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BUREAU OF INDIVIDUAL TAXES #-;rY~N}~E'~~T~N.C~~ i:A)( DEPARTMENT OF REVENUE
' REV-1607 EX AFP (12-11) '
INHERITANCE TAX DIVISION ST/k~.EMENT 0~'~.~~ COUNT
PO BOX 280601 i.
HARRISBURG PA 17128-0601 - - - ,.i_,,_~;
• ~ ;~, ,~.- DATE 11-19-2012
`~ r `- -~ ~ ~ ~ ' ~'~~I'ATE OF BEAVERSON JAMES K
DATE OF DEATH 09-05-2011
FILE NUMBER 21 12-0635
'~`~~ -' COUNTY CUMBERLAND
CHARMANYE GROVE '~'
~ , ~ ,9_ _ ~ t ~ '~.~. `. ~ ,1 .`'`,`:SAC N 111616 9 8
TRLR b
Amount Remitted
300 RIDGE RD
ETTERS PA 17319-9690
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 _ ~ _ _ _ _
REV-1607 EX AFP C12-11~ *** INHERITANCE TAX STATEMENT OF ACCOUNT ***
ESTATE OF:BEAVERSON JAMES K FILE NO.: 21 12-0635 ACN: 11161698 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: 11-09-2012
PRINCIPAL TAX DUE:
1b2.75
PAYMENTS CTAX CREDITS:
PAYMENT RECEIPT DISCOUNT C+~ AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID C-)
11-06-2012 CD016745 1.03- 163.78
11-1b-2012 SBADJUST .00 1.03
TOTAL TAX PAYMENT 1b2.75
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.