HomeMy WebLinkAbout11-09-09BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
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AF?.P~A,I.~; EM~NT., A~OWANCE OR DISALLOWANCE
,~~fi}~]3EDU~C~fiONS L s.A)dD ASSESSMENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
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GLADYS D RHINEHART ~,,C,~~~~''~'~'-`~_~Rl`~~ ~~;~~., ~A
1 HOTPOINT AVE
SHIPPENSBURG PA 17257
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REV-1548 EX AFP CO1-09)
DATE 11-02-2009
ESTATE OF BOLEN HELEN M
DATE OF DEATH 05-06-2009
FILE NUMBER 21 09-0884
COUNTY CUMBERLAND
SSN/DC 172-24-8393
ACN 09156258
APPEAL DATE: 01-01-2010
(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 CO1-09)-------------------------r_-__--+-_- _
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 11-02-2009
ESTATE OF BOLEN HELEN M DATE OF DEATH 05-06-2009 COUNTY CUMBERLAND
FILE N0. 21 09-0884 S.S/D.C. N0. 172-24-8393
ACN 09156258
TAX RETURN WAS: CX) ACCEPTED AS FILED ( ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: ORRSTOWN BANK ACCOUNT N0. 320978
TYPE OF ACCOUNT: C )SAVINGS 4() CHECKING C )TRUST C )TIME CERTIFICATE
DATE ESTABLISHED 09-19-2005
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
1,619.64
X 0.500
809.82
_ .00
809.82
X •15
121.47
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 C+)
INTEREST/PEN PAID C-) AMOUNT PAID
09-23-2009 CD011780 .00 121.47
TOTAL TAX CREDIT 121.47
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF
NO PAYMENT IS REQUIRED.
C IF TOTAL DUE IS LESS THAN 81 ADDIT IONAL INTEREST.
,
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ~ CR), YOU MAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) '