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Home My WebLink About01-14-11a ~' .~~1i~ Sandra C. Snyder ~gister of ~ilZs and CCerkof Orphans' Court somas ~ C~acki, Esquire SoCcitor December 28, 2010 Virginia Bricker Balog 4259 Nantucket Drive Mechanicsburg, PA 17050-7650 Dear Mrs. Balog, I am returning the two Pennsylvania Inheritance Tax Information NoticE be filed in Cumberland County, not Dauphin. Paperwork on a decedent county of residence when they die. Please sign, date and put your phone and mail to Cumberland County for processing. I thank you in advance. Sincerely, y ~- Patricia S. Petrun First Deputy, Register of Wills ~:l~r%rrokon Dauphin County Court .7fouse 1~om 103 101 ~2arket Street .~farris6urg, ~A 17101-2080 7e1.' 717-780-6500 Fax 717-780-6474 s to you as they need to s always filed in the number at the bottom ~~~ -- ~._._ - ,_. : " ~ T . ~ Y j- r"'~ _.. i - -- -- ' .- r~ ~..~. ~ -. .. t J` ~ ..~ ~`._ X43 C ; C"7 _.rc7 ~" -rte ~.,_„ ~:.~ ~ 1 ~.. _, PENNSYLVANIA INHERYTANC TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES ` " ~ ` ' AND FILE N0. 2~ -- ~) .._ UC~I Po eox 2so6o1 ,~ ! ~^ ~~'~ ~ ~ HARRISBURG PA 1712 -814b'1 -~ - TAXPAYER RESPONSE ACN 10172626 ~'p I ~ '. --~ ~ :...,. ~ : ~.&BV 1545 EX,.1~P ( 08-08) DATE 12 -16 - 2 010 TYPE OF ACCOUN' ' ' ~ ~' '''~ ~ ' ~ ~ € ~ ~~ `~ EST. OF EUGENE T BALOG ^ savlr SSN 17 - 26 - 4182 ® CHECN C~~~~ ~~= DATE OF DEATH 04 - 25 - 2010 ^ TRUS1 .! ~ F ~ ~, ~i ~T RPM ,t°u ~ J ti,;{,,, ~ ~, : ; COUNTY DA P H I N ^ CERT ] l~J~~~,-., _ , ~, 4 EJ ~, _ (~,~~ REMIT PAYMENT AND r- ORMS T0: VIRGINIA BRICKERBALOG REGISTER OF WI LS 4259 NANTUCKET DR FRONT AND MARK T ROOM 103 MECHANICSBURG PA 17050-7650 HARRISBURG PA 17101 SOVEREIGN BANK provided the Department with the information below, whi h has been used in calculating the potential tax due. Records indicate that at the death of the above-named decedent, You were a jo nt owner/benefic:iary of this account. If you feel the information is incorrect, please obtain written correction from the financial ins itution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance T laws of the Commonwealth of Pennsvlvaniw. Plwas? mall 0717) 787-8327 with ge:cstions. ~ COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYM NT INSTRUCTIONS Account No. 0571131395 Date 11 - 1 0 - 1997 To ensure proper credit to the account, two Established copies of this notice must accompany $4 payment t Account Balance $ 7 050 the Register of Wills. Make check , . payable t "Register of Wills, Agent". Percent Taxable X 50.000 . .. _.._..._ NOTE: If Amoun~~- Su~ect to Tax ; $ 3 525 42 tax payments arE! made within three , . ~....,, months of , the decedent s date of death, Tax Rate X . 1 5 deduct a percent discount on the tax due. Anv Inher Potential Tax Due $ 528.81 tance Tax due will become delinquent nine wont s after the dates of death. PART TAXPAYER RESPONSE 1^ ~~ A. ^ The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain C H E C K a discount or avoid interest, or check box "A" and return this notice to the Register of 0 N E Wills and an official assessment will be issued by the PA Depa tment of Revenue. 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 informs ion is incorrect and/or debts and deductions wer Complete PART 2~ d/ PART b l paid. an or e ow. IJ PART If indicating a different tax rate please state relationship to decedent: ~~ 1~ ~ ~ TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS ~ LINE 1. Date Established 1 2. Account Balance 2 $ 3. Percent Taxable 3 X ('S' 4. Amount Subject to Tax 4 $ (`--, 5. Debts and Deductions 5 ~~ 6. Amount Taxable 6 $ 7. Tax Rate 7 X 8. Tax Due 8 $ ~ ~ PART `~ ~ ~~ ` ~ DEBTS AND DEDUCTIONS CLAIMED ~ ~ ~~ DATE PAID PAYEE DESCRIPTION AMOUNT PAI D ~.+. «~~~c~ v~~ ~1i~c 7 UT iax l.ompuLaLl~OnJ $ Under penalties of perjury, I declare that the facts I have reported above complete to the best of my knowledge and belief. HOME~'7 ~~] '", ~ ~ _~ WORK t ~XPAYER GNATURE TELEPHONE true, correct and r~ ~ ~ lL ER >~ GS ING F. r~ ~ ~ . ~ DATE BUREAU OF INDIVIDUAL TAX PO BOX 280601 ,~ ~ ~` HARRISBURG PA 17128- ~ T ' + f ~' ' '~ y f fit.. ~,....ii_' : ,.-. REY.-1543 EX-A~.,'~8-OB) PENNSYLVANIA INHERITANC INFORMATION NOTICE AND TAXPAYER RESPONSE TAX FILE NO. 22 ACN 10172754 DATE 12-17-2010 r~, ; , C~..~~~ ~~=~ ,, ~.:' _ LU~,r~ " _ "' ~ _ , ** VIRGINIA BRICKERBALOG 4259 NANTUCKET DR MECHANICSBURG PA 17050-7650 TYPE OF ACCOUNT ® SAVINGS CHECKING TRUST CERTIF. EST. OF EUGENE T BALOG SSN 17 -26-4182 DATE OF DEATH 04-25-2010 COUNTY DA PHIN REMIT PAYMENT AND ORMS T0: REGISTER OF WI LS FRONT AND MARK T ROOM 103 HARRISBURG PA 17101 SOVEREIGN BANK provided the Department with the information below, whi potential tax due. Records indicate that at the death of the above-named decedent, you were a ji If you feel the information is incorrect, please obtain written correction from the financial in and return it to the above address. This account is taxable in accordance with the Inheritance Pennsylvania. Please call X717) 787-832? wi±h q~!estions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYI Account No. 233408b940 Account Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Due PART CHECK ONE BLOCK ONLY Date O 1-14 - 2010 Established $ 12,024.02 X 100.00 $ 12,024.02 X .15 $ 1,803.b0 TAXPAYER RESPONS A. ~ The above information and tax due is correct. Remit payment 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 Wills and an official assessment will be issued by the PA Depa tment of Revenue. B. ~ The above asset has been or will be reported and tax paid with thelPennsylvania Inheritance Tax return to be filed by the estate representative. C. The above informs ion is incorrect and/or debts and deductions wer paid. Complete PART 2~ and/or PART ~ below. PART If indicating a different tax rated please state relationship to decedent: - Qo ~JTTD TAX RETURN - 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 PART DEBTS AND DEDUCTIONS CLAIMED a DATE PAID PAYEE DESCRIPTION AMOUNT PAID TOTAL CEnter on Line 5 of Tax Computatipn) S Under penalties of perjury, I declare that the facts I have reported above re true, correct and comtplete to the besft~ of mytknowled,gQe and belief . HOME C ~ - -~ ~~ 1 t n CUB -.~~ L ~21~ ems. ._ d.l ~ p' _ WORK t TAXPAYER SIGNATURE has been used in calculating the ~t owner/beneficiary of this account. itution, attach a copy to this form x laws of the Commonwealth of NT INSTRUCTIONS To ensure proper credit to the account, two copies of this notice must accompany payment t the Register of Wills. Make check payable t "Register of Wills, Agent". NOTE: If tax payments are made within three months of the decedent's date of death. deduct a percent discount on the tax due. Any Inher tance Tax due will become delinquent nine mont s after the date of death. ONE NUMBER DATE PENNSYLVANIA INHERITANC TAX INFORMATION NOTICE ~~ _ ~ ~ - ~~~~ BUREAU OF INDIVIDUAL TAXES AND FILE N0. 22 Po Box 260601 ~, ,,,,-Mrs,--. TAXPAYER RESPONSE ACN 10172755 HARRISBURG PA 171286)~0~ ' ' DATE 12-17-2010 t~ t REV-1543'E~( ~AF-~ (OB-08) >. € ~;,. ~~ EST. OF EUGENE BALOG SSN 175-26-4182 DATE OF DEATH 04-25-2010 COUNTY DAU HIN REMIT PAYMENT AND ORMS T0: REGISTER OF WIL S FRONT AND MARKE ROOM 103 HARRISBURG PA 17101 ~~ VIRGINIA BRICKERBALOG 4259 NANTUCKET DR MECHANICSBURG PA 17050-7650 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. SDVE REIG N BANK provided the Department with the information below, whic has been used 'in calculating the potential tax due. Records indicate that at the death of the above-named decedent, you were a jo nt owner/beneficiary of this account. If you feel the information is incorrect, Please obtain written correction from the financial ins itution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance T laws of the Commonwealth of Pennsylvania. Please call (717) 787-832? with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYM NT INSTRUCTIONS Account No. 2335547440 Account Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Due PART CHECK ONE BLOCK ONLY ER RESPONSE To ensure proper credit to the account, two copies of this notice must accompany payment t the Register of Wills. Make check payable t "Register of Wills, Agent". NOTE: If tax payments are made within three months of the decedent's date of death, deduct a percent discount on the tax due. Any Inher tance Tax due will become delinquent nine mont s after the date of death. A. ~ The above information and tax due is correct. Remit payment 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 Wills and an official assessment will be issued by the PA Depa tment of Revenue. B. ~ The above asset has been or will be reported and tax paid with thelPennsylvania Inheritance Tax return to be filed by the estate representative. C. The above i nforms ion is incorrect and/or debts and deductions wer ~ paid. Complete PA RT 2 and/or PART 3~ below. PART If indicating a different tax rate, lease state relationship to decedent: ~~{,~-~ TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Date Established 1 2. Account Balance 2 +fi 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 PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID _ TOTAL CEnter on Lfne 5 of Tax Computation) 8 Under penalties of perjury, I declare that the facts I have reported above re true, correct and omplete~ to •the best of my knowledge and eeb__elief . HOME ~ J lA. ~. p-~w WORK C ~ .. ~~- l d AXPAYE SIGNATURE TELEPHONE N MBER DATE Date 01-16-2010 Established $ 5,027.19 X 100.00 $ 5,027.19 X .15 $ 754.08 PENNSYLVANIA INHERITANC INFORMATION NOTICE AND TAXPAYER RESPONSE BUREAU OF INDIVIDUAL ~~r r PO BOX 280601 i 2 ,; , ~ ' 0.7., 1 HARRISBURG PA 171 ~ ,ti ~~ ~ t P . <08-OB) RSV-1541 El( AF v~~f'~i'\ ~~,r' VIRGINIA BRICKERBALOG 4259 NANTUCKET DR MECHANICSBURG PA 17050-7650 TAX FILE N0. 22 ACN 1017275b DATE 12-17-2010 EST. OF EUGENE BALOG SSN 175 26-4182 DATE OF DEATH 4-25-2010 COUNTY DAU HIN REMIT PAYMENT AND F RMS T0: REGISTER OF WIL S FRONT AND MARKE ROOM 103 HARRISBURG PA 17101 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. SOVEREIGN BANK 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 decedent, you were a joint owner/beneficiary of this account. If you feel the information is incorrect, Please obtain written correction from the financial instution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance T laws of the Commonwealth of Pennsylvania. Please call 0717? 787-8327 with questions. ` COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYM~NT INSTRUCTIONS Account No. 2335547457 Account Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Due PART CHECK ONE TAXPAYE A. ~ The above information and tax due is correct. Remit payment to the Register of Wills with two copies of thi notice to obtain 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 Dep rtment of Revenue. TOTAL CEnter on Line 5 of Tax Computation) S Date Established $ O1-1b-2010 5,010.05 X 100.00 $ 5,010.05 X .15 $ 751.51 To ensure proper credit to the account, two copies of this notice must accompany payment t the Register of Wills. Make check payable t "Register of Wills, Agent". NOTE: If tax payments are made within three months of the decedent's date of death, deduct a percent discount on the tax due. Any Inher tance Tax due will become delinquent nine wont s after the date of death. Under penalties of perjury, I declare that the facts I have reported above !a re true, correct and co lee to the best of my knowledge a/n~d belief . HOME C '7 ~Z; ) ~ ~a2 ~' ~-~ ~ /c.~vw~-~ ~ /~ E~-a WORK ( ) /~ ~ ~~3 / -- l ~ AXPAYER SIGNATUR TELEPHONE UMBER DATE ~-- - .P _,. ~. z °' ~, ~- ~~~ ~~ ~ -~ ~ ~ . ~ , ` ~`~• ,,~ 1 ~ o ~~ . ~ ..- ~~~ ~~~" o ~ ~. ~~ ~.a ~:.;. t~. ~ ~ ~ ~ ~.~~ ~ ~ ~ a ~ a ~ t~ ~° ~ ~ ~ ~. ~. ~ , ~.. ~. ~ ~ ~ --~ , ~ s, :~ a ,~ ~ .~ ~ M a w~ ~~ :... a dsn ..+ O~ SSy'1?'lam ~~ 'i 1~ d5n ' " I~i b3~''ti~j SSd~7