HomeMy WebLinkAbout03-19-12BUREAU OF INDIVIDUAL TAXES F INHERITANCE TAX
INHERITANCE TAX DIVISION ~~~:Mi ~ LLOIiANCE OR DISALLDNANCE pennsylvarna ~
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HARRISBURG, PA 17128-0601 ~~~ " TY ACCOUNTS HELD IN DEPARTMENT OF REVENUE
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108 NORTH DEODATE ROAD
MIDDLETOWN PA 17057
DATE 03-19-2012
ESTATE OF COULSON CARRIE R
DATE OF DEATH 01-26-2011
FILE NUMBER 21 11-0203
COUNTY CUMBERLAND
SSN/DC 208-38-5500
ACN 11500865
APPEAL BY DATE: 05-18-2012
(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-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: 03-19-2012
ESTATE OF:000LSON CARRTF R DATE OF DEATH: O1-26-2011 COUNTY: CUMBERLAND
FILE NO.: 21 11-0203 S.S/D.C. NO.: 208-38-5500
ACN: 115008b5
IAX RETURN WAS: CX) ACCEPTED AS FILED f )CHANGED
BENEFICIARY FORM OF ASSET INFORMATION
NAME OF SECURITY: FIDELITY ACCOUNT NO.: 73116
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:
6,650.87
X 1.000
6,650.87
- .00
6,650.87
X .15
997 6
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 C+)
INTEREST/PEN PAID (-)
AMOUNT PAID
04-25-2011 CD014360 49.88 947.77
TOTAL TAX PAYMENT 997.65
BALANCE OF TAX DUE .02CR
INTEREST AND PEN. .00
TOTAL DUE .02CR
* IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ~
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.