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HomeMy WebLinkAbout06-20-11 (3)BNHERITANCE TAX DIVISION TAXES PO BOX 280601 HARRISBURG PA 17128-0601 ~~ TANCE TAX ~~~~"`~-`!~.~~. T OF ACCOUNT e~ t ~.~ , ; ~. ~.. i ~ `CLERK ~~ URT ~~Pf`S ~~ NORMAN C BAILE~~~~=`~ ~~., PA 31 HICKORY ROAD PA 19540 MOHNTON ~~,___. pennsylvan~a ~~~$ • ~= DEPARTMENT OF REVENUE REV-1607 EX AFP C12-10) DATE 06-13-2011 NICOLE M ESTATE OF BAILEY DATE OF DEATH 06-•11-2010 FILE NUMBER 21 10-0672 COUNTY CUMBERLAND ACN 11001804 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQ70R3 CARLISLE PA ccount, submit the upper portion of this form with your tax payment. NOTE: To ensure proper credit to your a RETAIN LOWER PORTION FOR YOUR R ACCOUNT LINE ~'~' ......................... TEMENT~OF ..................................... CUT ALONG THIS *** INHERITANCE TAX STA REV X1607 SEX AFP C12 10~ ~~~~~~~~• 21 10-0672 ACN: 11001804 DATE: 06-13-2011 .~Trn~ F M FILE NO • : ~, ,,,., rc a SUMMARY •F THE PRINCIPAL ESTATE OF:BAILEY IS STATEMENT PROVIDES CURRENT STATUS OF THE STATED ACN IN THE NAM - H TS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FI T ~,..,.~ nr el I_ rAYMEN TAX DUE, APPLtcv~il~^ ~' "-- AST ASSESSMENT OR RECORD ADJUSTMENT: 04-18-2011 DATE OF L 720.00 PRINCIPAL TAX DUE: PAYMENTS CTAX CREDITS: PAYMENT DATE 05-06-2011 06-10-2011 RECEIPT NUMBER CD014438 SBADJUST DISCOUNT t+) AMOUNT PAID INTEREST/PEN PAID C-~ --- 3.13- 723.13 .18 .00 720.00 TOTAL TAX PAYMENT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. __ TOTAL DUE .00 TER THIS DATE, SEE REVERSE SIDE FOR CALCULATIDNDUE ADREFUNDALSEETREVERSE SIDE OF THIS FORM * IF PAID AF IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY B FOR INSTRUCTIONS.