HomeMy WebLinkAbout12-13-13 BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX
INHERITANCE TAX DIVISION APPRAISEMENT ALLOWANCE OR DISALLOWANCE p pennsytvania
PO BOX 280601 OF DEDUCTION AND ASSESSMENT OF TAX ON
HARRISBURG, PA 17128-0601 SECURIEY ACCOUNTS HELD IN DEPARTMENT OF REVENUE
RECORDED OFFICE OF BENEFICIARY FORM
REGISTER OF WILLS ESTATE 12-16-2013
ESTATE OF GODFREY JUDITH A
U�3 DEC p DATE OF DEATH 06-19-2013
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j 2y FILE NUMBER 21 13-0710
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COUNTY CUMBERLAND
RICHARD A GODF&y'R({ OF SSN/DC
p ACN 13504062
26910 WHITE PQRNM W"i COURT APPEAL BY DATE: 02-14-2014
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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 0-
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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- 12-16-2013
ESTATE OF:_GODFREY JUDITH A DATE OF DEATH: 06-19-2013 COUNTY: CUMBERLAND
FILE NO. : 21 13-0710 S.S/D.C. NO. : ACN: 13504062
TAX RETURN WAS: (X) ACCEPTED AS FILED ( )CHANGED
BENEFICIARY FORM OF ASSET INFORMATION
NAME OF SECURITY: AMERIPRISE ACCOUNT NO. : 16432906
TYPE OF ASSET: ( ) SECURITIES ( X SECURITY ACC ( ) STOCK ( ) BONDS
DOD Valuation 59,904.71 NOTE: TO ENSURE PROPER CREDIT TO
Percent Taxable X 0.500 YOUR ACCOUNT, SUBMIT THE
Amount Subject to Tax 29,452.36 UPPER PORTION OF THIS NOTICE
Debts and Deductions .00 WITH YOUR TAX PAYMENT TO THE
Taxable Amount 24 952.36 REGISTER OF WILLS AT THE
Tax Rate X .045 ABOVE ADDRESS. MAKE CHECK
Tax Due 1 .347.86 OR MONEY ORDER PAYABLE TO:
TAX CREDITS:
"REGISTER OF WILLS, AGENT."
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
10-16-2013 CDO18266 .00 1,347.86
TOTAL TAX PAYMENT 1,347.86
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
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.