HomeMy WebLinkAbout12-17-08 (3)COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL raxES ~ ~ .INHERITANCE TAX
INHERITANCE TAX D~V?SIDN, ~ RECORD ADJUSTMENT
Pa Box 2Ba6o1 - -~JO-INTtY-HELD OR TRUST ASSETS
HARRISBURG PA 17128-0601
REV-1604 EX AFP (03-05)
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LISA HAUENST~FV`~~ -'
391 SHERWDOD DR
CARLISLE PA 17015
CUT ALONG THIS LINE ---) RETAIN LOWER PORTION FOR YOUR RECORDS E--
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REV-1604 EX AFP C03-05~
~* INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS *~
DATE 12-04-2008
ESTATE OF PETERSON MINNIE K DATE OF DEATH 09-13-2007 COUNTY CUMBERLAND
FILE N0. 21 07-1109 S.S/D.C. N0. 168-34-2100 ACN 07146323
ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1ST FCU
DATE 12-04-2008
ESTATE OF PETERSON MINNIE K
DATE OF DEATH 09-13-2007
FILE NUMBER 21 07-1109
COUNTY CUMBERLAND
SSN/DC 168-34-2100
ACN 07146323
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
CUMBERLAND C:0 COURT HOUSE
CARLISLE, PA 17013
ACCOUNT N0. 34999-11
TYPE OF ACCOUNT: C ) SAVINGS (X) CHECKING C ) TRUST C ) TIME CERTIFICATE
DATE ESTABLISHED 01-31-1992
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
00
X 0.166
.00
- .00
.00
X .45
.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
T0: "REGISTER OF WILLS, AGENT."
TAX CREDITS:
PAYMENT I RECEIPT DISCOUNT (+)
DATE NUMBER INTEREST/PEN PAID C-) AMOUNT PAID
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
* IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTERESDUE
C IF TOTAL DUE IS LESS THAN 51, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), L,..
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) fi
~ -, ~~, INHERITANCE TAX
. r ~~ ~-~~~, ~r~ < <,,~,~; ~ .,:~r~i,> EXPLANATION
~'Fi,~~rriri ~ ~ Er~uF
~~~rzFau r~r- ir~rnivin i~r rnxFS OF CHANGES
i~ti~,~ ~_~,_,~~„i
---
- -___- =-
i~E ~.I ul=Nr ~ Na.r,~~ -
_- - -:
-_-
Minnie Peterson Fi~_E Ivunu3Fr: `°'
rz E v l ~ ~-v l~r~ F3~ _ _ - ---- ----- ---- -- -
- - -- _ 2107-1109
-_-
__
- ___ __ -
ACN __-_ --- ----
e artment of Revenue/ Emerson Luciano 07146323
----
--
T E M ---------- ---- -- - ____ _ __ _ __
SCHEDULE NO.
EXPLANATION OF CHANGES
The above referenced ACN has been reduced to zero, as this account
was reported on the probate return.
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