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BUREAU OF INDIVIDUAL TAXES r, a ~-~~JNOTICE OF INHERITANCE TAX
INHERITANCE TAX DIVISION APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
Po BOX 280601 OF DEDUCTIONS, AND ASSESSMENT OF TAX ON REV-1548 EX AFP (12-11)
HARRISBURG PA 17128-0601 L' n ~ ~ ~ r ~,~ L J ~~-JO'L,yTLY HELD OR TRUST ASSETS
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BEVERLY L ESLINGER
3815 MOUNTAIN VIEW RD
MECHANICSBURG PA 17050-2131
DATE 04-23-2012
ESTATE OF HAVERSTOCK MARTIN L
DATE OF DEATH 07-24-2010
FILE NUMBER 21 10-1003
COUNTY CUMBERLAND
SSN/DC
ACN 11135290
APPEAL BY DATE:06-22-2012
(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 E~
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: 04-23-2012
ESTATE OF:HAVERSTOCK MARTIN L
DATE OF DEATH:07-24-2010 COUNTY:CUMBERLAND
FILE NO.: 21 10-1003 S.S/D.C. NO.: ACN: 11135290
TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: CITIZENS BANK OF PENNSYLVANIA ACCOUNT NO.: 6140179173
TYPE OF ACCOUNT: C)OSAVINGS ( ) CHECKING C )TRUST C )TIME CERTIFICATE
DATE ESTABLISHED 08-04-1982
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
23,059.79
X 0.166
3,843.38
- .00
3,843.38
X 15
576.51
PAYMENT I RECEIPT DISCOUNT (+)
DATE NUMBER INTEREST/PEN PAID C-)
INTEREST IS CHARGED THROUGH 05-01-2012
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
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."
AMOUNT PAID
TOTAL TAX PAYMENT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
.00
576.51
17.63
594.14
* 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. ~~_n