HomeMy WebLinkAbout08-03-15 BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX
INHERITANCE TAX DIVISION APPRAISEMENT ALLONANCE OR DISALLONANCE - �� pe n n SyLVa rn a
PO BOX 286601 OF DEDUCTION AND ASSESSMENT OF TAX ON
HARRISBURG, PA 17128- r SECURITY ACCOUNTS HELD IN DEPARTMENT OF REVENUE
t\�C O R D E D OFFICE O F BENEFICIARY FORM REV-1548A AFP (11-14)
REGIST-R OF WILLS DATE 08-03-2015
RORE
HIS 9JG 3 PM 12 03 DATETOFODEATH 04-20-2013 WILLIAM A
FILE NUMBER 21 13-1269
CLE1'-i K C)F COUNTY CUMBERLAND
SSN/DC
COLLEEN OR041R.tC CO,[ T ACN 14505955
1615 STALf9ERLAi,I� (,{ APPEAL BY DATE: 10-02-2015
DUNCANNON PA 17020-9538 (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 C11-14) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS
AND ASSESSMENT OF TAX ON SECURITY ACCOUNTS HELD IN BENEFICIARY FORM
DATE: 08-03-2015
ESTATE OF: ROHRER WILLIAM A DATE OF DEATH: 04-20-2013 COUNTY: CUMBERLAND
FILE NO. : 21 13-1269 S.S/D.C. NO. : ACN: 14505955
TAX RETURN WAS: (X) ACCEPTED AS FILED C )CHANGED
BENEFICIARY FORM OF ASSET INFORMATION
NAME OF SECURITY: CODORUS VALLEY BANCORP INC ACCOUNT NO. : 3200021985
TYPE OF ASSET: C ) SECURITIES C X SECURITY ACC C ) STOCK C ) BONDS
DOD Valuation 200,000.00 NOTE: TO ENSURE PROPER CREDIT TO
Percent Taxable X 1 .000 YOUR ACCOUNT, SUBMIT THE
Amount Subject to Tax 200,000.00 UPPER PORTION OF THIS NOTICE
Debts and Deductions - .00 WITH YOUR TAX PAYMENT TO THE
Taxable Amount 200,000.00 REGISTER OF WILLS AT THE
Tax Rate X .00 ABOVE ADDRESS. MAKE CHECK
Tax Due 00 OR MONEY ORDER PAYABLE TO:
TAX CREDITS: "REGISTER OF WILLS, AGENT."
PAYMENT RECEIPT DISCOUNT (+)
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
TOTAL TAX PAYMENT .00
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" CCR), YOU MAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.