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HomeMy WebLinkAbout05-17-10INHERITANCE TAX RECORD ADJUSTMENT +rr~..,..,r»n y_- JOINTLY HELD OR TRUST ASSETS BUREAU OF INDIVIDUAL TA~~~`_ i'; `~`1 ! ~ '+•-~-~~~~ {~~ INHERITANCE TAX DIVISION •- PO BOX 280601 ~'"~ ,E,a; ~~ ~~~- l <+~i! HARRISBURG PA 17128-0601 - - ZD~~ ~4AY i 7 PPS 2~ 3 I ~C.ERK ~'F ORP{~~~}'~ G~URT KAT H L E E N M~~~~ ~?K±i~ r~ PA 13 CEDAR RD MECHANICSBURG PA 17055 p~ennsylvania ~ DEPARTMENT OF REVENUE REV-1604 IX AFP C12-09) DATE 05-11-20.0 ESTATE OF SWARTZ ALICE M DATE OF DEATH 02-15-2009 FILE NUMBER 21 09-0628 COUNTY CUMBERL ND SSN/DC 201-16-5-939 ACN 09138454. MAKE CHECK PAYABLE AND'REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SgUA ~ CARLISLE PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS I ~ REV-1604 EX AFP C12-09) ** INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASS TS ~* DATE: 05-11-2010 ESTATE OF: SWARTZ ALICE M DATE OF DEATH: 02-15-2009 CO NTY: CUMBERLAND FILE NO.: 21 09-0628 S.S/D.C. N0.:201-16-5939 CN: 09138454 ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION FINANCIAL I NST I TUT I ON : SOVEREIGN BANK ACCOUNT NO .: 1681793822 TYPE OF ACCOUNT: C ) SAVINGS CX) CHECKING C ) TRUST C ) TIME CERTI KATE DATE ESTABLISHED 08-18-2007 Account Balance •00 NOTE: TO ENSURE PRO ER CREDIT TO YOUR Percent Taxable X 0.500 ACCOUNT, SUBM T THE UPPER PORTION Amount Subject to Tax •00 OF THIS NOTIC WITH YOUR TAX Debts and Deductions - •00 PAYMENT TO TH REGISTER OF WILLS Taxable Amount •00 AT THE ADDRES SHOWN ABOVE. Tax Rate X .045 MAKE CHECK OR MONEY ORDER PAYABLE Tax Due •00 T0: "REGISTE OF WILLS, AGENT." TAX CREDITS: PAYMENT DATE RECEIPT NUMBER DISCOUNT C+) INTEREST/PEN PAID C-) AMOUNT PAID 07-06-2009 CD011458 .00 9.99 ' 05-10-2010 REFUND .00 9.99 TOTAL TAX PAYMENT .00 BALANCE OF TAX ~lE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL uE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIO S. (~)ti~ REV-1470 EX (6-88) 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 FI NUMBER Alice M. Swartz 2109-0628 REVIEWED BY AC Jennifer J. Schaefer 09138454 SCHEDULE I INO. I EXPLANATION OF CHANGES Reported on probate return. Refund in process. Row ~ Page 1