HomeMy WebLinkAbout09-14-11 (2)BUREAU OF INDIVIDUAL
INHERITANCE TAX DIVISION TAXES [ ',
Po BOX 28oco1 R(~'~~~`i~~RALS~~~F INHERITANCE TAX ~enns ,,,, _+•r
HARRISBURG PA 1 71 28-0 601 ' LLOWANCE OR DISALLpWANCE ' DEPARTMENT~parlNa
NFL- aF D,EDkcT+)r~4M~ AND ASSESSMENT OF TAX ON
JbIN7{gr~HELD OR TRUST ' REV-1548 E
tt ~* ASSETS EX AFP (12_10) ~~~
.,~t~ f ~~j , 1- r , E
~ / ESTATE OF 09-13-211
DATE OF DEATH 06U09I2010
~LFRK p~ FILE NUMBER DIMOSTENI G
MADELINE G KAUNPIA ORPHgN~S CURT COUNTY CUMBERLA D
APT 2 ~tlrt~R~~,,~~~ r,,1, pA ACN,DC 081-24-096
1141 COLUMBUS AVE
LEMOYNE APPEAL By 0157549',.
PA 17043 DATE:11_1'2_2011
(See reverse side under Obi cans)
Amount ReAftted
MAKE CHECK PAYABLE AND
REGISTER OF .EMIT PAYMENT T0:
1 COURTHOUSEWILLS
CARLISLE SQUARE
CUT ALONG PA 17013
THIS LINE
REV- - ~
1548 EX AFP----'-----____-RETAIN LOWER PORTION FOR
C12-10j ____ YOUR
NOTICE OF INHERITANCE TAX RECORDS
DEDUCTIONS -~----'---_-- __~___'
• AND ASSESSMENTAPPRAISEMENT, ALLOWANCE --
OF TAX ON JOINTLY HELD OR DISALLOWANCE O
ESTATE OR TRUST ASSETS
OF:KOUMPIAS DATE:
DIMOSTENI G 09-1 -2011
FILE NO.: DATE OF DEATH:06-09-
21 10-1087 2010 COU TY:
S'S~D•C• NO.: CUMBE-A~
TAX RETURN WAS; 081-24-0096
CX) ACCEPTED -
AS FILED A N' 10157549
FINANCIAL INSTITUTION; M ~ JOINT C ) CHANGED
OR TRUST ASSET INFORMATION
TYPE OF ACCOUNT: T BANK
DATE ESTABLISHED 06C ~ SAVINGS C ) CHECK ACCOUNT
17-200 ING C )T NO.: 150042
4 RUST C )TIME 1 212367
Account Balance CERTIFICATE ~'
Percent Taxable
Amount X 4,540.20
Subject to Tax 0.166 NOTE: TO ENSURE
Debts and Deduc PROP~R CREDIT
Taxable tions - 756,72 YOUR ACCOUNT TO
Amount UPPER PO UBMIT THE
Tax Rate •00 RTION 0 THIS
Tax Due 756.72 WITH YOUR TAX ~ NOTICE
REGISTER P'~YMENT TO THE
.00 OF WILDS qT THE
TAX CREDITS: •00 ABOVE ADDRESS.
OR MONEY MAKE CHECK
PAYMENT ORDER P~gyABLE
DATE RECEIPT "REGISTER OF TO:
NUMBER DISCOUNT C+) WIL~L$, gGENT. ~~
INTEREST/PEN PAID (-) AMOUNT PAID '
TOTAL TAX PAYMENT
BALANCE OF TAX DUE '00
INTEREST AND pEN. •00
TOTAL DUE •00
IF PAID AFTER THIS D •00
IF TOTAL DUE IS REFLECTED SEE REVERSE FO
SEE REVERSE SIDE AS A "CREDIT+.R CALCULATION OF ADDITIONAL INTEREST.
OF THIS FORM FOR INSTRUCTIONS.
YOU MAY BE DUE A REFUND.