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BUREAU OF INDIVIDUALIJ~kEs
INHERITANCE TAX DIVISION!""";'.,
PO BOX 280601 ,
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
01-10-2006
EPPLEY
05-23-2005
21 05-0958
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~!_~~9~9_!~~~_~~~~______~___~~!~!~_~~~~~_~~~!!~~_~~~_!~~~_~~~~~~~__~____________________
REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
PAULINE E FILE NO. 21 05-0958 ACN 101
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
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DIlLSBURG
PA 17019
ESTATE OF
EPPLEY
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
If an assessment was issued previously, lines
reflect figures that include the total of ~
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate
16. Amount of Line 14 taxable at Lineal/Class A rate
17. Amount of Line 14 at Sibling rate
18. Amount of Line 14 taxable at Collateral/Class B rate
19. Principal Tax Due
TAX CREDITS:
NOTE:
+
DATE
10-27-2005
NUMBER
CD005948
INTEREST/PEN PAID (-)
.00
· IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
CHANGED
(1)
(2)
(3)
(4)
(5)
(6)
(7)
.00
.00
.00
.00
1.000.00
165,765.67
.00
(8)
REV-1547 EX AFP (06-05)
PAULINE
E
(9)
(10)
4,077 .30
DATE 01-10-2006
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
166,765.67
10.930 96
155,834.71
.00
155,834.71
14, 15 and/or 16, 17, 18 and 19 will
returns assessed to date.
.00
.00
18,700.17
.00
18,700.17
18,700.17
.00
.00
.00
IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. /_
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE(
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) .
6.853.66
(11)
(12)
(13)
(14)
(15)
(16)
(17)
(18)
.00 X 00 =
.00 X 045=
155,834 . 71 X 12 =
.00 X 15 =
(19)=
AMOUNT PAID
18,700.17
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE