HomeMy WebLinkAbout11-07-11~rt~~ ~~ ~ ~~ - r Pennsylvania ~
BUREAU OF INDIVIDUAL TAXES - II'IF~~~TANCE TAX DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION ~ ',
Po Box zeo6ol ~ `' `" S TAT E`'M£ T O F ACCOUNT REV-1607 EX AFP c12-lo)
HARRISBURG PA 17128-0601
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HAMILTON C DAVIS C~)~~9~~--.'~L_ ~w`` `~~ ~ P~
20 EAST BURD STREET
SUITE 6
SHIPPENSBURG PA 17257
DATE
ESTATE OF
DATE OF DEA
FILE NUMBER
COUNTY
ACN
~_
10-24-2011
SHUGHART JR DALE F
TH 03-23-2010
21 10-0326
CUMBERLAND
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 _
RE1~=1607 EX AFB (1~2 1~5~ ~~~~~°*° INHER~~'AN~~~~'FAX STATEMENT~~OF ACCOUFIT ~~ ~~"'~"""""""•
ESTATE OF:SHUGHART JR DALE F FILE NO.: 21 10-0326 ACN:: 101
THIS STATEMENT PROVIDES CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. BELOW IS A SUMMARAYTOF THE P INCI~PAL
TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 05-31-2011
PRINCIPAL TAX DUE:
38,635.00
PAYMENTS CTAX CREDITS):
PAYMENT
DATE RECEIPT DISCOUNT (+)
NUMBER INTEREST/PEN PAID C-) AMOUNT PAID
12-22-2010 CD013816
08-12-2011
CD014849 .00
37,218.17
09-29-2011
CD015022 21.35- 1,438.18
5.92-
5.92
TOTAL TAX PAYMENT 38,635.00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE
.00
~ 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.