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BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX '!mil DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
PO BOX 280601 OF DEDUCTIONS, AND ASSESSMENT OF TAX ON REV-1548 EX AFP (12-13)
HARRISBURG PA 17128-0601 JOINTLY HELD OR TRUST ASSETS
DATE 09-22-2014
ESTATE OF SIMS DAVID C
DATE OF DEATH 09--19-2013
FILE NUMBER 21 13-1031
COUNTY CUMBERLAND
SSN/DC
LOIS M SIMS ACN 13155843
413 ALLENDALE WAY APPEAL BY DATE:11-21-2014
CAMP HILL PA 17011-8407 (See reverse side under Objections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE RETAIN LOWER PORTION FOR YOUR RECORDS 4--
'--------------------------______________________________-___-_______--
REV-1548 EX AFP C12-13)
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE: 09-22-2014
ESTATE OF:SIMS DAVID C DATE OF DEATH:09-19-2013 COUNTY:CUMBERLAND
FILE NO. : 21 13-1031 S.S/D.C. NO. : ACN: 13155843
TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: PNC BANK NA ACCOUNT NO. : 5005798755
TYPE OF ACCOUNT: ( X)SAVINGS ( ) CHECKING ( )TRUST ( )TIME CERTIFICATE
DATE ESTABLISHED 07-27-2010
Account Balance 9, 195.32 NOTE: TO ENSURE PROPER CREDIT TO
Percent Taxable X 0. 166 YOUR ACCOUNT, SUBMIT THE
Amount Subject to Tax 1 ,532.58 UPPER PORTION OF THIS NOTICE
Debts and Deductions - .00 WITH YOUR TAX PAYMENT TO THE
Taxable Amount 1 ,532.58 REGISTER OF WIL" AT THE
Tax Rate X .00 ABOVE "DRESS. ` TAKE-MCK ,
Tax Due .00 OR MON d$RDER MYABgECXO:
"REGIS R�F WIgS, ?,�G5IT."
TAX CREDITS: m �-, c') .-.; c7
fV
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID +i� ;J d
DATE NUMBER INTEREST/PEN PAID (-) V _J
F, r m
r
3 � cn U)
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" (CR), YOU MAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.