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HomeMy WebLinkAbout03-18-13 (16) BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX INHERITANCE TAX DIVISION APPRAISEMENT ALLONANCE OR DISALLONANCE pennsylvania PO sox z866B1 OF DEDUCTION6 AND ASSESSMENT OF TAX ON DEPARTMENT OF REVENUE HARRISBURG. PA 17128-0601 RECORDED OFFICE OF BENYEFICCIARY ACCOUNTS HELD IN REG! , �R OF .1k ' LS DATE 03-18-2013 ESTATE OF PTASZEK BARBARA E '3 MR 18 p,,r, 8 `/p DATE OF DEATH 1I-29-2012 tuu FILE NUMBER 21 12-1297 CLERK COUNTY CUMBERLAND SSN/DC THOMAS F PO ANS• COURT ACN 13500353 695 JULIE CCUMBERLA�t � O AA APPEAL BY DATE: 05-17-2013 MECHANICSBURG PA 5 6032• (See reverse side under06T'ecdons) - Amount Remitted ---_--- �� MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE RETAIN LOWER PORTION FOR YOUR RECORDS 4— ------------------'-_- _ _--_ - -----_--------------` 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 j I I ESTATE OF: PTASZEK BARBARA F DATE OF DEATH: 11-29-2012 COUNTY: CUMBERLAND j r 1 ' FILE NO. : 21 12-1297 S.S/D.C. NO. : ACN: 13500353 I ICI TAX RETURN WAS: (X) ACCEPTED AS FILED C )CHANGED BENEFICIARY FORM OF ASSET INFORMATION I NAME OF SECURITY: AMERICHOICE FCU ACCOUNT NO. : 35165 i TYPE OF ASSET: C } SECURITIES C X SECURITY ACC C 7 STOCK ( > BONDS I DOD Valuation 9,607.07 NOTE: TO ENSURE PROPER CREDIT TO Percent Taxable X 0.500 YOUR ACCOUNT, SUBMIT THE Amount Subject to Tax 4,803.54 UPPER PORTION OF THIS NOTICE Debts and Deductions .00 WITH YOUR TAX PAYMENT TO THE Taxable Amount 4,803.54 REGISTER OF WILLS AT THE Tax Rate X .045 ABOVE ADDRESS. MAKE CHECK Tax Due 216. 16 OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 02-19-2013 CDO17202 10.81 205.35 j 1 TOTAL TAX PAYMENT 216.16 BALANCE OF TAX DUE 0 i INTEREST AND PEN. .00 TOTAL DUE .00 j i i t 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. s „ "