HomeMy WebLinkAbout08-29-14 (3) INHERITANCE TAX
RECORD ADJUSTMENT pennsyLvarna
JOINTLY HELD OR TRUST ASSETS DEPARTMENT OF REVENUE
BUREAU OF IX DIVISION TAXES
INHERITANCE TAX DIVISION REV-1604 IX ARE (12-13)
PO BOX 280601
HARRISBURG PA 17128-0601
DATE 08-25-2014
ESTATE OF MATTSON WALTER E
DATE OF DEATH 03-30-2013
FILE NUMBER 21 13-0665
COUNTY 21CUMBERLAND
SSN/DC
GREGORY MATTSON ACN 13126497
APT 2
16 PEACHTREE AVE HE Amount Remitted
ATLANTA GA 30305-3021
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 F
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REV-1604 EX AFP (12-13)
INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS x■
DATE: 08-25-2014
ESTATE OF: MATTSON WALTER E DATE OF DEATH: 03-30-2013 COUNTY: 21CUMBERLAND
FILE NO. : 21 13-0665 S.S/D.C. NO. : ACN: 13126497
ADJUSTMENT BASED ON : ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: PSECU ACCOUNT NO . : 0159245129-S7
TYPE OF ACCOUNT: ( X) SAVINGS ( ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 07-07-2004
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 YOUR TAX
Debts and Deductions •00 PAYMENT TO THE REGISTER OF WILLS
Taxable Amount •00 AT THE ADDRESS SHOWN ABOVE.
Tax Rate X .045 MAKE CHECK OR MONEY ORDER PAYABLE
Tax Due •00 TO: "REGISTER OF WILLS, AGENT."
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PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID 3. rn(7D 0 h
DATE NUMBER INTEREST/PEN PAID (-) C
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TOTAL TAX PAYM�NT CJ 0@IA1
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE nn
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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