HomeMy WebLinkAbout01-08-07
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
., !'[:X'i'~!HtRITANCE TAX
"R'E'CORD ADJUSTMENT
"Jo;fNTI..V ,HELD OR TRUST ASSETS
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 2B0601
HARRISBURG PA 17128-0601
'*
REV-1604 EX AFP (03-05)
~ pt.1 2' 52 DATE
2GBl JAj~ -8 11' ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN/DC
ACN
CONNIE L THOMPSON
2712 LISBURN RD
CAMP HILL
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PA 17011
CUT ALONG THIS LINE
12-18-2006
THOMPSON
02-14-2006
21 06-0376
CUMBERLAND
185-24-4943
06128191
J
SHIRLEY
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
4-
....-..-...-------..--------..------....-----------...--------------..---..--------------------..---..-------------------..--------------..-----------..
REV-1604 EX AFP (03-05J
-- INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS __
DATE 12-18-2006
ESTATE OF THOMPSON
SHIRLEY
CUMBERLAND
J DATE OF DEATH 02-14-2006
F I L E NO. 21 06- 0376
ADJUSTMENT BASED ON:
COUNTY
S.S/D.C. NO. 185-24-4943
ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: PSECU
ACN
06128191
ACCOUNT NO.
0185244943
TYPE OF ACCOUNT: (X) SAVINGS () CHECKING () TRUST () TIME CERTIFICATE
DATE ESTABLISHED 02-05-1991
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 ,00
* IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION DF 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.)
Cb
.
REV.!470 EX'(6-88)
'*
INHERITANCE TAX
EXPLANATION
OF CHANGES
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
PO Box 280601
HARRISBURG PA 17128-0601
DECEDENrS NAME
FILE NUMBER
Shirley J Thompson
REVIEWED BY
ACN
2106-0376
06128191
Department of Revenue I Teresa Seiders
ITEM
SCHEDULE NO.
EXPLANATION OF CHANGES
Above-referenced ACN(s) are being adjusted to reflect zero tax due since they have
been reported on the probate return.
ROW
PaQe 1