HomeMy WebLinkAbout05-04-15 (2) BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX
pe1111S�/LVa111a
INHERITANCE TAX DIVISION APPRAISEMENT ALLOWANCE OR DISALLOWANCE
PO BOX 280601 OF DEDUCTION AND ASSESSMENT OF TAX ON
HARRISBURG, PA 17128-0601 SECURIfY ACCOUNTS HELD IN DEPARTMENT OF REVENUE
R 1_C Q R Q C D OFFICE t Q F BENEFICIARY FORM REV-1548A AFP (11-14)
REC{STE- OF ` ILLS DATE 05-04-2015
ESTATE OF GILKEY SYLVIA B
?ols FIRY 9 QM 12 15 DATE OF DEATH 10-08-2012
FILE NUMBER 21 13-0254
CLLR,.` OF COUNTY CUMBERLAND
n SSN/DC
t7fi `L1 Jf P C3ItfCEY ACN 14503556
C#X,;,B U R G'}S T„ r PA 17110-1402 (See reverse side under APPEAL BY DATE: Objectins)5
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--1-548A - - - - -(1-1---4) - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS
AND ASSESSMENT OF TAX ON SECURITY ACCOUNTS HELD IN BENEFICIARY FORM
DATE: 05-04-2015
ESTATE OF:GILKEY SYLVIA B DATE OF DEATH: 10-08-2012 COUNTY: CUMBERLAND
FILE NO. : 21 13-0254 S.S/D.C. NO. : ACN: 14503556
TAX RETURN WAS: (X) ACCEPTED AS FILED ( )CHANGED
BENEFICIARY FORM OF ASSET INFORMATION
NAME OF SECURITY: AT&T STOCK INC. ACCOUNT NO. : C1002027042
TYPE OF ASSET: C ) SECURITIES C ) SECURITY ACC (X) STOCK C ) BONDS
DOD Valuation 8,472.40 NOTE: TO ENSURE PROPER CREDIT TO
Percent Taxable X 0.500 YOUR ACCOUNT, SUBMIT THE
Amount Subject to Tax 4,236.20 UPPER PORTION OF THIS NOTICE
Debts and Deductions - .00 WITH YOUR TAX PAYMENT TO THE
Taxable Amount 4,236.20 REGISTER OF WILLS AT THE
Tax Rate X .045 ABOVE ADDRESS. MAKE CHECK
Tax Due 190.63 OR MONEY ORDER PAYABLE TO:
TAX CREDITS: "REGISTER OF WILLS, AGENT."
PAYMENT RECEIPT DISCOUNT C+)
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
INTEREST IS CHARGED THROUGH 05-12-2015* TOTAL TAX PAYMENT .00
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 190.63
REVERSE SIDE OF THIS FORM INTEREST AND PEN. 10.52
TOTAL DUE 201 .15
* 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. P_\
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. \��Y�