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Home My WebLink About07-06-10BUREAU OF INDIVIDUAL TAXES _ NQTICB,OF INNERITANCE TAX • INHERITANCE TAX DIVISION -~ ;AP~I~AYSEx~r~r ~,,;dttLONANCE OR DISALLOxANCE pennsylvanla ..~ ~,- PO BOX 2BO6oI OF DBDUCTIQN~. AND ASSES5lIENT OF TAX ON DEPARTMENT OF REVENUE HARRISBURG, PA Irizs-o6ol _ - " SECURI'~Y ACCOUNTS HELD IN -" " - - °BENEFICIARY FORI'I REV-1548A AFP (1T-09) -~ ~ ~ ~~ ~ L.l r,i i ~ ~ ~, ; fy ..,t. ;;-~T LARRY R CLAYCOMB v~. ~~ ;~; - ~'`'~ 141 MIDDLESEX ROAD CARLISLE PA 17013 DATE 07-05-2010 ESTATE OF CLAYCOMB HELEN DATE OF DEATH 03-24-2010 FILE NUMBER 21 10-0601 COUNTY CUMBERLAND SSN/DC 210-38-4407 ACN 10500759 APPEAL BY DATE: 09-03-2010 (See reverse side under Objections) Amount Remitted 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-1548A AFP C12-09~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ON SECURITY ACCOUNTS HELD IN BENEFICIARY FORM DATE: 07-05-2010 ESTATE OF:~LAYCOMB HELEN DATE OF DEATH: 03-24-2010 COUNTY: CUMBERLAND FILE NO.: 21 10-0601 S.S/D.C. NO.: 210-38-4407 ACN: 10500759 TAX RETURN WAS: (X) ACCEPTED AS FILED C )CHANGED BENEFICIARY FORM OF ASSET INFORMATION NAME OF SECURITY: MERRILL LYNCH ACCOUNT NO.: 87257395 TYPE OF ASSET: C ) SECURITIES (X SECURITY ACC ( ) STOCK ( ) BONDS DOD Valuation Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAX CREDITS: 701,926.15 X 0.333 233,973.04 - .00 233,973.04 X .045 10,528.79 NOTE: 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 ORDER PAYABLE: T0: "REGISTER OF WILLS, AGENT." PAYMENT DATE RECEIPT NUMBER DISCOUNT C+) INTEREST/PEN PAID C-~ AMOUNT PAID 06-11-2010 CD012895 526.44 10,002.35 TOTAL TAX PAYMENT 10,528.79 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" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. `~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG, PA 17128-0601 ,~~~ ~;" ,.~ ~. L. - - • " BO`I'~CE OF INHERITANCE TAX APPRAISElI~NT ALLOfiANCE OR DISALLONANCE OF DEDUCTiON~ AND ASSE5SIiENT OF TAX ON .. "SECURI~'Y ACCOUNTS HELD IN BENEFICIARY FORlI r' }.i ' ,.,_ ;,: pennsyLvan~a ~ _ DEPARTMENT OF REVENUE REV-1548A AFP (1"1.-09) ~,~~ -~„' -~~ ~~L. ~` ~ DATE 07-05-2010 ~,- -, ,~. , L, ;t ~ ' ~- PAUL E CLAYCOhI~~B`~ 351 BIRCH LANE BEDFORD PA 15522 ESTATE OF CLAYCOMB HELEN DATE OF DEATH 03-24-2010 FILE NUMBER 21 10-0601 COUNTY CUMBERLAND SSN/DC 210-38-4407 ACN 10500760 APPEAL BY DATE: 09-03-2010 (See reverse side under Objections) Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG_THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~"'~ ---------------------------------------------------------------------------------------------------- REV-1548A AFP C12-09~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ON SECURITY ACCOUNTS HELD IN BENEFICIARY FORM DATE: 07-05-2010 ESTATE OF:CLAYCOMB HELEN DATE OF DEATH: 03-24-2010 COUNTY: CUMBERLAND FILE NO.: 21 10-0601 S.S/D.C. NO.: 210-38-4407 ACN: 10500760 TAX RETURN WAS: (X) ACCEPTED AS FILED C )CHANGED BENEFICIARY FORM OF ASSET INFORMATION NAME OF SECURITY: MERRILL LYNCH ACCOUNT NO.: 87257395 TYPE OF ASSET: ( ) SECURITIES C X SECURITY ACC ( ) STOCK ( ) BONDS DOD Valuation Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAX CREDITS: 701,926.15 X 0.333 233,973.04 - .00 233,973.04 X .045 10,528.79 NOTE: 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 ORDER PAYABLE T0: "REGISTER OF WILLS, AGENT." PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-~ AMOUNT PAID 06-11-2010 CD012893 526.44 10,002.35 TOTAL TAX PAYMENT 10,528.79 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. ~~ BUREAU OF INDIVIDUAL TAXES .--r,- ; ~ ~..-ND~'~ICE OF INHERITANCE TAX INHERITANCE TAX DrvISION - APPRAISEI~ENT ALLOfiANCE OR DISALLONANCE Po eox zso6ol OF DEDUCTIONS AND ASSESSMENT OF TAX ON HARRISBURG, PA Ines-o6ol - - -SECURI~'Y ACCOUNTS HELD IN BENEFICIARY FORK ~I F;-~, , ~~~}~;~ ~„~ f, ar~T t t P - ~ ~~~ (~~ }i ,' BETTY L MITTON~`' 330 ENOLA RD CARLISLE PA 17013 ~, pennsylvan~a ~ ,~.. DEPARTMENT OF REVENUE RFV-1548A AFP (12-09) ~-~~~~- + DATE 07-05-2010 ESTATE OF CLAYCOMB HELEN DATE OF DEATH 03-24-2010 FILE NUMBER 21 10-0601 COUNTY CUMBERLAND SSN/DC 210-38-4407 ACN 10500761 APPEAL BY DATE: 09-03-2010 (See reverse side under Objections) Amount Remitted 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-1548A AFP C12-09) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ON SECURITY ACCOUNTS HELD IN BENEFICIARY FORM DATE: 07-05-2010 ESTATE OF:CLAYCOMB HELEN DATE OF DEATH: 03-24-2010 COUNTY: CUMBERLAND FILE NO.: 21 10-Ob01 S.S/D.C. NO.: 210-38-4407 ACN: 10500761 TAX RETURN WAS: CX) ACCEPTED AS FILED { )CHANGED BENEFICIARY FORM OF ASSET INFORMATION NAME OF SECURITY: MERRILL LYNCH ACCOUNT NO.: 87257395 TYPE OF ASSET: ( ) SECURITIES C ~ SECURITY ACC ( ) STOCK C ) BONDS DOD Valuation Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAX CREDITS: 701,926.15 X 0.333 233,973.04 - .00 233,973.04 X .045 10,528.79 NOTE: 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 ORDER PAYABLE T0: "REGISTER OF WILLS, AGENT." PAYMENT DATE RECEIPT NUMBER DISCOUNT C+) INTEREST/PEN PAID C-) AMOUNT PAID 06-11-2010 CD012894 526.44 10,002.35 TOTAL TAX PAYMENT 10,528.79 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.