HomeMy WebLinkAbout03-10-14 (2) INHERITANCE TAX
RECORD ADJUSTMENT pennsylvanla
JOINTLY HELD OR TRUST ASSETS DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES - -
INHERITANCE TAX DIVISION REV-1694 EX AFP (32-13)
PO BOX 280601
HARRISBURG PA 17128-0601
DATE 03-03-2014
ESTATE OF GREEY FLORENCE
DATE OF DEATH 11-19-2012
FILE NUMBER 21 13-1177
COUNTY CUMBERLAND
SSN/DC
CHARLOTTE G CHRISTY ACN 12166049
8690 RICE RD
Amount Remitted
SHIPPENSBURG PA 17257-8725 _
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
I COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE --► RETAIN LOWER PORTION FOR YOUR RECORDS 4-
---'----------------------------------'----------------------'--------------------------------------------------------------------------'^---------
REV-1604 EX AFP (12-13)
■II INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS 7e*
DATE: 03-03-2014
ESTATE OF: GREEY FLORENCE DATE OF DEATH: 11-19-2012 COUNTY: CUMBERLAND
FILE NO. : 21 13-1177 S.S/D.C. N0. : ACN: 12166049
ADJUSTMENT BASED ON : ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: FARMERS & MERCHANTS TRUST CO ACCOUNT NO . : 3415708
TYPE OF ACCOUNT: ( ) SAVINGS ( 3 CHECKING ( X) TRUST C ) TIME CERTIFICATE
DATE ESTABLISHED 02-13-2002
Account Balance •00 NOTE: TO ENSURE PROPER CREDIT TO YOUR
Percent Taxable X 0.500 ACCOUNT, SUBMIT THE UPPER PORTION
Amount Subject to Tax •P0 - OF THIS NOTICE WITH YOUR TAX
Debts and Deductions .00 PAYMENT TO THE REGISTER OF WILLS
Taxable Amount •D0 AT THE ADDRESS SHOWN ABOVE.
Tax Rate X 1045 MAKE CHECK OR MONEY ORDER, PAYABLE
Tax Due •D0 TO: ^REGISTER L& WILLS rD-AGENT. }
r ff,
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT C+7 AMOUNT PAID ,
DATE NUMBER INTEREST/PEN PAID (-) — r,-; r:,7,
ca-
C r
rn.-r7
37 _
y fT7
co
TOTAL TAX PAYMENT .00
BALANCE OF TAX DUE
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.