HomeMy WebLinkAbout11-29-10BUREAU OF INDIVIDUAL TAXES ~' ~'` r' - ~`' +~ ~. ~IC~E OF INHERITANCE TAX
INHERITANCE TAX DIVISION ~'..<<. ~• ~~- - ARPRAIsENT, ALLOWANCE OR DISALLOWANCE
PO BOX 280601 ~ QF .DEY~I~G~.IONS, AND ASSESSMENT OF TAX ON
HARRISBURG PA 17128-0601 ••- - -• JOINTLY HELD OR TRUST ASSETS
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JOAN K CLOOS~w^~ _'" _' _ I-,A
87 NORTHVIEW DR
MECHANICSBURG PA 17050
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DEPARTMENT OF REVENUE
REV-:L548 EX AFP (12-09)
DATE 11-22-2010
ESTATE OF CLOOS TIMOTHY N
DATE OF DEATH 03-25-2010
FILE NUMBER 21 10-0626
COUNTY CUMBERLAND
SSN/DC 107-28-1067
ACN 10152131
APPEAL BY DATE:O1-21-2011
(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 ~
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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: 11-22-2010
ESTATE OF:CLOOS
TIMOTHY N DATE OF DEATH:03-25-2010
COUNITY:CUMBERLAND
FILE NO.: 21 10-0626 S.S/D.C. NO.: 107-28-1067 ACN: 10152131
TAX RETURN WAS: CX) ACCEPTED AS FILED ( ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: WACHOVIA BK NA ACCOUNT NO.: 1010218393873
TYPE OF ACCOUNT: ( )SAVINGS (X) CHECKING C )TRUST ( )TIME CERTIFICATE
DATE ESTABLISHED 12-16-2008
Account Balance 460.68 NOTE: TO ENSURE PROPER CREDIT TO
Percent Taxable X 0.500 YOUR ACCOUNT, SUBMIT THE
Amount Subject to Tax 230.34 UPPER PORTIONI OF THIS NOTICE
Debts and Deductions - •00 WITH YOUR TAX: PAYMENT TO THE
Taxable Amount 230.34 REGISTER OF WiILLS AT THE
Tax Rate x •15 ABOVE ADDRESS. MAKE CHECK
Tax Due 34.55 OR MONEY ORDER PAYABLE T0:
"REGISTER OF WILLS, AGENT."
TAX CREDITS:
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID (-)
AMOUNT PAID
10-08-2010 CD013476 .00 34.55
TOTAL TAX PAYMENT 34.55
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.
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