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BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 2B0601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE 'INHERITANCE TAX STATEMENT OF ACCOUNT REV-1607 EX AFP (03-05) fES -8 II: ! ..." DATE ,} J ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 01-22-2008 KELLER 03-06-2005 99 07-0530 NON-RESIDENT 101 ROBERT L SUSAN H CONFAIR ESQ 2331 MARKET ST CAMP HILL PA 17011 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 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 +- REV-1607 EX AFP (03-05) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - *** INHERITANCE TAX STATEMENT OF ACCOUNT *** ESTATE OF KELLER ROBERT L FILE NO. 99 07-0530 ACN 101 DATE 01-22-2008 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: 10-15-2007 PRINCIPAL TAX DUE: 7,621.32 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 06-07-2007 CD008262 816.56- 8,437.88 10-31-2007 NR010109 7.36- 7.36 TOTAL TAX CREDIT 7,621.32 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN tl, 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. ) PAYMENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address printed on the reverse side. If payment if for a RESIDENT DECEDENT. make check or money order payable to: Register of Wills, Agent If payment if for a NON-RESIDENT DECEDENT. make check or money order payable to: Commonwealth of Pennsylvania Failure to pay the tax. interest. and penalty due may result in the filing of a lien of record in the appropriate county, or the issuance of an Orphan's Court citation. REFUND (CR): A refund of a tax credit. which was 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 online at www.revenue.state.Da.us. any Register of Wills or Revenue District Office, or from the Department's 24-hour answering service for forms orders: 1-800-362-2050; services for taxpayers with special hearing and/or speaking needs: 1-800-447-3020 (TT onlY). REPLY TO: Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue. Bureau of Individual Taxes. ATTN: Post Assessment Review Unit. P.O. Box 280601. Harrisburg, PA 17128-0601, phone (717) 787-6505. DISCOUNT: If any tax due is paid within three (3) calendar months after the decedent's death. a five percent (5%) discount of the tax paid is allowed. PENALTY: The 15% tax amnesty non-participation penalty is computed on the total of the tax and interest assessed. and not paid before JanuarY 18. 1996. the first day after the end of the tax amnesty period. INTEREST: Interest is charged beginning with first day of delinquency. or nine (9) months and one (1) day from the date of death. to the date of payment. Taxes which became delinquent before January 1. 1982 bear interest at the rate of six (6%) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1. 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. Rates for years 1982 through 1999 can be found in the Pennsylvania Resident Instruction Booklet, (REV-1501), the Pennsylvania Non-resident Instruction Booklet(REV-1736) or on the Pennsylvania Dept. of Revenue web site www.revenue.state.pa.us. The applicable interest rates for 2000 through 2008 are: Interest Daily Interest Daily Interest Da ilY Year Rate Factor Year Rate Factor Year Rate Factor 2000 8% .000219 2001 9% .000247 2002 6% .000164 2003 5% .000137 2004 4% .000110 2005 5% .000137 2006 7% .000192 2007 8% .000219 2008 7% .000192 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice. additional interest must be calculated. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES PO BOX 280601 HARRISBURG, PA 17128-0601 . ----, .', I ,"" 'PENNSYLVANIA INHER[r4NCE AND ESTATE TAX OFFICIAL RECEIPT 'inn" r.-'-r, I"'I.~ j,\ '1: 1 " LU,."~ 1- C:' -0 N;d.' NRb1 01 09 RECEIVED FROM: SUSAN H CONFAIR ESQ 2331 MARKET ST CAMP HILL PA 17011 ESTATE INFORMATION FILE NUMBER 99 07-0530 NAME OF DECEDENT (l.AST) KELL.ER DATE OF PAYMENT POSTMARK DATE COUNTY Non-Resident DATE OF DEATH REMARKS FL SEAL ACN ASSESSMENT CONTROL NUMBER 101 (FIRST) ROBERT (MI) L 1/3/2008 10/31/2007 3/6/2005 TOTAL AMOUNT PAID RECEIVED BY COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE Register AMOUNT 7.36 $7.36 John M. Riedman