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BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 2B0601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
P""('(':O"JT, !~:~fR!..~ENT OF REVENUE
. ,t,.. ,1.'_'-' >;_tl.~,~~RITANCE TAX
"S~AT:EMENT OF ACCOUNT
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REV-1607 EX AFP (03-05)
2007 DEe ~5 PH 12: 34
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DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
11-19-2007
HELLER
03-19-2007
21 07-0305
CUMBERLAND
07120180
GLENROY
G
ROGER G HELLER
685 N MIDDLESEX RD
CARLISLE PA 17015
Amount Remitted
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
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-+
RETAIN LOWER PORTION FOR YOUR RECORDS
+-
REV-1607 EX AFP (03-05)
*** INHERITANCE TAX STATEMENT OF ACCOUNT ***
ESTATE OF HELLER
GLENROY
G FILE NO. 21 07-0305
ACN 07120180 DATE 11-19-2007
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: 11-05-2007
PRINCIPAL TAX DUE: 301.54
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
10-15-2007 CD008808 .00 301.54
TOTAL TAX CREDIT 301.54
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
II IF PAID AFTER THIS DATE. SEE REVERSE TOTAL DUE .00
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR).
YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
4
( IF TOTAL DUE IS LESS THAN $1.
NO PAYMENT IS REQUIRED.