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BUREAU OF INDIVIDUAL TAXES~~C~ i~, r `~I~~E-~~NOTICE OF INHERITANCE TAX
INHERITANCE TAX oIVISION ~€ ~~i;~ i ~~; ~4;r~~~~ SEMENT, ALLOWANCE OR DISALLOWANCE REV 154EE XT O PRE12 NUE
PO BOX 280601 0~~ ~~UCTIONS, AND ASSESSMENT OF TAX ON
HARRISBURG PA 17128-0601 JOINTLY HEL D OR TRUST ASSETS
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~~~2..~~6't t~ ~~ ~~ ~+G. DATE 06-18-2012
ESTATE OF MADARA NANCY J
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`~~I'',i°. .~'
URPHA11i~~ u~Ut'i; DATE OF DEATH 07-03-2011 _
FILE NUMBER ~~-~,~-U~~S~
COUNTY CUMBERLAND
~~
~R~~ ~~~~ SSN/DC
JOHN J MADARA ACN 11148791
3812 CANDLE LIGHT DR APPEAL BY DATE:08-17-2012
CAM P H I L L P A 17 O 1 1- 14 0 8 (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: 06-18-2012
ESTATE OF:MADARA NANCY J DATE OF DEATH:07-03-2011
FILE NO.:
S.S/D.C. NO.:
COUNTY:CUMBERLAND
ACN: 11148791
TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO.: 189039-05
TYPE OF ACCOUNT: (X)SAVINGS C ) CHECKING C )TRUST ( )TIME CERTIFICATE
DATE ESTABLISHED 09-18-2006
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
79,189.07
X 0.500
39,594.54
- .00
39,594.54
x .00
.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
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE T0:
"REGISTER OF WILLS, AGENT."
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID (-)
AMOUNT PAID
TOTAL TAX PAYMENT .00
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" CCR), YOU MAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.