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BUREAU DF INDIVIDUAL 7AX~S !~- `~ ~~~. NOTICE OF INHERITANCE TAX
INHERITANCE TAX DIVISION ;i , ~ ~ ~ AP•PRAISEMENT, ALLOWANCE OR DISALLOWANCE
PO BOX 280601 •- - ~ - ~ ~ OF DEDUCTIONS, AND ASSESSMENT OF TAX ON
HARRISBURG PA 17128-0601 JOINTLY HELD OR TRUST ASSETS
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303 W MAPLE AVE
SHIREMANSTOWN PA 17011
Pennsylvania ~•
DEPARTMENT OF REVENUE
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REV-1548 EX AFP C12-09)
DATE 11-15-2010
ESTATE OF FAHNESTOCK CONNIE L
DATE OF DEATH 10-11-2009
FILE NUMBER 21 09-0962
COUNTY CUMBERLAND
SSN/DC 195-38-7541
ACN 09179805
APPEAL BY DATE:O1-14-2011
(See reverse side under Objectr'ons)
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 F'~'
REV-1548 EX AFP t12-09~--------------------------------------------------~------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE: 11-15-2010
ESTATE OF:FAHNESTOCK CONNIE L DATE OF DEATH:10-11-2009
FILE NO.: 21 09-0962 S.S/D.C. NO.: 195-38-7541
ACN: 09179805
TAX RETURN WAS: CX) ACCEPTED AS FILED C ~ CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: SOVEREIGN BANK ACCOUNT NO.: 1684304221
TYPE OF ACCOUNT: C)U SAVINGS C ) CHECKING C TRUST C )TIME CERTIFICATE
DATE ESTABLISHED 06-05-2009
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
1,004.77 NOTE:
X 1.000
1,004.77
- .00
1,004.77
x .15
__ 150.72
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
lrv I CKtJ I 1J l.F1AKlitU 1 HKUU(GH 11 -23-2010
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
TOTAL TAX PAYMENT .00
BALANCE OF TAX DUE 150.72
INTEREST AND PEN. 2.24
TOTAL DUE 152.96
COUNTY:CUMBERLAND
* 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.