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" � DEPARTMENT OF REVENl1E
BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX REV-16o� Ex AFP (12-12)
iNHEx�rnxce r,ix orvisioN STATEMENT OF ACCOUNT
ro aax zaosoi
HARRISBURG PA 17128-0601
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��e��'''��;=�{ UP 's';'IJ, ( S DATETOFaDEATH 05LOLN2D12 MATTHEW
'���i� �r��� �� m �� �� FILE NUMBER 21 12-0652
SHAUN OTOOLE �' I � COUNTY CUMBERLAND
ACN 101
220 PINE ST Ci�,.���� �•��� Amount Remitted
HARRISBURG PA aftPW�q-��bQ;pJRT
CUM BERCAt�D GG., PA MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WLLLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
NOTE: To ensure proper cradit ko your account, su6mit ths upper portion of this form with your tax payment.
CUT ALON6 THIS LINE _ _ _ _ �► RETAIN LOWER PORTION FOR YOUR RECORDS �
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REV-1607 EX AFP (12-12) ■�� INHERITANCE TAX STATEMENT OF ACCOUNT ���
ESTATE OF:CALLEN III MATTHEW FILE N0. : 21 12-0652 ACN: LO1 DATE: 05-06-2013
THIS STATEMENT PROVIDES CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. BELOW IS A SUMMARY OF THE PRINLIPAL
TAX DUE, APPLICATION OF ALL PAVMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTEO INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 03-18-2013
PRINCIPAL TAX DUE: 10,951.56
PAYMENTS (TAX CREDITS) :
PAYMENT RECEIPT DISCOUNT (+) pMOUNT PAID
DATE Nl1MBER INTEREST/PEN PAID (-)
07-24-2012 CD016299 547.58 14,000 .00
04-15-2013 REFUND .00 3,596.02-
TOTAL 7AX PAYMENT 10,951 .56
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE
.00
� IF PAID AFTER THIS OATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL TNTEREST. \
IF TOTAL DUE IS REFLECTED AS A "CREDIT^ (CR)� YOU MAY BE DUE A REFUND. SEE HEVERSE SIDE OF THIS FORM ��j
FOR INSTRUCTIONS. V✓
PAYMENT: Oatach the toP Oortion of khis notice and subnit wiih your oavnent mada Oavable to khe name anA atltlress
printed on the reveree sitle.
IF pavment is for a residenf tlecatlent, make check or noney ordar oavable to: ReBister of Wills. Agent
If paY�ent is for a non-resident decedenk, nake check or nonev order payable to: Connonvealth of Pennsvlvania
Failure to uaY khe tax. 3nYerest, and penaltY tlue may result in the filing of a lien of recortl 3n the
ao0�op�iate county, or the issuant¢ of an Orphan's Court ciYation.
REFUND (CR): A refuntl ot a kax cred3t, vhich was nok requestetl on fhe tax return, may be requesteA Cv comoleY3ng an
"ApOlication for Refuntl oF Pennsvlvania lnheritance antl Estate Tax^ (REV-1313). ADOlicat3ons are available from
deoarSnenY s web site at vw.rewnue.state.oa.us, any Register of W311s or Ravenue District Office or from the
departnent's 24-hour ansvering service: 1-800-362-2050; services for taxpavers w3kh soec3al hearing antl/or
sDeakine needs: 1-B00-447-3020 (TT only).
REPLY T0: 4uestions regartlin9 arrors should be atltlressed to: PA OepaMnent of Revenue, Bureau of Intlividual Taxes.
ATTN: Post AssessmenY Review Unit. PO Box 280601, HarrisEUrg, PA P128-0601, or call (]1]) ]8]-6505.
OISCOUNT: If anv tax due is paid within khree calentlar months after the tlecetlent's death, a five oercent tl3scount
oF the Yax oaitl is allowed.
PENALTV: The 1$ pQftPf�k Sd% anneskv f10l1-02I't1C1D2t]00 DPI181Ly 1S conouted O!1 th¢ tOt21 Of t�l¢ t2X 30(� inkerest d552552tlr
antl not oa3tl Cefore Jan. 18, 1996, (the firsk tlav after the end of khe tax amnesky periotl.)
INTEREST: Interest is charged beginning with firsY tlav of tlalinuuencv, or nine wonths antl one day fron khe tlake of
death, to khe date of oavnent. Taxes vhich became tlel3nuuent before Jan. I, 1982, bear interesf at the reke of
six oercent oer ann�m calculated at a daily rate of 0.000164. A11 tazes which becane delinuuent on and affer
Jan. 1, 1982, vill bear 3nterest at a rete which varies fron vear to vear w3th tha refe announcaJ Ev tha PA
Department of Revenue. Rakes for 1982 through 1999 can be fountl 3n the Pennsvlvan3a Bes3tlent Instruction
Booklet (REY-1501), the PennsYlvania Non-resitlenk Instruction Booklet (REV-1736) or an the Oepartmenf of
Revenue Web site ww.revenue.state.0a.us. The aool3cable 3nYerest rates for 2000 through 2013 are.
Inte�est Daily Interest �ailY Interesi Da33y
Year Rate Factor Vear Rate Factor Year Rate Factor
2000 8Y. .000219 2001 9: .00024] 200T 6Y. .000164
2003 5Y. .000131 2004 4R .000110 2005 SY. .000137
2006 �Y. .000192 200] BY. .000219 2008 T/. .000192
2009 Sv. .00013] 2010 4Y. .000110 2011-2013 3: .000082
Interest is calculatetl as follovs:
INTEREST = BALANCE OF TAX UNPA10 X NIIMBER OF MVS DELINOUENT X UAILV INTEREST FACTOR
Any notice issued after the Yaz becoaes delinauent vill �efleck an interest calculak3on to 15 tlavs
bevontl the tlate of tM1e assessnent. If omwenk 3s eatle after the 3nterest computat3on dake shown on the
notice, additional inkeresk must be calcalatetl. �