HomeMy WebLinkAbout05-20-11 (4)BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION NOTICE OF INHERITANCE TAX np „
PO BOX 280601 APPRAISEMENT, N`~~ LSylVan,a s,
HARRISBURG PA 1 71 28-0601 ALLOWANCE OR . '_
OF DEDUCTIONS, AND gSSESSMENTSOFLOWANCE DEPARTMENT OF REVENUE
JOINTLY HELD OR TAX ON REV-1548
TRUST ASSETS ~ AFP C12-10)
DATE 05-16-
ESTATE OF 2011
DATE OF FLUEVOG
DEATH 05-29-2010 JANET
FILE NUMBER 21 10-0837
HARLOW FLUEVOG COUNTY CUMBERLAND
14 SUNSET DRIVE SSN/DC
ACN 206-24-8892
MECHANICSBURG PA 17050 10133429
APPEAL BY DATE:07-15-2011
(See reverse side under Objections)
Amount Remitted
MAKE CHECK PAY,4BLE AND REMIT p
REGISTER OF AYMENT T0:
1 COURTHOUSEWS6IUARE
CARLISLE PA 17013
CUT ALONG THIS LINE
REV-1648 ~~""" " -----___ y -_RETAIN LOWER PORTION FOR YOUR
EX AFP C12-10) ----_ _______
NOTICE OF INHERITANCE TAX ---_____-RECI7RDS F~
DEDUCTIONS, AND APPRAISEMENT, ALLOWANCE OR
ASSESSMENT OF TAX ON JOINTLY HELD OR DISALLOWANCE OF
TRUS1' ASSETS
ESTATE OF:FLUEVOG DATE:
JANET 05-16-2011
FILE NO,; DATE OF DEATH:05-
21 10_pg37 29-2010 -_ COUNTY:CUMBE=
S.S/D.C. NO.;
TAX RETURN 206-24-8892
WAS: CX) ACCEPTED ACN:
AS FILED C ) CHANGED 10133429
FINANCIAL INSTITUTION; JOINT OR TRUST ASSET
TYPE OF MEMBERS 1ST FCU INFORMATION
ACCOUNT: C )SAVINGS CX) CHECKING ACCOUNT
DATE ESTABLISHED 08- NO•' 73374-11
18-1987 C )TRUST C )TIME CERTIFICATE
Account Balance
Percent Taxable 478,44
Amount Subject X NOTE: TO ENSURE P
to Tax 0.166 ROPER CREDIT
Debts and Deductions - 79.74 YOUR ACCOUNT TO
Taxable ~ SUBMIT THE
Amount ,00 UPPER PORTION OF THIS
Tax Rate WITH YOUR NOTICE
79'74 TAX PAYMENT TO THE
Tax Due REGISTER
.00 OF WILLS AT THE
.00 ABOVE ADDRESS. MAKE CHECK
TAX CREDITS: OR MOPJEY ORDER PAYABLE T0:
PAYMENT "REGIS:TER OF
DATE RECEIPT WILLS, AGENT.'
NUMBER DISCOUNT (+~
INTEREST/PEN PAID (-T
AMOUNT PAID
TOTAL TAX PAYMENT
BALANCE OF TAX DUE •00
INTEREST AND PEN, •00
TOTAL DUE •00
.00
* IF PgID AFTER THIS DATE,
IF TOTAL DUE IS SEE REVERSE FOR CALCULATION OF
SEE REVERSE SIDEROFLTHISDFORMAFORRINSTRUCTIONS.
(CR), YOU MAY BEADDITIONgL INTEREST. -
DUE q REFUND.