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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
,l<<J'fIC~ .oF-INHJ:RITANCE TAX
APPRAISEMENT,' ALI..OWANCE OR DISALLOWANCE
OF OEDUCTIONS, AND ASSESSMENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
REV-1548 E: AFP (06-05)
ROSE BROWN
9 ASHBURG DR
MECHANICSBURG PA 17050
DATE
, :': 2~~:T~F O~EATH
FILE NUMBER
COUNTY
SSN/DC
ACN
05-29-2006
BLAHA
03-28-2005
21 06-0297
CUMBERLAND
126-30-1600
06111817
APPEAL DATE: 07-28-2006
(See reverse side under Objections)
Amount Remitted I I
MAKE CHECK PAYABLE AND REMIT PAYMENT
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
FRANK
TO:
CUT ALONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS +--
REY=is4S-EX-AFP-roi=osi--------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 05-29-2006
ESTATE OF BLAHA
FRANK
DATE OF DEATH 03-28-2005
COUNTY
CUMBERLAND
FILE NO. 21 06-0297
TAX RETURN WAS:
S.S/D.C. NO. 126-30-1600
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
ACN
06111817
FINANCIAL INSTITUTION: SOVEREIGN BANK
ACCOUNT NO.
2891041259
TYPE OF ACCOUNT: ()SAVINGS ~) CHECKING ()TRUST ()TIME CERTIFICATE
DATE ESTABLISHED 06-02-2000
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
x
4,567.76
0.166
761.31
180.69
580.62
.15
87.09
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 (-)
03-31-2006 CD006514 .00 87.09
BALANCE OF UNPAID INTEREST/PENALTY AS OF 04-01-2006 TOTAL TAX CREDIT 87.09
BALANCE OF TAX DUE .00
INTEREST AND PEN. 1.54
TOTAL DUE 1.54
· 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" ( CRJ, YOU MAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. J
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