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HomeMy WebLinkAbout06-02-15 INHERITANCE TAX RECORD ADJUSTMENT 1 pennsyLvarna JOINTLY HELD OR TRUST ASSETS DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES _.....__...s INHERITANCE TAX DIVISION _ _ _ n REV-1604 EX AFP (11-14) PO BOX 280601 (i U {' d U G HARRISBURG PA 1712 t DATE 05-21-2015 Zg13 luN 2 qF;` 1133 ESTATE OF RUGGIERI JOAN J U DATE OF DEATH 01-10-2013 FILE NUMBER 21 14-1155 CLE, COUNTY CUMBERLAND ANNE 0f7,pr,,ALV,O' V SSN/DC ACN 14101966 620 GA I&T-ON- RD ' rel L,r— - Amount Remitted YORK HAVEN PA 17370-9160 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: 05-21-2015 ESTATE OF: RUGGIERI JOAN DATE OF DEATH: 01-10-2013 COUNTY: CUMBERLAND FILE NO. : 21 14-1155 S.S/D.C. NO. : ACN: 14101966 ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION : SANTANDER BANK ACCOUNT NO . : 7674079503 TYPE OF ACCOUNT: ( X) SAVINGS C ) CHECKING C ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 07-10-2012 Account Balance 72,108.83 NOTE: TO ENSURE PROPER CREDIT TO YOUR Percent Taxable X 0.500 ACCOUNT, SUBMIT THE UPPER PORTION Amount Subject to Tax 36,054.42 OF THIS NOTICE WITH YOUR TAX Debts and Deductions - 5,934.44 PAYMENT TO THE REGISTER OF WILLS Taxable Amount 30,119.98 AT THE ADDRESS SHOWN ABOVE. Tax Rate X .045 MAKE CHECK OR MONEY ORDER PAYABLE Tax Due 1,355.40 TO: "REGISTER OF WILLS, AGENT." TAX CREDITS : PAYMENT RECEIPT DISCOUNT C+) DATE NUMBER INTEREST/PEN PAID C-) AMOUNT PAID INTEREST IS CHARGED THROUGH 06-05-2015 TOTAL TAX PAYMENT .00 AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 1 ,355.40 REVERSE SIDE OF THIS FORM INTEREST AND PEN. 67.02 TOTAL DUE 1 .422-42 * 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.