HomeMy WebLinkAbout02-23-15 BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX
INHERITANCE TAX DIVISION APPRAISEMENT ALLONANCE OR DISALLONANCE pennsytvania
PO BOX 2BO601 OF DEDUCTION6 AND ASSESSMENT OF TAX ON
HARRISBURG, PA 17128-0601 SECURIfY ACCOUNTS HELD IN DEPARTMENT OF REVENUE
BENEFICIARY FORM REV-1548A AFP (11-14)
RECORC-D OFFICE OF
R E t,1 TL-7, ti'F VI:L 1-S DATE 02-24-2015
ESTATE OF ELLIS CLIFFORD W
DATE OF DEATH 12-27-2013
?01S FEB 23 FM 12 33 FILE NUMBER 21 14-0504
COUNTY CUMBERLAND
SSN/DC
VICKIECLEL STARNER ACN 14501727
18 QfNff1.H,§YS' T APPEAL BY DATE: 04-25-2015
MT L"J0L-Y1!S P GS PK '17065-1307 (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 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: 02-24-2015
ESTATE OF: ELLIS CLIFFORD W DATE OF DEATH: 12-27-2013 COUNTY: CUMBERLAND
FILE NO. : 21 14-0504 S.S/D.C. NO. : AGN: 14501727
TAX RETURN WAS: (X) ACCEPTED AS FILED C )CHANGED
BENEFICIARY FORM OF ASSET INFORMATION
NAME OF SECURITY: FIDELITY ACCOUNT NO. : 00872
TYPE OF ASSET: SECURITIES C X SECURITY ACC C ) STOCK BONDS
DOD Valuation 64,153.85 NOTE: TO ENSURE PROPER CREDIT TO
Percent Taxable X 1.000 YOUR ACCOUNT, SUBMIT THE
Amount Subject to Tax 64,153.85 UPPER PORTION OF THIS NOTICE
Debts and Deductions .00 WITH YOUR TAX PAYMENT TO THE
Taxable Amount 64,153.85 REGISTER OF WILLS AT THE
Tax Rate X .15 ABOVE ADDRESS. MAKE CHECK
Tax Due 9,623.08 OR MONEY ORDER PAYABLE TO:
"REGISTER OF WILLS, AGENT."
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID
05-22-2014 CDO19198 .00 9,623.08
TOTAL TAX PAYMENT 9,623.08
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.