HomeMy WebLinkAbout06-20-11__ - ~_~,:
_ ennsylvan~a ~
DEPARTMENT OF REVENUE
^~ '~ OF INHERITANCE TAX REV-1548 EX AFP (12-10)
~~ G` ,~'"' t ~~ '~~ ICE ALLOWANCE OR DISALLOWANCE
TAXES i ;~-~' S~''~"'" NT , OF TAX ON
NDIVIDUAL .-rrn ¢ IONS, AND ASSESSMENT TS
BUREAU OF I [/~ ASSE
INHERITANCE TAX DIVISION ~iL.,i~'..%rL~ ~ Q-' ~ JOINTLY HELD OR TRUST 2011
Po Box zaobol 06-13 STELLA H
HARRISBURG PA 17128-0601 DATE SIEKIEWICZ
~~!~ ~ .~~~ ~~ ~~~ ~~'-' ~~ ~ DATETOFODEATH 01-07-2011
FILE NUMBER 21 11-0307
~~GnK ~~ COUNTY CUMBERLAND
~p ~rQ~~ SSN/DC 167-24-2071
ACN 11111231
Vnf~~~ ~~.~ L BY DATE:08-12-2011
G ENT A~~EA
ANTONIETT DR (See reverse side under Objections)
5313 COBBLESTONE PA 17055 Amount Remittedf
MECHANICSBURG CHECK PAYABLE AND REMIT PAYMENT T0:
MAKE
REGISTER OF WILLS
1 COURTHOU FA SQ ~ U13
CARLISLE
OR YOUR RECORDS E"~ _-----____-_
~ RETAIN-LOWER PORTION _F _---------..---------------
CUT ALONG THIS LINE --_________
_ -- --- _-- p C12-10~ EMENT, ALLOWANCE OR TRUSTLASSETS 0
REV-1548 EX AF TAX ON JOINTLY HELD O DATE: O6_13-2011
NOTICE OF INHERITSSESSMENTAOFRAIS
DEDUCTIONS, AND A
:01-07-2011 COUNTY:CUMBERLAND
STELLA H DATE OF DEATH 11111231
SIEKIEWICZ ACN:
ESTATE OF'
S.S/D.C. NO.: 167-24-2071
FILE NO.: 21 11-0307 ~ ~ CHANGED
ETURN WAS ~X) ACCEPTED AS FILED
TAX R JOINT OR TRUST ASSET INFORMATION 63892707
ACCOUNT NO.:
L INSTITUTION: M&T BANK TRUST C )TIME: CERTIFICATE
FINANCIA ~~q CHECKING ~
)SAVINGS
TYPE OF ACCOUNT: 07_1998
DATE ESTABLISHED 12- 7,680.42 NOTE:
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
0.500
X 3,840.21
.00
- 3,840.21
.045
172.81
TAX CREDITS:
RECEIPT
PAYMENT NUMBER
DATE
03-07-2011
CD014091
06-06-2011
SBADJUST
DISCOUNT ~+~
INTEREST/PEN PAID ~'~
g.64
.00
TO ENSURE PROPER MITDTHETO
YOUR ACCOUNT, SUB
THIS NOTICE
UPPER PORTION OF
WITH YOUR TAX PAYMpTTTHE THE
REGISTER OF WILLMAKE CHECK
ABOVE ADDRESS.
OR MONEY ORDER LLSAB AGENT."
"REGISTER OF WI
AMOUNT PAID
164.1b
.O1
TOTAL TAX PAYMENT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
172.81
0
00
00
REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ~
F PAID AFTER THIS DATE, SEE CREDIT" YOU MAY BE DUE A REFUND.
* I
IF TOTAL DUE IS R~FLTHISDFORMAFOR INSTRUCTIONS.
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