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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
NonCE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS, AND ASSESSMENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
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CAROL PAYNE
220 W MAIN ST
MECHANICSBURG PA 17055
REV-1548 EX AFP (06-05)
DATE 04-16-2007
ESTATE OF PAYNE CHARLES T
DATE OF DEATH 12-27-2006
FILE NUMBER 21 07-0286
COUNTY CUMBERLAND
SSN/DC 348-36-1386
ACN 07111296
APPEAL DATE: 06-15-2007
(See reverse side under Objections)
A.aunt Re.ltted 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=is48-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 04-16-2007
ESTATE OF PAYNE
CHARLES
COUNTY
CUMBERLAND
T DATE OF DEATH 12-27-2006
FILE NO. 21 07-0286
TAX RETURN WAS:
S.S/D.C. NO. 348-36-1386
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1ST FCU
TYPE OF ACCOUNT:
DATE ESTABLISHED
ACN
07111296
ACCOUNT NO.
198262-05
~ )SAVINGS () CHECKING ()TRUST ()TIME CERTIFICATE
11-26-2001
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
20,205.88
0.166
3,367.71
.00
3,367.71
.00
.00
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 (-)
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" ( CRJ, YOU MAY BE DUE A REFUND.
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