HomeMy WebLinkAbout02-13-09BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBDRG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
<,_;',"~f i j~~ ~~~~1~~IH~~RITANCE TAX
~i~,Cfy1tD ADJUSTMENT
~ i:.; ~;(9i[~4~T ,~ ~~#~LD OR TRUST ASSETS
2009 FEB 13 PM 1 ~ 41
QFiP~i~~n~',~ COUNT
CHARLES SHAMBAUGH(;~J4' _. I~) ',(` , PA
344 WALNUT ST
LEMOYNE PA 17043
REV-1604 EX AFP (01-09)
DATE 02-09-2009
ESTATE OF SHAMBAUGH MARY J
DATE OF DEATH 07-07-2007
FILE NUMBER 70 0370044 ~ ~,~- ((~ ' ~~~~~
COUNTY CUMBERLAND
SSN/DC 203-10-7990
ACN 07145383
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
CUMBERLAND C;0 COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~- RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV-1604 EX AFP CO1-09)
** INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS **
DATE 02-09-2009
ESTATE OF SHAMBAUGH MARY J DATE OF DEATH 07-07-2007 COUNTY CUMBERLAND
FILE N0. 70 0370044 S.S/D.C. N0. 203-10-7990 ACN 07145383
ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: PNC BANK ACCOUNT N0. 5140056682
TYPE OF ACCOUNT: C ) SAVINGS (X) CHECKING C ) TRUST C ) TIME CERTIFICATE
DATE ESTABLISHED 01-08-2001
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
5,242.87 NOTE:
X 0.500
2,621.44
2,621.44
.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
* IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN 61, 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-7470 EX (8-88)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
PO Box. 280601
HARRISBURG. PA 17128-0601
ENT'S NAME
INHERITANCE TAX
EXPLANATION
OF CHANGES
1- IL.G IV VIVIOCR
Mary J. Shambaugh 700370044
REVIEWED BY ACN
Eunice Baker 07145383
ITEM
SCHEDULE NO.
EXPLANATION OF CHANGES
A portion of the deductions submitted have been approved. There is no tax due en this
account.
Row Page 1