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HomeMy WebLinkAbout05-07-10`r ~, BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 INHERITANCE TAX j?~~ ~h,-~r;~~`~"'f''. ~rr~'~~~~Y HELD 0 J TRUST ASSETS ~_~. 24i~ MA~t -~ Ate ~-: o~ ~~~~~ ~~ o~~r~~~s ~~~~~~ KATHY HARTMAN 3601 SULLIVAN ST MECHANICSBURG PA 17050 Pennsylvania ~ DEPARTMENT OF REVENUE REV-1604 EX AFP C12-09) DATE 04-30-210 ESTATE OF HARTMAN CARL B DATE OF DEATH 05-09-2 06 FILE NUMBER 21 06-0 76 COUNTY CUMBERL ND SSN/DC 204-03- 677 ACN 0600232 MAKE CHECK PAYABLE AN REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SgUA E CARLISLE PA 170 3 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS t~- REV-1604 EX AFP C12-09~ ~* INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST AS ETS ** DATE: 04-30-2010 ESTATE OF: HARTMAN CARL B DATE OF DEATH: 05-09-2006 CO NTY: CUMBERLAND FILE NO.: 21 06-0476 S.S/D.C. N0.:204-03-7677 ACN: 06002323 ADJUSTMENT BASED ON : ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: AMERICHOICE FED CREDIT UNION ACCOUNT NO :34051 TYPE OF ACCOUNT: CX) SAVINGS C ) CHECKING ( ~ TRUST C ~ TIME CERTIIFICATE DATE ESTABLISHED 04-01-2004 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due Tex f_R~iITTC .00 X 0.500 .00 .00 .00 X .045 .00 NOTE: TO ENSURE PRO ER CREDIT TO YOUR ACCOUNT, SUBM T THE UPPER PORTION OF THIS NOTIC WITH YOUR TAX PAYMENT TO TH REGISTER OF WILLS AT 7HE ADDRES SHOWN ABOVE. MAKE CHECK OR MONEY ORDER PAYABLE T0: "REGISTE OF WILLS, AGENT." PAYMENT DATE RECEIPT NUMBER DISCOUNT C+) INTEREST/PEN PAID C-) AMOUNT PAID 10-26-2006 CD007392 .00 300.82 04-29-2010 REFUND .00 300.82 TOTAL TAX PAYME T .~ BALANCE OF TAX DUE INTEREST AND PE . TOTAL DUE * IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL E IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIO S. ,,~ ti~1 ~ ~ REV-1470 EX (6-88) INHERITANCE TAX COMMONWEALTH OF PENNSYLVANIA EXPLANATION DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES I' PO Box 280601 HARRISBURG PA 17128-0601 ~ DECEDENT'S NAME FI E NUMBER Carl B. Hartman 2106-0476 REVIEWED BY A N Jennifer J. Schaefer 06002323 SCHEDULE ` INO ~ EXPLANATION OF CHANGES Reported on probate return. Refund in process. Row ~ Page 1