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Home My WebLink About03-12-10 (2)BUREAU OF INDIVIDUAL TAXES ~' ~(r ~ r~, ^fn~ I~TLCE OF INHERITANCE TAX INHERITANCE TAX DIVISION r~i -- A~dR~ S ~IENT, ALLOWANCE OR DISALLOWANCE PO BoX 280601 ; ;~'~;~ ! ~', ~~ ~~~U.~TIONS, AND ASSESSMENT OF TAX ON HARRISBURG PA 17128-0601 JOINTLY HELD OR TRUST ASSETS 2a~a n~R ~ 2 ~~ ~: 09 CLERK 0~ QRPt-iAN'S CJURT JEFFREY DOUD~,~I1Pi~~~L+N1~ICi CC., ~~!. 119 EWE ROAD MECHANICSBURG PA 17055 Pennsylvania ~ DEPARTMENT OF REVENUE REV-1548 EX AFP Q 2-09) DATE 03-08-2010 ESTATE OF DOUDEN ORPHA M DATE OF DEATH 10-29-2009 FILE NUMBER 21 09-1121 COUNTY CUMBERLAND SSN/DC 194-28-8479 ACN 09174455 APPEAL BY DATE:05-07-2010 (See reverse side under Objections) Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE '~ RETAIN LOWER PORTION FOR YOUR RECORDS <"~ ------------------------------------------------------------------------------------------- REV-1548 EX AFP (12-09) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE: 03-08-2010 ESTATE OF:DOUDEN ORPHA M DATE OF DEATH:10-29-2009 COUNTY:CUMBERLAND FILE NO.: 21 09-1121 S.S/D.C. NO.: 194-28-8479 ACN: 09174455 TAX RETURN WAS: CX) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO.: 217940-,05 TYPE OF ACCOUNT: (X)SAVINGS C ) CHECKING ( )TRUST C )TIME CERTIFICATE DATE ESTABLISHED 06-05-2002 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAX CREDITS: 6,896.43 X 0.500 3,448.22 - .00 3,448.22 Y .45 155.17 NOTE: TO ENSURE 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 T0: "REGISTER OF WILLS, AGENT." PAYMENT DATE RECEIPT NUMBER DISCOUNT C+) INTEREST/PEN PAID C-) AMOUNT PAID 01-29-2010 CD012295 7.76 147.42 TOTAL TAX PAYMENT 155.18 BALANCE OF TAX DUE .O1CR INTEREST AND PEN. .00 TOTAL DUE .O1CR ^ IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. BUREAU OF INDIVIDUAL TAXES '~a ~'rFM~~~ OF INHERITANCE TAX INHERITANCE TAX DIVISION i - /kPP~tAiSE,1~E~1~7, ALLOWANCE OR DISALLOWANCE PO BOX 280601 ~'~ ~~'~' ~ OFD DliD~~7IDbIS, AND ASSESSMENT OF TAX ON HARRISBURG PA 17128-0601 JOINTLY HELD OR TRUST ASSETS 20lQ ~9AR 12 ~~ 4~ 09 CLERK OF ORPN~,N'S COl1RT JEFFREY DOUDENCU~~~RL~'~'~ ~~ ~ P~ 119 EWE ROAD MECHANICSBURG PA 17055 Pennsylvania ~ DEPARTMENT OF REVENUE REV-1548 EX AFP (12-09) DATE 03-08-2010 ESTATE OF DOUDEN ORPHA M DATE OF DEATH 10-29-2009 FILE NUMBER 21 09-1121 COUNTY CUMBERLAND SSN/DC 194-28-8479 ACN 09174456 APPEAL BY DATE:05-07-2010 (See reverse side under Objections) Amount ReB~itted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ------------------------------------------------------------------------------------------- REV-1548 EX AFP C12-09) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE: 03-08-2010 ESTATE OF:DOUDEN ORPHA M DATE OF DEATH:10-29-2009 COUNTY:CUMBERLAND FILE NO.: 21 09-1121 S.S/D.C. NO.: 194-28-8479 ACN: 09174456 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET FINANCIAL INSTITUTION: MEMBERS 1ST FCU TYPE OF ACCOUNT: C )SAVINGS ( ) CHECKING ( )TRUST DATE ESTABLISHED 06-05-2002 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due 6,194.12 X 0.500 3,097.06 - .00 3,097.06 Y .45 139.37 TAX CREDITS: INFORMATION ACCOUNT NO.: 217940-40 CX)TIME CERTIFICATE NOTE: TO ENSURE 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 T0: "REGISTER OF WILLS, AGENT." PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID C-) AMOUNT PAID 01-29-2010 CD012295 6.97 132.41 TOTAL TAX PAYMENT 139.38 BALANCE OF TAX DUE .O1CR INTEREST AND PEN. .00 TOTAL DUE .O1CR ~ IF PAID AFTER THIS DATE. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ~ ~'1 BUREAU OF INDIVIDUAL TAXES T-" f ~'' j-,,-~i;}~NS,F-ICE OF INHERITANCE TAX INHERITANCE TAX DIVISIDN _-- -•- APP MII ENT, ALLOWANCE OR DISALLOWANCE PO BOX 280601 `^~ ` ~i Q~ AEIIUDTIONS, AND ASSESSMENT OF TAX ON HARRISBURG PA 17128-0601 ~~ '' -' ` ""~O'PNTLY HELD OR TRUST ASSETS Z4i0 MAR f 2 ~M 4= Og Cf.ERK C~ ORPHA~1'S COURT JEFFREY DOUD~MR~~~~(~ ~Q, Pf~ 119 EWE ROAD MECHANICSBURG PA 17055 Pennsylvania . DEPARTMENT OF REVENUE REY-1548 EX AFP C12-09) DATE 03-08-2010 ESTATE OF DOUDEN ORPHA M DATE OF DEATH 10-29-2009 FILE NUMBER 21 09-1121 COUNTY CUMBERLAND SSN/DC 194-28-8479 ACN 09174457 APPEAL BY DATE:05-07-2010 (See reverse side under Objections) Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ------------------------------------------------------------------------------------------- REV-1548 EX AFP C12-09) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE: 03-08-2010 ESTATE OF:DOUDEN ORPHA M DATE OF DEATH:10-29-2009 COUNTY:CUMBERLAND FILE NO.: 21 09-1121 S.S/D.C. NO.: 194-28-8479 ACN: 09174457 TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO.: 217940-41 TYPE OF ACCOUNT: ( )SAVINGS ( ) CHECKING ( )TRUST (X)TIME CERTIFICATE DATE ESTABLISHED 06-05-2002 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due reY raFnrrc~ 15,186.20 X 0.500 7,593.10 - .00 7,593.10 Y .45 341.69 NOTE: TO ENSURE 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 T0: "REGISTER OF WILLS, AGENT." PAYMENT DATE RECEIPT NUMBER DISCOUNT C+) INTEREST/PEN PAID (-) AMOUNT PAID 01-29-2010 CD012295 17.08 324.61 TOTAL TAX PAYMENT 341.69 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 ~ IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ~ IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ~~~~^` BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 JEFFREY DOUDEN 119 EWE ROAD ~ .~,:,~r ,~,~p+'~Y¢~OF INHERITANCE TAX t '- C PE~tJIt B ALLOWANCE OR DISALLOWANCE "r°~~ Of` ~DEDUC~'~$bIG~, AND ASSESSMENT OF TAX ON ~'-`~~`-"'-r~ "~JOY~JTC~ HELD OR TRUST ASSETS 2010 MAR 12 ~M 4~ 09 CLARK Or ORPHAN'S COURT CUMR~Ri.~UD CO., PA MECHANICSBURG PA 17055 Pennsylvania ~ DEPARTMENT OF REVENUE REV-1548 EX AFP C12-09) DATE 03-08-2010 ESTATE OF DOUDEN ORPHA M DATE OF DEATH 10-29-2009 FILE NUMBER 21 09-1121 COUNTY CUMBERLAND SSN/DC 194-28-8479 ACN 09174458 APPEAL BY DATE:05-07-2010 (See reverse side under Objectioves) Amount Remitted -~ MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ------------------------------------------------------------------------------------------- REV-1548 EX AFP (12-09) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE: 03-08-2010 ESTATE OF:DOUDEN ORPHA M DATE OF DEATH:10-29-2009 COUNTY:CUMBERLAND FILE NO.: 21 09-1121 S.S/D.C. NO.: 194-28-8479 ACN: 09174458 TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO.: 217940-47 TYPE OF ACCOUNT: ( )SAVINGS ( ) CHECKING ( )TRUST CX)TIME CERTIFICATE DATE ESTABLISHED 06-05-2002 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAX CREDITS: 14,928.73 X 0.500 7,464.37 - .00 7,464.37 Y .45 335.90 NOTE: TO ENSURE 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 T0: "REGISTER OF WILLS, AGENT." PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID C-) AMOUNT PAID 01-29-2010 CD012295 16.80 319.11 TOTAL TAX PAYMENT 335.91 BALANCE OF TAX DUE .O1CR INTEREST AND PEN. .00 TOTAL DUE .O1CR ~ IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ~ IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. ~,~^ SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. „ l nr ~ ~- ~ .-.-; .y iICE OF INHERITANCE TAX BUREAU OF INDIVIDUAL TAXES'' ~ }}f C INHERITANCE TAX DIVISION _ '_" A~'PR'J4~S ENT, ALLOWANCE OR DISALLOWANCE PO BOX 280601 - r% OF 31~bU~TIONS, AND ASSESSMENT OF TAX ON HARRISBURG PA 17128-0681 ~ `'" ' ~ ~' "1`"TDtNTLY HELD OR TRUST ASSETS ZOI~ MAR i 2 PM 4~ 09 ~~~~ Q ORPHAN'S COURT JEFFREY DOUB~R~`:~I~~ (;~., pq 119 EWE ROAD MECHANICSBURG PA 17055 Pennsylvania ~ DEPARTMENT OF REVENUE REV-1548 EX AFP C12-09) DATE 03-08-2010 ESTATE OF DOUDEN ORPHA M DATE OF DEATH 10-29-2009 FILE NUMBER 21 09-1121 COUNTY CUMBERLAND SSN/DC 194-28-8479 ACN 09174459 APPEAL BY DATE:05-07-2010 (See reverse side under Objections) Amount Reoitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ------------------------------------------------------------------------------------------- REV-1548 EX AFP C12-09) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE: 03-08-2010 ESTATE OF:DOUDEN ORPHA M DATE OF DEATH:10-29-2009 FILE NO.: 21 09-1121 S.S/D.C. NO.: 194-28-8479 COUNTY:CUMBERLAND ACN: 09174459 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO.: 217940-48 TYPE OF ACCOUNT: C )SAVINGS ( ) CHECKING C )TRUST CX)TIME CERTIFICATE DATE ESTABLISHED 06-05-2002 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAX CREDITS: 15,019.53 X 0.500 7,509.77 - .00 7,509.77 Y .45 337.94 NOTE: TO ENSURE 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 T0: "REGISTER OF WILLS, AGENT." PAYMENT DATE RECEIPT NUMBER DISCOUNT C+) INTEREST/PEN PAID (-) AMOUNT PAID 01-29-2010 CD012295 16.90 321.05 TOTAL TAX PAYMENT 337.95 BALANCE OF TAX DUE .O1CR INTEREST AND PEN. .00 TOTAL DUE .O1CR ~ IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE A REFUND. ~~~ SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ~ ~~r„!• ~ '~'r~' 1~T OF INHERITANCE TAX BUREAU OF INDIVIDUAL TAXES ~ ~ ~~ INHERITANCE TAX DIVISION r -~ d4PP~AI~~~ , ALLOWANCE OR DISALLOWANCE Po BoX 280601 ~ ~)•1 :~~ `DED~~"r~XgNS, AND ASSESSMENT OF TAX ON HARRISBURG PA 17128-0601 JOINTLY HELD OR TRUST ASSETS 2QE0 MAR i Z ~M 4~ 09 CLEf~K ~;= ORPHAN'S COURT JEFFREY DOUDE~U~~~~'~~~~n ~~. PA, 119 EWE ROAD MECHANICSBURG PA 17055 Pennsylvania ~ DEPARTMENT OF REVENUE REY-1548 EX AFP C12-09) DATE 03-08-2010 ESTATE OF DOUDEN ORPHA M DATE OF DEATH 10-29-2009 FILE NUMBER 21 09-1121 COUNTY CUMBERLAND SSN/DC 194-28-8479 ACN 09174460 APPEAL BY DATE:05-07-2010 (See reverse side under Objections) Amount Re^itted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ------------------------------------------------------------------------------------------- REV-1548 EX AFP C12-09) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE: 03-08-2010 ESTATE OF:DOUDEN ORPHA M DATE OF DEATH:10-29-2009 COUNTY:CUMBERLAND FILE NO.: 21 09-1121 S.S/D.C. NO.: 194-28-8479 ACN: 09174460 TAX RETURN WAS: (X) ACCEPTED AS FILED C ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO.: 217940-49 TYPE OF ACCOUNT: C )SAVINGS ( ) CHECKING ( )TRUST CX)TIME CERTIFICATE DATE ESTABLISHED 06-05-2002 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAX CREDITS: 10,013.02 X 0.500 5,006.51 - .00 5,006.51 Y .45 225.29 NOTE: TO ENSURE 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 T0: "REGISTER OF WILLS, AGENT." PAYMENT DATE RECEIPT NUMBER DISCOUNT C+) INTEREST/PEN PAID C-) AMOUNT PAID 01-29-2010 CD012295 11.26 214.03 TOTAL TAX PAYMENT 225.29 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. BUREAU OF INDIVIDUAL TAXES i '.-~IrCE~~I~~ RITANCE TAX INHERITANCE TAX DIVISION AP~RA~SEMENT', 14L',LOlY'ANCE OR DISALLOWANCE HARRISBURG6PA 17128-0601 ~ ~~~JOINT~4 'N~ D~'ORS TRUSTS ASSETS AX ON Pennsylvania ~ DEPARTMENT OF REVENUE REV-1548 EX AFP C12-09) ~~~~ MAR ~ Z ~~ ~{~ O9~STATE OF DOUDEN2010 ORPHA M DATE OF DEATH 10-29-2009 ~L~~~ ~~ FILE NUMBER 21 09-1121 Q~p~l~~~ vd~~7 SSNNDC 194B28~-8479 JEFFREY DOUDEN ~CU~R~~~~~~ i;Q,, ~~ ACN 09176093 119 EWE ROAD APPEAL BY DATE:05-07-2010 MECHANICSBURG PA 17055 (See reverse side under Objections) Amount Re^itted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS 4- ------------------------------------------------------------------------------------------- REV-1548 EX AFP C12-09) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE: 03-08-2010 ESTATE OF:DOUDEN ORPHA M DATE OF DEATH:10-29-2009 FILE NO.: 21 09-1121 S.S/D.C. NO.: 194-28-8479 COUNTY:CUMBERLAND ACN: 09176093 TAX RETURN WAS: (X) ACCEPTED AS FILED C ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO.: 217940-11 TYPE OF ACCOUNT: C )SAVINGS CX) CHECKING C )TRUST C )TIME CERTIFICATE DATE ESTABLISHED 06-06-2009 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAX CREDITS: 761.40 X 1.000 761.40 - .00 761.40 Y .45 34.26 NOTE: TO ENSURE 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 T0: "REGISTER OF WILLS, AGENT." PAYMENT DATE RECEIPT NUMBER DISCOUNT C+) INTEREST/PEN PAID C-) AMOUNT PAID 01-29-2010 CD012295 1.71 32.55 TOTAL TAX PAYMENT 34.26 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ~ IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ~~ __ _. n ~` ^:~''~r`'C ~~:-NOTICE OF INHERITANCE TAX BUREAU OF INDIVIDUAL TAXES - ~ INHERITANCE TAX DIVISION A~,~~'R SEMENT, ALLOWANCE OR DISALLOWANCE PO BOX 280601 {-!,~ `~;';~,; ~, 5~} 0l~;.IJET~UCTIONS, AND ASSESSMENT DF TAX ON FYIRRISBURG PA 17128-0601 JOINTLY HELD OR TRUST ASSETS Zara ~~~ i 2 ~~ ~= og c~~~x a~ oa~aN~~ ~ou~T JEFFREY L DOQ~RE Fi~C CJ., P~ 119 EWE ROAD MECHANICSBURG PA 17055 Pennsylvania ~ DEPARTMENT OF REVENUE REY-1548 EX AFP C12-09) DATE 03-08-2010 ESTATE OF DOUDEN ORPHA M DATE OF DEATH 10-29-2009 FILE NUMBER 21 09-1121 COUNTY CUMBERLAND SSN/DC 194-28-8479 ACN 10003590 APPEAL BY DATE:05-07-2010 (See reverse side under Objections) Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS 4- ------------------------------------------------------------------------------------------- REV-1548 EX AFP C12-09) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE: 03-08-.2010 ESTATE OF:DOUDEN ORPHA M DATE OF DEATH:10-29-2009 COUNTY:CUMBERLAND FILE NO.: 21 09-1121 S.S/D.C. NO.: 194-28-8479 ACN: 10003590 TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: MEMBER 1ST FED CREDIT UNION ACCOUNT NO.: 217940-43 TYPE OF ACCOUNT: C )SAVINGS ( ) CHECKING C )TRUST CX)TIME CERTIFICATE DATE ESTABLISHED 06-05-2002 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAX CRFt)TTS: 15,130.36 X 0.500 7,565.18 - .00 7,565.18 X .45 340.43 NOTE: TO ENSURE 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 T0: "REGISTER OF WILLS, AGENT." PAYMENT DATE RECEIPT NUMBER DISCOUNT C+) INTEREST/PEN PAID C-) AMOUNT PAID 01-29-2010 CD012296 17.02 323.41 TOTAL TAX PAYMENT 340.43 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 ~ IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ~ y)^