HomeMy WebLinkAbout04-23-10BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
INHERITANCE TAX
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JOHN L SWARTZ
4606 COUNTRY LN
WOOSTER OH 44691-5515
Pennsylvania ~
DEPARTMENT OF REVENUE
REV-1604 EX AFP (12-09)
DATE 02-22-2010
ESTATE OF SWARTZ RUTH M
DATE OF DEATH 11-30-2008
FILE NUMBER 21 09-0043
COUNTY CUMBERLAND
SSN/DC 222-05-5506
ACN 08163184
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE ~) RETAIN LOWER PORTION FOR YOUR RECORDS E-
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REV-1604 EX AFP C12-09~
** INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS *~
DATE• 02-22-2010
ESTATE OF: SWARTZ RUTH M DATE OF DEATH: 11-30-2008 COUNTY: CUMBERLAND
FILE NO.: 21 09-0043 S.S/D.C. N0.:222-05-5506
ACN: 08163184
ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: PNC BANK NA
ACCOUNT NO.: 000031900280728
TYPE OF ACCOUNT: C ) SAVINGS C ) CHECKING ( ) TRUST CX) TIME CERTIFICATE
DATE ESTABLISHED 12-10-2005
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
9,597.45
X 0.500
4,798.73
_ .00
4,798.73
X .00
.DO
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
01-14-2009 CD010764 10.80 205.14
02-19-2010 SBADJUST .00 .06
TOTAL TAX PAYMENT 216.00
BALANCE OF TAX DUE .00
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" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.
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INHERITANCE TAX
RECORD ADJUSTMENT
_ . JQ~N~I~~(t, HELD OR TRUST ASSETS
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601 - + "
HARRISBURG PA 17128-0601
2G~~ APR 23 Phi !2: t+4
~`~ + T
_ +~, t
JOHN L SWARTZ CAL `
4606 COUNTRY LN
WOOSTER OH 44691-5515
Pennsylvania ~
DEPARTMENT OF REVENUE
REV-1604 EX AFP (12-09)
DATE 02-22-2010
ESTATE OF SWARTZ RUTH M
DATE OF DEATH 11-30-2008
FILE NUMBER 21 09-0043
COUNTY CUMBERLAND
SSN/DC 222-05-5506
ACN 08163183
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
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: 02-22-2010
ESTATE OF: SWARTZ RUTH M DATE OF DEATH: 11-30-2008 COUNTY: CUMBERLAND
FILE NO.: 21 09-0043 S.S/D.C. N0.:222-05-5506
ACN: 08163183
ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: PNC BANK NA ACCOUNT NO.: 000031100239439
TYPE OF ACCOUNT: C ) SAVINGS C ) CHECKING ( ) TRUST CX) TIME CERTIFICATE
DATE ESTABLISHED 02-17-2004
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
22,705.49 NOTE:
X 0.500
11,352.75
.00
11,352.75
X .00
.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."
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID C-) AMOUNT PAID
01-14-2009 CD010764 25.54 485.32
03-27-2009 SBADJUST .00 .O1
02-19-2010 SBADJUST .00 .13
TOTAL TAX PAYMENT 511.00
BALANCE OF TAX DUE .00
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" (CR), YDU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.
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