HomeMy WebLinkAbout01-30-12BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION ~~ 1
PO BOX 280601 A ,j ~RITANCE TAX
HARRISBURG PA 17128-0601 OF ~~ "'~~~~ ! CE OR DISALLOWANCE
7il;ONS~j '~ SESSMENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
,?OI2 JAN 30. PM t2• rE
pennsyLvania ;L
DEPARTMENT OF REVENUE
REV-1546 EX AFP C12-11)
~rATE OF 01-30-2012
DATE OF DEATH 03D05U20~0 DIMITRI
CLERK OF FILE NUMBER 21
KEITH ORPHAN S CpURr COUNTY 10-0345
L DEIBERT CIJMR~~! A~,~(? ~;~). ~PAacN/nc 058B3oL74oo
4905 E TRINDLE RD OFC C
MECHANICSBURG PA 17050-3643
APPEAL BY DATE 4039
(See reverse side under Objections)2
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SG!UARE
CARLISLE PA 17013
CUT ALONG THIS LINE
REV-1b48 EX ----------- y --RETAIN-LOWER PORTION FOR YOUR RECORDS E~
AFP C12-11) _____
NOTICE OF INHER',ITANCE TAX APPRAISEMENT _
DEDUCTIONS, AND'ASSESSMENT OF TAX ON JOINTLY HELD OR T
. ALLOWANCE OR DISALLOWANCE OF
RUST' ASSETS
ESTATE OF:ANDRIUTSO DATE: 01-30-
DIMITRI 2012
DATE OF DEATH:03-05-
FILE NO.: 21 10-0345 2010 ~~ COUNTY:CUMBE=A~
S.S/D.C. NO.: 058-30-7400
TAX RETURN WAS;
CX) ACCEPTED AS FILED ACN: 11114919
C ) CHANGED
FINANCIAL INSTITUTION: JOINT OR TRUST
CITIZENS BANK OF PENNSYLVAN A INFORMATION
TYPE OF ACCOUNT: C )SAVINGS C ) CHECKING C ACCOUNT
DATE ESTABLISHED 06- NO•Q 6225343796
25-2009 ~ TRUST ( )TIME CERTIFICATE
Account Balance
Percent Taxable 87,111.54
Amount Sub' X NOTE: TO ENSURE P
sect to Tax 0.500 ROPER CREDIT TO
Debts and Deductions - 43,555.77 YOUR ACCOUNT, SUBMIT THE
Taxable Amount .00 UPPER PORTION OF T
Tax Rate 43,555.77 WITH YOUR T HIS NOTICE
y AX PAYMENT TO THE
Tax Due 15 REGISTER OF WILLS AT THE
6,533.37 ABOVE ADDRESS. MAKE CHECK
TAX CREDITS: OR MONEY ORDER PAYABLE T0:
PAYMENT "REGIStTER OF
DATE RECEIPT WILLS, AGENT."
NUMBER DISCOUNT (+)
INTEREST/pEN PAID (-~ AMOUNT PAID
INTEREST IS CHARGED THROUGH 02-07-2012
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF TOTAL TAX PAYMENT
THIS FORM BALANCE OF •00
TAX DUE
INTERESr AND pE~N, 6.533.37
TOTAL DUE 234.59
6,767.96
IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTE
SEETREVERSEESIDEROFLTHISDFORMAFORRINSTRUCTIONS.
YOU MAY BE DUE A REFUND, REST.