HomeMy WebLinkAbout08-31-11BUREAU OF INDIVIDUAL TAJI~$
I m ~ NOTICE
~ OF INHERITANCE TAX • `~~J/ ~Y~~~~ •
NHERITANCE TAX DIVISION
PO A~'P
'ISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
BOX 280601 ~
HARRISBURG PA 17128-0607 - ~ OF~~DUCTIONS,
~ AND ASSESSMENT OF TAX I]N REV-1548 EX AFP (12-10)
-~-~
JOINTLY HELD OR TRUST ASSETS
"' - ;~. DATE 08-29-2011
~^ ~ '` `' ESTATE OF POLLAK
JEFFREY D
DATE OF DEATH 01-03-2011
C~_Et~h;,;- FILE NUMBER 21 11-0779
O~O~~~,CrJ I"~I SSN/DC CUMBERLAND
BERENICE ~'L`AK~` I ~; Pr1 087-36-4142
3661 POINCIANA 401 ACN 11139216
LAKE WORTH FL 33467 APPEAL BY DATE:10-28-2011
(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 RE~CDRDS ~
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REV-1548 EX AFP C12-10~--------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DIS,4LLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE: 08-29-2011
ESTATE OF:POLLAK JEFFREY D DATE OF DEATH:O1-03-2011
COUNTY:CUMBERLAND
FILE NO.: 21 11-0779 S.S/D.C. NO.: 087-36-4142
ACN: 11139216
TAX RETURN WAS: CX) ACCEPTED AS FILED C ~ CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: WELLS FARGO
ACCOUNT NO.: 1010199086555
TYPE OF ACCOUNT: C )SAVINGS CX) CHECKING C )TRUST C UTIME CERTIFICATE
DATE ESTABLISHED 03-03-2008
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
PAYMENT RECEIPT
DATE NUMBER
07-12-2011 CD014705
15,773.00
X 0.166
2,628.89
- .nn
2,628.89
x 15
394.33
DISCOUNT (+)
INTEREST/PEN PAID C-)
.00
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
ABDVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE T0:
"R1=GISTER OF WILLS, AGENT."
AMOUNT °AID
394.33
TOTAL TAX PAYMENT 394.33
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DIVE .00
^ IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ~
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND.
SEE REVERSE SIDE DF THIS FORM FOR INSTRUCTIDNS.