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HomeMy WebLinkAbout03-23-07 "';r-' ,,-.,..:r,, !-'I!'.t- -'. ~,""'" I :f)' ji~'; BUREAU OF INDIVIDUAL'::TAiE$cf~ INHERITANCE TAX DIVISION i " I ~ f I PO lOX 280'01 . ". ~ HARRISIURG PA 17128-0'01 COMMONWEALTH Of PENNSYLVANIA DEPAR~NT 'F REVENUE INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS '* REV-l'04 EX AFP (03-05) ZG01I'll\R 23 AI'! 10: 36 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 03-15-2007 FRANCIS 09-04-2006 21 06-0834 CUMBERLAND 202-24-7489 06159517 ELSIE M Cr ir"',l/ ('"",r- Ltf~l'\ l,jr- ORPf".l/~,,r\r.s C>~~:!..JRT JOSEPH CUt.i!:~~~~~~D:E~1 14 MALLARD CT MECHANICSBURG PA 17055 Amount R.mitted 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 ~ b. ....L.________._._____... REV-1604 EX AFP (03-05) .. INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS .. DATE 03-15-2007 ESTATE OF FRANCIS ELSIE M DATE OF DEATH 09-04-2006 COUNTY CUMBERLAND FILE NO. 21 06-0834 ADJUSTMENT BASED ON: S.S/D.C. NO. 202-24-7489 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION ACN 06159517 FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 252074-40 TYPE OF ACCOUNT: () SAVINGS () CHECKING () TRUST (X) TIME CERTIFICATE DATE ESTABLISHED 10-05-2004 Account Balance .00 NOTE: TO INSURE PROPER CREDIT TO YOUR Percent Taxable X 0.500 ACCOUNT, SUBMIT THE UPPER PORTION A.ount Subject to Tax .00 OF THIS NOTICE WITH YOUR TAX Debts and Deductions .00 PAYMENT TO THE REGISTER OF WILLS Taxable A.ount .00 AT THE ADDRESS SHOWN ABOVE. Tax Rate X .15 MAKE CHECK OR MONEY ORDER PAYABLE Tax Due .00 TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 12-26-2006 CD007649 .00 3,022.65 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE * IF PAID AFTER THIS DATE. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $I I NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) 3,022.65 3,022.65CR .00 (CR). an * ,. . '\ INHERITANCE TAX EXPLANATION OF CHANGES REV.1470 EX <-l COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDMDUAL TAXES PO Box 280601 HARRISBURG PA 17128-0601 DECEDENT'S NAME FILE NUMBER REVIEWED BY ACN 2106-0834 06159517 Elsie M. Francis Joan Peters ITEM SCHEDULE NO. EXPLANATION OF CHANGES The above referenced Account Control Number has been adjusted to zero since the Joint bank account was reported on the Inheritance Tax Return. ROW PaQe 1