HomeMy WebLinkAbout01-08-10~,_~.~--~_=-~ INHERITANCE TAX
RECORD ADJUSTMENT
__ _;~lOINTLY HELD OR TRUST ASSETS
BUREAU OF INDIVIDUAL TAXFS ~ ~_~`, ~ .~ ~~ 'µ
INHERITANCE TAX DIVISION ~ '
PO BOX 280601 _ ' ,,,=
HARRISBURG PA 17128-0601 ~
~._~~ rrt.
SUSAN HOLTZI'~~~ ~`, ~~ ' : ~ , +Q~
46 STATE RD
MECHANICSBURG PA 17050
pennsylvania ~
DEPARTMENT OF REVENUE
REV-1604 EX AFP (12-09)
DATE 12-23-2009
ESTATE OF LEHMAN JUNE I
DATE OF DEATH 01-30-2008
FILE NUMBER 21 08-0141
COUNTY CUMBERLAND
SSN/DC 179-18-1465
ACN 08117345
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 C12-09)
** INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS **
DATE: 12-23-2009
ESTATE OF: LEHMAN JUNE I DATE OF DEATH: 01-30-2008 COUNTY: CUMBERLAND
FILE NO.: 21 08-0141 S.S/D.C. N0.:179-18-1465
ACN: 08117345
ADJUSTMENT BASED ON : ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: PNC BANK ACCOUNT N0.:5o7oos3684
TYPE OF ACCOUNT: C ) SAVINGS CX) CHECKING C ~ TRUST C ) TIME CERTIFICATE
DATE ESTABLISHED 01-01-1979
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 .045
.00
NOTE: TO ENSURE 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
04-06-2009 CD011172 .00 45.90
05-29-2009 SBADJUST .00 .03
12-22-2009 REFUND .00 45.90-
TOTAL TAX PAYMENT .03
BALANCE OF TAX DUE 3CR
INTEREST AND PEN. .00
TOTAL DUE
IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A
"CREDIT" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.