HomeMy WebLinkAbout08-01-05
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
n~'^nn'Y" !'~~Irr .iJ:HHERITANCE TAX
"t'>vi'ILlCu u:T,,,CRltORD ADJUSTMENT
,~~y, HELD OR TRUST ASSETS
*'
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
Z005 AUG - I Pf112: 26
CLERi<
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PATRICIA .I SLATIClSI} ,-
32 HAZEL CIR
MECHANICSBURG PA 17050
REV-16D4 EX AFP (03-05)
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN/DC
ACN
07~26~2005
MITCHELL
05~20~2004
21 05~0448
CUMBERLAND
194~09~2345
04136239
AmOUlt Relli ttecl
~
JACK
C
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE
--+ RETAIN LOWER PORTION FOR YOUR RECORDS
-
----......-----------..-------------------------------------------------------------------------------......---..------------------------
REV-1604 EX AFP (03-05)
__ INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS --
DATE 07-26-2005
ESTATE OF MITCHELL
JACK
CUMBERLAND
C DATE OF DEATH 05-20-2004
COUNTY
ACN
04136239
FILE NO. 21 05-0448
ADJUSTMENT BASED ON:
S.S/D.C. NO. 194-09-2345
ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: WAYPOINT BANK
ACCOUNT NO. 755261224
TYPE OF ACCOUNT: () SAVINGS () CHECKING () TRUST (X) TIME CERTIFICATE
DATE ESTABLISHED 02-15-1995
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Due
4,400.40
0.500
2,200.20
2,250.00
.00
.15
.00
TAX CREDITS:
NOTE: TO INSURE PROPER CREDIT TO YOUR
ACCOUNT, SUBMIT THE UPPER PORTION
OF THIS NOTICE WITH YOUR TAX
PAYMENT TO THE REGISTER OF WILLS
AT THE ADDRESS SHOWN ABOVE.
MAKE CHECK OR MONEY ORDER PAYABLE
TO: "REGISTER OF WILLS, AGENT."
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
TOTAL TAX CREDIT .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.
I IF TDTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRJ,
YDU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. J
<j{-.
Q,.:
REV-1470EX(6-88)
'*'
INHERITANCE TAX
EXPLANATION
OF CHANGES
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
PO Box 280601
HARRISBURG PA 17128-0601
DECEDENTS NAME
JACK MITCHELL
FILE NUMBER
REVIEWED BY
ACN
2105-0448
04136239
SCOTT ELLISON
ITEM
SCHEDULE NO.
EXPLANATION OF CHANGES
THE FUNERAL EXPENSE HAS BEEN APPLIED AS A DEDUCTION TO THIS ACCOUNT.
ROW
PaQe 1
p;::r:mnEf' rnlrr rr
BUREAU OF INOIVIDUAL"~~ LJ \)-, 'v: V
INHERITANCE TAX DIVISION R:'-i ..;~;;r.C; \};; ! ~~
PO BOX 280601 ...... v I - . '" : _,'
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
*'
REV-16D7 EX AFP (03-05)
2005 WG 19 PI>; 12: 33
CLEF.!( C~
OPFl'!iL,~'
PATRICI{/.:j- SLATICK
32 HAZEL CIR
MECHANICSBURG PA 17050
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
08-15-2005
MITCHELL
05-20-2004
21 05-0448
CUMBERLAND
04136239
AlIOunt R_ittlld
JACK
C
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax pa~ent.
CUT ALONG THIS LINE
-
RETAIN LOWER PORTION FOR YOUR RECORDS
-
---------------------------------------------------------------------------
REV-1607 EX AFP (03-05)
~~~ INHERITANCE TAX STATEMENT OF ACCOUNT ...
ESTATE OF MITCHELL JACK C FILE NO.21 05-0448 ACN 04136239 DATE 08-15-2005
THIS STATENENT IS PROVIDED TD ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NANED ESTATE, SHOWN BELOW
IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYNENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 07-25-2005
PRINCIPAL TAX DUE: .00
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
07-15-2005 CD005585 .00 337.78
08-08-2005 REFUND .00 337.78-
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00
.
~
SIDE FOR CALCULATION DF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1,
NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRJ,
YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. J