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BN ERITANCE TAXDD VISION TAXES ~~wC~ ~~P~ ENTE ALLOWANCETORCDISALLOWANCE
~~
PO BOX 280601 ~tGIS~~:'SF -~. TIONS, AND ASSESSMENT OF TAX ON
HARRISBURG PA 17126-D601 JOINTLY HELD OR TRUST ASSETS
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SCOTT W EVA~-YIB~RL~ND r~., {)A.
80 MILLERS GAP RD
ENOLA PA 17025-1009
Pennsylvania ~-
DEPARTMENT OF REVENUE
REV-1548 EX AFP (12-10)
DATE 05-30-2011
ESTATE OF EVANS MABELLE B
DATE OF DEATH 03-01-2010
FILE NUMBER 21 10-0241
COUNTY CUMBERLAND
SSN/DC 201-16-7392
ACN 10138809
APPEAL BY DATE:07-29-2011
(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 E~
REV-1548 EX AFP C12-10)--------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE: 05-30-2011
ESTATE OF:EVANS MABELLE B DATE OF DEATH:03-O1-2010 COUNTY:CUMBERLAND
FILE NO.: 21 10-0241 S.S/D.C. NO.: 201-16-7392
ACN: 10138809
TAX RETURN WAS: CX) ACCEPTED AS FILED ( ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: PSECU ACCOUNT NO.: 0201167392-S4
TYPE OF ACCOUNT: C )SAVINGS CX) CHECKING ( )TRUST ( )TIME CERTIFICATE
DATE ESTABLISHED 01-17-2001
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
55,942.78
X 0.500
27,971.39
- .00
27,971.39
x .045
1,258.71
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
i,~i~n~a~ iJ V1"IA RbCU II'1KUUGFI U6-Ul-ZU11
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
TOTAL TAX PAYMENT .00
BALANCE OF TAX DUE 1,258.71
INTEREST AND PEN. 20.46
TOTAL DUE 1,279.17
~ 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.
SJ