HomeMy WebLinkAbout01-30-12J'~ {fir.., r
BUREAU OF INDIV '~
INHERITANCE T IDUAL TAXES ~~~'~.l ~~~
PO BOX AX DIVISION TTT INHERITANCE TAX
280601 {7~(~~ o ~"} ~t
HARRISBURG PA 17128-0601 1' :-)0 Tom! .i„ LLOWANCE OR DISALLOWANCE
DEDUCTIONS, AND ASSESSMENT OF
JOINTLY HELD OR TRUST ASSETS AX ON
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pennsy(vania '" ;
DEPARTMENT OF REVENUE
REV-1548 EX AFP (12-11)
ESTATE OF 01-30-2012
f',,(,E~j~ V~ DATE OF DEATH 02N09-2011 JAMES C
ORPHAN'S CQt~RT FILE NUMBER 21 11-1162
JEFFREY C BANTZ ~~~~~~ AN{~ (;~ p,A COUNTY CUMBERLAND
101 SOUTH SSN/DC
2ND, ST ACN 508"42-4148
APT #1014 APPEAL BY 11115031
HARRISBURG DATE:03-30-2012
PA 17101 (See reverse side under Obj
Amount Re~n3tted ections)
MAKE CHECK PAYABLE AND REMIT p
REGISTER OF AYMENT T0:
1 COURTHOUSE WELLS
CARLISLE QUARE
I'A 1 7013
CUT ALONG THIS LINE
REV-1548 ---"-' __~___ RETAIN LOWER PORTION FOR
EX AFP C12-11~ ___
-"- " ----- ____ YOUR RECORDS (.
NOTICE OF INHER~TTANCE TAX APPRAISEMENT
DEDUCTIONS, AND ASSESSMENT OF TAX ON ---
. ALLOWANCE OR DISALLOWANCE OF
JOINTLY HELD OR TRUST ASSETS
ESTATE OF:BANTZ DATE:
JAMES C 01-30-2012
DATE OF DEATH:02-09-2011
FILE NO,; COUNTY:CUMBE~ R
21 11-1162 S.S/D.C.
TAX RETURN Wq$: (X) NO.. 508-42-4148
ACCEPTED AS FILED ACN: 11115031
~ ) CHANGED
FINANCIAL INSTITUTION:! JOINT OR TRUST
MEMBERS 1ST FCU ASSET INFORMATION
TYPE OF ACCOUNT: ( )SAVINGS (1U CHECKING
DATE ESTABLISHED O9_ ACCOUNT NO.: 235451-11
15-2008 ~ )TRUST C )TIME CERTIFICATE
Account Balance
Percent Taxable 3,593.41
Amount Sub' X NOTE:
sect to Tax 0.500 TO ENSURE PROPER CREDIT TO
Debts and Deductions - 1,796.71 YOUR ACCOUNT
Taxable UPPER SUBMIT THE
Amount .00 PORTION OF THIS
Tax Rate 1,796.71 WITH ti'OUR NOTICE
Tax Due TAX PAYMENT TO THE
.045 REGISTER OF WILLS AT THE
80.85 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-
AT THE RATES APPLICABLE 07-2012
REVERSE SIDE OF A~ OUTLINED ON THE TOTAL TAX PAYMENT
THIS FORM BALANCE OF •00
TAX DUE
INTEREST AND PEN. 80.85
TOTAL DUE •60
81.45
* IF PAID AFTER THIS DATE,
IF TOTAL DUE IS SEE REVERSE FOR CALCULATIDN OF
SEE REVERSE SIDEROFLTHISDFORMAFORRINSTRUCTIONS.
(CR), YpU MAY BE ADDITIONAL INTEREST.
DUE A REFUND.