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HomeMy WebLinkAbout01-17-12f INHERITANCE TAX ""' r ,..,, RECORD ADJUSTMENT pennsylvarna - JD BUREAU DF INDIVIDUAL TAXES ~~ t ; INTLY H~L~ _ ,,.OR TRUST ASSETS , tlfF- DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION PO BOX 280601 '. J t? REV-1604 EX AFP (12-11) HARRISBURG PA 17126-0601 `-~ '°'~~ ~ ~ ,;~` (~; ' ~ DATE :L2-30-2011 ESTATE OF REESE ROBERT R „ ~ ~`~ L~~`~ ~ `- DATE OF DEATH 12-03-2010 - ~ C FILE NUMBER 21 11-0694 RFN 4~ti' ~ ;' n ~~ r n "r COUNTY CUMBERLAND JOHN W REESE '~~ ~ ~ ~' SSN/DC ].14-14-2624 731 ERFORD RD ACN ].1101900 CAMP HILL PA 17011 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 (12 -11) C --- -'--'--'--'---'-°--'--'---°--°---°---- ** INHERITAN E TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS e* DATE• 12-30-2011 ESTATE OF: REESE ', ROBERT R DATE OF DEATH: 12-03-2010 COUNTY: CUMBERLAND FILE NO.: 21 11-0694' S.S/D.C. N0.:114-14-2624 ACN ADJUSTMENT BASED N: ADMINISTRATIVE : 11101900 CORRECTION JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUI~ION: METRO BANK ACCOUNT N0 .:536308927 TYPE OF ACCOUNT: ( )''SAVIN GS (X) CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 07-0~-2003 Account Balance ', Percent Taxabl 2,944.70 NOTE: TO ENSURE PROPER CREDIT TO YOUR e X Amount Subject to Tax''. 0.500 1,472.35 ACCOUNT, SUBMIT THE UPPER PORTION Debts and Deductions ' - 1,113.84 OF THIS NOTICE WITH YOUR TAX Taxable Amount 358.51 PAYMENT TO THE REGISTER OF WILLS Tax Rate ' X .045 AT THE ADDRESS SHOWN ABOVE. Tax Due 16.13 MAKE CHECK OR MONEY ORDER PAYABLE T0: "REGISTER OF WILLS, AGENT " TAX CREDITS: . PAYMENT RECEI T DATE NUMB R DISCOUNT (+) 06-20-2011 CD0146 4 INTEREST/PEN PAID C-) AMOUNT PALD 1 .00 16.13 TOTAL TAX PAYMENT 16.1 j BALANCE OF TAX DUE 0 INTEREST AND PEN. •0 TOTAL DUE ~ IF PAID AFTER THIS DATE, $EE 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.