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HomeMy WebLinkAbout09-03-10BUREAU OF INDIVIDUAL TAXES. ~;~" 'INHERITANCE TAX INHERITANCE TAX DIVISION - ,.5 TAT E M E N T O F A C C O U N T PO BOX 280601 - HARRISBURG PA 17128-0601 {,{ , , ,- _ Jt~..~1i '~,~1 1/r- WILLIAM M SU~E`B'ERGER' ``'` ''~' 1311 WOODWARD DR CARLISLE PA 17013 Pennsylvania ~ r DEPARTMENT OF REVENUE REV-160i' EX AFP C12-09) ? DATE 08-30-2010 ESTATE OF SHUFFLEBARGER MARTHA J DATE OF DEATH 09-04-2009 FILE NUMBER 21 09-0860 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 X1607 SEX AFP C12 09~~~~~ ~ *** INHERITANCE TAX STATEMENT~OF ACCOUNT ~~~** ~~~~~~~~~~~~~~~~~~~~~ ESTATE OF:SHUFFLEBARGER MARTHA J FILE NO.: 21 09-0860 ACN: 101 DATE: 08-30-2010 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: 08-09-2010 PRINCIPAL TAX DUE: 15,b70.71 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID C-) 10-28-2009 CD011907 783.54 17,000.00 08-13-2010 REFUND .00 2,112.83- TOTAL TAX PAYMENT ~ 15,670.71 BALANCE OF TAX DUET .00 INTEREST AND PEN. ~ .00 TOTAL DUE * IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. .00 FT`n