HomeMy WebLinkAbout03-03-14 INHERITANCE TAX
RECORD ADJUSTMENT pennsylvania
BUREAU OF INDIVIDUAL TAXES JOINTLY HELD OR TRUST ASSETS DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION REV-1604 EX AFP (12-13)
PO BOX 280601
HARRISBURG PA 17128-0501
DATE 02-20-2014
ESTATE OF EADS JR JACK C
DATE OF DEATH 07-16-2012
FILE NUMBER 21 12-0822
COUNTY CUMBERLAND
DOROTHY BOLTON SSN/DC
70
ACN 12143002
CA Remitted
OLD FEDERAL RD Amount Re
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 RETAIN LOWER PORTION FOR YOUR RECORDS t--
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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: 12143002
ADJUSTMENT BASED ON : PROTEST BOARD DECISION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1sT FCU ACCOUNT NO. : 343748-11
TYPE OF ACCOUNT: ( ) SAVINGS ( X) CHECKING ( ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 11-25-2008
Account Balance 67,416.69 NOTE: TO ENSURE PROPER CREDIT TO YOUR
Percent Taxable X 0.166 ACCOUNT, SUBMIT THE UPPER PORTION
Amount Subject to Tax 11,236.34 OF THIS NOTICE WITH YOUR TAX
Debts and Deductions - .00 PAYMENT TO THE REGISTER OF WILLS
Taxable Amount 11,236.34 AT THE ADDRESS SHOWN ABOVE.
Tax Rate X .045 MAKE CHECK OR MONEY ORDER PAYABLE
Tax Due 505.64 TO: "REGISTER OF WILLS, AGENT."
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID C-7
07-09-2013 CDO17857 3.48- 509.12
TOTAL TAX PAYMENT 505.64
BALANCE OF TAX DUE 0
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.