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DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX REV-1607 EX AFP (12-13)
INHERITANCE TAX DIVISION STATEMENT OF ACCOUNT
PO BOX 280601
HARRISBURG PA 17128-0601
DATE 07-21-2014
ESTATE OF YOUNG JOHN D
DATE OF DEATH 06-23-2013
FILE NUMBER 21 14-0563
COUNTY CUMBERLAND
ROSE MCBETH ACN 13139217
34 SANDBANK RD Amount Remitted
SHIPPENSBURG PA 17257-9687
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 F
REV-1607 EX AFP (12-13) ** INHERITANCE TAX STATEMENT OF ACCOUNT **
ESTATE OF:YOUNG JOHN D FILE NO. : 21 14-0563 ACN: 13139217 DATE: 07-21-2014
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: 06-09-2014
PRINCIPAL TAX DUE: 51 .98
PAYMENTS (TAX CREDITS) :
PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
07-10-2014 CDO19401 .40- 52.38
07-18-2014 SBADJUST .00 .06
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TOTAL TAX PAYMENT 51 .98
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\