HomeMy WebLinkAbout06-08-15 (2) BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX
INHERITANCE TAX DIVISION APPRAISEMENT ALLANDOWANCE OR DISALLOWANCE pennsytvania
PC BOX 280601 OF DEDUCTION6 ASSESSMENT OF TAX ON
HARRISBURG, PA 17128-0401 SECURITY ACCOUNTS HELD DEPARTMENT OF REVENUE
IN I
FBENEFICIARY FORK REV-1548A AFP (11-14)
DATE 06-08-2015
ESTATE OF HARMON STACEY L
e% DATE OF DEATH 02-17-2015
0 FILE NUMBER 21 15-0228
R11V COUNTY CUMBERLAND
SSN/DC
SANDFCA-'L K`HARM-ON ACN 15502378
1�7SCENERY DR APPEAL BY DATE: 08-07-2015
M N I CSBURG PA 17050-1942 (See reverse side under Objections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
I COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE --# RETAIN LOWER PORTION FOR YOUR RECORDS --- - -- --- - - - --- - -
REV-1548A- AFP 011-14)
NOTICE OF INHERITANCE TAX APPRAISEMENTP ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS
AND ASSESSMENT OF TAX ON SECURITY ACCOUNTS HELD IN BENEFICIARY FORM
DATE: 06-08-2015
ESTATE OF: HARMON STACEY L DATE OF DEATH: 02-17-2015 COUNTY: CUMBERLAND
FILE NO. : 21 15-0228 S.S/D.C. NO. : ACN: 15502378
TAX RETURN WAS: (X) ACCEPTED AS FILED C )CHANGED
BENEFICIARY FORM OF ASSET INFORMATION
NAME OF SECURITY: AMERIPRISE ACCOUNT NO. : 93007777567
TYPE OF ASSET: C ) SECURITIES C X SECURITY ACC STOCK C ) BONDS
DOD Valuation 135,339.64 NOTE: TO ENSURE PROPER CREDIT TO
Percent Taxable X 0.500 YOUR ACCOUNT, SUBMIT THE
Amount Subject to Tax 67,669.82 UPPER PORTION OF THIS NOTICE
Debts and Deductions . 00 WITH YOUR TAX PAYMENT TO THE
Taxable Amount 67,669.82 REGISTER OF WILLS AT THE
Tax Rate X .045 ABOVE ADDRESS. MAKE CHECK
Tax Due 3,045, 14 OR MONEY ORDER PAYABLE TO:
"REGISTER OF WILLS, AGENT."
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID
05-11-2015 CD020638 152.26 2,892.88
TOTAL TAX PAYMENT 3,045.14
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.