HomeMy WebLinkAbout06-22-12 (2)BUREAU OF INDIVIDUAL TA ..,;-~,,-~ ,- NOTICE OF INHERITANCE TAX
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PO BOX 280601 _.., OF{~DUCTIONS, AND ASSESSMENT OF TAX ON
HARRISBURG PA 17128-0601 ~"~~-; ", ~~~ ~~j-4~1JDINTLY HELD OR TRUST ASSETS
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DEPARTMENT OF REVENUE
REV-1548 IX AFP C12-11)
DATE 06-25-2012
ESTATE OF KOLLER BARBARA R
DATE OF DEATH 12-24-2011
FILE NUMBER 21 12-0229
COUNTY CUMBERLAND
SSN/DC
ACN 12104030
APPEAL BY DATE:08-24-2012
(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 F"'
REV-1548 EX AFP (12-11)--------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE: 06-25-2012
ESTATE OF:KOLLER
FILE NO.: 21 12-0229
BARBARA R DATE OF DEATH:12-24-2011 COUNTY:CUMBERLAND
S.S/D.C. NO.:
ACN: 12104030
TAX RETURN WAS: (X) ACCEPTED AS FILED C ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: FULTON BANK NA ACCOUNT NO.: 400-1859588
TYPE OF ACCOUNT: C )SAVINGS ( ) CHECKING C )TRUST (X)TIME CERTIFICATE
DATE ESTABLISHED 09-24-1985
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
15,000.00
X 0.500
7,500.00
- .00
7,500.00
x .045
337.50
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
02-15-2012 CD015607 16.87 320.62
06-18-2012 SBADJUST .00 .O1
TOTAL TAX PAYMENT 337.50
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" CCR), YOU MAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.
\~Q,