HomeMy WebLinkAbout02-22-13INHERITANCE TAX
RECORD ADJUSTMENT
JOINTLY HELD OR TRUST ASSETS
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION.
PO BOX 280601
HARRISBURG PA 17128-0601
RECGR~IE~ 4F~'I~E a~
REGISTER OF 'R ILLS
113 FEB 22 P~ l~ ~~
ROBERT W C~~.I~ ~~
325 WESLE~~DIt'A~S~ Ct1URT
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~ pennsyLvania
DEPARTMENT OF REVENUE
REV-1604 EX AFP (12-12)
DATE 02-15-2013
ESTATE OF OMMERT ISABELLE F
DATE OF DEATH 09-17-2011
FILE NUMBER 21 11-1007
COUNTY CUMBERLAND
ACN 12107865
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 ~
REV-1604 EX AFP C12-12~
** INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS **
DATE: 02-15-2013
ESTATE OF: OMMERT ISABELLE F DATE OF DEATH: 09-17-2011 COUNTY: CUMBERLAND
FILE NO.: 21 11-1007 S.S/D.C. N0.:195-16-3961 ACN: 12107865
ADJUSTMENT BASED ON : ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: SOVEREIGN BANK ACCOUNT NO.: 0354000820
TYPE OF ACCOUNT: CX) SAVINGS C ) CHECKING C ) TRUST C ) TIME CERTIFICATE
DATE ESTABLISHED 01-01-1971
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
.00
X 0.500
.00
_ .00
.00
X .15
.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
T0: "REGISTER OF WILLS, AGENT."
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT (+)
INTEREST/PEN PAID C-) AMOUNT 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" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.