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HomeMy WebLinkAbout10-15-13 INHERITANCE TAX RECORD ADJUSTMENT p ,_ Pennsylvania BUREAU OF INDIVIDUAL TAXES JOINTLY HELD OR TRUST ASSETS - DEPARTMENT OF REVENUE INHERITANCE TAX DIV2615NG 0 R L)L tt 0 F(0L OF - REV-1604 IXAFP t12-12] HARRISBURG PA 27126-Y0601- tt!^� rU i� f t� i LCISTER OF 6"."LLS q DATE 10-02-2013 i� � ESTATE OF FINNEGAN DOROTHY DATE OF DEATH 10-17-2011 FILE NUMBER 21 12-0443 C U K COUNTY CUMBERLAND JUDITH QPi MARIZNEILijT SSN/DC ACN 1722 BRqIl`6o-tSSTL/AND CO., PA 12141312 Amoun# Remi tted NEW CUMBERLAND PA 17070-1124 ��-- MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE —1 RETAIN LOWER PORTION FOR YOUR RECORDS 4- -------------_-"--------------_------_..._._._.....___._._.._--------------------------------------------------------------------- REV-1604 EX AFP (12-12) *■ INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS N* DATE: 10-02-2013 ESTATE OF: FINNEGAN DOROTHY DATE OF DEATH: 10-17-2011 COUNTY: CUMBERLAND FILE NO. : 21 12-0443 S.S/D.C. NO. : ACN: 12141312 ADJUSTMENT BASED ON : ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: WELLS FARGO ACCOUNT NO. : 001010313654116 TYPE OF ACCOUNT: ( ) SAVINGS ( ) CHECKING ( X) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 03-16-2011 Account Balance .00 NOTE: TO ENSURE PROPER CREDIT TO YOUR Percent Taxable X 1.000 ACCOUNT, SUBMIT THE UPPER PORTION Amount Subject to Tax • 00 OF THIS NOTICE WITH YOUR TAX Debts and Deductions - .00 PAYMENT TO THE REGISTER OF WILLS Taxable Amount .DO AT THE ADDRESS SHOWN ABOVE. Tax Rate X • 15 MAKE CHECK OR MONEY ORDER PAYABLE Tax Due .00 TO: 'REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-7 TOTAL TAX PAYMENT_ ,00 BALANCE OF TAX DUE .00 INTEREST AND PEN. _ .00 TOTAL DUE Tin IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION 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. {�,-[}h} �/7