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HomeMy WebLinkAbout03-30-07 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE ,INHERITANCE TAX R'ECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS '* BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280&01 HARRISBURG PA 17128-0&01 ~':DD7 ~HJ v, r!'I. I!: ? -J. t'll 1 ~ TRACEY LUNCH 612 W LOCUST ST CLEARFIELD PA 16830 REV-l&04 EX AFP (03-05) DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 03-22-2007 FRY 08-12-2005 21 06-0454 CUMBERLAND 200-32-2830 05149241 K HAZEL Amount Remitted 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 03-22-2007 ESTATE OF FRY HAZEL CUMBERLAND K DATE OF DEATH 08-12-2005 COUNTY ACN FILE NO. 21 06-0454 ADJUSTMENT BASED ON: S.S/D.C. NO. 200-32-2830 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION 05149241 ACCOUNT NO. 12122602 FINANCIAL INSTITUTION: CLEARFIELD BANK & TRUST CO TYPE OF ACCOUNT: () SAVINGS () CHECKING (X) TRUST () TIME CERTIFICATE DATE ESTABLISHED 10-10-1997 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due 4,892.63 0.333 1,630.86 .00 1,630.86 .45 73.39 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 (-) 06-11-2006 CD006825 .00 5.08 INTEREST IS CHARGED THROUGH 04-06-2007 TOTAL TAX CREDIT 5.08 AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 68.31 REVERSE SIDE OF THIS FORM INTEREST AND PEN. 4.52 TOTAL DUE 7? R~ * IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. J ( 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.) 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 Hazel K. Fry FILE NUMBER REVIEWED BY Laurel Fulmer ACN 2106-0454 05149241 ITEM SCHEDULE NO. EXPLANATION OF CHANGES The above referenced ACN has been adjusted to the lineal rate of 4.5% since the joint tenant is the grandchild of the decedent. ROW Page 1