HomeMy WebLinkAbout09-11-08COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1162 EXI11-961
NO. CD 010256
ZAGORIC LINDA G
6401 S WESTSHORE BLVD APT 1 101
TAMPA, FL 33616
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ESTATE INFORMATION: ssrv:
FILE NUMBER: 2108-0832
DECEDENT NAME: ZAGORIC DAVID R
DATE OF PAYMENT: 09/ 1 1 /2008
POSTMARK DATE: 09/08/2008
couNTY: CUMBERLAND
DATE OF DEATH: 07/29/2008
REMARKS:
CHECK# 1505
SEAL
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
08135639 ~ 54.71
TOTAL AMOUNT PAID:
INITIALS: CJ
54.71
RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLYANIA
DEPARTMENT OF REVENUE '
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BUREAU OF INDIVIDUAL TAXES ,,:-.
NFORMATION NOTICE FILE N0. 21 'd g-vD~J~
DEPT. 280601 '"
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HARRISBURG, PA nlza-o6ol rj'':. '`--'` TAXPAYER RESPONSE ACN 08135639
DATE 08-08-2008
REV-1543 EX AFP (09-00)
Z~l1t! 5tt' L ~ r~ IL• w ~ TYPE OF ACCOUNT
EST. OF DAVID ZAGORIC ® SAVINGS
CLER~CI~~ S.S. No. ~ CHECKING
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~ DATE' OF DEATH 07-29-2008 ~ TRUST
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COUNTY
CUMBERLAND
~ CERTIF.
REMIT PAYMENT AND FORMS T0:
LINDA ZAGORIC REGISTER OF WILLS
6401 S WESTSHORE BLVD CUMBERLAND CO COURT H OUSE
APT 1101 CARLISLE, PA 17013
TAMPA FL 33616-1391
MEMBERS 1ST FCU has provided the Department with the information 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 point owner/beneficiary of
this account. If you feel this information is incorrect, please obtain written cgrrection from the financial institution, attach a copy
to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth
of Pennsylvania. Yuestions may be answered by calling C717) 787-8327.
COMPLETE PART 1 BELOW * * * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
r penalties of perjury, I declare that the facts I have report d above are true, correct and
to the ~~ of know edgfl and belief. HOME C ~_~'-~~ ~~
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SIGNATURE v ~ ~ TELEPHONE NUMBER DATE
IuIAL cEnter on Line 5 of~Tax Computation) $
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CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: Harriet June Piontkowski
Date of Death: July 25, 2008
File No.: 21-08-834
To the Register:
I certify that notice of estate administration required by Rule 5.6(a) of the Orphans' Court
Rules was served on or mailed to the following beneficiaries of the above-captioned estate on
September 9, 2008.
Dorothy J. Martin
509 Francis Drive
Mechanicsburg, PA 17050
Frank J. Kelly
719 Seth Drive
Cranberry Township, PA 16066
Dorothy J. Martin
Trustee of the Ariel Kaufmann Trust
509 Francis Drive
Mechanicsburg, PA 17050
Notice has now been given to all persons entitled thereto under Rule 5.6(a).
Dated: , 2008
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00076828
9/9/2008 1:54 PM
Signature
Name: Stephen P. Paschall, Esq.
Address: Lovett Bookman Harmon Marks LLP
Fifth Avenue Place, Suite 2900
120 Fifth Avenue
Pittsburgh, PA 15222
Telephone: (412) 392-2502
Capacity: Counsel for Personal Representative
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