HomeMy WebLinkAbout11-14-05
BUREAU OF INDIVIDUAL T~XES
INHERITANCE TAX DIVISION -
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
. ,
INHERITANCE TAX
RECORD ADJUSTMENT
JOINTLY HELD OR TRUST ASSETS
REV-160~ EX AFP (03-05)
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DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN/DC
ACN
1l-03-2005
KLINGER
12-11-2004
21 05-0016
CUMBERLAND
181-01-2104
05116569
Amount Remitted
CHARLES
G
JAMES W KLINGER
15 N HIGH ST
SHIREMANSTOWN PA 17011-6306
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 11-03-2005
ESTATE OF KLINGER
CHARLES
G DATE OF DEATH 12-11-2004
COUNTY
CUMBERLAND
FILE NO. 21 05-0016
ADJUSTMENT BASED ON:
S.S/D.C. NO. 181-01-2104
ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
ACN
05116569
FINANCIAL INSTITUTION: CITIZENS BANK OF PA
ACCOUNT NO. 6140-850908
TYPE OF ACCOUNT: () SAVINGS () CHECKING () TRUST (X) TIME CERTIFICATE
DATE ESTABLISHED 12-10-2001
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Due
.00
0.500
.00
.00
.00
.15
.00
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."
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
09-26-2005 '-. CD005844 .00 458.92
TOTAL TAX CREDIT 458.92
BALANCE OF TAX DUE 458.92CR
INTEREST AND PEN. .00
TOTAL DUE 6I:iA.q?~R
. IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. nY
( IF TOTAL DUE IS LESS THAN $1, NO PAVI1ENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), 1lJ"
YOU I1AY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORI1 FOR INSTRUCTIONS.)
REV-1470 EX (6-88)
INHERITANCE TAX
EXPLANATION
OF CHANGES
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG PA 17128-0601
DECEDENTS NAME
FILE NUMBER
REVIEWED BY
ACN
2105-0016
05116569
CHARLES KLINGER
SCHEDULE
ITEM
NO.
EXPLANATION OF CHANGES
The above referenced ACN has been reduced to zero, as this account was reported on the
probate return.
Paqe 1