HomeMy WebLinkAbout03-06-09 (5)COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
/~~i r~r
BUREAU OF INDIVIDUAL TAXES ~ ,I~ HQT~~'E CIF.'INHERITANCE TAX
INHERITANCE TAX OIYISION /~PR~SEMENTu /\1:LOWANCE OR DISALLOWANCE
PO BOX 280601 ; p~`D~3UG,T.TO~1~a.dND ASSESSMENT OF TAX ON
HARRISBURG PA 17128-0601 JOINTLY HELD OR TRUST ASSETS
249 ~}AR -6 P~ l2~ 5
CLERK C=
ORFH?~`~ UJ'J~T
THOMAS DLUGOLECKI(~,U~l~''= ~' ' ;~ ' ~.„ ~A
1413 EUCLID AVE
SAN DIEGO CA 92105
DATE 03-09-2009
ESTATE OF DLUGOLECKI PAUL S
DATE OF DEATH Oi-06-2008
FILE NUMBER 21 08-0496
COUNTY CUMBERLAND
SSN/DC
ACN 08115018
APPEAL DATE: 05-08-2009
(See reverse side under Objections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV-1548 EX AFP (01-09)--------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 03-09-2009
ESTATE OF DLUGOLECKI
FILE N0. 21 08-0496
PAUL S DATE OF DEATH 01-06-2008
S.S/D.C. N0. 198-07-8768
COUNTY CUMBERLAND
ACN 08115018
TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT N0. 7502-11
TYPE OF ACCOUNT: C )SAVINGS 4() CHECKING C )TRUST ( )TIME CERTIFICATE
DATE ESTABLISHED 08-09-1984
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
5,300.31
X 0.050
265.02
.00
265.02
X .45
11.93
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 T0:
"REGISTER OF WILLS, AGENT."
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID (-) AMOUNT PAID
INTEREST IS CHARGED THROUGH 03-17-2009 TOTAL TAX CREDIT .00
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 11.93
REVERSE SIDE OF THIS FORM INTEREST AND PEN. .32
TOTAL DUE 12,25 ;'~,
^ IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL IN
F TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" C CR), YOU MAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )