HomeMy WebLinkAbout11-23-11 (3)BUREAU OF INDIVIDUAL TAXES _ NOTICE OF INHERITANCE TAX
INHERITANCE TAX DIVISION ~.;. ~~ ''APPR(~ ISEMBN~ ALLONANCE OR DISALLONANCE pennsylvan~a ~, ~ ``,
PO BDX 280601 OF bEDUCT 0 ~' AND ASSESSMENT OF TAX ON DEPARTMENT OF REVENUE
HARRISBURG, PA nlzs-ocBl SECURi~'Y ACCOUNTS MELD IN
BENEFICIARY FORM REV-1548 aFr uz-ia~
MARJORY J DENGLERC ': ;(;; ~;=~
366 N 24TH ST
CAMP HILL PA 17011-3605
DATE 11-14-2011
ESTATE OF WOLF ROGER A
DATE OF DEATH 08-07-2011
FILE NUMBER 21 11-0970
COUNTY CUMBERLAND
SSN/DC 199-34-9504
ACN 11502648
APPEAL BY DATE: O1-13-2012
(See reverse side under Objections)
Amount Renitted
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 RECORDS <"'
REV-1548A AFP (12-10)
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS
AND ASSESSMENT OF TAX ON SECURITY ACCOUNTS HELD IN BENEFICIARY FORM
DATE: 11-14-2011
ESTATE OF:W_OLF ROGER A DATE OF DEATH: 08-07-2011 COUNTY: CUMBERLAND
FILE NO.: 21 11-0970 S.S/D.C. NO.: 199-34-9504 ACM: 11502648
TAX RETURN WAS: fX) ACCEPTED AS FILED f )CHANGED
BENEFICIARY FORM OF ASSET INFORMAT:[ON
NAME OF SECURITY: AMERIPRISE ACCOUNT NO.:
TYPE OF ASSET: C ) SECURITIES (X SECURITY ACC ( ) STOCK C ) BONDS
DOD Valuation
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
49,876.72
X 0.333
16,625.51
- .00
16,625.51
X .12
.99 .07
000074232448602
NOTE: 7'0 ENSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE T0:
"REGISTER OF WILLS, AGENT."
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT (+)
INTEREST/PEN PAID f-)
AMOUNT PAID
~,-., ,,u~~ r, ~,~, Dc nAWC DT U7-UC-LU1L*.
TOTAL TAX PAYMENT .00
BALANCE OF TAX DUE 1,995.07
INTEREST AND PEN. .00
TOTAL DUE 1,995.07
^ IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.