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HomeMy WebLinkAbout06-20-11__- . ennsylvania • DEPARTMENT OF REVENUE ~._.._! ~'~'~ ' ~"' NHERITANCE TAX REV-1607 EX AFP clz-log C~F~~~rC' c~I~~=aU~ t BUREAU OF INDIVIDUAL TAX ~.,,;'~.,`,..G..r., ~ ,+' INHERITANCE TAX DIVISION r~.~#€~,~;L~.. ~ ~~- `~~~~-TEMENT OF ACCOUN ~'~' -` PO BOX 280601 HARRISBURG PA 17128-0601 DATE 0 6 - 0 6 - 2 011 CI.ER~ 4~ o~~.~ s couR1 GREGORY S CH~-U-~'~'D ~i~.,t~,`: 6TH FLR 17 S 2ND ST HBG PA 17101 PINTI ROSA ESTATE OF DATE OF DEATH 02-12-2010 FILE NUMBER 21 10-0178 COUNTY CUMBERLAND ACN 101 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 our account, submit the upper Portion of this form with your tax payment. NOTE: To ensure proper credit to Y RETAIN LOWER PORTION FOR YOUR R ACCOUNT THIS LINE ~ :.......................... STATEMENT~OF..................................... CUT ALONG *** INHERITANCE TAX REV X1607 SEX AFP C12 10) ~~~ DATE: 06-Ob-2011 21 10-0178 ACN: 101 ROSA FILE NO.: ESTATE OF:PINTI OF THE STATED ACN IN THE NAMED ESTATLE,BALPROJECTED INTEREST FIGUREINCIP THIS STATEMENT PROVIDES CURRENT STATUS .,.., .,~ ei i PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICA TAX DUE, APrul~H~ ~~~~ ~~ ~-- OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 05-16-2011 DATE 45,962.00 PRINCIPAL TAX DUE: PAYMENTS CTAX CREDITS): RECEIPT DISCOUNT C+) PAYMENT NUMBER INTEREST/PEN PAID C-~ DATE 1,052.63 05-12-2010 CD012739 1,245.47 05-12-2010 CD012740 ,00 05-18-2011 REFUND AMOUNT PAID 20,000.00 30,000.00 6,336.10- 45,962.00 TOTAL TAX PAYMENT BALANCE OF TAX DUE INTEREST AND PEN. .00 .00 TOTAL DUE ~ .00 PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATgENDUE ADREFUNDALSEETREVERSE SIDE OF THIS FORM * IF IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MA FOR INSTRUCTIONS.