HomeMy WebLinkAbout05-31-13 Pennsylvania
DEPARTMENT OF REVENUE
BUREAU of INDIVIDUAL TAXES INHERITANCE TAX REV-1607 EX AFP 02.12)
INHERITANCE TAX DIVISION STATEMENT OF ACCOUNT
PO BOX 280601 �1
HARRISBURG PA 17128-0601 RECORDED OFFICE OF
REGISTER OF VJIL I S DATE 05-28-2013
ESTATE OF BLACK DOROTHY F
j(l{3 f}RY "l DATE OF DEATH 02-26-2011
FILE NUMBER 21 11-0283
CLERK Or COUNTY CUMBERLAND
CHARLES E SHIELDS I�1PFidNS' CDC ACN 101
6 CLOUSER RD ili - Amount Remittod
MECHANICSBURG 1��3ififiRLO3'5CD•, PA
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
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 --i RETAIN LOWER PORTION FOR YOUR RECORDS +—
_ _ _ _ _ _ _ _ _ _ _ _ __ __ _ _ __ _ ___ _ _ _ ____ _ _ _ __ _ ..- _ _ __ . . ___ . ._. ._. ..._ ... _ __ .._-- -_ __-
REV-1607 EX AFP (12-12) yR* INHERITANCE TAX STATEMENT OF ACCOUNT ■*If
ESTATE OF:BLACK DOROTHY F FILE NO. - 21 11-0283 ACN: 101 DATE: 05-28-2013
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: 10-11-2011
PRINCIPAL TAX DUE: 19,571.54
PAYMENTS (TAX CREDITS) :
PAYMENT RECEIPT DISCOUNT C+> AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID C^)
05-09-2011 CDO14433 250.98 4,768.65
05-25-2011 CDO14509 727.60 13,859.55
07-15-2011 CDC14714 .00 179.09
05-08-2013 REFUND .00 214.33-
+ TOTAL TAX PAYMENT 19,571 .54
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.
N'