HomeMy WebLinkAbout12-27-10 (2)AF~~?~~~~~ ~;-~~ Pennsylvania
~~~~~h, ~' '* +c;~',~~ ~~ NOTICE OF INHERITANCE TAX DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAX ~ w~4 k"j ~~,,,- 4a~~Pi+RCf~ISEMENT, ALLOWANCE OR DISALLOWANCE
INHERITANCE TAX DIVISION REV-1548 IX AFP C12-10)
PO BOX 280601 OF DEDUCTIONS, AND ASSESSMENT OF TAX ON
HARRISBURG PA 17128-0601 INTLY HELD OR TRUST ASSETS
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DENISE B BORSUK
280 ECHO ROAD
CARLISLE PA 17015
DATE 12-27-2010
ESTATE OF BORSUK DREW A
DATE OF DEATH 11-02-2010
FILE NUMBER 21 10-1154
COUNTY CUMBERLAND
SSN/DC 202-48-4422
ACN 10164667
APPEAL BY DATE:02-25-2011
(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 F"
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REV-1548 EX AFP C12-10~
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE: 12-27-2010
ESTATE OF:BORSUK
DREW
FILE NO.: 21 10-1154 S.SlD.C. NO.: 202-48-4422
COUNTY:CUMBERLAND
ACN: 10164667
TAX RETURN WAS: CX~ ACCEPTED AS FILED C ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO.: 154193-00
TYPE OF ACCOUNT: CX)SAVINGS C ~ CHECKING C 3TRUST ( )TIME CERTIFICATE
DATE ESTABLISHED 10-26-1995
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAY CRFi1TTC~
1,179.73 NOTE:
X 0.166
196.63
- .00
196.63
~ .00
.00
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
A DATE OF DEATH:11-02-2010
TOTAL TAX PAYMENT .00
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. C