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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAC':rAX~<T
INHERITANCE TAX DIVISION '.., "'.'
PO BOX 280601
HARRISBURG PA 17128-0601
NOTICE OF INHERITANCE TAX
:APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS, AND ASSESSMENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
REV-1548 EX AFP (06-05)
,) ()
DATE 10-24-2005
ESTATE OF PECHART MARY F
DATE OF DEATH 03-21-2005
FILE NUMBER 21 05-0412
COUNTY CUMBERLAND
SSN/DC 186-34-0521
ACN 05138336
APPEAL DATE: 12-23-2005
(See reverse side under Objections)
Amount Remitted I I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
BRENDA L NYE
305 BURN HILL RD
SHERMANS DALE PA 17090
CUT ALONG THIS LINE -+ RETAIN LOWER PORTION FOR YOUR RECORDS +-
REV=is4S-EX-AFP-r03=Osi----------------------------------__________________________________
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 10-24-2005
ESTATE OF PECHART
MARY
F DATE OF DEATH 03-21-2005
COUNTY
CUMBERLAND
FILE NO. 21 05-0412
TAX RETURN WAS:
S.S/D.C. NO. 186-34-0521
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
ACN
05138336
FINANCIAL INSTITUTION: MEMBERS 1ST FCU
ACCOUNT NO.
190107-11
TYPE OF ACCOUNT: ()SAVINGS ~) CHECKING ()TRUST ()TIME CERTIFICATE
DATE ESTABLISHED 08-31-2001
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
X
2,355.32
0.500
1,177.66
3,828.00
.00
.45
.00
NOTE: TO INSURE 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 TO:
"REGISTER OF WILLS, AGENT."
X
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
TOTAL TAX CREDIT .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 LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CR), YOU MAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
Pt.