HomeMy WebLinkAbout06-17-13 INHERITANCE TAX •
RECpRD ADJUSTMENT � pennsylvarna
JOINTLY HELD OR TRUST ASSETS � DEPARTMENTOFREVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIYISION REY-1604 EX AFP f12-IZ}
PO BOX 280b01
HARRISBURG PA 17128-0601
REt��}��s�=�:' �z°,:.I�t�� �?�
DATE OS-04-2013
RE�I� ; ��"C l��" �s�I�i._� ESTATE OF WILSON JAMES B
DATE OF DEATH 05-27-2012
����� ��� �� �� � � COUNTY�MBER CUMBERLAND
SSN/DC 17b-30-6432
DENISE WILSONDEHNERT ����� (��: ACN 121382q4
217 FINEVIEW RD �„„�a��� ����.r ,
� .. � tted
CAMP HIL� PA 1?Ol � � moun em_
CUMBER�AND CO., PA
MAKE CHECIC PAYAB�E AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE � RETAIM LQWER PQR7ION FOR YOUR RECORDS r--
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REV-1604 EX AFP C12-12)
** INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS **
DATE• 06-04-2013
ES�'ATE ❑F: WILSON JAMES B DATE OF DEATH: 05-27-2d12 COUNTY: CUMBERLAND
FILE NO. : 21 I2-0741 S.SID.C. N0. : 17b-30-G932 ACN: 12138204
ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTIQN
JOINT OR TRUST ASSET INFORMATION
FTNANCIAL INSTITUTION: SUSQUEHANNA BANK ACCOUNT NO. : 1730002100
TYPE OF ACCOUNT: CX} SAVINGS C ) CHECKIN� t ) TRUST C } TIME CERTIFICATE
DATE ESTABLISHED 08-07-2048
Account Balance 12,113.13 �pTE: TO ENSURE PROPER CREDIT TO YBUR
Percent Taxable X �• �'�6 ACCOUNT, SUBMIT TNE UPPER PORTION
Amount Subject to Tax 2t��$�g� OF THIS FIOTICE WITN YOUR TAX
Debts and Deductions - ��0 PAYMENT TO THE REGISTER OF WILLS
Taxable Amaunt 2a018•gQ AT THE ALIDRESS SHOWN ABOYE.
Tax Rate X •a�� MAKE CHECK OR MONEY ORDER PAYABLE
T�x Due 90,85 T0: "RE6ISTER OF WILLSr AGENT."
TAX CREDITS:
PDATE�T RNUMBER IFtTERESTIPEN PAID {-)
AMOUNT PAID
07-05-2012 CD016222 4.54 86.31
TOTAL TAX PAYMENT 90.85
BALANCE OF TAX DUE ��
INTEREST AND PEN. .a0
TOTAL DUE
� IF PAIA AFTER THIS DA7E, SEE REVERSE FOR CALCULATION OF ADDI7IONAL INTEREST. IF TqTa� DUE IS REFLECrED As a
"CREDIT" {CR): YOU MAY BE DUE A REFUND. SEE REVERSE SIDE QF THIS FdRM FOR INSTRUCTFONS. �