HomeMy WebLinkAbout03-30-15 INHERITANCE TAX
RECORD ADJUSTMENT pennsytvarna
JOINTLY HELD OR TRUST ASSETS !QL7
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION C REV-1604 EX AFP (11-14)
PO BOX 280j�(�,L
HARRISBUR(GG llii 8888 �1 UR56n OFFICE OF,
REGISTER Or WILLS
DATE 03-20-2015
?a1S MER 30 PM l� `�� ESTATE OF ROBINSON PEARL I
DATE OF DEATH 02-10-2011
FILE NUMBER 21 11-0276
GLE�,\-K 0F• COUNTY CUMBERLAND
SSN/DC 171-28-4887
JOHd5PHANN' Q Tt�SUN ACN 11168578
2�2++5 � 1iNNST, C,) r a. Amount Remitted
W7Y MU9 is T014 ' 'PA 17266-9708
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: 03-20-2015
ESTATE OF: ROBINSON PEARL I DATE OF DEATH: 02-10-2011 COUNTY: CUMBERLAND
FILE NO. : 21 11-0276 S.S/D.C. NO. : 171-28-4887 ACN: 11168578
ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: CITIZENS BANK OF PENNSYLVANIA ACCOUNT NO . : 6140761638
TYPE OF ACCOUNT: C ) SAVINGS C ) CHECKING ( X) TRUST C ) TIME CERTIFICATE
DATE ESTABLISHED 04-04-2000
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 :
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.