HomeMy WebLinkAbout04-07-14 BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX
HE ITANCE AX DIVISION PDEDUCTINT ALLONANCE
ASSESOR DISALLOWANCE Pen nSyLVam a
HARRISBURG, PA 17128-0601 SECURI'T'Y ACCOUNTS HELD IN )a DEPARTMENT OF REVENUE
BENEFICIARY FORK REV-1543A WP (12-131
DATE 04-07-2014
ESTATE OF GODFREY JUDITH A
DATE OF DEATH 06-19-2013
FILE NUMBER 21 13-0710
COUNTY CUMBERLAND
SSN/DC
DEBRA J MAUGANS ACN 13504061
28 BRENTWOOD RD APPEAL BY DATE: 06-06-2014
CAMP HILL PA 17011-2505 (See reverse side under Objections)
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-1548A AFP (12-13)
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS
AND ASSESSMENT OF TAX ON SECURITY ACCOUNTS HELD IN BENEFICIARY FORM
DATE: 04-07-2014
ESTATE OF: GODFREY JUDITH A DATE OF DEATH: 06-19-2013 COUNTY: CUMBERLAND
FILE NO. : 21 13-0710 S.S/D.C. NO. : ACN: 13504061
TAX RETURN WAS: (X) ACCEPTED AS FILED C )CHANGED
BENEFICIARY FORM OF ASSET INFORMATION
NAME OF SECURITY: AMERIPRISE ACCOUNT NO. : 16432906
TYPE OF ASSET: ( ) SECURITIES ( X SECURITY ACC ( ) STOCK C ) BONDS
DOD Valuation 59,904.71 NOTE: TO ENSURE PROPER CREDIT TO
Percent Taxable X 0.500 YOUR ACCOUNT, ,S.1IBMIT THE
Amount Subject to Tax 29,952.36 UPPER,�ORTION k#-i TH=AOTICE
Debts and Deductions . 00 WITH Y.DU& TAX P$YME �0 THE
Taxable Amount 29.952.36 REGIS j Y%RaF WII]� AV;T.NE 3
Tax Rate X . 045 ABOVE TADDRERS. MAKE;qHgK }
Tax Due 1 ,347.86 OR MON"" 5Rd1ER PAYABVEOrO: �
TAX CREDITS:
"REGIST�E RPO�ZWILLS, QCGJ 1T.'!
PAYMENT RECEIPT DISCOUNT C+)
P AMOUNT PAILS G
DATE NUMBER INTEREST/PEN PAID C-) A r Yr1,.
03-05-2014 CDO18848 . 00 1,347v86 fV
D C.0
C
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.