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HomeMy WebLinkAbout06-17-13 INHERITANCE TAX RECORD ADJUSTMENT � pennsylvania JOINTLY HELD OR TRUST ASSETS DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION REV-1604 EX AFP (12-12) PO BOX 280601 HARRISBURG PA 17128-0601 ��G�a't3.`:=� {�i�'�C� �F DATE 06-05-2013 RG�`I� � �i`� OF ���I�E.S ESTATE OF HOCK LARUE C DATE OF DEATH 04-02-2011 �p �} FILE NUMBER 21 11-0474 s`.��3 JUN 17 pl l 1 .L� COUNTY CUMBERLAND SSN/DC 174-03-9089 JARED L HOCK $- ACN 11162182 1055 SQUIRES DR ����� �' WEST CHESTER Pd)ft��4�o�AURT Amount Remitted CUMBERLANQ GO., PA 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: 06-05-2013 ESTATE OF: HOCK LARUE C DATE OF DEATH: 04-02-2011 COUNTY: CUMBERLAND FILE NO. : 21 11-0474 S.S/D.C. N0. : 174-03-9089 ACN: 11162182 ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: GRAYSTONE TOWER BANK ACCOUNT NO . : 7o1ss610 TYPE OF ACCOUNT: C ) SAVINGS C ) CHECKING O TRUST ( b TIME CERTIFICATE DATE ESTABLISHED 04-02-2011 Account Balance •00 NOTE: TO ENSURE PROPER CREDIT TO YOUR Percent Taxable X 1 .000 ACCOUNT, SUBMIT THE UPPER PORTION Amount Subject to Tax •�� OF THIS NOTICE WITH YOUR TAX Debts and Deductions - •�� 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 •�� T0: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT C+) pMOUNT PAID DATE NUMBER INTEREST/PEN PAID C-) 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 707AL DUE IS REFLECTED AS A "CREDIT^ (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. \ 0