HomeMy WebLinkAbout04-1135 COHHONWEALTH OF PENNSYLVANIA ~"l~)l/~r ~
BUREAU OF INDIVIDUAL TAXES DEPARTHENT OF REVENUE ~'
INHERITANCE TAX DZVZS/ON
DEPT. 280601
HARRISBURC, PA 17128-0601 NOTICE OF /NHER/TANCE TAX
APPRAXSEHENT. ALLOHANCE OR DXSALLO#ANCE
OF DEDUCTXONS, AND ASSESSHENT OF TAX ON
JOXNTLY HELD OR TRUST ASSETS REV-2~48 £X AFP C01-0S)
DATE 06-14-Z00~
ESTATE OF BLYSKAL HARTA
DATE OF DEATH 05-0~-2005
FILE NUHBER ~-/-O~-J/3 ~
COUNTY CUHBERLAND
SSN/DC 501-28-1060
VINCENT BLYSKAL ACN 0q116012
1~1 LAKEVIEW DR I Amount Remitted
CARLISLE PA 17015
I
HAKE CHECK PAYABLE AND REHXT PAYHENT TO:
REGISTER OF WILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LXNE ~ RETAIN LOWER PORTION FOR YOUR RECORDS *"~
REV-1548 EX AFP (01-03)
NOTICE OF INHERXTANCE TAX APPRAXSENENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTXONS, AND ASSESSHENT OF TAX ON ,JOINTLY HELD OR TRUST ASSETS
DATE 06-1~-200~
ESTATE OF BLYSKAL HARTA DATE OF DEATH 0:5-0~-2005 COUNTY CUHBERLAND
FILE NO. S.S/D.C. NO. 501-28-1060 ACN 0~116012
TAX RETURN WAS: eX) ACCEPTED AS FILED ( ) CHANGED
dOINT OR TRUST ASSET ZNFORHATION
FINANCIAL INSTITUTION: PNC BANK ACCOUNT NO. 51900210652
TYPE OF ACCOUNT: ( ) SAVINGS ( ) CHECKING ( ) TRUST (~ TIHE CERTIFICATE
DATE ESTABLISHED 05-25-2001
Accoun'c Ba/ance 86,77:5.87 NOTE: TO INSURE PROPER CREDIT TO
Percen'c Taxable X 0.08:5 YOUR ACCOUNT, SUBHIT THE
Amoun'c Sub.~ec~c 'co Tax 7,2:50.87 UPPER PORTION OF THIS NOTTCE
Deb'cs and Deduc'cions - .00 WITH YOUR TAX PAYHENT TO THE
TaxabZe Amoun'c 7,2:50.87 REGISTER OF HILLS AT THE
Tax Ra'ce X .00 ABOVE ADDRESS. HAKE CHECK
Tax Due .00 OR HONEY ORDER PAYABLE TO:
**REGISTER OF WTLLS, AGENT.*°
TAX CRED'rTS: '~,.
PAYHENT RECEIPT DISCOUNT (+) AHOUNT PAID
DATE NUHBER INTEREST/PEN PAID (-)
TOTAL TAX CREDIT I .00 O~/~
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
ZF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ~
ZF TOTAL DUE IS LESS THAN $1, NO PAYHENT 1S REQUIRED.
XF TOTAL DUE IS REFLECTED AS A "CRED/T' ( CR}, YOU HAY BE DUE A REFUND.
SEE REVERSE S/DE OF THIS FORH FOR INSTRUCTIONS. )
PURPOSE OF
NOTICE: To fulfill the requirements of Section Z10`0 of the Inheritance and Estate Tax Actj Act 25 of ZOOO. (7Z P.S.
Section 910`0).
PAYHENT: Detach the top portion of this Notice and submit aith your payment to the Register of Hills printed on the
reverse side.
-- Hake check or money order payable to: REGISTER OF NILLSj AGENT.
REFUND (CR): A refund of a tax credit~ ahich Has not requested on the tax return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1515). Applications are available at the Office o~
the Register of Hills~ any of the 25 Revenue District Offices or by calling the special Z0`-hour anmeering service
for forms ordering: 1-800-56Z-Z050; services for taxpayers Hith special hearing and or speaking needs:
1-800-~0`7-50Z0 (TT only).
OBJECTIONS: Any party in interest not satisfied HJth the appraisement, allcHance, or disalloHance of deductions or assessment
o{ tax (including discount or interest) as shoHn on this Notice may object within sixty (60) days of receipt of
this Notice by:
--Hritten protest to the PA Department of Revenue, Board of Appeals~ Dept. ZBIOZ1, Harrisburg, PA 171ZB-lOZ1, OR
--electing to have the matter determined at the audit of the account of the personal representative, OR
--appeal to the Orphans' Court
ADHIN-
ISTRATIVE
CORRECTIONS: Factual errors discovered on this assessment should be addressed in Hriting to: PA Department of Revenue~
Bureau of Individual Taxes, ATTN= Post Assessment Review Unit, DEPT. ZB060I, Harrisburgj PA 171Z8-0601
Phone (717) 787-6505. See page 5 of the booklet "instructions ~or Inheritance Tax Return for a Resident
Decedent" (REV-lSD1) for an explanation of administratively correctable errors.
DISCOUNT: Tf any tax due is paid Hithin three (5) calendar months after the decadent's death~ a five percent (SX)
discount of the tax paid is allowed.
PENALTY: The 157. tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January 18, 1996., the first day after the and o~ the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
INTEREST= Interest is charged beginning Hith first day of delinquency, or nine (9) months and one (I) day
~roe the date of death, to the date of payment. Taxes Hhich became delinquent before January 1, 198Z
bear interest at the rate o~ six (67.) percent per annum calculated at a daily rate of .000160`.
A11 taxes Hhich became delinquent on or after January 1, IgBZ Hill bear interest at a rate ahich will vary from
calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable
interest rates {or 198Z through ZOO0` ara:
Interest Daily Interest Daily Tnterest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
198'--~ ZOZ .00050`8 198'--8-1991 IIZ .000501 ZO0--'~ 9Z .000Z0`7
1965 I6Z .0000`58 199Z 9Z .000Z0`7 ZOOZ 6X .000Z19
1980` iix .000501 1995-1990` 7Z .000192 ZOO5 5Z .000157
1985 152 .000556 1995-1998 9Z .00020`7 2000` 0`2 .000110
1986 IOZ . O00ZT~ 1999 7Z .000192
1987 9Z .00020,7 ZOO0 8Z .000Z19
--Interest is calculated as foXlows:
XNTEREST= BALANCE OF TAX UNPAXD X NUIIBER OF DAYS DELIN{~UENT X DAILY INTEREST FACTOR
--Any Notice issued a~ter the tax becomes delinquent Hill reflect an interest calculation to fifteen (15) days
beyond the data of the assessment. If payment is made after the interest computation date shown on the
Notice, additional interest must be caXculated.
CONNONWEALTH OF PENNSYLVANIA ~k_
DUR£.~UOF INDIVIDUAL TAXES DEPARTHENT OF REVENUE
INHERITANCE TAX D/VISION
DEPT. 2B0601
HARRISBURG, PA 171Z8-060! NOT/CE OF /NHERZTANCE TAX
APPRAXSEHENT. ALLO#ANCE OR DXSALLOHANCE
OF DEDUCTIONS, AND ASSESSHENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS R£¥-lS~SEXA~PCOI-OS)
DATE 06-14-2004
ESTATE OF BLYSKAL HARTA
DATE OF DEATH 03-04-2003
COUNTY
CUH~ERLAND
SSN/DC 501-28-1060
EDWARD BLYSKAL ACH 04116014
141 LAKEVZEW DR Amoun~ Remi~ed
CARLISLE PA 17013
HAKE CHECK PAYABLE AND RENXT PAYHENT TO:
REGISTER OF WILLS
CUNBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LXNE ~* RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV-X548 EX AFP (01-03)
NOTICE OF INHERITANCE TAX APPRAXSEHENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 06-14-2004
ESTATE OF BLYSKAL HARTA DATE OF DEATH 03-04-2005 COUNTY CUHBERLAND
FILE NO. S.S/D.C. NO. 501-Z8-1060 ACH 04116014
TAX RETURN WAS: ( ) ACCEPTED AS FILED (X) CHANGED SEE ATTACHED NOTICE
JOINT OR TRUST ASSET INFORNATION
FINANCIAL INSTITUTION: PNC BANK ACCOUNT NO. 31900210652
TYPE OF ACCOUNT: ( ) SAVINGS ( ) CHECKING ( ) TRUST (~ TIHE CERTIFICATE
DATE ESTABLISHED 05-23-2001
Account Balance 86,773.87 NOTE: TO INSURE PROPER CREDIT TO
Percent Taxable X 0.083 YOUR ACCOUNT, SUBHXT THE
Amount Subject to Tax 7,230.87 UPPER PORTION OF THIS NOTXCE
Debts and Deductions .00 WITH YOUR TAX PAYHENT TO THE
Taxable Amount 7,230.87 REGISTER OF WILLS AT THE
Tax Rate X .45 ABOVE ADDRESS. HAKE CHECK
Tax Due 325.39 OR HONEY ORDER PAYABLE TO:
"REGISTER OF WILLS, AGENT."
TAX CREDTTS: , .
PAYHENT RECEIPT DISCOUNT (+) ANOUNT PAID
DATE NUHBER INTEREST/PEN PAID (-)
INTEREST IS CHARGED THROUGH 06-ZZ-2004 TOTAL TAX CREDIT .00
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUEI 325.39
REVERSE SIDE OF THIS FORH INTEREST AND PEN. 7.43
TOTAL DUE 332.82
~ IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ~
( ZF TOTAL DUE IS LESS THAN $1, NO PAYHENT 1S REQUIRED.
IF TOTAL DUE ZS REFLECTED AS A "CRED/T" (CR), YOU HAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. )
PURPOSE OF
NOTICE: To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act Z$ of ZOO0. (72 P.S.
Section 9140).
PAYNENT: Detach the top portion of this Notice and submit aith your payment to the Register of Hills printed on the
reverse side.
-- Naks check or manay order payable to: REGXSTER OF NILLS, AGENT.
REFUND (CR): A refund of a tax credit, ehich was not requested on the tax return, may be requested by completing an "Application
far Refund of Pennsylvania Inheritance and Estate Tax" (RE¥-1515). Applications are available at the Office of
the Register of Hills) any of the Z5 Revenue District Offices ar by calling the special Z4-hour ansaering service
for forms ordering: 1-SOO-56Z-Z050; services for taxpayers HJth special hearing and or speaking needs:
1-800-447-50Z0 (TT only).
OBJECTTONS: Any party in interest nat satisfied Hith the appraisement, alloeance, ar diselloHance of deductions or assessment
of tax (including dlscount or interest) as shomn on this Notice may object within sixty (60) days of receipt of
this Notice by:
--Hritten protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR
--electing to have the matter determined at the audit of the account of the personal representative, OR
--appeal to the Orphans' Court
ADHTN-
ISTRATIVE
CORRECTIONS: Factual errors discovered on this assessment should be addressed in Hriting to: PA Department of Revenue,
Bureau of /ndividual Taxes, ATTN: Post Assessment Revise Unit, DEPT. Z80601, Harrisburg, PA 171Z8-0601
Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-1501) for an explanation of administratively correctable errors.
DTSCOUNT.' If any tax due is paid mithin three (5) calendar months after the decedent's daath~ a five percent (SZ)
discount of the tax paid is allomed.
PENALTY: The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the and of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same time period as you mould appeal the tax and interest
that has been assessed as indicated an this notice.
INTEREST: Tnterest is charged beginning eith first day of delinquency, or nine (9) months and one (1) day
from the date of death, to the data of payment. Taxes mhich became delinquent before January 1, 198Z
bear interest at the rate of six (6Z) percent per annum catculated at a daily rate of .000164.
Ail taxes ahich became delinquent on or after January 1, 198Z Hill bear interest at a rate ehich mill vary from
calendar year to calendar year Hith that rate announced by the PA Department of Revenue. The applicable
interest rates for 1982 through ZOO4 are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
198Z ZOZ .000548 198'~8-1991 11Z .000501 2009 9X .000247
1985 162 .000458 1992 92 .000247 ZOOZ 6Z .000z19
1984 llZ .000501 1995-1994 72 .00019Z 2003 52 .000137
1985 13Z .000556 1995-1998 92 .000247 ZO0~ 42 .000110
1986 lOX .0 O0274 1999 7Z .000192
1987 92 .000247 ZOOO 8X .000Z19
--Interest is caXculatad as falloas:
INTEREST = BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent mill reflect an interest calculation to fifteen (15) days
beyond the date of the assessment. If payment is made after the interest computation date sheen on the
Notice, additionaX interest must be caXcuIated.
RG, ,470 EX (6~8)
COMMONINEALTH OF PENNSYLVANIA EXPLANATION
DEPARTMENT OF REVENUE OF CHANGES
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
DECEDENT'S NAME FILE NUMBER
MARTA BLYSKAL 21/501-28-1060
REVIEWED BY ACN
MICHAEL KODOSKY 04116014
ITEM
SCHEDULE NO. EXPLANATION OF CHANGES
Please be advised that the execution of a joint tenancy contract (signature card) which
provides that all monies are payable to either surviving party is sufficient to establish
Commonwealth's right to the tax. The Supreme Court in Olson Estate 447 PA 483 (1972)
held that under Section 241 (9108 of the Pennsylvania Inheritance and Estate Tax Act of
1995), such accounts are taxable in proportion to the number of joint tenants. The court
rejected the convenience account argument by noting that under Section 241 (9108), it is
improper to apply principles of ownership to determine the taxable portion of a joint bank
account. Joint property is taxable even though the decedent's name was added as a
matter of convenience.
The tax rate, on this assessment, has been reduced to 4.5 percent. This rate now reflects
your correct relationship with the decedent.
Adjustments have been made to reflect these changes.
ROW Page 1
CONMONNEALTH OF PENNSYLVANZA
BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION
DEPT. Z80601
HARRISBURg, PA 17128-0601 NOTICE OF INHERITANCE TAX
APPRAISEMENT. ALLONANCE OR DISALLONANCE
OF DEDUCTIONS, AND ASSESSMENT OF TAX ON
JOZNTL¥ HELD OR TRUST ASSETS REV-iS~SEXAFPCOI-OS)
DATE 06-1q-200q
ESTATE OF BLYSKAL MARTA
DATE OF DEATH
COUNTY
SSN/DC 501-28-1060
PETER BLYSKAL ACN 0q116015
lql LAKEVIEN DR I Amoun~ RemL~ed
CARLISLE PA 17015
I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV-1548 EX AFP (01-03)
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 06-1q-200q
ESTATE OF BLYSKAL MARTA DATE OF DEATH 05-0q-2005 COUNTY CUMBERLAND
FILE NO. S.S/D.C. NO. 501-28-1060 ACN 0q116015
TAX RETURN WAS: ¢ ) ACCEPTED AS FILED eX) CHANGED SEE ATTACHED NOTICE
dOZNT OR TRUST ASSET ZNFORMATZON
FINANCIAL INSTITUTION: PNC BANK ACCOUNT NO. $1900210652
TYPE OF ACCOUNT: ( ) SAVINGS ( ) CHECKING ( ) TRUST (~ TIME CERTIFICATE
DATE ESTABLISHED 05-25-2001
Account Balance 86,775.87 NOTE: TO INSURE PROPER CREDIT TO
Percent Taxable X 0.083 YOUR ACCOUNT, SUBMIT THE
Amount Subject to Tax 7,130.87 UPPER PORTION OF THIS NOTICE
Debts and Deductions - .00 WITH YOUR TAX PAYMENT TO THE
TaxabZe Amount 7,130.87 REGISTER OF WILLS AT THE
Tax Rate X .q, 5 ABOVE ADDRESS. MAKE CHECK
Tax Due 325.39 OR MONEY ORDER PAYABLE TO:
**REGISTER OF WILLS, AGENT.**
TAX CREDTTS:
PAYMENT RECEIPT DI'SCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PATD (-)
INTEREST IS CHARGED THROUGH 06-ZZ-ZOOq TOTAL TAX CREDIT I .00
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUEI 325.39
REVERSE SIDE OF THIS FORM INTEREST AND PEN.
TOTAL DUE 332.82
~ IF PAID AFTER THIS DATE~ SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ~
( IF TOTAL DUE IS LESS THAN .1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CA), YOU MAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
PURPOSE OF
NOTICE: To fulfill the requirements of Section ZlqO of the Inheritance and Estate Tax Act, Act Z3 of ZOO0. (TI P.S.
Section 91qO),
PAYMENT: Detach the top portion of this Notice and subsit with your payment to the Register of Nilis printed on the
reverse side.
-- Make check or money order payable to: REGISTER OF WILLS, AGENT.
REFUND (CR): A refund of a tax credit, which ems not requested on the tax return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-l:51:5). Applications are available at the Office of
the Register of Wills, any of the 2:5 Revenue District Offices or by calling the special Iq-hour answering service
for forms ordering: 1-800-:56Z-ZOSO; services for taxpayers with special hearing and or speaking needs:
1-800-0`q7-30ZO (TT only).
OBJECTTONS: Any party in interest not satisfied with the appraisement) allowance, or disallowance of deductions or assessment
of tax (including discount ar interest) as shown on this Notice may object within sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. 2810Z1, Harrisburg, PA 171za-loz1, OR
--electing to have the matter determined at the audit of the account of the personal representative, OR
--appeal to the Orphans' Court
ADMIN-
ISTRATIVE
CORRECTIONS: Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, DEPT. Z80601, Harrisburg, PA 171Z8-0601
Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-lSD1) for an explanation of administratively correctable errors.
DISCOUNT: If any tax due is paid within three (:53 calendar months after the decedent's death, a five percent CSX)
discount of the tax paid is allowed.
PENALTY: The 157. tax esnssty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January 16, 1996, the first day after the end of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same tiaa period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one il) day
from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982
bear interest at the rate of six [67.) percent per annum calculated at a daily rate of .000160`.
All taxes which became delinquent on or after January 1, 198Z will bear interest at a rate ahich will vary fros
calendar year to calendar year with that rate announced by the PA Oapartsent of Revenue. The applicable
interest rates for 19BI through ZOOq are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
lgB-'--~ ZOZ .00050`8 198'~-1991 IIX .000301 200~-~ 9Z . OOOg0`7
198:5 16X .0000`38 199Z 9Z .00020`7 ZOOZ 6Z . OOOZ19
1960` llZ .000301 199:5-199o, 77. .000192 ZOO:5 57. .0001:57
1985 1:5Z .000356 1995-1998 9Z .00020`7 2000` 0`Z ,000110
1986 107. .000270` 1999 77. .000192
1987 9Z .OOOZ0`7 ZOOD 8Z .O00Z19
--Interest is calculated as follows:
/NTBREST = BALANCE OF TAX UNPA/D X NUMBER OF DAYS DBLZN{~UENT X DA/LY TNTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days
beyond the date of the assessment. If payment is sade after the interest cosputation date shown on the
Notice, additional interest eust be calculated.
REV-1470 EX ~-88)
COMMONWEALTH OF PENNSYLVANIA EXPLANATION
DEPARTMENT OF REVENUE OF CHANGES
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
DECEDENTS NAME FILE NUMBER
MARTA BLYSKAL 21/501-28-1060
REVIEVVED BY ACN
MICHAEL KODOSKY 04116013
ITEM
SCHEDULE NO. EXPLANATION OF CHANGES
Please be advised that the execution of a joint tenancy contract (signature card) which
provides that all monies are payable to either surviving party is sufficient to establish
Commonwealth's right to the tax. The Supreme Court in Olson Estate 447 PA 483 (1972)
held that under Section 241 (9108 of the Pennsylvania Inheritance and Estate Tax Act of
1995), such accounts are taxable in proportion to the number of joint tenants. The court
rejected the convenience account argument by noting that under Section 241 (9108), it is
improper to apply principles of ownership to determine the taxable portion of a joint bank
account. Joint property is taxable even though the decedent's name was added as a
matter of convenience.
The tax rate, on this assessment, has been reduced to 4.5 percent. This rate now reflects
your correct relationship with the decedent.
Adjustments have been made to reflect these changes.
ROW Page 1
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE REV-1162 EX(11-96)
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 004786
BLYSKAL PETER
141 LAKEVIEW DRIVE
CARLISLE, PA 17013
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
........ fold
04116014 $50.00
ESTATE INFORMATION: SSN. 501-28-1060
FILE NUMBER: 2104- 1135
DECEDENT NAME: BLYSKAL MARTA
DATE OF PAYMENT: 12/30/2004
POSTMARK DATE: 12/30/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 03/04/2003
TOTAL AMOUNT PAID: $50.00
REMARKS: EDWARD BLYSKAL
INITIALS: VZ
SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE REV-1162 EX(11-96)
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601 ~
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 004787
DUPLICATE
BLYSKAL PETER
141 LAKEVlEW DRIVE
CARLISLE, PA 17013
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
........ fold
041 1 601 3 $50.00
ESTATE INFORMATION: SSN: 501-28-1060
FILE NUMBER: 2104- 1 1 35
DECEDENT NAME: BLYSKAL MARTA
DATE OF PAYMENT: 12/30/2004
POSTMARK DATE: 12/30/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 03/04/2003
TOTAL AMOUNT PAID: $50.00
REMARKS: P BLYSKAL
INITIALS' VZ
SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
CCMMO~j"\'EALTH OF Pc:~JNSYLVANIA
DEPARTc/ENT OF REVENUE
BUREAU OF I:\:DIV;DUAL TAXES
DEPT,28:)601
HARRISBuRG, PA 17128-0601
REV-1162 EXlll-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
BLYSKAL PETER
141 LAKEVIEW DRIVE
CARLISLE, PA 17013
h,c.
ESTATE INFORMATION: SSN: 501-28-1060
FILE NUMBER: 2104-1135
DECEDENT NAME: BLYSKAL MARTA
DATE OF PAYMENT: 01/31/2005
POSTMARK DATE: 01/31/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 03/04/2003
NO. CD 004901
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
04116014 I $100.00
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$100.00
REMARKS: P BLYSKAL
SEAL
INITIALS: VZ
RECEIVED BY:
REGISTER OF WillS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
cD~.'lMmJV'!EALTf1 OF PE""NSYLVANIA
CJ::?ARTrv1ENT OF REVENUE
SUh!::AU CF INDIVIDUAL TAXES
DEi"T.280601
HARi'iISS.JRG, PA 17128-0601
REV.1162 EX("I1-96i
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
BLYSKAL PETER
141 LAKEVIEW DRIVE
CARLISLE, PA 17013
nn_n bid
ESTATE INFORMATION: SSN: 501~28~1060
FILE NUMBER: 2104-1135
DECEDENT NAME: BL YSKAL MART A
DATE OF PAYMENT: 01/31/2005
POSTMARK DATE: 01/31/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 03/04/2003
NO. CD 004900
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
04116013 I $100.00
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$100.00
REMARKS: PETER BLYSKAL
INITIALS: VZ
SEAL
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
- - - - - - - - - - - - - - - - - -
PLEASE RETURN THIS PORTION WITH YOUR PAYMENT TO
THE REGISTER OF WILLS LISTED BELOW
ESTATE OF
BLYSKAL MARTA
FILE NO/SSN 501-28-1060
COUNTY CUMBERLAND
DATE OF ASSESSMENT
ACN
06- 0 7 -; doi4c\' ....,;:10"iJ
I ~"" , .', 'i:jt.
04116013 \"-::i"1 "
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-
REGISTER OF WILLS
CUMBERLAND CO COURT
CARLISLE, PA 17013
- - ~~- -
HOUSE
gODl
,;;,./ - 0 L/ - 1/3 6-
PLEASE RETURN THIS PORTION WITH YOUR PAYMENT TO
THE REGISTER OF WILLS LISTED BELOW
ESTATE OF
BLYSKAL MARTA
FILE NO/SSN 501-28-1060 REGISTER OF WILLS
COUNTY CUMBERLAND. CUMBERLAND CO COURT HOUSE
DATE OF ASSESSMENT 06-07-2ltq~'..., ":",i!" J1:JCARLISLE, PA 17013
ACN 04116014,.c'.,v.j """",udO
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10 :[ '.i,) cu' I ["[fr'rn07
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG. PA 17128-0601
REV-1162 EX( 11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
BLYSKAL PETER
141 LAKEVIEW DRIVE
CARLISLE, PA 17013
nn__n told
EST A TE INFORMATION: SSN: 501 -28- 1060
FILE NUMBER: 2104-1135
DECEDENT NAME: BL YSKAL MARTA
DATE OF PAYMENT: 01/19/2005
POSTMARK DATE: 01/19/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 03/04/2003
NO. CD 004858
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
04116013 I $30.00
04116014 I $30.00
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS:
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
$60.00
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(1 1-96}
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
BLYSKAL EDWARD
141 LAKEVIEW DRIVE
CARLISLE, PA 17013
--------told
ESTATE INFORMATION: SSN: 501-28-1060
FILE NUMBER: 2104-1135
DECEDENT NAME: BL YSKAL MARTA
DATE OF PAYMENT: 02/11/2005
POSTMARK DATE: 02/11/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 03/04/2003
NO. CD 004933
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
04116014 I $105.00
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS:
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
$105.00
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV.1162 EX(1 '-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
BLYSKAL PETER
141 LAKEVIEW DRIVE
CARLISLE, PA 17013
--------told
ESTATE INFORMATION: SSN: 501-28-1060
FILE NUMBER: 2104-1135
DECEDENT NAME: BLYSKAL MART A
DATE OF PAYMENT: 02/11/2005
POSTMARK DATE: 02/11/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 03/04/2003
NO. CD 004934
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
04116013 I $105.00
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$105.00
REMARKS:
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
GLENDAFARNERSTRASBAUGH
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX( 11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
BLYSKAL EDWARD
141 LAKEVIEW DRIVE
CARLISLE, PA 17013
______n fold
ESTATE INFORMATION: SSN: 50'-28-'060
FILE NUMBER: 2104-1135
DECEDENT NAME: BL YSKAL MART A
DATE OF PAYMENT: 02/25/2005
POSTMARK DATE: 02/25/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 03/04/2003
NO. CD 004987
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
04116014 I $56.29
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$56.29
REMARKS: E BLYSKAL
SEAL
INITIALS: VZ
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
BLYSKAL PETER
141 LAKEVIEW DRIVE
CARLISLE, PA 17013
____n__ fold
ESTATE INFORMATION: SSN: 501-28-1060
FILE NUMBER: 2104-1135
DECEDENT NAME: BL YSKAL MART A
DATE OF PAYMENT: 02/25/2005
POSTMARK DATE: 02/25/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 03/04/2003
NO. CD 004988
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
04116013 I $56.29
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$56.29
REMARKS: P BLYSKAL
SEAL
INITIALS: VZ
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
BUREAU OF INOIV~QuAL TAXES
INHERITANCE TAX DIVISION
PO BOX Z8D60l
HARRISBURG PA 17128-0691
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
'*
REV-liD7 EX AFP n2.-D~}
r~ ~~
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
01-31-2005
BLYSKAL
03-04-2003
21 04-1135
CUMBERLAND
04116014
MARTA
EDWARD BLYSKAL
141 LAKEVIEW DR
CARLISLE PA 17013
Amount Re..itted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account} subllit the upper portion of this for.. with your tax pay.ent.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
~~:r&b,r.!1:.K'~..rftl~.6~'...........irA~!~e1r"TA1:.~t~'f!~.tnr.Atl:60~...;;...........__.._._--_.
ESTATE OF BLYSKAL MARTA FILE NO. 21 04-1135 ACN 04116014 DATE 01-31-2005
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 06-14-2004
PRINCIPAL TAX DUE:.
~,.,.,.'."'''.'''.'.'"'''''.'.'.'.'.'.'.'''''.'.'.'.'.'.'.'.'""",y,.,..
325.39
PAYMENTS (TAX CREDITS):
INT
AT
REV
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
12-30-2004 CD004786 .00 50.00
EREST IS CHARGED THROUGH 02-15-2005 TOTAL TAX CREDIT 50.00
THE RATES APPLICABLE AS OUTLINED ON THE
ERSE SIDE OF THIS FORM.. BALANCE OF TAX DUE 275.39
INTEREST AND PEN. 16.04
. IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE 291 . 43
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
~
( IF TOTAL DUE IS LESS THAN $lJ
NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI,
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. I
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
*'
kEY.1601U 'FP {12-D4l
: ~? I:
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
01-31-2005
BLYSKAL
03-04-2003
21 04-1135
CUMBERLAND
04116013
MARTA
PETER BLYSKAL
141 LAKEVIEW DR
CARLISLE PA 17013
Allount Re..itted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, subllit the upper portion of this for.. with your tax pay.ent.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ...
~W -"r&'1J.,.lr.KW.rll1"-.I1J,.........;.."fflftW'!mel""f~r.~''AYI!Am.b'1!'.~l:cI10Fff...ii'.......................
ESTATE OF BLYSKAL MARTA FILE NO. 21 04-1135 ACN 04116013 DATE 01-31-2005
TNIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW
IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 06-14-2004
PRINCIPAL TAX DUE:.
325.39
PAYMENTS (TAX CREDITS):
INT
AT
REV
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
12-30-2004 CD004787 .00 50.00
EREST IS CHARGED THROUGH 02-15-2005 TOTAL TAX CREDIT 50.00
THE RATES APPLICABLE AS OUTLINED ON THE
ERSE SIDE OF THIS FORM.~ BALANCE OF TAX DUE 275.39
INTEREST AND PEN. 16.04
. IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE 291. 43
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
~
( IF TOTAL DUE IS LESS THAN $1,
NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI,
YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FDRH FOR INSTRUCTIONS. I
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
*'
REV-1Ul EX AFP 112-D~)
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
02-28-2005
BLYSKAL
03-04-2003
21 04-1135
CUMBERLAND
04116014
Anount R_itted
MARTA
EDWARD BLYSKAL
141 LAKEVIEW DR
CARLISLE PA 17013
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
NOTE: To insure proper credit to your account. submit the upper portion of this form with your tax payment.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
AW::r~~".!Y.A'fI..rllr-.d'.!"..........'"fA~fn'Ner"'AY'l'AYlAWf.b1!'.A~~c50FN....................... ...
ESTATE OF BLYSKAL MARTA FILE NO. 21 04-1135 ACN 04116014 DATE 02-28-2005
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW
IS A SUMMARY OF THE PRINCIPAL TAX DUE. APPLICATION OF ALL PAYMENTS. THE CURRENT BALANCE. AND. IF APPLICABLE.
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 06-14-2004
PRINCIPAL TAX DUE:.
325.39
PAYMENTS (TAX CREDITS):
INT
AT
REV
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
12-30-2004 CD004786 .00 50.00
01-19-2005 CD004858 .00 30.00
01-31-2005 CD004901 .00 100.00
EREST IS CHARGED THROUGH 03-15-2005 TOTAL TAX CREDIT 180.00
THE RATES APPLICABLE AS OUTLINED ON THE
ERSE SIDE OF THIS FORM.~ BALANCE OF TAX DUE 145.39
INTEREST AND PEN. 16.28
IF PAID AFTER THIS DATE. SEE REVERSE TOTAL DUE 161. 67
.
~
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1.
NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR).
YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. )
BUREAU OF INDIVIDUAl,.. TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
:INHER:ITANCE TAX
STATEMENT OF ACCOUNT
*'
REV-1U7 EX AFP 112-04)
, ,~ ;;'""",
i'''''''
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
02-28-2005
BLYSKAL
03-04-2003
21 04-1135
CUMBERLAND
04116013
AIIount Re..i tted
MARTA
PETER BLYSKAL
141 LAKEVIEW DR
CARLISLE PA 17013
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
NOTE: To insure proper credit to your account. subllit the upper portion of this for.. with your tax pay..ent.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
Iw:r&'f).,.!r.A'fI..rllr-.crJ'.........;..YAft'W!'rA"Ner"fly.~'A'WAm.bV.ll:1!'60R'f........................ ...
ESTATE OF BLYSKAL MARTA FILE NO. 21 04-1135 ACN 04116013 DATE 02-28-2005
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY OF THE PRINCIPAL TAX DUE. APPLICATION OF ALL PAYMENTS. THE CURRENT BALANCE. AND. IF APPLICABLE.
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 06-14-2004
PRINCIPAL TAX DUE:,
325.39
PAYMENTS (TAX CREDITS):
INT
AT
REV
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
12-30-2004 CD004787 .00 50.00
01-19-2005 CD004858 .00 30,00
01-31-2005 CD004900 .00 100.00
EREST IS CHARGED THROUGH 03-15-2005 TOTAL TAX CREDIT 180.00
THE RATES APPLICABLE AS OUTLINED ON THE
ERSE SIDE OF THIS FORM.* BALANCE OF TAX DUE 145.39
INTEREST AND PEN. 16.28
IF PAID AFTER THIS DATE. SEE REVERSE TOTAL DUE 161. 67
.
~
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1.
NO PAYMENT IS REQUIRED.
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 TA*~S
INHERITANCE TAX DIVISION -
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
i3
1.;,3
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
OR,C):J\\:<"
.; ; "..'.'..".'
PETER CU/I!LYSKAL
141 LAKEVIEW DR
CARLISLE PA 17013
*'
REV-1607 EX AFP (03-05)
06-06-2005
BLYSKAL
03-04-2003
21 04-1135
CUMBERLAND
04116013
haunt R..ittad
MARTA
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account~ submit the upper portion of this form with your tax pey..nt.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ...
.......................................~........................................................................
REV-1607 EX AFP (03-05) ~~~ INHERITANCE TAX STATEMENT OF ACCOUNT ~~.
ESTATE OF BLYSKAL MARTA FILE NO.21 04-1135 ACN 04116013 DATE 06-06-2005
THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELDN
IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 06-14-2004
PAYMENTS (TAX CREDITS):
PRINCIPAL TAX DUE: 325.39
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
~~~ SUMMARY OF LL 005 PAYMENTS ~~~
02-25-2005 15.72- 341.29
TOTAL TAX CREDIT 325.57
BALANCE OF TAX DUE .18CR
INTEREST AND PEN. .00
IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .18CR
.
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1,
NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRJ,
YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FDRH FOR INSTRUCTIONS. J
0-":::> V-
BUREAU OF INDIVIDUAL lAKES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 11128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
*'
REV-1607 EX AFP (03-051
i 3 . l,g
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
06-06-2005
BLYSKAL
03-04-2003
21 04-1135
CUMBERLAND
04116014
AI."...t ReMi tt...
MARTA
ORH""C'
EDWARD '" JtiltYSKAL
VCu
141 LAKEVIEW DR
CARLISLE PA 17013
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account I submit the upper portion of this form with your t.x pay..nt.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
...............................................................................................................1
REV-1607 EX AFP (03-05) ~~~ INHERITANCE TAX STATEMENT OF ACCOUNT ...
ESTATE OF BLYSKAL MARTA FILE NO. 21 04-1135 ACN 04116014 DATE 06-06-2005
THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATEO ACN IN THE MANED ESTATE. SHOWN BELOW
IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PRO~ECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 06-14-2004
PRINCIPAL TAX DUE: 325.39
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
~~~ SUMMARY OF ~LL 005 PAYMENTS ~~~
02-25-2005 15.72- 341. 29
TOTAL TAX CREDIT 325.57
BALANCE OF TAX DUE .18CR
INTEREST AND PEN. .00
IF PAlO AFTER THIS OATE, SEE REVERSE TOTAL DUE .18CR
.
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL IIUE IS LESS THAN $1,
NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTEO AS A "CREDIT" (CRI,
YOU HAY BE DUE A REFUND. SEE REVERSE SlOE OF THIS FORH FOR INSTRUCTIONS. )
~
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