HomeMy WebLinkAbout01-03-12BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
INHERITANCE TAX
RECORD ADJUSTMENT
JOIM.TL~Y HELD OR TRUST ASSETS
~.. ~ n
- ~ ~ .,
~.. _ ,,
i ~-~/ ,
~~,-~ , ~ ,C..
/t 1 ~~J / IJ' I
RICHARD S HOCKLEY ~ ` ~ F-~
206 ACRE DR
CARLISLE PA 17013-4201
Pennsylvania ^ ~`~~=
DEPARTMENT OF REVENUE
REV-1604 EX AFP C12-111
DATE 12-16-2011
ESTATE OF SENTZ ANNA C
DATE OF DEATH 06-13-2010
FILE NUMBER 21 10-0910
COUNTY CUMBERLAND
SSN/DC 174-05-0104
ACN 10154582
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-1604 EX AFP C12-11)
** INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS **
DATE: 12-16-2011
ESTATE OF: SENTZ ANNA C DATE OF DEATH: 06-13-2010 COUNTY: CUMBERLAND
FILE NO.: 21 10-0910 S.S/D.C. N0.:174-05-0104 ACN: 10154582
ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: PNC BANK NA ACCOUNT NO.: 000005005226343
TYPE OF ACCOUNT: C ) SAVINGS CX) CHECKING C ) TRUST C ) TIME CERTIFICATE
DATE ESTABLISHED 01-19-2007
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
.00
X 0.500
.00
.00
.00
X .15
.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."
PDATENT RN UMBER INTEREST/PEN PAID (-) AMOUNT PAID
TOTAL TAX PAYMENT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE
IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A
"CREDIT" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.
vC1J