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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT 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
01-10-2006
ELLIS
06-07-2005
21 05-0528
CUMBERLAND
101
APPEAL DATE: 03-11-2006
(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
~~!_~~9~~_!~!~_~!~~______~___~~!~!~_~Q~~~_~Q~!!Q~_~Q~_!Q~~_~~~Q~~~__~____________________
REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ELEANOR B FILE NO. 21 05-0528 ACN 101
DONN L SNYDER
SAUL EWING
PO BOX 1291
HBG
ESQ
PA 17108
ESTATE OF
ELLIS
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. Mortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
(1)
(2)
(3)
(4)
(5)
(6)
(7)
) CHANGED
.00
4.894.26
.00
.00
164.899.97
7,654.30
.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage 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
NOTE: I~ an assessment was issued previously, lines
re~lect ~igures that include the total o~ ALL
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:
DATE
11-03-2005
+
INTEREST/PEN PAID (-)
.00
NUMBER
CD005967
(9)
(10)
23,911.38
1.814.20
(11)
(12)
(13)
(14)
REV-1547 EX AFP (06-05)
ELEANOR
B
.00 X 00 =
.00 X 045 =
150,722.95 X 12 =
.00 X 15 =
(19)=
AMOUNT PAID
18,086.75
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
DATE 01-10-2006
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
177,448.53
25.725 58
151,722.95
1.000.00
150,722.95
14, 15 and/or 16, 17, 18 and 19 will
returns assessed to date.
.00
.00
18,086.75
.00
18,086.75
18,086.75
.00
.00
.00
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUEf"
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) ~'