HomeMy WebLinkAbout03-03-14 INHERITANCE TAX
RECORD ADJUSTMENT Pennsylvania
JOINTLY HELD OR TRUST ASSETS DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX p7Y7SIDN REV•1604 EX AFP (12-I3)
806
PO BOX
HARRISBURG URG PA PA 17128-0601
DATE 02-20-2014
ESTATE OF EADS JR JACK C
DATE OF DEATH 07-16-2012
FILE NUMBER 21 12-0822
COUNTY CUMBERLAND
SSN/DC
DOROTHY BOLTON ACN 12143000
70 OLD FEDERAL RD Amount Remitted
CAMP HILL PA 17011-2047
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE y RETAIN LOWER PORTION FOR YOUR RECORDS
REV-1604 EX AFP (12-13)
■■ INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS *
DATE: 02-20-2014
ESTATE OF: EADS JR JACK C DATE OF DEATH: 07-16-2012 COUNTY: CUMBERLAND
FILE NO. : 21 12-0822 S.S/D.C. NO. : ACN: 12143000
ADJUSTMENT BASED ON: PROTEST BOARD DECISION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. : 343748-00
TYPE OF ACCOUNT: ( X) SAVINGS t > CHECKING t ) TRUST C ) TIME CERTIFICATE
DATE ESTABLISHED 11-25-2008
Account Balance 280,806.38 NOTE: TO ENSURE PROPER CREDIT TO YOUR
Percent Taxable X 0 . 166 ACCOUNT, SUBMIT THE UPPER PORTION
Amount Subject to Tax 46,802.00 OF THIS NOTICE WITH YOUR TAX
Debts and Deductions - .00 PAYMENT TO THE REGISTER:AF WILLS-y
Taxable Amount
46,802.00 AT THE ADDRESS OWN ABOVE. T
TS -
Tax Rate X .045 MAKE CHECK DR M ORDER'=PAYdCB G�
Tax Due 2,106.09 TO: ^REGISTER ILLS, ';AGEN'rG.'!'�-!I
TAX CREDITS; , ;r�.
PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
07-09-2013 CDD17857 14.51- 2,120 .6 0 C7
N yn
TOTAL TAX PAYMENT 2,106.09
BALANCE OF TAX DUE 0
INTEREST AND PEN. 8
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. `\n