HomeMy WebLinkAbout10-07-11BUREAU OF INDIVIDUAL TAXE~~r~ Jf ' ~ ~~ HERITANCE TAX
INHERITANCE TAX DIVISION ~ $i E M E N T O F AC C O U N T
PO BOX 280601 t ,` _ _ __ - 4'1
H1IRRISBURG PA 17128-0601
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CLERK rr
ONRPHt~N'S C1OURT
ANDREA W~)nF':L1.'v'+.~1 ' 0., PA,
3795 CARLISLE RD
GARDNERS PA 17324-9511
Pennsylvania ~
DEPARTMENT OF REVENUE
REV-1607 EX AFP C12-10)
DATE 09-26-2011
ESTATE OF HENSCHEN HOMER E
DATE OF DEATH 08-10-2010
FILE NUMBER 21 10-0858
COUNTY CUMBERLAND
ACN 10146542
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TD:
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_ALON6 THIS LINE _~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ _ _ _
RESIN 1607 SEX AFP C12 105 ~ ~ *** INHERIrT~1~1~CE TASC~ S~fY-fEMEN~~OF ACCOUti*T~~~*** ~~ ~~~~~~ ~ •••••••^
ESTATE OF:HENSCHEN HOMER E FILE N0.:21 10-0858 ACN: 10146542 DATE: 09-26-2011
TAXSDUE/,TAPPLICATIONDOF ALLRPAYMENTS~,STHE CURRENTTBALANCEINANDE IFMAPPLICABLE,BALPROJECTED INTEREST FIGUREINCIPAL
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 08-22-2011
26.66
PRINCIPAL TAX DUE:
PAYMENTS CTAX CREDITS):
PAYMENT RECEIPT DISCDUNT C+)
DATE NUMBER INTEREST/PEN PAID C-)
INTEREST IS CHARGED THROUGH 10-11-2011
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM.*
AMOUNT PAID
TOTAL TAX PAYMENT .00
BALANCE OF TAX DUE 26.66
.34
INTEREST AND PEN.
TOTAL DUE ~ 27,00
^ IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIDNAL INTEREST.
LF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM
FOR INSTRUCTIONS.