HomeMy WebLinkAbout12-28-11BUREAU OF INDIVIDUAL TAXES ',-{G `!{4TICE d>~-~ TANCE TAX
INHERITANCE TAX DIVISION APF-RA'IS~lIENT ALL E OR DISALLDRANCE Pennsylvania ~`~'x
PO BOX 280601 OF D6DUL'}Ty~Iy~O.N>; ANDi N ESSNENT OF TAX ON DEPARTMENT OF REVENUE
HARRISBURG, PA I7I2$'B6UI _SGA.VRI~Y A ItTS HELD IN REY-1548A AFP (12-11)
BENEFICIARY FORK
,, ~-
JACK D PHILLIPS
2134 RUDY RD
~ ':., z_t~ t ! i UAL 12-26-2011
ESTATE OF PHILLIPS MARSHALL V
~~„ ,-,-~
~~-~~''t ~~'
O~~'N,'~`r4~~ ~.r~
(;O~ ter,' DATE OF DEATH
,FILE NUMBER
~n~COUNTY
~N/DC
ACN 10 - O 1- 2011
21 11-1218
CUMBERLAND
170-64-4484
11502758
HARR:[SBURG PA 17104-2019
APPEAL BY DATE: 02-24-2012
(See reverse side under Objections)
Amount Reeitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 1'7013
CUT ALON6_THIS_LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~"'
REV-1548A AFP C12-11) --------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS
AND ASSE SMENT OF TAX ON SECURITY ACCOUNTS HELD IN BENEFICIARY FORM
DATE: 12-26-2011
ESTATE OF•puriirpc MARSHALL V DATE OF DEATH•10-01-2011 COUNTY: CUMBERLAND
FILE NO.: 21 11-1218 S.S/D.C. NO.: 170-64-4484 ACN: 11502758
TAX RETURN IWAS: CX) ACCEPTED AS FILED C )CHANGED
BENEFICIARY FORM OF ASSET INFORMATION
NAME OF SECURITY: AMERIPRISE FINANCIAL ACCOUNT NO.: 594AQEAZ
TYPE OF ASSET: C ) SECURITIES ( X SECURITY ACC C ) STOCK C ) BONDS
DOD Valuation 3,274.44 NOTE: TO ENSURE PROPER CREDIT TO
Percent Taxable X 0.500 YOUR ACCOUNT, SUBMIT THE
Amount Subject to Tax 1,637.22 UPPER PORTION OF THIS NOTICE
Debts and Deductions - .00 WITH YOUR TAX PAYMENT TO THE
Taxable Amount 1,637.22 _ REGISTER OF WILLS AT THE
Tax Rate X .045 ABOVE ADDRESS. MAKE CHECK
Tax Due 73.67 OR MONEY ORDER PAYABLE T0:
"REGISTER OF WILLS, AGENT."
Twv rornrrc.
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID (-) AMOUNT' PAID
11-10-2011 CD015198 3.68 69.99
TOTAL TAX PAYMENT 73.67
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
* 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.
BUREAU OF INDIVIDUAL TAXES ~ ~'_ '~~~j~ E OF INHERITANCE TAX
INHERITANCE TAX DIVISION ~ APpRAtElii' ALLORANCE OR DISALLORANCE
Po eox zaosol _ OF DEDtIgT7,pN~ AND ASSESS![ENT OF TAX ON
HARRISBURG, PA Iriza-o6ol C RI'~Y ACCOUNTS HELD IN
BENEFICIARY FOR![
r:
.,_ ~.
0~~'i~'~P~ ~'f1i i~r
~ , ,~~n
MARY C PHILLIPS 1
2134 RUDY RD
HARR:[SBURG PA 17104-2019
Pennsylvania ~
DEPARTMENT OF REVENUE
REY -1548A AFP (12-11)
DATE 12-26-2011
ESTATE OF PHILLIPS MARSHALL V
DATE OF DEATH 10-01-2011
FILE NUMBER 2:L 11-1218
COUNTY CUMBERLAND
SSN/DC 1'70-64-4484
ACN 11502759 -
APPEAL BY DATE: 02-24-2012
(See reverse side under Objections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS.
1 COURTHOUSE SQIJARE
CARLISLE PA 1'7013
CUT ALONG 7HIS LINE - _ _"'~ _ RETAIN_LOWER_PORTION FOR_YOUR_ RECORDS _ - ~_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
REV-1548A~ AFP C12-lI)
NOTICEAND ASSE$SMENTEOFATAXPONASECURITY ACCOUNTSEHELDDINABENEFICIARY FORMCTIONS
DATE: 12-26-2011
ESTATE OF:PHTLLiPS MARSHAIL Y DATE OF DEATH: 10-O1-2011 COUNTY: CUMBERLAND
ACN: 11502759
FILE NO.: 21 11-121.8 S.S/D.C. NO.: 170-64-4484
TAX RETURN AS: (X) ACCEPTED AS FILED ( )CHANGED
BENEFICIARY .FORM OF ASSET INFORMATION
NAME OF SECURITY: AMERIPRISE FINANCIAL ACCOUNT NO.: 594AQEAZ
TYPE OF ASSET: ( ) SECURITIES C X SECURITY ACC ( ) STOCK ( ) BONDS
DOD Valuation
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
3,274.44
X 0.500
1,637.22
_ .00
1,637.22
X .045
73.67
TAX CREDITS:
PAYMENT' RECEIPT
DATE NUMBER
11-10-2011 CDb15198
DISCOUNT C+)
INTEREST/PEN PAID C-)
3.68
69.99
TOTAL TAX PAYMENT
BALANCE OF' TAX DUE
INTEREST AND PEN.
TOTAL DUE
NOTE: TO 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."
AMOUNT PAID
73.67
.00
.00
~ IF PAIL1 AFTER THIS IDATE, 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.