HomeMy WebLinkAbout07-27-15 INHERITANCE TAX —lye
RECORD ADJUSTMENT 1 Pennsylvania
JOINTLY HELD OR TRUST ASSETS DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES REV-1604 EX AFP (11-14)
INHERITANCE TAX DIVISION
BOX
HARRISBURGURG PPA 17128-
CUCO:RDED OFFICE OF
HAA
REGISTER OF WILLS DATE 07-10-2015
ESTATE OF YOHE RONALD E
?015 iUL 27 0n 2 12 DATE OF DEATH 03-18-2014
FILE NUMBER 21 15-0284
COUNTY CUMBERLAND
CLEF;, OF SSN/DC
JOYCE OlaMAP;k1NGCOURT ACN 14120468
1825 EA �AFRL �F U}_ �t p Amount Remitted
PITTSBO �7 12-x$842
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-
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REV-1604 EX AFP (11-14)
** INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS **
DATE: 07-10-2015
ESTATE OF: YOHE RONALD E DATE OF DEATH: 03-18-2014 COUNTY: CUMBERLAND
FILE NO. : 21 15-0284 S.S/D.C. NO. : ACN: 14120468
ADJUSTMENT BASED ON : ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: ORRSTOWN BANK ACCOUNT NO . : 103010335
TYPE OF ACCOUNT: ( ) SAVINGS ( X) CHECKING C ) TRUST C ) TIME CERTIFICATE
DATE ESTABLISHED 10-16-2012
Account Balance 3,404.26 NOTE: TO ENSURE PROPER CREDIT TO YOUR
Percent Taxable X 0.500 ACCOUNT, SUBMIT THE UPPER PORTION
Amount Subject to Tax 1,702. 13 OF THIS NOTICE WITH YOUR TAX
Debts and Deductions - •00 PAYMENT TO THE REGISTER OF WILLS
Taxable Amount 1,702. 13 AT THE ADDRESS SHOWN ABOVE.
Tax Rate X • 12 MAKE CHECK OR MONEY ORDER PAYABLE
Tax Due 204.26 TO: "REGISTER OF WILLS, AGENT."
TAX CREDITS :
PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID C-)
INTEREST IS CHARGED THROUGH 07-27-2015 TOTAL TAX PAYMENT .00
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 204.26
REVERSE SIDE OF THIS FORM INTEREST AND PEN. 3.70
TOTAL DUE 207.96
* 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.