HomeMy WebLinkAbout03-10-15 INHERITANCE TAX
RECORD ADJUSTMENT pennsyLvania
JOINTLY HELD OR TRUST ASSETS UVI DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES REV-1604 EX AFP (11-14)
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601 RE
DATE 02-25-2015
ESTATE OF PATTISON ANNIE G
niS ARR 10 PM 1 26 DATE OF DEATH 09-05-2013
FILE NUMBER 21 13-0989
C L' COUNTY CUMBERLAND
SSN/DC
HELEN M DEVOR 0R^., ACN 13156714
121 WALNUT BOTTOM RD 11.1--1 I Amount Remitted
SHIPPENSBURG PA ��7�-8131 1 7�
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 (11-14)
INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS
DATE: 02-25-2015
ESTATE OF: PATTISON ANNIE G DATE OF DEATH: 09-05-2013 COUNTY: CUMBERLAND
FILE NO. : 21 13-0989 S.S/D.C. N0. : ACN: 13156714
ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: CITIZENS BANK OF PENNSYLVANIA ACCOUNT NO. : 6140899087
TYPE OF ACCOUNT: C ) SAVINGS CHECKING C TRUST ( )0 TIME CERTIFICATE
DATE ESTABLISHED 05-29-1990
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 .15 MAKE CHECK OR MONEY ORDER PAYABLE
Tax Due .00 TO: "REGISTER OF WILLS, AGENT."
TAX CREDITS :
PAYDATE NMENT REUMBERT CEIPINTEREST/PUENDISCONT PAID AMOUNT PAID
- -
—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.