HomeMy WebLinkAbout05-30-14 (3) INHERITANCE TAX
•• RECORD ADJUSTMENT pennsylvania
JOINTLY HELD OR TRUST ASSETS DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION REV-1604 IX AFP (12-13)
PO BOX 280601
HARRISBURG PA 17128-0601
DATE 05-21-2014
ESTATE OF SUNDERLAND KLARE S
DATE OF DEATH 01-06-2013
FILE NUMBER 21 13-0074
COUNTY CUMBERLAND
SSN/DC
JUDY A BARBUSH ACN 13111242
510 ALISON AVE
Amount Remitted
MECHANICSBURG PA 17055-6656
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE 1 RETAIN LOWER PORTION FOR YOUR RECORDS
____—---------_________—------------------___ ___ ___ ._ __________________ ____.____....._________________--------------------
REV-1604 EX AFP C12-13)
INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS ■
DATE: 05-21-2014
ESTATE OF: SUNDERLAND KLARE S DATE OF DEATH: 01-06-2013 COUNTY: CUMBERLAND
FILE NO. : 21 13-0074 S.S/D.C. NO. : ACN: 13111242
ADJUSTMENT BASED ON : ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: SUSQUEHANNA BANK ACCOUNT NO. : 1710022045
TYPE OF ACCOUNT: C ) SAVINGS CX) CHECKING ( ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 04-07-2011
Account Balance •00 NOTE: TO ENSURE PROPER CREDIJ-,TO YOUR
Percent Taxable X 0. 166 ACCOUNT, SUBMLi THE UPtIR P-ORAON
Amount Subject to Tax •00 OF THIS NOTICECYQTH YOUR TCg o0
Debts and Deductions - •00 PAYMENT TO THr RUGJ;TE02OF CW,I4JLS
Taxable Amount • 00 AT THE ADDRESSUS4DWN Aa(BVE..'n o rn
Tax Rate X •15 MAKE CHECK OR.,MO� ET OR§@Ii P.i4'Y LE
Tax Due •00 TO: "REGISTE�'3—OF- WILLS AGENT.�"
TAX CREDITS : o
no -� -n
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID I fl'1
DATE NUMBER INTEREST/PEN PAID (-7
CD
TOTAL TAX PAYMENT .00
BALANCE OF TAX DUE •00
INTEREST AND PEN. .00
TOTAL DUE
t 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.
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DEPARTMENT OF REVENUE EXPLANATION 116/2013
BUREAU OF INDIVIDUAL TAXES OF CHANGES
PO Box 280601
DECEDENT'S NAME FILE NUMBER
Klare S. Sunderland 21 13-0074
REVIEWED BY ACN
Steven James 13111242
ITEM
SCHEDULE NO. EXPLANATION OF CHANGES
The above-referenced ACN has been reduced to zero as this account was reported on the
probate return.
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