HomeMy WebLinkAbout10-07-11RECORDIADJUSTMENT
BUREAU DF INDIVIDUAL TAXES ~~~ ~~~' ~- ~~-r(~!~?~LY HELD OR TRUST ASSETS
INHERITANCE TAX DIVISION Lr '~'~;;' ;
~_~
PO BOX 280601
HARRISBURG PA 17128-0601 - `~ ~ ~~ ,~; }_C
CLERK ~F
((;` ORPHA.'V'S CO~.~RT
JOSEPH A MART~T~~~^:;~ `~~1 ~~. PA
104 HEMLOCK DR
CLARKS SUMMIT PA 18411
Pennsylvania ~
DEPARTMENT OF REVENUE
REV-1604 EX AFP C12-10)
DATE 09-23-2011
ESTATE OF MARTIN
DATE OF DEATH 09-25-2010 LILLIAN G
FILE NUMBER 21 10-1085
COUNTY CUMBERLAND
SSN/DC 196-22-4140
ACN 101589b0
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
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** INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS **~ r
ESTATE OF: MARTIN DATE: 09-23-2011
LI
FILE NO.: 21 10-1085
ADJUSTMENT aecrn
LLIAN
G DATE OF DEATH: 09-25-2010
S.S/D.C. N0.:196-22-4140
• ADMINISTRATIVE CORRECTION
COUNTY: CUMBERLAND
ACM: 10158960
.JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: PSECU
ACCOUNT NO.: 9848849973-s1
TYPE OF ACCOUNT: CX) SAVINGS ( ) CHECKING ( ) TRUST C ) TIME CERTIFICATE
DATE ESTABLISHED 11-24-2008
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
PAYMENT RECEIPT
DATE NUMBER
43,099.90
X 0.166
7,183.46
- .00
7,183.46
X .00
.00
INTEREST%pEN PAID (-)
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."
AMOUNT PAID
TOTAL TAX PAYMENT
BALANCE OF TAX DUE
INTEREST AND PEN.
* IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTERE ST .A IF DTOTAL DUE IS REFLECTED AS A
"CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.