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HomeMy WebLinkAbout08-24-12 (2) BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 171"<'8-0601 RITANCE TAX ~~'pPJ~-(7 (~''~.'I I D ADJUSTMENT b LD OR TRUST ASSETS REG;~ ~ ~,, L,~ 2J12 AUG 24 AM II~ 34 Pennsylvania ~ DEPARTMENT OF REVENUE REV-1684 EX AFP U2-lll DATE 08-16-2012 ESTATE OF STEWART MARYANN DATE OF DEATH 07-19-2011 FILE NUMBER 21 12-0036 COUNTY CUMBERLAND SSN/DC 199-38-2983 ACN 11162273 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA, 17813 ORPFiaN'~ COURT CUMBERLAND CO.. PA PATRICIA S WUNbERLIN 32 BEACH FARM Rb WORMLEYSBURG PA 17043-1135 CUT ALONG THIS LINE REV-1604 EX AFP C12-1~) *~ INHERITANC TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS ^x DATE: 08-16-2012 ESTATE OF: STEWART COUNTY: CUMBERLAND FILE NO.: 21 12-00361 S.S/D.C. N0.: 199-38-2983 ACV: 11162273 ADJUSTMENT BASED N: ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUI~ION: MELLON BANK ACCOUNT N0.: 355259030 TYPE OF ACCOUNT: (X) SAVINGS ( ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 03-31-2003 Account Balance Percent Taxable Amount Subject to Ta Debts and Deductions Taxable Amaunt Tax Rate Tax Due TAX CREDITS: ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ MARYANN DATE OF DEATH: 07-19-2011 21,658.50 X 0.083 1,804.80 .00 1,804.80 X .045 81.22 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 RECE NUM PT ER DISCOUNT INTEREST/PEN (+) PAID (-) AMOUNT PAID 01-20-2012 CD015 it 87 .00 81.22 ', TOTAL TAX PAYMENT 81.22 BALANCE OF 7AX DUE .00 INTEREST AND PEN. .00 ~. TOTAL DUE ~ IF PAID AFTER THIS DAT E, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFiECTED AS A "CREDIT" CCRJ. VOU MAY ~E DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ~~