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HomeMy WebLinkAbout08-06-10BUREAU OF INDIVIDUAL TAXiE$ INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 ~ ar t~f` ~. c.~iu ~.~~ -- .. ,_. . ;_ ~:,~ ''~ NOTICE OF INHERITANCE TAX 'Ap'PFtAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON ,.~~ OINTLY HELD OR TRUST ASSETS Fit ~~,~.~ ~.. , ~; ROBERT F CHOMA 2145 15TH STREET BETHLEHEM PA 18020 pennsylvania ~ DEPARTMENT OF REVENUE ~' REV-1548 EX AFP (12-09) DATE 08-09-2010 ESTATE OF BONIN MARTHA G DATE OF DEATH 02-25-2010 FILE NUMBER 21 10-0261 COUNTY CUMBERLAND SSN/DC 205-26-2115 ACN 10047025 APPEAL BY DATE:10-O8-2.010 (See reverse side under Objections) Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE S6lUARE CARLISLE PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS 4'~' ----------------------------------------------------------------------------------------- - REV-1548 EX AFP C12-09) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE: 08-09•-2010 ESTATE OF:BONIN MARTHA FILE ND.: 21 10-0261 S.S/D.C. NO.: 205-26-2115 ACN: 10047025 TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: ALLSTATE LIFE ANNUITY ACCOUNT NO.: GA16881072 TYPE OF ACCOUNT: C )SAVINGS C ) CHECKING C )TRUST DATE ESTABLISHED 10-30-2003 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due Twv r~rnrrc. C )TIME CERTIFICATE 136,282.35 NOTE: X 1.000 136,282.35 - .00 136,282.35 x .15 20,442.35 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 ORDEfZ PAYABLE T0: "REGISTER OF WILLS, AGENT." PAYMENT DATE RECEIPT NUMBER DISCOUNT (+~ INTEREST/PEN PAID C-) AMOUNT PAID PAYMENT MUST BE MADE BY 11-26-2010. G DATE OF DEATH:02-25-2010 TOTAL TAX PAYMENT .00 BALANCE OF TAX DUE 20,442.35 INTEREST AND PEN. .00 TOTAL DUE 20,442.35 COUNTY:CUMBERLAND * IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRS, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ,,~~--s~,\