HomeMy WebLinkAbout01-25-13 (2)BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
BARRY CLAY
225 PINE VIEW RD
CAMP HILL
INHERITANCE TAX
r ~ ~ ~`~ S.T~4TEMEIV~' ~t~F ACCOUNT
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PA 17011
DATE
ESTATE OF
DATE OF DEA
FILE NUMBER
COUNTY
ACN
C
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DEPARTMENT OF REVENUE
REV-1607 EX AFP (12-12)
01-22-2013
SIMMONS CAROLINE R
TH 10-16-2011
21 11-1140
CUMBERLAND
12004609
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 u
pper portion of this form with your tax payment.
CUT ALONG THIS LINE _ ~--- " _RETAIN LOWER P_ORT_ION FOR YOUR RECORDS _ F-
REV-1607 EX AFP C12-12~ *** INHERITANCE TAX STATEMENT OF ACCOUNT ~ - - - - - - - - - - -
*~
ESTATE OF:SIMMONS CAROLINE R FILE NO.: 21 11-1140
THIS STATEMENT PROVIDES CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATEC BEL w200 A60 MM DATo : 0 E-22-213
TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGUREINCIPAL
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 12-31-2012
PRINCIPAL TAX DUE:
428.14
PAYMENTS CTAX CREDITS:
PAYMENT
DATE RECEIPT DISCOUNT C+)
NUMBER INTEREST/PEN PAID (-~
12-03-2012 CD016878
01-02-2013
REFUND 4.92-
.00
AMOUNT PAID
866.00
432.94-
TOTAL TAX PAYMENT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
* IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM
FOR INSTRUCTIONS.
428.14
.00
.00
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