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HomeMy WebLinkAbout04-27-11BUREAU of INDIVIDUAI{~~pXr,~~~ ;, INHERITANCE TAX INHERITANCE TAX DIVISION ~~- ~~' Po Box zaocol t "~ ~ c` STATEMENT OF ACCOUNT HARRISBURG PA 17128-0601 _ - ~ ' CLEPK CF P~r"i~~ ~' r.ni nT ,R, i J 'v.li.,lfl l WM D SCHI~(~ns(EP~T-`„ a ~,, PA 124 W HARRISBURG ST DILLSBURG PA 17019 Pennsylvania i DEPARTMENT OF REVENUE - REV-1607 EX AFP (12-10) DATE 04-11-2011 ESTATE OF SHIVELY DAVID G DATE OF DEATH 05-19-2010 FILE NUMBER 21 10-0537 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 EX AFP C12-10) *** INHERITANCE TAX STATEMENT OF ACCOUNT *** ESTATE OF:SHIVELY DAVID G FILE NO.: 21 10-0537 ACN: 101 DATE: 04-11-2011 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: 03-21-2011 PRINCIPAL TAX DUE: 28,672.93 PAYMENTS CTAX CREDITS): PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID C-) 08-02-2010 CD013164 1,433.65 28,500.00 03-24-2011 REFUND .00 1,260.72- TOTAL TAX PAYMENT ~ 28,672.93 BALANCE OF TAX DUET .00 INTEREST AND PEN. I .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" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ~~