HomeMy WebLinkAbout03-26-10 (2)BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
Ii~HERITb-NCE TAX
RECORD ADJUSTMENT
_ - - ~.,,- .~Q~„rITLY HELD OR TRUST ASSETS
.. ; .:: ~ t ~::
/''
-~- ~ ~ ~
~0~~ ~~~ ~b F,~ !~. 42
'` '~
Q~~'N,~ ~'•~'~~ t~f l' r~~
r
ALFREDA RIVERS~~%~`-rr ~~. ~' ~j '~n ~3
- - , ,~,
2069 SPRING ROAD
CARLISLE PA 17013
pennsylvania ~
DEPARTMENT OF REVENUE
REV-1604 IX AFP C12-09)
DATE 03-18-2010
ESTATE OF SALISBURY ROSE
DATE OF DEATH 03-14-2009
FILE NUMBER 21 09-0299
COUNTY CUMBERLAND
SSN/DC 201-20-6591
ACN 09118412
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: 03-18-2010
ESTATE OF: SALISBURY ROSE DATE OF DEATH: 03-14-2009 COUNTY: CUMBERLAND
FILE NO.: 21 09-0299 S.S/D.C. N0.:201-20-6591
ACN: 09118412
ADJUSTMENT BASED ON : ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1sT FCU ACCOUNT NO.: 144864-0 0
TYPE OF ACCOUNT: CX) SAVINGS C ) CHECKING C ~ TRUST C ~ TIME CERTIFICATE
DATE ESTABLISHED 07-22-1994
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
.00
X 0.166
.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
TOTAL TAX PAYMENT .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" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ,
IN~~ERIT/-dNCE TAX '
RECORD ADJUSTMENT pennsylvan~a ~
JOINTLY HELD OR TRUST ASSETS DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES REV-1604 EX AFP C12-o9)
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
DATE 03-18-2010
ESTATE OF SALISBURY ROSE
DATE OF DEATH 03-14-2009
FILE NUMBER 21 09-0299
COUNTY CUMBERLAND
SSN/DC 201-20-6591
ALFREDA RIVERS ACN 09118414
2069 SPRING ROAD Amount Remitted
CARLISLE PA 17013
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: 03-18-2010
ESTATE OF: SALISBURY ROSE DATE OF DEATH: 03-14-2009 COUNTY: CUMBERLAND
FILE NO.: 21 09-0299 S.S/D.C. N0.:201-20-6591
ACN: 09118414
-----
ADJUSTMENT BASED ON : ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1sT FCU
ACCOUNT NO.: 144864-11
TYPE OF ACCOUNT: C ) SAVINGS CX) CHECKING C ) TRUST C ~ TIME CERTIFICATE
DATE ESTABLISHED 07-22-1994
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
.00
X 0.166
.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
TOTAL TAX PAYMENT .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" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.
REV-1470 EX (Ot-10) i ,
~ pel'~11Sy~VaClla INHERITANCE TAX
DEPARTMENT OF REVENUE EXPLANATION
BUREAU OF INDIVIDUAL TAXES OF CHANGES
PO Box 280601
A I R A 17 8- 601
DECEDENT'S NAME FILE NUMBER
Rose Salisbury 2109-0299
REVIEWED BY ACN
Joan M. Peters 09118410, 09118411,
09118412.09118414
ITEM
SCHEDULE NO.
EXPLANATION OF CHANGES
The above referenced Account Control Numbers have been adjusted to zero since the joint
bank accounts were listed on the Inheritance Tax Return.
Row Page 1