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HomeMy WebLinkAbout06-14-10t pennsylvania ~ BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION APPRAISEMENT, ALLOWANCE OR DISALLOWANCE REV-1548 EX AFP C12-09) PO BOX 280601 OF DEDUCTIONS, AND ASSESSMENT OF TAX ON HARRISBURG PA 17128-0601 JOINTLY HELD OR TRUST ASSETS DATE 06-08-2010 ESTATE OF PUSEY JOHN H DATE OF DEATH 12-14-2009 FILE NUMBER 21 10-0505 COUNTY CUMBERLAND SSN/DC 162-09-9826 CLAIRE M LYTER ACN 10122541 658 COLONIAL VIEW RO APPEAL BY DATE:08-07-2010 MECHANICSB RG PA 1 055 (See reverse side under Objections) Amount Remitted MAKE CHECK PAYABLE AND REMIT PAI NT T0: - 1 REGISTER OF WILLS n ~, --~:~ ~-' / 1 COURTHOUSE SQUARE ~ ~ G ~~; -, ~:.~=~ 1 (,1 RLISLE PA 17013 , ~~~`a~a :~= ' %~ `' ~'t CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~~ ;r°-,L~ - _ - ,`' REV-1548 EX AFP C12-09) --> ~ -" NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE O~Ev---+ ~ '"~ DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS :v ~,,,? DATE: 06-08-2010 ESTATE OF:PUSEY JOHN COUNTY:CUMBERLAND S.S/D.C. NO.: 162-09-9826 ACN: 10122541 FILE NO.: 21 10-0505 TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: MEMBERS 1ST FCU TYPE OF ACCOUNT: CX)SAVINGS C ) CHECKING C )TRUST DATE ESTABLISHED 03-27-1961 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Dus TAY (`DCi1TTC. ACCOUNT NO.: 5495-00 C )TIME CERTIFICATE 33,842.12 NOTE: X 0.166 5,640.47 - .00 5,640.47 .045 253.82 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 ORL)ER PAYABLE T0= "REGISTER OF WILLS, AGENT." PAYMENT DATE RECEIPT NUMBER DISCOUNT C+) INTEREST/PEN PAID (-) AMOUNT PAID PAYMENT MUST BE MADE BY 09-15-2010*. TOTAL TAX PAYMENT .00 BALANCE OF TAX DUE 253.82 INTEREST AND PEN. .00 TOTAL DUE 253.82 * IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE A REFUND. .~.~~ nr..rnnr nrnr ne Turc Cf1RM F'f1R TNSTRUCTIONS. H DATE OF DEATH:12-14-2009 aGV_, ~~~ Fxr~ 1-961 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT LYTER CLAIR M 658 COLONIAL VIEW ROAD MECHANICSBURG, PA 17055 ACN ASSESSMENT CONTROL NUMBER -------- fn~d ESTATE INFORMATION: FILE NUMBER: DECEDENT NAME: DATE OF PAYMENT: POSTMARK DATE: COUNTY: DATE OF DEATH: SSN: 162-09-9826 2110-0505 PUSEY JOHN H 05/ 14/ 2010 05/ 13/2010 CUMBERLAND 12/ 14/ 2009 TOTAL AMOUNT PAID: REMARKS: JOHN H PUSEY REV-1162 EX{11-96) NO. CD 012749 AMOUNT $253.82 CHECK# 2086 INITIALS: WZ RECEIVED BY: GLENDA EARNER STRASBAUGH SEAL _..,.._ - _ ._ _. REGISTER OF WILLS TAXPAYER