HomeMy WebLinkAbout06-01-12 (2)INHERITANCE TAX
BUREAU DF INDIVID ~~~_~ ~,irY,,'~,+ JOINT Y HELD 0 J TRUST ASSETS Pennsylvania ~ ~,
~t Fr~~ ~~ DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISIO ~~~? ;'" ~"- `,'`~i! ~ ~ REV-1604 EX AFP (12-11)
PO BOX 280601 `` ~ 1`-y'
HARRISBURG PA 17128-0601
10 f 2 JUN -1 P~ i2.4 ~
`'~~ n~
MAE S A NEIL"
5007 MCDONALD DR
MECHANICSBURG PA 17050-2445
DATE 05-29-2012
ESTATE OF STARNER DONALD L
DATE OF DEATH 01-12-2011
FILE NUMBER 21 12-0447
COUNTY CUMBERLAND
SSN/DC
ACN 11129058
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE ~1 RETAIN LOWER PORTION FOR YOUR RECORDS F~
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REV-1604 EX AFP C12-11)
** INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS **
DATE: 05-29-2012
ESTATE OF: STARNER DONALD L DATE OF DEATH: 01-12-2011 COUNTY: CUMBERLAND
FILE NO.: 21 12-0447 S.S/D.C. N0.: ACN: 11129058
ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: CITIZENS BANK OF PENNSYLVANIA ACCOUNT NO.: 6241084971
TYPE OF ACCOUNT: (X) SAVINGS C ) CHECKING C ) TRUST C ) TIME CERTIFICATE
DATE ESTABLISHED 04-10-2003
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
80,129.20
X 0.500
40,064.60
.00
40,064.60
X .00
.00
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."
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.
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