HomeMy WebLinkAbout08-29-14 (2) BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX
INHERITANCE TAX DIVISION OF DEDU AND
PCTION� ALLONANCE
ASSESSMENT DISALLOWANCE -`' pennSyLVarna
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HARRISBURG, PA 17128-0681 SECURI'T'Y ACCOUNTS HELD IN DEPARTMENT OF REVENUE
BENEFICIARY FORM REV-1535A AFP uE-u,
DATE 09-01-2014
ESTATE OF MENGLE PHYLISS C
DATE OF DEATH 05-30-2014
FILE NUMBER 21 14-0566
COUNTY 21CUMBERLAND
SSN/DC
OLIVIA C RICKARDS ACN 14504390
7 ALEXANDRIA CT APPEAL BY DATE: 10-31-2014
MECHANICSBURG PA 17050-8224 (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
REV-1548A !FP 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: 09-01-2014
ESTATE OF: MENGLE PHYLISS C DATE OF DEATH: 05-30-2014 COUNTY: 21CUMBERLAND
FILE NO. : 21 14-0566 S.S/D.C. NO. : ACN: 14504390
TAX RETURN WAS: (X) ACCEPTED AS FILED ( )CHANGED
BENEFICIARY FORM OF ASSET INFORMATION
NAME OF SECURITY: AMERIPRISE ACCOUNT NO. : 062428742
TYPE OF ASSET: I ) SECURITIES I X SECURITY ACC ( ) STOCK I ) BONDS
DOD Valuation 41 ,747.95 NOTE: TO ENSURE PROPER CREDIT TO
Percent Taxable X 1 . 000 YOUR ACCOUNT, SUBMIT THE
Amount Subject to Tax 41 ,747.95 UPPER PORTION OF THIS NOTICE
Debts and Deductions .00 WITH YOUR TAX PAYMENT TO THE
Taxable Amount 41 ,747.95 REGISTER OF WILLS AT THE
Tax Rate X . 045 ABOVE ADDRESS. MAKE CHECK '
Tax Due 1 .878.66 OR MONEY &DER PA1%LE Tn-
"REGISTER=X) WILLS AGP�"
TAX CREDITS: z � O j
PAYMENT RECEIPT DISCOUNT (+) rn cn
DATE NUMBER INTEREST/PEN PAID C-) AMOUNT PAID D m r\) M m
08-07-2014 CDO19515 93.93 1 ,784.73
p O
m
_J f
ca cn �
s
TOTAL TAX PAYMENT 1,878.66
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.