HomeMy WebLinkAbout04-27-11BUREAU OF INDIVIDUAL T~c,SS ~'~j~l;~(~~~`}}- NOTICE OF INHERITANCE TAX
INHERITANCE TAX DIVISION ~,C „ `A?PRAISEHENT ALLONANCE OR DISALLONANCE
Po eox zeo6ol '''? 1 OF DEDUCTION AND ASSESSMENT OF TAX ON
HARRISBURG, PA Iriza-o6ol ~"~~._.~..-~ "~`'~ SECURI~fY ACCOUNTS HELD IN
BENEFICIARY FORM
,.- C.~ t
n j 7
UR.P'~~~'~`` j ~'~, I..~i j i
BEATRICE MC~ALL
6 LANTERN LANE
SHIPPENSBURG PA 17257
Pennsylvania
DEPARTMENT OF REVENUE ~,
REV-1548p AFP (12-101
DATE 04-25-2011
ESTATE OF KIRKMAN HELEN B
DATE OF DEATH 12-08-2010
FILE NUMBER 21 10-1256
COUNTY CUMBERLAND
SSN/DC 177-16-1654
ACN 11500145
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
~- RETAIN LOWER PORTION FOR YOUR RECORDS ~ _______
CUT ALONG THIS LINE _
-------------------- ----
REV-1548A AFP C12-10)
NOTICEAND ASSESSMENTEOFATAXPONASECURITY ACCOUNTSEHELDDINABENEFICIARY FORMCTIONS
DATE: 04-25-2011
ESTATE OF:'~T~"~~~'~ HELEN B DATE OF DEATH: 12-08-2010 COUNTY: CUMBERLAND
S.S/D.C. NO.: 177-16-1654 ACN: 11500145
FILE NO.: 21 10-1256
TAX RETURN WAS: CX) ACCEPTED AS FILED ( )CHANGED
BENEFICIARY FORM OF ASSET INFORMATION
NAME OF SECURITY: AMERIPRISE
TYPE OF ASSET: ~ AI SECURITIES C ) SECURITY ACC C ) STOCK
DOD Valuation
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
120,413.16
X 0.333
40,137.32
_ .00
40,137.32
X .045
1,806.18
TAX CREDITS:
PAYMENT RECEIPT
DATE NUMBER
02-19-2011 CD014042
DISCOUNT C+)
INTEREST/PEN PAID C-)
90.31
1,715.88
TOTAL TAX PAYMENT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
ACCOUNT NO.: 15414262
( ) BONDS
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."
AMOUNT PAID
1,806.19
.00
.O1CR
~ IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST.
SEETREVERSEESIDEROFLTHISDFORMAFORRINSTRUCTIONSYOU MAY BE DUE A REFUND.