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Home My WebLink About12-07-12 INHERITANCE TAX RECORD ADJUSTMENT pet1115yLVal11a JOINTLY HELD OR TRUST ASSETS DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES REV-1604 EX AFP (12-11) INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 RECORDrD "FFJ^~r-- OF DATE 12-04-2012 REGISTER OF S ESTATE OF SISSON MARGARET T ~1 DATE OF DEATH 02-17-2009 DEC 7 05 FILE COUNTYUMBER CUMBERLAND 21 09-0451 SSN/DC 212-24-6725 JULIE MARCH CLERK C ACN 09114060 5 PRIMROSE LANORpHAWCO., OURT Amount Remitted CARLISLE Cumft-t PA c.R MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE RETAIN LOWER PORTION FOR YOUR RECORDS REV-1604 EX AFP (12-11) INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS DATE: 12-04-2012 ESTATE OF: SISSON MARGARET T DATE OF DEATH: 02-17-2009 COUNTY: CUMBERLAND FILE NO.: 21 09-0451 S.S/D.C. NO.:212-24-6725 ACN: 09114060 ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: MEMBERS 1sT FCU ACCOUNT NO.: 17452-00 TYPE OF ACCOUNT: (X) SAVINGS ( ) CHECKING C ) TRUST C ) TIME CERTIFICATE DATE ESTABLISHED 06-25-1975 Account Balance .00 NOTE: TO ENSURE PROPER CREDIT TO YOUR Percent Taxable X 0.166 ACCOUNT, SUBMIT THE UPPER PORTION Amount Subject to Tax .00 OF THIS NOTICE WITH YOUR TAX Debts and Deductions - .00 PAYMENT TO THE REGISTER OF WILLS Taxable Amount .00 AT THE ADDRESS SHOWN ABOVE. Tax Rate X .045 MAKE CHECK OR MONEY ORDER PAYABLE Tax Due .00 TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID C-) TOTAL TAX PAYMENT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. INHERITANCE TAX RECORD ADJUSTMENT pennsylvania h JOINTLY HELD OR TRUST ASSETS DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES~ECORCC C^}C REV-1604 EX AFP (12-11) POINHERITANCE 280601 DIVISION REGISTER CF vv s HARRISBURG PA 17128-0601 D~ 7 PM OS EDATE STATE OF SISSON2012 MARGARET T CLEF DATE OF DEATH 02-17-2009 FILE NUMBER 21 09-0451 ORPHANS-COURT COUNTY CUMBERLAND SSN/DC 212-24-6725 JULIE MA AMBERLAND CO,, PA ACN 09114062 5 PRIMROSE LANE Amount Remitted CARLISLE PA 17015 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE RETAIN LOWER PORTION FOR YOUR RECORDS 4-- REV-1604 EX AFP (12-11) INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS DATE: 12-04-2012 ESTATE OF: SISSON MARGARET T DATE OF DEATH: 02-17-2009 COUNTY: CUMBERLAND FILE NO.: 21 09-0451 S.S/D.C. NO.:212-24-6725 ACN: 09114062 ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO.: 17452-11 TYPE OF ACCOUNT: ( ) SAVINGS (X) CHECKING C ) TRUST C ) TIME CERTIFICATE DATE ESTABLISHED 02-05-1980 Account Balance .00 NOTE: TO ENSURE PROPER CREDIT TO YOUR Percent Taxable X 0.500 ACCOUNT, SUBMIT THE UPPER PORTION Amount Subject to Tax .00 OF THIS NOTICE WITH YOUR TAX Debts and Deductions - .00 PAYMENT TO THE REGISTER OF WILLS Taxable Amount .00 AT THE ADDRESS SHOWN ABOVE. Tax Rate X .045 MAKE CHECK OR MONEY ORDER PAYABLE Tax Due .00 TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT AMOUNT PAID DATE NUMBER INTEREST/PEN PAID TOTAL TAX PAYMENT .00 BALANCE OF TAX DUE .00 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" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. INHERITANCE TAX RECORD ADJUSTMENT pennsylvania di JOINTLY HELD OR TRUST ASSETS DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES REV-1604 EX AFP (12-11) INHERITANCE DIVISION RECORDED OFFICE OF PO BOX OX 28 280606001 1 HARRISBURG PA 17128-0601 REOISTE:R 0F Vi S M DATE 12-04-2012 L9M7 DEC 7 PM 1 0 5 DATETOFODEATH 02-107-2009 MARGARET T FILE NUMBER 21 09-0451 CLERK Of- COUNTY CUMBERLAND 212-24-6 JULIE MARCH ORPHANS COURT ACN/DC 0 9114063725 5 PRIMROSE LANE CUMBERLAND GO., PA Amount Remitted CARLISLE PA 17015 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE RETAIN LOWER PORTION FOR YOUR RECORDS REV-1604 EX AFP (12-11) INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS DATE: 12-04-2012 ESTATE OF: SISSON MARGARET T DATE OF DEATH: 02-17-2009 COUNTY: CUMBERLAND FILE NO.: 21 09-0451 S.S/D.C. NO.:212-24-6725 ACN: 09114063 ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: MEMBERS 1sT FCU ACCOUNT NO.: 17452-05 TYPE OF ACCOUNT: (X) SAVINGS C ) CHECKING C ) TRUST C ) TIME CERTIFICATE DATE ESTABLISHED 09-22-1985 Account Balance .00 NOTE: TO ENSURE PROPER CREDIT TO YOUR Percent Taxable X 0.500 ACCOUNT, SUBMIT THE UPPER PORTION Amount Subject to Tax .00 OF THIS NOTICE WITH YOUR TAX Debts and Deductions - .00 PAYMENT TO THE REGISTER OF WILLS Taxable Amount .00 AT THE ADDRESS SHOWN ABOVE. Tax Rate X .045 MAKE CHECK OR MONEY ORDER PAYABLE Tax Due .00 TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT C+) DATE NUMBER INTEREST/PEN PAID AMOUNT PAID TOTAL TAX PAYMENT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE . Do * IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. INHERITANCE TAX pennsylvania BUREAU OF INDIVIDUAL TAXES RECORD ADJUSTMENT DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION PO BOX 280601 BENEFICIARY FORM ASSETS REV-1604A EX AFP (12-11) HARRISBURG PA 17128-0601 RECORDED 13F-'CE REGIS TER O==S ESTATE OF SISSON2012 MARGARET T DATE OF DEATH 02-17-2009 ZVI? DEC 7 Fi l i 0- FILE NUMBER 21 09-0451 MOLLY J RESSLER COUNTY CUMBERLAND SSN/DC 212-24-6725 1009 TRINDLE ROAD CLERK OF ACN 09503506 CARLISLE PA 17013-$ANANS' COURT Amount Remitted CUMBERLAND CO., RA MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE RETAIN LOWER PORTION FOR YOUR RECORDS REV-1604A EX AFP (12-11) INHERITANCE TAX RECORD ADJUSTMENT BENEFICIARY FORM ASSETS DATE: 12-04-2012 ESTATE OF: SISSON MARGARET T DATE OF DEATH: 02-17-2009 COUNTY: CUMBERLAND FILE NO.: 21 09-0451 S.S/D.C. NO.: 212-24-6725 ACN: 09503506 ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION BENEFICIARY FORM ASSETS NAME OF SECURITY: AMERIPRISE ACCOUNT NO.: 041228308148002 TYPE OF ACCOUNT: (X) SECURITIES ( ) SEC ACCT ( ) STOCK C ) BOND DOD Valuation .00 NOTE: TO ENSURE PROPER CREDIT TO YOUR Percent Taxable X 0.000 ACCOUNT, SUBMIT THE UPPER PORTION Amount Subject to Tax .00 OF THIS NOTICE WITH YOUR TAX Debts and Deductions - .00 PAYMENT TO THE REGISTER OF WILLS Taxable Amount .00 AT THE ADDRESS SHOWN ABOVE. Tax Due X .045 MAKE CHECK OR MONEY ORDER PAYABLE Tax Rate .00 TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID C-) TOTAL TAX PAYMENT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX pennsytvania INHERITANCE TAX DIVISION RECORD ADJUSTMENT •7 DEPARTMENT OF REVENUE PO BOX 280601 BENEFICIARY FORM ASSETS REV-1604A EX AFP (12-11) HARRISBURG PA 17128-0601 RECORDED OFFICE OF kz'I l_S REGIST-E OF ~7 DATE 12-04-2012 Llfl? DEC r 0c DATETOFODEATH 02-177-2009 MARGARET T FILE NUMBER 21 09-0451 JULIE A MARCH CLERK CP COUNTY CUMBERLAND 5 PRIMROSE LANE ORPHANS' COURT SSN/DC 212-24-6725 ACN 09503508 CARLISLE PA 1701-108MBERLAND CC., PA Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE RETAIN LOWER PORTION FOR YOUR RECORDS F- REV-1604A EX AFP (12-11) INHERITANCE TAX RECORD ADJUSTMENT BENEFICIARY FORM ASSETS DATE: 12-04-2012 ESTATE OF: SISSON MARGARET T DATE OF DEATH: 02-17-2009 COUNTY: CUMBERLAND FILE NO.: 21 09-0451 S.S/D.C. NO.: 212-24-6725 ACN: 09503508 ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION BENEFICIARY FORM ASSETS NAME OF SECURITY: AMERIPRISE ACCOUNT NO.: 041528308145002 TYPE OF ACCOUNT: (X) SECURITIES C ) SEC ACCT ( ) STOCK C ) BOND DOD Valuation .00 NOTE: TO ENSURE PROPER CREDIT TO YOUR Percent Taxable X 0.000 ACCOUNT, SUBMIT THE UPPER PORTION Amount Subject to Tax .00 OF THIS NOTICE WITH YOUR TAX Debts and Deductions - .00 PAYMENT TO THE REGISTER OF WILLS Taxable Amount .01 AT THE ADDRESS SHOWN ABOVE. Tax Due X .045 MAKE CHECK OR MONEY ORDER PAYABLE Tax Rate .00 TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT DATE NUMBER INTEREST/PEN PAID C-) AMOUNT PAID 06-29-2009 SBADJUST .00 1.34 TOTAL TAX PAYMENT 1.34 BALANCE OF TAX DUE INTEREST AND PEN. .00 TOTAL DUE 1.34CR IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. 1