HomeMy WebLinkAbout12-29-09 INHERI TANCE TAX
Pennsy van~a
ST" A
ORJ TR
'
~'~
^r~
I ~
~l~"
NR.~, ,
._ ,
` U
SSETS DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
TANCE TAX DIVISION ~ ~ i' T ~ ~ ,- c {~
i
j
+ li: L
~~ ~ REV-1604 EX AFP (12-09)
INHERI r
+ y -_
.
,+ +
PO BDX 280601
HARRISBURG PA 17128-0601
Z~~Q~~~ 29 AM ~~` 35
DATE 12-17-2009
ESTATE OF BENDER MARGUERIT P
CL~~~{ ~~ DATE OF DEATH OS-13-2008
ORPHAN S C0:l~T FILE NUMBER 70 0383818
CUM~?~~I_:;^''CJ l~''`~
~~, COUNTY
SSN/DC CUMBERLAND
180 - O 1- 9734
KATHY J LLOYD , ACN 08150572
1642 WALNUT BOTTOM RD Amount Remitted
NEWVILLE PA 17241
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: 12-17-2009
ESTATE OF: BENDER MARGUERIT P DATE OF DEATH: 08-13-2008 COUNNTY: CUMBERLAND
FILE NO.: 70 0383818 S.S/D.C. N0.:180-01-9734 ACN: 08150572
ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: ADAMS COUNTY NATIONAL BK ACCOUNT NO.: 111589
TYPE OF ACCOUNT: C ) SAVINGS (X) CHECKING ( ) TRUST C ) TIME CERTIFICATE
DATE ESTABLISHED 09-01-2004
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
51,987.83 NOTE:
X 0.166
8,664.81
_ 8,835.04
.00
X .045
.00
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."
TAX CREDITS:
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT (+)
INTEREST/PEN PAID (-) AMOUNT PA[D
TOTAL TAX PAYMENT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. 0
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.
~~