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HomeMy WebLinkAbout01-08-10 Pennsylvania PARTMENT OF REVEN ~ •F` r r ~ I E 3'NHERITANCE TAX ir'NO~fiL'Q ~ .' DE BUREAU OF INDIVIDUAL TAXES IVISION ~',/~ppfZ/CI,SEM~NT,z ALIFOWANCE OR DISALLOWANCE `~AND ASSESSMENT OF TAX ON ~ O ` REV-1548 EX AFP C12-09) INHERITANCE TAX D pD BOX 280601 NS ;; T'L "gF~y'I111~iD~1~ JOINTLY. HELD OR TRUST ASSETS HARRISBURG PA 17128-0601 DATE ~~ ' ~ ~ ~ 12-28-2009 HELEN M ESTATE OF ~~IIII .~~~ ~'$ BURTSAVAGE DATE OF DEATH 11-01-2008 1 08-1265 FILE NUMBER 2 `~~ ~~~`~ `~' CUMBERLAND h , 4 .,;-~~ ~~-~ COUNTY (~~~~~~',`~.~''`'`' SSN/DC 168-18-3207 R~~`~" ~;' `~ -1 : ~~' ACN 09105688 EDWARD M BURTSAVAGE ~' APPEAL DATE: 02-26-2010 327 SOMERSET DR (See reverse side under Objections) SHIREMANSTOWN PA 17011 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ -_________ CUT ALONG THIS LINE_____________________________________________ ----------------- REV-1548 EX AFP C12-09) NOTUCTIONSINANDIASSESSMENTAOFRTAXEONNJOINTLYWHELD OR TRUSTLASSETS OF DED DATE: - 8-2 0 ESTATE OF: BURTSAVAGE HELEN M DATE OF DEATH: 11-01-2008 COUNTY: CUMBERLAND ACN: 09105688 FILE NO.: 21 08-1265 S.S/D.C. NO.: 168-18-3207 TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED JOINT OR TRUST ASSET INFORMATION 4000UNT NO.: 950203485 FINANCIAL INSTITUTION: M & T BANK TYPE OF ACCOUNT: C )SAVINGS CX) CHECKING C )TRUST DATE ESTABLISHED 10-08-1999 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due 10 239.01 X 0.500 5,119.51 _ .00 5,119.51 .45 230.38 TAX CREDITS: PAYMENT RECEIPT DATE NUMBER 01-29-2009 I CD010829 DISCOUNT ~+) INTEREST/PEN PAID C-) 11.52 C )TIME CERTIFICATE NOTE: TO ENSURE 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." AMOUNT PAID 218.86 TOTAL TAX PAYMENT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE .00 * IF TOTALADUERISNREFLECTEDSAS AE"CREDITOR~CCR)uLYOUOMAYFBEDDUEIANREFUNDEREST. _______ ...,,~ „~ Turc FORM FOR INSTRUCTIONS.