HomeMy WebLinkAbout08-03-09COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL. TAXES - INHERITANCE TAX
INHERITANCE TAX DIVISION RECORD ADJUSTMENT
Po Box zao6ol ; ~..~ ~~ ~- " ~ JOINTLY HELD OR TRUST ASSETS
HARRISBURG PA 17128-0601
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CLERK rGU~T
ORPNi Sa n PA
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351 RITE HOLLOW RD
HYNDMAN PA 15545
REV-1604 EX AFP (01-09)
DATE 07-06-2009
ESTATE OF HITE KENNETH D
DATE OF DEATH 11-23-2008
FILE NUMBER 21 09-0319
COUNTY CUMBERLAND
SSN/DC 214-28-6934
ACN 09118519
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 07-06-2009
ESTATE OF HITE KENNETH D DATE OF DEATH 11-23-2008 COUNTY CUMBERLAND
FILE N0. 21 09-0319 S.S/D.C. N0. 214-28-6934
ACN 09118519
ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL I NST I T UT I ON : STANDARD BANK ACCOUNT NO . 1021445
TYPE OF ACCOUNT: ( ) SAVINGS C ) CHECKING C ~ TRUST CX) TIME CERTIFICATE
DATE ESTABLISHED 10-31-2000
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
16,281.27 NOTE:
X 0.500
8,140.64
4,364.63
3,776.01
X .15
566.40
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 (-) AMOUNT PAID
PAYMENT MUST BE MADE BY 08-24-2009*. TOTAL TAX CREDIT .00
BALANCE OF TAX DUE 566.40
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 #1, 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.)