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HomeMy WebLinkAbout09-14-11 (3)BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 ~`~~+~' ,~_~ OF INHERITANCE TAX ((''~~ ` kRPRAIt$~~'~-'b 11LLOWANCE OR DISALLOWANCE f's~'t~; `, CAF 15Eb~~#~5~, AND ASSESSMENT OF TAX ON J~f~'L~Y HELD OR TRUST ASSETS ORP~~ERK OF JOSEPH A MARTII~;(J(~J~~'Fy~~~ ~~U~~ 104 HEMLOCK DR '" ~~~ ~~., Pq CLARKS SUMMIT PA 18411 ~pennsy(vania ~'; DEPARTMENT OF REVENUE REV-1548 EX AFP (12-10) DATE 09-13- ESTATE OF 2011 DATE OF MARTIN LILLIAN G FILE NUMBERTH 09_25-2Q10 COUNTY 21 10-101,85 SSN/DC CUMBERLAI,ND ACN 196-22-4!140 APPEAL BY 10158960 DATE:11-,~2-2011 (See reverse side under Ob.~ections) Amount Rewitted MAKE CHECK PAYABLE ANDEMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE REV-1548 --------------- y ------ _____ EX AFP RETAIN LOWER PORTION FOR YOUR C12-10) --___ _______ RECORDS ~ NOTICE OF INHERITANCE TAX APPRAISEMENT ___ DEDUCTIONS, AND ASSESSMENT OF ALLOWANCE OR DISALLOWANCE ~F TAX ON JOINTLY HELD OR TRUST ASSETS ESTATE pF;MARTIN DATE: LILLIAN 09-1 -2011 G DATE OF DEATH:09- FILE NO.: 21 10-1085 25'2010 COU~ITY:CUMBE~ R_ L S.S/D.C. NO.: TAX RETURN WqS; 196-22_4140 CX) ACCEPTED AS FILED I~CN: C ) CHANGED 10158960 FINANCIAL INSTITUTION: JOINT OR TRUST PSECU ASSET INFORMATION TYPE OF ACCOUNT: (X)SAVINGS DATE ESTABLISHED 11_ ~ ) CHECKING C )TRUST ACCOUNT NO.: 984884 973-S1 24-2008 ~ )TIME CERTIFICATE Account Balance Percent Taxable 43,099.90 Amount Subject to X NOTE: TO ENSURE Debts Tax 0.166 PROPER CREDIT TO and Deductions - 7,183.46 YOUR ACCOUNT,] Taxable Amount UPPER PORTION SUBMIT THE Tax Rate •00 pF THIS NOTICE 7,183.46 WITH YOUR TAX ~gYMENT Tax Due REGISTER pF TO THE •045 WILLS AT THE 323.26 ABOVE ADDRESS.' MAKE CHECK TAX CREDITS: OR MONEY ORDER 'P PAYMENT "REGISTER ~ AYABLE T0: DATE RECEIPT OF WT!LLS, AGENT.' NUMBER DISCOUNT (+) INTEREST/PEN pgID (_) AMOUNT PAID INTEREST IS CHARGED THROUGH A7 THE RATES APPLICABLE AS 09-21-2011 REVERSE SIDE OUTLINED ON THE TOTAL TAX PAYMENT OF THIS FORM BALANCE OF TAX DUE •00 INTEREST AND PEN. 323'26 TOTAL DUE 2.33 325.59 * IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF IF TOTAL DUE IS REFLECTED AS A "CREDIT" SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ADDITIONAL INTEREST. CCR), YOU MAY BE DUE A REFUND.