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HomeMy WebLinkAbout07-30-07 - COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE '* BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX OIVISION PO BOX 2B0601 HARRISBURG PA 17128-0601 "'\r"~;~.(" -~ ' " ,.' --f.laT-ICE OF INHERITANCE TAX :'AP,PRAISEHEHt, ALLOWANCE OR DISALLOWANCE 'OF'DEDUCTIOkS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS Z001 JUL 30 p?,\ I: 22 REV-154B EX AFP (06-05) JAMES DAVIS 3929 BROOKRIDGE DR MECHANICSBURG PA 17050 CLEP\( OF ORPHll}Yc' ('1\1 )'Dl \ '" "J ,j.......J~. I \ I CII'..'-' -.. -, (-,,\ l/'",.- !" 'r,;"", DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 07-30-2007 DAVIS 04-12-2007 21 07-0594 CUMBERLAND 040-42-3539 07123128 APPEAL DATE: 09-28-2007 (See reverse side under Objections) A.aunt Re.ltted I I MAKE CHECK PAYABLE AND REMIT PAYMENT REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CYNTHIA 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 07-30-2007 ESTATE OF DAVIS CYNTHIA DATE OF DEATH 04-12-2007 COUNTY CUMBERLAND FILE NO. 21 07-0594 TAX RETURN WAS: S.S/D.C. NO. 040-42-3539 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 07123128 FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 181555-00 TYPE OF ACCOUNT: DATE ESTABLISHED ~ )SAVINGS () CHECKING ()TRUST ()TIME CERTIFICATE 02-01-1999 1,121.93 0.166 186.99 .00 186.99 .00 .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." Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due x x TAX CREDITS: 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" ( CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) en .