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HomeMy WebLinkAbout11-30-09_. _.. _._ __ _ _. _. __ __ T_., __ _. _ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE '~^~i '~~.lr~1t~~~k~OF,~?INHERITANCE TAX BUREAU OF INDIVIDUAL TAXES PR ~uu LOWANCE OR DISALLOWANCE INHERITANCE TAX DIVISION {~. 'S r'„ '~ Po Box 2soboi ' ' `~U~SfiIO~$t, aND ASSESSMENT OF TAX ON HARRISBURG PA i~lza-oboe JOINTLY HELD OR TRUST ASSETS REV-1548 EX AFP COl-091 2009 NOY 30 AM 1f : I~~. DATE 11-30-2009 ESTATE OF CLOUSE ELMER E DATE OF DEATH 11-03-2008 ~~~~(~ FILE NUMBER 21 OS-1167 ~~'S ~~T COUNTY CUMBERLAND BESSIE V CLOUSE Cv~~?ER~°'~~'~ C~., ~~ ACN/DC 09100689982 844 DOUBLING GAP RD APPEAL DATE: 01-29-2010 NEWUILLE PA 17241 (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 (01-09) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 11-30-2009 ESTATE OF CLOUSE ELMER E DATE OF DEATH 11-03-2008 COUNTY CUMBERLAND FILE N0. 21 08-1167 S.S/D.C. N0. 201-18-3982 ACN 09100689 TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: ORRSTOWN BANK ACCOUNT N0. 10100'1041 TYPE OF ACCOUNT: ( )SAVINGS O() CHECKING ( )TRUST ( )TIME CERTIFICATE DATE ESTABLISHED 01-01-2001 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAX CREDITS: 1,010.73 NOTE: X 0.500 505.37 .00 505.37 X .15 75.81 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 (+) INTEREST/PEN PAID C-) AMOUNT PAID INTEREST I5 GFIARGED TMRUUGM lG-Ut3-"LUUY AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORM * IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ( IF TOTAL DUE IS LESS THAN Sl, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CR), YOU MAY B SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE 75.81 INTEREST AND PEN. 1.32 TOTAL DUE 77.13 ADDITIONAL INTEREST. ^ E DUE A REFUND.