HomeMy WebLinkAbout01-14-13 (2)BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
JOHN J SCOTT
3584 GOLFVIEW DR
MECHANICSBURG PA
INHERITANCE TAX
RECORD ADJUSTMENT ~ Pennsylvania
JOINTLY HELD OR TRUST ASSETS DEPARTMENT OF REVENUE
REV-1604 EX AFP (12 -12)
RECORO~.m c~;r
REGIS i ~~; Uf vE~~€ATE OF SCOTT 2013 MARY F
9 DATE OF DEATH 12-18-2011
(~13 .i~P~ 1l~ ~l i i~F}r~TYUMBER CUMBERLAN^ ~ (- ~~ _
SSN/DC
CLC \i ~.'." ACN 12101194
ORFHAtdS' GU1~i Amount Remitted
17D5o~~~~ERLA"E~ ;., ?r~
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 t~
REV-1604 EX AFP (12-12)
^* INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS ~~
DATE' 01-04-2013
ESTATE OF: SCOTT MARY F DATE OF DEATH: 12-18-2011 COUNTY: CUMBERLAND
FLLE NO.: 70 0452701 S.S/D.C. N0.: 169-16-9570 ACN: 12101194
ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: cIr12ENS BANK OF PENNSYLVANIA ACCOUNT N0.: 6223986657
TYPE OF ACCOUNT: ( ) SAVINGS (X) CHECKING ( ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 02-09-2009
Account Balance
Percent Taxable
Amount Sub]ect to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
197,962.06
X 0.500
98,981.03
.00
98,981.03
X .00
.00
N07E: TD 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
(-) gMOUNT PATD
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 OUE IS REFLECTED AS A
"CREDIT" CCR), YOU MAV BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.
~H