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HomeMy WebLinkAbout12-17-08 (2)COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 REV-1604 EX AFP C03-05) DATE 12-11-2008 ESTATE OF MORTIMORE ELIZABETH C DATE OF DEATH 02-24-2008 FILE NUMBER 21 08-0537 COUNTY CUMBERLAND SSN/DC 540-30-2439 ACN 08004584 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 ~.~-.r-.i ~-„- EDWARD F MORTIMORE~~~f~ ~ :] _ ,,, , HAZEN ELDERLAW STE 20 2000 LINGLESTOWN RD HBG PA 17110 CUT ALONG THIS LINE ~ 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 08004584 ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: PNC BANK ACCOUNT N0. 5005250722 TYPE OF ACCOUNT: ( ) SAVINGS (X1 CHECKING C ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 06-04-1982 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAX CREDITS: INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS ?~`~i .~~G 9 ~ I'i'i ~:J: ~~ 2,314.07 NOTE: X 0.166 385.69 385.69 00 X .45 .00 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 TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 ~ ^ 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 (E88) .~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES PO Box 280601 DECEDENT'S NAME REVIEWED BY Elizabeth C Mortimore Department of Revenue NUMBER 2108-0537 08004584 ITEM SCHEDULE NO. EXPLANATION OF CHANGES Deductions were added to this acn. INHERITANCE TAX EXPLANATION OF CHANGES Row Page 1