HomeMy WebLinkAbout04-07-14 BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX I
INHERITANCE TAX DIVISION APPRAISEMENT ALLOKANCE OR DISALLONANCE pennsylvam a
PO BOX 280601 OF DEDUCTION AND ASSESSMENT OF TAX ON
HARRISBURG, PA 17128-0601 SECURI+Y ACCOUNTS HELD IN DEPARTMENT OF REVENUE
BENEFICIARY FORM REV-1548A AFP (13-13)
DATE 04-07-2014
ESTATE OF RAYMUNDO RODOLFO G
DATE OF DEATH 09-11-2013
FILE NUMBER 21 13-1271
COUNTY CUMBERLAND
SSN/DC
ROCHELLE MELLOTT ACN 13504595
UNIT 14 APPEAL BY DATE: 06-06-2014
1115 W SWALLOW RD (See reverse side under Objections)
FORT COLLINS CO 80526-6035 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 t-
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: RAYMUNDO RODOLFO G DATE OF DEATH: 09-11-2013 COUNTY: CUMBERLAND
FILE NO. : 21 13-1271 S.S/D.C. NO. : ACN: 13504595
TAX RETURN WAS: (X) ACCEPTED AS FILED ( )CHANGED
BENEFICIARY FORM OF ASSET INFORMATION
NAME OF SECURITY: AMERICAN FUNDS ACCOUNT NO. : 191460366
TYPE OF ASSET: ( X SECURITIES C 7 SECURITY ACC ( ) STOCK C ) BONDS
DOD Valuation 32,172. 00 NOTE: TO ENSURE PROPER CREDIT TO
Percent Taxable X 0.500 YOUR ACCOUNT, SUBMIT THE
Amount Subject to Tax 16,086.00 UPPER PORTION OF THIS NOTICE s
Debts and Deductions .00 WITH YOURCJAX PAYPt�OT TO 5JIE
Taxable Amount 16.086.00 REGISTER Ff dJILLS A`T TA rrI
Tax Rate X .045 ABOVE ADDaq. MAKiDCH50Kp
Tax Due 723.87 OR MONEY )_q:. D€RC'T AYTBLEUPV
TAX CREDITS: "REGISTER"OZ WL LS ETV
-
(n p
PAYMENT RECEIPT DISCOUNT (+) p O p
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 0..7 3
R n
r-• rn
CO T
PAYMENT MUST BE MADE BY 06-12-2014•. TOTAL TAX PAYMENT .00
BALANCE OF TAX DUE 723.87
INTEREST AND PEN. .00
TOTAL DUE 723.87
IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR7, YOU MAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.