HomeMy WebLinkAbout08-03-15 INHERITANCE TAX
RECORD ADJUSTMENT pen11SJ/ Val11a
JOINTLY HELD OR TRUST ASSETS DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES --------
REV-1604 EX AFP (11-14)
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HARRISBURG PA 17128-0601
REGISTDR, OF WILLS
{�1C �+ �p nu DATE 07-28-2015
ESTA?U1J RUG 3 P i 12 U { DATE TOFODEATH 02-05-2015 ING EVELYN M
FILE NUMBER 21 15-0476
CLERK Gr COUNTY CUMBERLAND
WILMAQRPHI�VS�fMELIiNG SSN/DC
ACN 15135669
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E1 I Amount Remitted
PLANTATION FL 33324-6158 1 9
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: 07-28-2015
ESTATE OF: STIMELING EVELYN M DATE OF DEATH: 02-05-2015 COUNTY: CUMBERLAND
FILE NO. : 21 15-0476 S.S/D.C. NO. : ACN: 15135669
ADJUSTMENT BASED ON : ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: ORRSTOWN BANK ACCOUNT NO. : 1500030280
TYPE OF ACCOUNT: ( ) SAVINGS C ) CHECKING C ) TRUST ( X) TIME CERTIFICATE
DATE ESTABLISHED 01-04-2015
Account Balance 2,001.37 NOTE: TO ENSURE PROPER CREDIT TO YOUR
Percent Taxable X 1 .000 ACCOUNT, SUBMIT THE UPPER PORTION
Amount Subject to Tax 2,001.37 OF THIS NOTICE WITH YOUR TAX
Debts and Deductions - •00 PAYMENT TO THE REGISTER OF WILLS
Taxable Amount 2,001 .37 AT THE ADDRESS SHOWN ABOVE.
Tax Rate X .045 MAKE CHECK OR MONEY ORDER PAYABLE
Tax Due 90.06 TO: "REGISTER OF WILLS, AGENT."
TAX CREDITS :
PAYMENT RECEIPT
ATENUMBER INTEREST/PEN PAID (-)
AMOUNT PAID
PAYMENT MUST BE MADE BY 11-06-2015*. TOTAL TAX PAYMENT .00
BALANCE OF TAX DUE 90.06
INTEREST AND PEN. .00
TOTAL DUE 90.06
* 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.