HomeMy WebLinkAbout10-09-09 (11)COMMONWEALTH OF PENNSYLVANIA
~ DEPARTMENT OF REVENUE
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BUREAU OF INDIVIDUAL TAXES ,,,;ff'n~C`}~~j rs4 i '~ ~r `~dHERITANCE TAX
INHERITANCE TAX DIVISION ~ `~-'-'`" "` ~ R!ECORD ADJUSTMENT
PO BOX 280601 ~ ~
WIRRISBURG PA 17128-0601 ~;[_~~'~ ~;`.J,QI~IT~L•Y-- HELD OR TRUST ASSETS
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SU PITZER
8 BLUE GILL TRAIL CVO.
FAIRFIELD PA 17320
REV-1604 EX AFP COl-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 09005635
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 ~
EV-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 ACM 09005635
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
X 1.000
25,827.90
- .00
25,827.90
X .15
3,874.19
PAYMENT RECEIPT
DATE NUMBER
-05-2009 CD011576
NOTE: TO INSURE PROPER CREDIT TO YOUR
ACCOUNT, SUBMIT THE UPPER PORTION
OF THIS NOTICE WxTH YOUR TAX
PAYMENT TO THE REGISTER OF WILLS
AT THE ADDRESS SOWN ABOVE.
MAKE CHECK OR MONEY ORDER PAYABLE
T0: "REGISTER OF WILLS, AGENT."
DISCOUNT C+)
INTEREST/PEN PAID (-)
193.71
AMOUNT PAID
3,680.48
TOTAL TAX CREDIT 3,874.19
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
* IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTERES DUE
C IF TOTAL DUE IS LESS THAN 61, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "~REDIT" CCR),
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) ~1`