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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
*'
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
NOTICE OF INHERITANCE TAX
APp,RAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS, AND ASSESSMENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
REV-1548 EX AFP (06-05)
DATE 05-14-2007
ESTATE OF HEPFORD GRACE I
DATE OF DEATH 06-21-2005
FILE NUMBER 21 07-0355
COUNTY CUMBERLAND
SSN/DC 174-20-2902
ACN 07108402
APPEAL DATE: 07-13-2007
(See reverse side under Objections)
A.ount Re.ltted I I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
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, i LLl j'.: ' d: :'; 7
DIANNE G DILGEROF:?- I'~T
4 CEDARVIEW DR ::1"
LEBANON PA 17042
CUT ALONG THIS LINE --. RETAIN LOWER PORTION FOR YOUR RECORDS 4--
REY:is4i-EX-AFP-C03:0s5--------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 05-14-2007
ESTATE OF HEPFORD
GRACE
I DATE OF DEATH 06-21-2005
COUNTY
CUMBERLAND
FILE NO. 21 07-0355
TAX RETURN WAS:
S.S/D.C. NO. 174-20-2902
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
ACN
07108402
FINANCIAL INSTITUTION: PNC BANK
ACCOUNT NO.
21001021677
TYPE OF ACCOUNT:
DATE ESTABLISHED
()SAVINGS () CHECKING ()TRUST ex )TIME CERTIFICATE
02-24-1995
x
45,178.42
0.500
22,589.21
.00
22,589.21
.45
1,016.51
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
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
INTEREST IS CHARGED THROUGH 05-22-2007 TOTAL TAX CREDIT .00
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 1,016.51
REVERSE SIDE OF THIS FORM INTEREST AND PEN. 87.23
TOTAL DUE 1,103.74
* IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. *
( IF TOTAL DUE IS LESS THAN tl, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CRl, YOU MAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. l
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