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HomeMy WebLinkAbout09-14-11 (2)BUREAU OF INDIVIDUAL S INHERITANCE 7AX DIVISION ~1.f. _ ~ ~ } ,(('~~ NOTICE OF I PO BOX 280601 C; ' -'' ~~~~'~"^~~gISEMENT, NHERITANCE TAX HARRISBURG P ~ ` J, ALLOWANCE A 1128-0681 `~gF('DEDUCTIONS, OR DISALLOWANCE ~'"~`" .~J JOINTLY AND ASSESSMENT OF TAX ON HELD OR TRUST ASSETS ~'~~E SCE ~~+ Fs.: I~~ C r CiL.CCIf\ nt RALPH ~~~'~S ~iQtJRT 606 SOUTH MO -i` ,4f4(~? t ,~ pp. DILLSBURG ROAD PA 17019 Pennsylvania DEPARTMENT OF REVENUE REV-1548 EX AFP C12-101 DATE 09-05-2011 ESTATE OF CHUBB DATE OF DEATH 09-13-2010 JOSEPHINE FILE NUMBER 21 10-1153 COUNTY CUMBERLAND SSN/DC 201-16- ACN 2827 APPEAL BY DATE618004- (See reverse side under Ob, jection )1 Amount ReAftted 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 REV-1548 EX AFP C12-10~ - NOT ----- ------------------------- RECORDS (~ DEDUCTIONSINANDIASSESSMENTAOFRTAXEONNJO ALLOWANCE OR DISALLOWANCE OF INTLY HELD OR TRUST ASSETS ESTATE OF:CHUBB DATE: 09- 5-2011 JOSEPHINE DATE OF DEATH:09-13- FILE NO.: 21 10-1153 2010 COUNTY:CUMBE_ R~ L~D S.S/D.C. NO.: TAX RETURN WqS; 201-16-2827 CX) ACCEPTED AS FILED ACN: 10156780 C ) CHANGED FINANCIAL INSTITUTION: JOINT OR TRUST ASSET INFORMATION MEMBERS 1ST FCU TYPE OF ACCOUNT: CX3SAVINGS C ) CHECKING C )TRUST ACCOUNT NO.: DATE ESTABLISHED 11- 20585-05 27-1985 C )TIME CERTIFICATE Account Balance Percent Taxable 4.972.43 Amount S X NOTE: TO ENSURE PROPER ubject to Tax 0.166 CREDIT TO Debts and Deductions - 828.75 YOUR ACCOUNT, SUBMIT THE Taxable Amount .00 UPPER PORTION OF THIS NOTICE Tax Rate 828 75 WITH YOUR TAX PAYMENT Tax Due REGISTER OF WILLS AT THE THE .00 .00 ABOVE ADDRESS. MAKE CHECK TAX CREDITS: OR MONEY ORDER PAYABLE T0: PAYMENT "REGISTER OF WILLS, AGENT. ~~ DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (_~ AMOUNT PAID TOTAL TAX PAYMENT BALANCE OF TAX DUE •DO INTEREST AND PEN. •00 TOTAL DUE •00 .00 IF TOTALADUERIS REFLECTED AS pEVERSE FOR CALCULATIDN OF SEE REVERSE SIDE OF THIS FORM FOR RINSTRUCTIONS. ADDITIONAL INTEREST. YOU MAY BE DUE A REFUND.