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Home My WebLink About12-15-10COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT GONTKOVIC CATHERINE 161 BRINDLE ROAD MECHANICSBURG, PA 17055 REV-1162 EXI11-961 NO. CD 013789 ACN ASSESSMENT AMOUNT CONTROL NUMBER fold ESTATE INFORMATION: ssN: 003-09-9580 FILE NUMBER: 2110-1029 DECEDENT NAME: MARTEL WILFRED J DATE OF PAYMENT: 12/15/2010 POSTMARK DATE: 1 2/ 14/2010 COUNTY: CUMBERLAND DATE OF DEATH: 07/31 /2010 101 ~ 524.91 TOTAL AMOUNT PAID: REMARKS: SEAL CHECK# 389 524.91 INITIALS: CJ RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS PENNSYLVANIA INHERITANCE T INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES AN D Po Box 2BO6o1 ^~~~~~~T~CPAYER RESPONSE HARRISBURG PA 17128-0601 ,_ ? REV-1543 EX (i R ~~ 6!ij ~~ ~ ~ hf~~:~"4~ ' (4 ~yt~ i ~ FILE N0. 21 10-1029 ACN 10169762 DATE 12-13-2010 2010 QEC 15 PM 12~ 16 ~~~ ~~ ot~~s cou~T CUUIBFRLA~~~ ter)., PA. CATHERINE M GONTKOVIC 161 BRINDLE RD MECHANICSBURG PA 17055-9515 EST. OF WILFRED J MARTEL SSN 003-09-9580 DATE OF DEATH 07-31-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS ® CHECKING TRUST CERTIF. PNC BANK NA Provided the Departeent with the inforeation below. which has been used in calculating the potential tax due. Records indicate that at the death of the above-nosed decedent, you were a ioint owner/beneficiary of this account. If you feel the inforeation is incorrect, please obtain written correction froe the financial institution, attach a copy to this fore and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Coeeonwealth of Pennsylvania. Please call 0717) 787x8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 000005005799133 Date 08-05-2008 To ensure proper credit to the account, two Established copies of this notice Bust accoepany payeent to the Register of Wills. Make check Account Balance $ 1 ~ 107.06 payable to "Register of Wills, Agent". Percent Taxable X 50.000 NOTE: If tax payeents are cede within three Amount Subject to TaX $ 553.53 months of the decedent's date of death, X .045 deduct a 5 percent discount on the tax due. Tax Rate Arty Inheritance Tax due will becoee delinquent Potential Tax Due $ 24 • 91 nine months after the date of death. PART TAXPAYER RESPONSE 0 ail~#.tE` T#I ltESP~#~iI3 IEILi~x„i~S#l1,Ts1k! -AK'~~I~IAl.f.7'#~X:'~.~'S~~~ ; :. A. ~ The above infonation and tax due is correct. Resit payeent to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or check box "A" and return this notice to the Register of CHECK Wills and an official assesseent will be issued by the PA Departeent of Revenue. ONE C B L 0 C K 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 inforea ion is incorrect and/or debts and deductions were paid. Coeplete PART 2~ and/or PART 3~ below. PART If indicating a different tax rate, please state relationship to decedent: 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 TAX ON JOINT/TRUST ACCOUNTS ~ PAI3.~` "'~~ ""'"'"~''~ ~~,x ~'~`~"~ 4 2 5 7 B $ /V_ 2 ~ w,.> j ~2- -~ ~ ~ _ ~ ~~ DEBTS AND DEDUCTIONS CLAIMED PART a DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported above are/t~rue7, c(o~rrQect and ~eplnplete to the best of knowle a and belief . HOME C ~ ) ~ % / ~ Q~ C /~1 WORK ..,~.. ..r.....~~~ r TFI FPHONE NUMBER DATE - IUTAL Fencer vn amine ~ .+n.r ••~o ~~~••- - BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 260601 HARRISBURG PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS CATHERINE GONTKOVIC 161 BRINDLE ROAD MECHANICSBURG PA 17055 Pennsylvania ~ DEPARTMENT OF REVENUE REV-1548 EX AFP C12-09) DATE 11-22-2010 ESTATE OF MARTEL WILFRED J DATE OF DEATH 07-31-2010 FILE NUMBER 21 10-1029 COUNTY CUMBERLAND SSN/DC 003-09-9580 ACN 10145026 APPEAL BY DATE:O1-21-2011 (See reverse side under Objections) Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1548 EX AFP C12-09)-------------------------------------------------------------------- NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE: 11-22-2010 ESTATE OF:MARTEL FILE NO.: 21 10-1029 S.S/D.C. NO.: 003-09-9580 ACN: 10145026 TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO.: 194797-05 TYPE OF ACCOUNT: C ~ SAVINGS C ) CHECKING C )TRUST C )TIME CERTIFICATE DATE ESTABLISHED 06-06-2000 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due rwv rornrrc. WILFRED J DATE OF DEATH:07-31-2010 COUNTY:CUMBERLAND 35,440.24 X 0.050 1,772.01 - .00 1,772.01 ., .045 ..79.74 NOTE: TO ENSURE 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 TO: "REGISTER OF WILLS, AGENT." PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID 10-09-2010 CD013483 3.99 79.74 TOTAL TAX PAYMENT 83.73 BALANCE OF TAX DUE 3.99CR INTEREST AND PEN. .00 TOTAL DUE 3.99CR * IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ~ IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REYERSE SIDE OF THIS FORM FOR INSTRUCTIONS. USA FIR$T{ S~..k w'. '~ f; ;. ;:. ~ .: -.:. ,. ,. :,~ ~~. R~ '6. ~ a+~p £ [[£ Y (d"{ ~t4F ~k TT}}~ £ •E J 1~ !~ ~~ 4 ,~ . i I i h r ~/ a ~~ ~•° ~"h~• 4, .. ..::..~=,..~ ,.~..:r.4.:~~ .~ , 1 i~~~ti}.' Lf'j alt 'r'~~~~ l 1 2010 DEC 15 PM i2~ 16 GLERi( OF ORPHfW`S uOURT CUMBFRCA~p ~0 , PA ~3 ~~ ~tif ~~! ~~ t~~p i'D i„ t •i~f ~•