HomeMy WebLinkAbout03-26-12BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BDX 280601
HARRISBURG PA 17128-0601
INHERITANCE TAX
RECORD ADJUSTMENT
I' r""~~ Q~i~T~1wHELD OR TRUST ASSETS
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SHIRLEY E SULTAT~O~~'~~~~~'~'''~~~' ~'~~ PA
38 SALT ROAD
ENOLA PA 17025-2017
Pennsylvania ,.5 ~ ~-:
DEPARTMENT OF REVENUE
REV-1604 EX AFP (12-11)
DATE 03-13-2012
ESTATE OF SULTATOS PETER J
DATE OF DEATH 08-13-2010
FILE NUMBER 70 0432398
COUNTY CUMBERLAND
SSN/DC
ACN 11113487
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 ~
REV-1604 EX AFP C12-11~
~* INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS **
DATE: 03-13-2012
ESTATE OF: SULTATOS PETER J DATE OF DEATH: 08-13-2010 COUNTY: CUMBERLAND
FILE NO.: 70 0432398 S.S/D.C. N0.: ACN: 11113487
ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: SOVEREIGN BANK ACCOUNT NO.: 0921710011
TYPE OF ACCOUNT: C ~ SAVINGS CX) CHECKING C ) TRUST C ) TIME CERTIFICATE
DATE ESTABLISHED 02-07-1997
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
27,965.90 NOTE:
X 0.500
13,982.95
.00
13,982.95
X .00
.00
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."
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID C-) 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.
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