HomeMy WebLinkAbout12-17-08COMMONWEALTH OF PENNSYLVANIA
' DEPARTMENT OF REVENUE
INHERITANCE TAX
BUREAU OF INDIVIDUAL TAxES RECORD ADJUSTMENT
INHERITANCE TAX DIVISION JOINTLY HELD OR TRUST ASSETS
PO BOX 290601 REV-1604 EX AFP (03-05)
HARRISBURG PA 17128-0601 - -'
DATE 12-11-2008
~-,~1' r-'' f -~ ~''° ~`~• ~9STATE OF MORTIMORE ELIZABETH C
E. ~i s ~.;;~ L s 1` f i L• v
DATE OF DEATH 02-24-2008
FILE NUMBER 21 08-0537
~,~:_, , ,, ,_~- COUNTY CUMBERLAN
r' ~jrl ~ SSN/DC 540-30-2439
EDWARD F MORTIMORE L~Oti~~~ ~ ,; v~lf! ~~ ACN 08004586
HAZEN ELDER LAW STE 202 Amount Remitted
2000 LINGLESTOWN RD
HBG PA 17110
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE --'1 RETAIN LOWER PORTION FOR YOUR RECORDS f~
------------------------------------------------
REV-1604 EX AFP C03-05)
~~ INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS *~
DATE 12-11-2008
ESTATE OF MORTIMORE ELIZABETH C DATE OF DEATH 02-24-2008 COUNTY CUMBERLAND
FILE N0. 21 08-0537 S.S/D.C. N0. 540-30-2439 ACN 08004586
AT1_III~TMENT BASED ON : ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: PNC BANK ACCOUNT N0. 5002354366
TYPE OF ACCOUNT: (X) SAVINGS ( ) CHECKING ( ) TRUST C ) TIME CERTIFICATE
DATE ESTABLISHED 05-13-1985
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
4,824.05 NOTE:
X 0.166
804.02
_ 222.81
581.21
X .45
26.15
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."
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT (+)
INTEREST/PEN PAID C-) AMOUNT PAID
INTEREST IS CHARGED THROUGH 12-26-2008 TOTAL TAX CREDIT .00
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 26.15
REVERSE SIDE OF THIS FORM INTEREST AND PEN. .16
TOTAL DUE ,3
~ IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST,.
( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR),
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
REV-1470 EX (6-88)
INHERITANCE TAX
EXPLANATION
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE OF CHANGES
BUREAU OF INDIVIDUAL TAXES
PO Box 280601
HARRISBURG PA 17128-0601
DECEDENT'S NAME FILE NUMBER
Elizabeth C Mortimore 2108-0537
REVIEWED BY ACN
Department of Revenue 08004586
ITEM EXPLANATION OF CHANGES
SCHEDULE NO.
Deductions were added to this acn.
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