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HomeMy WebLinkAbout08-01-05 STELLA J PLACZEK 2100 BENK CREEK BLVD MECHANICSBURG PA 17050-1835 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE P~COt\i~~ Q;~~"''fTANCE TAX APP~i$E~~~'Al~~A~E OR DISAllDWANCE OF DED.rC1'tllNS / 'AND ~ASSESSI1ENT DF TAX ON ~ JOINTlY HELD OR TRUST ASSETS 2005 WG -I Pfl12: DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ~SSN/DC ACN '* BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BDX 280601 HARRISBURG PA 17128-0601 REY-1548 EX AFP (06-05) CLE:Ci\ O,DD~.'" I'"~ ,:, " CU" ~ 08-01-2005 AUGUSTYN 03-18-2005 21 05-0596 CUMBERLAND 129-07-7909 05128242 APPEAL DATE: 09-30-2005 (See reverse side under Objections) Amount ReRittedl I MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 TEDDY CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ..... REY=is4S-EX-AFP-r03=Osi-------------------------------------------------------------------- NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 08-01-2005 ESTATE OF AUGUSTYN TEDDY DATE OF DEATH 03-18-2005 COUNTY CUMBERLAND FILE NO. 21 05-0596 TAX RETURN WAS: S.S/D.C. NO. 129-07-7909 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 05128242 FINANCIAL INSTITUTION: SUSQUEHANNA BANK PA ACCOUNT NO. 1046504906 TYPE OF ACCOUNT: ()SAVINGS ex) CHECKING (>TRUST ()TIME CERTIFICATE DATE ESTABLISHED 07-13-1998 Account Balance Percent Taxable X Amount Subject to Tex Debts and Deductions Taxable Amount Tax Rate X Tax Due 17,822.33 0.166 2,970.45 .00 2,970.45 .15 445.57 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 DR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: ~. PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) PAYMENT MUST BE MADE BY 12-19-2005~. TOTAL TAX CREDIT .00 BALANCE OF TAX DUE 445.57 INTEREST AND PEN. .00 TOTAL DUE 445.57 IF PAID AFTER THIS DATE, SEE REVERSE 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 OUE A REFUND. ~~E DEU~~~ ~TnF OF THIS FORM FOR INSTRUCTIONS. )