HomeMy WebLinkAbout12-04-09f -1'T-"-
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BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
Pennsylvania ~
DEPARTMENT OF REVENUE
REV-1604 EX AFP (10-09)
DATE 12-01-2009
ESTATE OF GRACEY MICHAEL P
DATE OF DEATH 09-12-2007
FILE NUMBER 21 07-1046
COUNTY CUMBERLAND
SSN/DC 210-40-3297
ACN 08103867
Amount Remitt®d
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
INHERITANCE TAX
RECORD ADJUSTMENT
Y GELD OR TRUST ASSETS
1 ~Rr l~~i.1~ j'~.,
r ~
~~~9 DEC -4 P~4 {s 45
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AUDREY C GRACEY ~~~.
304 TICHY DR
MT HOLLY SPRINGS PA 17065
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~'-~
REV-1604 EX AFP C10-09)
** INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS **
DATE: 12-01-2009
ESTATE OF: GRACEY MICHAEL P DATE OF DEATH: 09-12-2007 COUNTY: CUMBERLAND
FILE NO.: 21 07-1046 S.S/D.C. N0.:210-40-3297 ACN: 08103867
ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: PNC BANK ACCOUNT N0.:5140185003
TYPE OF ACCOUNT: C ) SAVINGS CX) CHECKING ( ) TRUST C ) TIME CERTIFICATE
DATE ESTABLISHED 08-01-1968
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
.00
X 0.500
.00
.00
.00
X .15
.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 MOwEY ORDER PAYABLE
T0: "REGISTER OF WILLS, AGENT."
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID C-) AMOUNT PAID
TOTAL TAX PAYMENT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN.
TOTAL DUE
IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF T07AL DUE IS REFLECTED AS A
"CREDIT" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.
Ri +L1470 EX (&88)
/" INHERITANCE TAX
COMMONWEALTH OF PENNSYLVANIA EXPLANATION
DEPARTMENT OF REVENUE OF CHANGES
BUREAU OF INDIVIDUAL TAXES
PO Box 280601
HARRISBURG PA 17128-0601
DECEDENT'S NAME FILE NUMBER
Michael Gracey 21 07-1046
REVIEWED BY ACN
Steven James 08103867
ITEM
SCHEDULE NO. EXPLANATION OF CHANGES
The above referenced ACN has been reduced to zero as this account was reported on the
probate return.
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