HomeMy WebLinkAbout06-17-15 BpFfEK [N` VA TAC LS NOTICE OF INHERITANCE TAX •
I ITANCE TAX_DIVISION4A �� APPRAISEHENT LALLONANCE OR DISALLONANCEPO -, pt'1111S�/LVa11�a
HARVISBURG60PA {17128-0601 OF DEDUSECURI+YAND
ACCOUNTSASSESSMENT
HELD IN TAX ON DEPARTMENT OF REVENUE
BENEFICIARY FORK BEV-1548A AFP ui-w
MN 17 LTi l i `�3
DATE 06-15-2015
C L
OF ESTATE OF BREITENBACH JOSEPH H
c „n _ DATE OF DEATH 04-11-2015
Qi�t� �;ti C � � FILE NUMBER 21 15-0428
C� F.�.� r,r) COUNTY CUMBERLAND
SSN/DC
PENNY P TORRENCE ACN 15503683
18900 CHIMNEY PL APPEAL BY DATE: 08-14-2015
MONTGOMRY VLG MD 20886-3140 (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
REV-1548A AFP (11-14) -
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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: 06-15-2015
ESTATE OF:BREITENBACH JOSEPH H DATE OF DEATH: 04-11-2015 COUNTY: CUMBERLAND
FILE NO. : 21 15-0428 S.S/D.C. NO. : ACN: 15503683
TAX RETURN WAS: (X) ACCEPTED AS FILED C )CHANGED
BENEFICIARY FORM OF ASSET INFORMATION
NAME OF SECURITY: EDWARD JONES ACCOUNT NO. : 37715620
TYPE OF ASSET: C ) SECURITIES ( X SECURITY ACC C ) STOCK C ) BONDS
DOD Valuation 641,247.72 NOTE: TO ENSURE PROPER CREDIT TO
Percent Taxable X 1 .000 YOUR ACCOUNT, SUBMIT THE
Amount Subject to Tax 641 ,247.72 UPPER PORTION OF THIS NOTICE
Debts and Deductions - .00 WITH YOUR TAX PAYMENT TO THE
Taxable Amount 641,247.72 REGISTER OF WILLS AT THE
Tax Rate X .045 ABOVE ADDRESS. MAKE CHECK
Tax Due 28,856. 15 OR MONEY ORDER PAYABLE TO:
TAX CREDITS: "REGISTER OF WILLS, AGENT."
PAYMENT RECEIPT DISCOUNT (+)
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
05-19-2015 CD020700 1,442.81 27,413.34
TOTAL TAX PAYMENT 28,856. 15
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.