HomeMy WebLinkAbout01-07-14 (2) INHERITANCE TAX
RECORD ADJUSTMENT pennsylvania
BUREAU OF INDIVIDUAL TAXES JOINTLY HELD OR TRUST ASSETS DEPARTMENT OF REVENUE
-
INHERITANCE TAX DIVISION REV-1604 IX AFP (12-73)
PO BOX 230601
HARRISBURG PA 17128-0601
RECORDED OFFICE OF DATE 12-17-2013
HATSCK
REGISTER OF WILLS DATETOFODEATH 09-25-2612 RUTHELLA
AN 7 q�Dt ('7 FILE NUMBER 21 13-0984
�lY
COUNTY AN ! till 1U 10 SSN/DC 166-32`1959
SHERRY A KUFFA ACN 12156274
547 HILLCREST DR CLERK OF Amount Remitted
CARLISLE @k2PWANV40HRT
CUMBERLAND CO., PA
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE --► RETAIN LOWER PORTION FOR .YOUR RECORDS 4—
......_...._........_............__.........-----_----------—--------------------------------------------------" ------------------
REV-1604 EX AFP (12-13)
x INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS
DATE: 12-17-2013
ESTATE OF: HARTSOCK RUTHELLA DATE OF DEATH: 09-25-2012 COUNTY: CUMBERLAND
FILE NO. : 21 13-0984 S.S/D.C. NO. : 166-32-1959 ACN: 12156274
ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: SUSQUEHANNA BANK ACCOUNT NO. : 1603298501
TYPE OF ACCOUNT: C ] SAVINGS ( X) CHECKING C 3 TRUST t 3 TIME CERTIFICATE
DATE ESTABLISHED 10-29-1982
Account Balance 4,021.64 NOTE: TO ENSURE PROPER CREDIT TO YOUR
Percent Taxable X 0.500 ACCOUNT, SUBMIT THE UPPER PORTION
Amount Subject to Tax 2,010.82 OF THIS NOTICE WITH YOUR TAX
Debts and Deductions 31950.00 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 •00 TO: "REGISTER OF WILLS, AGENT."
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (J
TOTAL TAX PAYMENT .00
BALANCE OF TAX DUE ,00
INTEREST AND PEN. p
TOTAL DUE
• 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.