HomeMy WebLinkAbout04-09-10A* ~~~+r A^~~+- - ~~~^~~ICE OF INHERITANCE TAX
BUREAU OF INDIVIDUAL TAXES~.~~ F~~~h:; ~ ENT, ALLOWANCE OR DISALLOWANCE
INHERITANCE TAX DIVISION _
PO BOX 280601 .« ~~~~~~,~ t'Q~ ' T~,IONS, AND ASSESSMENT OF TAX ON
HARRISBURG PA 17128-0601 ' °``~~''~~'~ t,ii 4 ~ 0~lNTLY HELD OR TRUST ASSETS
~~~o APR -9 ~M Eo: 4~'9
SANDRA CROi~~~~a
18 CUMBERLAND ESTATES
DRIVE
MECHANICSBURG PA 17050
pennsylvania ~
DEPARTMENT OF REVENUE
REV-1548 EX AFP (12-09)
DATE 04-05-2010
ESTATE OF KOZLOWSKI FELIX
DATE OF DEATH 10-07-2009
FILE NUMBER 21 10-0199
COUNTY CUMBERLAND
SSN/DC 097-12-8905
ACN 09168135
APPEAL BY DATE:06-04-2010
(See reverse side under Objections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SgUARE
CARLISLE PA 17013
CUT-ALONG-THIS-LINE - - ~ --RETAIN-L~WER-PORTION-FOR-YOUR-RECORDS-- ~ ---_-
REV-1548 EX AFP C12-09) '~ -------------
NOTICE OF INHERITANCE TAX APPRAI~EMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TA ON JOINTLY HELD OR TRUST ASSETS
DATE: 04-05-2010
ESTATE OF:KOZLOWSKI FELIX IODATE OF DEATH:10-07-2009 COUNTY:CUMBERLAND
FILE NO.: 21 10-0199 S.S/D.C. N01.: 097-12-8905 ACN: 09168135
TAX RETURN WAS: CX) ACCEPTE AS FILED C ) CHANGED
JOINT R TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO.: 182035-05
TYPE OF ACCOUNT: C ~ SAVINGS C ) CHE KING C )TRUST C )TIME CERTIFICATE
DATE ESTABLISHED 03-01-1999
Account Balance ~ 53,557.45 NOTE: TO ENSURE PROPER CREDIT TO
Percent Taxable X 0.500 YOUR ACCOUNT, SUBMIT THE
Amount Subject to Tax 26,778.73 UPPER PORTION OF THIS NOTICE
Debts and Deductions - 8,669.46 WITH YOUR TAX PAYMENT TO THE
Taxable Amount 18,109.27 REGISTER OF WILLS AT THE
Tax Rate .45 ABOVE ADDRESS. MAKE CHECK
Tax Due 814.91 OR MONEY ORDER PAYABLE T0:
"REGISTER OF WILLS, AGENT."
TAX CREDITS: '!
PAYMENT
DATE RECEIPT
NUMBER DISC
INTEREST OUNT C+)
PEN PAID C-)
AMOUNT PAID
03-01-2010 CD012407 .00 814.91
TOTAL TAX PAYMENT 814.91
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
* IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ~ yv'1