HomeMy WebLinkAbout08-16-117 _„-
~~-..
BUREAU OF INDIVIDUAL TAXESrr~ ! I r ~r~ t-'~ERITANCE TAX
INHERITANCE TAX DIVISION j•..`_~Y.~.,~,` .t ~~~ ~ 1
Po Box zao6ol ' .-~ S~'~~EMENT OF ACCOUNT
HARRISBURG PA 17128-0601
~ ~ 1 A
• ~ .W l,J ~ 3, "
uL~~?K ^F
r~`~i-~~r`~1,1'~ C~1 ~~,
1 ,~,.. ~T
JEAN D SEIBER
109 LOCUST ST
HBG PA 17101
Pennsylvania
DEPARTMENT OF REVENUE
REV-1607 EX AFP C12-10)
DATE 08-08-2011
ESTATE OF HICKOK ELISABETH H
DATE OF DEATH 06-29-2009
FILE NUMBER 21 09-0643
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 107 EX AF~~'~ C12 10) ~~ ~~ ~*° INHERITANCE TAX S~A~EMENT~OF ACCOUNT ~~~'~~~""""""""'
ESTATE OF:HICKOK ELISABETH H FILE NO.: 21 09-0643 ACN: 101 DATE: 08-08-2011
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: 07-18-2011
PRINCIPAL TAX DUE: 146,531.85
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT C+)
DATE NUMBER INTEREST/PEN PAID C-)
09-29-2009 CD011814 6,842.11
03-22-2010 CD012507 .00
07-21-2011 REFUND .00
TOTAL DUE
~ IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM
FOR INSTRUCTIONS.
AMOUNT PAID
130,000.00
11,400.00
1,710.26-
TOTAL TAX PAYMENT 146,531.85
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
.00