HomeMy WebLinkAbout07-10-12 (5)F(rp~~Qlarw Q DI ADJUSTMENT
CILUIJ~~~ ; LD OR TRUST ASSETS
BUREAU OF INDIVIDUAL TAXES UJ [[[Cj , ,~,~
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBORG PA 11128-0601 2Ql2 JUt I 0 Pti 12.18
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DEBRA D MILLER
1146 PHEASANT DR N
CARLISLE ', PA 17013-1251
CUT ALONG THIS LINE
REV-1604 EX AFP (12- 1)
^^ INHERI7AN E TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS ^~
DATE: 06-28-2012
ESTATE OF: WELTON
FILE NO.: 21 12-0391 S.S/D.C. NO ACN: 12120689
ADJUSTMENT BASED N: ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITU ION: MEMBERS lsr Fcu ACCOUNT N0.:326503-45
~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
MARY L DATE OF DEATH: 03-11-2012 COUNTY: CUMBERLAND
Pennsylvania ~
DEPARTMENT OF RE VENUE
REV-1604 EX AFP Q2-]ll
DATE f16-28-2D12
ESTATE OF WELTON MARY L
DATE OF DEATH CI3-11-2012
FILE NUMBER `e!1 12-0391
COUNTY CUMBERLAND
SSN/DC e!74-24-0983
ACN 12120689
Amount RemitteE
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF' WILLS
1 COURTHOUSE SQUARE
CARLISLE P'A 17D13
TYPE OF ACCOUNT: ( ~ SAVINGS ( ) CHECKING C ) TRUST (X) TIME CERTIFICATE
DATE ESTABLISHED 12- 2-2010
Account Balance
Percent Taxable
Amount Subject to Ta
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
15.823.00
X 0.500
7,911.50
1,781.61
6,129.89
X .045
275.85
NOTE: TO ENSURE PROPER CREDIT TO YOUR
ACCOUNT, SUBMIT THE UPPER PORTION
OF THIS NOTICE WITH YOUR TAX
PAYMENT TO 7HE REGISTER OF WILLS
AT THE ADDRESS SHOWN ABOVE.
MAKE CHECK OR MONEY ORDER PAYABLE
T0: "REGISTER OF WILLS, AGENT."
PAYMENT
DATE RECE
NUM PT
ER DISCOUNT C+)
INTEREST/PEN PAID (-) AMOUNT P,4ID
05-29-2012 CD016 098 13.79 262.06
TOTAL 7AX PAYMENT 275,g5
~i BALANCE OF TAX DUE .00
INTEREST AND PEN.
TOTAL DUE
~ IF PAID AFTER THIS DATE1I SEE REVERSE FOR CALCULATION OF ADDITIDNAL INTEREST. IF TOTAL DUE IS REFLECTED AS A
"CREDIT" (CR), YOU MAY NE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.
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