HomeMy WebLinkAbout10-20-09COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 7 7128-0801
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
CEKOVIC FRANK J
6050 WERTZVILLE RD
ENOLA, PA 17025-1159
ACN
ASSESSMENT
CONTROL
NUMBER
fold
ESTATE INFORMATION: SSN: 202-20-1973
FILE NUMBER: 2109-0981
DECEDENT NAME: CEKOVIC ELI
DATE OF PAYMENT:. 10/20/2009
POSTMARK DATE:. 10/17/2009
COUNTY: CUMBERLAND
DATE OF DEATH: 07/29/2009
REV-1162 EX(11-96)
N0. CD 01 1874
AMOUNT
09161636. ~ 548.73
TOTAL AMOUNT. PAID: $48.73
REMARKS:
CHECK# 2302.
.INITIALS: JN
sEA~ RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS'
REGISTER OF WILLS
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE p./
BUREAU OF INDIVIDUAL TAXES AND FILE ND. 21 ~ ~p 1
Po Box 2BOSOI ~ ~'"''r ,~ ;'"~~'AXPAYER RESPONSE ACN 09161636
HARRISBURG PA 171zB-o6o1 DATE 09-28-2009
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FRANK J CEKOVIC
6050 WERTZVILLE RD
ENOLA PA 17025-1159
EST. OF ELI CEKOVIC
SSN 202-20-1973
DATE OF DEATH 07-29-2009
COUNTY CUMBERLAND..
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
TYPE OF ACCOUNT
SAVINGS
® CHECKING
TRUST
CERTIF.
PNC BANK NA provided the Department with the information below, which has been used in calculating the
potential tax due. Records indicate that at the death of the above-named decadent, you were a ]oint owner/beneficiary of this account.
If you feel the information is incorrect, please obtain written correction 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. Please call C717) 787-8327 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 000005112031218 Date 05-06-2005 To ensure proper credit to the account, two
Established copies of this notice must accompany
payment to the Register of Wills. Make check
Account Balance ~ 6,838.65 payable to "Register of Wills, Agent".
Percent Taxable X 16.667
NOTE: If tax payments are made within three
Amount Subject to Tax $ 1,139.80 months of the decedent's date of death,
Tax Rate ~( .045 deduct a 5 percent discount on the tax due.
Any Inheritance Tax due will become delinquent
Potential Tax Due ~ 51 • 29 nine months after the date of death.
PART TAXPAYER RESPONSE
a
A. ~ Tha above information and tax due is correct.
Remit payment to the Register of Wills with two copies of this notice to obtain
CHECK a discount or avoid interest, or 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.
C ONE
BLOCK B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
0 N L Y to be filed by the estate representative.
C. ~ The above informa ion is incorrect and/or debts and deductions were paid.
Complete PART ~2 and/or PART ~ below.
PART If indicating a different tax rate, please state
relationship to decedent:
TAX RE TURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
LINE 1. Date Established 1
2. Account Balance 2
3. Percent Taxable 3 X
4. Amount Subject to Tax 4 $
5. Debts and Deductions 5 -
6. Amount Taxable 6
7. Tax Rate 7 X
8. Tax Due 8 $
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
complete to`` the best' of my knowledge and belief. HOME C ) '~'
~IL ~/ ~l~, WORK C ) l Gf
r.veav~o crc Tno~ TFIFPHONE NUMBER DA E
PART DEBTS AND DEDUCTIDNS CLAIMED
DATE PAID PAYEE DESCRIPTION AMOUNT PAID