HomeMy WebLinkAbout04-04-08 (2)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
::C "r [."[1"' OFP0C nc
; ,.__Cdl :;);.i) , I l~iL.IWHERITANCE TAX
i~q::~-;FT r-'. ,/,!*EtORD ADJUSTMENT
-~'- e'Jcl1NTtY"-HELD OR TRUST ASSETS
'*
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601.
HARRISBURG PI, 17128- 0601
2008 APR -4 PH I: 55
CLERK OF
ORPHpN'S COURT
ClH."i:-:=~.i" i"~i. PA
OBRIEN
MICHAEL
APT 3
4l~00 WARRINGTON
MECHANICSBURG
AVE
PA 17055
REV-1604 EX AFP (03-05)
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN/DC
ACN
03-26-2008
OBRIEN
01-20-2007
21 07-0101
CUMBERLAND
182-22-7360
07111309
C
LILLIAN
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 03-26-2008
ESTATE OF OBRIEN
LILLIAN
CUMBERLAND
C DATE OF DEATH 01-20-2007
COUNTY
ACN
07111309
FILE NO. 21 07-0101
ADJUSTMENT BASED ON:
S.S/D.C. NO. 182-22-7360
ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1ST FCU
ACCOUNT NO.
49432-00
TYPE OF ACCOUNT: (X) SAVINGS () CHECKING () TRUST () TIME CERTIFICATE
DATE ESTABLISHED 01-08-1986
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Due
.00
0.166
.00
.00
.00
.45
.00
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
DA.TE NUMBER INTEREST/PEN PAID (-)
02-14-2008 CD009306 .00 6.19
TOTAL TAX CREDIT 6.19
BALANCE OF TAX DUE 6.19CR
INTEREST AND PEN. .00
TOTAL DUE {;. 19CR
* 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). r J
'uU -- -"- . n....../I..n <,,::~ ~~V!=RSE SIDE OF THIS FORM FOR INSTRUCTIONS.) 0