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HomeMy WebLinkAbout05-20-11 (2)BUREAU OF INDIVIDUAL TAxES - NOTICE OF INHERITANCE TAX INHERITANCE TAX DIVISION APPRAIS£P~EkT ALLORANCE OR DISALLONANCE Pennsylvania r; Po Box zaocol - OF DEDUCTION AND ASSESSMENT OF TAX ON HARRISBURG, PA I~IZa-o6ol - ~ SECURI~'Y ACCOUNTS HELD IN DEPARTMENT OF REVENUE BENEFICIARY FORM Rev-~zaea RFR eiz-~a~ DATE 05-16-2011 ESTATE OF HUGHES NEWTON A DATE OF DEATH 01-16-2011 FILE NUMBER 21 11-0445 COUNTY CUMBERLAND KENNETH HUGHES SSN/DC 146-22-5851 ACN 1150074b 108 LEGATO AVENUE APPEAL BY DATE: 07-15-2011 THOROFARE NJ 08086 (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 RECDRDS ~- --------------------------- -------------------------------------------- REV-1548A AFP (12-10) --------------------------------- NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ON SECURITY ACCOUNTS HELD IN BENEFICIARY FORM DATE: 05-16-2011 ESTATE OF:~fUGHES N wrnN A DATE OF DEATH: O1-16-2011 COUNTY: CUMBERLAND FILE NO.: 21 11-0445 S.S/D.C. NO.: 146-22-5851 ACN: 11500746 TAX RETURN WAS: (X) ACCEPTED AS FILED ( )CHANGEI) BENEFICIARY FORM OF ASSET INFORMATION NAME OF SECURITY: AMERIPRISE ACCOUNT NO.: 931070051491004 TYPE OF ASSET: ( ) SECURITIES ( A( SECURITY ACC ( ] STOCK ( ) BDNDS DOD Valuation 20,479.09 NOTE: TO ENSURE PROPER CREDIT TO Percent Taxable X 0.200 YDUR ACCOUNT, SUBMIT THE Amount Subject D bt to Tax 4,095.82 UPPER PORTION OF THIS NOTICE e s and Deduc Taxable Amount tions - .00 WITH YOUR TAX PAYMENT TO THE Tax Rate 4,095 82 REGISTER OF WI LLS AT THE Tax Due X .045 ABOVE ADDRESS. MAKE CHECK _ 184 31 OR MONEY ORDER PAYABLE T0: TAX CREDITS: "REGISTER OF W ILLS, AGENT." PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID PAYMENT MUST BE MADE BY 10-17-2011* . TOTAL TAX PAYMENT .00 BALANCE OF TAX DUE 184.31 INTEREST AND PEN. .00 TOTAL DUE 184.31 IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDIT IF TOTAL DUE IS REFLECTED AS A "CREDIT" IONAL INTEREST. SEE REVERSE SIDE CCR), YOU MAY BE DUE OF THIS FORM FOR INSTRUCTIONS. A REFUND.