HomeMy WebLinkAbout10-09-09 (3)
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
G~ .-,,.
~rih'~~~J~~ ;~~?;,~rNi~ERITANCE TAX
~~, r ~~ RECORD ADJUSTMENT
.LLB, ~;#Qa~,TL`:Y HELD OR TRUST ASSETS
ZQQ9 OCT - 9 A~ 1 I ~ ~ ~
~~~~'~~ ~ S V ~T
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SARAH F CLAPSADDLE~`Lrt ~ ~, '~ .~` , fart.
1062 FEATHER DRIVE
DELTONA FL 32725
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN/DC
ACN
REV-1604 EX AFP (D1-09)
10-02-2009
REDDIN RUBY M
05-09-2009
21 09-0735
CUMBERLAND
560-40-9766
09005630
Amount Remitt@d
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 10-02-2009
ESTATE OF REDDIN RUBY M DATE OF DEATH 05-09-2009 COUNTY CUMBERLAND
FILE N0. 21 09-0735 S.S/D.C. N0. 560-40-9766 ACN 09005630
ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: FIDELITY INVESTMENTS ACCOUNT N0. X62-269654
TYPE OF ACCOUNT: C ) SAVINGS ( ) CHECKING CX) TRUST C ) TIME CERTIFICATE
DATE ESTABLISHED 05-09-2007
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
77,483.70 NOTE:
X 1.000
77,483.70
.00
77,483.70
X .15
11,622.56
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 M(1NEY ORDER PAYABLE
T0: "REGISTER OF WILLS, AGENT."
TAX CREDITS:
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID C-) AMOUNT PAID
08-05-2009 CD011596 581.13 11,041.43
TOTAL TAX CREDIT 11,622.56
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.)