HomeMy WebLinkAbout10-20-14 INHERITANCE TAX
RECORD ADJUSTMENT pennsyLvarna
BUREAU OF INDIVIDUAL TAXES
JOINTLY HELD OR TRUST ASSETS DEPARTMENT OF REVENUE
_......__
INHERITANCE TAX DIVISION REV-1604 EX AFP (12-13)
PD BOX RECORDED OFFICE OF
HARRISBURGURG PPA 17128-0601
A
REGISTER ER OF WILLS DATE 10-07-2014
ESTATE OF CLOUSE TIFFANY B
?014
i UC iT 20 FM
I t 12 18
DATE OF DEATH 05-20-2012
FILE NUMBER 21 14-0407
CLE,-.:,' OF COUNTY CUMBERLAND
CALENEM 9 U,'$�,�IS' COURT ACN/DC 13128753809
2075 RITNEttiL6W�FRL A-:D -,') Amount Remitted
CARLISLE PA 17015=9303
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 t—
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REV-1604 EX AFP (12-13)
** INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS
DATE: 10-07-2014
ESTATE OF: CLOUSE TIFFANY B DATE OF DEATH: 05-20-2012 COUNTY: CUMBERLAND
FILE NO. : 21 14-0407 S.S/D.C. NO. : ACN: 13128753
ADJUSTMENT BASED ON : ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: SOVEREIGN BANK ACCOUNT NO . : 1671001486
TYPE OF ACCOUNT: C ) SAVINGS ( X) CHECKING ( ) TRUST C ) TIME CERTIFICATE
DATE ESTABLISHED 01-03-2002
Account Balance 583.54 NOTE: TO ENSURE PROPER CREDIT TO YOUR
Percent Taxable X 0.500 ACCOUNT, SUBMIT THE UPPER PORTION
Amount Subject to Tax 291 .77 OF THIS NOTICE WITH YOUR TAX
Debts and Deductions - •00 PAYMENT TO THE REGISTER OF WILLS
Taxable Amount 291.77 AT THE ADDRESS SHOWN ABOVE.
Tax Rate X .045 MAKE CHECK OR MONEY ORDER PAYABLE
Tax Due 13.13 TO: "REGISTER OF WILLS, AGENT."
TAX CREDITS :
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID C-)
08-15-2014 CDO19561 .58- 45.70
TOTAL TAX PAYMENT 45. 12
BALANCE OF TAX DUE 31 .99CR
INTEREST AND PEN. .00
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.
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