HomeMy WebLinkAbout05-13-14 (2) ,. =x; �,. �. w , ,;_ ,.�.�.
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� � INHERITANCE TAX
RECORD ADJUSTMENT � pennSyLVaI1�a
N.T�Y- H� �� �R TRUST ASSETS
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BUREAU OF INDIVIDUAL TAXES �� �t) `_✓
INHERITANCE TAX DIVISION {^ �, � "` �;f;�C
REV-1604 DC AFP Q 2-13>
PD BOX 280601 ��+�7;�,'`�_r� '4 '
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HARRISBURG PA 17128-0601
�,,,�;���� �� p� ��: �rE 05-02-2014
° ESTATE OF ROBERTS LAWRENCE E
DATE OF DEATH 05-01-2013
� FILE NUMBER 21 14-0356
U��������`���J�T CSN/DC
KELLY A MINITO �M����� �'o" P�pCN 13125598
339 THORLEY RD
Amount Remitted
NEW CUMBERLAND PA 17070-3133
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE —1 RETAIN LOWER PORTION FOR YOUR RECORDS E—
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: 13125598
ADJUSTMENT BASED ON : ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT N0. : 489035-11
TYPE OF ACCOUNT: C ) SAVINGS C ) CHECKING C � TRUST O TIME CERTIFICATE
DATE ESTABLISHED 12-28-2012
Account Balance •00 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 •�� 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 (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
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" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.
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REV-1470 EX(Oi•10)
� ° 2114-0356
y�"* � ��� pennsylvania lNHERITANCE 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 13125598
ITEM
SCHEDULE Np, EXPLANATION OF CHANGES
Members 15t reported this account had no joint owners 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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