HomeMy WebLinkAbout06-08-15 (4) BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX
INHERITANCE TAX DIVISION A PRAISEMENT ALLONANCE OR DISALLONANCE p e n n SyLVa ni a
C
PO BOX 280601 t� r r, n =t 0Y DEDUCTION.6 AND ASSESSMENT OF TAX ON
HARRISBURG, PA 17121SkFS-0R,1Ev :w ` SECURITY ACCOUNTS HELD IN DEPARTMENT OF REVENUE
': LS BENEFICIARY FORM Ul-�IIM AFP M-i11
REG!")7
��( �� 3"' ESTATE
06-08-2015
9015 JIN $ ESTATE OF HARMON STACEY L
DATE OF DEATH 02-17-2015
CLE; �" FILE NUMBER 21 15-0228
COUNTY CUMBERLAND
��QR�)i SSN/DC
SANDRA ACN SCE4W,DRl` APPEAL BY DATE?080
1223 07-2015
MECHANICSBURG PA 17050-1942 (See reverse side under Objections)
Amount Remitted I
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--
REV-1548A AFP (11-14) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
NOTICE OF INHERITANCE TAX APPRAISEMENT, 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: 15502380
TAX RETURN WAS: (X) ACCEPTED AS FILED C )CHANGED
BENEFICIARY FORM OF ASSET INFORMATION
NAME OF SECURITY: METLIFE ACCOUNT NO. : 32044123171
TYPE OF ASSET: C ) SECURITIES ( X SECURITY ACC C ) STOCK C ) BONDS
DOD Valuation 112,757. 17 NOTE: TO ENSURE PROPER CREDIT TO
Percent Taxable X 0.500 YOUR ACCOUNT, SUBMIT THE
Amount Subject to Tax 56,378.59 UPPER PORTION OF THIS NOTICE
Debts and Deductions - . 00 WITH YOUR TAX PAYMENT TO THE
Taxable Amount 56,378.59 REGISTER OF WILLS AT THE
Tax Rate X .045 ABOVE ADDRESS. MAKE CHECK
Tax Due 2,537.04 OR MONEY ORDER PAYABLE TO:
TAX CREDITS: "REGISTER OF WILLS, AGENT."
PAYMENT RECEIPT DISCOUNT C+)
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
05-11-2015 CD020638 126.85 2,410. 19
TOTAL TAX PAYMENT 2,537. 04
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. * (✓ 1
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.