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HomeMy WebLinkAbout03-08-13INHERITANCE TAX JOINTLY HELD ORJ TRUST ASSETS ~ PEn11SJ/LVcln18 BUREAU OF INDIVIDUAL TAXES ~ DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION PO BOX 280601 REV-1604 EX AFP (12-12) HARRISBURG PA 17128-0601 DATE 02-26-2013 RECORC}~.C C1=1"I~c aFESTATE OF OMMERT ISABELLE F REGISTER OF '~''i~.LS DATE OF DEATH 09-17-2011 FILE NUMBER 21 11-1007 COUNTY CUMBERLAND ROBERT W OMMERT :,Ji~ (1RR 8 ~~ ~ ~~SSN/DC APT 3315 ACN 12107865 325 WESLEY DR CLERK a Amount Remitted MECHANICSBURG PA 1705~~NS' CaURT CUMBERLAND Ca., FAMAKE 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 F• EV - 1 6 0 4 EX AFP C 1 2- 1 2) ------------------------- ** INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS ~* DATE• 02-26-2013 ESTATE OF: OMMERT ISABELLE F DATE OF DEATH: 09-17-2011• COUNTY: CUMBERLAND FILE NO.: 21 11-1007 S.S/D.C. N0. ADJUSTMENT BASED ON: ACN: 12107865 PROTEST BOARD DECISION JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: SOVEREIGN BANK ACCOUNT NO.: 0354000820 TYPE OF ACCOUNT: CX) SAVINGS C ) CHECKING C ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 01-01-1971 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due .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." TAX CREDITS: PAYMENT RECEIPT DATE NUMBER INTEREST%PENT 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 CALCULATIDN 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. \` r /