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HomeMy WebLinkAbout12-15-06 (2) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE c!""r'(lnf'!Fccl' r,r:pr~~,ERITANCE TAX " ',',.11 iljc) :.Jt ! "1tECORD ADJUSTMENT ,r"'j 1 rt!,_ I"~ \~ENlFICIARY FORM ASSETS DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN BUREAU OF' INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG, PA 17128-0601 2006 DEe I 5 At111: 33 CLERK OF ORPi 'AI'I',,\ enl IDT DENISE L ANOLK" tr!n:-~i,\;,j '7'.'~,I\'D'\ POBOX 852 vu'k' x "" f\ MECHANICSBURG PA 17055-0000 CUT ALONG THIS LINE REY-l'DU EX AFP lll-D41 12-06-2006 ANOKA 07-18-2005 21 05-0722 CUMBERLAND 117-24-5745 05500662 Allount Rellitted RUTH A MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 --+ RETAIN LOWER PORTION FOR YOUR RECORDS +-- ---------------------------------------------------------------------------------------------------------------------------------------------------------------- REV-1604A EX AFP (01-03) -- INHERITANCE TAX RECORD ADJUSTMENT BENEFICIARY FORM ASSETS __ DATE 12-06-2006 ESTATE OF ANOKA RUTH CUMBERLAND A DATE OF DEATH 07-18-2005 FILE NO. 21 05-0722 ADJUSTMENT BASED ON: COUNTY S.S/D.C. NO. 177-24-5745 ADMINISTRATIVE CORRECTION BENEFICIARY FORM ASSETS NAME OF SECURITY: PPL TYPE OF ACCOUNT: (X) SECURITIES () SEC ACCT DOD Valuation 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: ACN 05500662 ACCOUNT NO. 309902189 ( ) STOCK ( ) BOND 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: IIREGISTER OF WILLS, AGENT.II PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 1l-07-2006 CD007420 .00 747.10 12-05-2006 REFUND .00 747.10- 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. I ( IF TOTAL DUE IS LESS THAN $I, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), c:c/ YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) REV-1470 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 DECEDENT'S NAME RUTH A ANOKA FILE NUMBER Judy Watts ACN 2105-0722 05500662 REVIEWED BY ITEM SCHEDULE NO. EXPLANATION OF CHANGES Above ACN has been zeroed out since it was already reported on the Inheritance Tax return. You will be receiving your refund in 4-6 weeks. ROW Paae 1