HomeMy WebLinkAbout09-24-12BUREAU OF INDIVIDUAL ( (l ;, INHERITANCE .TAX
INHERITANCE TAX DIVISION ~l ~L,~~t~ ~r~r
Po Box zao6ol Q[/~~~~~~~, ,~;,~ ~~~~ ~TATEMENT OF ACCOUNT
HARRISBURG PA 17128-0601 I i[~,7 _ ~~„ ! !,,;, _~ ~- ,~
L012 SEP 24 P~9 I ~ 37
'~i.~~ t
RICHARD C ~ ~'~~{~T
77 WEST MA C~"
MECHANICSBURG PA 17055
DATE
ESTATE OF
DATE OF DEA
FILE NUMBER
COUNTY
ACN
Pennsylvania ~
DEPARTMENT OF REVENUE
REV-1607 EX AFP (12-11)
09-17-2012
BLACK SAMUEL H
TH 11-11-2011
21 11-1224
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 _ F
REV-1607 EX AFP C12-11) ~** INHERITANCE TAX STATEMENT OF ACCOUNT **~ "--""-"-""'-
ESTATE OF:BLACK SAMUEL H FILE NO.: 21 11-1224 ACN: 101
THIS STATEMENT PRDVIDES CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. BELOW IS A SUMMARAYTOF H E P INCIPA?
TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 08-13-2012
PRINCIPAL TAX DUE:
2,783.88
PAYMENTS CTAX CREDITS):
PAYMENT RECEIPT DISCOUNT C+)
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
02-06-2012 CD015549
08-31-2012 REFUND 139.19 2,800.00
.00 155.31-
TOTAL TAX PAYMENT 2,783.88
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.