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HomeMy WebLinkAbout84-0478COMMONWEALTH OF PENNSYLVANIA BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-060 1 INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS REV-1605 EX ~FP c01-03) DATE 02-05-2004 - ~ ~- ESTATE OF FOLTZ BERTHA DATE OF DEATH 08-25-1983 FILE NUMBER 21 84-0478 ~- : • ~ " COUNTY CUMBERLAND ~~ ~~-~ ~~ ~ ~ SSN/DC 203-10-9418 BARBARA M OVERHEIM ACN 83021921 601 JULIE DR GALLUP NM 87311~f~ - ~° amount Renittea tl-...+.- ._ MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS -~ ---------------------------------------------------------------------------------------------------------------- REV-1604 EX AFP (01-031 ** INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS *~ DATE 02-05-2004 ESTATE OF FOLTZ BERTHA DATE OF DEATH 08-25-1983 COUNTY CUMBERLAND FILE ND. 21 84-0478 S.S/D.C. NO. 203-10-9418 ACN 83021921 ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: CUMBERLAND VALLEY SAVINGS ACCOUNT N0. 01-139519 TYPE OF ACCOUNT: (X) SAVINGS ( ) CHECKING C ) TRUST C ) TIME CERTIFICATE DATE ESTABLISHED 01-11-1963 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAX CREDITS: 14,504.88 NOTE: X 0.500 7,252.44 .oa 7,252.44 X .06 435.15 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 A80VE. MAKE CHECK OR MONEY ORDER PAYABLE T0: "REGISTER OF WILLS, AGENT." PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID 01-18-1996 AMNP PEN 140.42 .00 02-04-2004 WRITEOFF .00 1,346.49 NOTE: AMNESTY NP PENALTY ASSESSED TOTAL TAX CREDIT 435.15 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 S1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" [CR), - ---- - ~«~~•~.+ ccc RFUFRSE SIDE OF THIS FORM FOR INSTRUCTIONS.) REV-1470 EX (6.88) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG. PA 17128-0601 DECEDENT'S NAME Foltz, Bertha Steven James INHERITANCE TAX EXPLANATION OF CHANGES FILE NUMB 29 84-0478 83021921 ITEM '~yCHEDULE NO, EXPLANATION OF CHANGES The Department of Revenue has waived the balance due as uncollectable. However, the department reserves the right to collect the tax, penalty and interest at a later date. Page 1