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HomeMy WebLinkAbout07-28-14 INHERITANCE TAX RECORD ADJUSTMENT pennsyLvarna JOINTLY HELD OR TRUST ASSETS DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION REV-1604 EX AFP (12-13) PO BOX 280601 HARRISBURG PA 17128-0601 DATE 07-15-2014 ESTATE OF BEAUDUY RUTH E DATE OF DEATH 01-17-2013 FILE NUMBER 21 13-0152 COUNTY CUMBERLAND SSN/DC 146-16-7040 CECILIA C BEAUDUY ACN 13111259 1709 BRIDGE ST Amount Remitted NEW CUMBERLND PA 17070-1141 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 4— —------_------_--_------_-- REV-1604 EX AFP (12-13) ■* INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS ■ DATE: 07-15-2014 ESTATE OF: BEAUDUY RUTH E DATE OF DEATH: 01-17-2013 COUNTY: CUMBERLAND FILE NO. : 21 13-0152 S.S/D.C. NO. : 146-16-7040 ACN: 13111259 ADJUSTMENT BASED ON : ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: WELLS FARGO ACCOUNT NO . : 1000190417353 TYPE OF ACCOUNT: ( ) SAVINGS ( X) CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 10-27-1986 Account Balance 1,581 .87 NOTE: TO ENSURE PROPER CREDIT TO YOUR Percent Taxable X 0.500 ACCOUNT, SUBMIT THE UPPER PORTION Amount Subject to Tax 790.94 OF THIS NOTICE WITH YOUR TAX Debts and Deductions - . 00 PAYMENT TO THE REGISTER OF WILLS Taxable Amount 790.94 AT THE ADDRESS SHOWN ABOVE. Tax Rate X .045 MAKE CHECK OR OnY ORDER PAYABL-E Tax Due 35.59 TO: "REGISTER fEOWILLS&GE17fi'^ M TAX CREDITS: C" PAYMENT RECEIPT DISCOUNT C+) 00 1i DATE NUMBER INTEREST/PEN PAID C-) AMOUNT PAID ri 7? Cn Co O T INTEREST IS CHARGED THROUGH 07-30-2014 TOTAL TAX PAYMENT . 00 AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 35.59 REVERSE SIDE OF THIS FORM INTEREST AND PEN. .83 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.