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HomeMy WebLinkAbout08-03-07 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX RECORD ADJUSTMENT c~rri~Y HELD OR TRUST ASSETS *' REV-1604 EX AFP (03-05) 2007 AUG -3 Prl 4: 22 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 07-23-2007 ONEILL 06-19-2006 21 06-0622 CUMBERLAND 213-26-7671 06151792 ROBERT C MARGARET L MATHE CLERK OF 1316 N HARVARD AV~~~g,~Cr.j,'? CQ~;RTD ARLINGTON HTS ~t:'. 60004 . I.A. 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 07-23-2007 ESTATE OF ONEILL ROBERT C DATE OF DEATH 06-19-2006 COUNTY CUMBERLAND FILE NO. 21 06-0622 ADJUSTMENT BASED ON: S.S/D.C. NO. 213-26-7671 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION ACN 06151792 FINANCIAL INSTITUTION: PNC BANK ACCOUNT NO. 5070088995 TYPE OF ACCOUNT: () SAVINGS (X) CHECKING () TRUST () TIME CERTIFICATE DATE ESTABLISHED 11-01-1978 Account Balance .00 NOTE: TO INSURE PROPER CREDIT TO YOUR Percent Taxable X 0.166 ACCOUNT, SUBMIT THE UPPER PORTION Amount Subject to Tax .00 OF THIS NOTICE WITH YOUR TAX Debts and Deductions .00 PAYMENT TO THE REGISTER OF WILLS Taxable Amount .00 AT THE ADDRESS SHOWN ABOVE. Tax Rate X .45 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 (-) 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 *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.)