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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TA~no,\"'rn OF~ICE (. NOTICE OF INHERITANCE TAX
INHERITANCE TAX DIVISION-' .j. ,- ,4~P,R,AISEMENT, ALLOWANCE OR DISALLOWANCE
PO BOX 280601 'OF DEDUCTIONS, AND ASSESSMENT OF TAX ON
HARRISBURG PA 17128-0601 JOINTLY HELD OR TRUST ASSETS
'*
1001 JUN 29 PM I: 16
CLERK OF
ORPHAN'S COt},RT
JUDITH NEet:J!('1?--:-: r'\, FA.
28 LINDEN AVE
QUEENSBURY NY 12804
REV-1548 EX AFP (06-05)
DATE 07-02-2007
ESTATE OF WALLOWER EVA
DATE OF DEATH 02-28-2007
FILE NUMBER 21 07- 0552
COUNTY CUMBERLAND
SSN/DC 160-16-8651
ACN 07119696
APPEAL DATE: 08-31-2007
(See reverse side under Objections)
A.ount Re.1ttedl 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=is4i-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 07-02-2007
ESTATE OF WALLOWER
EVA
DATE OF DEATH 02-28-2007
COUNTY
CUMBERLAND
ACN
07119696
FILE NO. 21 07-0552
TAX RETURN WAS:
S.S/D.C. NO. 160-16-8651
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1ST FCU
ACCOUNT NO.
6050-05
TYPE OF ACCOUNT: ~ )SAVINGS () CHECKING ()TRUST ()TIME CERTIFICATE
DATE ESTABLISHED 03-15-2000
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
75,639.98
0.166
12,606.92
461. 66
12,145.26
.45
546.54
x
x
TAX CREDITS:
PAYMENT
DATE
05-29-2007
RECEIPT
NUMBER
CD008249
DISCOUNT (+)
INTEREST/PEN PAID (-)
.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."
AMOUNT PAID
519.21
519.21
27.33
.00
27.33
PAYMENT MUST BE MADE BY 11-29-2007*. 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. )