HomeMy WebLinkAbout12-27-10BUREAU OF INDIVIDUAL TA ~{~ ~~ 'NHERITANCE TAX
INHERITANCE TAX DIVISION ~~~~~~`" ,;, ,. , ~~~ATEMENT OF ACCOUNT
PO BOX 280601 [~`(~_~~~~ ..:'~ ;~ s g~ ,~
HARRISBURG PA 17128-0601 ..,.
~~~` ~\ ~~~~~T
SAMUEL L AND ,~~~ C~.. P~,~:
525 N 12TH S~~~
LEMOYNE PA 17043
~ r ~ ~F
pennsyLvan~a ~:~~ ~ s
DEPARTMENT OF REVENUE
REV-1607 EX AFP C12-10)
DATE 12-20-2010
ESTATE OF ANSEL SR ROBERT M
DATE OF DEATH 08-12-2009
FILE NUMBER 21 09-0827
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 10~ ~~~~~ *** INHERITANCE TAX STATEMENT~OF ACCOUNT ~~*** ~'~ ~~~~~
ESTATE OF:ANSEL SR ROBERT M FILE NO.: 21 09-0827 ACN: 101 DATE: 12-20-2010
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: 11-08-2010
PRINCIPAL TAX DUE:
11,789.05
PAYMENTS tTAX CREDITS):
PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
10-27-2009 CD011903 589.45 12,000.00
12-02-2010 REFUND .00 800.40-
TOTAL TAX PAYMENT I 11,789.05
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.
P~