HomeMy WebLinkAbout07-20-15 INHERITANCE TAXpennsytvarna
BUREAU OF INDIVIDUAL TAXES RECORD ADJUSTMENT —
INHERITANCE TAX DIVISION DEPARTMENT OF REVENUE
PO Box 2806p0�1 BENEFICIARY FORM ASSETS REV-1604A EX AFP (11-14)
HARRISBRE V V RHBEp60F'F'I C E OF
REGISTER OF
WILLS
DATE 07-13-2015
ESTASMTH
?015 JUL 20 Pr�p� 12 '39 DATETOFODEATH 12-31-2013 ROSEMARY J
FILE NUMBER 21 14-0248
CHERYL LE R t' COUNTY CUMBERLAND
IT r SSN/DC
9417 Dd5kR&V4bkCOURT ACN 14500225
VIENILAU�$E ��a � V�A)22�P2-3411
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 E-
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REV-1604A EX AFP (11-14)
** INHERITANCE TAX RECORD ADJUSTMENT BENEFICIARY FORM ASSETS **
DATE: 07-13-2015
ESTATE OF: SMITH ROSEMARY J DATE OF DEATH: 12-31-2013 COUNTY: CUMBERLAND
FILE NO. : 21 14-0248 S.S/D.C. NO. : ACN: 14500225
ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION
BENEFICIARY FORM ASSETS
NAME OF SECURITY: AMERICAN FUNDS ACCOUNT NO. : 82600366
TYPE OF ACCOUNT: (X) SECURITIES ( ) SEC ACCT C ) STOCK C ) BOND
DOD Valuation 00 NOTE: TO ENSURE PROPER CREDIT TO YOUR
Percent Taxable X 0.000 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 Due X .045 MAKE CHECK OR MONEY ORDER PAYABLE
Tax Rate •00 TO: "REGISTER OF WILLS, AGENT."
TAX CREDITS :
PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID
DATE NUMBER INTEREST/PEN 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" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.
REV-1470 EX(01-10)
lapennsylvania INHERITANCE TAX
DEPARTMENT OF REVENUE EXPLANATION
BUREAU OF INDIVIDUAL TAXES OF CHANGES
PO Box 280601
HARRISBURG, 17128-0601
DECEDENTS NAME FILE NUMBER
Rosemary J. Smith 21 14-0248
REVIEWED BY ACN
Steven -Agent# 193 14500225
ITEM
SCHEDULE NO, EXPLANATION OF CHANGES
The above-referenced ACN has been reduced to zero as this account was reported on the
probate return.
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