HomeMy WebLinkAbout03-25-11INHERITANCE TAX
RECORD ADJUSTMENT
,1..Q.-~~ ~Y HELD OR TRUST ASSETS
BUREAU OF INDIVIDUAL TAXES ~j~ ! t.
INHERITANCE TAX DIVISION ;„ {
PO BOX 280601 ~y ~ ~ : N '~- j$_
HARRISBURG PA 17128-0601
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HENRY HOBAU~~I~~~~`~ `°~~j ' ~,. PA
26 ANDES DR
MECHANICSBURG PA 17055
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DEPARTMENT OF REVENUE
REV-1604 EX AFP (12-10) 7
DATE 03-09-2011
ESTATE OF HOBAUGH JEANNE M
DATE OF DEATH 06-14-2009
FILE NUMBER 21 10-0247
COUNTY CUMBERLAND
SSN/DC 206-32-4170
ACN 09143351
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 f-
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REV-1604 EX AFP C12-10~
** INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS **
DATE• 03-09-2011
ESTATE OF: HOBAUGH JEANNE M DATE OF DEATH: 06-14-2009 COUNTY: CUMBERLAND
FILE NO.: 21 10-024i' S.S/D.C. N0.:206-32-4170 ACN: 09143351
ADJUSTMENT BASED ON : ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: PSECU ACCOUNT NO.:8605373318
TYPE OF ACCOUNT: tX) SAVINGS ( ~ CHECKING ( ) TRUST C ~ TIME CERTIFICATE
DATE ESTABLISHED 07-28-2003
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 .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
06-01-2010 SBAD.IUST .00 3.12
TOTAL TAX PAYMENT 3.12
BALANCE OF TAX DUE 3.12CR
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.