HomeMy WebLinkAbout03-15-11BUREAU OF INDIV~D.UAL_T.AXES _
INHERITANCE TAX DIVrISION -_'
PO BOX 280601
HARRISBURG, PA 17128-0601
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3017 NORTHWEST 62ND TER
GAINESVILLE FL 32606
NOTICE OF INHERITANCE TAX ~°
OFpDEDUCTI ON~ AAND"A55ESS![ENTSOFLTAXNON p e n n sy lva n~ a ~
SECURI'~Y ACCOUNTS HELD IN DEPARTMENT OF REVENUE
BENEFICIARY FOR!! REV-1548A AFP ciz-ion
DATE 03-07-2011
ESTATE OF UPHOLD MYRTLE Y
DATE OF DEATH 11-07-2010
FILE NUMBER 21 10-1270
COUNTY CUMBERLAND
SSN/DC 196-14-5340
ACN 11500034
APPEAL BY DATE: 05-06-2011
(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-1548A AFP C12-10)
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS
AND ASSESSMENT OF TAX ON SECURITY ACCOUNTS HELD IN BENEFICIARY FORM
DATE: 03-07-2011
ESTATE OF:UPHOLD MYRTLE Y DATE OF DEATH: 11-07-2010
FILE NO.: 21 10-1270 S.S/D.C. NO.: 196-14-5340
COUNTY:
CUMBERLAND
ACN: 11500034
TAX RETURN WAS: (X) ACCEPTED AS FILED ( )CHANGED
BENEFICIARY FORM OF ASSET INFORMATION
NAME OF SECURITY: AMERIPRISE ACCOUNT NO.:
TYPE OF ASSET: C ) SECURITIES C X SECURITY ACC C ) STOCK ( ) BONDS
DOD Valuation
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
179,481.39
X 0.500
89,740.70
- .00
89,740.70
X .045
4,038.33
311799225
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
01-15-2011 CD013900 201.92 3,836.41
TOTAL TAX PAYMENT 4,038.33
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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