HomeMy WebLinkAbout01-31-11
~ INHERITANCE TAX
RECORD ADJUSTMENT
,- - JQtN'F'~Y HELD OR TRUST ASSETS
BUREAU OF INDIVIDUAL TAXES _ '-''
INHERITANCE TAX DIVISION
PO BOX 280601 _ --
HARRISBURG PA 17128-0601
;~ .--, ,
i_ __ _ ,
GLORIA KEMP~:. `. ^:~'~
428 LAFAYETTE STREET
ENOLA PA 17025
pennsyLvania ~
DEPARTMENT OF REVENUE
REV-1604 EX AFP (12-10)
DATE 01-21-2011
ESTATE OF KEMPER III JOSEPH H
DATE OF DEATH 01-18-2009
FILE NUMBER 21 09-0867
COUNTY CUMBERLAND
SSN/DC 178-24-9162
ACN 09108135
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SgUARE
CARLISLE PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
-----------------------------------------------------------------------------------------------------
REV-1604 EX AFP C12-10~
** INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS **
DATE• 01-21-2011
ESTATE OF: KEMPER III JOSEPH H DATE OF DEATH: 01-18-2009 COUNTY: CUMBERLAND
FILE NO.: 21 09-0867 S.S/D.C. N0.:178-24-9162 ACN: 09108135
ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO.: 315040-47
TYPE OF ACCOUNT: C ) SAVINGS C ~ CHECKING C ) TRUST CX) TIME CERTIFICATE
DATE ESTABLISHED 10-01-2007
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
.00
X 0.166
.00
- .00
.00
X .00
.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 (+)
INTEREST/PEN PAID (-) 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.
~`;J
~ INHERITANCE TAX •
RECORD ADJUSTMENT pennsylvan~a ~
_ _ ,JOINTLY HELD OR TRUST ASSETS DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES ~-, ~' -~
INHERITANCE TAX DIVISION `' `~ `~' REV-1604 EX AFP (12-10)
PO BOX 280601 ~"~
HARRISBURG PA 17128-0601 - -'`-'
~. ~_
GLORIA KEMP f ~ ~ ~ ~~~~
._; ;-,
428 LAFAYETTE STREET ~~
ENOLA PA 17025
CUT ALONG THIS LINE ~-~-- RETAIN LOWER PORTION FOR YOUR RECORDS t--
------------------------------------------------------------------------------------------------------------------
REV-1604 EX AFP C12-10~
*~ INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS **
DATE: 01-21-2011
ESTATE OF: KEMPER III JOSEPH H DATE OF DEATH: 01-18-2009 COUNTY: CUMBERLAND
FILE NO.: 21 09-0867 S.S/D.C. N0.:178-24-9162 ACN: 09108133
ADJUSTMENT BASED ON : ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO.: 315040-46
.E ,, - _, _
r
..~
.:= ° ~ ~,'
DATE 01-21-2011
ESTATE OF KEMPER III JOSEPH H
DATE OF DEATH 01-18-2009
FILE NUMBER 21 09-0867
COUNTY CUMBERLAND
SSN/DC 178-24-9162
ACN 09108133
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
TYPE OF ACCOUNT: C ) SAVINGS ( ) CHECKING C ) TRUST C b TIME CERTIFICATE
DATE ESTABLISHED 10-01-2007
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
.00
X 0.166
.00
- .00
.00
X .00
.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 (-) 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.
REV 7470 EX (01-10)
• INHERITANCE TAX
~ ~ pennsylvan~a
DEPARTMENT OF REVENUE EXPLANATION
BUREAU OF INDIVIDUAL TAXES OF CHANGES
PO Box 280601
HARRISBURG PA 17128-0601
DECEDENT'S NAME FILE NUMBER
JOSEPH H KEMPER III 2109-0867
REVIEWED BY ACN
Robin Graff 091084133 09108135
SCHEDULE I ITEM
NO.
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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