HomeMy WebLinkAbout06-20-11TANCE TAX ennsylvan~a •
INHERI p
RE ORD ADJUSTMENT DEPARTMENT OF REVENUE
~.jf~}~ ~ 5. JO~ !~~tD OR TRUST ASSETS REV-1604 EX AFP clz-log
;~, ~ ~~,
BUREAU OF INDIVIDUAL TAXES ~s_ `f
INHERITANCE TAX DIVISION "
PO BOX 280601
HARRISBURG PA l~lzs-o6o1 DATE 06 - 06 - 2011 ROBERT M
r .' ~ ,' `~'' a
~• ~ ~ ' *~' ~ "' `~ ~ ~ ESTATE OF BEAUDRY
DATE OF DEATH O1 10_1035
-~L~~~ ~'ZF FILE NUMBER CUMBERLAND
. ~ORfi'~~'~ ~~trfi~i k,~ SSN/DC 0 07 -14 - 9889
,$~~1~`~~~4 `,,,,e~., "'~~ ACN 10135735
JAQUELINE BEAUDRY Amount Remitted
118 W SOUTH ST PA 17013
CARLISLE
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE: SAUARE
CARLISLE PA 17013
YOUR RECORDS ~
LOWER PORTION FOR -------------------------
I N E ~-"~ R ETA I N ------°----------
---------------
T H I S L --------------------
C U T ALONG ------------------
- -----------
------------------------------------------ --
TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSET
REV-1604 EX AFP C12'10~ 06-06-2011
** INHERITANCE DATE:
COUNTY: CUMBERLAND
. RY ROBERT M DATE OF DEATH: 01-29-2010
ESTATE OF. BE:AUD ACN: 10135735
S.S/D.C. N0.:007-14-9889
FILE NO.: 21 10-1035 ADMINISTRATIVE CORRECTION
ADJUSTMENT BASED ON:
JOINT OR TRUST ASSET INFORMATION o.. 18813755
ACCOUNT N
F INANCIAL I NST I T UT I ON : TD BANKNORTH N A
TYPE OF ACCOUNT: C ) SAVINGS
DATE ESTABLISHED 12-02-1988
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
~ ~ CHECKING ( ) TRUST ( ) TIME CERTIFICATE
NOTE: TO ENSURE PROPER CEEUPPEROPORTION
ACCOUNT, SUBMIT TH
OF THIS NOTICE REGISTERRD AWILLS
PAYMENT TO THE
AT THE ADDRERSMONEYNORDEREPAYABLE
MAKE CHECK 0
T0: "REGISTER OF WILLS, AGENT."
10,700.24
0.500
X 5,350.12
.00
5,350.12
.00
X .00
PAYMENT RNUMBER
DAT E
DISCOUNT C+~ I AMOUNT PAID
INTEREST/PEN PAID ~-~ 1
TOTAL TAX PAYMENT •"
BALANCE OF TAX DUE .~
INTEREST AND PEN. •~
TOTAL DUE ~
ERSE FOR CALCULATION OF ADDITIONAL INTEREST • STRUCTIONS •IS REFLECTED AS A
* IF PAID AFTER THIS DATE, SEE REV
~~ ~~ CCR~, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR IN
CREDIT