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11-05-09 (2)
COMMONWEALTH O OF REVENUE NIA DEPARTMENT ~ ~i (~~''-~~~~OT~CE OF INHERITANCE TAX ~,~~~;,~~~ ~'" T, ALLOWANCE OR DISALLOWANCE F INDIVIDUAL TAXES <~.~^, ~:~~ ~ED~~7'l~NS~ AND ASSESSMENT OF TAX ON REV-1548 EX AFP Col-o9) BUREAU o ~:.~ b~ 2009 M DIVISION ~pINTLY HELD OR TRUST ASSETS 10 - 05' INHERITANCE TAX L D I S ~ awc 2eo6ol ~~ DATE LANTZY 1y,RRISBURG PA 17128-0601 Z00©l~~V _5 ~. ~~ ESTATE OF 07-03-2008 7 ' DATE OF DEATN 8_0744 +~ ~~{l, gERLAh1d COQ MARY K LANT E ao3 ~~~i1 ~; MECHANICSBURG PA 17055 FILE NUMBER CUMBERLAND COUNTY 161_34-2046 SSN/DC p8149154 ACN 12-04-2009 APPEAL DATE: eCpons) (See reverse side under ~'. a' Amount Rea+itted AND REMIT PAYMENT T0: MAKE CNECK PAYABLE REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 YOUR RECORDS _ ---~- LOWER PORTION FOR ___ .~- RETAIN _ _T, _ __