The URL can be used to link to this page

Home My WebLink About04-14-08 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG. PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT KOSTELAC JOANNE 9 CONWAY DR MECHANICSBURG, PA 17055 -------- fold ESTATE INFORMATION: FILE NUMBER: 2108-0494 DECEDENT NAME: DRAGOVAN ANNA T DATE OF PAYMENT: 05/02/2008 POSTMARK DATE: 04/1 4/2008 COUNTY: CUMBERLAND DATE OF DEATH: 11/24/2007 NO. CD 009652 ACN ASSESSMENT CONTROL NUMBER AMOUNT 08106459 I $178.72 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: CHECK# 9228 SEAL INITIALS: AKK RECEIVED BY: REGISTER OF WillS $178.72 GLENDA FARNER STRASBAUGH REGISTER OF WILLS COMMOtoltlEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 prrnpOE" ~;r i"~")""')~ REGS1~-~ ~'.~s.0Q) INFORMATION NOTICE AND TAXPAYER RESPONSE FILE NO. ACN DATE 21 .O~ '1C\t 08106459 02-15-2008 7688 "AY -2 PM I: '8 EST. OF ANNA T DRAGOVAN 5.5. NO. DATE OF DEATH 11-24-2007 COUNTY CUMBERLAND TYPE OF ACCOUNT o SAVINGS Iil CHECK I NG o TRUST o CERTIF. ~8&.ro CUMBER\.)NO CAJH ~ JOANNE A KOSTELAC i' .; 8 CONWAY DR MECHANICSBURG PA i7055 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 "&T BANK has provided the DepartMent with the inforaation 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 ioint owner/beneficiary of this account. If YOU feel this infor.ation is incorrect, please obtain written correction fro. the financial institution, attach a COpy to this fora 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 May be answered by calltng (717) 787-8327. COMPLETE PART 1 BELOW Account No. 29091489 . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Date 06 -28 -1982 x 5,804.25 50.000 2,902.13 .12 348.26 TAXPAYER RESPONSE To insure proper credit to your account, two (2) copies of this notice Must aCCOMpany your paYMent to the Register of Wills. Make check payable to: "Register of Wills, Agent". Established Account Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Due x NOTE I If tax paYMents are Made 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. PART [!] A. [ CHECK ] ONE BLOCK B. ONLY c. ~ 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 May check box "A" and return this notice to the Register of Wills and an official asseSSMent 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 inforMation is incorrect and/or debts and deductions were paid by you. You MUSt COMPlete PART 0 and/or PART ~ below. PART [!] TAX RETURN - COMPUTATION 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 OF 1 2 3 4 5 6 7 8 TAX ON J~T/TRUST 3// n ,Il!\ 8'tJ L/, ;L \ ~, ()/J d- 9~, /3 /~'~ / "s3 , /2,., /7?; 7 ~ ACCOUNTS If you indicate a different tax rate, please state your relationship to decedent: x x PART [!) DEBTS AND DEDUCTIONS CLAIMED TOTAL (Enter on Line 5 of Tax Computation) . Under penalties of perjury, I declare that the facts I complet&\to the best of my nowledge and belief. have reported above are true, correct HOME (717) 7t~- 9'/ '1{ WORK ( ) TELEPHONE NUMBER and T WJto t ~ -f.~ .po! ',r',Qf)E. Dt OFrY'\~ r,:: ',.I',t" j rllve. \",1. Of.'.t; t"';" r \~ \M1. I C! '. !fll' J1''; \ r\ VI :, 1\ l~"" 1{._ . ~'BKA'1-2 PH I: 18 :/ ~ot ( ORPH,AN'S COUR1 \ OJMBERtAND CO.. PA ~ !"~ ~ ~ ~ r6 V) rt. ti it( .~ t ". ~ r1 ~ -( ~ w0 ::;)W z><z .... wi!o 0 >~- ~ wa: cC !! CD ....> ~ II.~- ogo ;:: >>< .... !iiSr! f ",,- ~~wiCJ ~ ....11. CJ oa: a:OZCD~ ~j~~= w~a:oa: Ottwma:: ~=2ocC -...-Q..:I: \ ! Q. N ~ $:! ii) ... ~ c 0 ~ ~ ! c .. W ~ = - - - - = - - - - - - - - - - - - - - .: - - -