HomeMy WebLinkAbout05-22-12BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIYISIDN
PO BOX 280601
HARRISBURG, PA 17128-0601
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F INHERITANCE TAX
~~ILLOiiANCE OR DISALLONANCE
AND ASSESSMENT OF TAX ON
~Y ACCOUNTS HELD IN
NEFICIARY FORK
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STEPHEN C GERHOLD
321K W SHADY LANE
ENOLA PA 17025
Pennsylvania' .``:
DEPARTMENT OF REVENUE
PEV-1548A AFP (12-11) ..
DATE 05-21-2012
ESTATE OF GERHOLD ROBIN A
DATE OF DEATH 05-08-2010
FILE NUMBER 21 10-0527
COUNTY CUMBERLAND
SSN/DC 168-60-1372
ACN 11501396
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 FOR YOUR RECORDS ~'
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REV-1548A AFP (12-11)
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS
AND ASSESSMENT OF TAX ON SECURITY ACCOUNTS HELD IN BENEFICIARY FORM
DATE: 05-21-2012
ESTATE OF:GERHOLD ROBIN A DATE OF DEATH:05-08-2010 COUNTY: CUMBERLAND
FILE NO.: 21 10-0527 S.S/D.C. NO.: 168-60-1372 ACN: 11501396
TAX RETURN WAS: (X) ACCEPTED AS FILED ( )CHANGED
BENEFICIARY FORM OF ASSET INFORMATION
NAME OF SECURITY: FIDELITY ACCOUNT NO.: OP005436-74401
TYPE OF ASSET: ( ) SECURITIES C ~ SECURITY ACC ( ) STOCK C ) BONDS
DOD Valuation
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
59,785.87
X 1.000
59,785.87
- .00
54,785.87
X .15
8.967.88
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
i
INTEREST IS CHARGED THROUGH 05-29-2012*
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
TOTAL TAX PAYMENT .00
BALANCE OF TAX DUE 8,967.88
INTEREST AND PEN. 350.03
TOTAL DUE 9,317.91
* IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YDU MAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. !i"'
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