HomeMy WebLinkAbout06-30-15 INHERITANCE TAX
RECORD ADJUSTMENT law pennsy vania
JOINTLY HELD OR TRUST ASSETS DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISIONpp REV-1604 EX AFP (11-14)
PO BOX 280
HARRIISBURG601 PA 17128-0601 R L�^W/�C R O LCC D OFFICE 0 F
REGISTEf rr ""'ILLS DATE 06-17-2015
ESTATE OF KAUTZ FLOYD G
DATE OF 09-11-2013
?015 JUN 30 M 3 99 FILE NUMBERTH 21 15-0022
COUNTY CUMBERLAND
CLE_;,. OF SSN/DC 168-24-3810
FLOYD G KAUTZ ORPHANS' COURT ACN 14105789
429 W KELLER ST t-p
r^i a •,,� n A Amount Remitted
MECHANICSBURG �A 17055-377 2 0., E'N
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: 06-17-2015
ESTATE OF: KAUTZ FLOYD G DATE OF DEATH: 09-11-2013 COUNTY: CUMBERLAND
FILE NO. : 21 15-0022 S.S/D.C. NO. : 168-24-3810 ACN: 14105789
ADJUSTMENT BASED ON : ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: SANTANDER BANK ACCOUNT NO. : 7678135513
TYPE OF ACCOUNT: ( X) SAVINGS ( ) CHECKING ( ) TRUST C ) TIME CERTIFICATE
DATE ESTABLISHED 08-30-2013
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 C+)
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.