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Home My WebLink About04-01-13 (2) BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX • INHERITANCE ra�c DIVISION APPRAISEMENT ALLONANCE OR DISALLONANCE � penllSyLVaI1�a PO BOX 280601 OF DEDUCTION� AND ASSESSI'IENT OF TAX ON DEPARTMENT OFREVENUE HARRISBURG, PA 17128-0601 SECURI�Y ACCOUNTS HELD IN FZ E C{}R�'�I� Q�F I C E O F B��ICIARY FOR![ REV-154BR AiP (12-12) R�(y'�SZ�� Q� '��.�,.� DATE 04-01-2013 ESTATE OF PTASZEK BARBARA E :�ui3 �PR 1 P�1 12 `�3 FILE NUMBERTH 21 12-1297 COUNTY CUMBERLAND ROBERT S PTASZ �'�'�RK �� SSN/DC 208-24-4523 ��ANS• �i�UR� ACN 13500233 111 ADAMS RD APPEAL BY DATE: 05-31-2013 CARLISLE C(�B��l��•. P� (SeereversesideunderObjections) 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-1548A AFP C12-12� NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ON SECURITY ACCOUNTS HELD IN BENEFICIARY FORM DATE: 04-01-2013 ESTATE OF:PTASZEK BARBARA E DATE OF DEATH: 11-29-2012 COUNTY: CUMBERLAND FILE NO. : 21 12-1297 S.S/D.C. NO. : 208-24-4523 ACN: 13500233 TAX RETURN WAS: (X) ACCEPTED AS FILED C )CHANGED BENEFICIARY FORM OF ASSET INFORMATION NAME OF SECURITY: ALLIANCE DEVELOPMENT FUND ACCOUNT NO. : 22835 TYPE OF ASSET: C ) SECURITIES C � SECURITY ACC C ) STOCK O BONDS DOD Valuation 10,787.70 NOTE: TO ENSURE PROPER CREDIT TO Percent Taxable X 0.500 YOUR ACCOUNT, SUBMIT THE Amount Subject to Tax 5,393.85 UPPER PORTION OF THIS NOTICE Debts and Deductions - .00 WITH YOUR TAX PAYMENT TO THE Taxable Amount 5,393.85 REGISTER OF WILLS AT THE Tax Rate X .045 ABOVE ADDRESS. MAKE CHECK Tax Due 242.72 OR MONEY ORDER PAYABLE T0: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT C+7 DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 02-25-2013 CD017226 12.14 230.58 TOTAL TAX PAYMENT 242.72 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 � � 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 REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. J BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX • INHERITANCE rnx DIVISION APPRAISElIENT ALLONANCE OR DISALLORANCE � pennsylvarna PO BOX 280601 OF DEDllCTION� AND ASSESSlIENT OF TAX ON DEPARTMENT OFREVENUE HARRISBURG, PA i7iza-ocol SECURI"I'Y ACCOUNTS HELD IN BENEF'ICIARY FOR![ REV-1548A RFP(32-12) RECOR�ED O�FlCE 4F ��'�� 5 DATE 04-01-2013 ESTATE OF PTASZEK BARBARA E DATE OF DEATH 11-29-2012 1413 flPR 1 P�1 12 `�3 FILE NUMBER 21 12-1297 COUNTY CUMBERLAND ROBERT S PTASZEK C LE R K �i� SSN/DC 208-24-4523 111 ADAMS RD �R��A�S� ,rr��(' ACN APPEAL BY DA E�:O05631-2013 CA R L I S L E `R��!��9G�,� �� (See reverse side under Objections) A�ount 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-1548A AFP C12-12) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ON SECURITY ACCOUNTS HELD IN BENEFICIARY FORM DATE: 04-01-2013 ESTATE OF: PTASZEK BARBARA E DATE OF DEATH: il-29-2012 COUNTY: CUMBERLAND FILE NO. : 21 12-1297 S.S/D.C. NO. : 208-24-4523 ACN: 13500366 TAX RETURN WAS: (X) ACCEPTED AS FILED OCHANGED BENEFICIARY FORM OF ASSET INFORMATION NAME OF SECURITY: EDWARD JONES ACCOUNT NO. : 270-07931 TYPE OF ASSET: C X SECURITIES O SECURITY ACC O STOCK C ) BONDS DOD Valuation 72,432.45 NOTE: TO ENSURE PROPER CREDIT TO Percent Taxable X 0.500 YOUR ACCOUNT, SUBMIT THE Amount Subject to Tax 36,216.23 UPPER PORTION OF THIS NOTICE Debts and Deductions - .00 WITH YOUR TAX PAYMENT TO THE Taxable Amount 36,216.23 REGISTER OF WILLS AT THE Tax Rate X .045 ABOVE ADDRESS. MAKE CHECK Tax Due 1 .629.73 OR MONEY ORDER PAYABLE T0: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT C+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 02-25-2013 CD017226 81 .49 1,548.24 TOTAL TAX PAYMENT 1,629.73 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * 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 REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX INHERITANCE TAX DIVISION APPRAISEMENT ALLORANCE OR DISALLONANCE � pen n syLva ni a Po eox zao6oi OF DEDUCTION�t.'AND ASSESSlIENT OF TAX ON DEPARTMENT OFREVENUE HARRISBURG. PA 17128-0601 ��C�d 11�$6Cl}(:�Tr}i��S HELD IN R��'•�j ��IQ I FORK REV-1568R RFP(12-12) R��IST�� Q�' �� ATE 04-01-2013 J��J ��1 1 t I ► 1� ��TETOFODEATH 11A29E2012 BARBARA E FILE NUMBER 21 12-1297 CLERK Q��' couNrY CUMBERLAND ROBERT S PTASZEK ORPNANS' CO�,JR� ACN,DC 13500354523 111 ADAMS RD GUM�ERLAND CO,, P�, APPEAL BY DATE: 05-31-2013 C A R L I S L E P A 17 015-9 2 0 9 (See reverse side under Objections) Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TD: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALON6 THIS LINE —► RETAIN LOWER PORTION FOR YOUR RECORDS � - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - REV-1548A AFP C12-12� NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ON SECURITY ACCOUNTS HELD IN BENEFICIARY FORM DATE: 04-01-2013 ESTATE OF: PTASZEK BARBARA E DATE OF DEATH: 11-29-2012 COUNTY: CUMBERLAND FILE NO. : 21 12-1297 S.S/D.C. NO. : 208-24-4523 ACN: 13500354 TAX RETURN WAS: CX) ACCEPTED AS FILED C )CHANGED BENEFICIARY FORM OF ASSET INFORMATION NAME OF SECURITY: AMERICHOICE FCU ACCOUNT NO. : 35165 TYPE OF ASSET: C ) SECURITIES C � SECURITY ACC C ) STOCK C ) BONDS DOD Valuation 9,607.07 NOTE: TO ENSURE PROPER CREDIT TO Percent Taxable X 0.500 YOUR ACCOUNT, SUBMIT THE Amount Subject to Tax 4,803.54 UPPER PORTION OF THIS NOTICE Debts and Deductions - .00 WITH YOUR TAX PAYMENT TO THE Taxable Amount 4,803.54 REGISTER OF WILLS AT THE Tax Rate X .045 ABOVE ADDRESS. MAKE CHECK Tax Due 216. 16 OR MONEY ORDER PAYABLE T0: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT C+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 02-25-2013 CD017226 10.81 205.35 TOTAL TAX PAYMENT 216.16 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 � IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. * IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX . INHERITANCE TAX DIVISION APPRAISEMENT ALLONANCE OR DISALLONANCE � pe n n sylva n�a PO BOX 280601 OF DEDUCTION� AND ASSESSlIENT OF TAX ON . DEPARTMENT OFREVENUE HARRISBURG, Pa i�iza-o6o1 r /� SECURppIQQ�'Y ACCOUNTS HELD IN �r�i,C�� tr+/IiY�I��RY FORlI REV-1548A�FP (12-12) �• �� rr� R��(� Q� ��j(��S DATE 04-01-2013 ESTATE OF PTASZEK BARBARA E ::013 APR � t � 12 ��FILE NUMBERTH 21 12-1297 COUNTY CUMBERLAND �rL�� Q�' SSN/DC 208-24-4523 1�11EADAMS RDPTASZEK o��N�, �Q�R�,,, ACN APPEAL BY DATE o05431-2013 CARL I SL E PA i��4A�d D G 0., PQ (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-1548A AFP (12-12� NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ON SECURITY ACCOUNTS HELD IN BENEFICIARY FORM DATE: 04-01-2013 ESTATE OF: PTASZEK BARBARA E DATE OF DEATH: 11-29-2012 COUNTY: CUMBERLAND FILE NO. : 21 12-1297 S.S/D.C. NO. : 208-24-4523 ACN: 13500324 TAX RETURN WAS: (X) ACCEPTED AS FILED OCHANGED BENEFICIARY FORM OF ASSET INFORMATION NAME OF SECURITY: CENTRIC BANK ACCOUNT NO. : 3055720 TYPE OF ASSET: C ) SECURITIES C � SECURITY ACC C ) STOCK C ) BONDS DOD Valuation 26,861.03 NOTE: TO ENSURE PROPER CREDIT TO Percent Taxable X 0.500 YOUR ACCOUNT, SUBMIT THE Amount Subject to Tax 13,430.52 UPPER PORTION OF THIS NOTICE Debts and Deductions - .00 WITH YOUR TAX PAYMENT TO THE Taxable Amount 13,430.52 REGISTER OF WILLS AT THE Tax Rate X .045 ABOVE ADDRESS. MAKE CHECK Tax Due 604.37 OR MONEY ORDER PAYABLE T0: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT C+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 02-25-2013 CD017226 30.22 574.15 TOTAL TAX PAYMENT 604.37 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 � 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 REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. BUREAU oF INDIVIDUAL TAXES NOTiCE oF iNHERiTANCE TAX . INHERITANCE rax DIYISION APPRAISElIENT ALLONANCE OR DISALLONANCE � pennsylvarna PO BoX 280601 OP DEDUCTION� AND ASSESSI'IENT OF TAX ON DEPARTMENT OFREVENUE HARRISBURG, PA i�i2e-o6oi SECURI'�Y ACCOUNTS HELD IN BENEFICIARY FORM REV-1548�AFP u2-�� C� �� DATE 04-01-2013 P�EGIST�i� �F ��LLS ESTATE OF PTASZEK BARBARA E DATE OF DEATH 11-29-2012 :?(il3 �PR 1 p� �L ��J COUNTYUMBER CUMBERLAND SSN/DC 208-24-4523 ROBERT S PTASZEK (�(��K ��' ACN 13500322 111 ADAMS RD 0{{�"��a�js' C4�iir APPEAL BY DATE: 05-31-2013 CARL I S L E PA��7��2�� `� PA (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-1548A AFP (12-12) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ON SECURITY ACCOUNTS HELD IN BENEFICIARY FORM DATE: 04-01-2013 ESTATE OF:PTASZEK BARBARA E DATE OF DEATH: 11-29-2012 COUNTY: CUMBERLAND FILE NO. : 21 12-1297 S.S/D.C. NO. : 208-24-4523 ACN: 13500322 TAX RETURN WAS: (X) ACCEPTED AS FILED C )CHANGED BENEFICIARY FORM OF ASSET INFORMATION NAME OF SECURITY: CENTRIC BANK ACCOUNT NO. : 3053618 TYPE OF ASSET: C ) SECURITIES ( �( SECURITY ACC O STOCK O BONDS DOD Valuation 10,584.90 NOTE: TO ENSURE PROPER CREDIT TO Percent Taxable X 0.500 YOUR ACCOUNT, SUBMIT THE Amount Subject to Tax 5,292.45 UPPER PORTION OF THIS NOTICE Debts and Deductions - .00 WITH YOUR TAX PAYMENT TO THE Taxable Amount 5,292.45 REGISTER OF WILLS AT THE Tax Rate X .045 ABOVE ADDRESS. MAKE CHECK Tax Due 238. 16 OR MONEY ORDER PAYABLE T0: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 02-25-2013 CD017226 11 .91 226.25 TOTAL TAX PAYMENT 238.16 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * 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 REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX INHERITANCE TAX DIVISION APPRAISEMENT ALLONANCE OR DISALLONANCE � pe n n sylva ni a PO BOX 280601 OF DEDUCTION� AND ASSESSMENT OF TAX ON DEPARTMENT OFREVENUE HARRISBURG, PA i�izs-o6oi SECURI�'Y ACCOtJNTS HELD IN BENEFICIARY FORM REV-1548�AFP �,z-�z� ��4�� }�`� �F DATE 04-01-2013 EZEGJSTE� O� �'8i�9�..�..5 ESTATE OF PTASZEK BARBARA E DATE OF DEATH 11-29-2012 ?013 APR 1 ( � 1 l� �J COUNTYUMBER CUMBERLAND SSN/DC 208-24-4523 ROBERT S PTASZEK ��f��( (�� ACN 13500320 111 ADAMS RD (� �� ' �ia�� APPEAL BY DATE: 05-31-2013 C A R L I S L E P A 17 0'1�- .9 (See reverse side under Objections) C�M$ �� '�•' p� 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-1548A AFP C12-12� NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX UN SECURITY ACCOUNTS HELD IN BENEFICIARY FORM DATE: 04-01-2013 ESTATE OF: PTASZEK BARBARA E DATE OF DEATH: 11-29-2012 COUNTY: CUMBERLAND FILE NO. : 21 12-1297 S.S/D.C. NO. : 208-24-4523 ACN: 13500320 TAX RETURN WAS: CX� ACCEPTED AS FILED C )CHANGED BENEFICIARY FORM OF ASSET INFORMATION NAME OF SECURITY: VANGUARD ACCOUNT NO. : 88014595918 TYPE OF ASSET: C ) SECURITIES C JI SECURITY ACC O STOCK C ) BONDS DOD Valuation 90,079.21 NOTE: TO ENSURE PROPER CREDIT TO Percent Taxable X 0.500 YOUR ACCOUNT, SUBMIT THE Amount Subject to Tax 45,039.61 UPPER PORTION OF THIS NOTICE Debts and Deductions - .00 WITH YOUR TAX PAYMENT TO THE Taxable Amount 45,039.61 REGISTER OF WILLS AT THE Tax Rate X .045 ABOVE ADDRESS. MAKE CHECK Tax Due 2,026.78 OR MONEY ORDER PAYABLE T0: ' "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT C+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 02-25-2013 CD017226 101.34 1,925.44 TOTAL TAX PAYMENT 2,026.78 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. * IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. BUREAU OF INDIVIDUAL TAXES NOTICE OF INBERITANCE TAX • INHERITANCE TAX DIVISION APPRAISEqENT ALLOKANCE OR DISALLORANCE � pe n n sylva rn a Po BoX 260601 OF DEDUCTION� AND ASSESSMENT OF TAX ON DEPARTMENT OFREVENUE HARRISBURG, Pa i�iza-o6oi SECURI�'Y 6CCOtJNTS HELD IN aeNe�icieex Foen REV-1548A RFP (12-12) RECORD�D UFFlCE 4F" DATE 04-01-2013 RE�IST�k� OF ��I�,LS ESTATE OF PTASZEK BARBARA E DATE OF DEATH 11-29-2012 1U1� [iP(l 1 P�1 12 `I3 COUNTYUMBER CUMBERLAND SSN/DC 208-24-4523 ROBERT S PTASZEK CL�� ACN 13500237 111 ADAMS RD Q(��3(.fANC.�� COURT APPEAL BY DATE: 05-31-2013 CARLISLE PAC1�.Q��,.�t2p5�� a.. P� (SeereversesideunderObjections) UM KLAtV A�ount 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-1548A AFP C12-12� NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ON SECURITY ACCOUNTS HELD IN BENEFICIARY FORM DATE: 04-01-2013 ESTATE OF: PTASZEK BARBARA E DATE OF DEATH: 11-29-2012 COUNTY: CUMBERLAND FI�E NO. : 21 12-1297 S.S/D.C. NO. : 208-24-4523 ACN: 13500237 TAX RETURN WAS: (X) ACCEPTED AS FILED C )CHANGED BENEFICIARY FORM OF ASSET INFORMATION NAME OF SECURITY: ALLIANCE DEVELOPMENT FUND ACCOUNT NO. : 22387 TYPE OF ASSET: O SECURITIES C � SECURITY ACC C ) STOCK C ) BONDS DOD Valuation 16,404.32 NOTE: TO ENSURE PROPER CREDIT TO Percent Taxable X 0.500 YOUR ACCOUNT, SUBMIT THE Amount Subject to Tax 8,202. 16 UPPER PORTION OF THIS NOTICE Debts and Deductions - .00 WITH YOUR TAX PAYMENT TO THE Taxable Amount 8,202.16 REGISTER OF WILLS AT THE Tax Rate X .045 ABOVE ADDRESS. MAKE CHECK Tax Due 369. 10 OR MONEY ORDER PAYABLE T0: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT C+) DATE NUMBER INTEREST/PEN PAID C-) AMOUNT PAID 02-25-2013 CD017226 18.46 350.65 TOTAL TAX PAYMENT 369.11 BALANCE OF TAX DUE .O1CR INTEREST AND PEN. .00 TOTAL DUE .O1CR * IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ■ IF TOTAL DUE IS REFLECTED AS A "CREDIT^ CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. �.,Ka�..,��.�� ,�.��.�.,_ >. �a�.�_��.y..,�.F �.,�� BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX . INHERITANCE TAX DIVISION APPRAISE!lENTt ALLONANCE OR DISALLONANCE � pe n n sylva n�a PO BOX 280601 OF DEDUCTIONS AND ASSESS![ENT OF TAX ON DEPARTMENT OFREVENUE HARRISBURG, Pn niza-o6oi SECIIRI�'Y ACCOt1NTS HELD IN BENEFICIARY FOR![ REVa548�AFP (12-12) ��i�}��} �� ' DATE 04-01-2013 ��Ca`�'�� (��' �t�',.,�� ESTATE OF PTASZEK BARBARA E DATE OF DEATH 11-29-2012 1�13 APR � ��i � i� �� COUNTYUMBER CUMBERLAND SSN/DC 208-24-4523 ROBERT S PTASZEK C��K �� ACN 13500235 111 ADAMS RD D� �G, ��.�. APPEAL BY DATE: 05-31-2013 CAR L I SL E PA 1�OY��P'�9 (See reverse side under Objections) CUMBERLAND C(?., F'�� 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-1548A AFP (12-12) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ON SECURITY ACCOUNTS HELD IN BENEFICIARY FORM DATE: 04-01-2013 ESTATE OF: PTASZEK BARBARA E DATE OF DEATH: 11-29-2012 COUNTY: CUMBERLAND FILE NO. : 21 12-1297 S.S/D.C. NO. : 208-24-4523 ACN: 13500235 TAX RETURN WAS: (X) ACCEPTED AS FILED OCHANGED BENEFICIARY FORM OF ASSET INFORMATION NAME OF SECURITY: ALLIANCE DEVELOPMENT FUND ACCOUNT NO. : 22388 TYPE OF ASSET: C ) SECURITIES C a( SECURITY ACC O STOCK O BONDS DOD Valuation 23,201.22 NOTE: TO ENSURE PROPER CREDIT TO Percent Taxable X 0.500 YOUR ACCOUNT, SUBMIT THE Amount Subject to Tax 11,600.61 UPPER PORTION OF THIS NOTICE Debts and Deductions - .00 WITH YOUR TAX PAYMENT TO THE Taxable Amount 11 ,b00.61 REGISTER OF WILLS AT THE Tax Rate X .045 ABOVE ADDRESS. MAKE CHECK Tax Due 522.03 OR MONEY ORDER PAYABLE T0: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT C+) DATE NUMBER INTEREST/PEN PAID C-) AMOUNT PAID 02-25-2013 CD017226 26. 10 495.93 TOTAL TAX PAYMENT 522.03 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * 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 REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. NOTICE OF INHERITANCE TAX � pennsylvania BUREAU OF INDIVIDUAL TAXES DEPARTMENTOFREVENUE INHERITANCE TAX DIVISION APPRAISEMENT, ALLOWANCE OR DISALLOWANCE PO BOX 280601 OF DEDUCTIONS, AND ASSESSMENT OF TAX ON REV-1548 D( AFP C12-12) HARRISBUR6 PA 17128-0601 T HELD OR TRUST ASSETS REGORDEI} O�FF��'� ��' ��.�.�� l�L� DATE 04-01-2013 ESTATE OF PTASZEK BARBARA E DATE OF DEATH 11-29-2012 �u1� llpR � i f 4 z� �1 FILE NUMBER 21 12-1297 COUNTY CUMBERLAND ROBERT S PTASZEK CL�R� �}f" SSN/DC 208-24-4523 ACN 12167271 111 ADAMS RD pRpN,q��' �,Q(,j�,� APPEAL BY DATE:05-31-2013 CAR L I S L E ,i'��7�� , �� (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 (12-12) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE: 04-01-2013 ESTATE OF: PTASZEK BARBARA E DATE OF DEATH:11-29-2012 COUNTY:CUMBERLAND FILE NO. : 21 12-1297 S.S/D.C. NO. : 208-24-4523 ACN: 12167271 TAX RETURN WAS: CX� ACCEPTED AS FILED O CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. : 403-43 TYPE OF ACCOUNT: ( )SAVINGS ( ) CHECKING � �TRUST ( )TIME CERTIFICATE DATE ESTABLISHED 08-18-2012 Account Balance 28,818.69 NOTE: TO ENSURE PROPER CREDIT TO Percent Taxable X 0.500 YOUR ACCOUNT, SUBMIT THE Amount Subject to Tax 14,409.35 UPPER PORTION OF THIS NOTICE Debts and Deductions ' •�� WITH YOUR TAX PAYMENT TO THE Taxable Amount 14,409.35 REGISTER OF WILLS AT THE Tax Rate Y .045 ABOVE ADDRESS. MAKE CHECK Tax Due 648.42 OR MONEY ORDER PAYABLE T0: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT C+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 02-25-2013 CD017225 32.42 616.00 TOTAL TAX PAYMENT 648.42 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * 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 REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. NOTICE OF INHERITANCE TAX � pennsylvania BUREAU OF INDIVIDUAL TAXES DEPARTMENTOFREVENUE INHERITANCE TAX DIVISIDN APPRAISEMENT, ALLOWANCE DR DISALLOWANCE PO BOX 280601 OF DEDUCTIONS; AND ASSESSMENT OF TAX ON REV-1546 DcAFP C12-12) HARRISBURG PA 17128-0601 JOINTLY HELD OR TRUST ASSETS ��QR�� DATE 04-01-2013 RE�lS7�R OF �1�.�� ESTATE OF PTASZEK BARBARA E DATE OF DEATH 11-29-2012 �.'013 APR 1 P�l 12 y1 COUNTYUMBER CUMBERLAND SSN/DC 208-24-4523 ROBERT S PTASZEK CL��( �� ACN 12167273 111 ADAMS RD ORp�Q�S� ��R� APPEAL BY DATE:05-31-2013 CA R L I S L E F��L5�20,Q � (See reverse side under Objections) AIVlJ Q,, PA 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 C12-12�-------------------------------------------------------------------- NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE: 04-01-2013 ESTATE OF: PTASZEK BARBARA E DATE OF DEATH:11-29-2012 COUNTY:CUMBERLAND FILE NO. : 21 12-1297 S.S/D.C. NO. : 208-24-4523 ACN: 12167273 TAX RETURN WAS: (X) ACCEPTED AS FILED C ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. : 403-48 TYPE OF ACCOUNT: OSAVINGS C ) CHECKING C �TRUST OTIME CERTIFICATE DATE ESTABLISHED 10-20-2011 Account Balance 19,838.01 NOTE: TO ENSURE PROPER CREDIT TO Percent Taxable X 1.000 YOUR ACCOUNT, SUBMIT THE Amount Subject to Tax 19,838.01 UPPER PORTION OF THIS NOTICE Debts and Deductions ' .00 WITH YOUR TAX PAYMENT TO THE Taxable Amount 19,838.01 REGISTER OF WILLS AT THE Tax Rate Y .045 ABOVE ADDRESS. MAKE CHECK Tax Due 892.71 OR MONEY ORDER PAYABLE T0: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT C+) DATE NUMBER INTEREST/PEN PAID (—) AMOUNT PAID 02-25-2013 CD017225 44.64 848.08 TOTAL TAX PAYMENT 892.72 BALANCE OF TAX DUE .O1CR INTEREST AND PEN. .00 TOTAL DUE .O1CR � 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 REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. NOTICE OF INHERITANCE TAX � pennsylvania BUREAU OF INDIVIDUAL TAXES DEPARTMENTOFREVENUE INHERITANCE TAX DIVISION APPRAISEMENT, ALLOWANCE OR DISALLOWANCE PO BOX 280601 p A OF DEDUCTIONS, AND ASSESSMENT OF TAX ON REV-1546 DC AFP (12-12) HARRISBURG PA 17128-0601 (��`j��p�� '�T�HELD OR TRUST ASSETS �� .�.i DATE 04-01-2013 ESTATE OF PTASZEK BARBARA E ��`� �� FILE NUMBER�� 21 12-1297 COUNTY CUMBERLAND CLERK 0�- SSN/DC 208-24-4523 ROBERT S PTASZE�R�NA�S� �,Q�� ACN 12167276 111 ADAMS RD �( p�a u [� APPEAL BY DATE:05-31-2013 CAR L I S L E '�'P'�T'f"0 i�'�4�9'�^� pQ (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 C12-12� NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE: 04-01-2013 ESTATE OF: PTASZEK BARBARA E DATE OF DEATH:11-29-2012 COUNTY:CUMBERLAND FILE NO. : 21 12-1297 S.S/D.C. NO. : 208-24-4523 ACN: 12167276 TAX RETURN WAS: CX) ACCEPTED AS FILED O CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. : 403-64 TYPE OF ACCOUNT: ( )SAVINGS ( ) CHECKING ( �TRUST ( )TIME CERTIFICATE DATE ESTABLISHED 10-10-2008 Account Balance 13,459. 19 NOTE: TO ENSURE PROPER CREDIT TO Percent Taxable X 1.000 YOUR ACCOUNT, SUBMIT THE Amount Subject to Tax 13,459. 19 UPPER PORTION OF THIS NOTICE Debts and Deductions ' •0� WITH YOUR TAX PAYMENT TO THE Taxable Amount 13,459.19 REGISTER OF WILLS AT THE Tax Rate Y .045 ABOVE ADDRESS. MAKE CHECK Tax Due 605.66 OR MONEY ORDER PAYABLE T0: "REGISTER OF WILLS, A6ENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT C+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 02-25-2013 CD017225 30.28 575.38 TOTAL TAX PAYMENT 605.66 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 � 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. t SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. NOTICE OF INHERITANCE TAX � pennsylvania BUREAU OF INDIVIDUAL TAXES ; DEPARTMENTOFREVENUE INHERITANCE TAX DIVISION APPRAISEMENT, ALLOWANCE OR DISALLOWANCE PO BOX 280601 OF DEDUCTIONS, AND ASSESSMENT OF TAX ON REV-1548 IX AFP (12-12> HARRISBURG PA 17128-0601 JOINTLY HELD OR TRUST ASSETS ��f'�� a��i�'� �� DATE 04-01-2013 (�E(��=�� ;��,�� ESTATE OF PTASZEK BARBARA E DATE OF DEATH 11-29-2012 I013 �PR I i�l l �� COUNTYUMBER CUMBERLAND SSN/DC 208-24-4523 ROBERT S PTASZEK CLERK G�" ACN 12167278 111 ADAMS RD �J . C��-� APPEAL BY DATE:05-31-2013 CAR L I SL E P��4�� . �� (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 (12-12� NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE: 04-01-2013 ESTATE OF: PTASZEK BARBARA E DATE OF DEATH:11-29-2012 COUNTY:CUMBERLAND FILE NO. : 21 12-1297 S.S/D.C. NO. : 208-24-4523 ACN: 12167278 TAX RETURN WAS: (X? ACCEPTED AS FILED C ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. : 403-66 TYPE OF ACCOUNT: OSAVIN6S C ) CHECKING C )UTRUST C )TIME CERTIFICATE DATE ESTABLISHED 10-13-2010 Account Balance 6,200.17 NOTE: TO ENSURE PROPER CREDIT TO Percent Taxable X 1 .000 YOUR ACCOUNT, SUBMIT THE Amount Subject to Tax 6,200. 17 UPPER PORTION OF THIS NOTICE Debts and Deductions ' •�� WITH YOUR TAX PAYMENT TO THE Taxable Amount 6,200. 17 REGISTER OF WILLS AT THE Tax Rate Y .045 ABOVE ADDRESS. MAKE CHECK Tax Due 279.01 OR MONEY ORDER PAYABLE T0: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 02-25-2013 CD017225 13.95 265.06 TOTAL TAX PAYMENT 279.01 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 ■ IF PAID AFTER THIS DATE, SEE REVERSE FOR GALCULATION OF ADDITIONAL INTEREST. * IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. NOTICE OF INHERITANCE TAX � pennsylvania BUREAU OF INDIVIDUAL TAXES DEPARTMENTOFREVENUE INHERITANCE TAX DIVISION APPRAISEMENT, ALLOWANCE OR DISALLOWANCE PO BOX 260601 OF DEDUCTIONS, AND ASSESSMENT OF TAX ON REV-1548 IX AFP C12-12) HARRISBURG PA 17128-0601 JOINTLY HELD OR TRUST ASSETS �E�� c� �� DATE 04-01-2013 �� y,�s'�'�� (}�' ��l�f,!� ESTATE OF PTASZEK BARBARA E DATE OF DEATH 11-29-2012 ��1J I!I R 1 �� fi� COUNTYUMBER CUMBERLAND SSN/DC 208-24-4523 ROBERT S PTASZEK CLERK ��-� acr, 12168924 111 ADAMS RD N p�fi, (�f� APPEAL BY DATE:05-31-2013 CAR L I S L E ��p 7�i 5'9�0'9'�� (See reverse side under Objections) CUMBERLANB CO., P,�s Amount Reuitted 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 (12-12�-------------------------------------------------------------------- NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE: 04-01-2013 ESTATE OF: PTASZEK BARBARA E DATE OF DEATH:11-29-2012 COUNTY:CUMBERLAND FILE NO. : 21 12-1297 S.S/D.C. NO. : 208-24-4523 ACN: 12168924 TAX RETURN WAS: (X) ACCEPTED AS FILED C ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: SUSQUEHANNA BANK ACCOUNT NO. : 10005034128 TYPE OF ACCOUNT: C )SAVINGS O CHECKING ( �TRUST OTIME CERTIFICATE DATE ESTABLISHED 07-01-2008 Account Balance 29,150.49 NOTE: TO ENSURE PROPER CREDIT TO Percent Taxable X 1 .000 YOUR ACCOUNT, SUBMIT THE Amount Subject to Tax 29,150.49 UPPER PORTION OF THIS NOTICE Debts and Deductions ' .00 WITH YOUR TAX PAYMENT TO THE Taxable Amount 29, 150.49 REGISTER OF WILLS AT THE Tax Rate Y .045 ABOVE ADDRESS. MAKE CHECK Tax Due 1 ,311 .77 OR MONEY ORDER PAYABLE T0: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT C+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 02-25-2013 CD017227 65.59 1,246. 18 TOTAL TAX PAYMENT 1,311 .77 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 � 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 REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. J NOTICE OF INHERITANCE TAX � pennsylvania BUREAU OF INDIVIDUAL TAXES pppRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENTOFREVENUE INHERITANCE TAX DIVISION PO BOX 280601 OF DEDUCTIONS, AND ASSESSMENT OF TAX ON REV-1548 IX AFP c12-12) HARRISBURG PA 17128-0601 JOINTLY HELD OR TRUST ASSETS �� '� �� DATE 04-01-2013 ��rST�R OF �J�,(,s ESTATE OF PTASZEK BARBARA E DATE OF DEATH 11-29-2012 ?r�13 APR 1 Pi� 12 y2 COUNTYUMBER CUMBERLAND SSN/DC 208-24-4523 ROBERT S PTASZEK CLERK t�� ACN 13100948 APT 202 Q��A�S' �,O��T APPEAL BY DATE:05-31-2013 5 AL L I A N C E D R C�M��R (See reverse side under Objections) CARLISLE PA 1 �+JOCO•� p� 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 (12-12� NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE: 04-01-2013 ESTATE OF:PTASZEK BARBARA E DATE OF DEATH:11-29-2012 COUNTY:CUMBERLAND FILE NO. : 21 12-1297 S.S/D.C. NO. : 208-24-4523 ACN: 13100948 TAX RETURN WAS: CX) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: ORRSTOWN BANK ACCOUNT NO. : 4000036879 TYPE OF ACCOUNT: OSAVINGS C ) CHECKIN6 ( �TRUST C )TIME CERTIFICATE DATE ESTABLISHED 03-05-2010 Account Balance 13,716.30 NOTE: TO ENSURE PROPER CREDIT TO Percent Taxable X 1.000 YOUR ACCOUNT, SUBMIT THE Amount Subject to Tax 13,716.30 UPPER PORTION OF THIS NOTICE Debts and Deductions ' •�� WITH YOUR TAX PAYMENT TO THE Taxable Amount 13,716.30 REGISTER OF WILLS AT THE Tax Rate Y .045 ABOVE ADDRESS. MAKE CHECK Tax Due 617.23 OR MONEY ORDER PAYABLE T0: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT C+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 02-25-2013 CD017225 30.86 586.37 TOTAL TAX PAYMENT 617.23 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * 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 REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. BUREAU OF INDIVTDUAL TAXEKf�� j��r ��CE OF TNHERTTANCE TAX � p�nnsy[vania SNHERITANCE TAX DIYISION p�ftlt�`'�'�� qp��T, ALLOWANCE OR DISALLOWANCE �Ey_1548 EX AFP {12-12) PO &OX 280G01 �� `�� OF DEDUCTIdNS, AFID ASSESSMENT OF TAX dN HARRISHURG PA 17128-Ob01 N HELD OR TRU$T AS$ETS JQ�� 11t 1j � �� '" � DATE 04-D1-2013 ESTATE OF PTASZEK BARBARA E (�,��,�� l�i DATE OF DEATH 11-24-2012 ��_ ��' FI�E NUMBER 21 12-1297 COUNTY CUMBERLAND ��gE'�LAN� C�., �� ssNlnc Zas-24-�52� ROBERT S PTAS ACN 131Q0949 APT 202 APPEAL BY DATE:05-31-2013 5 A��I AN C E D R {See reverse side under 4bJectians) CARLISLE PA 17013-4140 Amount Remitted �� MAKE GNEGIG PAYAB�E AND REMIT PAYMENT T0: RE�ISTER OF WILLS 1 COURTHOt1SE SQUARE CARLISLE PA 17013 CUT AI.ONG THIS LINE �" RETAIN L.QWER PORTION FOR YQUR RECORDS 'f"' REY-1548 EX AFP C12-12�-------------------------------------------------------------------- NOTICE OF INHERITANCE 7AX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HE�D OR TRUST ASSETS DATE: 04-01-2013 ESTATE OF:PTASZEK BARBARA E DATE OF DEATH:Z1-29-2012 COUNTY:CUMBERLAND FILE NO. : 21 12-1297 S.StD.C. NO. : 208-24-4523 ACN: 13100944 TAX RETURN WAS: (X) ACCEPTED AS FILEn C ? CHAN6ED JQINT OR TRUST ASSET INFORMATION FINAMCIAL INSTTTUTION. C}RRSTOWN BANK ACCQUNT NO. : 40000425b4 TYPE OF ACCOUNT: C )SAVINGS C ) CHECKIN� ( X)TRUST C )TIME CERTIFICATE DATE ESTABLISHED 08-I2-2011 Account Balance 10,262.U0 NOTE: TO ENSURE PROPER CREDIT TO Percent Taxabie X 0.5Q0 YOUR ACC0t1NT: SUBMIT TNE Amount Subject to Tax 5, 131.00 UPPER PORTION OF THIS NOTICE Debts and Deductions ' •�Q WITN YOUR TAX PAYMENT TO THE Taxable Amaunt 5,131 .00 REGTSTER OF WILLS AT TNE Tax Rate x, , , .045 ABOVE ADDRESS. MAKE CHECK Tax Due 23�•g� OR MONEY ORDER PAYABLE T0: "REGISTER OF WILLS, A�ENT," TAX CREDI7S: PAYMENT RECEIPT DISCOUNT C+) DATE NUMBER IhiTERESTtPEN PAID {-} AMOUMT PAID 02-25-2013 CD017226 11 .55 219.36 TOTAL TAX PAYMENT 230.91 BA�ANCE OF TAX DUE .OlCR INTEREST AND PEN. .00 TOTA� DUE .OICR � IF PAID AFTER THIS DATE, SEE REVERSE FQR CALGULATiON OF ADDITIONAL INTER6ST. � IF TUTAL DllE IS REFLECTED AS A "CREDIT'• CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTZONS.