HomeMy WebLinkAbout09-14-11 (3)BUREAU OF INDIVIDUAL TAXES ~~~ 1'~ ~~~ - ~' .,
INHERITANCE TAX DIVISION r ~ia~ ^~i/l ICE OF INHERITANCE TAX
PO BOX 280601 i~' ` , '~('PR~4'1f ENT,
HARRISBURG PA 1 7128-0601 ~.~ ~ ~~ ALLOWANCE OR DISALLOWANCE
OF DLDUC.~IONS, AND ASSESSMENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
f iF i ~ ^ P"
~~p ~ ~, nil
p~ennsy(vania ~
DEPARTMENT OF REVENUE
REV-1548 EX AFP (12_10)
~ `~ ~`~' ~ ~ DATE
CLERK pF ESTATE OF 09-05-2011
C'HUBB
DATE OF
ORPH,~N c;;OJPT JOSEPHINE
DEATH 09_13_2010
UMBER 21
RALPH CH
B(J~~r~t :~2f~`~t r~~ 10-1153
COUNTY
UB
P,4
606 SOUTH MOUNTAIN ROAD SSN/DC CUMBERLgNn
ACN 201-16-Zg27
DILLSBURG
PA 17019 APPEAL By 10156778
DATE:11-
0 4 `
2 011
(See reverse side under 0
~lec~z
A
ons)
mount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0
REGISTER
:
OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE
REV-1548 EX AF'P -_-:'--- y _ RETAIN LOWER
C12 10) ___________ PORTION FOR
YOUR
RECORDS tr•
___________
DEDUCTIONSINANDIA
RAISEMEN
- -- " '----
A
SSESSMENT
OF
TAX ON T,
---_ _
JOINTLYWHELD
OF
L
ESTATE OF:CHUBB OR TRUST
ASSETS
DATE:
JOSEPHINE
DATE 09- 5'2011
FILE NO.: 21 10-1153
S OF DEATH:09-13-2010
COUN1`Y:CUMBE
.S/D.C. NO.;
T 2 =ND
01-16
AX RETURN WAS;
-?R97
CX) ACCEPTED AS FILED
FINANCIAL INSTITUTION: JOINT OR TRUST
MEMBERS 1ST FCU ASSET
TYPE OF ACCOUNT: CX3SAVINGS ( ) CHECKING C )TRUST
DATE ESTABLISHED 06-02-1978
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
PAYMENT
DATE RECEIPT
NUMBER
X 1,628.13
0.166
_ 271.36
.00
271.36
.00
.00
DISCOUNT C+)
INTER_ E_ S~ PAID (-)
~C~° 10156778
INFORMATION
ACCOUNT NO.: 20585-00
~ )TIME CERTIFICATE
NOTE: TO ENSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF W1'LLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE T0:
"REGISTER OF WILLS, AGENT.~~
AMOUNT PAID
TOTAL TAX PAYMENT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTER
IF TOTAL DUE IS REFLECTED AS A "CREDIT~~
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.
(CR), YOU MAY BE DUE A REFUND, EST. ~
C ) CHANGED
.00
.00
.00
.00