HomeMy WebLinkAbout06-22-15 BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX
INHERITANCE TAX DIVISION APPRAISEMENT ALLONANCE OR DISALLONANCE pe n n sy Lva rn a
PO BOX 280601 OF DEDUCTION AND ASSESSMENT OF TAX ONQV
HARRISBURG, rl 2 660} SECURI'PY ACCOUNTS HELD IN DEPARTMENT OF REVENUE
ri-0�"�It'D OFFICE O F BENEFICIARY FORM REW-1548A AFP (11-14)
REGIS i E;, "T WILLS
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DATE 06-22-2015
ESTAEBRSLE
2-015 UJUN 22 ~M 12 25 DATETOFODEATH 10-30-2014 MARY J
FILE NUMBER 21 15-0194
CLE0 F COUNTY CUMBERLAND
ROBET �'H`itrCBRSOE.E SSN/DC
ACN 15500396
60T,MJAMI:LTON,'1'-STR' ETPA APPEAL BY DATE: 08-21-2015
CARLISLE PA 17 013 (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 THISLINE --4 RETAIN LOWER PORTION FOR YOUR RECORDS
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: 06-22-2015
ESTATE OF:EBERSOLE MARY J DATE OF DEATH: 10-30-2014 COUNTY: CUMBERLAND
FILE NO. : 21 15-0194 S.S/D.C. NO. : ACN: 15500396
TAX RETURN WAS: (X) ACCEPTED AS FILED C )CHANGED
BENEFICIARY FORM OF ASSET INFORMATION
NAME OF SECURITY: AMERIPRISE FINANCIAL ACCOUNT NO. : 18730439
TYPE OF ASSET: C ) SECURITIES ( X SECURITY ACC C ) STOCK C ) BONDS
DOD Valuation 6,209.58 NOTE: TO ENSURE PROPER CREDIT TO
Percent Taxable X 0.500 YOUR ACCOUNT, SUBMIT THE
Amount Subject to Tax 3, 104.79 UPPER PORTION OF THIS NOTICE
Debts and Deductions - .00 WITH YOUR TAX PAYMENT TO THE
Taxable Amount 3,104.79 REGISTER OF WILLS AT THE
Tax Rate X .045 ABOVE ADDRESS. MAKE CHECK
Tax Due 139.72 OR MONEY ORDER PAYABLE TO:
TAX CREDITS:
"REGISTER OF WILLS, AGENT."
PAYMENT RECEIPT DISCOUNT C+)
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
04-18-2015 CD020542 .00 139.72
TOTAL TAX PAYMENT 139.72
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. \�vj✓�`
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.