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Home My WebLink About01-17-12 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 TERESA L SNANER 23 EDGEWOOD DR'. INHERITANCE TAX - RECOR ,,ADJUSTMENT Pennsylvania = ~ , ~' r~`,`JO.INTLY Fi~E~ TRUST ASSETS "-' - DEPARTMENT OF REVENUE ~'~ REV-1604 EX AFP (12-11) _ _ _'J y ...„ ~ 7 t ~~~~ ~i ~ I ~bATE 111-03-2012 ESTATE OF NAVRATIL NADA M ~.,L~~,,e ; ,, _. DATE OF DEATH 01 - 14 - 2011 ~ ~'~`'~ - ~ _ FILE NUMBER 21 11-0359 C~F'~'J,,4,•~,.', r,v'.;''ir COUNTY [;UMBERLAND Cll`':~{`' ,= 1 ''`~ 'i".1 SSN/DC 209-12-5368 ACN 11105341 MECHANICSBURG PA 17055 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 E- R E V -16 0 4 EX AFP C 12 -1 _--_------_------~------~------_----~ 1 ~ ---------------------------------------------------------------------------- ** INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS ** DATE' 01-03-2012 ESTATE OF. NAVRATIL NADA M DATE OF DEATH: 01-14-201].• COUNTY: CUMBERLAND FILE NO.: 21 11-0359 S.S/D.C. N0.:209-12-5368 ADJUSTMENT BASED N: ACN: 11105341 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT N0.:4o676-00 TYPE OF ACCOUNT: C10 SAVINGS C ) CHECKING ( ) TRUST C ) TIME CERTIFICATE DATE ESTABLISHED 09-08-1984 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAX CREDITS: PAYMENT RECEI DATE NUMB * IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE'DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. .00 NOTE: X 0.500 .00 - .00 .00 X .045 .00 DISCOUNT C+) INTEREST/PEN PAID (-) 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. TOTAL DUE INHERITANCE TAX ~/ JOINTLYE HELD ORJ TRUST ASSETS Penns-+ ~Vanla ~~' ~ BUREAU OF INDIVIDUAL TAXES 1 ~ :` INHERITANCE TAX DIVISION DEPARTMENT OF REVENUE PO BOX 280601 REV-1604 EX AFP C12-11) HARRISBURG PA 17128-0601 TERESA L SF~ANER 23 EDGEWOOD DI~ MECHANICSBURG'' PA 17055 DATE 01-03-2012 ESTATE OF NAVRATIL NADA DATE OF DEATH 01-14-2011 M FILE NUMBER 21 11-0359 COUNTY CUMBERLAND SSN/DC ;Z09-12-5368 ACN :L1105342 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF' WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE y RETAIN LOWER PORTION FOR YOUR RECORDS REV-1604 EX AFP C12- '-°-----'----°°-- _________________ li l ) ------------------- _______ __ ** INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD 0 ESTATE OF: NAVRATIL COUNTY: CUMBERLAND ACN: 11105342 FILE NO.: 21 11-0359 ADJUSTMENT BASED N: FINANCIAL FCU ACCOUNT N0.:40676-11 NADA M DATE OF DEATH: 01-14-2011 S.S/D.C. N0.:209-12-5368 ADMINISTRATIVE CORRECTION ' JOINT OR TRUST ASSET INFORMATION INSTITUTIION: MEMBERS 1ST TYPE OF ACCOUNT: C )SAVINGS CX) CHECKING C ) TRUST C ) TIME CERTIFICATE DATE ESTABLISHED 09-081-1984 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAX CREDITS: PAYMENT RECEIPT DATE NUMBER 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, SE~ REVERSE FOR CALCULATION OF ADDITIONAL INTEREST.ALF DIUAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FDRM FOR INSTRUCTIONS. .00 X 0.500 .00 - .00 00 X .045 .00 R TRUST ASSETS ** DATE: 01-03-2012 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 TERESA L SI~ANER 23 EDGEWOOD Dik MECHANICSBURG' PA 17055 INHERITANCE TAX JOINTLYE HELD ORJ TRUST ASSETS Pennsylvania ,` ~~ DEPARTMENT OF REVENUE REV-1604 EX AFP (12-11) DATE 01-03-2012 ESTATE OF NAVRATIL NADA M DATE OF DEATH 01-14-2011 FILE NUMBER 21 11-0359 COUNTY CUMBERLAND SSN/DC 209-12-5368 ACN 11105343 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 FOR YOUR RECORDS E-•~ R E V -16 0 4 EX AFP (12 - ~ I) ~---------------------------------------------------------------------------------------------------------- ** INHERITAN E TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS ** DATE• 01-03-2012 ESTATE OF: NAVRATIL ', NADA M DATE OF DEATH: 01-14-201a COUNTY: CUMBERLAND FILE NO.: 21 11-0359'.. S.S/D.C. N0.:209-12-5368 ADJUSTMENT BASED N: ADMINISTRATIVE CORRECTION ACN: 11105343 JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITU~`ION: MEMBERS 1ST FCU ACCOUNT N0.:4o676-42 TYPE OF ACCOUNT: C ),SAVINGS C ) CHECKING ( ) TRUST (X) TIME CERTIFICATE DATE ESTABLISHED 09-0$-1984 Account Balance .00 Percent Taxable X 0.500 Amount Subject to Tax''. .00 Debts and Deductions ', - .00 Taxable Amount .00 Tax Rate X .045 Tax Due .00 TAX CREDITS: PAYMENT RECEIPT DATE NUMB EIR R C PUC T INTE EST / U D TT TOTAL TAX PAYMENT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 * IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST.A IF DTOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE 'DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTF!UCTIONS. 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 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17126-0601 TERESA L SHANER 23 EDGEWOOD D~Z MECHANICSBURG' PA 17055 CUT ALONG THIS LINE • ~, ~: pennsylvarna ,; , ~-. DEPARTMENT OF REVENUE REV-1604 EX AFP C12-11) DATE 01-03-2012 ESTATE OF NAVRATIL NADA M DATE OF DEATH 01-14-2011 FILE NUMBER 21 11-0359 COUNTY CUMBERLAND SSN/DC 209-12-5368 ACN 11105344 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER Of= WILLS 1 COURTHOUSE SQUARE CARLISLE F'A 17013 ""~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ -- --------------------- .. ~.- i o u ~e t x A t F' ------------------------------------------- } 1) ---------------------- ** INHERITAN E TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS *~ _. DATE O1 03-2012 ESTATE OF. NAVRATIL FILE NO.: 21 11-0359' ADJUSTMENT BASED NADA INHERITANCE TAX JOINTLYE HELD ORJ TRUST ASSETS M DATE OF DEATH: 01-14-201:1 COUNTY: S.S/D.C. N0.:209-12-5368 ACN: +~~-~i ~~iJIRAIIVF f'f1RDC!`Trnu CUMBERLAND 11105344 JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUI~ION: MEMBERS 1ST FCU ACCOUNT N0.:4o676-43 TYPE OF ACCOUNT: ( )'',SAVINGS C ) CHECKING ( ) TRUST DATE ESTABLI SHED 09-0~-1984 Account Balance ' Percent Taxable ' X .00 0.500 Amount Subject to Tax', .00 Debts and Deductions ' - .00 Taxable Amount ' Tax Rate X .00 .045 Tax Due ' .00 TAX CREDITS: PAYMENT DATE RECEIP NUMBS DISCOUNT (+) INTEREST/PEN PAID ( ) CX) TIME CERTIFICATE 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, S~E REVERSE FOR CALCULATION OF ADDITIONAL INTERS ST.ALF DTOTAL DUE IS REFLECTED AS A "CREDIT" (CR)„ YOU MAY BE ~UE A REFUND. SEE REVERSE SIDE OF THIS FORM FDR INSTRUCTIONS. I REV•1470 EX (01-i D) a ~ . pennsylvania DEPARTMENT OF REVENUE BUREAU OFINDIVIDUAITAXES PO Box 280601 HARRISBURG PA 17128. 601 DECEDENTS NAME NADA MA NAVATIL REVIEWED BY Robin Graff SCHEDULE ITEM NO. INHERITANCE TAX EXPLANATION OF CHANGES EXPLANATION OF CHANGES 2111-0359 11105341 11105342 1110534311105344 A revievljr has been conducted on this account. The Department has determined that this joint bank account was properly reported on the probate return. Therefore, this assessrrhent has been corrected. ROW Page 1