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HomeMy WebLinkAbout12-27-10:.~ ~ INHERITANCE TAX RECORD ADJUSTMENT '~` E"'~"" ~t~ ~~' ~~LD OR TRUST ASSETS BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION ~~~~;~;~~~ +~~. ~~i{~ PO BOX 280601 ' HARRISBURG PA 17128-0601 ~_~ ~ aEC ~'~ P~ ~ _ ~ CLERK C3F ~~~~~~~~ C~~~~ JEFFREY 0 SEES CU~~FP`_f~~~D ~~~~ 1109 APPLE DR APT 3 MECHANICSBURG PA 17055-3918 Pennsylvania ~ DEPARTMENT OF REVENUE REV-1604 EX AFP (12-09) DATE 12-02-2010 ESTATE OF BRUDOWSKY MARIAN L DATE OF DEATH 07-24-2009 FILE NUMBER 21 09-0736 COUNTY CUMBERLAND SSN/DC 179-14-8711 ACN 09158295 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: 12-02-2010 ESTATE OF: BRUDOWSKY MARIAN L DATE OF DEATH: 07-24-2009 COUNTY: CUMBERLAND JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: PNC BANK NA ACCOUNT NO.: 000031900239234 FILE NO.: 21 09-073b S.S/D.C. N0.:179-14-8711 ACN: 09158295 ADJUSTMENT BASED ON : ADMINISTRATIVE CORRECTION TYPE OF ACCOUNT: ( ) SAVINGS C ~ CHECKING C ) TRUST CX) TIME CERTIFICATE DATE ESTABLISHED 03-18-2004 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAX CREDITS: .00 X 0.500 .00 _ .oo .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" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ~~ .~ REV-1NT5 EX (01-10) `` F ~ INHERITANCE TAX } ~ ~ - pennsylvania DEPARTMENT OF REVENUE EXPLANATION BUREAU OF INDIVIDUAL TAXES OF CHANGES PO Box 280601 HARRISBURG PA 17128-0601 DECEDENTS NAME FILE NUMBER MARIAN L BRUDOWSKY 2109-0736 REVIEWED BY ROBIN GRAFF I„~.,,~ 09158295 SCHEDULE ITEM EXPLANATION OF CHANGES NO. 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.