HomeMy WebLinkAbout03-12-12,~,,;_ _ _~„~[
BUREAU OF INDIVIDUAL TAXES'~~~'' - ! 1 fit.%~ IIYDTICE
OF INHERITANCE TAX enns lvania
DEPARTME ~
INHERITANCE TAX DIVISION 'sir ~
'"J#PPV~1~&EMENT,
ALLOWANCE OR DISALLOWANCE NT OF REVENUE
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PO BOX ~
' REV
1
280601 "OF
'DE~tfCTIONS, AND ASSESSMENT OF TAX ON -
548 EX AFP (12-11)
HARRISBURG PA 17128-0601 JOINTLY HELD OR TRUST ASSETS
F1~iw I~+s~~ ~ ~ ~~~"; i~~ ~f,j DATE 03-12-2012
C~~~i~ ~C
ALEXIS WARREN~~~~ ~~", r"'', Fig
1397 LOWTHER RD
CAMP HILL PA 17011-7535
ESTATE OF DORMAN MAX
DATE OF DEATH 01-22-2012
FILE NUMBER ,~1- ~ ~ - (~~~~
COUNTY CUMBERLAND
SSN/DC 192-30-2124
ACN 12108168
APPEAL BY DATE:05-11-2012
(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 ~
REV-1548 EX AFP C12-11)--------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE: 03-12-2012
ESTATE OF:DORMAN MAX DATE OF DEATH:O1-22-2012 COUNTY:CUMBERLAND
FILE NO.:
S.S/D.C. NO.: 192-30-2124
ACN: 12108168
TAX RETURN WAS: CX) ACCEPTED AS FILED ( ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO.: 208765-00
TYPE OF ACCOUNT: CX)SAVINGS C ) CHECKING ( )TRUST C )TIME CERTIFICATE
DATE ESTABLISHED 08-25-2001
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
662.47
X 0.166
110.41
- .00
110.41
x .045
4.97
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
03-05-2012 SBADJUST .00 4.97
TOTAL TAX PAYMENT 4.97
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
* IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. * A
IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE A REFUND. (`Vj~1/
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.