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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 2B060I
HARRISBURG PA 17128-0601
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS. AND ASSESSMENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
RE\'-I5~8 EX AFP (06-05)
JODY A SHIVELL
8 TEABERRY DR
CARLISLE PA 17013-9041
06-18-2007
FASOLD PAUL
O. ~..-09.-2007.. I,""
.>< I C -,: ir '",y
CUMBERLAND
193-18-332;)
07119698
APPEAL DATE: 08-17-2007
(See reverse side under Objections)
Amount Rami tted l :=J
MAKE CHECK PAYABLE AND REMIT PAYMENT
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN/DC
ACN
I
TO:
CUT ALONG THIS LINE -+ RETAIN LOWER PORTION FOR YOUR RECORDS +-
------------------.-------------------------------------------------------------------------
REV-1548 EX AFP (03-05)
NOTICE OF INffERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 06-18-2007
ESTATE OF FASOLD
PAUL
I DATE OF DEATH 03-09-2007
COUNTY
CUMBERLAND
FILE NO. S.S/D.C. NO. 193-18-3323
TAX RETURN WAS: (X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
ACN 07119698
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FINANCIAL INSTITUTION: CITIZENS BANK OF PA
ACCOUNT NO.
6214353175
TYPE OF ACCOUNT:
DATE ESTABLISHED
()SAVINGS 0<) CHECKING (HRUST (HIME CERTIFICATE
03-14-2006
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
X
.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."
X
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NU~1BER INTEREST/PEN 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" ( CRJ, YOU MAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. J
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