HomeMy WebLinkAbout10-06-14 INHERITANCE TAX
RECORD ADJUSTMENT i pennsylvania
BUREAU OF INDIVIDUAL TAXES
JOINTLY HELD OR TRUST ASSETS DEPARTMENT OF REVENUE
—_
INHERITANCE TAX DIVISION REV-1604 EX AFP (12-13)
PO BOX 280601
HARRISBURG PA 17128-0601
DATE 09-29-2014
ESTATE OF JACOBS HANNAH
DATE OF DEATH 10-27-2012
FILE NUMBER 21 14-0512
COUNTY CUMBERLAND
SSN/DC
JOEL R JACOBS ACN 13134071
2 LOCUST HOLW
Amount Remitted
CARLISLE PA 17015-7429 —
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 4__
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REV-1604 EX AFP (12-13)
** INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS **
DATE: 09-29-2014
ESTATE OF: JACOBS HANNAH DATE OF DEATH: 10-27-2012 COUNTY: CUMBERLAND
FILE NO. : 21 14-0512 S.S/D.C. NO. : ACN: 13134071
ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION : SOVEREIGN BANK ACCOUNT NO. : 0021086338
TYPE OF ACCOUNT: C ) SAVINGS CX) CHECKING C ) TRUST C ) TIME CERTIFICATE
DATE ESTABLISHED 08-07-2007
Account Balance 3,032.01 NOTE: TO ENSURE PROPER CREDIT TO YOUR
Percent Taxable X 0.500 ACCOUNT, SUBMIT THE UPPER PORTION
Amount Subject to Tax 1,516.01 OF THIS NOTICE WITH YOUR TAX
Debts and Deductions 2,244.51 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 WILL$ AGENT."
TAX CREDITS: c c
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID C'� <7 C-3DATE NUMBER INTEREST/PEN PAID (-) G�
"T1 rn
} r O) T1 C.7
C 3 C. ,Z3 C]
C n 2-3 TT
N f— rn
TOTAL TAX PAYMENT --c .00n
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
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.
REV-1470 EX(01-10) -
2114-0512
pennsylvania INHERITANCE TAX
DEPARTMENTOF REVENUE 10/27/2012
...._.� EXPLANATION
BUREAU OF INDIVIDUAL TAXES OF CHANGES
PO Box280601
HARRISBURG.
AR I BU PA 17128-0601
DECEDENTS NAME
Hannah Jacobs 2114-0512
REVIEWED BY ACN
Robin /Agent 191 13134071
ITEM
SCHEDULE NO. EXPLANATION OF CHANGES
Applied debts against the above A C N, documentation provided.
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