HomeMy WebLinkAbout04-1166
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
'*
BUREAU OF INDIVIDUA4'lAXES
INHERITANCE TAX DIVISION' -
PO BOX 280601
HARRISBURG PA 17128-0601 '
NOTICE OF INHERITANCE TAX
APPRAISEKENT~ ALLOHANCE OR DISALLOHANCE
OF DEDUCTION~. AND ASSESSKENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
REY-15~' EX AFP IlZ-D~1
~ l'.'i
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DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN/DC
ACN
04-11-2005
COOPER JR
09-05-2004
21 04-1116
CUMBERLAND
200-22-6463
05103566
Allount Relli Ued
WILLIAM
J
JOSEPH ~DXNOBLE
1621 MOUNTAIN RD
DAUPHIN PA 17018
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
iifi:is4li-EX--AFP--foi-:03i------------------------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 04-11-2005
ESTATE OF COOPER JR
WILLIAM J DATE OF DEATH 09-05-2004
COUNTY
CUMBERLAND
FILE NO. 21 04-1116
TAX RETURN WAS:
S.S/D.C. NO. 200-22-6463
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
ACN
05103566
FINANCIAL INSTITUTION: FULTON BANK
ACCOUNT NO.
010-0102575
TYPE OF ACCOUNT: () SAVINGS ( ) CHECKING ( ) TRUST (Xl TIME CERTIFICATE
DATE ESTABLISHED 01-06-2000
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Due
1.040.20
0.500
520.10
.00
520.10
.15
78.02
NOTE: TO INSURE PROPER CREDIT TO
YOUR ACCOUNT. SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO:
"REGISTER OF WILLS. AGENT."
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
03-04-2005 CD005029 .00 78.02
TOTAL TAX CREDIT 78.02
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 LESS THAN $1. NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CRl. YOU MAY BE DUE A REFUND.
--- __....B...., "'TnJ: nJ: TilTc:. ~nRM FOR INSTRUCTIONS. l
'5'<
~
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
'*
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISIbH
PO BOX 280601
HARRISBURG PA 17128-0601
NOTICE OF INHERITANCE TAX
APPRAISEKENT~ ALLOHANCE OR DISALLOHANCE
OF DEDUCTION~. AND ASSESSKENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
REY-15~' EX AFP (lZ-D~1
~ ,--'-.
tJ
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN/DC
ACN
04-11-2005
COOPER JR
09-05-2004
21 04-1116
CUMBERLAND
200-22-6463
05103570
Allount Rellitted
WILLIAM
J
JODI D K.NOBLE
1621 MOUNTAIN RD
DAUPHIN PA 17018
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
iifi:is4-i-EX--AFP--foi-:03i------------------------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 04-11-2005
ESTATE OF COOPER JR
WILLIAM
J DATE OF DEATH 09-05-2004
COUNTY
CUMBERLAND
FILE NO. 21 04-1116
TAX RETURN WAS:
S.S/D.C. NO. 200-22-6463
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
ACN
05103570
FINANCIAL INSTITUTION: FULTON BANK
ACCOUNT NO.
010-0102574
TYPE OF ACCOUNT: () SAVINGS ( ) CHECKING ( ) TRUST (Xl TIME CERTIFICATE
DATE ESTABLISHED 01-06-2000
x
1.040.20
0.500
520.10
.00
520.10
.15
78.02
NOTE: TO INSURE PROPER CREDIT TO
YOUR ACCOUNT. SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO:
"REGISTER OF WILLS. AGENT."
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
x
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
03-04-2005 , CD005030 .00 78.02
TOTAL TAX CREDIT 78.02
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 LESS THAN $1. NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CRl. YOU MAY BE DUE A REFUND.
S~~ R~V~RS~ SIDE OF THIS FORM FOR INSTRUCTIONS. l
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