HomeMy WebLinkAbout12-08-08BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280681
HARRISBURG, PA 17128-8601
COMMONWEALTH OF PENNSYLVANIA
~-~ ~ :-DEPA-RT~IENT OF REVENUE
. ,i ~.
-~~ NOTICE OF INHERITANCE TAX
.-'_ ibpPRAISEMENT ALLONANCE OR DISALLORANCE
OF DEDUCTION AND ASSESSHENT OF TAX ON
SECURI~'Y ACCOUNTS HELD IN
LO~U C ^~ ~I'r ~: ~FNEFICIARY FORK
nl Yl!rl
i~L. i ~ I
Ci' k. ~ - r'~r~i ~nnT
(-~ ,. i,~ril
l.«,~ ~ _
PAULA D POTTERGEN
30 FAITH CIRCLE
CARLISLE PA 17013
REV-1548A AFP (06-OS)
DATE 12-08-2008
ESTATE OF ADAMS SANDRA
DATE OF DEATH 11-06-2007
FILE NUMBER 21 07-1068
COUNTY CUMBERLAND
SSN/DC 288-40-4517
ACN 08500031
APPEAL DATE: 02-06-2009
(See reverse side under objections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
T0:
L
CUT ALONG THIS LINE -- RETAIN LOWER PORTION FOR YOUR RECORDS t-
----------------------------------------------------------------------------------------------------------------
REV-1548A AFP (01-03)
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALILOWANCE OF DEDUCTIONS
AND ASSESSMENT OF TAX ON SECURITY ACCOUNTS HELD IN BIENEFICIARY FORM
DATE 12-08-2008
ESTATE OF ADAMS SANDRA L DATE OF DEATH 11-06-2007 COUNTY CUMBERLAND
FILE N0. 21 07-1068 S.S/D.C. N0. 288-40-4517 ACN 08500031
TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED
BENEFICIARY FORM OF ASSET INFORMATION
NAME OF SECURITY: AMERICAN FUNDS ACCOUNT N0. 75745712
TYPE OF ASSET: ( ) SECURITIES (~ SECURITY ACC ( ) STOCK ( ) BONDS
DOD Valuation
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
10,156.41 NOTE:
X 1.000
10,156.41
.00
10,156.41
X .45
457.04
TO INSURE PROPER CREDIT TO
YOURR ACCOUNT, SUBMIT THE
UP PIER PORTION OF THIS NOTICE
WITIH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR (MONEY ORDER PAYABLE T0:
"REGISTER OF WILLS, AGENT."
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT (+)
INTEREST/PEN PAID (-) AMOUNT ('AID
INTEREST IS CHARGED THROUGH 12-16-2008 TOTAL TAX CREDIT .00
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 457.04
REVERSE SIDE OF THIS FORM INTEREST ANII PEN. 11.58
TOTAL DIIE 468.62
* IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ~ /"~
C IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. j ,
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CR), YOU MAY BE DUE A REFUND. ~/f7v
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
I