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HomeMy WebLinkAbout05-22-12 (3)f' f'~,~~!~'~. ~ QjdCE OF INHERITANCE TAX BUREAU OF INDIVIDUAL TAXES ,~F~..~.,... ;,~ , r} ~" INHERITANCE TAX DIVISION ARPRA~~U E NT, ALLOWANCE OR DISALLOWANCE PO BOX 280601 ~E ! OF~.DEbUCQ'IDNS, AND ASSESSMENT OF TAX ON HARRISBURG PA 17128-0601 ~ ~'JQ7~l7LY HELD OR TRUST ASSETS i" w i ~. Ci <i r L P .. .. C ,; ~ ~ -- LOIS A FARR~I~,~~r;~ bv,) ~; ), ~,r 263 W SOUTH ST CARLISLE PA 17013-2825 Pennsylvania r-: DEPARTMENT OF REVENUE REV-1548 EX AFP (1.2-11) DATE 05-21-2012 ESTATE OF FARRELL JAMES K DATE OF DEATH 07-01-2011 FILE NUMBER 21 11-1000 COUNTY CUMBERLAND SSN/DC 297-14-5377 ACN 12120160 APPEAL BY DATE:07-20-2012 (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 FDR YOUR RECORDS E'er ------------------------------------------------------------------------------------------- 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: 05-21-2012 ESTATE OF:FARRELL JAMES K DATE OF DEATH:07-O1-2011 FILE NO.: 21 11-1000 S.S/D.C. NO.: 297-14-5377 COUNTY:CUMBERLAND ACN: 12120160 TAX RETURN WAS: CX) ACCEPTED AS FILED ( J CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: ORRSTOWN BANK ACCOUNT NO.: 4000036224 TYPE OF ACCOUNT: C )SAVINGS C ) CHECKING C )TRUST CX)TIME CERTIFICATE DATE ESTABLISHED 01-06-2010 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAX CREDITS: 13,582.32 X 0.083 1,131.81 - .00 1,131.81 Y .00 .00 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 C-) AMOUNT PAID TDTAL TAX PAYMENT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 • 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. !,~1 ~%,