HomeMy WebLinkAbout10-09-09 (5)COMMONWEALTH OF PENNSYLVANIA
~ DE~I4RTMENT OF REVENUE
BUREAU OF INDIVIDUAL TaxES "" •: IidHERITANCE TAX
INHERITANCE TAX DIVISION .<~r, ~ i~: ` RECORD ADJUSTMENT
Po Banc 2BO6B1 JOINTLY HELD OR TRUST ASSETS
HARRISBURG PA 17128-0601
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130 HICKORY STICK COURT
DEBARY FL 32713
REY-1604 EX AFP CO1-09)
DATE 10-02-2009
ESTATE OF REDDIN RUBY M
DATE OF DEATH 05-09-2009
FILE NUMBER 21 09-0735
COUNTY CUMBERLAND
SSN/DC 560-40-9766
ACN 09005632
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 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 09005632
ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: FIDELITY INVESTMENTS ACCOUNT N0. X62-269654
TYPE OF ACCOUNT: C ) SAVINGS C ) 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
TAX CREDITS:
25,827.90 NOTE:
X 1.000
25,827.90
- .00
25,827.90
X .15
3,874.19
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 SHIOWN ABOVE.
MAKE CHECK OR MONEY ORDER PAYABLE
T0: "REGISTER OF WILLS, AGENT."
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID C-)
AMOUNT PAID
08-04-2009 CD011584 193.71 3,680.48
TOTAL TAX CREDIT 3,874.19
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.)