HomeMy WebLinkAbout02-22-13BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
RECaRDED QFFigE 4F'
REGISTER qF ~~.LS
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INHERITANCE TAX
RECORD ADJUSTMENT
JOINTLY HELD OR TRUST ASSETS
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SPRING ~I~ERL~I@'~ ~7~36 8632
~ Pennsylvania
DEPARTMENT OF REVENUE
REV-1604 IX AFP C12-12)
DATE 02-13-2013
ESTATE OF GLATFELTER DONALD M
DATE OF DEATH 12-13-2009
FILE NUMBER 21 10-0342
COUNTY CUMBERLAND
ACN 10141868
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: 02-13-2013
ESTATE OF: GLATFELTER DONALD M DATE OF DEATH: 12-13-2009 COUNTY: CUMBERLAND
FILE NO.: 21 10-0342 S.S/D.C. N0.:200-28-7170
ACN: 10141868
ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL I NST I TUT I ON : PSECU ACCOUNT NO .: 8930181659I RA50
TYPE OF ACCOUNT: t ) SAVINGS C ) CHECKING C ) TRUST CX} TIME CERTIFICATE
DATE ESTABLISHED 04-03-2001
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
.00
X 1.000
.00
_ .00
.00
X .045
.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 C+)
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.