HomeMy WebLinkAbout07-13-12 (2)BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
ODA C HOPPLE
108 SUNSET DR
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INHERITANCE TAX ~-
JUSTMENT pe11t1S~/LV811~a ~ :;
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ESTATE OF KOLLER BARBARA R
~~+ ~~^~;` ~w!j' DATE OF DEATH 12 - 24 - 201 1
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ACN 12104029
NEW CUMBERLAND PA 17070-3059
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 E--
REV-1604 EX AFP C12-11)
** INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS ~*
DATE: 07-09-2012
ESTATE OF: KOLLER BARBARA R DATE OF DEATH: 12-24-2011 COUNTY: CUMBERLAND
FILE NO.: 21 12-0229 S.S/D.C. N0.: ACN: 12104029
ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: FULTON BANK NA ACCOUNT NO.: 400-1859570
TYPE OF ACCOUNT: C ) SAVINGS C ~ CHECKING C ) TRUST CX? TIME CERTIFICATE
DATE ESTABLISHED 05-31-1984
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
.00
X 0.500
.00
.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."
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT (+)
INTEREST/PEN PAID C-) AMOUNT PAID
02-15-2012 CD015607 .00 682.37
06-18-2012 SBADJUST .00 3.96
TOTAL TAX PAYMENT 686.33
BALANCE OF TAX DUE 686.33CR
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.