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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 2B0601
HARRISBURG PA 17128-0601
1'40TICE el'-INHERITANCE TAX
APPRAISEME~T, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS, AND ASSESSMENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
10-22-2007
GOUSE
10-01-2006
21 06-1050
CUMBERLAND
714-18-2611
06157533
APPEAL DATE: 12-21-2007
(See reverse side under Objections)
Amount Remitted I I
MAKE CHECK PAYABLE AND REMIT PAYMENT
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
r', I" DATE
rli c:2iisTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN/DC
ACN
'11 C'~''- I;)
:~I '.) ; ., . 1 ! i
-, I.,
(,; ,70'.(
C~,~....~<~ ~ " 1\
.II ;1
STEVEN L GOUSE
23RD STREET EXT
ENOLA
"'\1 :\
\...) ~.....
PA 17025
REV-1548 EX AFP (06-05)
WALTER
E
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 10-22-2007
ESTATE OF GOUSE
WALTER
E DATE OF DEATH 10-01-2006
COUNTY
CUMBERLAND
FILE NO. 21 06-1050
TAX RETURN WAS:
S.S/D.C. NO. 714-18-2611
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: PNC BANK
TYPE OF ACCOUNT:
DATE ESTABLISHED
ACN
06157533
ACCOUNT NO.
21001030348
()SAVINGS () CHECKING ()TRUST ~ )TIME CERTIFICATE
02-15-2001
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
18,413.04
0.166
3,068.90
.00
3,068.90
.45
138.10
X
X
TAX CREDITS:
PAYMENT
DATE
11-27-2006
RECEIPT
NUMBER
CD007492
DISCOUNT (+)
INTEREST/PEN PAID (-)
6.91
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
138.10
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. )
145.01
6.91CR
.00
6.91CR
l'-6