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HomeMy WebLinkAbout06-23-14 [' J pennsylvania DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX REV-1607 EX AFP (12-13) INHERITANCE TAX DIVISION PO BOX 280601 STATEMENT OF ACCOUNT HARRISBURG PA 17128-0601 DATE 06-16-2014 ESTATE OF KELLER JOHN W DATE OF DEATH 06-27-2013 FILE NUMBER 21 13-0903 COUNTY CUMBERLAND ROGERS ESQ ELYSE E ACN 101 STE 400 Amount Remitted 625 NORTH 12TH STREET LEMOYNE PA 17043 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 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - REV-1607 EX AFP (12-137 ■■■ INHERITANCE TAX STATEMENT OF ACCOUNT ESTATE OF:KELLER JOHN W FILE NO. : 21 13-0903 ACN: 101 DATE: 06-16-2014 THIS STATEMENT PROVIDES CURRENT STATUS OF THE STATED ACM 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: 04-28-2014 PRINCIPAL TAX DUE: 18,755.48 PAYMENTS (TAX CREDITS) : PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) ,v 09-18-2013 CDO18159 937.77 18,000.00 c s f�r7 rTl 05-29-2014 REFUND .00 182.29 c a7 0 cp -icy r\) -ry m r m w o n- c� n -3 tz n C.- H `- c r M s U) o n rn n TOTAL TAX PAYMENT 18,755.48 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. V \