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HomeMy WebLinkAbout04-16-08 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 2B0601 HARRISBURG, PA 17128-0601 '* INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO.21 07-0430 07125542 06-08-2007 REV-1543 EX AFP (09-00) TYPE OF ACCOUNT EST. OF ANN HUNCHARIK S.S. NO. 196-18-0778 1 . ( 0ATE OF DEATH 10-20-2006 <::::"" h / 1--1. Lt. f'\C~'n t< S pkl> t. OUNTY CUMBERLAND J e r: ~ ('-;'\ "/ I) REMIT PAYMENT AND FORMS TO: JAMES HUNCHARIK . uec..e-uS'~ 3~/f)' Ob REGISTER OF WILLS 557 WOODLAND AVE CUMBERLAND CO COURT HOUSE JOHNSTOWN PA 15902 CARLISLE, PA 17013 (") ~ C; 0 2i5 .... :0 :z,.. ; IJ~f p ;g} PNC BANK has provided the Depart..ent with the information listed below which has ~~sed ...... ,..) calculating' the potential tax due. Their records indicate that at the death of the above decedent, you were a ~~~ ~ner/bfJI9fici~~~., cif"'.l this account. If you feel this information is incorrect, please obtain written correction from the financial insti)~on, attach a .-co.p.. y:::J to this form and return.it to the above address. T~is account is taxable in accordance with the Inheritance T~~~of t~ommo~e~~ of Pennsyl"'ania~ QuestIons may be answer~d by cilll:'-ng (717) 787-8327. ;~'-')(,:...: ::J::' ~.';'i COMPLETE PART 1 BELOW ~ ~ ~ SEE REVERSE SIDE FOR FILING AND PAYMENT JLNSfRUCTtDNS-~~ ..J.;'> .' - To insure proper credit to your ac~nt, t~o ~ . , : (2) copies of this notice must acc~anY your payment to the Register of Wills. Make check payable to: "Register of Wills, Agent". [i] SAVINGS o CHECKING o TRUST o CERTIF. Account No. 5003157946 Date 03-13-2000 Established x 3,056.72 50.000 1,528.36 .15 229.25 NOTE: If tax payments are .ade within three (3) months of the decedent's date of death, you may deduct a 5% discount of the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. Account Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Due x PART ill TAXPAYER RESPONSE [CHECK ] ONE BLOCK ONLY A. [] The above information and tax due is correct. 1. You may choose to remit payment 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 assessment will be issued by the PA Department of Revenue. B. [] 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. C. [] The above information is incorrect and/or debts and deductions were paid by you. You must complete PART ~ and/or PART ~ below. LINE 1- Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due PART ~ DATE PAYEE OF TAX ON JOINT/TRUST ACCOUNTS 1 2 3 X 4 5 II../- J I~}? I () 0 6 7 X 8 PART ~ TAX RETURN - COMPUTATION If you indicate a different tax rate, please state your relationship to decedent: DEBTS AND DEDUCTIONS CLAIMED DESCRIPTION Under penalties of perjury, I declare that the facts complete to the best of my knowledge and belief. have reported above are true, correct and "'I'"__na""r-n C""-Tro...IATIIDI:' HOME ( WORK ( TELEPHONE ) ) NUMBER DATE ~1 TOTAL ~ $ u.s. INFORMATION RETURN FOR 2007 I Sua.:::: B for I ~~. Stalement for RecIpIents d Proceeds from Broker and Barter Exchange Transactions T} X~=~ 0I5101f2007 56501R10 :z &lOCkS, Bonds, etc:. 11140.25 3 BarterIng 4 FEIIERAllNCOlE TAX W\'l14HELD 7 DescitPUon 0.00 MANULlFEFlNANCIAL.'CORPORATlON - - 5 No. d WIleS exch8nged 6 Classes d stock exchanged ~mrHARIKSHERAOOOO 00175056501R10 w:,. SHERIAL A HUNCHARIK PAID 557 WOODLAND AVENUE JOHNSTOWN PA 15902-2666 RECIPIENT'S Idelltlfbtlon number on file 189-38-5160 ~S......1IdcIIess, ZIP code and Federal IcfentIIiaitIon number MELLON INVESTOR SERVICES 480 WASHINGTON BLVD JERSEY CITY NJ 07310 (800) 249-7702 WWW.MELLONINVESTOR.COM 22-3367522 FORM 109&08 D CORRECTED If checked 0Zl DUPUCATE YotJl can quickly access payment history of dividends and more on your account online. Please refer to the above referenced website address. VieW Infonnation Diviidend Check History Dividend Reinvestment Activity Account Detail Certificate History Boolk Entry History Hist.orical Stock Price Information Transactions Available Change Your Address Requesta. Dividend Check Replacement . Request a Duplicate Reinvestment s.tatement Request a -Duplicate Form 1099 J ,G~~VL;.,< ~ \[\ \1\ ~f\.v V~e < ~ u- ~ Y- ~oJ\ c.s \t/./ GLENDPl FARNER STRASBAUGH cumberland County - Register of Wills One Courthouse Square Carlisle, PA 17<J13 Receipt Date: Receipt Time: Receipt No. : 5/03/2007 14:17:33 1048330 nUNCHARIK ANNA Estate File No. : Paid By Remarks: 2007-00430 SHERIAL A HUNCHARIK CJ Fee/Tax Description PETITION LTRS TEST WILL SHORT CERTIFICATE JCP FEE AUTOMATION FEE Check# 126 Total Received.... ..... Receipt Distribution ------------------------ Payment Amount Payee Name 45.00 15.00 8.00 10.00 5.00 ---------------- $83.00 $83.00 CUMBERLAND COUNTY GENERAL FUN CUMBERLAND COUNTY GENERAL FUN CUMBERLAND COUNTY GENERAL FUN BUREAU OF RECEIPTS & CNTR M.D CUMBERLAND COUNTY GENERAL FUN ~ ~ -i o -i )> r o 'T1 ~ m :JJ (") :I: )> Z o en m en m r m (") -i m o :@ ~ m )> r- )> z o m c c m ~ (")(")~:JJ)> 0"a;(1)~~~ ~~5~5iii eo <=:-< ~ ~ lS-_ o 'T1 ID CD ~Q.8~ :; ~,..Q) iil ' ~ :u 3- ill (") '< III ~ ~ (") III a. fI) "U 0 )> 0 -< s: s: "U m r- Z m -i -i :0 m m -i o 0 m -i <: )> m r- o "'Tl :0 o s: )> o o =i 6 Z )> r- =i m s: Ul o :0 o m :0 m o > -i m :0 -ien o III ~ i!" (")-i III III ~!< )> ::;; a. 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