HomeMy WebLinkAbout02-24-12(~(~~+ r"~~'" T OF INHERITANCE TAX
BUREAU OF INDIVIDUAL TAXES ~/ti/'+`-% ~~~„1~~ ALLOWANCE OR DISALLOWANCE
INHERITANCE TAX DIVISION R~r~<;,' +
PO BOX 280601 (1 ~ ~~; I 0~ i-~Z~1~~_. NS, AND ASSESSMENT OF TAX ON
HARRISBURG PA 17128-0601 JOINLY HELD OR TRUST ASSETS
CLERK Q~
ORRHAN'S CUR''
LISA wlLSa~~l~~i-.~~~? ~(~., P~:
6217 BLUE STONE AVENUE
HARRISBURG PA 17112
Pennsylvania ~
DEPARTMENT OF REVENUE
REY-1548 EX AFP (12-11)
DATE 02-28-2012
ESTATE OF CHIOVARO MARIE C
DATE OF DEATH 03-20-2011
FILE NUMBER 21 11-0467
COUNTY CUMBERLAND
SSN/DC 094-26-0978
ACN 11120928
APPEAL BY DATE:04-28-2012
(See reverse side under Objections)
Amount Rewitted ~-
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 ~
REV-1548 EX AFP C12-11)----------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE: 02-28-2012
ESTATE OF:CHIOVARO MARIE C DATE OF DEATH:03-20-2011 COUNTY:CUMBERLAND
FILE NO.: 21 11-0467 S.S/D.C. NO.: 094-26-0978
ACN: 11120928
TAX RETURN WAS: CX) ACCEPTED AS FILED ( ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO.: 35697-00
TYPE OF ACCOUNT: CX)SAVINGS ( ) CHECKING ( )TRUST C )TIME CERTIFICATE
DATE ESTABLISHED 11-18-1983
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
2,302.76
X 0.083
191.89
- .00
191.89
.045
8.64
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 (-) AMOUNT PAID
INTEREST IS CHARGED THROUGH 03-07-2012
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
TOTAL TAX PAYMENT .00
BALANCE OF TAX DUE 8.b4
INTEREST AND PEN. .06
TOTAL DUE 8.70
~ IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATIDN 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.
~r^ ~ ,~, ~ .-~ pennsylvania ~
f ~ !~ `{ N ~Iv~iNHERITANCE TAX
BUREAU OF INDIVIDUAL TAXES --~"~'~'~-~ ~ ~~ DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION Cry"M4~I(S!EM~NT<,~~!~11~LOWANCE OR DISALLOWANCE
PO BOX 280601 f ~`9_~F`HE~9~ICgTOWS`;~D ASSESSMENT OF TAX ON REV-1548 EX AFP C12-11)
HARRISBURG PA 17128-0601 JOINTLY HELD OR TRUST ASSETS
~~~~Z ~~B 2~ ~~~ ~; ~~ DATE iD2-28-2012
ESTATE OF CHIOVARO MARIE C
/~ DATE OF DEATH 03-20-2011
li~ER~ I~F FILE NUMBER 21 11-0467
QR~`S COI~Rj COUNTY CUMBERLAND
FRANK CHIOVARO ~jM~CI~{°~~~~ ~~~ P~ SSN/DC 094-26-0978
ACN :L 1120930
6617 FAIRDEL AVENUE APPEAL BY 1)ATE:04-28-2012
B A L T I M O R E M D 212 0 6 (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 -~1 RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV-1548 EX AFP C12-11)--------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE: 02-28-2012
ESTATE OF:CHIOVARO
MARIE C DATE OF DEATH:03-20-2011
COUNTY:CUMBERLAND
FILE NO.: 21 11-0467 S.S/D.C. NO.: 094-26-0978 ACN: 11120930
TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO.:
TYPE OF ACCOUNT: CX)SAVINGS C ) CHECKING C )TRUST
DATE ESTABLISHED 11-18-1983
Account Balance
• Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
2,302.76
X 0.083
191.89
- .00
191.89
x .045
8.64
TAX CREDITS:
35697-00
C )TIME CERTIFICATE
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 C-)
AMOUNT PAID
1nItKt51 is CHARGED THROUGH 03-07-2012
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
TOTAL TAX PAYMENT .00
BALANCE OF~ TAX DUE 8.64
INTEREST AND PEN. .06
TOTAL DUE 8.70
~ 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.
~f.CQ~~~~C? ~";~~ic~: Pennsylvania ~
BUREAU OF INDIVIDUAL TAXES [[~~('"'-; ~ ~ 41 ICE OF INHERITANCE TAX DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION f?C'.;~i.,f,~;? 'Qa?P~~~„f1ENT, ALLOWANCE OR DISALLOWANCE
PO BOX 280601 OF DEDUCTIONS, AND ASSESSMENT OF TAX ON REV-1548 EX AFP <12-11)
HARRISBURG PA 17128-0601 JOINTLY HELD OR TRUST ASSETS
~t1~7 ~~B ~4 ~'~ ~~ ~~
c~~R~ o~
ORPHAN'S cOUPsT
Cl)MBPPI.A~~~? t~0 , PA
LISA WILSBACH
6217 BLUE STONE AVENUE
HARRISBURG PA 17112
DATE 02-28-2012
ESTATE OF CHIOVARO MARIE C
DATE OF DEATH 03-20-2011
FILE NUMBER ;?1 11-0467
COUNTY (:UMBERLAND
SSN/DC 094-26-0978
ACN :L1120931
APPEAL BY I)ATE:04-28-2012
(See reverse side under Objections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TD:
REGISTER OF WILLS
1 COURTHOUSE SgUARE
CARLISLE PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS F'
REV-1548 EX AFP C12-11)--------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE: 02-28-2012
ESTATE OF:CHIOVARO MARIE C DATE OF DEATH:03-20-2011
FILE NO.: 21 11-0467 S.S/D.C. NO.: 094-26-0978
COUNTY:CUMBERLAND
ACN: 11120931
TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NCI.: 35697-04
TYPE OF ACCOUNT: CX)SAVINGS C ) CHECKING ( )TRUST C )TIME CERTIFICATE
DATE ESTABLISHED 11-18-1983
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
4,000.52
X 0.083
333.36
- .00
333.36
x .045
15.00
NOTE: TO ENSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPIPER 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 C-)
AMOUNT PAID
1rvItKtJ1 15 l.F1AK6tll IHKUU6H 03-07-2012
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
TOTAL TAX PAYMENT .00
BALANCE OF' TAX DUE 15.00
INTEREST AND PEN. .10
TOTAL DUE 15.10
^ 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.
BUREAU OF INDIVIDUAL TAXES ~ ~~~# ~~~~~~~~,~~ Q~IECE OF INHERITANCE TAX
INHERITANCE TAX DIVISION ''~- 1K-'ti- T, ALLOWANCE OR DISALLOWANCE
PO BOX 280601 r~;'F{~~C ~ ;O~i~121~1C~'IDNS, AND ASSESSMENT OF TAX ON
HARRISBURG PA 17128-0601 `-`~''w F~~' `' `'j~p`II~TLY HELD OR TRUST ASSETS
~~~~ ~~~ 2~ ~~ ~~ ~~
c~~~~ o~
o~~~~v~s ~ouRT
LORETTA CHI01(~I~~L~J N.~1'~ C~. p~
7 KINGSWOOD DRIVE
MECHANICSBURG PA 17055
Pennsylvania ~~.
DEPARTMENT OF REVENUE
REV-1548 EX AFP (12-11)
DATE ID2-28-2012
ESTATE OF CHIOVARO MARIE C
DATE OF DEATH 03-20-2011
FILE NUMBER ;?1 11-0467
COUNTY CUMBERLAND
SSN/DC 094-26-0978
ACN /1120932
APPEAL BY I)ATE:04-28-2012
(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 ~
REV-1548 EX AFP C12-11)--------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE: 02-28-2012
ESTATE OF:CHIOVARO MARIE C DATE OF DEATH:03-20-2011
FILE NO.: 21 11-0467 S.S/D.C. NO.: 094-26-0978
COUNTY:CUMBERLAND
ACN: 11120932
TAX RETURN WAS: (X) ACCEPTED AS FILED C ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NCI.: 35697-04
TYPE OF ACCOUNT: C)bSAVINGS C ) CHECKING ( )TRUST C )TIME CERTIFICATE
DATE ESTABLISHED 11-18-1983
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
4,000.52
X 0.083
333.36
- .00
333.36
x .045
15.00
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
AB!DVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE T0:
"REEGISTER OF WILLS, AGENT."
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT (+)
INTEREST/PEN PAID (-)
AMOUNT PAID
initKtai ll GHAKGtL IHKUUGH 03-07-2012
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
TOTAL TAX PAYMENT .00
BALANCE OF' TAX DUE 15.00
INTEREST AND PEN. .10
TOTAL DUE 15.10
~ 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.
/ r ~ ~1tI~E BR
~ ~~`~~? , ~ INHERITANCE TAX
BUREAU OF INDIVIDUAL TAXES ^ !"~~~ --
INHERITANCE TAX DIVISION I'~?-;~fff~i[-~S~P,~4~'I~i~I~,I S~LLOWANCE OR DISALLOWANCE
PO BOX 280601 OF DEDUCTIONS; AND ASSESSMENT OF TAX ON
HARRISBURG PA 17128-0601 JOINTLY HELD OR TRUST ASSETS
?ul2 EEB 24 p~
FRANK CHIOVARO
6617 FAIRDEL AVENUE
BALTIMORE MD 21206
ESTATE OF CHIOVARO MARIE C
DATE OF DEATH D3-20-2011
FILE NUMBER 21 11-0467
COUNTY CUMBERLAND
SSN/DC iD94-26-0978
ACN 11120933
APPEAL BY DATE:04-28-2012
(See reverse side under Objections)
Amount Remitted ~-
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE S6lUARE
CARLISLE PA 1.7013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV-1548 EX AFP C12-11)--------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE: 02-28-2012
ESTATE OF:CHIOVARO MARIE C DATE OF DEATH:03-20-2011. COUNTY:CUMBERLAND
FILE NO.: 21 11-0467 S.S/D.C. NO.: 094-26-0978
ACN: 11120933
TAX RETURN WAS: (X) ACCEPTED AS FILED C ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO.: 35697-04
TYPE OF ACCOUNT: CX)SAVINGS ( ) CHECKING C )TRUST C )TIME CERTIFICATE
DATE ESTABLISHED 11-18-1983
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
Pennsylvania ~
DEPARTMENT OF REVENUE
REY-1548 EX AFP C12-11)
~~ ~ ! DATE 02-28-2012
4,000.52 NOTE:
X 0.083
333.36
- .00
333.36
x .045
15.00
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
INTEREST IS CHARGED THROUGH 03-07-2012
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
CLERK Cfi
oRPHAn,~s Co~~RT
TOTAL TAX PAYMENT .00
BALANCE OF TAX DUE 15.00
INTEREST AND PEN. .10
TOTAL I)UE 15.10
~ 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.
BUREAU OF INDIVIDUAL TAXES ;~f ~C~i ~~t ~ r!`-~ ~' CE OF INHERITANCE TAX
INHERITANCE TAX DIVISION ~ ~ ~ ~A~k~,~T, ALLOWANCE OR DISALLOWANCE
PO BOX 280601 ~~~~ ~ OF}~D~1~~'IONS, AND ASSESSMENT OF TAX ON
HARRISBURG PA 17128-0601 ~ ~ ~jU`I~i~TLY HELD OR TRUST ASSETS
~i~~~ F~~B 24 FM 2~ 27
CLERK 0~
~yO~R~~P,HAN`S (,OUR?'
LISA WILS~~,RI~,~~~ (`,(}, pq
6217 BLUE STONE AVENUE
HARRISBURG PA 17112
'~
Pennsylvania ~~~''r
DEPARTMENT OF REVENUE
REV-1548 EX AFP (12-11)
DATE 02-28-2012
ESTATE OF CHIOVARO MARIE C
DATE OF DEATH iD3-20-2011
FILE NUMBER 21 11-0467
COUNTY CUMBERLAND
SSN/DC iD94-26-0978
ACN :11120934
APPEAL BY 1)ATE:04-28-2012
(See reverse side under Objections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SC!UARE
CARLISLE PA 17013
CUT ALONG THIS LINE '~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV-1548 EX AFP (12-11)--------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE: 02-28-2012
ESTATE OF:CHIOVARO MARIE C DATE OF DEATH:03-20-2011
FILE NO.: 21 11-0467 S.S/D.C. NO.: 094-26-0978
COUNTY:CUMBERLAND
ACN: 11120934
TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO.: 35697-01
TYPE OF ACCOUNT: (X>SAVINGS C ) CHECKING C )TRUST C )TIME CERTIFICATE
DATE ESTABLISHED 11-22-2005
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
606.06
X 0.083
50.50
- .00
50.50
x .045
2.27
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 (-)
AMOUNT PAID
02-21-2012 SBADJUST .00 2,2g
TOTAL TAX PAYMENT 2.27
BALANCE OF' TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
~ 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.
BUREAU OF INDIVIDUAL TAXES ~ ~~£t'r~~ ,~)i~~~ HERITANCE TAX pennsylvania ~
1 ~ ~[y't~/[^u' DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION ,.,~~~~~.N ~ f `,'74L)<OWANCE OR DISALLOWANCE
PO BOX 260601 1fY:Q }*~UCTIOyyS1;! fl~{`9,D ASSESSMENT OF TAX ON REV-1548 EX AFP (12-II)
1~YY. i 'S ..«L
HARRISBURG PA 17128-0601 JOINTLY HELD OR TRUST ASSETS
~~~2~~~2~ p~ 2' L~ ESTATE OF OHIOVAR012 MARIE C
DATE OF DEATH iD3-20-2011
CLARK QF FILE NUMBER 21 11-0467
~RPNAN's G~~Fir SSN/DC 094B26L0978
LORETTA CHIOVARO CIIMRrRI_ta~~l~, r(l. RA ACN :11120935
7 KINGSWOOD DRIVE APPEAL BY 1)ATE:04-28-2012
MECHANICSBURG PA 17055 (See reverse side under Objections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SC!UARE
CARLISLE PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV-1548 EX AFP C12-11)--------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE: 02-28-2012
ESTATE OF:CHIOVARO
MARIE C
DATE OF DEATH:03-20-2011
COUNTY:CUMBERLAND
FILE NO.: 21 11-0467 S.S/D.C. NO.: 094-26-0978 ACN: 11120935
TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED
JOINT OR TRUST ASSET
FINANCIAL INSTITUTION: MEMBERS 1ST FCU
TYPE OF ACCOUNT: CX}SAVINGS ( ) CHECKING C )TRUST
DATE ESTABLISHED 11-22-2005
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
606.06
X 0.083
50.50
- .00
50.50
x .045
2.27
INFORMATION
ACCOUNT NO.: 35697-01
( )TIME CERTIFICATE
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 (-)
AMOUNT PAID
02-21-2012 SBADJUST .00 2,2g
TOTAL TAX PAYMENT 2.27
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
~ 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.
BUREAU OF IND~~!(1,pflY~'~~~S ,,f. y C NOTICE OF INHERITANCE TAX
INHERITANCE TAX DI ~S "~ APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
y~- ~_ , ~- ~, t s.,uJ
PO BOX 280601 j~~.~ ~ OF DEDUCTIONS, AND ASSESSMENT OF TAX ON
HARRISBURG PA 17128-0601 JOINTLY HELD OR TRUST ASSETS
?~{~2 F~.3 24 P~ 2~ 21
~pc~~~K ~~
Vr,~~~~ Vpp,1~1~~ v'Q~J~r
FRANK C~~~~~`NfOVA~RO
6617 FAIRDEL AVENUE
BALTIMORE MD 21206
Pennsylvania ~
DEPARTMENT OF REVENUE
REV-1548 IX AFP (12-11)
DATE 172-28-2012
ESTATE OF CHIOVARO MARIE C
DATE OF DEATH 03-20-2011
FILE NUMBER ;?1 11-0467
COUNTY CUMBERLAND
SSN/DC 094-26-0978
ACN :L1120936
APPEAL BY 1)ATE:04-28-2012
(See reverse side under Objections)
ABtount Renitted
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 ~'-
REV-1548 EX AFP C12-11)--------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE: 02-28-2012
ESTATE OF:CHIOVARO MARIE C DATE OF DEATH:03-20-2011 COUNTY:CUMBERLAND
FILE NO.: 21 11-0467 S.S/D.C. NO.: 094-26-0978
ACN: 11120936
TAX RETURN WAS: (X} ACCEPTED AS FILED C ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO.: 35697-01
TYPE OF ACCOUNT: CX)SAVINGS C ) CHECKING C )TRUST C )TIME CERTIFICATE
DATE ESTABLISHED 11-22-2005
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
606.06 NOTE:
X 0.083
50.50
- .00
50.50
x .045
2.27
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 C-)
AMOUNT PAID
02-21-2012 SBADJUST .00 2.28
TOTAL TAX PAYMENT 2.27
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
~ IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIDNAL INTEREST. ~
IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.
~FCG~ ~F~ ~~~ ~E ~~ Pennsylvania
BUREAU OF INDIVIDUAL TAXES !^((`~~~~( r~'{'~ ;^~.- ~ ,r TICS OF INHERITANCE TAX DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION ~i~..Ua,.`~i.„`,Ki `~.~R~?~~.. MENT, ALLOWANCE OR DISALLOWANCE REV-1548 IX AFP (12-11)
PO BOX 280601 OF DEDUCTIONS, AND ASSESSMENT OF TAX ON
HARRISBURG PA 17128-0601 JOINTLY HELD OR TRUST ASSETS
DATE 02-28-2012
CLERK OF
ORPH.AN'S CC~'R''
Cll~iac{-~I..A~~; CG . F~
LISA WILSBACH
6217 BLUE STONE AVENUE
HARRISBURG PA 17112
ESTATE OF CHIOVARO MARIE C
DATE OF DEATH D3-20-2011
FILE NUMBER 21 11-0467
COUNTY CUMBERLAND
SSN/DC D94-26-0978
ACN 11120937
APPEAL BY 1DATE:04-28-2012
(See reverse side under Objections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE S[lUARE
CARLISLE PA 1.7013
CUT ALONG THIS LINE ~"> RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV-1548 EX AFP C12-11)--------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE: 02-28-2012
ESTATE OF:CHIOVARO MARIE C DATE OF DEATH:03-20-2011.
FILE NO.: 21 11-0467 S.S/D.C. NO.: 094-26-0978
COUNTY:CUMBERLAND
ACN: 11120937
TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED
JOINT OR TRUST ASSET INFORMATICIN
FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO.: 35953-00
TYPE OF ACCOUNT: C ~ SAVINGS C ) CHECKING C )TRUST ( )TIME CERTIFICATE
DATE ESTABLISHED 12-14-1983
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
3,221.88
X 0.500
1,610.94
- .00
1,610.94
x .045
72.49
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 (-)
AMOUNT PAID
1NItKts- iS CHARGED THROUGH 03-07-2012
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
TOTAL TAX PAYMENT .00
BALANCE OF TAX DUE 72.49
INTEREST AND PEN. .46
TOTAL DUE 72.95
~ 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.
~~'~' `~~~`f ~~~~ OTtCE OF INHERITANCE TAX
BUREAU OF INDIVIDUAL TAXES .~ ~~~<r--;~. ,+'~" +Af~~ C~
INHERITANCE TAX DIVISION ~L~j`;L;l~,^: ~~PR'JY,~.~EMENT, ALLOWANCE OR DISALLOWANCE
PO BOX 280601 OF DEDUCTIONS, AND ASSESSMENT OF TAX ON
HARRISBURG PA 17128-0601 JOINT Y HELD OR TRUST ASSETS
.• re.
pennsylvania ~
DEPARTMENT OF REVENUE
REV-1548 IX AFP C12-11)
~'~~( ~- ` ~-~ - DATE 02-28-2012
QRPHAN'~ ~~~~PT
LISA WILSBACH
6217 BLUE STONE AVENUE
HARRISBURG PA 17112
ESTATE OF CHIOVARO MARIE C
DATE OF DEATH 03-20-2011
FILE NUMBER 21 11-0467
COUNTY CUMBERLAND
SSN/DC 094-26-0978
ACN 11120938
APPEAL BY ]DATE:04-28-2012
(See reverse side under 06jections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SClUARE
CARLISLE PA 1.7013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS F'
REV-1548 EX AFP (12-11~--------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE: 02-28-2012
ESTATE OF:CHIOVARO MARIE C DATE OF DEATH:03-20-2011. COUNTY:CUMBERLAND
FILE NO.: 21 11-0467 S.S/D.C. NO.: 094-26-0978
ACN: 11120938
TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO.: 35953-04
TYPE OF ACCOUNT: CX)SAVINGS C ) CHECKING C )TRUST C )TIME CERTIFICATE
DATE ESTABLISHED 12-14-1983
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
4,000.52
X 0.500
2,000.26
- .00
2,000.26
x .045
90.01
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 C-)
AMOUNT PAID
INTEREST IS CHARGED THROUGH 03-07-2012
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
TOTAL TAX PAYMENT .00
BALANCE OF TAX DUE 90.01
INTEREST AND PEN. .58
TOTAL DUE 90.59
~ 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.
~C~J~~E~; ~;~~ ~~[~,({y~ Pennsylvania ~
NOTICE OF INHERITANCE TAX
BNHERITANCE TAXDD VISIONL TAXES ~[p~~~.` k'-r ;^r^ I- DEPARTMENT OF REVENUE
PO BOX 280601 f1~.t"i.v ~~: t;#tP~~p~~EMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS, AND ASSESSMENT OF TAX ON REV-1548 EX AFP (12-11)
HARRISBURG PA 17128-0601 JOINTLY HELD OR TRUST ASSETS
~~'i2 F'~?~ 2~- ~'~ ?~ ~:7
DATE 02-28-2012
p CLL/~EAR~C CF
Qi~QI i~+'~1tlr~ V~~ ~~T
Cl1P,~~k~ ~LA~`'J~' C~ , ~~.
LORETTA CHIOVARO
7 KINGSWOOD DRIVE
MECHANICSBURG PA 17055
ESTATE OF CHIOVARO MARIE C
DATE OF DEATH 03-20-2011
FILE NUMBER 21 11-0467
COUNTY CUMBERLAND
SSN/DC 094-26-0978
ACN 11120939
APPEAL BY 1)ATE:04-28-2012
(See reverse side under Objections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE S6lUARE
CARLISLE PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV-1548 EX AFP C12-11)--------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE: 02-28-2012
ESTATE OF:CHIOVARO MARIE C DATE OF DEATH:03-20-2011. COUNTY:CUMBERLAND
FILE NO.: 21 11-0467 S.S/D.C. NO.: 094-26-0978
ACN: 11120939
TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO.: 137410-00
TYPE OF ACCOUNT: CX)SAVINGS C ) CHECKING C )TRUST C )TIME CERTIFICATE
DATE ESTABLISHED 01-03-1994
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
692.46
X 0.500
346.23
- .DO
346.23
x .045
15.58
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 (-)
AMOUNT PAID
1NItRtsl 1S CHARGED THROUGH 03-07-2012
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
TOTAL TAX PAYMENT .00
BALANCE OF TAX DUE 15.58
INTEREST AND PEN. .10
TOTAL DUE 15.68
* 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.
~~(~D~~ t~"F~~f ~~
~~~'~~~~ r w ~'f~ J ~iJOTICE OF INHERITANCE TAX
BUREAU OF INDIVIDUAL TAXES ~-il!::~i.i} St- ~~
INHERITANCE TAX DIVISION `APdfr MENT, ALLOWANCE OR DISALLOWANCE
PO BOX 280601 OF DEDUCTIONS, AND ASSESSMENT OF TAX ON
HARRISBURG PA 17128-0601 ^)f!~~ (-~~ ~~ ~6i ~J¢I[~TLY HELD OR TRUST ASSETS
C~~~K ~r
OR~H~,f~!'S ~Ol'rr
LORETTA CHIOVARO
7 KINGSWOOD DRIVE
MECHANICSBURG PA 17055
Pennsylvania ~a-~.
DEPARTMENT OF REVENUE
REV-1548 EX AFP (12-11>
DATE 02-28-2012
ESTATE OF CHIOVARO MARIE C
DATE OF DEATH 03-20-2011
FILE NUMBER 21 11-0467
COUNTY CUMBERLAND
SSN/DC 094-26-0978
ACN 11120940
APPEAL BY DATE:04-28-2012
(See reverse side under Objections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA ].7013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS <~
REV-1548 EX AFP C12-11)----------------------------------------~----------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE: 02-28-2012
ESTATE OF:CHIOVARO MARIE C DATE OF DEATH:03-20-201]. COUNTY:CUMBERLAND
FILE NO.: 21 11-0467 S.S/D.C. NO.: 094-26-0978 ACN: 11120940
TAX RETURN WAS: {X) ACCEPTED AS FILED ( ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO.: 137410-11
TYPE OF ACCOUNT: C )SAVINGS CX) CHECKING C )TRUST C )TIME CERTIFICATE
DATE ESTABLISHED 01-03-1994
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
475.24 NOTE:
X 0.500
237.62
- .00
237.62
x .045
10.69
T0~ 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 C-) AMOUNT PAID
INTEREST IS CHARGED THROUGH 03-07-2012
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
TOTAL TAX PAYMENT .00
BALANCE OF TAX DUE 10.69
INTEREST AND PEN. .07
TOTAL DUE 10.76
~ 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.
[(~{~ ^~{ try Y1~-1-,
~C_llV~t ~ ,r ~ G~~T E OF INHERITANCE TAX
BUREAU OF INDIVIDUAL TAXES r w #K~R`RAI'~~t~QT, ALLOWANCE OR DISALLOWANCE
INHERITANCE TAX DIVISION ~~~a:~:1 ~ d
PO BOX 280601 OF 'DAD T'I~ NS, AND ASSESSMENT OF TAX ON
HARRISBURG PA 17128-0601 JOINTLY HELD OR TRUST ASSETS
pennsylvania i
DEPARTMENT OF REVENUE
REV-1548 EX AFP C12-11)
4[~~2 ~~~ ~~ ~ ~~ 26 DATE 0'2-28-2012
CLERK ~~
ORPHAN'S COURT
l~Y4RER1.~h!~ CO., PA
LORETTA CHIOVA~~
7 KINGSWOOD DRIVE
MECHANICSBURG PA 17055
ESTATE OF CHIOVARO MARIE
DATE OF DEATH 03-20-2011
FILE NUMBER 21 11-0467
COUNTY CUMBERLAND
SSN/DC 094-26-0978
ACN 11120929
APPEAL BY D,ATE:04-28-2012
(See reverse sidEr under Objections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQIJARE
CARLISLE PA 1'7013
C
CUT ALONG THIS LINE '~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV-1548 EX AFP C12-11)------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE: 02-28-2012
ESTATE OF:CHIOVARO
MARIE
COUNTY:CUMBERLAND
FILE NO.: 21 11-0467 S.S/D.C. NO.: 094-26-0978 ACN: 11120929
TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED
JOINT OR TRUST ASSET
FINANCIAL INSTITUTION: MEMBERS 1ST FCU
TYPE OF ACCOUNT: CX)SAVINGS C ) CHECKING C )TRUST
DATE ESTABLISHED 11-18-1983
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
2,302.76
X 0.083
191.89
- .00
191.89
X .045
8.64
rnrnrrc.
INFORMATION
ACCOUNT NCI.: 35697-00
( )TIME CERTIFICATE
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 03-07-2012
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
C DATE OF DEATH:03-20-2011
TOTAL TAX: PAYMENT .00
BALANCE OF TAX DUE 8.64
INTEREST AND PEN. .06
TOTAL DUE 8.70
^ 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.