HomeMy WebLinkAbout11-04-14 BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX
INHERITANCE TAX DIVISION APPRAISEMENT ALLOWANCE OR DISALLOWANCE pe n n sytva rn a
PO BOX 280601 OF DEDUCTION AND ASSESSMENT OF TAX ON
HARRISBURG, PAR12WVSECURITY ACCOUNTS HELD IN
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QED OFFICE OF BENEFICIARY FORM
REI-BIW AFP M-M
RE(';:'•STEW OF WILLS
DATE 11-03-2014
?01 �`+ t� n;�� �i 97 ESTATE OF BOWERSOX SYLVIA G
11 U fi DATE OF DEATH 10-22-2013
FILE NUMBER ),1—1 —L+a
CLER" C-F COUNTY CUMBERLAND
SSN/DC
HARORRRAN�kE—kT ACN 13505298
41etbWR�0RRD -!r1 ` ^ :A APPEAL BY DATE: 01-02-2015
MECHANICSBURG PA 17055-6659 (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 THISLINE RETAIN LOWER PORTION FOR YOUR RECORDS 4—
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NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS
AND ASSESSMENT OF TAX ON SECURITY ACCOUNTS HELD IN BENEFICIARY FORM
DATE: 11-03-2014
ESTATE OF:BOWERSOX SYLVIA G DATE OF DEATH: 10-22-2013 COUNTY: CUMBERLAND
FILE NO. : S.S/D.C. NO. : 177-16-1869 ACN: 13505298
TAX RETURN WAS: (X) ACCEPTED AS FILED C )CHANGED
BENEFICIARY FORM OF ASSET INFORMATION
NAME OF SECURITY: WELLS FARGO ADVISORS ACCOUNT NO. : 1690-9715
TYPE OF ASSET: C ) SECURITIES ( X SECURITY ACC ( ) STOCK C ) BONDS
DOD Valuation 400,963.86 NOTE: TO ENSURE PROPER CREDIT TO
Percent Taxable X 0.500 YOUR ACCOUNT, SUBMIT THE
Amount Subject to Tax 200,481 .93 UPPER PORTION OF THIS NOTICE
Debts and Deductions - .00 WITH YOUR TAX PAYMENT TO THE
Taxable Amount 200,481 .93 REGISTER OF WILLS AT THE
Tax Rate X .045 ABOVE ADDRESS. MAKE CHECK
Tax Due 9,021.69 OR MONEY ORDER PAYABLE TO:
TAX CREDITS:
"REGISTER OF WILLS, AGENT."
PAYMENT RECEIPT DISCOUNT (+)
DATE NUMBER INTEREST/PEN PAID C-) AMOUNT PAID
INTEREST IS CHARGED THROUGH 11-11-2014* TOTAL TAX PAYMENT .00
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 9,021 .69
REVERSE SIDE OF THIS FORM INTEREST AND PEN. 82.86
TOTAL DUE 9,104.55
* 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.
BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX
INHERITANCE TAX DIVISION APPRAISEMENT ALLONANCE OR DISALLONANCE u; pe1111S�/LVa1118
PO BOX 260601 OF DEDUCTION AND ASSESSMENT OF TAX ON
HARRISBURG, PA1 u SECURI'T'Y ACCOUNTS HELD IN DEPARTMENT OF REVENUE
R MD E D OFFICE O F BENEFICIARY FORM REV-1549A AFP (12-13)
REGISTER OF VYILLS DATE 11-03-2014
1 uu p i� L� 119
L�*7 ESTATE OF BOWERSOX SYLVIA G
C01i NOU ! i�� .11 11 DATE OF DEATH 10-22-2013
FILE NUMBER 2--J -l4 — 43
CLLF{;l OF COUNTY CUMBERLAND
SSN/DC
DAVIDORPHAto-wtk.,SOXr ACN 13505299
205C1;fNfAFLBA'NS fCT a, APPEAL BY DATE: 01-02-2015
1 I L T- k L.h - k
CHESTER SPRGS4� PA 19425-8730 (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 THISLINE —► RETAIN LOWER PORTION FOR YOUR RECORDS 4—
_ _
REV-1548A AFP C12:13) - - - - - - - - - - - - - - -- --- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - --- -
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS
AND ASSESSMENT OF TAX ON SECURITY ACCOUNTS HELD IN BENEFICIARY FORM
DATE: 11-03-2014
ESTATE OF: BOWERSOX SYLVIA G DATE OF DEATH: 10-22-2013 COUNTY: CUMBERLAND
FILE NO. : S.S/D.C. NO. : 177-16-1869 ACN: 13505299
TAX RETURN WAS: (X) ACCEPTED AS FILED C )CHANGED
BENEFICIARY FORM OF ASSET INFORMATION
NAME OF SECURITY: WELLS FARGO ADVISORS ACCOUNT NO. : 1690-9715
TYPE OF ASSET: C ) SECURITIES C X SECURITY ACC C ) STOCK ( ) BONDS
DOD Valuation 400,963.86 NOTE: TO ENSURE PROPER CREDIT TO
Percent Taxable X 0.500 YOUR ACCOUNT, SUBMIT THE
Amount Subject to Tax 200,481 .93 UPPER PORTION OF THIS NOTICE
Debts and Deductions - .00 WITH YOUR TAX PAYMENT TO THE
Taxable Amount 200,481 .93 REGISTER OF WILLS AT THE
Tax Rate X .045 ABOVE ADDRESS. MAKE CHECK
Tax Due 9,021 .69 OR MONEY ORDER PAYABLE TO:
TAX CREDITS: "REGISTER OF WILLS, AGENT."
PAYMENT RECEIPT DISCOUNT (+)
DATE NUMBER INTEREST/PEN PAID C-) AMOUNT PAID
INTEREST IS CHARGED THROUGH 11-11-2014* TOTAL TAX PAYMENT .00
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 9,021.69
REVERSE SIDE OF THIS FORM INTEREST AND PEN. 82.86
TOTAL DUE 9,104.55
IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.