HomeMy WebLinkAbout05-13-14 • INHERITANCE TAX •
, • RECORD ADJUSTMENT � pEI�I1Sy�VaI1�a
,�jC�'��I���LX� W,�,I�D +QR TRUST ASSETS DEPARTMENTOFREVENUE
BUREAU OF INDIVIDUAL TAXES ��� `"� 4 t.% ' ,`(�f; �+"
INHERITANCE TAX DIVISION �`_%' t+ REV-1604 IX AFP C12-13)
PO BOX 260601 �-1-� f..:'i _ '�1
HARRISBURG PA 17128-0601
:�;;v���' (� �*� ��: ��DATE 05-02-2014
ESTATE OF ROBERTS LAWRENCE E
DATE OF DEATH 05-01-2013
;� ;, FILE NUMBER 21 14-0356
(���:������\� vU���� COUNTY CUMBERLAND
MARK E ROBERTS
CUMB�Rl.fiNp C(� pq ACN,DC 13125597670
6420 GILLINGHAM LN
Amount Remitted
HARRISBURG PA 17111-6881
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALON6 THIS LINE � RETAIN LOWER PORTION FOR YOUR RECORDS (--
REV-1604 EX AFP C12-13)
** INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS **
DATE: 05-02-2014
ESTATE OF: ROBERTS LAWRENCE E DATE OF DEATH: 05-01-2013 COUNTY: CUMBERLAND
FILE NO. : 21 14-0356 S.S/D.C. N0. : 204-28-1670 ACN: 13125597
ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT N0 . : 489035-11
TYPE OF ACCOUNT: O SAVINGS C ) CHECKIN6 C � TRUST O TIME CERTIFICATE
DATE ESTABLISHED 12-28-2012
Account Balance •�� NOTE: TO ENSURE PROPER CREDIT TO YOUR
Percent Taxable X 0.500 ACCOUNT, SUBMIT THE UPPER PORTION
Amount Subject to Tax •�� OF THIS NOTICE WITH YOUR TAX
Debts and Deductions - •00 PAYMENT TO THE REGISTER OF WILLS
Taxable Amount •�� AT THE ADDRESS SHOWN ABOVE.
Tax Rate X .045 MAKE CHECK OR MONEY ORDER PAYABLE
Tax Due •�� T0: "REGISTER OF WILLS, A6ENT."
TAX CREDITS :
PAYMENT RECEIPT DISCOUNT (+) AMOUNT 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 TOTAL DUE IS REFLECTED AS A
"CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.
REV-1476'tX(01-10)
� � enns lvania 2114-0356
p y INHERITANCE TAX 204-28-1670
`; DEPARTMENT OF REVENUE EXPLANATION 05/01/2013
BUREAU OF INDIVIDUAL TAXES OF CHANGES
PO Box 280601
DECEDENT'S NAME
Lawrence Roberts 2114-0356
REVIEWED BY ACN
Robin /Agent 191 13125597
ITEM
SCHEDULE Np, EXPLANATION OF CHANGES
Members 15` reported this account had no joint owne�s or beneficiaries, therefore the
account will have to be reported on Schedule E of the Rev-1500, as an estate asset.
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