HomeMy WebLinkAbout10-06-14 INHERITANCE TAX
RECORD ADJUSTMENT pennsyLvarn•
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BUREAU OF INDIVIDUAL TAXES
JOINTLY HELD OR TRUST ASSETS DEPARTMENT OF REVENUE
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INHERITANCE TAX DIVISION REV-1604 EX AFP (12-13)
PO BOX 280601
HARRISBURG PA 17128-0601
DATE 09-26-2014
ESTATE OF CALLEN III MATTHEW
DATE OF DEATH 05-01-2012
FILE NUMBER 21 12-0652
COUNTY CUMBERLAND
SSN/DC
DORIS GARLAND ACN 13031304
C/O M A PLANKINTON ESQ Amount Remitted
PO BOX 363
KENNETT SQUARE PA 19348-0363
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 +-
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REV-1604 EX AFP (12-13)
** INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS **
DATE: 09-26-2014
ESTATE OF: CALLEN III MATTHEW DATE OF DEATH: 05-01-2012 COUNTY: CUMBERLAND
FILE NO. : 21 12-0652 S.S/D.C. NO. : ACN: 13031304
ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET—INFORMATION
FINANCIAL INSTITUTION: 36 LEE ANN CT. ACCOUNT NO. : o00oo
TYPE OF ACCOUNT: C ) SAVINGS C ) CHECKING C ) TRUST C ) TIME CERTIFICATE
DATE ESTABLISHED 05-15-2002
Account Balance 177,200.00 NOTE: TO ENSURE PROPER CREDIT TO YOUR
Percent Taxable X 0.500 ACCOUNT, SUBMIT THE UPPER PORTION
Amount Subject to Tax 88,600.00 OF THIS NOTICE WITH YOUR TAX
Debts and Deductions - •00 PAYMENT TO THE REGISTER OF WILLS
Taxable Amount 88,600.00 AT THE ADDRESS SHOWN ABOVE.
Tax Rate X • 15 MAKE CHECK OR MONEY ORDER PAYABLE
Tax Due 13,290.00 TO: "REGISTER OF WILLS�.>AGENT."
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TAX CREDITS :
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PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID �
DATE NUMBER INTEREST/PEN PAID C-) CM
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INTEREST IS CHARGED THROUGH 10-14-2014 TOTAL TAX PAYMENT' —3.00
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 13 290.00
REVERSE SIDE OF THIS FORM INTEREST AND PEN. 675.66
TOTAL DUE 13,965.66
* 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.