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HomeMy WebLinkAbout08-14-09COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE _. , .., .. _ . IN~iETtf.'IANCE TAX BUREAU OF INDIVIDUAL TAxES - RECORD ADJUSTMENT INHERITANCE TAX DIVISION JOINTLY HELD OR TRUST ASSETS PO BOX 280601 HARRISBURG PA 17128-0601 - ~ ~'~ 2Gu~ ~.t1~ C ~ r E=~ {Z~ 17 pRPH~i'J'S CCtiRT DALE L NOGG~~P~n;-G~; r`~",.lil Lr~ pP. 215 GARLAN DR CARLISLE PA 17013 REV-1604 EX AFP (01-09) DATE 07-29-2009 ESTATE OF SHEFFER PAULINE S DATE OF DEATH 06-14-2008 FILE NUMBER 21 08-0745 COUNTY CUMBERLAND SSN/DC 174-05-2754 ACN 08144518 Amount Remitted 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 CO1-09) ** INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS ** DATE 07-29-2009 ESTATE OF SHEFFER PAULINE S DATE OF DEATH 06-14-2008 COUNTY CUMBERLAND FILE N0. 21 08-0745 S.S/D.C. N0. 174-05-2754 ACN 08144518 ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: SOVEREIGN BANK ACCOUNT N0. 1685211250 TYPE OF ACCOUNT: C ) SAVINGS C ) CHECKING C ) TRUST CX) TIME CERTIFICATE DATE ESTABLISHED 06-07-1997 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAX CREDITS: .00 NOTE: X 1.000 .00 .00 .00 X .15 .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 C+) INTEREST/PEN PAID C-) AMOUNT PAID 09-30-2008 CD010342 .00 165.01 07-28-2009 REFUND .00 165.01- 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 S1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) REV-1470 EX (686) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES PO Box 280601. DECEDENT'S NAME Pauline S. Sheffer 2108-0745 REVIEWED BY IA`N 08144518 Jennifer Schaefer ITEM SCHEDULE NO, EXPLANATION OF CHANGES Reported on probate return. Refund in process. { INHERITANCE TAX EXPLANATION OF CHANGES ROw Page 1