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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
11-07-2005
KOSER
02-25-2005
21 05-0307
CUMBERLAND
101
APPEAL DATE: 01-06-2006
( See reverse side under Objections)
Amount Remitted I I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
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REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
MARY K FILE NO. 21 05-0307 ACN 101
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Hisc. Expenses (Schedule H)
10. Debts/Hortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
SEAN M SHULTZ ESQ
KNIGHT S ASSOCS
11 ROADWAY DR STE B
CARLISLE PA
17013
ESTATE OF
KOSER
TAX RETURN WAS: (X) ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Hortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
) CHANGED
Cl)
(2)
(3)
(4)
(5)
(6)
(7)
146,969.80
.00
.00
.00
152.410.06
1.722.00
.00
(8)
REV-1547 EX AFP (06-05)
MARY
K
(9)
ClO)
10,601.38
DATE 11-07-2005
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
301,101.86
10.9n 20
290,180.66
.00
290,180.66
NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 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)
16. Amount of Line 14 taxable at Lineal/Class A rate (16)
17. Amount of Line 14 at Sibling rate (17)
18. Amount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
TAX CREDITS:
319.82
(11)
Cl2)
Cl3)
Cl4)
.00 X 00 = .00
290,180.66 X 045 = 13,058.13
.00 X 12 = .00
.00 X 15 = .00
Cl9)= 13,058.13
~...~ "..... . {+J AHOUNT PAID
DATE NUHBER INTEREST/PEN PAID (-)
05-25-2005 " CD005363 652.63 12,400.00
08-19-2005 ......... CD005714 .00 5.50
TOTAL TAX CREDIT 13,058.13
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
· IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
Rt.
( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)