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HomeMy WebLinkAbout06-20-11BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 r r ~ l~.#' ' j'~~~,~~'r~;.~~~ f/~[[1~"/j~NCE TAX .. ~,,,` r...._. r.. ~. i ~~~~,~~;~~;~~~. v OF ACCOUNT CLER#t CQ~RT QRP1~A~['~ C ~i:l~ii~E:~I.D C~~~. , PA= . BRIDGET L BAILEY 31 HICKORY ROAD PA 19540 MOHNTON pennsylvan~a ~ • ; DEPARTMENT OF REVENUE REV-1607 EX AFP C12-10) DATE 06-13-2011 BAILEY NICOLE M ESTATE OF DATE OF DEATH 06-11-2010 FILE NUMBER 21 10-0672 COUNTY CUMBERLAND ACN 11001806 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 ccount, submit the upper Portion of this form with your tax payment. NOTE: To ensure proper credit to your a YOUR RECORDS ~ LINE ~ RETAIN LOWER PORTION FOR *** .........................ATEMENT~OF ACCOUNT '......................... CUT ALONG THIS *** INHERITANCE TAX ST REV X1607 SEX AFP C 12 10) ~~~~ ~~~ N0.:21 10-0672 ACN: 11001806 DATE: 06-13-2011 -~rrfll F M FILE .,~, ,,,., Te a SUMMARY •F THE PRINCIPAL ESTATE OF:BAILEY IS STATEMENT PROVIDES CURRENT STATUS OF THE STATED ACN IN THE NAME - H TS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FI T ~~.,.~ nc el L rAYMEN TAX DUE, APPLI~A~ l~~` "' "-- LAST ASSESSMENT OR RECORD ADJUSTMENT: 04-18-2011 DATE OF 342.00 PRINCIPAL TAX DUE: PAYMENTS CTAX CREDITS): PAYMENT DATE 05-06-2011 06-10-2011 RECEIPT NUMBER CD014437 SBADJUST DISCOUNT C+) AMOUNT PAID INTEREST/PEN PAID C-) 1.49_ 343.49 .08 .00 ~- 342.00 TOTAL TAX PAYMENT ----' . 0 0 BALANCE OF TAX DUE ----- . 0 0 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 BE FOR INSTRUCTIONS.