HomeMy WebLinkAbout07-24-09 (2)COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES.- .. _ INHERITANCE TAX
INHERITANCE TAX DIVISION ~ ~ RECORD ADJUSTMENT
PD Box zao6ol ~ -~ ~ JOINTLY HELD OR TRUST ASSETS
HARRISBURG PA 17128-0601
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DONNA J~JBERKHEIMER ~' ~~~
2160 SAND BEACH RD
HUMMELSTOWN PA 17036
REV-16D4 IX AFP (01-09)
DATE 07-15-2009
ESTATE OF HAMMACHER ARCHIE F
DATE OF DEATH 07-03-2007
FILE NUMBER 21 07-0657
COUNTY CUMBERLAND
SSN/DC 169-44-2562
ACN 07137872
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 !-
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REV-1604 EX AFP CO1-09~
** INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS *~
DATE 07-15-2009
ESTATE OF HAMMACHER ARCHIE F DATE OF DEATH 07-03-2007 COUNTY CUMBERLAND
FILE N0. 21 07-0657 S.S/D.C. N0. 169-44-2562 ACN 07137872
ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: FULTON BANK ACCOUNT N0. 1719-16835
TYPE OF ACCOUNT: ( ) SAVINGS CX) CHECKING C ) TRUST C ) TIME CERTIFICATE
DATE ESTABLISHED 03-08-1994
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 .12
.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 (+)
INTEREST/PEN PAID C-) AMOUNT PAID
IUTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE 0
* 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.)
R r ., 470 EX (6881
~:
INHERITANCE TAX
COMMONWEALTH OF PENNSYLVANIA EXPLANATION
DEPARTMENT OF REVENUE OF CHANGES
BUREAU OF INDIVIDUAL TAXES
PO Box. 280601
HARRISBURG, PA 17128-0601
DECEDENT'S NAME FILE NUMBER
Archie F. Hammacher 2107-0657
REVIEWED BY ACN
Eunice Baker 07137872
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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