HomeMy WebLinkAbout10-15-13 BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX
INHERITANCE TAX DIVISION APPRAISEMENT ALLOWANCE OR DISALLOWANCE pennsylvanfa
PO Box 280601 OF DEDUCTION6ut AND ASSESSMENT OF TAX ON
HARRISBURG, PA 17128-0601 SECURITY ACCOUNTS HELD IN Illy DEPARTMENT OF REVENUE
BENEFICIARY FORM M-11z M All ut.110
RECORLED G"-ICE OF DATE 10-14-2013
REGISTER } .LinJ ESTATE OF RIETHEIMER HELENE T
DATE OF DEATH 06-28-2012
r ,G> �+ FILE NUMBER 21 12-0791
1613 01,1 iJ Pf1 1t} COUNTY CUMBERLAND
SSN/DC
JOHN L RIE HE,IMERIII ACN 12503384
3710 LEYLAND DR�E�'''� �'�' APPEAL BY DATE: 12-13-2013
M EC HAN I C S B U AR P H xRAS 17A5U=9165 (See reverse side under Objections)
CUMBERLAND CO., PA Amount Remitted [
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE "A"t RETAIN LOWER PORTION FOR YOUR RECORDS r"' _ _ _ _
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REV-1548A AFP C12-12)
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS
AND ASSESSMENT OF TAX ON SECURITY ACCOUNTS HELD IN BENEFICIARY FORM
DATE: 10-14-2013
ESTATE OF: RIETHEIMER HFLENE T DATE OF DEATH: 06-28-2012 COUNTY: CUMBERLAND
FILE NO. : 21 12-0791 S.S/D.C. NO. : ACN: 12503384
TAX RETURN WAS: (X) ACCEPTED AS FILED ( )CHANGED
BENEFICIARY FORM OF ASSET INFORMATION
NAME OF SECURITY: PRUDENTIAL FINANCIAL ACCOUNT NO. : 167166258
TYPE OF ASSET: I ) SECURITIES ( X SECURITY ACC C ) STOCK ( ) BONDS
DOD Valuation 6,382.00 NOTE: TO ENSURE PROPER CREDIT TO
Percent Taxable X 1.000 YOUR ACCOUNT, SUBMIT THE
Amount Subject t0 Tax 6,382.00 UPPER PORTION OF THIS NOTICE
Debts and Deductions .00 WITH YOUR TAX PAYMENT TO THE
Taxable Amount 6,582.00 REGISTER OF WILLS AT THE
Tax Rate X .045 ABOVE ADDRESS. MAKE CHECK
Tax Due 287. 19 OR MONEY ORDER PAYABLE TO:
TAX CREDITS:
"REGISTER OF WILLS, AGENT."
PAYMENT RECEIPT DISCOUNT (+} AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
03-27-2013 CDO17373 .00 287.19
TOTAL TAX PAYMENT 287.19
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
S 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.