HomeMy WebLinkAbout10-26-12BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX
INHERITANCE TAX OIY IS ION f{F{~~l(~(''-r'''l NT ALLORANCE OR DISALLONANCE
rC ' ~ ' ~ ~-' ~ ~I OF'..'BYBLTION~ AND ASSBSSNBNT OF TA% ON
PD aox zaoeBl f'L ~, r.--- ~ ; ,r,~' SECURI{'Y ACCOUNTS HELD IN
HARRISBURG, PA 1712 B-0601 f-iL IT'. ;;I [,.i ,~, 'i~-iS BBNBFICIARY FORM
'~120CT26 ANiI~ 37
.,~C..: ,
ORPHAN`S COURT
ADELLA A wA~6M16ERLANO CO,. PA
20 FRELINGHUYSEN ST
BELVIDERE NJ 07823-2023
Pennsylvania ~
DEPARTMENT OF REVENUE
iEV -154BR PiP (IS-11)
DATE 10-29-2012
ESTATE OF AMMERMAN HELEN 0
DATE OF DEATH 06-09-2011
FILE NUMBER 21 11-0801
COUNTY CUMBERLAND
SSN/DC 153-16-4575
ACN 12503925
APPEAL BY DATE: 12-28-2012
(See reverse side under Objections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SpUARE
CARLISLE PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV-1548A AFP C12-11)----------------------------------
NOTICEAND ASSESSMENTEOFATAXPONASECURITY ACCOUNTSEHELDDINABENEFICIARY FORMCTIONS
DATE: 10-29-2012
ESTATE OF:eMMERMAN HELEN O_DATE OF DEATH: 06-09-2011 COUNTY: CUMBERLAND
FILE NO.: 21 11-0801
S.S/D.C. NO.: 153-16-4575
ACN: 12503925
TAX RETURN WAS: (X) ACCEPTED AS FILED ( )CHANGED
BENEFICIARY FORM OF ASSET INFORMATION
NAME OF SECURITY: WELLS FARGO ACCOUNT NO.: 3501761939
TYPE OF ASSET:
( ) SECURITIES ( ) SECURITY ACC (X7 STOCK 17 BONDS
DOD Valuation
Percent Taxable
Amount Sub]ect to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
6,336.00
X 0.333
2,111.98
.00
2.111.98
X .045
95.04
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."
IAA E.rtCUl(O:
PAYMENT
DATE
RECEIPT
NUMBER
DISCOUNT (+)
INTEREST/PEN PAID C-)
AMOUNT PAID
INTEREST IS CHARGED THROUGH 11-06-2011
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
TOTAL TAX PAYMENT .00
BALANCE OF TAX DUE 95.04
INTEREST AND PEN. 1.89
TOTAL DUE 96.93
IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ~ A
SEET REVERSEESIDER OFL THIS FOR MAFORRINSTRU CTIONSY OU MAY BE DUE A REFUND.