HomeMy WebLinkAbout06-20-11 (2)_____
ennsylvania •
r ~ DEPARTMENT OF REVENUE t
REV-
~~Cj~;~"',~,t~L t.!~~~~~ ~i TAX 1607 EX AFP (12-10)
,. „ ~~ ~„w ,,.,~~ ~ ~, INHERITANCE
BUHERI ANCE ~ ni IS ION TAx~"~ ~ ~~' ,`;` `~'ct.~.~ATEMENT OF ACCOUNT
IN
PO BOX 280601
HARRISBURG PA 17128-0601 ~~: ~ ~~~ a ~. ~t . DATE 06-06-2011 W
i".~} ~ , ~~ ~~ ~'~ ~~~ ~jl~ BROTHERS JR CLARK
F
C~.~RlC QF
4RPN~AN S C~~R ~A.
DARYL CHRISTOPHER
4503 N FRONT ST PA 17105
HARRISBURG
ESTATE O
DATE OF DEATH 10-16-2004
FILE NUMBER 21 06-0052
COUNTY CUMBERLAND
501
ACN
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
ount, submit the upper portion of this form with your tax Payment.
our acc
NOTE: To ensure proper credit to Y
RETAIN LOWER PORTION FOR YOUR R ACCOUNT
NE ~"` ....................... TEMENT~OF'••• .................................
CUT ALONG THIS LI *** INHERITANCE TAX STA
REV X1607 SEX AFP C12 10~ ~~~~~~~•^•^
501 DATE: 06-06-2011
~~~Q~ W FILE NO.:21 06-0052 ACN:
„~~nw rc o SUMMARY •F THE PRINCIPAL
ESTATE OF:BROTHEKS arc
S THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST
IS STATEMENT PROVIDES CURRENT STTTUS OF THE STATED ACN IN THE NA
TH _,,,, nr ei ~ rAYMEN
7AX DUE, APPLICA~IVry ~' ^"
AST ASSESSMENT OR RECORD ADJUSTMENT: 05-31-2011
DATE OF L 324.00
PRINCIPAL TAX DUE:
PAYMENTS tTAX CREDITS):
PAYMENT
DATE
03-30-2011
DISCOUNT C+) AMOUNT PAID
INTEREST/PEN PAID t-)
.00 324.00
RECEIPT
NUMBER
CD014227
~- 324.00
TOTAL T.AX PAYMENT
BALANCE OF TAX DUE
.00
INTEREST AND PEN.
AL DUE .00
TER THIS DATE, SEE REVERSE SIDE FOR CALCULATIONDUE ADREFUNDALSEET REVERSE SIDE OF THIS FORM
* IF PAID AF
IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY B
FOR INSTRUCTIONS.