HomeMy WebLinkAbout01-30-12BUREAU OF INDIVIDUAL TAXES { ~ TILE OF INHERITANCE TAX
INHERITANCE TAX DIVISION QC + ~~ ALLONANCE OR DISALLONANCE
n~"""~~ =QFi ION AND ASSESSMENT OF TAX ON
PO BOX 280601 ~ ~' ~+ , ~
HARRISBURG, PA 17128-0601 ~~~~~.~ ; ~..~ : ~ ~ ECURI~'Y ACCOUNTS HELD IN
BENEFICIARY FORM
~~ ~2 ,SAN 30 ~'~ i~~ ! 6
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MICHAEL L ODpNN~~~~~~,'~~ ~~ QA
525 CLAIRBORNE ROAD
NORTHEAST MD 21901
Pennsylvania ~
DEPARTMENT OF REVENUE
REV-15488 RFP (12-11)
DATE Oil-30-2012
ESTATE OF GDONNELL WILLIAM A
DATE OF DEATH 0~9-22-2010
FILE NUMBER e'1 11-0679
COUNTY CUMBERLAND
SSN/DC 186-28-5533
ACN 11500484
APPEAL BY DATE:03-30-2012
(See reverse side under Objections)
Amount Remitted
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 ~
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REV-1548A AFP C12-11)
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS
AND ASSESSMENT OF TAX ON SECURITY ACCOUNTS HELD IN BENEFICIARY FORM
DATE: O1-30-2012
ESTATE OF:ODONNELL WILLIAM A DATE OF DEATH: 09-22-2010 COUNTY: CUMBERLAND
FILE NO.: 21 11-0679 S.S/D.C. NO.: 186-28-5533 ACN: 11500484
TAX RETURN WAS: (X) ACCEPTED AS FILED C )CHANGED
BENEFICIARY FORM OF ASSET INFORMATION
NAME OF SECURITY: FIDELITY ACCOUNT NCI.: 000
TYPE OF ASSET: C ) SECURITIES ( X SECURITY ACC C ) STOCK C ) BONDS
DOD Valuation
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
36,866.17
X 0.500
18,433.09
- .00
18,433.09
X .045
829.49
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."
PAYMENT
DATE RECEIPT
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 THIS FORM
TOTAL TAX PAYMENT .00
BALANCE OF TAX DUE 829.49
INTEREST AND PEN. 15.64
TOTAL DUE 845.13
^ 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.