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HomeMy WebLinkAbout02-0816 /"/-P"/- ~ BUREAU Of INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE '*' NOTICE OF INHERITANCE TAX APPRAISEHENTL ALLOHANCE OR DISALLOMANCE OF DEDUCTION~._AND ASSESSHENT OF TAX ON JOINTLY KELD OR TRUST ASSETS II:EV-15U EX AFP (D1~D2l JOYCE A CAREY 1 TEE JAY DR MT HOLLY SPRINGS PA 17065 DATE 09-10-2002 ESTATE OF BREAM EDITH DATE OF DEATH 03-12-2000 FILE NUMBER ..:> I-O~-P/~ COUNTY CUMBERLAND SSN/DC 184-10-6120 ACN 01147348 Allount Rellitted E MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CD COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ... RETAIN LOWER PORTION FOR YOUR RECORDS ~ R!fi=is4-i-Eif-AFP--foi-=02'------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 09-10-2002 ESTATE OF BREAM EDITH E DATE OF DEATH 03-12-2000 COUNTY CUMBERLAND FILE NO. S.S/D.C. NO. 184-10-6120 TAX RETURN WAS: (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 01147348 FINANCIAL INSTITUTION: PNC BANK ACCOUNT NO. 5140181176 TYPE OF ACCOUNT: () SAVINGS (lO CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 04-01-1963 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due 10,238.35 0.166 1,706.43 .00 1,706.43 .06 102.39 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEI PT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) INTEREST IS CHARGED THROUGH 09-18-2002 TOTAL TAX CREDIT .00 AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 102.39 REVERSE SIDE OF THIS FORM INTEREST AND PEN. 14.04 TOTAL DUE 116.43 . If PAlO AfTER THIS DATE, SEE REVERSE fOR CALCULATION Of ADOITIONAL INTEREST. . ( If TOTAL OUE IS LESS THAN $1, NO PAY"ENT IS REQUIRED. If TOTAL DUE IS REfLECTED AS A "CREDIT" ( CRJ, YOU HAY BE DUE A REfUND. SEE REVERSE SIDE Of THIS fDR" fOR INSTRUCTIONS. J BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG~ PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE '* NOTICE OF INHERITANCE TAX APPRAIBEIIENT. ALLOHANCE OR OIBALLOHANCE OF OEOUCTION~, AND ABBEBBIIENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REV-15U EX AFP [0I~021 JOYCE A CAREY 1 TEE JAY DR MT HOLLY SPRINGS PA 17065 DATE 09-10-2002 ESTATE OF BREAM EDITH DATE OF DEATH 03-12-2000.~ " FILE NUMBER ,;;) 1-t::J:;J. ~6'/" COUNTY CUMBERLAND SSN/DC 184-10-6120 ACN 01147349 Allount Re..itted E ~ " MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CD COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ RE-v=is4-i-Ex--AFii-foi-=ozl------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 09-10-2002 ESTATE OF BREAM EDITH E DATE OF DEATH 03-12-2000 COUNTY CUMBERLAND FILE NO. S.S/D.C. NO. 184-10-6120 TAX RETURN WAS: (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 01147349 FINANCIAL INSTITUTION: PNC BANK ACCOUNT NO. 31800100863 TYPE OF ACCOUNT: () SAVINGS ( ) CHECKING ( ) TRUST (lO TIME CERTIFICATE DATE ESTABLISHED 09-12-1997 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due 11,370.18 0.166 1,895.07 .00 1,895.07 .06 113.70 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK DR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) INTEREST IS CHARGED THROUGH 09-18-2002 TOTAL TAX CREDIT .00 AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 113.70 REVERSE SIDE OF THIS FORM INTEREST AND PEN. 15.59 TOTAL DUE 129.29 . IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. . ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CRI, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS. I BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE *' NOTICE OF INHERITAHCE TAX APPRAISEMENT ALLOMANCE OR DISALLOHANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS Rn-15~a Ell' AFP (Dl~O.tl JOYCE A CAREY 1 TEE JAY DR MT HOLLY SPRINGS PA 17065 (',t DATE 09-10-2002 ESTATE OF BREAM EDITH DATE OF DEATH 03-12-2000.~~~ FILE NUMBER ~/-~-e;J'e i ,"COUNTY CUMBERLAND SSN/DC 184-10-6120 ACN 01147351 Allount R...itted E MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ~ Rifv:is4li-EX--AFP--foi-:ozi------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 09-10-2002 ESTATE OF BREAM EDITH E DATE OF DEATH 03-12-2000 COUNTY CUMBERLAND FILE NO. S.S/D.C. NO. 184-10-6120 TAX RETURN WAS: (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 01147351 FINANCIAL INSTITUTION: PNC BANK ACCOUNT NO. 5130331273 TYPE OF ACCOUNT: (lO SAVINGS ( ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 04-22-1985 Account Balance Pe~cent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due 1l,502.18 0.166 1,917.07 .00 1,917.07 .06 115.02 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK DR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) INTEREST IS CHARGED THROUGH 09-18-2002 TOTAL TAX CREDIT .00 AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 115.02 REVERSE SIDE OF THIS FORM INTEREST AND PEN. 15.77 TOTAL DUE 130.79 . IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. . ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CRI, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. I Pennsylvania DEPARTMENT OP REVENUE September 16, 2010 To the. Register of Wills of the County of CUMBERLAND RE: INHERITANCE TAX CREDIT MEMO Estate of: File Number: Decedent's SS#: ACN Number: Payment Amount Postmark Date: Date of Death EDITH E B AM 184-10-6120 01147351 $ 148.19 6/18/2010 3/12/2000 /33~ .f~~.(?~tnr,C F I~~~+ X71„ l[n' Li' .,,p? i t` ~~~.,,; 201QS£P2~ gHJO: Sg C~~t ~QtIRT ~'~ co. Pa. An Amnesty payment on the above-referenced inheritance tax liability has been received and transferred to the inheritance tax fund. Please issue an official inheritance tax receipt for the Tax Amnesty payment and postmark date above. Make the payment date on the receipt the date the receipt is prepared by your office. Also, type "AMNESTY" in the remarks area of the receipt. Mail the receipt to: Name: Street: City/State/ZIP: JOYCE A CAREY 1 TEE JAY DR MOUNT HOLLY SPRINGS PA 17065 The department's copy of the Official Receipt should be mailed using the postage paid Inheritance Tax bulk mail envelope (E-136) within five (5) business days after receiving this credit memo. Attach an "AMNESTY" cover sheet to the front of the receipt, or if multiple amnesty receipts are being submitted, attach the cover sheet to the top of the group. The amnesty cover sheet will help expedite the processing of the receipt when it arrives in the Inheritance Tax Division. Please keep the amnesty receipts sorted and bound separately from the other Inheritance Tax documents when placing them in the bulk envelope. On your next Register of Wills Monthly Report, REV-714, include the payment amount in the monthly inheritance tax collections reported on Line 5, and claim a credit on Line 7. Your monthly inheritance tax collections, less the credit for this payment, should equal the Total Amount Deposited on Line 12. Your efforts in expediting the issuance and mailing of the Department of Revenue's copy of the tax amnesty payment receipt is greatly appreciated. Thank you for your timely attention to this matter. If you have any questions, please call 717-787-7031. Indlvldual Taxes i PO Box 280603 I Harrisburg, PA 17128 i 717.787.70311 www.revenue.state.oa.us COMMONWEALTH OF PENNSYLVANIA DEPARTMENT DF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280801 HARRISBURG, PA 1)728-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT N0. CD 013388 CAREY JOYCE A 1 TEE JAY DR MOUNT HOLLY SPRINGS, PA 17065 ESTATE INFORMATION: ssN: iaa-io-si2o FILE NUMBER: 2102-081 6 DECEDENT NAME: BREAM EDITH E DATE OF PAYMENT: 09/21/2010 POSTMARK DATE: 06/18/2010 COUNTY: CUMBERLAND DATE OF DEATH: 03/12/2000 REMARKS: AMNESTY SEAL ACN ASSESSMENT AMOUNT CONTROL NUMBER 01 147351 ~ $148.19 REV-7162 EXI71-961 TOTAL AMOUNT PAID: INITIALS: WZ RECEIVED BY: 5148.19 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS /337 pennsylvania DEPARTMENT OFREVENUE September 16, 2010 To the Register of Wills of the County of CUMBERLAND RE: INHERITANCE TAX CREDIT MEMO Estate of: File Number: Decedent's SS#: ACN Number: Payment Amount .Postmark Date: Date of Death EDITH E(~BREAM~4/~ 184-10-6120 OO 01147349 $ 146.86 6/18/2010 3/12/2000 ii~~~~Jl,r~,~~ `;~~Ir;C ,~,~ 2010 SAP 2 ~ AM 10= 5 ~PH.4NRS COURT CUMBERL~Wn CO., PA, An Amnesty payment on the above-referenced inheritance tax liability has been received and transferred to the inheritance tax fund. Please issue an official inheritance tax receipt for the Tax Amnesty payment and postmark date above. Make the payment date on the receipt the date the receipt is prepared by your ofhce. Also, type "AMNESTY" in the remarks area of the receipt. Mail the receipt to: Name: JOYCE A CAREY Street: 1 TEE JAY DR City/State/ZIP: MOUNT HOLLY SPRINGS PA 17065 The department's copy of the Official Receipt should be mailed using the postage paid Inheritance Tax bulk mail envelope (E-136) within five (5) business days after receiving this credit memo. Attach an "AMNESTY" cover sheet to the front of the receipt, or if multiple amnesty receipts are being submitted, attach the cover sheet to the top of the group. The amnesty cover sheet will help expedite the processing of the receipt when it arrives in the Inheritance Tax Division. Please keep the amnesty receipts sorted and bound separately from the other Inheritance Tax documents when placing them in the bulk envelope. On your next Register of Wills Monthly Report, REV-714, include the payment amount in the monthly inheritance tax collections reported on Line 5, and claim a credit on Line 7. Your monthly inheritance tax collections, less the credit for this payment, should equal the Total Amount Deposited on Line 12. Your efforts in expediting the issuance and mailing of the Department of Revenue's copy of the tax amnesty payment receipt is greatly appreciated. Thank you for your timely attention to this matter. If you have any questions, please call 717-787-7031. Indlvldual Taxes I PO Box 280603 I Harrisburg, PA 17128 1717J87J0311 www.revenue.state.pa.us ~~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT Of REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280801 HARRISBURG, PA 17128-0801 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT CAREY JOYCE A 1 TEE JAY DR MOUNT HOLLY SPRINGS, PA 17065 -------- role ESTATE INFORMATION: ssN: isa-io-s~2o FILE NUMBER: 2102-0816 DECEDENT NAME: BREAM EDITH E DATE OF PAYMENT: 09/21/2010 POSTMARK DATE: 06/18/2010 COUNTY: CUMBERLAND DATE OF DEATH: 03/12/2000 REV-1162 EX111-961 N0. CD 013387 ACN ASSESSMENT AMOUNT CONTROL NUMBER 01147349 ~ $146.86 TOTAL AMOUNT PAID: REMARKS: AMNESTY SEAL INITIALS: WZ RECEIVED BY: $146.86 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS Pennsylvania DEPARTMENT OF REVENUE September 16, 2010 To the Register of Wills of the County of CUMBERLAND RE: INHERITANCE TAX CREDIT MEMO Estate of: File Number: Decedent's SS#: ACN Number: Payment Amount: Postmark Date: Date of Death EDITH E REAM 4-10-6120 01147348 $ 132.25 6/18/2010 3/12/2000 /33 ~ ~~ «,__ ~E~ul~ i k~ ~: ~,~,t 1 r . t. ~J 2010 SEP 21 AM !0: 55 CL~ OF CUMg S~ ~JR PA. An Amnesty payment on the above-referenced inheritance tax liability has been received and transferred to the inheritance tax fund. Please issue an official inheritance tax receipt for the Tax Amnesty payment and postmark date above. Make the payment date on the receipt the date the receipt is prepared by your office. Also, type "AMNESTY" in the remarks area of the receipt. Mail the receipt to: Name: JOYCE A CAREY Street: 1 TEE ]AY DR City/State/ZIP: MOUNT HOLLY SPRINGS PA 17065 The department's copy of the Official Receipt should be mailed using the postage paid Inheritance Tax bulk mail envelope (E-136) within five (5) business days after receiving this credit memo. Attach an "AMNESTY" cover sheet to the front of the receipt, or if multiple amnesty receipts are being submitted, attach the cover sheet to the top of the group. The amnesty cover sheet will help expedite the processing of the receipt when it arrives in the Inheritance Tax Division. Please keep the amnesty receipts sorted and bound separately from the other Inheritance Tax documents when placing them in the bulk envelope. On your next Register of Wills Monthly Report, REV-714, include the payment amount in the monthly inheritance tax collections reported on Line 5, and claim a credit on Line 7. Your monthly inheritance tax collections, less the credit for this payment, should equal the Total Amount Deposited on Line 12. Your efforts in expediting the issuance and mailing of the Department of Revenue's copy of the tax amnesty payment receipt is greatly appreciated. Thank you for your timely attention to this matter. If you have any questions, please call 717-787-7031. Individual Taxes I PO Box 280603 1 Harrisburg, PA 17128 1 717.787.70311 www.revenue.state.oa.us COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE 6UREAU OF INDIVIDUAL TAXES DEPT. 260601 HARRISBURG. PA 17126-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT CAREY JOYCE A 1 TEE JAY DR MOUNT HOLLY SPRINGS, PA 17065 10~ ESTATE INFORMATION: ssN: lea-1o-6120 FILE NUMBER: 2102-081 6 DECEDENT NAME: BREAM EDITH E DATE OF PAYMENT: 09/21/2010 POSTMARK DATE: 06/18/2010 COUNTY: CUMBERLAND DATE OF DEATH: 03/12/2000 REMARKS: AMNESTY SEAL REV-1162 EX111-961 N0. CD 013386 ACN ASSESSMENT AMOUNT CONTROL NUMBER 01147348 ~ 5132.25 TOTAL AMOUNT PAID: INITIALS: WZ RECEIVED BY 5132.25 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES _" ~ ;t7~1~I~RITANCE TAX INHERITANCE TAX DIVISION ,ST44TE'~'IENT OF ACCOUNT PO BOX 280601 HARRISBURG PA 17128-0601 -- ~^ ~ ` !^.; -rr~,~ % ~ _.~: -- _ r J' ' JOYCE A CARE a4 ' ~ ~~''' •~._ 1 TEE JAY DR MT HOLLY SPRINGS PA 17065 pennsylvan~a Y ~ DEPARTMENT OF REVENUE REV-1607 EX AFP (12-09) DATE 10-04-2010 ESTATE DF BREAM EDITH E DATE OF DEATH 03-12-2000 FILE NUMBER 21 02-0816 COUNTY CUMBERLAND ACN 01147348 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: 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 ~ _ _ _ REV 1607 EX AFP (12~ 09~ ~ ~~~ *** INHERITANCE TAX STATEMENT~OF ACCOUNT ~~*** ~~ ~ ~~~~~ ~~~~~~~~~~ ESTATE DF:BREAM EDITH E FILE NO.: 21 02-0816 ACN: 01147348 DATE: 10-04-2010 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: 01-03-2003 PRINCIPAL TAX DUE: 102.39 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 06-18-2010 CD013386 29.86- 132.25 TOTAL TAX PAYMENT ~ 102.39 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. ~)~ BUREAU OF INDIVIDUAL TAXES T!fiIME'~'ITANCE TAX INHERITANCE TAX orvlsloN _ ~ TAT E M ~'N T C F A C C O U N T PO BOX 280601 ~. _ ., _, .. ~ . HARRISBURG PA 17128-0601 !'~ I r - JOYCE A CAREY L, '"~'' 1 TEE JAY DR MT HOLLY SPRINGS PA 17065 pennsylvan~a ~ . DEPARTMENT OF REVENUE REV-1607 EX AFP (12-09) DATE 10-04-2010 ESTATE OF BREAM EDITH E DATE OF DEATH 03-12-2000 FILE NUMBER 21 02-0816 COUNTY CUMBERLAND ACN 01147349 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: 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 ~ _ _ _ _ REV 16Q7 SEX AFP~ C12 09~~~~~~ *** INHERITANCE TAX STATEMENT~OF ACCOUNT ~~*** ~~~~~~ ~ ~ ~~~~ ~~~~~ ESTATE OF:BREAM EDITH E FILE NO.: 21 02-0816 ACN: 01147349 DATE: 10-04-2010 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: 01-03-2003 PRINCIPAL TAX DUE: 113.70 PAYMENTS (TAX CREDITS}: PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID C-~ Od-18-2010 CD013387 33.16- 146.86 TOTAL TAX PAYMENT ~ 113.70 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE I .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. BUREAU OF INDIVIDUAL TAXES ~ ~!NH~tITANCE TAX INHERITANCE TAX DIVISION S,TAT E Mf N T O F A C C O U N T PO BOX 280601 HARRISBURG PA 17128-0601 .J 1 / ? ~..~ { Yi ~ f _ ~.< ,.. JOYCE A CAREY~'' ,` ~,,_ 1 TEE JAY DR MT HOLLY SPRINGS PA 17065 ~. pennsylvania~° ~ ~ DEPARTMENT OF REVENUE REV-1607 EX AFP (12-09) DATE 10-04-2010 ESTATE OF BREAM EDITH E DATE OF DEATH 03-12-2000 FILE NUMBER 21 02-0816 COUNTY CUMBERLAND ACN 01147351 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: 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 ~ _ __ REV X1607 SEX AFP C12 09~ ~~~ *** INHERITANCE TAX 3TATEMENT~OF ACCOUNT ~~*** ~ ~~ ~~~~~~~~~~r~~~~ ESTATE OF:BREAM EDITH E FILE NO.: 21 02-0816 ACN: 01147351 DATE: 10-04-2010 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: 01-03-2003 PRINCIPAL TAX DUE: 115.02 PAYMENTS CTAX CREDITS): PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID C-) Ob-18-2010 CD013388 33.17- 148.19 10-01-2010 SBADJUST .00 .37 TOTAL TAX PAYMENT I 115.02 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" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.