HomeMy WebLinkAbout01-03-11i;~.,
~~~.;~ ~,~~, ~ ,~ Pennsylvania ~~
~~~~'~ .~~~' •-~~~'~" ~"'" INHERITANCE TAX DEPARTMENT OF REVENUE
BUREAU DF INDIVIDUAL T ~'+4'• + • ~ F .: ;~,+~I ~ {~ REV-1607 EX AFP c12-10)
INHERITANCE TAX DIVISION '~-'t~ ~~ ~-~+ ~.'~ 4~~_.~.$TATEMENT OF ACCOUNT
PO BOX 280601
HARRISBURG PA 17128-0601
t,•~ ~ ~ •.~.: ~ _ ~: ~ c.,,F M Y .~ DATE
~~~~ E f~,i ~ ~~ 12-27-2010
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JOHN C OXZUSTOWICZ ...,~ 'Y ~~ ~~ ~ ~ "
104 S HANOVER ST
CARLISLE PA 17013
ESTATE OF DAVIDSON PATRICIA K
DATE OF DEATH 01-12-2010
FILE NUMBER 21 10-0269
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~ACC~UFIT~~*** ~~~ ~ ~~~ ~ ~~~~~~~~
ESTATE OF:DAVIDSON PATRICIA K FILE NO.: 21 10-0269 ACN: 101 DATE: 12-27-2010
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:
16,935.18
PAYMENTS tTAX CREDITS):
PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID C-~
04-12-2010 CD012596 842.11 16,000.00
09-10-2010 CD013336 .00 93.10
11-30-2010 CD013720 .00 174.17
TOTAL TAX PAYMENT 17,109.38
BALANCE OF TAX DUE 174.20CR
INTEREST AND PEN. .00
TOTAL DUE I
174.20CR
* 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.