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BUREAU OF INDIVIDUAL TAXES E OF INHERITANCE TAX
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ALLOWANCE OR DISALLOWANCE
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DEPARTMENT OF REVENUE
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INHERITANCE TAX DIVISION ,
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AND ASSESSMENT OF TAX ON
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: REV-1548 EX AFP (12-09~
PO BOX 280601
HARRISBURG PA 17128-0601 ,
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JOINTLY HELD OR TRUST ASSETS
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,.. C3 P~~~~ ~~ DATE 07-13-2010
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ESTATE OF STAMBAUGH DOROTHY L
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DIANE SWINEHA~~~{°
125 YORK STREET
WELLSVILLE PA 17365
DATE OF DEATH 07-15-2009
FILE NUMBER 21 09-0831
COUNTY CUMBERLAND
SSN/DC 189-18-5561
ACN 09152135
APPEAL BY DATE:09-11-2010
(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 ~
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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: 07-13-2010
ESTATE OF:STAMBAUGH
FILE ND.: 21 09-0831 S.S/D.C. NO.: 189-18-55b1
ACN: 09152135
TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO.:
296654-11
TYPE OF ACCOUNT: C )SAVINGS CX) CHECKING C )TRUST C )TIME CERTIFICATE
DATE ESTABLISHED 12-04-200b
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
rex raGnrrc.
DOROTHY L DATE OF DEATH:07-15-2009
468.39
X 0.500
234.20
- .00
234.20
~ .045
10.54
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 (-) AMOUNT PAID
INTEREST IS CHARGED THROUGH 07-21-2010
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
TOTAL TAX PAYMENT .00
BALANCE OF TAX DUE 10.54
INTEREST AND PEN. .11
TOTAL DUE 10.65
COUNTY:CUMBERLAND
* IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRS, YOU MAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. `~ }~