HomeMy WebLinkAbout02-19-10• • :~~H~R_~TANCE TAX
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION S T AT E M EIV T O F ACC 0 U N T
PU BUX 2606;1 " ~ ._
HARRISBURG PA L77?'B-0601
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225 NORTH MAIN ST
SHENANDOAH PA 17976
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DEPARTMENT OF REVENUE
REV-1607 EX AFP C12-09)
DATE 02-16-2010
ESTATE OF ROZENBURCH EUGENE
DATE OF DEATH 04-16-2008
FILE NUMBER 21 08-0559
COUNTY CUMBERLAND
ACN 101
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
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 SEX AFP (12 09 ~~ ~ ~** INHERITANCE TAX STATEMENT~OF ACCOUNT ~~~** ~~~ ~~ ~ ~~~~~~~• •
ESTATE OF:ROZENBURCH EUGENE FILE NO.: 21 08-0559 ACN: 101 DATE: 02-1b-2010
TAXSDUEATAPPLICATOONDOF ALLRPAYMENTS~,STHE CURRENTTBALANCEINANDE IFMAPPLICABEE,BALPROJECTED INTEREST FIGUREINCIPAL
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 02-09-2010
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?'RING; ~ ~L TAX DUE: '-
PAYMENTS (TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
TOTAL TAX PAYMENT .DO
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. l
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM ~
FOR INSTRUCTIONS. +~