HomeMy WebLinkAbout08-28-06
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
ri~I" r-tr:: f'}ltNHERITANCE TAX
,:1 "~"'RECORD ADJUSTMENT
t .JOINTl Y HELD OR TRUST ASSETS
*'
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
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DOUGLAS E FURST
260 SILVER SPRINGS RD
MECHANICSBURG PA 17055
REV-1604 EX AFP (03-05)
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN/DC
ACN
08-14-2006
FURST
09-10-2005
21 05-0858
CUMBERLAND
167-14-1868
05151252
Allount Rellitted
ANNA
E
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
+-
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REV-1604 EX AFP (03-05)
__ INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS --
DATE 08-14-2006
ESTATE OF FURST
ANNA
COUNTY
CUMBERLAND
E DATE OF DEATH 09-10-2005
ACN
05151252
FILE NO. 21 05-0858
ADJUSTMENT BASED ON:
S.S/D.C. NO. 167-14-1868
ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: VARTAN NATIONAL BANK
ACCOUNT NO. 1918184
TYPE OF ACCOUNT: () SAVINGS (X) CHECKING () TRUST () TIME CERTIFICATE
DATE ESTABLISHED 06-30-2004
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 OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $I, 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.)
~
"EV-1~70 "" (6-88)
INHERITANCE TAX
EXPLANATION
OF CHANGES
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG PA 17128-0601
DECEDENTS NAME
FilE NUMBER
2105-0858
05151252
Anna E. Furst
ACN
REVIEWED BY
Colin O'Malley
ITEM
SCHEDULE NO.
EXPLANATION OF CHANGES
The above account has been removed as it was already reported on the probate return.
ROW
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