HomeMy WebLinkAbout08-12-15 INHERITANCE TAX
RECORD ADJUSTMENT pennsylvarna
JOINTLY HELD OR TRUST ASSETS
BUREAU 0 ��{{V)I�jµA,4 �(�n� 4�° DEPARTMENT OF REVENUE
INHERITANCtD�{( N U I WILLS
is REV-1604 EX AFP (11-14)
PO BOX HARRIISBURG696Qb&0601 OF sIi I LE S
DATE 07-30
HIS PUG 12 A19 1119 ESTATE OF CAMPBELL15 JOHN L
DATE OF DEATH 07-26-2013
CLERK OF FILE NUMBER 21 13-0875
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COUNTY CUMBERLAND
T 5 PA POWERSn SSN/DC
230TH �AVE SE ACN 14108792
2
Amount Remitted
MAPLE VALLEY WA 98038-8920
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE --I� 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: 07-30-2015
ESTATE OF: CAMPBELL JOHN L DATE OF DEATH: 07-26-2013 COUNTY: CUMBERLAND
FILE NO. : 21 13-0875 S.S/D.C. NO. : ACN: 14108792
ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: SANTANDER BANK ACCOUNT NO. : 0924089520
TYPE OF ACCOUNT: ( ) SAVINGS C ) CHECKING ( X) TRUST C ) TIME CERTIFICATE
DATE ESTABLISHED 05-11-2010
Account Balance •00 NOTE: TO ENSURE PROPER CREDIT TO YOUR
Percent Taxable X 1 .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 Rate X .045 MAKE CHECK OR MONEY ORDER PAYABLE
Tax Due •00 TO: "REGISTER OF WILLS, AGENT."
TAX CREDITS :
PAYMENT RECEIPT DISCOUNT (+) 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" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.
REV-1470 EX(01-10)
t
i
i pennsylvania INHERITANCE TAX
DEPARTMENT OF REVENUE EXPLANATION
BUREAU OF INDIVIDUAL TAXES OF CHANGES
PO Box 280601
HARRISBURG. 128-0601
DECEDENTS NAME FILE NUMBER
John L. Campbell 2113-0875
REVIEWED BY ACN
Department of Revenue 14108792
ITEM
SCHEDULE NO. EXPLANATION OF CHANGES
The above ACN has been adjusted to zero as it was reported on the probate return.
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