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HomeMy WebLinkAbout08-31-11BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-D601 WALTER L NESS JR WOODRIDGE DR INHERITANCE TAX _ `R~~~ORD ADJUSTMENT BEtJEF3CIARY FORM ASSETS ~ ~~ r, ~~ C l.r ~. 850 MIDDLETOWN PA 17057-0000 pennsylvania ~ DEPARTMENT OF REVENUE REV-1604A EX AFP (12-10) ---~ DATE 08-10-2011 ESTATE OF NESS SR WALTER L DATE OF DEATH 03-03-2006 FILE NUMBER CUMBERLAND COUNTY SSN/DC 178-01-5988 ACN 06500147 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'~' -------------- - REV-1604A EX AFP C12-10~ ~(~ INHERITANCE TAX RECORD ADJUSTMENT BENEFICIARYDATEM ASSE08-10-2011 ESTATE OF: NESS SR WALTER L DATE OF DEATH: 03-03-2006 COUNTY: CUMBERLAND ACN: 06500147 FILE N0.:21 06-0389 S.S/D.C. NO.: 178-01-5988 PROTEST BOARD DECISION ADJUSTMENT BASED ON: BENEFICIARY FORM ASSETS ACCOUNT NO.: 87231 MERRILL LYNCH NAME OF SECURITY: ( ) STOCK ( ) BOND TYPE OF ACCOUNT: (X) SECURITIES ( ) SEC ACCT DOD Valuation Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Due Tax Rate TAX CREDITS: .00 X 0.000 .00 .00 .00 X .045 .00 PAYMENT RECEIPT 0 DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID TOTAL TAX PAYMENT .uu BALANCE OF TAX DUE INTEREST AND PEN. .00 TOTAL DUE .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." ~ IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS Y~/ A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.