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HomeMy WebLinkAbout04-11-08 BUREAU O~ INOIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 28060X HARRISBURG PA 11128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS REV-1604 EX AFP (03-05) 2008 APR 11 PH I: 02 JANET 168 LOCUST DILLSBURG ('Lr"OV l"\C \j Ci If\. )1 ORPHA\fS C:()tJRT MA ~~!trs GROVE RD PA 17019-9614 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 04-03-2008 DOTTER 09-09-2006 21 06-0819 CUMBERLAND 112-05-4168 07103246 HELEN C 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 4- ..----------....................---...---------........-.-.-.-.-.-.....-.-------.--.-.-.-.-.-.....-.-.----------------.--.-.-.....-----.-.-.....-------.------... REV-1604 EX AFP (03-05) ** INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS ** DATE 04-03-2008 ESTATE OF DOTTER HELEN C DATE OF DEATH 09-09-2006 COUNTY CUMBERLAND FILE NO. 21 06-0819 ADJUSTMENT BASED ON: S.S/D.C. NO. 112-05-4168 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION ACN 07103246 FINANCIAL INSTITUTION: CITIZENS BANK OF PA ACCOUNT NO. 6140221404 TYPE OF ACCOUNT: (X) SAVINGS () CHECKING () TRUST () TIME CERTIFICATE DATE ESTABLISHED 06-16-1997 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 .15 .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 no 31 IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. r, ( IF TOTAL DUE IS LESS THAN *1. NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), ~ -- - -__..u~ .."" DCVCge::I' Sloe OF THIS FORM FOR INSTRUCTIONS.) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES PO Box 280601 HARf':ISBURG PA 17128-0601 DECEDENT'S Nt,ME REV-1470 EX (6-88) REVIEWED BY ITEM SCHEDULE NO. INHERITANCE TAX EXPLANATION OF CHANGES FILE NUMBER Helen Dotter Department of Revenuel Emerson Luciano ACN EXPLANATION OF CHANGES The above referenced ACN has been reduced to zero, as this account was reported on the probate return. 2106-0819 07103246 Paqe 1