HomeMy WebLinkAbout10-16-09... ~~
COMMONWEA~.TH OF PENNSYLVANIA
DEPAR"~MENT 'OF REVENUE
-,r+~ ^'"y'~~ 11!I~NERITANCE TAX
BUREAU OF INDIVIDUAL TAXES ~~''-•
INHERITANCE TAX DIVISION ~' _ ~t~.~DRD ADJUSTMENT
"-' HELD OR TRUST ASSETS
PO BOX 280601 ;} ~. ,. ~ , ~~ ~ ~,~~~~X ..
HARRISBURG PA 17128-0601
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JAMES D HAMACHEI~L~ l' ~` _ ~r~.
871 MANDY LN
CAMP HILL PA 17011
REV-1604 EX AFP CO1-09)
DATE 10-06-2009
ESTATE OF HAMACHER MARY J
DATE OF DEATH 11-19-2007
FILE NUMBER 21 08-0037
COUNTY CUMBERLAND
SSN/DC
ACN 08121272
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 10-06-2009
ESTATE OF HAMACHER MARY J DATE OF DEATH 11-19-2007 COUNTY CUMBERLAND
FILE N0. 21 08-0037 S.S/D.C. N0.
ACN 08121272
ADJUSTMENT BASED ON : ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MKT BANK ACCOUNT NO. 15004215021003
TYPE OF ACCOUNT: CX) SAVINGS C ) CHECKING C ~ TRUST C ~ TIME CERTIFICATE
DATE ESTABLISHED 02-22-2007
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
.00
X 1.000
.00
.00
.00
X .45
.00
NOTE: 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 C-) AMOUNT PAID
TOTAL TAX CREDIT .00
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 ~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.)