HomeMy WebLinkAbout08-24-12BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PD BOX 280601
HARRISBURG PA 1]128-0601
r INHERITANUSTMENT
~~./~~I~F~~~ORM ASSETS
?~ 12 AUG 24 A~ I 1 ~ 34
ORPi-iA~J'S ~CiJRT
BEATRICE M HALL CUMBERLAND CO., PA
6 LANTERN LANE PA 17257-0000
SHIPPENSBURG
Pennsylvania ..
DEPARTMENT OF REVENUE
REV -1604A EX AFP (12-1ll
DATE OS-15-2012 HELEN B
ESTATE OF KIRKMAN
DATE OF DEATH 21-~~_1256
FILE NUMBER CUMBERLAND
COUNTY
SSN/DC 11500145
ACN
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 ~
~~ INHERITANCE TAX RECORD ADJUSTMENT BENEFICIARY FORM ASS
REV-1604A EX AFP (12-11) DATE; 08-15-
ESTATE OF: KIRKMAN
FILE N0.:21 10-1256
HELEN
g DATE OF DEATH: 12-OS-2010
S.S/D.C. NO.: 177-16-1654
ADMINISTRATIVE CORRECTION
BENEFICIARY FORM ASSETS
MERIPRISE
NAME OF SECURITY:
TYPE OF ACCOUNT:
COUNTY: CUMBERLAND
ACN: 11500145
v., c969
ACCOUNT NO.:~--j-
( ) STOCK ( ) BOND
~ ) SECURITIES IX1 SEC ACCT
DOD Valuation
Percent Taxable
Amount Sublect to Tax
Debts and Deductions
Taxable Amount
Tax Due
.00
0.333
X .00
.00
- .00
.045
X .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
TD: "REGISTER OF WILLS, AGENT."
* Ip PCREDITT ER Cµ)ISYOUT MAYS BE DUEE ASREFUNDCA SE EL REVERSEF SIDE OF THI SI FOR ME FOR INSTRUCTIONS.IS REFLECTED AS ~~
-V-110 Ex lOt-t0)
=~'" Pennsylvania
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
Po sox zsosol _ --
I ITEM
SCHEDULE NO.
Helen B. Kirkman
James Russell
INHERITANCE TAX
EXPLANATION
OF CHANGES
EXPLANATION OF CHANGES
2110-1256
11500145
Above-referenced ACN(s) are being adjusted to reflect zero tax due since they have been
reported on the probate return.
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