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HomeMy WebLinkAbout06-29-07 (4) - COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS *' r,~r'('\f,r',T'\ nr-'l"f- lUREAU OF INDIVIDUAL TAxa ,-I 11.'::'l) \) '\'~I= INHERITANCE TAX DIVISION 'X-:r~"'i:T; PO BOX 280&01 . """'J'; I .... . HARRIS8URG PA 17128-0&01 REV-1&04 EX AFP (03-05) 2001 JUN 29 PH I: 03 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 06-27-2007 HAKE 02-03-2007 21 07-0151 CUMBERLAND 191-18-3999 07113353 ELNORA E CLERf\ OF ORPHAN'S COURT BOBBETTE ClJta:~s8~i\ .-. . PA 826 ACRI RD MECHANICSBURG PA 17050 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 06-27-2007 ESTATE OF HAKE EL NORA E DATE OF DEATH 02-03-2007 COUNTY CUMBERLAND FILE NO. 21 07-0151 ADJUSTMENT BASED ON: S.S/D.C. NO. 191-18-3999 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION ACN 07113353 FINANCIAL INSTITUTION: COMMERCE BANK ACCOUNT NO. 513172536 TYPE OF ACCOUNT: () SAVINGS (X) CHECKING () TRUST () TIME CERTIFICATE DATE ESTABLISHED 09-08-2005 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 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." TAX CREDITS: 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 nn II IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF 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 R OF REVE SE SIDE THIS FORM FOR INSTRUCTIONS.) , COMMONWEALTH OF PENNSYLVANIA D~*~~~~ r~~ RE~ENUE ,=.J:aj.tltltl-t ANC€r:T~)( RiEt.p~DQAD~U$iT,~ENT JOINTLY HEL~:OR l~UST ASSETS '*' . BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 2B0601 HARRISBURG PA 17128-0601 REV-1604 EX AFP (03-05) BOBBETTE 826 ACRI RD MECHANICS BURG LARSON 2007 JUN 29 ,. ES~ ji30F CG(~t~~~J.?~~~"~~:TH 06-27-2007 HAKE 02-03-2007 21 07-0151 CUMBERLAND 191-18-3999 07112292 ELNORA E Amount Remitted PA 17050-2232 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 06-27-2007 ESTATE OF HAKE ELNORA E DATE OF DEATH 02-03-2007 COUNTY CUMBERLAND FILE NO. 21 07-0151 ADJUSTMENT BASED ON: S.S/D.C. NO. 191-18-3999 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION ACN 07112292 FINANCIAL INSTITUTION: CLEARVIEW FCU ACCOUNT NO. 10278783 TYPE OF ACCOUNT: (X) SAVINGS () CHECKING () TRUST () TIME CERTIFICATE DATE ESTABLISHED 07-08-1997 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 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." TAX CREDITS: 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 ""Db II IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF 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.) ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 2B0601 HARRISBURG PA 1712B-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE PECOP,.D,ED ,O!tl. ."~~fI"ANCE TAX ., -,r, " !'.~ ~c.tJ n ADJUSTMENT Hb.-'JOitMtL'r.ff I"p OR TRUST ASSETS *' REV-1604 EX AFP (03-05) BOBBETTE 826 ACRI RD MECHANICSBURG LARSON 2007 JUN 29 PH I: 04 DATE ESTATE OF DATE OF DEATH CLERK OF FILE NUMBER ORPHAN'S COURT COUNTY CUf,!flf-:-r)i",'r,r'.'1,. D.^ SSN/DC , . . '.', ' t'\ ACN 06-27-2007 HAKE 02-03-2007 21 07-0151 CUMBERLAND 191-18-3999 07112293 EL NORA E Amount Remitted PA 17050-2232 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 06-27-2007 ESTATE OF HAKE ELNORA E DATE OF DEATH 02-03-2007 COUNTY CUMBERLAND F I L E NO. 21 07- 0 151 ADJUSTMENT BASED ON: S.S/D.C. NO. 191-18-3999 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION ACN 07112293 FINANCIAL INSTITUTION: CLEARVIEW FCU ACCOUNT NO. 10278783 TYPE OF ACCOUNT: () SAVINGS (X) CHECKING () TRUST () TIME CERTIFICATE DATE ESTABLISHED 07-08-1997 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 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." TAX CREDITS: 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 nn * IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. OIJ ( 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 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES PO Box. 280601 HARRISBURG PA 17128-0601 DECEDENT'S NAME FILE NUMBER Elnora E. Hake 2107-0151 REVIEWED BY ACN Eunice Baker 07113353,07112292, 07112293 ITEM SCHEDULE NO. EXPLANATION OF CHANGES The above account has been adjusted to zero. The account was reported on the probate return. ROW PaQe 1