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HomeMy WebLinkAbout11-16-12BUREAU OF INDIVIDU,-I-~p~~f'., ` i~!;;C QF INHERITANCE TAX INHERITANCE TAX pIVISI • HARRISBURG6PA nlza-osol r"-~- --' _: ~ _ s.~'. I C STATEMENT OF ACCOUNT ~Iy~U~1N~ 1-t. v i5 l ~,. i~ ~. 310AW KCHOC OI E~~AVDE `'~~ PA HERSHEY PA 17033-1635 DATE ESTATE OF DATE OF DEA FILE NUMBER COUNTY ACN Pennsylvania ~ DEPARTMENT OF REVENUE REV-1607 EX AFP (1z -11) 11-13-2012 BREZINA WINIFRED R IH 01-08-2012 21 12-0084 CUMBERLAND 101 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 NOTE: To ensure proper cre tlit to your account, submit tha u pper portion of this form with your tax payment. CUT ALONG THIS LINE _~__ RE_TAIN LOWER P_OR TION FOR YOUR RECORDS (~ ___________________________ REV-1607 EX AFP (12-11) r~~ INHERITANCE TAX STATEMENT OF ACCOUNT ^*~ ESTATE OF:BREZINA WINIFRED R FILE N0.: 21 12-0084 ACN: 101 THIS STATEMENT PROVIDES CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. BELOW IS A SUMMARIVTOF• THE P INCU q2 TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, q PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 10-01-2012 PRINCIPAL TAX DUE: PAYMENTS (TAX CREDITS): PAYMENT DATE RECEIPT DISCOUNT (+) NUMBER INTEREST/PEN PAID (-) 03-02-2012 CD015658 2,105.26 05-24-2012 CD016022 10-26-2012 REFUND .0.0 .00 48,080.97 AMOUNT PAID 40,000.00 6,082.61 106.90- TOTAL TAX PAYMENT 48,080.97 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" (CRJ, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. Hq