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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXE~\ECXJRDED O~~~f~~~~~E ~~L~:~~~~T~C~I~:~LOWANCE
INHERITANCE TAll DIVISION ,-- "!!~:.l-' , '
PO BOll Z80601 i: i ''vyr'1)I;QUCTIONS, AND ASSESSMENT OF TAX ON
HARRISBURG PA 171Z8-0601 JOINTL Y HELD OR TRUST ASSETS
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REV-lS48 Ell AFP (06-0S)
20UG DEe 26 PM 12: 14
DATE 12-25-2006
ESTATE OF HESS KATHRYN E
DATE OF DEATH 06-09-2006
FILE NUMBER 21 06-1082
COUNTY CUMBERLAND
SSN/DC 066-22-6864
ACN 06152643
APPEAL DATE: 02-23-2007
(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
CLHiK OF
ORPHl}I'S COURT
SUSAN N MCNNR1;"- - ,,- D/~,
VVI\l~
475 WOODCREST DR
MECHANICSBURG PA 17050
CUT ALONG THIS LINE -+ RETAIN LOWER PORTION FOR YOUR RECORDS +-
Riv=is4S-ix-AFP-r03=Osi--------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 12-25-2006
ESTATE OF HESS
KATHRYN E DATE OF DEATH 06-09-2006
COUNTY
CUMBERLAND
FILE NO. 21 06-1082
TAX RETURN WAS:
S.S/D.C. NO. 066-22-6864
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
ACN
06152643
FINANCIAL INSTITUTION: MEMBERS 1ST FCU
ACCOUNT NO.
224635-11
TYPE OF ACCOUNT: ()SAVINGS ~) CHECKING ()TRUST ()TIME CERTIFICATE
DATE ESTABLISHED 12-02-2002
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Due
1,480.79
0.500
740.40
907.31
.00
.45
.00
NOTE: TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO:
"REGISTER OF WILLS, AGENT."
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
. IF PAID AFTER THIS DATE, 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 "CREDIr. ( CRJ, YOU HAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. J
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