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Home My WebLink About04-03-06 .COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 INFORMATION NOTICE AND TAXPAYER RESPONSE FILE NO. ACN DATE 21 rO~/ DJ Vii 06111817 03-15-2006 REY-1545 EX AFP 109-001 ......:' ',. J I EST. OF FRANK BLAHA S.S. NO. 126-30-1600 DATE OF DEATH 03-28-2005 COUNTY CUMBERLAND TYPE OF ACCOUNT D SAVINGS [X] CHECKING D TRUST D CERTIF. (.... \ ROSE BROWN 9 ASHBURG DR MECHANICSBURG PA 17050 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 SOVEREIGN BANK has provid..d th.. Department with th.. information listed b..low which has been used in calculating the pot..ntial tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of this account. If you f....l this information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordanc.. with the Inheritance Tax Laws of the Commonwealth of Pennsylvani~. Questions may be answered by calling (717) 787-8327. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 2891041259 Date 06-02-2000 Established x 4,567.76 16.667 761.31 .15 114.20 TAXPAYER RESPONSE To insure proper credit to your account, two (2) copies of this notice must accompany your payment to the Register of Wills. Make check payable to: "Register of Wills, Agent". Account Balance Percent Taxable Amount Subject to Tax Rate Potential Tax Due x NOTE: If tax payments are made within thre.. (3) months of the decedent.s date of death, you may deduct a 5Z discount of the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. Tax PART [!] A. [ CHECK ] ONE BLOCK B. ONLY c. [] The above information and tax due is correct. 1. You may choose to remit paym..nt to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or you may check box "An and return this notice to th.. Register of Wills and an official assessment will be issued by the PA Department of Revenue. [] The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return - 7 be filed by the decedent.s representative. ~ The above information is incorrect and/or debts and deductions were paid by you. You must complet.. PART ~ and/or PART ~ below. x ON JOINT/TRUST ACCOUNTS '-"2- 20CO '-fS'b 1.7(, 1(... ~(" '1 7{.1 . 3 \ If/D. (,'1 ~O . ~ 7..- IS'" 8,.oQ DEBTS AND DEDUCTIONS CLAIMED If you indicate a different tax rate, please state your relationship to decedent: PART [!1 TAX RETURN - COMPUTATION LINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due TAX OF 1 2 3 4 5 6 7 8 x PART [!] PAYEE DESCRIPTION I\:l AMOUNT PAID I ~ - TOTAL (Enter on Line 5 of Tax Computation) $ of perjury, I declare that the facts I have reported above are true, correct and of lIyknowledge and belief. HOME (111) t~O~IC\G.(" WORK ( ) T, :i1 r- &11..... r-n :31 ..~ "0" 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 BROWN ROSE 9 ASHBURG DRIVE MECHANICSBURG, PA 17050 -----~-- fold ESTATE INFORMATION: SSN: 126-30-1600 FILE NUMBER: 2106-0297 DECEDENT NAME: BLAHA FRANK DA TE OF PAYMENT: 04/03/2006 POSTMARK DATE: 03/31/2006 COUNTY: CUMBERLAND DATE OF DEATH: 03/28/2005 NO. CD 006514 ACN ASSESSMENT CONTROL NUMBER AMOUNT 06111817 I $87.09 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: ROSE BROWN CHECK# 2836 SEAL INITIALS: CM RECEIVED BY: REGISTER OF WILLS $87.09 GLENDA FARNER STRASBAUGH REGISTER OF WILLS F) r I ,..... "'" r- rf-u l:-' I"", 10 - I........, I" '\ "",v- f I 'COMMONWEALTH OF PENNSYLVANIA OEPARTMENT OF REVENUE BUREAU OF INOIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 '* INFORMATION NOTICE - AND TAXPAYER RESPONSE F:ILE NO. I~CN DATE 21-' (Ilv._ D}q 1 06111815 03-15-2006 REY-1545 EX lFP (09-00) r, ,.', ..,I ;; ^: <j i EST. OF FRANK BLAHA 5.5. NO. 126-30-1600 DATE OF DEATH 03-28-2005 COUNTY CUMBERLAND TYPE OF ACCOUNT o SAVINGS [i] CHECKING o TRUST o CERTIF. ROSE BROWN 9 ASHBURG DR MECHANICSBURG PA 17050 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 SOVEREIGN BANK has provided the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of this account. If you feel this information is incorrect, please obtain written correction froll the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth of Ponn~~lvania. Quasticn~ may be answerod by calling {117) 7~,-8~~7. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 2891024877 Date 06-02-2000 Established Account Balance Percent Taxable Amount Subject to Tax Rate Potential Tax Due x 7,015.74 16.667 1.169.31 .15 175.40 TAXPAYER RESPONSE To insure proper credit to your account, two (2) copies of this notice must accompany your payment to the Register of Wills. Make check payable to: "Register of Wills, Agent". x NOTE: If tax payments are made within three (3) months of the decedent's date of death, you may deduct a 5Z discount of the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. Tax PART [!] he above information and tax due is correct. 1. You may choose to remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or yoU may check box "A" and return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. [CHECK ] ONE BLOCK ONLY B. [] The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return -- ~ be filed by the decedent's representative. C. ~ The above information is incorrect and/or debts and deductions were paid by you. You must complete PART ~ and/or PART ~ below. x ON JOINT/TRUST ACCOUNTS G>- Z. - ~oo IbiS .ILI I C# . (~fD'{ I l (D 'I ' 31 \3"SO..C'D 0,00 IS D,DD DEBTS AND DEDUCTIONS CLAIMED If you indicate a different tax rate, please state your relationship to decedent: PART @] TAX RETURN - COMPUTATION LINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due OF 1 2 3 4 5 6 7 8 x TAX PART ~ PAYEE DESCRIPTION PAID TOTAL (Enter on Line 5 of Tax Computation) $ ~ of perjury, I declare that the facts I have reported above are true, correct and of knowledge and belief. HOME (, Ii) ., q 0 ~ I S ~& WORK ( ) .3 ,.. 30 ;o(Jf& - - - .."t ~ ~ - r~., - M 'If ~ ~ 0 iIf, '3. LL' f-. l.i. ~(". ~ ~ ~...i ~ (V) tL ~ ~ f~ , ~ C1J Cl -0 0 .,'!\ \' Ui 0( 'V\ ~ - ,-./ ~ f ~ ;i, - i.t ~ ~:( (T-; ~ J "'.... ~ s:-~ ~~ ~ & ITI ~ I') ~ j') '. C '.. -t ~ ,..) - ,.-1 I.... .~ '"'I ~w ....., ~ V\ ,.... '- ~- ,,.., ~ E '-C ~. J \5 '--J a '^.. a 1 rr \' ~~ - .-t -. c D.~ 1 ~, e "O>~: CD ~ '.... . ...t:\ ~ , ~ ~ ~~~ cl..~ ~. , i j j '(IV I' .'0' '....,') L {; ../ '.r i . \...~ ; 17 '0