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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
,.. ,_~ r\-
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.. .'. ... :~_'._,No'ffCEL-()F INHERITANCE TAX
. APPRM~EM.ENT, ALLOWANCE OR DISALLOWANCE
~FbEDUCTioNS, AND ASSESSMENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
2001 JUL 30 Pt~ \: 2 \
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
CLE~\\ OF
PH' .. I'" r.r)'\ lOT
OR..J r\\\ ).\._A_\\:~~\' rl!~'
-.--"-" . I ~,.\
DOROTHY KALBFLEISCHCUr.t" ..
1214 BENT CREEK BLVD
MECHANICSBURG PA 17055
REV-1548 EX AFP (06-05)
07-30-2007
KALBFLEISCH
07-23-2006
21 07-0585
CUMBERLAND
069-14-3891
07125540
APPEAL DATE: 09-28-2007
(See reverse side under Objections)
Amount Re.itted I I
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
EDMUND
J
TO:
CUT ALONG THIS LINE ...... RETAIN LOWER PORTION FOR YOUR RECORDS ~
REY=is48-EX-AFP-C03=OSj--------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 07-30-2007
ESTATE OF KALBFLEISCH
EDMUND
J DATE OF DEATH 07-23-2006
COUNTY
CUMBERLAND
FILE NO. 21 07-0585
TAX RETURN WAS:
S.S/D.C. NO. 069-14-3891
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: SOVEREIGN BANK
TYPE OF ACCOUNT:
DATE ESTABLISHED
ACN
07125540
ACCOUNT NO.
0774047047
~ )SAVINGS () CHECKING ()TRUST ()TIME CERTIFICATE
08-27-2002
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
13,577.57
0.166
2,262.97
.00
2,262.97
.00
.00
X
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. )
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