HomeMy WebLinkAbout05-23-14 BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX
INHERITANCE 01 DIVISION OFPDEDUCTION6 AANDNASSESOR DISOFLTAXNON pen nsylvania
HARRISBURG, PA 17128-0601 SECURHY ACCOUNTS HELD IN _ _ DEPARTMENT OF REVENUE
BENEFICIARY FORM REV-1543A AFP ,ss-,n
DATE 05-26-2014
ESTATE OF SWARTZ ROBERT C
DATE OF DEATH 02-28-2014
FILE NUMBER 21 14-0274
COUNTY CUMBERLAND
SSN/DC
LORI L KEEFER ACN 14502372
1027 CHELMSFORD DR APPEAL BY DATE: 07-25-2014
MECHANICSBURG PA 17050-2192 (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 r
REV-1548A AFP Yl 2-13) -
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS
AND ASSESSMENT OF TAX ON SECURITY ACCOUNTS HELD IN BENEFICIARY FORM
DATE: 05-26-2014
ESTATE OF: SWART7 ROBERT C DATE OF DEATH: 02-28-2014 COUNTY: CUMBERLAND
FILE NO. : 21 14-0274 S.S/D.C. NO. : ACM: 14502372
TAX RETURN WAS: CX) ACCEPTED AS FILED C )CHANGED
BENEFICIARY FORM OF ASSET INFORMATION
NAME OF SECURITY: PRUDENTIAL ACCOUNT NO. : 192146615
TYPE OF ASSET: C ) SECURITIES C X SECURITY ACC ( ) STOCK C ) BONDS
DOD Valuation 163,702.61 NOTE: TO ENSURE PROPER CREDIT TO
Percent Taxable X 0.500 YOUR ACCOUNT, SUBMIT THE
Amount Subject to Tax 81 ,851 .31 UPPER PORTION OF THIS N07ICE
Debts and Deductions - .00 WITH YOUR 'TAX PA NT TO- THE
Taxable Amount 81 ,851 .31 REGISTEI�nOF WILLS'LAT T�.iqu
Tax Rate X .045 ABOVE ADMUS. MA--U3 CHECAb
Tax Due 3.683.31 OR MONEY-6�)RbER PARABLE--TAO':
"REGISTERT OF VILLS AGE M--P.°
TAX CREDITS: ; ?'_' I— N m in
W C7
PAYMENT RECEIPT DISCOUNT C+)
AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID C-) _6I
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PAYMENT MUST BE MADE BY 11-29-2014*. TOTAL TAX PAYMENT .00
BALANCE OF TAX DUE 3,683.31
INTEREST AND PEN. .00
TOTAL DUE 3,683.31
• 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.