HomeMy WebLinkAbout04-02-12~,,, -~
INH T NCE TAX 'r' '"
O ~'r""~~"II~'~ JUSTMENT pennsylvarna ~ ~ .
i~~~.J.O~N-T-LY ~ bR TRUST ASSETS
BUREAU OF INDIVIDUAL TAXES (~'"~~ f rr ~ '~, `~ ~ DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION I tU~~i+'V'`~*~~ ~ ~'' ''r °4~~ REV-1604 EX AFP (12-11)
PO BOX 280601
HARRISBURG PA 17128-0601
r ~r? n-y~ ~~ ~ `n 'n 7
Ct,... r1t li .: ~ ~
DATE 03-26-2012
ESTATE OF MILLS WESLEY A
,~r DATE OF DEATH 10-27-2010
CLE'~'~ ,
~;'~'"' ~~~'~~'~~ FILE NUMBER 21 11-0554
~+ ~,~~^:~' ^nl'1 n:"~ r~A COUNTY CUMBERLAND
Ct);v ,~.t''~ ray a..~ ;.,~ ~ , r.r.
FERNE A MILLS SSN/DC
ACN 11128471
263 ALLEN RD
CARLISLE PA 17013 Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
00 0000000 0000000000000000 000
CARLISLE PA 17013
CUT ALONG THIS LINE ~• RETAIN LOWER PORTION FOR YOUR RECORDS F~
-----------------
E -1604 EX AFP C12-11)
** INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS **
DATE: 03-26-2012
ESTATE OF: MILLS WESLEY A DATE OF DEATH: 10-27-2010 COUNTY: CUMBERLAND
FILE NO.: 21 11-0554 S.S/D.C. N0.: ACN: 11128471
ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: WACHOVIA BK NA ACCOUNT NO.: 1010072343548
TYPE OF ACCOUNT: ( ~ SAVINGS CX) CHECKING ( ) TRUST C ) TIME CERTIFICATE
DATE ESTABLISHED 06-02-2003
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
3,525.00 NOTE:
X 0.500
1,762.50
.00
1,762.50
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 (-)
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" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.