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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRIS8URG PA 17128-0601
NOTICE OF INHERITANCE TAX
APPRAIsEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS, AND ASSESSMENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
REV-1548 EX AFP (06-05)
F~~.~ 22 t.;"111: 1 :';'
DATE
ESTATE OF
02-26-2008
PAEZ
ROSALIA
M
!:-r
DATE OF DEATH
FILE NUMBER
COUNTY
SSN/DC
ACN
12-16~200~hLJIo
ttl-D7-0:l'f
CUMBERLAND
545-12-2034
07113364
APPEAL DATE: 04-26-2008
(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
TO:
('1 ~ "-~ . \
JOAQUIN
APT 4302
10 PRIMROSE
HAVERHILL
\...
PAEZc'~ '
WAY
MA 99999
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 02-26-2008
ESTATE OF PAEZ
ROSALIA
M DATE OF DEATH 12-16-2006
COUNTY
CUMBERLAND
FILE NO. S.S/D.C. NO. 545-12-2034
TAX RETURN WAS: (X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
ACN
07113364
FINANCIAL INSTITUTION: MEMBERS 1ST FCU
ACCOUNT NO.
120898-11
TYPE OF ACCOUNT:
DATE ESTABLISHED
()SAVINGS ~) CHECKING ()TRUST ()TIME CERTIFICATE
07-08-1991
X
3,938.99
0.166
656.51
.00
656.51
.45
29.54
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
TAX CREDITS:
PAYMENT
DATE
RECEIPT
NUMBER
DISCOUNT (+)
INTEREST/PEN PAID (-)
AMOUNT PAID
INTEREST IS CHARGED THROUGH 03-05-2008
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
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" { CRl. YOU MAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. l
.00
29.54
1. 05
30.59
" I
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