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HomeMy WebLinkAbout06-23-14 INHERITANCE TAX RECORD ADJUSTMENT r pennsylvania BUREAU OF INDIVIDUAL TAXES JOINTLY HELD OR TRUST ASSETS DEPARTMENT OF REVENUE - INHERITANCE TAX DIYZSZON REV•1504 IX AFF (12-13) PO BOX 2SD6DI HARRISBURG PA 17128-D601 DATE 06-16-2014 ESTATE OF WRIGHTS GLORIA G DATE OF DEATH 03-19-2013 FILE NUMBER 21 13-0361 COUNTY CUMBERLAND SSN/DC 208-50-5597 APRIL C WRIGHTS ACN 13117169 2 WILLOW DR SHIPPENSBURG PA 17257-9430 Amount !!��9 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 E- --------------------------------------------------------------------------------------------------------------------------------------------------- REV-1604 EX AFP (12-13) INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS DATE: 06-16-2014 ESTATE OF: WRIGHTS GLORIA G DATE OF DEATH: 03-19-2013 COUNTY: CUMBERLAND FILE NO. : 21 13-0361 S.S/D.C. NO. : 208-50-5597 ACN: 13117169 ADJUSTMENT BASED ON : ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION : MEMBERS 1ST FCU ACCOUNT NO. : 420978-00 TYPE OF ACCOUNT: ( X) SAVINGS C ) CHECKING C ) TRUST C ) TIME CERTIFICATE DATE ESTABLISHED 06-04-2011 Account Balance .00 NOTE: TO ENSURE PROPER CREDIT TO YOUR Percent Taxable X 0.500 ACCOUNT, SUBMIT THE UPPER PORTION Amount Subject to Tax .00 OF THIS NOTICE WITH YC@A TAX -:�o Debts and Deductions - .00 PAYMENT TO THr-REGISTE!9OF�,iIVLS Taxable Amount • 0D AT THE ADDRESS-,SHOWN ABVE C? ca Tax Rate X •045 MAKE CHECK ORS MON'EY ORDI`R PXYAR LE Tax Due •00 TO: °REGISTERCI06 WILLW A6ENT•1" TAX CREDITS: o PAYMENT RECEIPT DISCOUNT {+) AMOUNT PAID n =D -+1 DATE NUMBER INTEREST/PEN PAID f-) F- iu rn� L -n +' 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 REFLFCTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. �.�