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Home My WebLink About07-16-10BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 SUSAN S SMITH 31g N 24TH ST CAMP HILL INHERITANCE TAX __ _ ~ _ ~. ,_,._ E~ORD ADJUSTMENT ~~- J~i~;it~`T~~l(j,HELD OR TRUST ASSETS ,. ~ k t!' i .._ _ ~.. a ~~.. >; pennsylvan~a ~ DEPARTMENT OF REVENUE REV-1604 EX AFP C12-09) ~~~ ~#~~. ~ ~ ~ ~' ~ ~ DATE 07-12-2010 ESTATE OF SMITH JOSEPHINE ~- ~~ ~~' ~ ' ~' DATE OF DEATH 08-15-2007 - - _ ~~}~~f,~~~ t~~iw~_"~i F I L E N UMBER COUNTY 21 0 7 -1171 CUMBERLAND ~" ~'•± ~ ' ~~~i ~~~~' , ~,~, SSN/DC 144- 16-2079 ACN 07141459 Amount Remitted PA 17011 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 4-- ------------------------------------------------------------------------------------------------------------------------------------------------------------------ REV-1604 EX AFP C12-09) *~ INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS ** DATE: 07-12-2010 ESTATE OF: SMITH JOSEPHINE DATE OF DEATH: 08-15-2007 COUNTY: CUMBERLAND FILE NO.: 21 07-1171 S.S/D.C. N0.:144-16-2079 ACN: 07141459 ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: MEMBERS 1sT FCU TYPE OF ACCOUNT: CX) SAVINGS C ) CHECKING ( ) TRUST t ) TIME CERTIFICATE DATE ESTABLISHED 01-16-1973 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAX CREDITS: .00 X 0.500 .00 _ .00 .00 X .045 .00 ACCOUNT NO.: 14169-00 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. r. ~ !i' INHERITANCE TAX RECORD ADJUSTMENT f ,,,~p,IyTjLY HELD OR TRUST ASSETS BUREAU OF INDIVIDUAL TAXES ~`'~`~ ' '~~ _ ~ '' 7w tt~J' INHERITANCE TAX DIVISION ~ a ~I; C' PO BOX 280b01 ~ "' '- ''- h-' ,r HARRISBURG PA 17128-0601 ~~"~ ~~ ~~; ~`t~1i~e~t~t~~ ~'~''r~~nA SUSAN S SMIT~I ~;,°~~`~~,,... `'`'t°~ s ~-=;-~, 319 N 24TH ST ~~ CAMP HILL PA 17011 pennsylvania'~ ~ DEPARTMENT OF REVENUE REV-1604 EX AFP (12-09) DATE 07-12-2010 ESTATE OF SMITH JOSEPHINE DATE DF DEATH 08-15-2007 FILE NUMBER 21 07-1171 COUNTY CUMBERLAND SSN/DC 144-1b-2079 ACN 07141460 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: 07-12-2010 ESTATE OF: SMITH JOSEPHINE DATE OF DEATH: 08-15-2007 COUNTY: CUMBERLAND FILE NO.: 21 07-1171 S.S/D.C. N0.:144-16-2079 ACN: 071414b0 ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION FINANCIAL I NST I TUT I ON : MEMBERS 1ST FCU TYPE OF ACCOUNT: CX) SAVINGS C ~ CHECKING ( 3 TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 01-16-1973 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAX CREDITS: .00 X 0.500 .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 t-) 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" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ACCOUNT NO.: 14169-04 ~~Jr"i^' BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PD BOX 280601 HARRISBURG PA 17128-0601 SUSAN S SMITH 319 N 24TH ST CAMP HILL INHERITANCE TAX Pennsylvania ~ RECORD ADJUSTMENT ,.,,..;_ .~,.K3-~~I~LY;~-Hf OR TRUST ASSETS DEPARTMENT OF REVENUE ,.,, ~ ,• , - - - - ~ t..~'._ ~ REV-1604 EX AFP (12-09) r _ , , .,,, .._ .~`~t..i ... ,.. ~ L .. , p ~ ~~~ ~ ~ ~ g ; Q ~ DATE 0 7 - 12 - 2010 ESTATE OF SMITH JOSEPHINE DATE OF DEATH 08-15-2007 ~L~~~{^~ FILE NUMBER 21 07-1171 ~ti~`J ~~,~!-'` ~ ~~ r COUNTY CUMBERLAND iC i ~ tom, ~-; ~ ,i;~ ~t~; ~F ~i~' ~" ` t SSN/DC 144-16-2079 '' _- ' .: ACN 07141461 Amount Remitted PA 17011 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: 07-12-2010 ESTATE OF: SMITH JOSEPHINE DATE OF DEATH: 08-15-2007 COUNTY: CUMBERLAND FILE NO.: 21 07-1171 S.S/D.C. N0.:144-16-2079 ACN: 07141461 ADJUSTMENT BASED ON : ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: MEMBERS 1sT FCU ACCOUNT NO.: 20620-00 TYPE OF ACCOUNT: ( ~ SAVINGS ( 1 CHECKING ( ) TRUST t ) TIME CERTIFICATE DATE ESTABLISHED 06-13-1978 Account Balance Percent Taxable Amount Sub3ect to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TOX CREDITS: .00 X 0.500 .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" (CR?, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. NEV-1470 EX (01-10) ~ enns lvania p y INHERITANCE TAX DEPARTMENT OF REVENUE EXPLANATION BUREAU OF INDIVIDUAL TAXES OF CHANGES PO Box 280601 HARRISBUR PA 17128-0601 DECEDENT'S NAME FILE NUMBER Josephine Smith 2107.1171 REVIEWED BY ACN Eunice Baker 07141459, 07141460, 07141461 ITEM SCHEDULE Np. EXPLANATION OF CHANGES The above accounts have been adjusted to zero since they were reported on the probate return. Row Page 1