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BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO lOX 2BO'01
HARRISBURG PA 1712B-0'01
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
r"rirINHERITANCE TAX
'::'rtt~tEMENT OF ACCOUNT
'*
REV-l'D7 EX AFP (03-05)
BRADLEY L GRIFFIE
GRIFFIE & ASSOCS
200 N HANOVER ST
CARLISLE
CLERi< OF
O"'P'H. " t, \,0 ,'(II IR,T
.h, JJ.',l\J \.) j~,"\j"..' 1\
CtJI/F"T
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
06-05-2007
HEBERLIG
06-02-2006
21 06-0556
CUMBERLAND
101
BETTY
T
2001 JUN II PM 2: GO
Amount Remitted
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
~
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REV-1607 EX AFP (03-05)
*** INHERITANCE TAX STATEMENT OF ACCOUNT ***
ESTATE OF HEBERLIG
BETTY
T FILE NO.21 06-0556
ACN 101
DATE 06-05-2007
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: 04-16-2007
PRINCIPAL TAX DUE: 3,453.86
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
09-01-2006 CDoo7169 168.42 3,200.00
02-01-2007 CDoo7765 .00 76.39
05-18-2007 CDo08183 .13- 9.18
06-01-2007 SBADJUST .00 .02
TOTAL TAX CREDIT 3,453.86
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00
II
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. )
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