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\.- BUREAU OF INOIVIOUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG~ PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
*'
NOTICE OF INHERITANCE TAX
APPRAISEHENT. ALLOHANCE OR OISALLOHANCE
OF DEDUCTIONl>..AND ASSESSMENT OF TAX ON
JOINTLY nELD OR TRUST ASSETS
REV-15UEX AFP (01-021
SAVARD
LN
'02
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
'!SS,,)rjJC
ACN
07-01-2002
ZUlKIS
06-01-2001 ,j
w/-6~-0/-r
CUMBERLAND
178-01-4963
01136409
Allount Re..itted
ALBERT
MARLENE
286 KERNEL
ETTERS
,JJL -1
PA 17319
\,
eli
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
iifv=isiii-iif-AFP--foi-=o21------------------------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 07-01-2002
ESTATE OF ZUIKIS
ALBERT
DATE OF DEATH 06-01-2001
COUNTY
CUMBERLAND
FILE NO. S.S/D.C. NO. 178-01-4963
TAX RETURN WAS: (X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
ACN
01136409
FINANCIAL INSTITUTION: COMMUNITY BANKS NA
ACCOUNT NO.
DDA-4141619909
TYPE OF ACCOUNT:
DATE ESTABLISHED
( ) SAVINGS (Xl CHECKING ( ) TRUST ( ) TIME CERTIFICATE
04-06-1994
x
710.72
0.500
355.36
.00
355.36
.45
15.99
NOTE: TO INSURE 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."
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
X
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
INTEREST IS CHARGED THROUGH 07-09-2002 TOTAL TAX CREDIT .00
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 15.99
REVERSE SIDE OF THIS FORM INTEREST AND PEN. .34
TOTAL DUE 16.33
. IF PAlO AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. .
( IF TOTAL OUE 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 FORH FOR INSTRUCTIONS. I
COMMONWEALTH Of PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU Of INOIVIDUAL TAXES
DEPT. 2B0601
HARRISBURG, PA 17128-0601
REV-1162 EX{11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
JAMES R SAVARD
30 DEER RUN DRIVE
ETTERS, PA 17319-9155
h____n fold
ESTATE INFORMATION: SSN: 178-01-4963
FILE NUMBER: 2102-0614
DECEDENT NAME: ZUIKIS ALBERT
DATE OF PAYMENT: 07/10/2002
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 06/01/2001
NO. CD 001395
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
01136409 I $16.33
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS: JAMES R SAVARD
CAN NOT READ POSTMARK DATE
CHECK# 0926
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
$16.33
MARY C. lEWIS
REGISTER OF WILLS
////,5 -//
~ BUREAU OF INOIVIOUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG. PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
*'
REV-1UlEX AfP (0I-D2)
MARLENE
286 KERNEL
ETTERS
'LL
SAVARD
LN
5
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
08-26-2002
ZUIKI S
06-01-2001
21 02-0614
CUMBERLAND
01136409
ALBERT
A.ount Remitted
PA 17319
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 for.. with your tax payment.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REv=ir.ifi-Ex-AFP-foFo2Y------iiioji-iNHERITANCrTAx-sTAYEMEN"T-O"-ACciiiiiif--jiiii---------------------
ESTATE OF ZUIKIS
ALBERT
FILE NO.21 02-0614
ACN 01136409 DATE 08-26-2002
THIS STATEHENT IS PROVIOEO 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: 07-01-2002
PRINCIPAL TAX DUE:_ 15.99
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
07-10-2002 CDOO1395 .34- 16.33
TOTAL TAX CREDIT 15.99
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
. IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1,
NO PAYHENT IS REQUIRED.
IF TDTAL DUE IS REFLECTED AS A "CREDIT" [CRI,
YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. I