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BUREAU OF INDIVIDUAL TAXES ~C17, Et,;~'~ ~ S'>~-~71,~+E OF INHERITANCE TAX
INHERITANCE TAX DIVISION A~RR/~~~~~MENT, ALLOWANCE DR DISALLOWANCE
PO BOX 280601 ~ '
~~~` l4r j ... 0'E 1 D& TAI ONS , AND ASSESSMENT OF TAX ON
HARRISBURG PA 17128-0601 JOINTLY HELD OR TRUST ASSETS
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pennsylvania ~~ ~
DEPARTMENT OF REVENUE
REV-1548 IX AFP (12-11)
r,~~,~p L~ ~'~ ~: ~7 DATE 02-20-2012
UU ESTATE OF BUDDY GEORGE
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ORP~1 „,,
KAREN L SHAFF~)~,~~;~R~..~~s`,4E1 tf,+, PA
3113 SYCAMORE ST
HARRISBURG PA 17111-1306
DATE OF DEATH 02-04-2011
FILE NUMBER 21 11-0284
COUNTY CUMBERLAND
SSN/DC 211-36-0520
ACN 11118564
APPEAL BY DATE:04-20-2012
(See reverse side under Objections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
J
CUT ALONG THIS LINE ~'> RETAIN LOWER PORTION FOR YOUR RECORDS f'~
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REV-1548 EX AFP C12-11~
NOTICE DF INHERITANCE TAX APPRAISEMENT, ALLOWANCE DR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE: 02-20-2012
ESTATE OF:BUDDY GEORGE J DATE OF DEATH:02-04-2011 COUNTY:CUMBERLAND
FILE NO.: 21 11-0284 S.S/D.C. NO.: 211-36-0520
ACN: 11118564
TAX RETURN WAS: CX) ACCEPTED AS FILED C ~ CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: PSECU ACCOUNT NO.: 9106340129-C50
TYPE OF ACCOUNT: C )SAVINGS C ) CHECKING ( )TRUST CX)TIME CERTIFICATE
DATE ESTABLISHED 03-05-2004
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
4,064.54
X 0.500
2,032.27
- .00
2,032.27
y .15
304.84
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+)
INTERESTIPEN PAID (-)
AMOUNT PAID
INTEREST IS CHARGED THROUGH 02-28-2012
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
TOTAL TAX PAYMENT .00
BALANCE OF TAX DUE 304.84
INTEREST AND PEN. 2.90
TOTAL DUE 307.74
* 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.
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