HomeMy WebLinkAbout10-30-06
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
.~~r,-\rr-."'i\ rnR.6CORD ADJUSTMENT
}..':::i.. : "'.JbINTL V.HELD OR TRUST ASSETS
BUREAV OF INDIVIDUAL TAXES
r INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
7.0D5 OCT 30 Pri 3: 3 I
KEVIN W DERMODY
55 CHERRY LN
CARLISLE
ORF"!'
0"
PA 17013
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CUT ALONG THIS LINE
REV-1604 EX AFP (03-05)
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSNI'DC
ACN
10-18-2006
DERMODY
03-16-2005
21 05-0356
CUMBERLAND
077-24-9073
05131533
DOROTHY
A
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
--+ RETAIN LOWER PORTION FOR YOUR RECORDS
+-
---------------------------------------------------------------------------------------------------..--------------------------------------------------------------
REV-1604 EX AFP (03-05)
-- INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS __
DATE 10-18-2006
ESTATE OF DERMODY
DOROTHY
CUMBERLAND
A DATE OF DEATH 03-16-2005
FILE NO. 21 05-0356
ADJUSTMENT BASED ON:
COUNTY
S.S/D.C. NO. 077-24-9073
ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: PNC BANK
ACN
05131533
ACCOUNT NO. 5070096848
TYPE OF ACCOUNT: () SAVINGS (X) CHECKING () TRUST () TIME CERTIFICATE
DATE ESTABLISHED 07-06-1989
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Due
.00
0.500
.00
.00
.00
.45
.00
TAX CREDITS:
NOTE: TO INSURE PROPER CREDIT TO YOUR
ACCOUNT, SUBMIT THE UPPER PORTION
OF THIS NOTICE WITH YOUR TAX
PAYMENT TO THE REGISTER OF WILLS
AT THE ADDRESS SHOWN ABOVE.
MAKE CHECK OR MONEY ORDER PAYABLE
TO: "REGISTER OF WILLS, AGENT."
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE nn
· IF PAID AFTER THIS DATE. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1. NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR).
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
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BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
RECORD ADJUSTMENT
JOINTLY HELD OR TRUST ASSETS
REV-1604 EX AFP (03-05)
KEVIN W DERMODY
55 CHERRY LN
CARLISLE PA 17013
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN/DC
ACN
10-18-2006
DERMODY
03-16-2005
21 05-0356
CUMBERLAND
077-24-9073
05131554
Allount Rellitted
DOROTHY
A
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE
--+ RETAIN LOWER PORTION FOR YOUR RECORDS
+-
------------------------------------------------------------------------------------------------------------------------------------------------------------------
REV-1604 EX AFP (03-05)
-- INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS __
DATE 10-18-2006
ESTATE OF DERMODY
DOROTHY A DATE OF DEATH 03-16-2005
COUNTY
CUMBERLAND
FILE NO. 21 05-0356
ADJUSTMENT BASED ON:
S.S/D.C. NO. 077-24-9073
ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
ACN
05131554
FINANCIAL INSTITUTION: PNC BANK
ACCOUNT NO. 5070062015
TYPE OF ACCOUNT: () SAVINGS (X) CHECKING () TRUST () TIME CERTIFICATE
DATE ESTABLISHED 06-01-1990
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Due
.00
0.500
.00
.00
.00
.45
.00
NOTE: TO INSURE PROPER CREDIT TO YOUR
ACCOUNT, SUBMIT THE UPPER PORTION
OF THIS NOTICE WITH YOUR TAX
PAYMENT TO THE REGISTER OF WILLS
AT THE ADDRESS SHOWN ABOVE.
MAKE CHECK OR MONEY ORDER PAYABLE
TO: "REGISTER OF WILLS, AGENT."
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .nn
· IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1, NO PAYI1ENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR),
YOU I1AY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORI1 FOR INSTRUCTIONS.)
v
REV-1470 EX (6-88)
INHERITANCE TAX
EXPLANATION
OF CHANGES
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG PA 17128-0601
DECEDENT'S NAME
REVIEWED BY
DOROTHY DERMODY
FILE NUMBER
PHYLLIS HOCH
ACN
2105-0356
05131533,05131554
SCHEDULE
ITEM
NO.
EXPLANATION OF CHANGES
The above referenced ACN has been reduced to zero, as this account was reported on the
probate return.
Paqe 1