line 14 at Sibling rate (17) .00X. 12 = .00
18. Amount of Line 14 taxable at Collateral/Class B rate (18) .00X.15 = .00
19. Principal Tax Due (19)
15,823.64
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID C-)
12-29-2014 CD020075 .00 15,814.23
12-30-2014 CD020080 .00 9.41
TOTAL TAX PAYMENT 15,823.64
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" (CR), YOU MAY BE DUE
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.
REV-14i J EX(01-10)
'R pennsylvania INHERITANCE TAX
DEPARTMENT OF REVENUE EXPLANATION
BUREAU OF INDIVIDUAL TAXES OF CHANGES
PO Box280601
HARRISBURG,
R B R 17128-0601
DECEDENTS NAME FILE NUMBER
Gerald J. Reber 21 14-0338
REVIEWED BY ACN
Steven -Agent# 193 101
ITEM
SCHEDULE NO. EXPLANATION OF CHANGES
E The value of this Schedule has been adjusted to correct a factual reporting error on the
original return.
H 8 The value of this item has been adjusted to correct a factual reporting error on the
original return.
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