HomeMy WebLinkAbout11-16-12 (4)BUREAU OF INDIVIDUAL TAXE'1B.CnUl 11 a ~.I-~If~[' NOTICE OF INHERITANCE TAX
INNER ITANCE TAX DIVISION (~- I A EMENT, ALLOWANCE OR DISALLOWANCE
PD BOX 280601 ('.. '~,, .__,.i~, i v~.' d'~IIQ UCTIONS, AND ASSESSMENT OF TAX ON
HARRISBURG PA 1]128-x601 ., JOINTLY HELD DR TRUST ASSETS
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BARRY W BR.6) (,Q., PA
917 HAMILTON ST
CARLISLE PA 17013-1526
Pennsylvania ~
DEPARTMENT OF REVENUE
REV-1548 E% AFP (12-1ll
DATE 11-20-2012
ESTATE OF BREITENBACH GERALDINE P
DATE OF DEATH 10-15-2012
FILE NUMBER 21 12-1151
C OUN7Y CUMBERLAND
SSN/DC 195-16-9494
ACN 12158493
APPEAL BY DATE:O1-19-2013
(See reverse side under Objecteons)
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 (12-11)
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE: 11-20-2012
ESTATE OF: BREITENBACH
FILE NO.: 21 12-1151
GERALDINE P DATE OF DEATH:10-15-2012 COUNTY:CUMBERLAND
S.S/D.C. NO.: 195-16-9494
ACN: 12158493
TAX RETURN WAS: (X) ACCEPTED AS FILED C ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO.: 29327-42
TYPE OF ACCOUNT: ( )SAVINGS ( ) CHECKING ( )TRUST CX)TIME CERTIFICATE
DATE ESTABLISHED 12-20-2004
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
13,449.92
X 0.033
448.29
.00
448.29
x .045
20.17
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
10-31-2012 CD016729 1.01 19.16
TOTAL TAX PAYMENT 20.17
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
~ IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIDNAL INTEREST. ~
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRT, YOU MAV BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.
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