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BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
'.~'-'r-""
(/ !lWTxc.e' OF INHERITANCE TAX
Ap:pRAIS'EI1ENT, ALLOWANCE OR DISALLOWANCE
OF'OEDUCTIONS, AND ASSESSI1ENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
-
REV-1548 EX AFP (06-05)
2007 JM~ 16 PM 12: 01
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN/DC
ACN
01-15-2007
BURKE
10-18-2006
21 06-0968
CUMBERLAND
128-20-6360
06161285
APPEAL DATE: 03-16-2007
(See reverse side under Objections)
A.ount Re.1tted\ I
MAKE CHECK PAYABLE AND REMIT PAYMENT
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
JOSEPHINE A
CLI=,-,\I (,r
J ,-r~ \ .'.)i-
ORPHP\'\'S CDURT
KATHLEE GALLACH~RF/--",-r, p,~,
719 BARBARA ST
NEW CUMBERLAND PA 17070
TO:
CUT ALONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS +--
REY=is4S-EX-iFP-C03=os5--------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 01-15-2007
ESTATE OF BURKE
JOSEPHINE A DATE OF DEATH 10-18-2006
COUNTY
CUMBERLAND
FILE NO. 21 06-0968
TAX RETURN WAS:
S.S/D.C. NO. 128-20-6360
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
ACN
06161285
FINANCIAL INSTITUTION: MEMBERS 1ST FCU
ACCOUNT NO.
263033-11
TYPE OF ACCOUNT:
DATE ESTABLISHED
()SAVINGS OC) CHECKING ()TRUST ()TIME CERTIFICATE
10-26-2005
.00
1. 000
.00
.00
.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."
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
x
x
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 "CREDIT" ( CR), YOU MAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )