HomeMy WebLinkAbout12-19-07
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 2B0601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
RECORD ADJUSTMENT
JOINTLY HELD OR TRUST ASSETS
*'
REV-1604 EX AFP (03-05)
2U01 DEe 19 PM 12: 40
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN/DC
ACN
12-07-2007
RANGE
07-27-2007
21 07-0985
CUMBERLAND
162-48-0958
07140162
STEPHANIE A
C1 r-r.l/ {'\:
JL'-\":,!\ ',,..Ii"
O"'~' I' ~ n('d IDT
Hr-:r/\\: :, \.),..11 1\^-
SHANE J RANC@,}'C:> "'.C"
1007 CHARLES ST
MECHANICSBURG PA 17055
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 12-07-2007
ESTATE OF RANGE
STEPHANIE A DATE OF DEATH 07-27-2007
COUNTY
CUMBERLAND
FILE NO.
21 07-0985
S.S/D.C. NO. 162-48-0958
ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
ACN
07140162
ADJUSTMENT BASED ON:
FINANCIAL INSTITUTION: MEMBERS 1ST FCU
ACCOUNT NO.
204497-00
TYPE OF ACCOUNT: (X) SAVINGS () CHECKING () TRUST () TIME CERTIFICATE
DATE ESTABLISHED 04-26-2001
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
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.)
4
~
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
DECEDENrS NAME
FILE NUMBER
STEPHANIE A. RANGE
REVIEWED BY
ACN
2107 -0985
07140162
MICHAEL KODOSKY
ITEM
SCHEDULE NO.
EXPLANATION OF CHANGES
This ACN has been adjusted to reflect zero tax due since it was billed to the wrong
survivor. The assessment on this ACN was mistakenly issued to Shane J. Range but
was instead to be issued to Dennis Range who is the spouse of the decedent.
A correct assessment has been issued under ACN 07002799 to Dennis Range on his
share of Members 1st Federal Credit Union savings account 204497-00.
ROW
Page 1