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DEPARTMENT OF REVENUE
TICS OF INHERITANCE 7AX REV-1548 EX AFP 012-10)
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JAMES
DATE
HARRISBU ~~ ~ ~~ ~l~ a~ ~~' ~4K~
~~ MEAD
ATETOFODEATH O1•-13-2011
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FILE NUMBER 21 11-0308
CUMBERLAND
~~ COUNTY
193-01-2449
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a SSN/DC 11113147
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APPEAL BY DATE : 08 -12 - 2 ns
ectto
Ob
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JAMES HEATH ~
er
(See reverse side un
AY
1752 CONW
HILL PA 17011
Amount Remitted
AND REMIT PAYMENT T0:
CAMP
AKE CHECK PAYABLE
M
REGISTER OF WILLS
1 COURTHOUPA SQ~lU1
3
CARLISLE
ON FOR YOUR RECORDS E~ --------------
~ RETAIN LOWER PORTI-----------------------------
CUT ALONG THIS LINE _____________________'-
------ " ""-- C12-10~ T, ALLOWANCE OR DISALLASSETS OF
REV-1548 EX AFP
NOTICE OF INHERITANCE TAX APPRAISEMEN DATE: 06-13-2011
SESSMENT OF TAX ON JOINTLY HELD OR TRUS
DEDUCTIONS, AND AS
ATH:O1-13-2011 COUNTY:CUMBERLAND
JAMES L DATE OF ~E 11113147
ESTATE OF:MEAD ACN:
S.S/D.C. NO.: 193-01-2449
FILE NO.: 21 11-0308 ~ ) CHANGED
TAX RETURN WAS (X) ACCEPTED AS FILED SSET INFORMATION
JOINT OR TRUST A ACCOUNT NO.: 120001574
CHECKING C )TRUST CX}TIME CERTIFICATE
FINANCIAL INSTITUTION: METRO BANK)
)SAVINGS
TYPE OF ACCOUNT:
03.71 NOTE: TO ENSURE PROPEUBMITDTHETO
DATE ESTABLISHED 05-05-2008 17 0 UNT S
Account Balance
X 0.500
86
501
Percent Taxable .
g,
Amount Subject
to Tax _ ,00
Debts and Deductions 8,501.86
Taxable Amount ,15
Tax Rate 1,275.28
Tax Due
TAX CREDITS : DISCOUNT c+)
RECEIPT INTEREST/PEN PAID ~-)
PAYMENT NUMBER 63 , 7 6
DAT E
03-07-2011
CD014096
YOUR ACCO
UppER PORTION OF MENT TOTTHE
WITH YOUR TAX PAY
REGISTER OF WILLMAKE CHECK
ABOVE ADDRESS
OR MONEY ORDERILLSABAGENOT•"
"REGISTER OF W
AMOUNT PAID
1,275.28
TOTAL TAX PAYMENT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE ___
1,339.04 I
63.76CR
,00
63.76CR
TE, SEE REVERSE FOR CALCULATION OF ADDITIONAL '[NTEREST.
* IF PAID AFTER gHREFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE A REFUND.
IF TOTAL DUE I
__..~~cr c7nE OF THIS FORM FOR INSTRUCTION