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BUREAU OF INDIVIDUAL TAXES APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 EX AFP (11-14)
PO BOX 280601 RECORDED OFFICE O
HARRISBURG PA 17128-0601
REGISTER OF V1IL S
DATE 08-17-2015
��1J !!J �� � U ESTATE OF HOERNER IZORA F
U DATE OF DEATH 07-07-2014
FILE NUMBER 21 14-0697
CLEr�t; Cf COUNTY CUMBERLAND
LOCK ESQ HERSCBIRLPHA S' COURT ACN 101
3107 N FRONT ST CUMBCRLAINN GO PA APPEAL DATE: 10-16-2015
HARRISBURG PA 17110-1343 (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 E-
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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: HOERNER IZORA .: FFILE NO. :21 14-0697 ACN: 101 DATE: 08-17-2015
TAX RETURN WAS: ( 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,
3. Closely Held Stock/Partnership Interest (Schedule C) (3) 00 submit the upper portion
of this form with your
4. Mortgages/Notes Receivable (Schedule D) (4) •00 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 55,344.40
6. Jointly Owned Property (Schedule F) (6) .00
7. Transfers (Schedule G) (7) 26,426.50
8. Total Assets CB) 81 ,770.90
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 3,931 .50
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 511 .70
11. Total Deductions (11) 4,443.20
12. Net Value of Tax Return (12) 77,327.70
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C1s) .00
14. Net Value of Estate Subject to Tax (14) 77,327.70
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 1 X 00 = .00
16. Amount of Line 14 taxable at lineal rate (16) 77•'i77-70 X 045 = 3,479.74
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)= 3,479.74
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+)
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
10-02-2014 CDO19753 173.68 3,300.00
04-16-2015 CD020519 .00 6.05
08-10-2015 SBADJUST .00 .01
TOTAL TAX PAYMENT 3,479.74
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 FOR INSTRUCTIONS.