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Home My WebLink About01-0853 /?-R....~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE *' BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG I PA 171Z8-0601 NOTICE OF INHERITANCE TAX APPRAISEKENT~ ALLOHANCE OR DISALLOHANCE OF DEDUCTION~1 AND ASSESSKENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REV-l548 EX AFP U2-OD' MICHAEL A TAKACH RR 1 BOX 714 302 POLECAT RD LANDISBURG PA 11040 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 11-12-2001 TAKACH 06-20-2001 21 01-0853 CUMBERLAND 172-14-5027 01139994 Allount RBllittBd MARGARET B 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 ~ iErv=isiri-i)f-AFrFi-fi1f=ooi------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 11-12-2001 ESTATE OF TAKACH MARGARET B DATE OF DEATH 06-20-2001 COUNTY CUMBERLAND FILE NO. 21 01-0853 TAX RETURN WAS: S.S/D.C. NO. 172-14-5027 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 01139994 FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 118973-11 TYPE OF ACCOUNT: () SAVINGS (~ CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 02-20-1991 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due 4,,256.57 0.500 2,,128.29 3,,000.00 .00 .45 .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 ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS" AGENT." TAX CREDITS: 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. . ( IF TOTAL DUE IS LESS THAN $1" NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CRl, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. l COHMOHNiALTH OF PENNSYLVANIA 'bEPARTMENT OF REVENUE Burc~U OF INDIVIDUAL TAXES DEPI. 280601 HARRISBURG, PA 17128-0601 *' "7 - 7-3 INFORMATION NOTICE AND TAXPAYER RESPONSE FILE NO. 21-0 ,- ~53 ACN 01139994 DATE 09-05-2001 REV-lS45 EX AFP (09-00> EST. OF MARGARET B TAKACH S.S. NO. 172-14-5027 DATE OF DEATH 06-20-2001 COUNTY CUMBERLAND TYPE OF ACCOUNT D SAVINGS 00 CHECKING D TRUST o CERTIF. MICHAEL A TAKACHPo -eArn' RR 1 BOX 714 "jO~ .' tt ' "'C!- LANDISBURG PA 17040 RE"IT PAY"ENT AND FOR"S TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 "EMBERS 1ST FCU has provided the Depart.ent with the infor.ation listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of this account. If you feel this infor.ation is incorrect, please obtain written correction fr~ the financial institution, attach a copy to this for. and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Co..onwealth of Pennsylvania. Questions .ay be answered by calling (717) 787-83Z7. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 118973-11 Date 02-20-1991 Established Account Balance Percent Taxable AMount Subject to Tax Rate Potential Tax Due x 4,256.57 50.000 2,128.29 .045 95.77 TAXPAYER RESPONSE To insure proper credit to your account, two (Z) copies of this notice .ust acc~pany your pay.ent to the Register of Wills. Make check payable to: "Register of WillS, Agent". x NOTE: If tax pay.ents are .ade within three (3) ~nths of the decedent's date of death, you .ay deduct a 5Y. discount of the tax due. Any inheritance tax due will beco.e delinquent nine (9) .onths after the date of death. Tax PART [!] A. [ CHECK ] ONE BLOCK B. ONLY c. c=J The above infor.ation and tax due is correct. 1. You .ay choose to re.it pay.ent to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or you .ay check box "A" and return this notice to the Register of Wills and an official assess.ent will be issued by the PA Depart.ent of Revenue. [] The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent.s representative. [] The above infor.ation is incorrect and/or debts and deductions were paid by you. You .ust co.plete PART ~ and/or PART ~ below. If you indicate a different tax rate, p~eas~ state your relationship to decedent: ~oJV PART ~ TAX lINE RETURN - COMPUTATION 1. Date Established 2. Account Balance 3. Percent Taxable 4. A.ount Subject to Tax 5. Debts and Deductions 6. A~unt Taxable 7. Tax Rate 8. Tax Due OF TAX ON 1 2 3 X 4 5 6 7 X 8 JOINT/TRUST ACCOUNTS "'2-'2D -Icrcr { L.j "2.. sf" . 5l ~~.~O "2.} 2. ~, z. '1 "3 oot> J (J () -0- PART [!] DATE PAID G,-i'i,t>) -0- DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION O/le AMOUNT PAID 3000.. (70 TOTAL (Enter on line 5 of Tax Co.putation) $ , O<:}}O J C>" Under penalties of perjury, I declare that the facts I COMPlete to the best of ny knowledge and belief. ~~~ TAX AY R SIGNATURE have reported above are true, correct HOME (71 'l ) 7?J 9 - '-/394- WORK (,n) l:,oj-i0"'30 TEL PHONE NUMBE and 0, -I 2. -t:;:> / DATE ... ... Statement United Church of Christ Homes Thornwald Home 442 Walnut Bottom Road Carlisle, PA 17013 Statement Date: 06/01/2001 Mike Takach RD 1 Box 714 Landisburg, PA 17040 Due Date: 07/27/2001 Re: Margaret B Takach Account Nr: 423 -------------------------------------------------------------------------------- Date Description Days Quant Rate Charges Payments Balance -------------------------------------------------------------------------------- 3,000.00 4,737.35 1,737.35 1,744.85 -2,695.15 -31.15 BALANCE FORWARD 06/19/01 PAYMENT 06/30/01 Cable Television 06/30/01 Room & Board - Semi 06/30/01 Room & Board - Semi 4,737.35 1.00 30 18 7.50 148.00 148.00 7.50 -4,440.00 2 , 6 6 4 . 0 Q. Recently we have had money and personal items disappear on our nursing units. We strongly encourage you to use the locked drawer on your bed- side stand . Please report missing items as soon as you know they are missing. Fay Y. Henry Administrator