HomeMy WebLinkAbout08-31-11BUREAU OF IND~1~iDUA1_ TAXES ,
INHERITANCE TAX D~~EISION ` ~
PO BOX 280601 ~ - - ~
HARRISBURG PA 17128-0601
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VALD,~N~3`'r~'-~~C~,DOWNS PA
703 W PINE ST
MT HOLLY SPRINGS PA 17065
DATE 08-08-2011
ESTATE OF SEITZ ENID
DATE OF DEATH 02-28-2010 M
FILE NUMBER 21 10-0394
COUNTY CUMBERLAND
SSN/DC 17b-14-3946
ACN 10144970
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF~ WILLS
1 COURTHOUSE SQUARE
CARLISLE F'A 17013
CUT ALONG THIS LINE -~ RETAIN LOWER PORTION FO
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R E V- 1 6 0 4 EX A F P C 1 2- 1 0~ O U R R E CI'-----------------------------------------------
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** INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRl1ST ASSETS ~*
DATE:• 08-08-2011
ESTATE OF: SEITZ ENID M DATE OF DEATH: 02-28-201U• COUNTY:
CUMBERLAND
FILE NO.: 21 10-0394 S.S/D.C. N0.:176-14-3946
ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION ACN' 10144970
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: SOVEREIGN BANK
ACCOUNT NO.: 3385024124
TYPE OF ACCOUNT: ( ~ SAVINGS ( ~ CHECKING ( ~ TRUST (X) TIME CERTIFICATE
DATE ESTABLISHED 11-14-2000
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 .15
.00
INTEREST~PEN PAID (-)
NOTE: TO ENSUF!E 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."
AMOUNT PAI])
TOTAL TAX PAYMENT
BALANCE OF TAX DUE
INTEREST ANID PEN.
* IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTERESOT.ALF TOTAL DUE IS REFLECTED AS A
"CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.
INHERITANCE TAX
i
JOINTLY HERD ORJ TRUST ASSETS Pennsylvania ` ~'
DEPARTMENT OF REVENUE
REV-1604 EX AFP C12-10) ~~-~-
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