HomeMy WebLinkAbout04-02-12 (2)BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
FERNE A MILLS
263 ALLEN RD
CARLISLE PA 17013
INHERITANCE TAX
RECORD ADJUSTMENT
JO ~jI~~LL~1~~F~L1~_~~I~ T(R}~ST ASSETS
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DEPARTMENT OF REVENUE
REV-1604 EX AFP (12-11)
r?°' qt7~ r<~IAT~, 03-26-2012
"`~'{` f~ ~2 ~i'E~71k~ OF MILLS WESLEY A
DATE OF DEATH 10-27-2010
CI.ERY<~,r FILE NUMBER 21 11-0554
~{~,~~,~,, ;,~ ~ NTY CUMBERLAND
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C111v1~~~ ~+L;~ L 1~:;b,c~
11128470
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
00 0000000 0000000000000000 000
CARLISLE PA 17013
CUT ALONG THIS LINE ~i RETAIN LOWER PORTION FOR YOUR RECORDS E~
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REV-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: 11128470
ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: WACHOVIA BK NA ACCOUNT NO.: 3000023888057
TYPE OF ACCOUNT: CX) SAVINGS C ) CHECKING C ) TRUST C ) TIME CERTIFICATE
DATE ESTABLISHED 11-15-2001
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
964.00
X 0.500
482.00
.00
482.00
X .00
.00
NOTE: TO ENSURE PROPER CREDIT TD 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 (+)
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.
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