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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 2B0601
HARRISBURG PA 1712B-0601
NOTICE OF INHERITANCE TAX
A~PRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS, AND ASSESSMENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
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MADISON A WAGNER
13 HOMESTEAD LN
CAMP HILL
PA 17011
-
REV-1S~B EX AFP (06-0S)
DATE 09-11-2007
ESTATE OF POWElL JEAN D
DATE OF DEATH 08-12-2006
FILE NUMBER 21 06-0730
COUNTY CUMBERLAND
SSN/DC 174-20-6085
ACN 06152635
APPEAL DATE: 11-10-2007
(See reverse side under Objections)
A.ount Re.1tted L 1
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 4--
REY=is4i-EX-AFP-coi=osj---------------_____________________________________________________
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANC~ OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 09-11-2007
ESTATE OF POWELL
JEAN
D DATE OF DEATH 08-12-2006
S.S/D.C. NO. 174-20-6085
ex) ACCEPTED AS FILED e) CHANGED
JOINT OR TRUST ASSET INFORMATION
FILE NO. 21 06-0730
TAX RETURN WAS:
FINANCIAL INSTITUTION: MEMBERS 1ST FCU
TYPE OF ACCOUNT:
DATE ESTABLISHED
COUNTY
CUMBERLAND
ACN
06152635
ACCOUNT NO.
261573-54
e )SAVINGS e) CHECKING OC >TRUST e >TIME CERTIFICATE
03-16-2005
PAYMENT RECEIPT DISCOUNT e+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID e-)
INTEREST IS CHARGED THROUGH 09-19-2007 TOTAL TAX CREDIT .00
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 450.66
REVERSE SIDE OF THIS FORM INTEREST AND PEN. 12.83
TOTAL DUE 463.49 ~
* 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.
Account Balance
Percent Taxable
Amount SUbject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
x
10,014.74
1. 000
10,014.74
.00
10,014.74
.45
450.66
x
TAX CREDITS:
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. J
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."