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BUREAU OF INDIVIDUAL TAXES 'r '. ~ . _I N~C~I~I'~'ANCE TAX
INHERITANCE TAX DIVISION ,,. , ~. ST1~7EM~hl~` OF ACCOUNT
PO BOX 280601 ~ _ _. ,_,r
HARRISBURG PA 17128-0601
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JOHN D KILLIAN ESQ L Cl t~1:- ~ . ~a~ ~ ~ '`,~-~.
PO BOX 886
HARRISBURG PA 17108-0886
Pennsylvania ~ ~
DEPARTMENT OF REVENUE
REV-1607 EX AFP (12-11) -
DATE 11-19-2012
ESTATE OF FOX PHILIP E
DATE OF DEATH 06-27-2010
FILE NUMBER 21 10-0839
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 _ _-_~_ RE_TAIN LOWER PORTION FOR YOUR RECORDS _ F-'-
REV-1607 EX AFP C12-11~ *** INHERITANCE TAX STATEMENT OF ACCOUNT ***
ESTATE OF:FOX
PHILIP E FILE NO.: 21 10-0839 ACN: 101 DATE: 11-19-2012
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: 10-12-2012
PRINCIPAL TAX DUE:
28,305.00
PAYMENTS (TAX CREDITS:
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT (+)
INTEREST/PEN PAID C-~
AMOUNT PAID
02-28-2012 CD015634 .00 28,305.00
11-09-2012 CD016764 784.50- 784.50
TOTAL TAX PAYMENT 28,305.00
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" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM ~!,
FOR INSTRUCTIONS.