HomeMy WebLinkAbout96-00775
...~
to-t
t'.
,
~
....
o
.!
.2
ut
LLI
,-~_i{i">
;f"'''i.''-..^''
i;!j ..
,
'~t;F;'..
, ",,'
,
~
.
....0
,B
:.","
.:,..
,
.:;../.q Ir775
CO""ONWUllll or PlHNSVIVANIA
D[PARIH[Nl or RlV[NU[
BUREAU or INDIVIDUAl IAXlS
OCP'. ZUbOI
ItARRISBURC. PA IIlza-ObOI
'*
FILE NO. 21
ACN 96143182
DATE 09-14-96
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
l'I.lh'" .', ".,,,
EST. OF ANTltONV J BORZOK
S.S. NO. 206-12-5293
DATE OF DEATH 07-15-96
COUNTY CUMBERLAND
TVPE OF ACCOUNT
[Xl SAVINGS
o CHECKING
o TRUST
o CERTIF.
GREGORV BORZOK
5530 MERIVALE CT
HBG PA 17112
REHIT PAYHENT AND FDRHS TO.
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
DAUPHIN DEPOSIT OK I T hu providod tho Depart..nt with tho InforGrltlc" llstlld bolow which has bo." u!IIId In calculatlnll tho
p01l1ntlal tax dUll. Ih.lr r.cord. Indicate that at tho death of tho abovlI docodont. you ..lIr. III joint owner/beneficiary of thl. account.
If you f..1 this InforMation I. Incorrect, plea'lI obtain wrltton correction froll tho financial Institution, attach II copy to thl. for.
_nrl roturn it tn th_ ftbOVlI addre... Ihl. account II taxable In accordanc. with tho Inheritance Tnx laws of the Co..onwealth of Pennsvlvanla.
Cuestlons eay be anlwered by calling (717) 787-81Z7.
COMPLETE PART 1 BELOW . . . SEE
Account No. 4914706474 D.t.
EstabUshed
REVERSE SIDE FOR
07-17-62
FILING AND PAVMENT INSTRUCTIONS
To Inlur. proper credit to your account, two
CZ) copies of this notic. eust ncco.pany your
pay..nt to the Register of Wills. "ek. check
payabl. to: "Regist.r of Wills, Agent".
PART
ill
719.52
50.000
359.76
.06
21. 59
TAXPAYER RESPONSE
FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSNENT BASED ON THIS NOTICE
Account aelance
Percent Texable
Amount Subjact to
Ta)( Rat.
Potantial Tax Du.
x
NOTt: If tax paye.nts ar. .ade within three
(1) .onths of the decedent's date of death,
you 8ay deduct a SZ dllcount of the tax due.
Any inheritance tax due will becoee delinquent
nine (9) eonths after the date of death.
Tn
x
[CHECK ]
ONE
BLOCK
ONLY
A. ~ The above Infor.atlon and ta. due Is correct.
~ 1. You .ay chaos. to re.lt pay..nt to the Register of wills with two caples of this notice to obtain
a discount or avoid interest, or you .av ch.ck box "A" and return this notice to the Register of
wills and an official aSlels.ent will be Issued by the PA Depart.ent of Revenue.
B. r=J The above aSlet has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
to be filed by the decedent'. representative.
C. [:] The nbove Infor.atlon is Incorrect nnd/or debts and deductions were paid by you.
You 8uSt co.plete PART ~ nnd/or PART ~ below.
If you indicate a different tax rate, pl.asa stat. your
relationship to decadent:
OFFICIAL USE ONLY 0 AAF
PA DEPARTMENT OF REVENUE
PART
~
lAX KE"fUKN - \;Ur1l'uTAHON
LINE 1. Data Eltablllhad
2. Account aalance
3. Parcant Taxable
4, Amount Subject to Tax
5. Debts and Deductions
6. Amount Taxabl.
7. Tax R.~.
8. Tax Due
lAX UN J01Nj'TKU~' ACCOUN1~
PART
[!]
DATE
DEBTS AND DEDUCTIONS
I'AD
1
2
3
4
5
6
7
8
CLAIMED
t d
'_.1
U~
1
2
3
4
5
&
7
8
\.J'
~
-'.j
x
~.;;
x
PAID
PAYEE
DESCRIPTION
AMOUNT PAID
I
TOTAL CEnter on Line 5 of Tax Comput.tion)
I
$
Under panaltlas of
cOMPlete to the be.t ot
..f!Jt#'~ a'i' .1-'
TAXPAVE SIGNA~E
perjury, I daclare that the facts I
ny knowledge and belief.
haYe report ad above are
HOME ("11 7 ) t: \'.1-
WORK ((.1(', ) 'I J3 .
TELEPHONE NUMBER
true, correct
5/1t" 9
S')c"1
and
GEHERAL IHFORMAT10H
1. FAILURE TO RESPONO WILL RESULT IN AN ornCI^L lAM ASS[SSHINT ."10 .",01,..101. ,,,,...., ......, ,,,.1,,,,,,..11""
subllltted bv the """,neill' InlUtutlol1.
Z. Inherltftnc8 tall been..' delinquent nh18 ~o"th. ,,'hI thll 111Ie..,len", lllt'e III 11."lh.
S. A Joint account I. ,.."ble 11"11" thnuII" Ihll d8l,"1.1l1', "".. ..", 'tll.tll" I'l' ",,,,,t., lit 1.111.",.,,1111\1..
.. ."oun', Ilnc'udlno '100" h.'d h.,...n ,,,..,'",,,, ..", ."., .101.10 'h. "....I.'" ,,,., I" 1,,1'" ".... ,"101" ,,,.. "" IHt"' '0
d.ath are fullY ,,,ubi_ ... trt""hrl.
5. 'ccoun" ....bll.h.d jotnllv ...,..." 10"...."" ."" .". .no. 'h." "". ".. '" ,,,. '0 "..", ... ",,' ,.....t.,
6. Account_ held bv It decedent "In trult lor" ..nlllh.r III 11th." It'8 ,,,...1I1e lull.,
REPORTIHG IHSTRUC110HS
PARI
TAXPAYER RESPOHSE
I. OlOCK' _ If 'h. 'n,o...lIo" ...., '.""01011"" I.. 'h. .."II.. ... 0""'" ...., "..,,,.11,,,,, ... ..., ".Ino d.l..d. p"co .n 'K'
In b'ock ... of I'''' I ., 'h. "I..,,",,, ,....."..." "0 """ \I,,, ,." .",.,.. "',,' ."...11 ,.... .1110 you, ch.c' '0' 'h. ..oun' of
,.. '0 'h' .'0"'" 0' wtll' "f 'h. c....." I"'''''''''' II.. "~A II.....'...., ,,' ,,,...,,. .111 ,..U. on offld.t ........n'
(For. R[V-l\ft8 [)II ullon r.(811,t III the ,.'"11' hUll 11.. JI."hI8' III Willi.
Z. OlOCK ft _ If 'h. ...., ....clft..' "" "... ""II.. 00.. ...." '" ."t h. ..,,,,, ,.., ",," '0' "o'd ."10 'h. ..nn,,'..n', Inh.d,.nc.
To' ...u'" ",.d b, 'h' ,,,...'.n". ..,,,...,,,.11,,, "I..' ." '.," ,,, "'''0' "ft" "f "'" . .f 'h' 'lo'p,," ....on..' ..cllon. "On on.
COpy .nd ..'u," '0 I'" I" II..... ,..". ,,' '''''''''' ."..." ,,' """.1,'"'' ,..... II.,.. '''b''. ""d.bu'O. .. 17I28..b" In 'h.
envelop. provided.
1. OlOCK r. _ If 'h. .ollco 1..,,,...11,,. I. ,.".".... .",,,,,, "..,,,.11"'" ... 10.1... d.t..d. c..oc' b'ock 'C' .nd co.pl'" ..... Z .nd 1
......,.. O. 'h' ,.."".".....00.'''. "". ,... ...",.. ...., ,,,,,'11 "... .IIh .n", cOo." fo' 'h. ..oun' of ." o...b', '0 'h. ..ot...,
01 WII" 0' Ih. ,,,,.,Iv ,,,,,,,,..... II.. ,'. II.....'...., "f ...."". .,11 t..u. ." oll'cI.1 ........n. ITo" .[y-.... [XI upo' ,"c.tp'
of thll r.turn Ita. thll Nag"'.f II' wll".
TAX RETURH - PART
2
TAX COMPUTATIOH
lIHE.
1. (ntar
HDT(:
tha data Ih. account Iuluhllllly.,,, ..'.IIII'hllllll' 'I"ad In thll IIIftllnar ..l,ttng ftl data of dlilllth.
'0' . d...don' d,I.. .11.. ""/1'" ..."..... .101.10 II.. ,....d.". ,,,' ,. loin' ..... .\lhln 0" III V'" of dOft'h'"
....bt. lullv .. ."".,.... ""...... II.... I. ... ....".110. ..0' '0 .....d n.oo' p" ...n...... ,",,,d"" of .h. va'u' 0'
the account or Ih. ,It..b.r lit "u;ouuh hold,
If a doub" ........ ,n, .,......10"0" ,IOU' 11..1....' I. 'h' ndd.... po,lIon 01 'hi. .ollc" 'h. n.oo' ..du.lon
alralldy hili b..n deduct.d frua Ih. .UIII"" hal"n"8 ,.. ,0,lort.d 11'1 1ho flnllncllll Institution.
Z. [ntar tho totnl blll_nea 01 t"lI fu;cnunl Indlltllnl) In'-'." Accrued to Ihll d"'o of dOllth.
1. 1h. pornnt of thll account Ih.1 ,. ,..,.1110 for 11,,1.11 lurvlvor h dlltar.lned III followsl
A. 1hll parcant tn_lib I. for jotnt 1I...h ."alllhh8.1 IIIor. H"'" nn. yll"t prior 10 thll docedant.s death:
1 DIVIDED BY 1DU\ NUtlflrR Of
JOIN1 OWNI NS
ba.pl.1 . Joint "...t nlllll.r.d
DIVIOI 0 aV 10Ul NUI~.lA or )( 100 . PERCENT TAXABlE
SUMVIVING JOINT OWNERS
In Ih. m'.. 01 Ih. "acadanl ftnd Iwo olh." parsons.
I DIViDED BY S (JOIN1 OWN(RS) UIVIOIO BV ~ ISURVIVORS) . .,., X 100
'..1% I1AXABlE FOR EACH SURVIVOR)
ft. lh. p"c.n' ....b" 10' ...... c".,.II .11101. on. .." ,,' 'h. d".don". doo'h 0' .ceou.II own.d bV 'ho d"odon' bU' h.,d
In trust for ftnoth.r Intlh"II""lltl IHutt han.flcl"rlu':
1 DIVID[D av toUI NutlBlR or suRVIVING JOINt
OWNIRS OR IRIIS' IIIH!lIC.UNItS
lC 100 . III AClN1 UIlABlE
["'P'OI Jotn' .ccounl ...'.....11 In 'h. ..... ,,' 'h. ",,,,,on' .nd "0 0'10" p."OOl ond ...abll.h.d wllhln on. Y'" of dOft.h b,
\h. dacatlanl.
1 DIVIDED BY 1ISUItVIVOASI. .\0 . 100 'tOZ 1 ,,,AIllI lOR llW SURYJlJORI
.. Th. oooun' .ubj.C' '0 I.. .11...., I. ".,...,..11 It, .u'""'VI'. Ih. mou" bO,.nc' III.. Zl bV 'h. p"c.n' '..ab" llIno 1'.
S. Enta,. the totlll of \h. debh ,.,..tI deduction' II,hd II.. 1,,,,1 ~.
.. lh. a.oun' ,...b" IlIn. ., ,. ".....".... h, ...,oU.cllno 'h. ".b" ond ".",,11001 "... " "0' tOo. a.ouo\ 1U0J'C' to '" "... ...
7. Ent.r \h. approp' lilt. ,.. rlt'" Illna II It, .lal.,.lnll.1 hlllo",
.. ror dat.. of d...lh OctU" I"'.. .".r 1".\0/'1", thll 1,,_ f.la' for Ir"nthr. to ',IOU'.' ara a, 10110"':
I. D.tu 01 d...I" on Of .."., 1/1/'1" 111'1I1 h.fllf. 1/11"\ thll fllla I' !~.
Z. Dllt.. of d..lh on 0' ""ar 1/1/"\ I".n,f.f' lu 'I,".,un Mill ha I"..d.I O~ tn. r"t..
Hot.1 ror d.t., of d..'h III lot In 1/1/11.. I""'"f.' , In '111I"'.' M. tll."hl. Itt h~.
B. 1ran.f.r, to 11'....1 d.u.mll1,.,I. Inrllllll".. I."..f, IIInt".r, """ 1'""Vl'lhr, Vrl'lnclchtldran, son. In-I.",
dlllUlIhl.r.ln-III", ."'Ilfhthl lI1'1d thalf luu. ",. '..."lil. .., ,I- ".,(._"t 1hZ'.
C. ...n."" 10 .tI ,,'h... ,..d,"""1 ''''''''''. .1...,. ......, ."",. ...,.,... ond .I.co'" ,...bt. .. III1'on p.".n' 115"'.
O. II you c.hlllnll. the h. r.'., III.... II1.l111 .,0." ,.111,101",11111 to th. t1_C1I1I_n\ In tha "rea provtd.d.
ft. 'h. oom..' "f ... "". IItno.' ,. .,,1...1....' It, .",",,,,1... 'h. ..."...., ,...b" tllno hI bv 'h. ... ,.,. ",no II.
CLAIMED DEDUCTIOHS - PART
3
DEBTS AHD DEDUCTIOHS CLAIMED
II1""..hl. .1."" "1Il111."",'ln'" ",. 11_lal.\,,_.1 ". lalln"'l
.. ,,," t,".tI, ... ...."",.11.1. .." ,,,,""'. 0' 'h. ....,. ..bl.cI '0 od.I.I....llon bV' P."ono' "p"..n.all" I. In..flldon'
In 11"__ tI.a 11_.1"" 1It1_ II..'
.. Vn" "1,,,..11. 1...1.1 lh. II.hl' ..tl., II."'" of ",. d.cadant I'lnd c"" furnhh proof 01 p.y..nt.
I. n..... ...1"" . ,.,..., ...., ... "..".., ,,,tI, In "'" ,. If .ddlllono' .p." I. ...d.d. un p,al. p.p" ft I/Z' ,11'. .,oof of
II.....", ""f ". ,......"... II., Ih. III n.II/H,..n1 al "avanua.
TAXPAYER ASSISTANCE
IF YOU tlLtD FURHtER lHFORHATlOH OR ASSISTAHCE, CONTACT AHY
RFOIS1ER OF WILLS, PA DEPARTMENT OF REVENUE DISTRICT OFFICE
OR CAll tilE BUREAU OF lHDIVIDUAL TAXES. TAXPAYER IHQUIRY UHIT 1H
II^RRlSftURO ^T 17171 787-8327. TOOl (717) 772'2252 (HEARING IMPAIRED ONLY)
OlNlHAL lNFOHMATION
1. FAILURE TO RUPONO Will "lSOLT tN AN UIfICIAI lAM AS51SSHlNI .11" .,.,.11,,"1. I.'."" b...d on Inl.,on'l.n
,uballhd b'l' th. 11l11M1f;h,1 "'III'1l11ull.
Z. IM.>I..n" ... ".,.... 0'.11""....., ..I'" ."..11" .11.0 11,. ".0.."."'" ".,. "I "..11',
" . I. In' ."..... I. ,..."1. .,.n ."",.." '''. ",,,,,,,,". "... ... ..",.., .. . ..11" "I ,,,n,.,,I."'..
.. A""""" ""<1..011,,. ,,,,,00 ".101 "....." ,..."..,,1 ..", .11" .""" ",. "...".", ,..., In 1"lnl n.... .11"1" ... ,... .>1., ..
d..th .r. fyllY 11....111..' "..,,,hr..
,. ."...... ..'01011'''''' ,,,1,,01, I..,..." ,..."..., ..", .". .".. """ "". .... ,,11"0 ,,, 010"" ... "., ,,,.b",
6. Aceoun" "eld bY" 11...,1.'" "'n I,,,,t Ill'" I,n.,tha' III 11th." "'. Ifl.llhl- full.,.
HlPOHTINO INS1HUCllONS
PART
I
_ TAXPAYER RESPONSE
I. 110"'. II 1100 1"1,,...110.' ..., ,,,.....'.11"" ,,, II'. ",,'I.. ... ,."".<1.,,01 "."..,'1"'" .,. n'" b.ln. <1.1..01. .I.".n "X"
'" bl." "A" .1 '0.11 I "I ,,,. ",."..,,, .........." ..,II"". 'I." ... <0,"" .,,01 .u,..1I .".. .11" ,.u, ,,,.,, I.' ,,,. ...un' .1
,,, ,. I'"~ ...1.'" .1 .111. .1 1100 "".... I..."'.."". I'"~ "A 0.,.."..", .1 ....n... .111 I"u' .n .Illd.1 .........,
tror. PtV'I"ftl .)11 utili" 1.,.1t11 lit 'he I.tu'" If... 'h. ".lIh'.' of wlIl,.
Z. 110" I . II 1100 ...., .....1"." "n ,,,I. ""II.. ".. "..n '" .111 ". .."."." .n" ... ".101 .11" ,,,. ..n.oyl..nl. In".>lt.n"
,.. ...u,,, 111.01 '" 1100 "....,...,..0.,,,...,,..11... "I." "n ..," I" "I." "I" .1 ".., I .1 .". "I..p.," ...p.n.." ..,tI... Sl.n .n.
,.,,, .nd ,,'uon .. ,,,. "A II...."..n. ,,' ..,...... ...,.....1 ,,,dl.ldu.1 ,..... II.p' Z".". "."I..u'.' P' 1l1lO.,.'1 In tho
env.lop. "rovllled.
,. alO" C . II ,,,. n.II.. In,.,..II.n I. ""."", ...<11.' d."udl.n. ... ..In. <1.1..01. ,h'" bl." "C" .nd ,..pl." P.'" Z .nd ,
"",oil'. " ,n, \"0'....'-", ..\... "n" ."" "'"... .... ...n." ..... _"n "M" ,..... ._, .... .."",,' " '.. .".,,,,. ,. Ok" ...."...
nl .111. ., .". ,....... 1""1,,..01. ,,,. "A II.,o.....n' "I ....nu. .111 I..". .n .1I1c1.1 ........nt cr.,. .CV,"'1 [XI up.n ..,.Ip'
of ",. r.turn fro. 1"" p.oh'.' of ..\th.
TM RETURN - PART
2
. TAX COMPUTATION
LlH[
1. [nt.r
N01(:1
I'"~ ".,. ,,,. ."..... .>I.ln.ll, .oo .....11.".01 ., tltl" In '''. ..on.' ..I.tln. .. d.t. .1 d..th.
,., . ""..,.n' .,,1". .".. IUluaZ, A"...n" .,,1," 1100 d."d.nt put In J.lnt n.... .lthln .n. III Y'" .1 d80th .,.
....bl. ".lIy oo ".n.I.", ".....,. ."... I. .n ..,lu.l.n n.' ,. ."..01 ".00' p.' t,.n.f.'.. ,...,011." .f tho ..Iu. .1
the ACCOunt or the nueber of Account. held.
II . .lnu,.I. ..,..,., 1..1 .pp.... b.I,,' you' II..' n.oo 'n 'h. .0101.... p"tI.n .f this n.II<o, tho ",00' ."lu.\.n
01".01, "" h'on ".du".d 1,.. .". .".un' h.l.n<o .. "."tod by tho f'n.nd.1 In.tllutl.n.
Z. [n'" 'h' ,.,.1 h.''''<O .f I"' .".unt Indudln. In'....t .",u.d t. tho d.t. .1 d..th.
,. I". "",.nt .1 I"' .,,,..,,. 'h.t I. ,...bl. I.' ..," .u,ul'.' \. d..."ln.d .. f.II..S:
.. 'h. p.".n' ....bl. I., 1.ln' ....t. ..t.bll.".d ..,. 'h.n .n. y.., p,I.' .. tho d.,.d.nt'. d..'h'
DIIJID[D IV lOTAl NUHfttR or
JOiNT OWHrRS
l,..plel A Jotnl ftllet r.gt.t.red
DIVIDED 8Y Total "UNBtM or J( 100 . PERerHT tAXABLE
SURVIVINC JOiNt OWNERS
In Ih. n... of the decedent ftnd two othor portonl.
I DIYIDID IV J IJOINI OWNIRS) DIVIDED IV Z ISURVIVORS) . ,1&1 X 100
1&.7Z (TAXABLE FDA EACH SURVIVOR)
.. 'h. p.".n' ,...b" I., ....t. "....01 .I'hln on. y.., .1 'h. d.,.d.nt" d..'h ., .".unt. o.n.d by tho d.,.d.nt but h.ld
In truII lor .nothor Indlvlduall'. ttrutlt ben.flclllr1u):
1 alVIOlD IY 10lAl NUHllR or SURVIVING JOiNt
OWH[R5 OR tpust BlHtflelARlES
)( 100 . PERCENT TAXABLE
[...pl" J.ln' .".un' ,..1.,.,.01 'n ,h. n..' .1 tho d.,.d.nt .nd ... oth.' p.,.on. .nd ..t."II.".d .It"ln .n. ,.., .f d..tn by
the dec..dont.
1 OIVIDID BY 1 (sURVIVORS) . .!JO X 100 !JoZ (lAXAlIlE rOR EACH SURVIVOR)
., ,". ...un' 'Ubl'" .. ... II\n. .1 I. d.t.,.\n.d by .ultlplyln. 'h. .".unt b.l.n" Illn. ZI by tho p.".n' t.,.bl. 111n. ".
... [nt.r the 10,,.1 of the debh and deduction' lhted In Pllrt J.
h. 'h. ..oun' ,...bl. '11n. hi I. d.,.,.ln.d b, ,ubt,.,.ln. tho d.bt. .nd d.du,tl.n. 111n' ., f,.' tho ...unt ,Ubj.,t t. t.. '11n. .1.
I, [n,.r the IIPproprln'o 'a. rat. (llno 1) al dotor.inlld b.lo~.
a. I.' d.... .1 d...h .,'u"In. .1..' """'. tho t., ,.t.. f.r ".n.I.,. to ...u... .,. .. 1.110."
1. Oat.. of lI.ath on or aftllr 1111'1" and b.for. 1/1/9S tho rat. Is !Z.
Z. 0.'" .1 d..t" .n ., .It., l'I"~ ".n.I." .. ,p'u'.' .111 b. t.,.d .t ,. t., ,.t..
Notlll ror d.t.' 01 d.ath prior to 111/9" tranlf.rl to spou'.' sr. ts.sblll 8t bZ.
I. 1'....101. t. IIn..1 d....nd.n.. In,ludln. I.'"." ..th.'. ..n. d.u.ht". .,.nd,""dlOn. oon.ln'I...
d"UQht.r"n'ln~, Itapchlld and th.lr Inu. IIr. tn.llblll ,.t I'. Pllrcent l6Z).
C, ".n.f.,..O .11 .'h.,. In,ludln. b,.th.'. .I.t.'. un,I.. .unt, n.ph.. .nd nl.'. .,. ,.,.bl. .. 1II,..n p.,..nt 11.".
O. II y,u ,h.n.. tho t., ,.t.. pl.... ...,lly v.u, ,.I.tl.n.hlp t. tho d...d.nt In tho .,.. .,..101.01,
a. I". ...unt .1 ,.. du' II In. 81 I. d..."ln.d by ""Itlplyln. tho ..."n' ..,.bl. Illn. .1 hy tho t.' r.t. Illn. 71.
CLAIMED DEDUCTIONS - PART
3
DEBTS AND DEDUCTIONS CLAIMED
A, ,.u 1...lly .,. ,..p.n.lbl. I.r p.,..n', ., .". ..t.'. ."bl.,t to .d.lnl."..lon by . p.,..n.1 ,.p,...nt.tl.. I. In.ull',I.nt
to p.", th. Itaductlbl. It....
I. ,.u ."".lly p.ld 'h' d.bt. .f'" d..'h .f tho d.,.d.nt .nd ,.n lu,nl." p,..1 01 p.,..nt.
C. O.b" 'ooln, ".1..01 .u.t b. 110011001 lullY In POlt', If .ddltl.",1 ,p." I. nood.d. uu pl.ln .'P" I lIZ" ,11-. PlOof.f
pa..,..nt 11"'1 h. r.qu.st.d by tho PA OIlPllrt.ant of AllvllnulI.
Allowabl. dllbt, and dllductlonl are dlltllr.lnlld II' follo~':
TAXPAYER ASSISTANCE
IF YOU NEED FURTHER INFORMATION OR ASSISTANCE, CONTACT ANY
REGISTER OF WILLS, PA DEPARTMENT OF REVENUE DISTRICT OFF1CE
OR CALL THE BUREAU OF INDIVIDUAL TAXES. TAXPAYER INQUIRY UNIT IN
HARRISBURG AT (717) 787-8327. TOOl (717) 772-2252 (HEARING IMPAIRED ONLY)
I.'J" j,)'! f
COMMONWEALTM OF PENNSYLVANIA
DEPARTMENT OF REVENUE
~*
(i
BUREAU OF INDIVIDUAL 'A~[S
IHI.RIIAHU U.DlvUtllN
DIP," leGU)
IIAR.IULlNO, 11& lIllI-ont
NDTlC& or INII&RITANC& TAX
APPRAISr."&NT1 ALLDMANC& OR DtSALLOMANC&
or D&DUCTION., AND ASSr.SS"&NT or TAX ON
JOINTLY 1Ir.L0 OR TRUST ASUTS
",.U,III ". 1l,-'1I
GREGORV BORZOK
5530 MERIVAlE CT
HBG PA 17\12
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN"DC
ACN
02-17-97
BORZOK
07-15-96
21 96-0775
CUMBERLAND
206-12-5293
96143183
Atlount Rellit t.d
ANTllONV
J
MAKE CHECK PAVABLE AND REMIT PAVMENT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ....
Rifv:is4-a-EiC-AFii-iiif:96-j-----------------------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT. ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS. AND ASSESSMENT OF TAX ON JOINTLV HELD OR TRUST ASSETS
DATE 02-17-97
ESTATE OF BDRZOK
ANTHONV J DATE OF DEATH 07-15-96
COUNTY
CUMBERLAND
S.S/D.C. NO. 206-12-5293
(X) ACCEPTED AS FILED ( ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: DAUPHIN DEPOSIT BK & TRST CO ACCOUNT NO.
ACN
96143183
FILE NO. 21 96-0775
TAX RETURN WAS:
4600063643
TVPE OF ACCOUNT: (lO SAVINGS ( ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 01-06-92
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Due
1.894.51
0.166
315.76
.00
315.76
.06
18.95
NOTE: TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAVMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEV ORDER PAVABLE TO.
"REGISTER OF WILLS, AGENT."
TAX CREDITS:
PAVMENT
DATE
09-30-96
RECEIPT
NUMBER
AA146790
DISCOUNT (+)
INTEREST (-)
.95
AMOUNT PAID
18.00
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
. IF PAID AFTER TNIS DATE. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ·
( IF TOTAL DUE IS LESS THAN Sl, NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" I CRI. YOU HAY SE DUE A REFUND.
SEE REVERSE SIDE OF THIS FDRH FOR INSTRUCTIONS. I
18.95
.00
.00
.00
"" .. .,
.- ";"; ~1~
'J) cO
,,:.,:
c:J
....
111
'"
,-
PlIlPO$[ Of
NOrItE,
&;0: P; ~8
To 'ulflll the requlr..en', 0' Section Zl~a of the Inneratenc. end E.tat. r.x Act, Act ZZ of 1991. e7l P.S.
Section '140).
PAYMENT I Detach the top portion of thl, Hotle. and lub.lt with your pay..nt to the Rlot.t.r of Will. printed on the
t...,.r.. alda.
-- "--. check or ~y ord.r p'Y~l. tal RECISTER OF WIllS, ACENT.
All pav.ent. tac.lv~ shall 'Jrst b. applIed to any Int.r..t which '.y be dua, wIth any t...lnd.r applIed to the t...
REfUND (CR)I , r.fund 0' . t.. cradlt, whIch wa. not reque.tad on the tax r.turn, .,y b. r.que.tad by COMpleting an -Application
'or R.fund of Penn.vlvanl. Inheritance end E.t.t. Tax. (REV-IlI]J. ApplIcation. .t. Ivallabl. It thl O,flcl of
the Regl.t.r of WIlli, any of th. 23 Revenue Dlltrlct O'flc.. or by cIlllng the splela. Z4-hour an.w.rlna ..rvlcl
~.r. 'o~ fo~.. o~de~lng: In P~'ylvanl. 1-800-362-2050, outlld. Penn.ylvanla and within local
Har~laburg ara. (717) 787-80'4, TDDI (717) 772-2252 (Haarlng lapalrad Only).
OBJECTIONS: Any party In Int_r..t not .atl.fled with the .ppral...ent, allowanc. o~ dl.allowanc. of d.ductlon. or .......ent
of t.. (Including dl.count or Int.r..t) a. .hown on thl. Hotlc. ..y Object within .I.ty (60) day. of ~.c.lpt of
this Notlc. by;
--written protl.t to the PA Depart-.nt of RIV'no., Board of App..l., Dapt. Z81021, Ha~rl.burg, PA 17128-1021, OR
--.lacUng to hev. the 'att.~ d.t.ralned lit the audit of the account of the par.onal r.prll.ntaUv., OR
--appa.l to the Drphan.. Court
_IN-
ISlRAlIVE
CORRtClIOHS r
Factual .rror. dl.cov.r.d on thl. a"'..lant should b. .ddr....d In writing tor PA a.partaant of R_v.nu.,
Buraau of Individual T...., ATTNr Po.t A.....-.ot R.vlew unit, DEPT. 280601, Harrl.burg, PA 171Z8-0601
~ (717) 787-6505. S.. pag. 5 of the bookl.t ~In.tructlon. for Inh.rltanc. Tex R.turn fo~ a Ra.ld.nt
Dacedlnt~ (REV-lS01) fo~ en axplanatlon of adllnl.tratlvelY corr.ctabl. .rror..
DISCDtJrfT:
If any ta. due I. paid vlthln thr'e (5) calend.r aonth. afte~ the d.c.dont.. death, a five p.rcent (5X)
dllcCM'lt of the t.. paid" .llowed.
PENALTY:
Th. 15X ta. .-na.ty non-pa~tlclp.tlon p.nalty I. coaput.d on the tot.l of the t.x and Int.re.t .......d, and not
p.ld befora January 18, 1996, the fl~.t day .ft.~ the end of the ta. aan..ty p.rlod. Thl. non-pa~tlclpatlon
penalty I. .ppallabl. In the ...e 'anna~ and In the the .... tl.. parlod a. YOU would .ppaal the tex and Int.re.t
that h.. blan a..I..ed a. Indlcat.d on thl. notlc..
IHT[REST:
Int.re.t I. cha~g.d beginning with flr.t daw of d.llnquency, o~ nine (9) aonth. and one (1) day
fru. the data of d.ath, to the data of payaant. T..a. which ble... d'llnquent be for. January 1, 1982
bla~ Int.re.t at the ~It. of .1. (6X) pG~cant p.r annua calcul.ted .t . dally rat. of .000164.
All t.... which bee... delinquent on o~ .ft.r January I, 1982 will b.ar Int.r..t at a rat. which will varw fru.
c.lendar y.a~ to c.lenda~ y.ar with that ~at. announced by the PA O.p.rtaant of R.venue. The applIcable
Int.re.t rat.. for 198Z through 1997 .r.:
V.ar Int.r..t Rat. O.llw Int.r..t F.eto~
1982
1913
1984
1985
1986
--Int.r..t
ZOX
lOX
ltiC
l3X
lOX
I. calculated a.
.000548
.000458
.000301
.000356
.000Z7lt
follow.:
V.ar Interllt Rat. Dally Int_rllt Faeto~
1987 'X .000Z47
1988-1991 11;( .000301
1992 'X .Oao2~7
1995-1994 n .000192
1995-1997 'X .000247
INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Anw Notle. I..ued .ft_r the ta. baeo... d.llnquent will refl.et en Int_r..t c.lculatlon to flft_an (IS) day.
tMyond the dlte of the ......-.nt. If paYHr1t II .acta .ft.~ the Int.rllt co.putatlon data .hown on the
Notice, additional Int_r..t au.t tM c.lculated.
,
of S.ctian ZI40 of the Inh.~ltanc. and E.tat. TaM Act, Act ZZ of 1991. (72 P.S.
PAYMENT I D.tach the top po~tlon of thl. Hotlc. and .ub.it with your pay.ent to the R.gl.t.~ of Will. print.d an the
rey.~.. .Id..
-- "ak. check or .on.y order paYabl. tal REGISTER OF WILLS, AGENT.
All p.yeent. rec.ived thall fl~.t b. appli.d to any Int.~..t which aay b. du., with any ~...ind.~ applied to the ta..
REfUND (CR): A r.fund a' a tax credit, whIch wa. not r.~.t.d on the taM r.turn, .ay b. r.que.t.d by caKPlatlng an -applicatIon
'a~ Rafund of Penn.ylvania Inh.~ltanc. and E.tat. TaM~ (REV.1313). Application. ar. avallabl. at the O"lc. of
the A.gl.t.r of Willi, any of the 23 Rlvenu. DI.trlct Offic.. or by calling the ,plclal Z~.hour en.w.~lng .lrvlcl
nueber. far for.. ord.ring: In Penn.ylvanl. 1.800.36Z-Z050, out.ld. Penn,ylvanla and within loc.1
Harrisburg .r.. (717) 181.8094, TOO' (717) 71Z.Z2SZ (H..rlng I~air.d Only).
DBJECTIONSr Any party In Int.r..t not 'atl.fl.d with the appr.I...ent, allawanc. a~ dl.allowanc. of d.ductlon. or .......ant
of tax (including dl.count or Int.r..t) .. shown an thl. Notlc. ..y obJ.ct within slMty (60) day. of r.c.lpt 0'
this Notlc. by:
--written prot..t to the PA D.p.rt-.nt of R.yenue, 80ard of App.al., Dept. 2810ZI, Harrl.burg, PA 17IZ8.1021, OR
--'I.ctlng to h.v. the .aU.r d.t.r.lned .t the audit of the acCOU"lt of the p.r,onal r.pr.,entatlv., OR
--appeal to the Orphan,' Court
ADHIH.
ISTRATlVE
CORRECTIONS:
Factual .rror. dl.cov.red an thl, ....'...nt .hould b. addr.,..d in wrltlna to: PA D.part..nt a' R.venue,
Buruu 0' Individual 1IxII, AnNI Po,t A.......nt A.vl.w Unit, DEPT. za0601, Ifarrhburg, PA 171Zl-0601
Phone (711) 787-6505. S.. pag. 5 of the bookl.t -Inltructlon. fo~ Inh.rltanc. r.M Return far a A..ld.nt
DIC.d'"t~ (REV.ISOI) far an 'MPlanatlan of adalnl.tr.tlv.ly carrectabl. .rror..
DISCOUNT:
If any taM due II p.ld within thr.. (]) cal.ndar .anth. aft.r the d.ced.nt'. d..th, . 'Ive p.rcent (S~)
dl.count 0' the tax paid II allow.d.
PENAL TV:
The .5~ ta. a.nalty non-partlclp.tlan p.nalty I. co~ut.d on the total of the taM and Inter..t .......d, and not
paid b.for. January 18, 1996, the flr.t d.y aft.r thl and of the taM aan..ty period. Thl. non-participation
penalty I. appealabl. In the .... .ann.~ and In the thl .... tl.. p.rlad al YOU would app.al the tax and Int.r..t
that ha. bien a......d a. Indlcat.d on thl. notic..
IHTEREST I
Int.r..t I, charged b.ginnlng with flr.t day of d.lInquency, or nine (9) .onth. and one (1) day
'rOl the data of d.ath, to the data of pay.ant. TaM" which beea.. d.lInquent b.far. Janua~y 1, 198Z
baar Int.r..t at the rat. of .1. (6~) p.rcent par annu. calculat.d at a dally rata of .000164.
All t.M., WhIch bee... d.IJnquent on or aft.r J8nU.~y I, 198Z will b.ar Intere.t .t a ~at. which will va~y fro.
calander Ylar to ce1andar y.ar with that rat. announcad by the PA Dlp.~t.ant of R.v.nue. Th. eppllcab1.
Int.r..t r.t.. 'or 198Z thrOUgh .991 a~'J
Vaar Inter..t Rata Dally Int.r..t fector V.ar 1ntar..t Rat. Dally Intar..t Factor
198Z lU .0005U 1987 .~ .000Z47
1913 16ll .00008 1988.1991 1I~ .000301
198~ 11% .000301 199Z .~ .000Z~7
19a5 13X .000356 1993.1994 n .000192
1916 lOX .000Z74 1995-1997 'X .000Z47
uInt.ra.t Is calculated a. fallows:
INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
."Any HoUe. I..uact .,tar the t.M bKaa.. dallnquW1t will ra'hct en Int.~ut calculaUon to flftaW1 CIS) day.
beyond the data of the .......W1t. If payunt Is .ede aftar the Inter..t coaputeUon data .hown an the
NoUca, additional Interut IlUIt be calculated.