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i pennsylvania
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX REV-1607 EX AFP c12-12)
INHERITANCE TAX UIVISION STATEMENT OF ACCOUNT
PO BO% 280601
HANRISBURG PA 17128-0601
RECOit:t� ^ ,r,°r";-.""- ;7;
- DATE 05-06-2013
REGIS k Lii CIY" �.����:-���::.�..5 ESTATE OF PATTERSON JERRY B
DATE OF DEATH 06-15-2012
;�!13 ���� 13 �� �j �� FILE NUMBER 21 12-0995
COUNTY CUMBERLAND
BRADLEY L GRIFFIE CLEIZK G��� ACN 101
200 N HANOVER ST g�p �
CARLISLE Qpq �,���-���+jC� Amount Remittee
GUMBERLAN� CC., PA
MAKE CHECK PAYABLE ANU REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
NOTE: To ensure proper cratlit to your account, submit the uppe� portion of this form with your tax payment.
CUT ALONG THIS LINE � RETAIN LOWER PORTION FOR YOUR RECORDS (�-�
" " " - - - - - - - - " " " - - - - - - - " " ' - - - - - " " ' - - - - - " " - - - - - " ' - - - - - - - " ' - - - - - -
REV-1607 EX AFP C12-12) ■*■ INHERITANCE TAX STATEMENT OF ACCOUNT ��*
ESTATE OF:PATTERSON JERRY B FILE NO. : 21 12-0995 ACN: 101 DATE: 05-06-2013
THIS STATEMENT PROVIDES LURRENT STA7US OF TXE STATED ACN IN THE NAMED ESTATE. BELOW IS A SUMMARY OF THE PRINCIPAL
TAX Dl1E, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTEU INTEREST FIGI/RE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 03-18-2013
PRINCIPAL TAX DUE: 434.98
PAYMENTS (TAX CREDITS) :
PAYMENT RECEIPT DISCOUNT (+) qMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
09-14-2012 CD016501 21 .75 2,700.00
04-15-2013 REFUND .00 2,286.77-
70TA1 TAX PAYMENT 434.98
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
70TAL DUE
.ao
� IF PAID AFTER THIS OATE, SEE REVERSE SI�E FOR CALCULATION OF ADOITIONAL INTEREST. \\\ �
IF TOTAL ➢UE IS REFLECTED AS A "CREDIT^ (CR), YOU MAV BE DIIE A REFUNO. SEE REVERSE SIDE OF THIS FORM \„�
\1\FOR INSTRUCTIONS.
PAYMENT: Detach the to0 port3on of Yhis notice and subnit vith your Oaymenk made oayable to Yhe nane antl atldress
printed on the reverse sitle.
If paymenk is for a res3dent tlecedent, nake check or noney orAer pavable to: He9�ster of W311s. Agent
If Daymenk is for a nom resident decedent. �ake check or monev artler oavaCle ko: Comnonwealth of PennsYlvania
Failure ko oay Me tax, intarest. and Oenalty due nay resulk 3n Yhe Hling of a lien of record in the
a0orooriake counYV, or the issuance of an Orohan's Courk cikat3on.
REFUNO (CR)� A refuntl of a tax credit, which was not requestetl on the tax return, may be requestetl by comOlekine an
"Application for Refund of PennSYlvania lnheritance and Esiake Tax^ BEV-1313). Aoolications are available from
de0artment's veb s3ke at www.ravenue.state.va.us, any Beeister of W311s or Revenue 03skricY OfHCe or froe the
tlepartment's 24-hour answering serv3ce: 1-800-3624050; servires tor kaxpayers with soecial hear3ng and/or
soeak9ng needs: 1-800-44]3020 (TT onlv).
REPLY T0: puest3ons regardine emors shoultl be atldressed to: PA DeOartnent of Revenue, Bureau of Intlivitlual Tazes,
ATTN: Post Assessment Revie� Unit. PO Box 280601, Harrisbur9. PA 1�128-0601, or call (]1]) ]B]-6505.
DISCDUNT: If anv Yu Eue 3s paid vithin three calendar months after the tleceAeni's tleath, a f3ve oercent tl3scaunk
of the kax oaid is allovetl.
PENALTY: The 15 oercent t� amnesty non-oartic3oat3on panaltv is comnuted on tha total of the tax and interest assessed.
anE not oa3d before Jan. 18, 1996. (the first tlay after khe entl of khe taz amnesYy peHatl.)
INTEREST: Inferest is chareed beginnine with first dav of delina�encv� or nine nonkhs antl one tlay From the tlate of
death, ko the date of oavment. Taxes wh3ch became tlel3nquent before Jan. 1, 1982, bear interest at the rate of
six oercent ver annum calculatetl at a dailv rate of 0.000164. All Tues Which becaae delinquent on and after
Jan. 1, 1982, will bear 3nYeresk at a rafe which varies fron vear to vear vith the rate announced bv the PA
�eOaMnenk oF Revenue. Rates for 3982 ihrough 1999 can De fountl in the Pennsvlvania Resitlent Instruction
Booklet (REV-1501). the Pennsvlvania Non-resitlent Instruciion Booklet (BEV-1]36) or on the Oepartnenk of
Revenue WeE s3te vww.revenue.staka.pa.as. The aDOlicable interesk rates for 2000 through 2013 are:
InteresY Oaily Interest Uailv Interest Oailv
Year Rate Factar Vear Raie Factor Vear RaYe Factor
2000 BY. .000219 20D1 9: .00024] 2002 6: .000164
2003 5Y. .00U137 2004 4: .D00110 2005 SY. .00013�
2006 �% .000192 200] B'L .000219 2008 ]Y. .000192
2009 5'/. .00013] 2010 4: .000110 2011-2013 3Y. .00U082
InYeresY is calc�lakeE as follovs:
INTEREST = BALANLE OF TAX UNPAID X NUMBEN OF OAYS OELIN7UENT X MILY INTEREST FACTOR
Am nofice issuetl after the t� becomes delinauenk vill reflect an interesS calculakion to 15 tlavs
beyontl ihe daYe of khe assessment. If oaynent is natle atter the inkerest computaYion dake shown on the �� ���
not3ce, atld3i3onal 3nYeresk nusk be calculatetl. .