HomeMy WebLinkAbout07-15-11INHERITANCE TAX
BUREAU OF INDIVIDUAL TAXES !~{~ r JOINTLyECORD ADJUSTMENT
INHERITANCE TAX DIV:[SION r nn~r, HELD OR
F ~,~~ ~~ ~` TRUST ASSETS
PO BOX 280601 ~
HARRISBURG PA 17128.0601 ~ ,.~ r b ~' ~ (~
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CARLISLE PA 17013
Pennsylvania -~
DEPARTMENT OF REVENUE
REV-1604 EX AFP C12-10)
DATE 06-01-2011
ESTATE OF SELECKY
DATE OF DEATH 02-17-2010 MARCELLA q
FILE NUMBER 21 10-0286
COUNTY CUMBERLAND
SSN/DC 195-12-8077
ACN 10111540
Announ- R fitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF= WILLS
1 COURTHOUSE SQUARE
CARLISLE P'A 17013
CUT ALONG THIS LINE y
_______________________ R E TA I N L O W E R P O R T I O N
------------------------------------------------------------ FOR YOUR R E C CIRD S ~
REV-1604 EX AFP n~_,,,.
«T.~_
---------- _ _________ -
** INHERITANCE TAX RECORD -~-
------------------
ADJUSTMENT JOINTLY HELD OR TRUST ASSETS **
-~~~~~ ur=: SELECKY DATE: 06-01-2011
MARCELLA A DATE OF DEATH:
02-17-2010 COUNTY:
FILE NO.: 21 10-0286 CUMBERLAND
ADJUSTMENT BASED ON: S•S/D.C. N0.:195-12-8077
ADMINISTRATIVE CORRECTION ACN: 10111540
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: LUZERNE NB
ACCOUNT NO.: 121095
TYPE OF ACCOUNT: C ) SAVINGS C ) CHECKING C ) TRUST (X) TIME CERT
DATE ESTABLISHED 03-18-2005
IFICATE
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
PAYMENT RECEIPT
DATE NUMBER
.00
X 0.500
.00
.00
.00
X .045
.00
DISCOUNT (+)
INTER~EN PAID (-)
NOTE: TO ENSURE= PROPER CREDIT TO YOUR
ACCOUNT, SUBMIT THE UPPER PORTION
OF THIS NIOTICE 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."
AMOUNT PAID
TOTAL TAX PA'VMENT
BALANCE OF TA;K DUE 0
INTEREST AND PEN, .0
* IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTERE O TAL DUIE '0
"CREDIT" CCR), YOU MAy BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.
IF TOT,OL DUE IS REFLECTED AS A
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