HomeMy WebLinkAbout06-07-13 �:°� pennsylvania
�� DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX REV-i607 IX acp <1E-12>
7wxexsruace ruc aivisiox STATEMENT QF ACCO'UMT
�o enz zaeam }���0€t��� OF'FICE OF
XRRRISBURG PA I7128-ObUi 1
RE61S7�,h� pF DylLLS DATE Ob-U3-2013
7 E5TATE OF ENGLE SHIRLEY S
j{IlJ JUN ! f � � ��ILE NUMBER�� 21 12-1288
6RE&ORY M KERYtZN ��-�R�C {}F �Q�NTY CUMBERLAND
��f Hb�.�'i� ����T ACN 101
4245 STATE ROUTE 209 - pmount Remittetl
ELTZABETHVTLLE RA i#'d�d8�#�AND CO., pq
NAKE CHECK PAYABLE AND REMI7 PAVMENT T0:
RECISTER 4F WIILS
1 COURTHDUSE SQUARE
CARLISLE PA 17013
NOTE: To ansu�� propar cretl3t to your accpunY. 5ubmlt tha upper portion of this form Nith yqur tax paymenY.
CUT ALON6 TNIS �INE � RHTAIN �OWER PORT36N FOR YOUR REtORDS �
""-- '..'---""--""'-"'-""'-- - " '--"'---" '-" " "-" "'-" """""
REV-1607 EX AFP C12-12) ■x* INHERITANCE TAX STATEMENT DF ACCOUN7 ■x�
fSTATE OF:EN6lE SNIR�EY S FILE NO. : 21 12-2288 ACNs 101 DATEs 06-p3-2�13
THIS STATEMENT PROVTDES CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. BELpW IS A SUMMARY OF THE PRINCIPAL
7AX DUE, APPlICA7I0N OF ALL PAVMEN7S. THE WRRENT HALANCE, AND, IF APPL2CABLE, A PROJECTED IN7EREST FIGURE.
DATE OF LAST AS58SSMENT OR REC4RD ADJUSTMENT: 05-06-2013
PRINCIPAL TA7t DUE: 4,442.92
PAYMENTS LTAX CREDITS):
PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID C-)
02-Ob-2013 CDQ1?148 222.I5 4.580.44
05-17-2013 REFUND .00 359.b7-
TOTAI TAX PAYMEkT 4:�+42.42
BALANCE OF TpX DUE •��
ZHFEREST AND PEN. �fl�
TOTAL DUE
.00
+ ZF PASD AFTER THZS DATE. SEE REY£RSE SZDE FOR CA�CULA7I6N OF ADDZ7IONAL INTEREST.
IF TOTAL DUE IS REFLEC7ED AS A "CREOIT" CCR). YOU MAY BE DOE A REFUNG. SEE REVERSE Si�E OF THI5 FoRM
fOR INSTRUCTIONS. ��