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HomeMy WebLinkAbout09-08-15 BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX POHBOX T280601 ANCE TAX DIVISION OFDEDUCTIONSAANDNASSESSMENTANCE OR SOFLTAX ON pe n n SyLVa rn a ORANCE HARRISBURG, PA 17128-0601 _ SECURIfPY ACCOUNTS HELD IN DEPARTMENT OF REVENUE RECORDED Q r E i C` OF BENEFICIARY FORM REQ-1548A aFP (11-14) REGISTER OF 1'r'i LS DATE 09-07-2015 ESTATE OF FREEDMAN RUTH C ?015 SE!p 8 IPI�p 112 L12 DATE OF DEATH 06-09-2015 FILE NUMBER 21 15-0669 COUNTY CUMBERLAND CLEC ` " SSN/DC BRENDA CjR""k NE ACN 15506484 8 S FRONTC5WERt -A APPEAL BY DATE: 11-06-2015 WORMLEYSBURG PA 17043-1329 (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 4— - - - REV-- - -1548A- - - - - - AFP-C1- -1--14)- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- --------- - - - - - - - - - - - - - - - NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ON SECURITY ACCOUNTS HELD IN BENEFICIARY FORM DATE: 09-07-2015 ESTATE OF: FREEDMAN RUTH C DATE OF DEATH: 06-09-2015 COUNTY: CUMBERLAND FILE NO. : 21 15-0669 S-S/D-C. NO. : ACN: 15506484 TAX RETURN WAS: (X) ACCEPTED AS FILED C )CHANGED BENEFICIARY FORM OF ASSET INFORMATION NAME OF SECURITY: EATON VANCE INVESTMENT ACCOUNT NO. : 5004090022 TYPE OF ASSET: ( ) SECURITIES C X SECURITY ACC C ) STOCK C ) BONDS DOD Valuation 18,363. 11 NOTE: TO ENSURE PROPER CREDIT TO Percent Taxable X 0.200 YOUR ACCOUNT, SUBMIT THE Amount Subject to Tax 3,672.62 UPPER PORTION OF THIS NOTICE Debts and Deductions - .00 WITH YOUR TAX PAYMENT TO THE Taxable Amount 3,672.62 REGISTER OF WILLS AT THE Tax Rate X .045 ABOVE ADDRESS. MAKE CHECK Tax Due 165.27 OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT C+) DATE NUMBER INTEREST/PEN PAID C-) AMOUNT PAID 08-03-2015 CD021069 8.26 157.01 TOTAL TAX PAYMENT 165.27 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. 1/