HomeMy WebLinkAbout06-26-09COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES •- , LNHE~,ITANCE TAX
INHERITANCE TAX DIVISION ".`'R~,OQRIi ADJUSTMENT
PO Box 2soeB1 _JOIIV'FLY .HELD 0R TRUST ASSETS
HARRISBURG PA 17128-0601 !-~, ~~ ,,, REV-1604 IX AFP CO1-09)
r
t~9i DATE 06-11-2009
~u~J J~ii ~~ R~ ~: ~STATE OF HESSE ADELINE L
ATE OF DEATH 12-25-2007
CLERK CF COUNTYUMBER CUMBERLAND
ORP~4N~S (;Q{_Jt~j SSN/DC 099 -14 - 0289
MYRNA HILL r ~r1!_,hw`o.~ ,V~•
PO BOX 667 G~~~11!,..,., ~l ~~' R~ ACN 08129231
LEWISBURG WV 24701 Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE: PA 17013
CUT ALONG THIS LINE y RETAIN LOWER PORTION FOR YOUR RECORDS !'-~
REV -16 0 4- EX AFP-- C O 1- 0 9 J ------------------------------------------------------------------------------------------------------------------------
** INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS **
DATE 06-11-2009
ESTATE OF HESSE ADELINE L DATE OF DEATH 12-25-2007 COUNTY CUMBERLAND
FILE N0. 21 08-0454 S.S/D.C. N0. 049-14-0289
ACN 08129231
AUJUS I MENT BASED ON: ADMINISTRATIVE CORRECTION
JOINT DR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: BANK OF AMERICA ACCOUNT N0. 1521960919
TYPE OF ACCOUNT: C ) SAVINGS CX) CHECKING t ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 05-02-1990
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
59,882.41
X 0.083
4,990.00
.oo
4,990.00
X .45
224.55
NOTE: 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 t-)
AMOUNT PAID
T\ITr19 rf.T
-•••-•.~~• +.+ ...,raw~u Inrtuuun UO-Lb-LUUY
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
^ IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDI
C IF TOTAL DUE IS LESS THAN SI, NO PAYMENT IS REQUIRED. IF T
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR IN
TOTAL TAX CREDIT ,00
BALANCE OF TAX DUE 224.55
INTEREST AND PEN. 9.63
TOTAL DUE
TIONAL INTEREST.
OTAL DUE IS REFLECTED AS A "CREDIT" CCR),
STRUCTIONS J
REV-1470 EX (8-88)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
PO Box 280601
HARRISBURG PA 17128-0601
)ECEDENTS NAME
Adeline L. Hess
tEVIEWED BY
Elizabeth A. Bloom
SCHEDULE I INO.
INHERITANCE TAX
EXPLANATION
OF CHANGES
FI
2108-0454
08129231
EXPLANATION OF CHANGES
Changed tax rate from 15 percent to 4.5 percent since a daughter is a lineal beneficiary.
ROW
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