HomeMy WebLinkAbout11-14-08 (2) COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION ~~-` ~,NOT#GB`}OP- INHERITANCE TAX
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Po Box zaoeol ~S~lBN AGLOliANCE OR DISALLONANCE
AT~PBA
HARRISBURG, PA 17128-0601 p~ B$D}iCTIAN~ J1Np ASSESSMENT OF TAX ON
i •, 4SPC~1$T'~Y,-ACCOUNTS HELD IN REV4548A AFP C06. OS)
BENEF~OIARY FORN
08
OLGA C
Z~~~ ~~OI~ 14 Alai I I ~ I STATE OF CALDWELL
DATE OF DEATH 04-19-2008 ,
FILE NUMBER ~I-®g ` ~~a~
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COUNTY CUMBERLAND
np rt~,,n r~ , ~ T
Oru ~~ ~ J ~,w~~ SSN/DC 137-14-7519
MICHAEL A CALDWELL C(v~;':` '.( ~'~_` ~~ pCN 08500922
302 LEWISBERRY ROAD APPEAL DATE: 12-12-2008
NEW CUMBERLAND PA 17070 (See reverse side under objections)
Amount Remitted ~Z./ ~
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
GUT ALONG THIS LINE ~- RETAIN LOWER PORTION FOR YOUR RECORDS f""'
REV-1548A AFP CO1-03)
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS
AND ASSESSMENT OF TAX ON SECURITY ACCOUNTS HELD IN BENEFICIARY FORM
DATE 10-13-2008
ESTATE OF CALDWELL OLGA C DATE OF DEATH 04-19-2008 COUNTY CUMBERLAND
FILE N0. S.S/D.C. N0. 137-14-7519 ACN 08500922
TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED
BENEFICIARY FORM OF ASSET INFORMATION
NAME OF SECURITY: METLIFE ACCOUNT N0. 806686342786
TYPE OF ASSET: ( ) SECURITIES C ) SECURITY ACC QO STOCK ( ) BONDS
DOD Valuation
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
1,603.00 NOTE:
X 1.000
1,603.00
.00
1,6D3.00
X .45
72.14
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 T0:
"REGISTER OF WILLS, AGENT."
TAX CREDITS:
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID C-) AMOUNT PAID
PAYMENT MUST BE MADE BY 01-20-2009*. TOTAL TAX CREDIT .00
BALANCE OF TAX DUE 72.14
INTEREST AND PEN. .00
TOTAL DUE 72.14
* IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ~
C IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED.
IF-TOTAL DUE IS REFLECTED AS A_"CREDIT" C CR), YOU MAY BE DUE A REFUND.