HomeMy WebLinkAbout04-20-15 INHERITANCE TAX ennSY lvania
RECORD ADJUSTMENT p
JOINTLY HELD OR TRUST ASSETS DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES ---
INHERITANCE TAX DIVISION REV-1604 EX AFP (11-14)
PO BOX 280601 REFI
CORDED OFFICE
OF
HARRISBURG PA 17128-Oa01 t 1 t
REGISTEt11 OF WILLS DATE 04-08-2015
R APR
ESTATE OF BLACK DOROTHY F
MIS PPR 20 F 1 [Q DATE OF DEATH 02-26-2011
FILE NUMBER 21 11-0283
CLE1 OF COUNTY CUMBERLAND
SSN/DC
STEVEN (bRK*'PI S' COURT ACN 11135071
225 RUPTURRRt,R A 1� I • ', is 4 1Amount Remitted
GETTYSBURG PA- 17325
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--
------------------------------------------------------------------------------------------------------------------------------------------------------------------
REV-1604 EX AFP (11-14)
** INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS
DATE: 04-08-2015
ESTATE OF: BLACK DOROTHY F DATE OF DEATH: 02-26-2011 COUNTY: CUMBERLAND
FILE NO. : 21 11-0283 S.S/D.C. NO. : ACN: 11135071
ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: M K T BANK ACCOUNT NO. : 10458530
TYPE OF ACCOUNT: C ) SAVINGS ( X) CHECKING C ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 08-13-1993
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 (+)
DATE NUMBER INTEREST/PEN 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.
REV-1470 EX(01-10)
enns Lvania
INHERITANCE TAX
DEPARTMENT OF REVENUE
f EXPLANATION 2/26/2011
BUREAU OF INDIVIDUAL TAXES OF CHANGES
PO Box 280601
HARRISBURG,PA 17128-0601
DECEDENT'S NAME FILE NUMBER
Dorothy F. Black 21 11-0283
REVIEWED BY ACN
Steven -Agent# 193 11135071
ITEM
SCHEDULE NO, EXPLANATION OF CHANGES
The above-referenced ACN has been reduced to zero as this account was reported on the
probate return..
ROW Page 1