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HomeMy WebLinkAbout05-17-10BUREAU OF INDIVIDUAL TAXES _. - , ~:' .~ ~'~~', `, NOTICE OF INHERITANCE TAX INHERITANCE TAX DIVISION ~'': i"':::;,°:~~~ `-iA-PP~tAt'S'EMENT, ALLOWANCE OR DISALLOWANCE PO BOX 280601 ~~ ~ OF DEDUCTIONS, AND ASSESSMENT OF TAX ON HARRISBURG PA 17128-0601 0 LY HELD OR TRUST ASSETS ~~ ~Tt .~ ~ ~ PATRICIA A JANTE~~~~ 5500 F GLOUCESTER ST MECHANICSBURG PA 17055 Pennsylvania ~ DEPARTMENT OF REVENUE REV-1548 EX AFP (12-09) DATE 05-17-2Q10 ESTATE OF DREIBEL~IS MARY L DATE OF DEATH 12-19-2 09 FILE NUMBER 21 10-O~i55 COUNTY CUMBERL/{-ND SSN/DC 172-24- 180 ACN 1011868 APPEAL BY DATE:07-16-2010 (See reverse side under O jections) Amount Remitted REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 MAKE CHECK PAYABLE ANDI REMIT PAYMENT T0: CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1548 EX AFP C12-09) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCIE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE: 0~-17-2010 ESTATE OF:DREIBELBIS MARY L DATE OF DEATH:12-19-2009 COUNTY:CUMBERLAND FILE NO.: 21 10-0455 S.S/D.C. NO.: 172-24-8180 ACN: 10118688 TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: MID PENN BANK ACCOUNT NO.: 104067 TYPE OF ACCOUNT: C )SAVINGS CX) CHECKING C )TRUST C )TIME CERTIFICATE DATE ESTABLISHED 03-06-2006 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAX CREDITS: 364.56 X 0.500 __ 182.28 - .00 182.28 Y .045 8.20 NOTE: TO ENSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER POR''TION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDIRESS. MAKE CHECK OR MONEY ORDER PAYABLE T0: "REGISTER OF WILLS, AGENT." PAYMENT DATE RECEIPT NUMBER DISCOUNT C+) INTEREST/PEN PAID C-) AMOUNT PAID PAYMENT MUST BE MADE BY 09-20-2010*. TOTAL TAX PAYMEN .00 BALANCE OF TAX D E 8.20 INTEREST AND PEN. .00 TOTAL DUE ' 8.20 * 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.