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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
*
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 1712B-0601
NOTICE OF INHERITANCE TAX
'APP~AISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS, AND ASSESSMENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
REV-154B EX AFP (06-05)
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file; II: 26
DATE 09-11-2007
ESTATE OF SAWYER MALCOLM M
DATE OF DEATH 05-27-2007
FILE NUMBER 21 07-0702
COUNTY CUMBERLAND
SSN/DC 091-18-9483
ACN 07130593
APPEAL DATE: 11-10-2007
(See re1Jerse side under Objections)
A.ount Re.ltted I I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
HELEN
APT 103
9 ALLIANCE DR
CARLISLE
CLER!< Of:
ORPH.L:J\],S COURT
L SAWWt:)~C"' i ',- ('r", D,\
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 09-11-2007
ESTATE OF SAWYER
MALCOLM
M DATE OF DEATH 05-27-2007
COUNTY
CUMBERLAND
FILE NO. 21 07-0702
TAX RETURN WAS:
S.S/D.C. NO. 091-18-9483
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
ACN
07130593
FINANCIAL INSTITUTION: PSECU
ACCOUNT NO.
8103282698
TYPE OF ACCOUNT:
DATE ESTABLISHED
~ )SAVINGS () CHECKING ()TRUST ()TIME CERTIFICATE
04-23-1992
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
x
2,960.26
0.166
493.39
.00
493.39
.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."
x
TAX CREDITS:
PAYMENT
DATE
RECEIPT
NUMBER
DISCOUNT (+)
INTEREST/PEN PAID (-)
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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