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HomeMy WebLinkAbout01-12-15 INHERITANCE TAX RECORD ADJUSTMENT pennsyLvania JOINTLY HELD OR TRUST ASSETS DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION REV-1604 EX AFP (11-14) PO BOX 280601 HARRISBURG PA 17128-0601 DATE 12-30-2014 ESTATE OF MORGAN BETTY M DATE OF DEATH 08-09-2012 FILE NUMBER 21 14-0536 COUNTY CUMBERLAND SSN/DC DENISE R DOTSON ACN 13136400 APT 2 Amount Remitted 706 HUMMEL AVE LEMOYNE PA 17043-1831 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 —------------—----------—--—--—--—--—--—---------—---—------—------—--—-----——---—----------—--—--—--——--------------------—----------—— REV-1604 EX AFP 01-14) INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS DATE: 12-30-2014 ESTATE OF: MORGAN BETTY M DATE OF DEATH: 08-09-2012 COUNTY: CUMBERLAND FILE NO. : 21 14-0536 S.S/D.C. NO. : ACh: 13136400 ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: PNC BANK NA ACCOUNT NO . : 5140319729 TYPE OF ACCOUNT: ( ) SAVINGS ( X) CHECKING TRUST TIME CERTIFICATE DATE ESTABLISHED 06-28-1983 Account Balance .00 NOTE: TO ENSURE PROPER CREDIT TO YOUR Percent Taxable X 0.500 ACCOUNT, SUBMIT THE W ER PORTION Amount Subject to Tax .00 OF THIS NOTIRE WITH MR TA" Debts and Deductions - .00 PAYMENT TO ME5EGISTER OTWALLS Taxable Amount .00 AT THE ADDRgS__0�"WN_"OVg; � Tax Rate X .15 MAKE CHECK t3it MONEY INWER4�ABLE Tax Due 00 TO: "REGISTER WIL AGENT."" TAX CREDITS: CLO -v i _T1 rl -1 1 - 171 7 PAYMENT RECEIPT DISCOUNT AMOUNT PAID (7-� DATE NUMBER INTEREST/PEN PAID — C'> r M C/) —TOTAL TAX PAYMENT .00 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.