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HomeMy WebLinkAbout05-20-15 (2) INHERITANCE TAX • RECORD ADJUSTMENT � �. pennSytvarna BUREAU OF INDIVIDUAL TAXES JOINTLY HELD OR TRUST ASSETS DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION REV-1604 EX AFP (I1-14) PO BOX 28060 n n,-n !'-?,7 j V` O,- HARRISIR fIV128-0601 1 LL DATE 05-05-2015 �nlC {�� �O � ESTATE OF RUGGIERI JOAN U J DATE OF DEATH 01-10-2013 FILE NUMBER 21 14-1155 - COUNTY CUMBERLAND G1 SSN/DC A N � 'L' FALVO ACN 14101307 6 0 QARRISTON RD 0&} K- 'HAVEN PA 17370-9160 Amount Remitted 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- ------------------------------------------------------------------------------------------------------------------------------------------------------------------ REV-1604 EX AFP (11-14) * INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS ** DATE: 05-05-2015 ESTATE OF: RUGGIERI JOAN DATE OF DEATH: 01-10-2013 COUNTY: CUMBERLAND FILE NO. : 21 14-1155 S.S/D.C. NO. : ACN: 14101307 ADJUSTMENT BASED ON : ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: SANTANDER BANK ACCOUNT NO . : 0771023375 TYPE OF ACCOUNT: ( ) SAVINGS ( X) CHECKING ( ) TRUST C ) TIME CERTIFICATE DATE ESTABLISHED 09-04-2002 Account Balance 2,336. 10 NOTE: TO ENSURE PROPER CREDIT TO YOUR Percent Taxable X 0.500 ACCOUNT, SUBMIT THE UPPER PORTION Amount Subject to Tax 1,168.05 OF THIS NOTICE WITH YOUR TAX Debts and Deductions - •00 PAYMENT TO THE REGISTER OF WILLS Taxable Amount 1,168.05 AT THE ADDRESS SHOWN ABOVE. Tax Rate X .045 MAKE CHECK OR MONEY ORDER PAYABLE Tax Due 52.56 TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID C-) AMOUNT PAID INTEREST IS CHARGED THROUGH 05-20-2015 TOTAL TAX PAYMENT .00 AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 52.56 REVERSE SIDE OF THIS FORM INTEREST AND PEN. 2.53 TOTAL DUE 55.09 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) 2114-1155 pennsylvania INHERITANCE TAX DEPARTMENT OF REVENUE 01/10/2013 EXPLANATION BUREAU OF INDIVIDUAL TAXES OF CHANGES PO Box 28061701 HARRI B R PA 128-060 DECEDENTS NAME Joan Ruggieri 2114-1155 REVIEWED BY ACN Robin /Agent 191 14101966 ITEM SCHEDULE NO. EXPLANATION OF CHANGES Applied debts of$ 5,934.44 against the above A C N. ROW Page 1