HomeMy WebLinkAbout01-08-10BUREAU OF INDIVIDUAL TAXES t ~~ ~ ~-~E~'ITAN~E TAX
INHERITANCE TAX DIVISION - '
Po BOX 280601 i ~ V~TAT'~M~NT OF ACCOUNT
HARRISBURG PA 17128-0601
2010 JAS -8 PM 1 ~ ! 3
ORPHr~N S. ~~ ~~RT, A
ELIZABETH J GOLDSTr°~ ~' ~''C~ ~ C
SUITE 202
355 N 21ST STREET
CAMP HILL PA 17011
Pennsylvania ~
DEPARTMENT OF REVENUE
REV-1607 EX AFP (12-09)
DATE 12-28-2009
ESTATE OF GOTTSHALL G A
DATE OF DEATH 03-07-2008
FILE NUMBER 21 08-0311
COUNTY CUMBERLAND
ACN 101
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To ensure 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 AF=P C12 09~ ~ ~~ ~*° INHE~t~I~A1fCE TAX S'~AT~EMENT~OF ACCOUNT ~~~ ~~~~~~~~~~~~~"""'
ESTATE OF:GOTTSHALL G A FILE NO.: 21 08-0311 ACN: 101 DATE: 12-28-2009
THIS STATEMENT PROVIDES CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. 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: 11-09-2009
PRINCIPAL TAX DUE:
»_:
PAYMENTS (TAX CREDITS):
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID (-)
AMOUNT PAID
06-02-2008 CD009820 289.47 5,500.00
06-05-2009 CD011324 .00 6,478.48
12-02-2009 CD012066 168.75- 177.75
12-25-2009 SBADJUST 00
. .O1
TOTAL TAX PAYMENT 12,276.95
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 REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM
FOR INSTRUCTIONS.