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BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
MAE STARNER
5007 MCDONALD DR
MECHANICSBURG P
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_ ~f F. INHERITANCE TAX
~l ..ABPRA~$EI~N'~O~ALLOWANCE OR DISALLOWANCE
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~"~~iJ~•9~~bEptTCI'ifl~lS,~, AND ASSESSMENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
Pennsylvania ,.r:,~
DEPARTMENT OF REVENUE
REV-1548 EX AFP (12-11)
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~ L i,,-.C~ ~ ~ ~'~ DATE 03-26-2012
ESTATE OF STARNER DONALD L
DATE OF DEATH 01-1.2-2011
~~~~r (~~= FILE NUMBER ,~ ~ - ~ 01 - (~j t~ ~( 7
aR~~~l:~'~~ ~~~iJ~; COUNTY CUMBERLAND
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+ ~ ACN 11129058
APPEAL BY DATE:05-25-2012
1 7 0 5 0 - 24 4 5 (See reverse side under Objections)
Amount Remitted ~- -~
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
A
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: 03-26-2012
ESTATE OF:STARNER DONALD L DATE OF DEATH:O1-12-2011
COUNTY:CUMBERLAND
FILE NO.: S.S/D.C. NO.: ACN: 11129058
TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: CITIZENS BANK OF PENNSYLVANIA ACCOUNT NO.: 6241084971
TYPE OF ACCOUNT: (X)SAVINGS C ) CHECKING C )TRUST C )TIME CERTIFICATE
DATE ESTABLISHED 04-10-2003
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
80,129.20
X 0.500
40,064.60
- .00
40,064.60
x .15
6,009.69
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
rurrnrr.r
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
TOTAL TAX PAYMENT .00
BALANCE OF TAX DUE 6,009.69
INTEREST AND PEN. 85.75
TOTAL DUE b,095.44
* IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ~
IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YDU MAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ~~'
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