HomeMy WebLinkAbout03-20-09 (2)COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
~. ~'~ .. .
.BUREAU OF INDIVIDUAL TAxES - k HERITANCE TAX
INHERITANCE TAX DIVISIDN ~ 'RECORD ADJUSTMENT
PD BOX 280601 jJOZNT•LY HELD OR TRUST ASSETS
HARRISBURG PA 17128-0601 REY-1604 IX AFP (O1-09)
~'~~~ ~~~ 2~ ~~ I2~ 2 ~ -2009
ESTATE OF KAUTZ
JANET L
DATE OF DEATH 02-26-2007
C~E~~ O~ FILE NUMBER 21 07-0852
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L
JOHN LUCY
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DC
ACN 202
20
2047
0'7134264
LOT 9A ,
Amount Remitted
124 WOODS
MECHANICSBURG PA 17050
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 YDUR RECORDS ~
REV-1604 EX AFP (01-09)
** INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS **
DATE 03-03-2009
ESTATE OF KAUTZ JANET L DATE OF DEATH 02-26-2007 COUNTY CUMBERLAND
FILE N0. 21 07-0852 S.S/D.C. N0. 202-20-2047 ACN 07134264
ADJUSTMENT BASED ON : ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MID PENN BANK ACCOUNT N0. 416011089
TYPE OF ACCOUNT: C ) SAVINGS C ) CHECKING C ) TRUST CX) TIME CERTIFICATE
DATE ESTABLISHED 04-15-2005
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
00
X 0.500
.00
.00
.00
X .15
.00
NOTE: TD 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
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID (-) 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.
C 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 (6-66)
R'
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
PO Box. 280601
HARRISBURG. PA 17128-0601
DECEDENT'S NAME
Janet L. Kautz
REVIEWED BY
Eunice Baker
INHERITANCE TAX
EXPLANATION
OF CHANGES
2107-0852
07134264
ITEM
SCHEDULE NO, EXPLANATION OF CHANGES
The above account has been adjusted to zero as the account was reported on the probate
return.
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