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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
02-13-2006
LUNDGREN
08-23-2005
21 05-0907
CUMBERLAND
101
APPEAL DATE: 04-14-2006
( 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
CUT ALONG THIS LINE -... RETAIN LOWER PORTION FOR YOUR RECORDS +-
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REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
FRANCES M FILE NO. 21 05-0907 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
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
-'
FRANCIS A ZULLI
WION ETAL
109 LOCUST ST
HBG
ESQ
PA 17101
ESTATE OF
LUNDGREN
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
CHANGED
ll)
(2)
(3)
(4)
(5)
(6)
(7)
.00
.00
.00
.00
72.211.86
.00
.00
(8)
REV-1547 EX AFP (06-05)
FRANCES
M
(9)
llO)
6,782.29
DATE 02-13-2006
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
72,211.86
6.915 14
65,296.72
.00
65,296.72
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 ~ 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:
132.85
(11)
ll2)
ll3)
ll4)
.00 X 00 = .00
.00 X 045 = .00
65,296.72 X 12 = 7,835.61
.00 X 15 = .00
ll9)= 7,835.61
~.. .~... ,,~..~.... (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
12-15-2005 CD006108 .00 7,835.61
TOTAL TAX CREDIT 7,835.61
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
· IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. Q
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DEi .J
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) .
.j