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BUREAU OF INDIVIDUAL TAXES '~-"~' °~~~j ~~{AQ~~II.E TAX DEPARTMENT OF REVENUE F
INHERITANCE TAX DIVISION ~f~~~lJ~w~i~.#i,.rY REY-1607 EX AFP (12-11)
PD BOX 280601 ~.. F A C C O U N T
HARRISBURG PA 17128-0601
{'~~ try ~ "`` ~~`~ '~"~ DATE 07-09-2012
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ESTATE OF PEARCE CATHRYN
~-r°~° r~.r DATE OF DEATH 02-18-2012
FILE NUMBER 21 12-0642
Ch~~''r`~ ~ ~ Lv' i(~T
MARY BRUNSKI ~«~ ~~i'~tN~~;~ (,t~, =~, COUNTY CUMBERLAND
ACN 12118619
7 HILLTOP DR
Amount Remitted
MT HOLLY SPGS PA 17065-1830
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 _ -_ ~1_ RE_TAIN LOWER PORTION FOR YOUR RECORDS _ ~
REV-1607 EX AFP C12-11) - *~* INHERITANCE TAX STATEMENT OF ACCOUNT ***
ESTATE OF:PEARCE CATHRYN FILE NO.: 21 12-0642 ACN: 12118619 DATE: 07-09-2012
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: 07-02-2012
PRINCIPAL TAX DUE:
20.11
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID C-)
06-06-2012 CD01612:-' .00 20.11
TOTAL TAX PAYMENT 20.11
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" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM
FOR INSTRUCTIONS.