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DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX REV-1607 EX APP (12-13)
INHERITANCE TAX DIVISION STATEMENT O F ACCOUNT
PO BOX 280601
HARRISBURG PA 17128-0601
DATE 04-21-2014
ESTATE OF MADDEN JOHN F
DATE OF DEATH 11-09-2007
FILE NUMBER 21 08-1196'
COUNTY CUMBERLAND
PATRICIA BANN ACN 08100057
116 SUNSET DR
Amount Remitted
NEW CUMBERLAND PA 17070
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 --+ RETAIN LOWER PORTION FOR YOUR RECORDS F
REV-1607 EX AFP (12-13) ■ INHERITANCE TAX STATEMENT OF ACCOUNT ■**
ESTATE OF:MADDEN JOHN F FILE NO. : 21 08-1196 ACN: 08100057 DATE: 04-21-2014
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: 11-05-2010
PRINCIPAL TAX DUE: 18.01
PAYMENTS (TAX CREDITS) :
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
11-20-2010 CDO13683 2. 04- 20.06
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(` R7 171 M
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TOTAL TAX PAYMENT 18.02
BALANCE OF TAX DUE . 01CR
INTEREST AND PEN. .00
TOTAL DUE .OLCR
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.