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HomeMy WebLinkAbout06-26-09COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES ~ ~JOTIGE QF,INHERITANCE TAX INHERITANCE TAX DIVISION APP_RAISEMENT,, ALLOWANCE OR DISALLOWANCE PO BOX 280601 @F 'DEDUC7~IONS'; AkD ASSESSMENT OF TAX ON HARRISBURG PA 17128-0601 JOINTLY HELD OR TRUST ASSETS REV-1548 EX AFP Col-09) ~6~9 Jtl~ 26 P~! I ~ ( 6 DATE 06-29-2009 ESTATE OF SHUGHART R DATE OF DEATH 12-19-2008 e~~{~~ Q~ FILE NUMBER 21 09-0426 ~~~'~ (~~~'( COUNTY CUMBERLAND JANICE BURKHOLDERCU~'~rr~"-.~b~~!;` r~., ~A SSN/DC 201-16-3944 ACN 09122481 319 GLENDALE DR SHIREMANSTOWN PA 17011 APPEAL DATE: 08-28-2009 (See reverse side under Objections) Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ------------------------------------------------------------------------------------------- REV-1548 EX AFP (01-09) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 06-29-2009 ESTATE OF SHUGHART R DATE OF DEATH 12-19-2008 FILE N0. 21 09-0426 S.S/D.C. N0. 201-16-3944 COUNTY CUMBERLAND ACN 09122481 TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: COMMERCE BANK HARRISBURG NA ACCOUNT N0. 537216996 TYPE OF ACCOUNT: ( )SAVINGS 4() CHECKING ( )TRUST C )TIME CERTIFICATE DATE ESTABLISHED 01-30-2006 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAX CREDITS: 1,218.89 X 0.500 609.45 _ 364.49 244.96 X .45 11.02 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 T0: "REGISTER OF WILLS, AGENT." PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID C-) AMOUNT PAID 05-OL-2009 CD011188 .00 11.02 TOTAL TAX CREDIT 11.02 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDIT IONAL INTEREST. ( IF TOTAL DUE IS LESS THAN 51, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" C CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )