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HomeMy WebLinkAbout03-18-13 (15) BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX INHERITANCE TAX DIVISION APPRAISEMENT ALLONANCE OR DISALLONANCE pennsylvania PO BOX 288681 OF DEDUCTION AND ASSESSMENT OF TAX ON DEPARTMENT OF REVENUE HARRISBURG, PA 17128-0601 SECURITY ACCOUNTS HELD IN BENEFICIARY FORSS cerawai aro uz-,v RECORD-z 0 ( ; L1F DATE 03-18-2013 REGISTEj� OF `. ESTATE OF PTASZEK BARBARA E DATE OF DEATH 11-29-2012 FILE NUMBER 21 12-1297 Ml fl� .�� 1 l7 COUNTY CUMBERLAND SSN/DC THOMAS F PT AS� �,I. ACN 13500323 695 JULIE �TDpDD4R ati( APPEAL BY DATE: 05-17-2013 MECHANICSBF&HAW CftW�6032 (See reverse side underOhjecdons) CUMBERLAND G;;., r-;' Amount Remitted —�� MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS i COURTHOUSE SQUARE CARLISLE PA 17013 I CUT ALONG THIS LINE �^► RETAIN LOWER PORTION FOR YOUR RECORDS -----_-_- --'-------- -- - -------------------------` ; REV-i548A 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 ESTATE OF:PTASZEK BARBARA E DATE OF DEATH: 11-29-2012 COUNTY: CUMBERLAND I � FILE NO. : 21 12-1297 S.S/D.C, NO. : ACN: 13500323 TAX RETURN WAS: (X) ACCEPTED AS FILED t )CHANGED i BENEFICIARY FORM OF ASSET INFORMATION NAME OF SECURITY: CENTRIC BANK ACCOUNT NO. : 3055720 ' TYPE OF ASSET: I ) SECURITIES C X SECURITY ACC ( ) STOCK f ) BONDS I ' I DOD Valuation 26,861.03 NOTE: TO ENSURE PROPER CREDIT TO li i Percent Taxable X 0.500 YOUR ACCOUNT, SUBMIT THE If Amount Subject to Tax 13,430.52 UPPER PORTION OF THIS NOTICE i Debts and Deductions .00 WITH YOUR TAX PAYMENT TO THE Taxable Amount 13,430.52 REGISTER OF WILLS AT THE Tax Rate X .045 ABOVE ADDRESS. MAKE CHECK I Tax Due 604.37 OR MONEY ORDER PAYABLE TO: TAX CREDITS: "REGISTER OF WILLS, AGENT." PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 02-19-2013 CDO17203 30.22 574. 15 i I I ; i I TOTAL TAX PAYMENT 604.371 BALANCE OF TAX DUE •00 INTEREST AND PEN. . 00 TOTAL DUE .00 I 1 I * 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- -.