HomeMy WebLinkAbout01-20-15 (4) INHERITANCE TAX '
RECORD ADJUSTMENT a pennsyLvarna
JOINTLY HELD OR TRUST ASSETS DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISSION
BUREAU OF INDIVIDUAL IONRInEURDED OFFICE OF
REV-1604 IX AFP (11-14)
PO BOX URG280601
PA REGISTER O �{ACLS
HARRISBURG PA 17128-0601 REGISTER J
20 PM 12 12 DATE 01-12-2015
iIIV ESTATE OF KAPP ELVERTA M
DATE OF DEATH 03-10-2014
CLEF,.; OF FILE NUMBER 21 14-0270
ORPHANS' COURT COUNTY CUMBERLAND
SSN/DC
JACK MIAMGRI-A" ;"�_, 1 ACN 14116307
613 CHARLES ST
Amount Remitted
MECHANICSBURG PA 17055-6635
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 C11-14)
** INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST. ASSETS **
DATE: 01-12-2015
ESTATE OF: KAPP ELVERTA M DATE OF DEATH: 03-10-2014 COUNTY: CUMBERLAND
FILE NO. : 21 14-0270 S.S/D.C. NO. : ACN: 14116307
ADJUSTMENT BASED ON : ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. : 472570-11
TYPE OF ACCOUNT: ( ) SAVINGS ( X) CHECKING ( ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 08-06-2012
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."
TAX CREDITS :
PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID 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.
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