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HomeMy WebLinkAbout01-16-07 (11) COMMONWEALTH OF PENNSYLVANIA DE~ARTMENT OF REVENUE -,-'0'" ; " ,-,n-,('r:r\;-D C'--"-t+ottCE OF INHERITANCE TAX '-, ';"'~i ,- ' AP~RAI~~MEt<lT, ALLOWANCE OR DISALLOWANCE elF 'DEDUCTIoNS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS 7.GUl Jr,\~\l \ f> pr' \2.: 02 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 r'u=n\< Ot \J .: }t... f'.,r"'\t \Pl QDP'>-, '1'\..'\\ -', 1 .'.)'...' I n. I :"'.'.~ .'., '......1 ".' -'~'" r", ETHEL J PETERSO~\ i\r' - oJ-.' 1520 SELTZER CT MECHANICSBURG PA 17050 *' REV-154B EX AFP (06-05) DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 01-15-2007 PETERSON 07-17-2006 21 06-1101 CUMBERLAND 086-20-0896 06153197 APPEAL DATE: 03-16-2007 (See reverse side under Objections) Amount Re.1tted I I MAKE CHECK PAYABLE AND REMIT PAYMENT REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 RICHARD N TO: CUT ALONG THIS LINE -+ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REY=is4S-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 01-15-2007 ESTATE OF PETERSON RICHARD COUNTY CUMBERLAND N DATE OF DEATH 07-17-2006 FILE NO. 21 06-1101 TAX RETURN WAS: S.S/D.C. NO. 086-20-0896 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: MEMBERS 1ST FCU TYPE OF ACCOUNT: DATE ESTABLISHED ACN 06153197 ACCOUNT NO. 118029-11 ()SAVINGS ~) CHECKING ()TRUST ()TIME CERTIFICATE 01-29-1993 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due X 21,416.51 0.166 3,569.49 .00 3,569.49 .00 .00 X TAX CREDITS: PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) 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." AMOUNT PAID TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE * 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. ) .00 .00 .00 .Op!) L{;