HomeMy WebLinkAbout03-10-15 (2) INHERITANCE TAX
RECORD ADJUSTMENT pennsytvania
BUREAU OF INDIVIDUAL TAXES JOINTLY HELD OR TRUST ASSETS DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISIONREV-1604 EX AFP (11-14)
PO BOX 280601 R E IV'CC R 2 C F
HARRISBURG PA 17128-0601
R E C
DATE 03-02-2015
IS M9
ESTA
H10 F(1 1 2,16 DATETE OFOF DEATH TOLLE04-28-Y 2013 HOWARD E
FILE NUMBER 21 14-1120
COUNTY CUMBERLAND
SSN/DC
ANN E KULP 0 P,pi!. ACN 13171715
5720 KENT WOOD ROAD C1111--
V,1— I I Amount Remitted
HARRISBURG PA 17112 1
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 (11-14)
INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS
DATE: 03-02-2015
ESTATE OF: TOLLEY HOWARD E DATE OF DEATH: 04-28-2013 COUNTY: CUMBERLAND
FILE NO. : 21 14-1120 S.S/D.C. NO. : ACN: 13171715
ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION : ACNE BANK ACCOUNT NO. : 9000135915
TYPE OF ACCOUNT: ( X) SAVINGS C ) CHECKING TRUST TIME CERTIFICATE
DATE ESTABLISHED 01-11-2010
Account Balance 262,741.62 NOTE: TO ENSURE PROPER CREDIT TO YOUR
Percent Taxable X 0. 166 ACCOUNT, SUBMIT THE UPPER PORTION
Amount Subject to Tax 43,791. 15 OF THIS NOTICE WITH YOUR TAX
Debts and Deductions .00 PAYMENT TO THE REGISTER OF WILLS
Taxable Amount 43,791 . 15 AT THE ADDRESS SHOWN ABOVE.
Tax Rate X .045 MAKE CHECK OR MONEY ORDER PAYABLE
Tax Due 1,970.60 TO: "REGISTER OF WILLS, AGENT."
TAX CREDITS:
PAYMENT REEIPT DOUNT
DATE NUCMBER INTEREISSTC/PEN PAID AMOUNT PAID
INTEREST IS CHARGED THROUGH 03-17-2015 TOTAL TAX PAYMENT .00
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 1,970.60
REVERSE SIDE OF THIS FORM INTEREST AND PEN. 66.74
TOTAL DUE 2,037.34
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.