HomeMy WebLinkAbout07-16-10 (2)INHERITANCE TAX
RECORD ADJUSTMENT
JOINTLY HELD OR TRUST ASSETS
BUREAU OF INDIVIDUAL TAXES ~-• , ' ~~_-;^~;-:~, ~-._.•,-;;•,,... ,~,_
INHERITANCE TAX DIVISION .~' ?.~~ `;~- `~;_
PO BOX 280601
HARRISBURG PA 17128-0501 V, ~'~,~ ~ ~ ,,,; ~~~
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CARL E SMI~Ir<<n,~~-, -,: , ~..~ f ,,..~ ~~
591 OXFORD RD '° '~`~
GARDNERS PA 17324
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DEPARTMENT OF REVENUE
REV-1504 EX AFP (12-09)
DATE 06-16-2010
ESTATE OF COBB HELEN A
DATE OF DEATH 02-01-2009
FILE NUMBER 70 0391439 _y1 ~ _. ~L _ ~ ~„L.,'
COUNTY CUMBERLAND
SSN/DC 363-22-3398
ACN 09113605
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 ~
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REV-1604 EX AFP C12-09~
** INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS ~~
DATE: 06-16-2010
ESTATE OF: COBB HELEN A DATE OF DEATH: 02-01-2009 COUNTY:. CUMBERLAND
FILE NO.: 70 0391439 S.S/D.C. N0.:363-22-3398 ACN: 09113605
ADJUSTMENT BASED ON : ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: PNC BANK NA ACCOUNT NO.: 000005000806306
TYPE OF ACCOUNT: (X) SAVINGS C ~ CHECKING C ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 11-15-1999
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
1,164.74
X 0.500
582.37
_ .00
582.37
X .045
26.20
NOTE: TO ENSURE PROPER CREDIT TO YOUR
ACCOUNT, SUBMIT THE UPPER PORTION
OF THIS NOTICE WITH YOUR TAX
PAYMENT TD 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
INTEREST IS CHARGED THROUGH 07-01-2010 TOTAL TAX PAYMENT .00
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 26.20
REVERSE SIDE OF THIS FORM INTEREST AND PEN. .74
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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