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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
C"C(i'r "'T, '~;-c-:",NO,TlCE OF INHERITANCE TAX
"'A~~~A'iSEH_E"T, ALLOWANCE OR DISALLOWANCE
O'F bI:DUCTIONS, AND ASSESSMENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
*'
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRIS8URG PA 17128-0601
?OO?
R 16 i~.; ill: 3 i
r" "
WILMA J CLARK
638 HIGHLAND AVE
MT HOLLY SPGS PA 17065
REV-1548 EX AFP C06-05)
DATE 03-19-2007
ESTATE OF QUIGLEY MELVIN K
DATE OF DEATH 09-03-2006
FILE NUMBER 21 07-0134
COUNTY CUMBERLAND
SSN/DC 207-07-9946
ACN 06154041
APPEAL DATE: 05-18-2007
(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
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS +-
REY=is4i-EX-AFP-C03=Os5--------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 03-19-2007
ESTATE OF QUIGLEY
MELVIN
COUNTY
CUMBERLAND
K DATE OF DEATH 09-03-2006
FILE NO. 21 07-0134
TAX RETURN WAS:
S.S/D.C. NO. 207-07-9946
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1ST FCU
TYPE OF ACCOUNT:
DATE ESTABLISHED
ACN
06154041
ACCOUNT NO.
240335-00
~ )SAVINGS () CHECKING ()TRUST ()TIME CERTIFICATE
01-27-2004
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
13,107.32
0.500
6,553.66
.00
6,553.66
.45
294.91
X
x
TAX CREDITS:
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,"
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
02-09-2007 CDOO7795 .00 294.91
TOTAL TAX CREDIT 294.91
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.