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HomeMy WebLinkAbout12-15-14 - pennsylvania BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION /� c .APPRAISEMENT, ALLOWANCE OR DISALLOWANCE PO BOX 28Q�0 ED OFFICE 01 OF DEDUCTIONS, AND ASSESSMENT OF TAX ON REV-1548 EX AFP (11-14) HARRISBURG YA� 28-0601 JOINTLY HELD OR TRUST ASSETS REGISTER OF WILLS DATE 12-15-2014 2914 OEC 15 PM 12 17 ESTATE OF GARBACIK RAYMOND R PM l DATE OF DEATH 02-08-2013 FILE NUMBER 21 13-0194 CLERK OF COUNTY CUMBERLAND SSN/DC ** R I CHfiF&H A b1%AgkPil ACN 14101750 22CLWB1E-Xt.t0 CO., PA APPEAL BY DATE:02-13-2015 CAMP HILL PA 17011-3911 (See reverse side under Objections) Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE RETAIN LOWER PORTION FOR YOUR RECORDS ------------------------------------------------------------------------------------------- REV-1548 EX AFP C11-14) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE: 12-15-2014 ESTATE OF:GARBACIK RAYMOND R DATE OF DEATH:02-08-2013 COUNTY:CUMBERLAND FILE NO. : 21 13-0194 S.S/D.C. NO. : ACN: 14101750 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: REAL ESTATE ACCOUNT NO. : 0000 TYPE OF ACCOUNT: ( )SAVINGS ( ) CHECKING ( )TRUST ( )TIME CERTIFICATE DATE ESTABLISHED 09-26-2012 Account Balance 140, 100.00 NOTE: TO ENSURE PROPER CREDIT TO Percent Taxable X 1 .000 YOUR ACCOUNT, SUBMIT THE Amount Subject to Tax 140, 100.00 UPPER PORTION OF THIS NOTICE Debts and Deductions •00 WITH YOUR TAX PAYMENT TO THE Taxable Amount 140,100.00 REGISTER OF WILLS AT THE Tax Rate x • 12 ABOVE ADDRESS. MAKE CHECK Tax Due 16,812.00 OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 05-08-2013 CDO17584 840.60 15,971.40 TOTAL TAX PAYMENT 16,812.00 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. PAYMENT: Detach the top portion of this notice and submit with your payment to the Register of Wills indicated on the front of the notice.Make check or money order payable to:Register of Wills,Agent. REFUND(CR): A refund of a tax credit not requested on the tax return may be requested by completing an Application for Refund of Pennsylvania Inheritance and Estate Tax(REV-1313). Applications are available at www.revenue.oa.aov or by calling 1-800-362-2050. Services for taxpayers with special hearing and/or speaking needs are available at 1-800-447-3020. Please allow four to six weeks from the date a refund was granted to receive the check. OBJECTIONS: Any party of interest not satisfied with the appraisment,allowance or disallowance of deductions,or assessment of tax as shown on this notice may object within 60 days of the date of receipt of this notice by: 1.Filing an appeal online at www.boardofappeals.state.pa.us on or before the appeal date identified on the front of this notice or sending a written protest to: PA Department of Revenue Board of Appeals PO BOX 281021 Harrisburg PA 17128-1021 2.Having the matter determined at audit of the account of the personal representative;or 3.Appealing to the Orphans'Court. ADMINISTRATIVE Errors discovered on this assessment should be addressed in writing to: CORRECTIONS: PA Department of Revenue Bureau of Individual Taxes Post Assessment Review Unit PO BOX 280601 Harrisburg PA 17128-0601 See instructions for Inheritance Tax Return for a Resident Decedent for details on an administrative correction. DISCOUNT: If any tax due is paid within three months after the decedent's death,a 5 percent discount of the tax paid is allowable. INTEREST: Interest is charged beginning nine months and one day from date of death,to the date of payment. An interest calculator is available at www.dorservices.state.oa.us. Annual interest rates can be found on form REV-1611. Any notice issued after the tax becomes delinquent will reflect an interest calculation to 15 days beyond the date of the assessment. If payment is made after the interest calculation date shown on the notice,additional interest must be calculated. pennsyLvania BUREAU OF INDIVIDUAL TAXES NOTICE NOTICE OF INHERITANCE TAX DEPARTMENT OF REVENUE POHBOXT280601TAX F VDED OFFICE OF OFPDEDUCTIONS,AANDWASSESSMENTANCE OR SOFTAX LNON REV-1546 EX AFP (11-14) HARRISBURG PA ley]] 8-060 REGI OF WILLS JOINTLY HELD OR TRUST ASSETS f\ •7 DATE 12-15-2014 1 Zglg OcC 15 PM 12 18 ESTATE OF GARBACIK RAYMOND R l U DATE OF DEATH 02-08-2013 FILE NUMBER 21 13-0194 CLERK OF COUNTY CUMBERLAND p (�(� � SSN/DC RICHARD aR9 �AC`1TC ACN 14101751 221 N C"IBEf AND CO., RA APPEAL BY DATE:02-13-2015 CAMP HILL P A 17011-3911 (See reverse side under Objections) Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 1701.3 CUT ALONG THIS LINE -01 RETAIN LOWER PORTION FOR YOUR RECORDS +— REV-1548 EX AFP C11-14)-------------------------------------------------------------------- NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE: 12-15-2014 ESTATE OF:GARBACIK RAYMOND R DATE OF DEATH:02-08-2013 COUNTY:CUMBERLAND FILE NO. : 21 13-0194 S.S/D.C. NO. : ACN: 14101751 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: METLIFE ANNUITY ACCOUNT NO. : 000001913 TYPE OF ACCOUNT: ( )SAVINGS C ) CHECKING ( )TRUST ( )TIME CERTIFICATE DATE ESTABLISHED 02-08-2013 Account Balance 34,074. 19 NOTE: TO ENSURE PROPER CREDIT TO Percent Taxable X 1 .000 YOUR ACCOUNT, SUBMIT THE Amount Subject to Tax 34,074. 19 UPPER PORTION OF THIS NOTICE Debts and Deductions - .00 WITH YOUR TAX PAYMENT TO THE Taxable Amount 34,074. 19 REGISTER OF WILLS AT THE Tax Rate Y . 12 ABOVE ADDRESS. MAKE CHECK Tax Due 4,088.90 OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 05-08-2013 CDC17584 204.44 3,884.45 01-24-2014 SBADJUST .00 .01 TOTAL TAX PAYMENT 4,088.90 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. PAYMENT: Detach the top portion of this notice and submit with your payment to the Register of Wills indicated on the front of the notice.Make check or money order payable to:Register of Wills,Agent. REFUND(CR): A refund of a tax credit not requested on the tax return may be requested by completing an Application for Refund of Pennsylvania Inheritance and Estate Tax(REV-1313). Applications are available at www.revenue.pa.aov or by calling 1-800-362-2050. Services for taxpayers with special hearing and/or speaking needs are available at 1-800-447-3020. Please allow four to six weeks from the date a refund was granted to receive the check. OBJECTIONS: Any party of interest not satisfied with the appraisment,allowance or disallowance of deductions,or assessment of tax as shown on this notice may object within 60 days of the date of receipt of this notice by: 1.Filing an appeal online at www.boardofappeals.state.pa.us on or before the appeal date identified on the front of this notice or sending a written protest to: PA Department of Revenue Board of Appeals PO BOX 281021 Harrisburg PA 1 71 28-1 021 2.Having the matter determined at audit of the account of the personal representative;or 3.Appealing to the Orphans'Court. ADMINISTRATIVE Errors discovered on this assessment should be addressed in writing to: CORRECTIONS: PA Department of Revenue Bureau of Individual Taxes Post Assessment Review Unit PO BOX 280601 Harrisburg PA 17128-0601 See instructions for Inheritance Tax Return for a Resident Decedent for details on an administrative correction. DISCOUNT: If any tax due is paid within three months after the decedent's death,a 5 percent discount of the tax paid is allowable. INTEREST: Interest is charged beginning nine months and one day from date of death,to the date of payment. An interest calculator is available at www.dorservices.state.pa.us. Annual interest rates can be found on form REV-1611. Any notice issued after the tax becomes delinquent will reflect an interest calculation to 15 days beyond the date of the assessment. If payment is made after the interest calculation date shown on the notice,additional interest must be calculated. pennsylvania BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION /� APPRAISEMENT, ALLOWANCE OR DISALLOWANCE I PO BOX 280601 gg_gRPEC OFFICE OF OF DEDUCTIONS, AND ASSESSMENT OF TAX ON REV-1548 EX AFP (11-14) HARRISBURG PA ``GU r REGISTER OF WILLS JOINTLY HELD OR TRUST ASSETS DATE 12-15-2014 2gll OvC 1C PM 12 18 ESTATE OF GARBACIK RAYMOND, R U J JJ ! 1 J 1 DATE OF DEATH 02-08-2013 FILE NUMBER 21 13-0194 CLERK OF COUNTY CUMBERLAND r�y� SSN/DC RICHARIpRPN �BAo3KT ACN 14101752 221 NCV EV�: 11D CO., PA APPEAL BY DATE:02-13-2015 CAMP HILL PA 17011-3911 (See reverse side under Objections) Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE RETAIN LOWER PORTION FOR YOUR RECORDS 4- ------------------------------------------------------------------------------------------- REV-1548 EX AFP (11-14) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE: 12-15-2014 ESTATE OF:GARBACIK RAYMOND R DATE OF DEATH:02-08-2013 COUNTY:CUMBERLAND FILE NO. : 21 13-0194 S.S/D.C. NO. : ACN: 14101752 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: AMERICAN GENERAL LIFE ACCOUNT NO. : AXXXX950A TYPE OF ACCOUNT: C )SAVINGS C ) CHECKING ( )TRUST ( )TIME CERTIFICATE DATE ESTABLISHED 02-08-2013 Account Balance 115,721 .34 NOTE: TO ENSURE PROPER CREDIT TO Percent Taxable X 1 .000 YOUR ACCOUNT, SUBMIT THE Amount Subject to Tax 115,721.34 UPPER PORTION OF THIS NOTICE Debts and Deductions - •00 WITH YOUR TAX PAYMENT TO THE Taxable Amount 115,721 .34 REGISTER OF WILLS AT THE Tax Rate x •12 ABOVE ADDRESS. MAKE CHECK Tax Due 13,886.56 OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID C-) 05-08-2013 CDO17584 694.33 13,481.63 TOTAL TAX PAYMENT 14,175.96 BALANCE OF TAX DUE 289.40CR INTEREST AND PEN. .00 TOTAL DUE 289.40CR 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. \�J SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. (vj� PAYMENT: Detach the top portion of this notice and submit with your payment to the Register of Wills indicated on the front of the notice.Make check or money order payable to:Register of Wills,Agent. REFUND(CR): A refund of a tax credit not requested on the tax return may be requested by completing an Application for Refund of Pennsylvania Inheritance and Estate Tax(REV-1313). Applications are available at www.revenue.oa.aov or by calling 1-800-362-2050. Services for taxpayers with special hearing and/or speaking needs are available at 1-800-447-3020. Please allow four to six weeks from the date a refund was granted to receive the check. OBJECTIONS: Any party of interest not satisfied with the appraisment,allowance or disallowance of deductions,or assessment of tax as shown on this notice may object within 60 days of the date of receipt of this notice by: 1.Filing an appeal online at www.boardofappeals.state.pa.us on or before the appeal date identified on the front of this notice or sending a written protest to: PA Department of Revenue Board of Appeals PO BOX 281021 Harrisburg PA 17128-1021 2.Having the matter determined at audit of the account of the personal representative;or 3.Appealing to the Orphans'Court. ADMINISTRATIVE Errors discovered on this assessment should be addressed in writing to: CORRECTIONS: PA Department of Revenue Bureau of Individual Taxes Post Assessment Review Unit PO BOX 280601 Harrisburg PA 17128-0601 See instructions for Inheritance Tax Return for a Resident Decedent for details on an administrative correction. DISCOUNT: If any tax due is paid within three months after the decedent's death,a 5 percent discount of the tax paid is allowable. INTEREST: Interest is charged beginning nine months and one day from date of death,to the date of payment. An interest calculator is available at www.dorservices.state.pa.us. Annual interest rates can be found on form REV-1611. Any notice issued after the tax becomes delinquent will reflect an interest calculation to 15 days beyond the date of the assessment. If payment is made after the interest calculation date shown on the notice,additional interest must be calculated. BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX pennsylvaniaDEPARTMENT OF REVENUE INHERITANCE TAX DIVISION APPRAISEMENT, ALLOWANCE OR DISALLOWANCE PO BOX 280601 gpRDED OFFICE 0.4r DEDUCTIONS, AND ASSESSMENT OF TAX ON REV-1548 EX AFP (11-14) HARRISBURG PA 171Ibt'REGISTER OF WILLSJOINTLY HELD OR TRUST ASSETS DATE 12-15-2014 n u OEC L m Q ESTATE OF GARBACIK RAYMOND R 2019 OEC 15 P! 1 12 18 DATE OF DEATH 02-08-2013 FILE NUMBER 21 13-0194 CLERK OF COUNTY CUMBERLAND 41017 RICHARD O8PdM��6WURT SSN/DC - ACN 114101753 221 N 1901MDERLAND CO., PPS APPEAL BY DATE:02-13-2015 CAMP HILL PA 17011-3911 (See reverse side under Objections) Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE RETAIN LOWER PORTION FOR YOUR RECORDS +— REV-1548 EX AFP CI1-14)-------------------------------------------------------------------- NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE: 12-15-2014 ESTATE OF:GARBACIK RAYMOND R DATE OF DEATH:02-08-2013 COUNTY:CUMBERLAND FILE NO. : 21 13-0194 S.S/D.C. NO. : ACN: 14101753 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: AMERICAN GENERAL LIFE ACCOUNT NO. : AXXXX048A TYPE OF ACCOUNT: ( )SAVINGS C ) CHECKING ( )TRUST ( )TIME CERTIFICATE DATE ESTABLISHED 02-08-2013 Account Balance 98,873. 12 NOTE: TO ENSURE PROPER CREDIT TO Percent Taxable X 1 .000 YOUR ACCOUNT, SUBMIT THE Amount Subject to Tax 98,873. 12 UPPER PORTION OF THIS NOTICE Debts and Deductions - .00 WITH YOUR TAX PAYMENT TO THE Taxable Amount 98,873. 12 REGISTER OF WILLS AT THE Tax Rate x • 12 ABOVE ADDRESS. MAKE CHECK Tax Due 11,864.77 OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT C+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 05-08-2013 CDO17584 593.24 11,271 .53 TOTAL TAX PAYMENT 11,864.77 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. \(vl\ SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. CY PAYMENT: Detach the top portion of this notice and submit with your payment to the Register of Wills indicated on the front of the notice.Make check or money order payable to:Register of Wills,Agent. REFUND(CR): A refund of a tax credit not requested on the tax return may be requested by completing an Application for Refund of Pennsylvania Inheritance and Estate Tax(REV-1313). Applications are available at www.revp-[Luea.gov or by calling 1-800-362-2050. Services for taxpayers with special hearing and/or speaking needs are available at 1-800-447-3020. Please allow four to six weeks from the date a refund was granted to receive the check. OBJECTIONS: Any party of interest not satisfied with the appraisment,allowance or disallowance of deductions,or assessment of tax as shown on this notice may object within 60 days of the date of receipt of this notice by: 1.Filing an appeal online at www.boardofappeals.state.pa.us on or before the appeal date identified on the front of this notice or sending a written protest to: PA Department of Revenue Board of Appeals PO BOX 281021 Harrisburg PA 1 71 28-1 021 2.Having the matter determined at audit of the account of the personal representative;or 3.Appealing to the Orphans'Court. ADMINISTRATIVE Errors discovered on this assessment should be addressed in writing to: CORRECTIONS: PA Department of Revenue Bureau of Individual Taxes Post Assessment Review Unit PO BOX 280601 Harrisburg PA 17128-0601 See instructions for Inheritance Tax Return for a Resident Decedent for details on an administrative correction. DISCOUNT: If any tax due is paid within three months after the decedent's death,a 5 percent discount of the tax paid is allowable. INTEREST: Interest is charged beginning nine months and one day from date of death,to the date of payment. An interest calculator is available at www.dorservices.state.oa.us. Annual interest rates can be found on form REV-1611. Any notice issued after the tax becomes delinquent will reflect an interest calculation to 15 days beyond the date of the assessment. If payment is made after the interest calculation date shown on the notice,additional interest must be calculated. pennsylvania BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX 51 INHERITANCE TAXt�t�APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE PO BOX 280601 Kfttb"RDED OFFICE wrOF DEDUCTIONS, AND ASSESSMENT OF TAX ON REV-1548 EX AFP (11-14) HARRISBURG PA 1712gtUtSTER OF WILLS JOINTLY HELD OR TRUST ASSETS �jI DATE 12-15-2014 2pju �E� 15 pM ,12 18 ESTATE OF GARBACIK RAYMOND R t117 U DATE OF DEATH 02-08-2013 LR OF FILE NUMBER 21 13-0194 CLERK CUMBERLAND C O D RT SSN/DC RICHARD O V GAR� 221 N id��(9;�RLAN CC P�� ACN 14101754 APPEAL BY DATE:02-13-2015 CAMP HILL PA 17011-3911 (See reverse side under Objections) Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE RETAIN LOWER PORTION FOR YOUR RECORDS (-- ------------------------------------------------------------------------------------------- REV-1548 EX AFP C11-14) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE: 12-15-2014 ESTATE OF:GARBACIK RAYMOND R DATE OF DEATH:02-08-2013 COUNTY:CUMBERLAND FILE NO. : 21 13-0194 S.S/D.C. NO. : ACN: 14101754 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: WESTERN NATIONAL LIFE ACCOUNT NO. : XXXX3674 TYPE OF ACCOUNT: ( )SAVINGS ( ) CHECKING ( )TRUST C )TIME CERTIFICATE DATE ESTABLISHED 02-08-2013 Account Balance 21,994.98 NOTE: TO ENSURE PROPER CREDIT TO Percent Taxable X 1 .000 YOUR ACCOUNT, SUBMIT THE Amount Subject to Tax 21,994.98 UPPER PORTION OF THIS NOTICE Debts and Deductions •00 WITH YOUR TAX PAYMENT TO THE Taxable Amount 21,994.98 REGISTER OF WILLS AT THE Tax Rate y .12 ABOVE ADDRESS. MAKE CHECK Tax Due 2,639.40 OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 05-08-2013 CDO17584 131 .97 2,507.43 TOTAL TAX PAYMENT 2,639.40 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. \�J SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. (v�1 PAYMENT: Detach the top portion of this notice and submit with your payment to the Register of Wills indicated on the front of the notice.Make check or money order payable to:Register of Wills,Agent. REFUND(CR): A refund of a tax credit not requested on the tax return may be requested by completing an Application for Refund of Pennsylvania Inheritance and Estate Tax(REV-1313). Applications are available at www.revenue_pa.gov or by calling 1-800-362-2050. Services for taxpayers with special hearing and/or speaking needs are available at 1-800-447-3020. Please allow four to six weeks from the date a refund was granted to receive the check. OBJECTIONS: Any party of interest not satisfied with the appraisment,allowance or disallowance of deductions,or assessment of tax as shown on this notice may object within 60 days of the date of receipt of this notice by: 1.Filing an appeal online at www.boardofappeals-state.pa.us on or before the appeal date identified on the front of this notice or sending a written protest to: PA Department of Revenue Board of Appeals PO BOX 281021 Harrisburg PA 17128-1021 2. Having the matter determined at audit of the account of the personal representative;or 3.Appealing to the Orphans'Court. ADMINISTRATIVE Errors discovered on this assessment should be addressed in writing to: CORRECTIONS: PA Department of Revenue Bureau of Individual Taxes Post Assessment Review Unit PO BOX 280601 Harrisburg PA 17128-0601 See instructions for Inheritance Tax Return for a Resident Decedent for details on an administrative correction. DISCOUNT: If any tax due is paid within three months after the decedent's death,a 5 percent discount of the tax paid is allowable. INTEREST: Interest is charged beginning nine months and one day from date of death,to the date of payment. An interest calculator is available at www.dorservices.state.pa.us. Annual interest rates can be found on form REV-1611. Any notice issued after the tax becomes delinquent will reflect an interest calculation to 15 days beyond the date of the assessment. If payment is made after the interest calculation date shown on the notice,additional interest must be calculated. BUREAU OFPAC"q p1�EFICE 4F' v NOTICE OF INHERITANCE TAX Pennsylvania INHERITANCE'TAX DIVISIO APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE PO BOX 28060 REV-1548 EX AFP (11-14) G�JSTIR OF WILLS OF DEDUCTIONS, AND ASSESSMENT OF TAX ON HARRISBURG P1 1 0601 p m JOINTLY HELD OR TRUST ASSETS 12 DATE ZUl `JL� 15 1 i 5� ESTATE OF GARBACIK14 RAYMOND R CLERK OF DATE OF DEATH 02-08-2013 FILE NUMBER 21 13-0194 ORPHANS CO{{��URT COUNTY CUMBERLAND RICUkbSE5L6-A`R• k," �`i SSN/DC ACN 14101755 221 N 17TH ST APPEAL BY DATE:02-13-2015 CAMP HILL PA 17011-3911 (See reverse side under Objections) Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE RETAIN LOWER PORTION FOR YOUR RECORDS 4-- REV-1548 EX AFP C11-14)-------------------------------------------------------------------- NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE: 12-15-2014 ESTATE OF:GARBACIK RAYMOND R DATE OF DEATH:02-08-2013 COUNTY:CUMBERLAND FILE NO. : 21 13-0194 S.S/D.C. NO. : ACN: 14101755 TAX RETURN WAS: (X) ACCEPTED AS FILED C ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: WESTERN NATIONAL LIFE ACCOUNT NO. : XXXX8458 TYPE OF ACCOUNT: ( )SAVINGS C ) CHECKING C )TRUST ( )TIME CERTIFICATE DATE ESTABLISHED 02-08-2013 Account Balance 24,529.70 NOTE: TO ENSURE PROPER CREDIT TO Percent Taxable X 1 .000 YOUR ACCOUNT, SUBMIT THE Amount Subject to Tax 24,529.70 UPPER PORTION OF THIS NOTICE Debts and Deductions - .00 WITH YOUR TAX PAYMENT TO THE Taxable Amount 24,529.70 REGISTER OF WILLS AT THE Tax Rate Y . 12 ABOVE ADDRESS. MAKE CHECK Tax Due 2,943.56 OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID C-) AMOUNT PAID 05-08-2013 CDO17584 131.97 2,507.43 INTEREST IS CHARGED THROUGH 12-23-2014 TOTAL TAX PAYMENT 2,639.40 AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 304.16 REVERSE SIDE OF THIS FORM INTEREST AND PEN. 10.23 TOTAL DUE 314.39 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. ., PAYMENT: Detach the top portion of this notice and submit with your payment to the Register of Wills indicated on the front of the notice.Make check or money order payable to:Register of Wills,Agent. REFUND(CR): A refund of a tax credit not requested on the tax return may be requested by completing an Application for Refund of Pennsylvania Inheritance and Estate Tax(REV-1313). Applications are available at www.revenue.pa.gov or by calling 1-800-362-2050. Services for taxpayers with special hearing and/or speaking needs are available at 1-800-447-3020. Please allow four to six weeks from the date a refund was granted to receive the check. OBJECTIONS: Any parry of interest not satisfied with the appraisment,allowance or disallowance of deductions,or assessment of tax as shown on this notice may object within 60 days of the date of receipt of this notice by: 1.Filing an appeal online at www.boardofappeals.state.pa.us on or before the appeal date identified on the front of this notice or sending a written protest to: PA Department of Revenue Board of Appeals PO BOX 281021 Harrisburg PA 17128-1021 2.Having the matter determined at audit of the account of the personal representative;or 3.Appealing to the Orphans'Court. ADMINISTRATIVE Errors discovered on this assessment should be addressed in writing to: CORRECTIONS: PA Department of Revenue Bureau of Individual Taxes Post Assessment Review Unit PO BOX 280601 Harrisburg PA 17128-0601 See instructions for Inheritance Tax Return for a Resident Decedent for details on an administrative correction. DISCOUNT: If any tax due is paid within three months after the decedent's death,a 5 percent discount of the tax paid is allowable. INTEREST: Interest is charged beginning nine months and one day from date of death,to the date of payment. An interest calculator is available at www.dorservices.state.oa.us. Annual interest rates can be found on form REV-1611. Any notice issued after the tax becomes delinquent will reflect an interest calculation to 15 days beyond the date of the assessment. If payment is made after the interest calculation date shown on the notice,additional interest must be calculated. pennsylvania BUREAU F ��jj��1.l}}��L �A NOTICE OF INHERITANCE TAX INHERITAI � �l11GiNOi tE OF APPRAISEMENT, ALLOWANCE OR DISALLOWANCE 17 DEPARTMENT OF REVENUE PO BOX 280AUOF WILLS t OF DEDUCTIONS, AND ASSESSMENT OF TAX ON REV-1548 EX AFP (11-14) HARRISBUR Yl JOINTLY HELD OR TRUST ASSETS 2014 OEC 1 5 PM 12 la DATE 12-15-2014 ESTATE OF GARBACIK RAYMOND R DATE OF DEATH 02-08-2013 CLERK OF FILE NUMBER 21 13-0194 ORPHANS' COURT COUNTY CUMBERLAND SSN/DC ** Rtt�ITR d lyC71R".PAq 1Kt% ACN 14101756 221 N 17TH ST APPEAL BY DATE:02-13-2015 CAMP HILL PA 17011-3911 (See reverse side under Objections) Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE RETAIN LOWER PORTION FOR YOUR RECORDS 4-- REV-1648 EX AFP (11-14)-------------------------------------------------------------------- NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE: 12-15-2014 ESTATE OF:GARBACIK RAYMOND R DATE OF DEATH:02-08-2013 COUNTY:CUMBERLAND FILE NO. : 21 13-0194 S.S/D.C. NO. : ACN: 14101756 TAX RETURN WAS: (X) ACCEPTED AS FILED C ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: M&T BANK ACCOUNT NO. : XXXXX809 TYPE OF ACCOUNT: ( )SAVINGS ( )0 CHECKING ( )TRUST ( )TIME CERTIFICATE DATE ESTABLISHED 02-08-2013 Account Balance 11,000.00 NOTE: TO ENSURE PROPER CREDIT TO Percent Taxable X 1 .000 YOUR ACCOUNT, SUBMIT THE Amount Subject to Tax 11,000.00 UPPER PORTION OF THIS NOTICE Debts and Deductions .00 WITH YOUR TAX PAYMENT TO THE Taxable Amount 11,000.00 REGISTER OF WILLS AT THE Tax Rate x .12 ABOVE ADDRESS. MAKE CHECK Tax Due 1 ,320.00 OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID C-) 05-08-2013 CDO17584 66.00 1,254.00 TOTAL TAX PAYMENT 1,320.00 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. V� t PAYMENT: Detach the top portion of this notice and submit with your payment to the Register of Wills indicated on the front of the notice.Make check or money order payable to:Register of Wills,Agent. REFUND(CR): A refund of a tax credit not requested on the tax return may be requested by completing an Application for Refund of Pennsylvania Inheritance and Estate Tax(REV-1313). Applications are available at www.revenue.pa.aov or by calling 1-800-362-2050. Services for taxpayers with special hearing and/or speaking needs are available at 1-800-447-3020. Please allow four to six weeks from the date a refund was granted to receive the check. OBJECTIONS: Any party of interest not satisfied with the appraisment,allowance or disallowance of deductions,or assessment of tax as shown on this notice may object within 60 days of the date of receipt of this notice by: 1.Filing an appeal online at www.boardofaooeals.state.pa.us on or before the appeal date identified on the front of this notice or sending a written protest to: PA Department of Revenue Board of Appeals PO BOX 281021 Harrisburg PA 1 71 28-1 021 2.Having the matter determined at audit of the account of the personal representative;or 3.Appealing to the Orphans'Court. ADMINISTRATIVE Errors discovered on this assessment should be addressed in writing to: CORRECTIONS: PA Department of Revenue Bureau of Individual Taxes Post Assessment Review Unit PO BOX 280601 Harrisburg PA 17128-0601 See instructions for Inheritance Tax Return for a Resident Decedent for details on an administrative correction. DISCOUNT: If any tax due is paid within three months after the decedent's death,a 5 percent discount of the tax paid is allowable. INTEREST: Interest is charged beginning nine months and one day from date of death,to the date of payment. An interest calculator is available at www.dorservices.state.oa.us. Annual interest rates can be found on form REV-1611. Any notice issued after the tax becomes delinquent will reflect an interest calculation to 15 days beyond the date of the assessment. If payment is made after the interest calculation date shown on the notice,additional interest must be calculated. Q"/ Pennsylvania BUREAU 0 l�+� t7p0[�$ OF.- NOTICE OF INHERITANCE TAX DEPARTMENT OF REVENUE INHER�I�Nca�19 IVV APPRAISEMENT, ALLOWANCE OR DISALLOWANCE PO BO 8KQ1 A SR691 )HILLS OF DEDUCTIONS, AND ASSESSMENT OF TAX ON REV-1548 EX AFP (11-14) HARRISBRE A JOINTLY HELD OR TRUST ASSETS 201 �L� is P-m 12 18 DATE 12-15-2014 11 ESTATE OF GARBACIK RAYMOND R DATE OF DEATH 02-08-2013 CLERK OF FILE NUMBER 21 13-0194 ORPHANS" COURT COUNTY CUMBERLAND SSN/DC 1 MR LAA QGAI'BAEPK ACN 14101757 1 N 17TH ST APPEAL BY DATE:02-13-2015 CAMP HILL P A 17011-3911 (See reverse side under Objections) Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE RETAIN LOWER PORTION FOR YOUR RECORDS 4- ------------------------------------------------------------------------------------------- REV-1548 EX AFP C11-14) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE: 12-15-2014 ESTATE OF:GARBACIK RAYMOND R DATE OF DEATH:02-08-2013 COUNTY:CUMBERLAND FILE NO. : 21 13-0194 S.S/D.C. NO. : ACN: 14101757 TAX RETURN WAS: (X) ACCEPTED AS FILED C ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: M&T BANK ACCOUNT NO. : XXXXX809 TYPE OF ACCOUNT: ( )SAVINGS ( X) CHECKING C )TRUST ( )TIME CERTIFICATE DATE ESTABLISHED 02-08-2013 Account Balance 974.80 NOTE: TO ENSURE PROPER CREDIT TO Percent Taxable X 1 .000 YOUR ACCOUNT, SUBMIT THE Amount Subject to Tax 974.80 UPPER PORTION OF THIS NOTICE Debts and Deductions - •00 WITH YOUR TAX PAYMENT TO THE Taxable Amount 974.80 REGISTER OF WILLS AT THE Tax Rate x .12 ABOVE ADDRESS. MAKE CHECK Tax Due 116.98 OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID C-) AMOUNT PAID 05-08-2013 CDO17584 5.85 111 . 13 TOTAL TAX PAYMENT 116.98 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. PAYMENT: Detach the top portion of this notice and submit with your payment to the Register of Wills indicated on the front of the notice.Make check or money order payable to:Register of Wills,Agent. REFUND(CR): A refund of a tax credit not requested on the tax return may be requested by completing an Application for Refund of Pennsylvania Inheritance and Estate Tax(REV-1313). Applications are available at www.revenue.oa.00v or by calling 1-800-362-2050. Services for taxpayers with special hearing and/or speaking needs are available at 1-800-447-3020. Please allow four to six weeks from the date a refund was granted to receive the check. OBJECTIONS: Any party of interest not satisfied with the appraisment,allowance or disallowance of deductions,or assessment of tax as shown on this notice may object within 60 days of the date of receipt of this notice by: 1. Filing an appeal online at www.boardofappeals.state.pa.us on or before the appeal date identified on the front of this notice or sending a written protest to: PA Department of Revenue Board of Appeals PO BOX 281021 Harrisburg PA 17128-1021 2. Having the matter determined at audit of the account of the personal representative;or 3.Appealing to the Orphans'Court. ADMINISTRATIVE Errors discovered on this assessment should be addressed in writing to: CORRECTIONS: PA Department of Revenue Bureau of Individual Taxes Post Assessment Review Unit PO BOX 280601 Harrisburg PA 17128-0601 See instructions for Inheritance Tax Return for a Resident Decedent for details on an administrative correction. DISCOUNT: If any tax due is paid within three months after the decedent's death,a 5 percent discount of the tax paid is allowable. INTEREST: Interest is charged beginning nine months and one day from date of death,to the date of payment. An interest calculator is available at www.dorservices.state.pa.us. Annual interest rates can be found on form REV-1611. Any notice issued after the tax becomes delinquent will reflect an interest calculation to 15 days beyond the date of the assessment. If payment is made after the interest calculation date shown on the notice,additional interest must be calculated.