HomeMy WebLinkAbout06-04-10 (3)INHERITANCE TAX Pennsylvania ~
BUREAU OF INDIVIDUAL TAXES •,: ,~.,,• ~R~Ca~D.,.~Q-DJUSTMENT DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION ~ ~~ ,~,~~'E~r~~IAR`Y FORM ASSETS REV-1604A EX AFP CO1-10)
PO BOX 280601 ,...~ , ; ,~
HARRISBURG PA 17128-0601 ' 1 - i~° '
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1329 DOUBLING GAP RD ~.1~~ ~,,•, ~~
NEWVILLE PA 17241-0000
DATE 05-28-2010
ESTATE OF RICKARDS EDITH M
DATE OF DEATH 05-16-2009
FILE NUMBER 21 09-0505
COUNTY CUMBERLAND
SSN/DC 202-20-2757
ACN 09503870
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-1604A EX AFP C12-09~
** INHERITANCE TAX RECORD ADJUSTMENT BENEFICIARY FORM ASSETS **
DATE: 05-28-2010
ESTATE OF: RICKARDS EDITH M DATE OF DEATH: 05-16-2009 COUNTY: CUMBERLAND
FILE NO.: 21 09-0505 S.S/D.C. NO.: 202-20-2757 ACN: 09503870
ADJUSTMENT BASED ON : ADMINISTRATIVE CORRECTION
BENEFICIARY FORM ASSETS
NAME OF SECURITY: AMERIPRISE
TYPE OF ACCOUNT: ( ) SECURITIES C~ SEC ACCT ( ) STOCK
DOD Valuation
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Due
Tax Rate
TAX CREDITS:
.00
X 0.500
.00
- .00
.00
X .045
.00
ACCOUNT N0.: 930072313792004
C ) BOND
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
INTEREST AND PEN. .00
TOTAL DUE .00
* 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 (01-10)
.' ~ enns lvania INHERITANCE TAX
y EXPLANATION
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES OF CHANGES
PO Box 280601
HARRISBURG PA 17128-0601
DECEDENT'S NAME FILE NUMBER
EDITH RICKARDS 2109-0505
REVIEWED BY ACN
Robin Graff 09503870
SCHEDULE INO EXPLANATION OF CHANGES
A review has been conducted on this account. The Department has determined that this
joint bank account was properly reported on the probate return. Therefore, this
assessment has been corrected.
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