HomeMy WebLinkAbout06-15-12INHERITANCE TAX •
RECORD ADJUSTMENT pennsylvarna ~
(` r'!1+~~1'~I~~~;~CF}4tD OR TRUST ASSETS
~`~•~~~'`-~~ ~ , '~ ~ L Vt' DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES f ~i ,_ r ,_'" REV-:L604 EX AFP (12-11>
INHERITANCE TAX DIVISION ~~~~ ~(I 1 (~
PO BOX 280601 - `~~ 't'~• "~
HARRISBURG PA 17128-0601
~~~[ ~~~ ~ 5 Pty 2: ~ ~ DATE 06-06-2012
ESTATE OF TREGL RUTH A
DATE OF DEATH 03-08-2012
.;hl'~` FILE NUMBER 21 12-0423
~f{Pti1~V'S G~^nUAT COUNTY CUMBERLAND
RONALD TREGL ~~ v~I•.~ SSN/DC
ACN 12122196
116 STRAYER DR
CARLISLE PA 17013-4407 __ Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SgUARE
CARLISLE PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS !--
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REV-1604 EX AFP C12-11)
~* INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS **
DATE• C16-06-2012
ESTATE OF: TREGL RUTH A DATE OF DEATH: 03-08-2012 COUNTY: CUMBERLAND
FILE NO.: 21 12-0423 S.S/D.C. N0.: ACN:: 12122196
ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: ORRSTOWN BANK ACCOUNT NO.: 103000234
TYPE OF ACCOUNT: ( ) SAVINGS (X) CHECKING C ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 04-17-1998
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
1,750..82
X 0.500
875.41
1,246.00
.00
X .045
.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."
TAX CREDITS:
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT (+)
INTEREST/PEN PAID C-) AMOUNT PAID
04-08-2012 CD015812 .00 10.78
TOTAL TAX PAYMENT 10.78
BALANCE OF TAX DUE 10.78CR
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.