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HomeMy WebLinkAbout01-11-08 BUREAU OF INL1V:DWAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS REV-160~ EX AFP (03-05) MATTHEW K WAGNER 13 HOMESTEAD LN CAMP HILL r" , :r; I [ I If. ! 9DATE 01-07-2008 " '-i- i- ESTATE OF POWELL DATE OF DEATH 08-12-2006 , ' (-";~. FILE NUMBER 21 06-0730 Ir'T COUNTY CUMBERLAND SSN/DC 174-20-6085 ACN 06152630 Amount Remitted JEAN D PA 17011 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 01-07-2008 ESTATE OF POWELL JEAN D DATE OF DEATH 08-12-2006 COUNTY CUMBERLAND FILE NO. 21 06-0730 ADJUSTMENT BASED ON: S.S/D.C. NO. 174-20-6085 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION ACN 06152630 FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 261572-53 TYPE OF ACCOUNT: () SAVINGS () CHECKING (X) TRUST () TIME CERTIFICATE DATE ESTABLISHED 03-16-2005 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 PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), ~ YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) REV-147Q 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 FILE NUMBER Jean D. Powell REVIEWED BY ACN 2106-0730 06152630 Eunice Baker 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