HomeMy WebLinkAbout04-27-11 (3)BUREAU OF INDIVIDUAL AXES if~~ NOTICE OF INHERITANCE TAX
INHERITANCE TAX DIVISION ~- ~ - -' '`"%~PPRAISEMENT, ALLOWANCE OR DISALLOWANCE
PO Box zao6ol OF DEDUCTIONS, AND ASSESSMENT OF TAX ON
HARRISBURG PA 17128-06,01 JOINTLY HELD oR TRUST assErs
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BRIDGET L BAILEY
31 HICKORY ROAD
MOHNTON PA 19540
Pennsylvania -:
DEPARTMENT OF REVENUE
REV-1548 EX AFP C12-10)
DATE 04-25-2011
ESTATE OF BAILEY NICOLE M
DATE OF DEATH 06-11-2010
FILE NUMBER 21 10-0672
COUNTY CUMBERLAND
SSN/DC 187-56-3732
ACN 11001805
APPEAL BY DATE:06-24-2011
(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 <"~
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: 04-25-2011
ESTATE OF:BAILEY
NICOLE M
DATE OF DEATH:06-11-2010 COUNTY:CUMBERLAND
FILE NO.: 21 10-0672 S.S/D.C. NO.: 187-56-3732 ACN: 11001805
TAX RETURN WAS: CX) ACCEPTED AS FILED ( ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: FIDELITY INVESTMENTS
TYPE OF ACCOUNT: ( )SAVINGS C ) CHECKING C )TRUST
DATE ESTABLISHED 06-11-2010
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
16,000.00
X 1.000
16,000.00
- .00
16,000.00
x .12
1,920.00
TAX CREDITS:
ACCOUNT NO.: 401K
C )TIME CERTIFICATE
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
-•• ~•~•-~ ~.+ ..~~r.,.o~u i nnvUVn U7-UJ-LUl l
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
TOTAL TAX PAYMENT .00
BALANCE OF TAX DUE 1,920.00
INTEREST AND PEN. 8.34
TOTAL DUE 1,928.34
r~
~ 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. ~