HomeMy WebLinkAbout09-18-09 (2)COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES r NOTI-CE OF'"INHERITANCE TAX
INHERITANCE TAX DIVISION APPR,.l~.ISE~MEN,F, ALLOWANCE OR DISALLOWANCE
PO 80X 280601 OF ~D~DUCTTONS-,• AND ASSESSMENT OF TAX ON
HARRISBURG PA 17128-0601 JOINTLY HELD OR TRUST ASSETS
REV-1548 EX AFP CO1-09)
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DEBRA HOUSERMAN -
1204 MITCHELL DRIVE
MECHANICSBURG PA 17050
ESTATE OF CLOUSER DAVID
DATE OF DEATH 02-20-2004
FILE NUMBER 21 09-0204
COUNTY CUMBERLAND
SSN/DC 184-26-5048
ACN 09117550
APPEAL DATE: 11-14-2009
(See reverse side under Objections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
H
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
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REV-1548 EX AFP CO1-09)
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT DF TAX ON JOINTLY HELD DR TRUST ASSETS
DATE 09-15-2009
ESTATE OF CLOUSER DAVID H DATE OF DEATH 02-20-2009 COUNTY CUMBERLAND
FILE NU. 21 09-0204 S.S/D.C. N0. 184-26-5048 ACN 09117550
TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT N0. 113054-41
TYPE OF ACCOUNT: C )SAVINGS ( ) CHECKING C )TRUST QOTIME CERTIFICATE
DATE ESTABLISHED 02-05-1990
Account. Balance
Percent. Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
85,579.74
X 0.083
7,131.36
.00
7,131.36
X .45
320.91
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
07-20-2009 CD011515 .00 320.91
TOTAL TAX CREDIT s[u.yi
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .OD ,,
~ IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST.
C IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" C CR), YOU MAY BE DUE A REFUND.