HomeMy WebLinkAbout03-18-13 (14) BUREAU OF INDIVIDUAL TAXES ❑�y NOTICE OF INHERITANCE TAX
INHERITANCE TAX DIVISION eEFA6Ct��� }�t'ANlyp����B���•�y�T1 ALLONANCE OR OISALLONANCE p@nnsylvania
PD BOX ANCE T R CORD - 7OF`_'{iCWCI'1OU AND ASSESSMENT OF TAX ON
HARRISBURG, PA 17128-0601 REGIS i ER 0-r sl . ..,=RIf'l ACCOUNTS HELD IN DEPARTMENT OF REVENUE
BENEFICIARY FORM xEV-ssau ua eu-:xs IR
20}3 t flq 18 Fs l 7 DATE 03-18-2013
ESTATE OF PTASZEK BARBARA E
CLERK DATE OF DEATH 11-29-2012
FILE NUMBER 21 12-1297
0RPHAMS' G0 COUNTY CUMBERLAND
THOMAS F PT"WRERLAND i,'._`., ' `, SSN/DC
ACN 13500321
695 JULIE CT APPEAL BY DATE: 05-17-2013
MECHANICSBURG PA 17055-6032 (See reverse side under Objections)
Amount Remitted F---. ��
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS t
1 COURTHOUSE SQUARE
CARLISLE PA 17013
I
CUT ALONG THIS LINE RETAIN LOWER PORTION FOR YOUR RECORDS 4-- _
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REV-i54BA - AFP (12-12)
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS
AND ASSESSMENT OF TAX ON SECURITY ACCOUNTS HELD IN BENEFICIARY FORM
DATE: 03-18-2013 I(
ESTATE OF:PTASZEK BARBARA E DATE OF DEATH: 11-29-2012 COUNTY: CUMBERLAND
FILE NO. : 21 12-1297 S.S/D.C. NO. : ACN: 13500321
TAX RETURN WAS: (X) ACCEPTED AS FILED C )CHANGED f
BENEFICIARY FORM OF ASSET INFORMATION E
NAME OF SECURITY: CENTRIC BANK ACCOUNT NO. : 3053618
TYPE OF ASSET: C ) SECURITIES C X SECURITY ACC { 7 STOCK C ) BONDS
DOD Valuation 10,584,40 NOTE: TO ENSURE PROPER CREDIT TO >
Percent Taxable X 01500 YOUR ACCOUNT, SUBMIT THE
Amount Subject to Tax 5,292.45 UPPER PORTION OF THIS NOTICE
Debts and Deductions .00 WITH YOUR TAX PAYMENT TO THE
Taxable Amount _ 5,292.45 REGISTER OF WILLS AT THE
Tax Rate X .045 ABOVE ADDRESS. MAKE CHECK j
Tax Due 238. 16 OR MONEY ORDER PAYABLE TO:
TAX CREDITS: "REGISTER OF WILLS, AGENT."
PAYMENT RECEIPT DISCOUNT (+)
DATE NUMBER INTEREST/PEN PAID C-) AMOUNT PAID
02-19-2013 CDO17201 11 .91 226.25
i
I
1
TOTAL TAX PAYMENT 238.161,
BALANCE OF TAX DUE 0
INTEREST AND PEN. .00 j
TOTAL DUE .00
+ IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. "
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. i