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HomeMy WebLinkAbout11-16-12 C r 1:J '~ I ~ Pennsylvania OF INHERITANCE TAX DEPARTMENT OF REVENUE ~ IDUAL NOTICE ( ~ i ~~ VL O TA~~ 1, i~ OWANCE BUREAU OF INDIV IVISION - _ ,APP eAISEMENT, i ~~91 ALLOWANCE OR DISALL REV-1548 EX AFP u2-11) INHERITANCE TAX D II 5'~ '~~' ': b'~.~.-EDU CTIONS P1-~ , AND ASSESSMENT OF TAX ON PO BO% 280601 HARRISBURG PA 17128-0601 . JOINTLY HELD OR TRUST ASSETS .. i,'i~h~l~ ~b PI~ ~I J~i DATE 11-20-2012 ESTATE OF MUSSELMAN HAROLD DATE OF DEATH 05-01-2012 FILE NUMBER 21 12-1049 ~ COUNTY CUMBERLAND 1~a~~vlr.iP'r ~,~i~'F SSN/DC 188-32-2776 ~~ ~48€~~Af~~u C~- PA ACN 12132051 AMANDA APPEAL BY DATE:O1-19-2013 235 CLAY RD (See reverse side under Objections) CARLISLE PA 17015-9468 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-1548 EX AFP I12-11) DEDUCTIONSINANDIASSESSMENTAOFRTAXEONNJOINTLYWHELD OR TRUSTLASSETS OF DATE: 11-20-2012 ESTATE OF: MUSSELMAN HAROLD DATE OF DEATH:05-O1-2012 FTIF NO.: JI 77-7049 S.S/D.C. NO.: 188-32-2776 COUNTY:CUMBERLAND ACN: 12132051 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO.: 206539-00 TYPE OF ACCOUNT: CX)SAVINGS C ) CHECKING C )TRUST ( )TIME CERTIFICATE DATE ESTABLISHED 06-25-2001 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due 595.88 X 0.166 99.32 100.00 .00 X .045 .00 NOTE: TO ENSURE PROPER CREDIT TO YDUR 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." IAX I,KtU11J: PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID C-7 AMOUNT PAID TOTAL 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" CCRJr VOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.