HomeMy WebLinkAbout09-14-11BUREAU OF INDIVIDUAL TAXES
INHERITANCE 7AX DIVISION
PO BOX 280601
HARRISBURG, PA 17128-0601
CLERK OF
JONES MICHELE ORQ~~~ COURT
3610 ALBERTA AVENUE Ct1Mf~F~,,._''`~'~C? r~~ P,4_
MECHANICSBURG PA 17050
NOTICE OF INHERITANCE TAX
'~}` R~A LLONANCE OR DISALLONANCE
~~`'' F~-pEB~ pAND ASS
ESSNENT OF TAX ON
', ~ R ACCOUNTS HELD IN
- ~,~'~ ~, ICIARY FORN
Pennsylvania ~
DEPARTMENT OF REVENUE
REV-1548A AFP (12-10)
DATE 09-05-2011
ESTATE OF JOHNSTON
DATE OF DEATH 07-03-2006 LOUISE
FILE NUMBER 21 06-0867
COUNTY CUMBERLAND
SSN/DC 180-28-5741
ACN 11501714
APPEAL BY DATE: 11-04-2011
(See reverse side under Objections)
Amount Resitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALON6__THIS_ LINE
~~-~"" ___ y RETAIN LOWER PORTION FOR YOUR
REV-1548A AFP C12-10~ ~~~""""'~--
------------------------------ RECORDS E--
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
AND ASSESSMENT OF TAX ON SECURITY ACCOUNTS HELD IN BENEFICIARY FORM
DEDUCTIONS
ESTATE OF:JOHNcrnN DATE: 09-05-2011
O DATE OF DEATH: 07-03-2006
FILE NO.: COUNTY: CUMBERLAND
21 06-0867 S.S/D.C.
NO.: 180-28-5741
TAX RETURN WAS: (X) ACCEPTED AS FILED ACN:
11501714
BENEFICIARY FORM OF ASSET INFORMATION
NAME OF SECURITY:
MELLON INVESTOR
TYPE OF ASSET: C ) SECURITIES C ) SECURITY ACC CX) STOCK ACC ONDS N0 • 806197241857
DOD Valuation
Percent Taxable 2,513.44 NOTE: TO ENSURE PROPER CREDIT TO
Amount Subject to Tax X 1.000
Debts and Deductions YOUR ACCOUNT, SUBMIT THE
- 2,513.44 UPPER PORTION OF
Taxable Amount .00 WITH YOUR TAX PAYMENT TOTTHE
Tax Rate 2 513.44 REGISTER OF
Tax Due X .045 WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
TAX CREDITS: OR MONEY ORDER PAYABLE T0:
PAYMENT "REGISTER OF WILLS, AGENT.'
DATE RECEIPT DISCOUNT (+)
NUMBER INTEREST/PEN PAID (-)
08-08-2011 AMOUNT PAID
CD014823
.00 113.10
BALANCE OF UNPAID INTEREST/PENALTY AS OF 08-09-2011 TOTAL TAX PA
YMENT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL n~~r
IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST.
SEETREVERSEESIDEROFLTHISDFORMAFORRINSTRUCTIONS.
CCR), YOU MAY BE DUE A REFUND.
113.10
26.9
26.9