HomeMy WebLinkAbout07-17-09 (3)COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT DF REYENUE
BUREAU OF INDIVIDUAL TAXES
INHERSTANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128.0601
DONNA WEST
7152 COUNTY ROAD #56
MT GILEAD OH 43338
N~7!1' ~ (~ y~ij-T6A,NC(:, TAX
APPRAISENF~. '; iyj'~M1Y4NG1f~dbiE,'DISALLOWANCE
OF DEDUCT~j]j~0 TC. ~LLkS &EB{NE NT OF TAX ON
JOINTLY HEL~~Oti 'I~IfIi4"~ ASSETS
REV-1548 IX AFP (01-09)
1Q04JUL 17 PI~a~ABA DF CLOUSER009 DAVID H
DATE OF DEATH 02-20-2009
CLERK OF~OUNTYUMBER CUMBERLAND
CRP~~S CC~/DC 184-26-5048
CU~'~R~:~{i„~,uC r/a,C I~Q 09117552
APPEAL DATE: 09'11-2609
(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 1 RETAIN LOWER PORTION FOR YOUR RECORDS !~
REV-1548 EX AFP (01-09)
NOTICE OF INHERITANCE TAX APPRAISEMEN7, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 07-13-2009
ESTATE OF CLOUSER
FILE N0. 21 09-0204
DAVID H DATE OF DEATH 02-20-2009
S.S/D.C. N0. 184-26-5048
COUNTY CUMBERLAND
ACN 09117552
TAX RETURN WAS: CX) ACCEPTED AS FILED C) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT N0. 113054-42
TYPE OF ACCOUNT: ( )SAVINGS ( ) CHECKING C )TRUST 0()TIME CERTIFICATE
DATE ESTABLISHED 08-11-2004
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
81,491.13
X 0.083
6,790.66
.00
6,790.66
x.45
305.58
NOTE: TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT 70 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
05-15-2009 CD011243 15.28 305.58
TOTAL TAX CREDIT 320.86
BALANCE OF TAX DUE 15.28CR
INTEREST AND PEN. .00
TOTAL DUE 15.28CR
IF PAID AFTER THIS DATE. SEE
( IF TOTAL DUE LS LESS THAN kl,
REVERSE FOR CALCULATION OF
NO PAYMENT IS REQUIRED.
ADDITIONAL INTEREST. ~ ///'''~~~
,... ,' J
G
~I
/
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CR). YOU MAY HE DUE A REFUND. Y
`
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) /