HomeMy WebLinkAbout09-18-09 (3)COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES ~ ' ~' 14~DTIL'E `dF INHERITANCE TAX
INHERITANCE TAX DIVISION ~-- APFRAISEMENT,,'ALLOWANCE OR DISALLOWANCE
PD BOX 280601 '_',;O,E'i~~pUGTIQN$; AND ASSESSMENT OF TAX ON
HARRISBINRG PA 17128-0601 JOINTLY HELD OR TRUST ASSETS
2~~9 SEf~ ( 8 ~ ~ i~: 43
DEBRA HOUSERMA~4~ '~`~ ~~ F'~
1204 MITCHELL DRIVE
MECHANICSBURG PA 17050
REV-1548 EX AFP (01-09)
DATE 09-15-2009
ESTATE OF CLOUSER DAVID H
DATE OF DEATH 02-20-2009
FILE NUMBER 21 09-0204
COUNTY CUMBERLAND
SSN/DC 184-26-5048
ACN 09117553
APPEAL DATE: 11-14-2004
(See reverse side under Objections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
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)
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 09-15-2009
ESTATE OF CLOUSER DAVID H DATE OF DEATH 02-20-2009 COUNTY CUMBERLAND
FILE ND. 21 D9-0204 S.S/D.C. N0. 184-26-5048 ACN 09117553
TAX RETURN WAS: CX) ACCEPTED AS FILED ( ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT N0. 113054-42
TYPE OF ACCOUNT: ( )SAVINGS C ) CHECKING C )TRUST 4()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 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 .00 305.58
TOTAL TAX CREDIT 305.58
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00 ~~'j'; ',,,,,,///
~ IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ~
( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" C CR)> YOU MAY BE DUE A REFUND.