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HomeMy WebLinkAbout03-26-10BUREAU OF INDIVIDUAL TAE'S ~_~ ;- `~'~ NOTICE OF INHERITANCE TAX INHERITANCE TAX DIVISION ~ _ :AP~JtAISEMENT, ALLOWANCE OR DISALLOWANCE PO BOX 280601 •~ •• ~- ~ E?F- DEDUCTIONS, AMD ASSESSMENT OF TAX ON HARRISBURG PA 17128-0601 JOINTLY HELD OR TRUST ASSETS Pennsylvania ~ DEPARTMENT OF REVENUE ~, REV-1548 EX AFP C12-09) '? DATE 03-15-2 10 ;_, '.J SHELLY L BGH ' " ' 114 DOGWOOD DR MT HOLLY SPRGS PA 17065 ESTATE OF BELLOMO DATE OF DEATH 02-11-2 !09 FILE NUMBER 21 09-0 76 COUNTY CUMBERL ND SSN/DC 721-18-0454 ACN 0912484 APPEAL BY DATE:05-14-2010 (See reverse side under O 'ections) Amount Remitted THELMA N MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE '~ RETAIN LOWER PORTION FOR YOUR RECORDS ---------------------------------------------------------------------- -------------------- REV-1548 EX AFP X12-09) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANC OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSET DATE: 0 -15-2010 ESTATE OF:BELLOMO THELMA N DATE OF DEATH:02-11-2009 OUNTY:CUMBERLAND FILE NO.: 21 09-0776 S.S/D.C. NO.: 721-18-0454 ACN: 09124845 TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: SUSQUEHANNA BANK ACCOUNT NO.: 12 '021236 TYPE OF ACCOUNT: C )SAVINGS CX) CHECKING C )TRUST C )TIME CERTIFIC TE DATE ESTABLISHED 12-13-2005 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAY f QCTITTC. 402.47 X 0.500 201.24 - .00 201.24 Y .45 9.06 NOTE: TO ENSURE PROPER CREDIT TO YOUR ACCO 'NT, SUBMIT THE UPPER POR ION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER F WILLS AT THE ABOVE ADD ESS. MAKE CHECK OR MONEY RDER PAYABLE T0: "REGISTER OF WILLS, AGENT." PAYMENT DATE RECEIPT NUMBER DISCOUNT C+) INTEREST/PEN PAID (-) AMOUNT PAID 08-18-2009 CD011642 .00 9.06 TOTAL TAX PAYMENT BALANCE OF TAX DU INTEREST AND PEN. TOTAL DUE * 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. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. 9.06 .00 .00 .00