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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISIDN
PD BDX 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)
RALPH RETTBERG
620 lETORT SPRING RD
CARLISLE PA 17013
DATE 05-01-2006
ESTATE OF RETTBERG CLAIRE A
DATE OF DEATH 01-08-2005
FILE NUMBER 21 05-0059
COUNTY CUMBERLAND
SSN/DC 009-10-9811
ACN 05117999
APPEAL DATE: 06-30-2006
(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
CUT ALONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS +--
REY=is4S-EX-AFP-COj=osi--------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 05-01-2006
ESTATE OF RETTBERG
CLAIRE
A DATE OF DEATH 01-08-2005
COUNTY
CUMBERLAND
FILE NO. 21 05-0059
TAX RETURN WAS:
S.S/D.C. NO. 009-10-9811
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
ACN
05117999
FINANCIAL INSTITUTION: WACHOVIA BANK NA
ACCOUNT NO.
1010083586792
TYPE OF ACCOUNT: ()SAVINGS ~) CHECKING ()TRUST ()TIME CERTIFICATE
DATE ESTABLISHED 10-24-2003
X
3,456.31
0.500
1,728.16
.00
1,728.16
.15
259.22
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 ADQRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO: ,
"REGISTER OF WIll~, AGENT.~
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
X
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
,.'
-
-
INTEREST IS CHARGED THROUGH 05-09-2006 TOTAL TAX CREDIT .00
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 259.22
REVERSE SIDE OF THIS FORM INTEREST AND PEN. 9.40
TOTAL DUE 268.62
IE IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IE (
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
.. ..
IF TOTAL DUE IS REFLECTED AS A CREDIT (CRl, YOU MAY BE DUE A REFUND.
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