HomeMy WebLinkAbout11-23-09COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17126-0601
--. ..INH.ERxTANCE TAX
R~EC'OI~D ADJUSTMENT
":JOINTLY :HE4D OR TRUST ASSETS
REV-1604 EX AFP (01-09)
~,,,~ ^JO,~~, ~^ ~~~ DATE 11-12-2009
-~~~= ~~'..:s' ~v y-y1•; ~~: 21 ESTATE OF ERICKSON HELEN L
DATE OF DEATH 05-29-2009
_ FILE NUMBER 21 09-0513
~~' ~~ COUNTY CUMBERLAND
C~ ~+~` ~_ ~'~ ~? SSN/DC 059-05-3018
BRUCE W ERICKSON ,^I ~ ACN 09147548
3921 RIDGELAND BLVD F''
Amount Remitted
MECHANICSBURG PA 17050
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 4-
REV-1604 EX AFP CO1-09)
** INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS **
DATE 11-12-2009
ESTATE OF ERICKSON HELEN L DATE OF DEATH 05-29-2009 COUNTY CUMBERLAND
FILE N0. 21 09-0513 S.S/D.C. N0. 059-05-3018 ACN 09147548
ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: CITZENS BANK OF PA ACCOUNT N0. 6254143136
TYPE 01= ACCOUNT: C ) SAVINGS C ) CHECKING C ) TRUST CX) TIME CERTIFICATE
DATE ESTABLISHED 09-11-2008
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."
PAYh1ENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID (-) AMOUNT PAID
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
^IF'F'AID'AFTER-THIS DATE,nSEE^REVERSEnFOR cALCULATI0Nu0F^ADDITTO~NATTINcEREST. ~
IF TO1"AL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR),
REV-1470 EX (6-88)
r.; n
v ,
~;~~:'
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BURS.AU OF INDIVIDUAL TAXES
PO Box 280601
HARRISBURG. PA 17128-0601
INHERITANCE TAX
EXPLANATION
OF CHANGES
DECEDENT'S fJAME FILE NUMBER
Helen Erikson 2109-0513
REVIEWED BY ACN
Scott Ellison 09147548
SCHEDULE
EXPLANATION OF CHANGES
An adjustment has been made to reflect this account will be reported on the probate
return.
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