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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 08-04-2014
ESTATE OF MISHKIN SHAWN M
DATE OF DEATH 10-30-2012
FILE NUMBER 21 12-1211
COUNTY CUMBERLAND
KUNKEL ESQ SHELLY J ACN 101
PO BOX 60974
Amount Remitted
HARRISBURG PA 17106-0974
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 C12-135 ■ * INHERITANCE TAX STATEMENT OF ACCOUNT
ESTATE OF:MISHKIN SHAWN M FILE NO. : 21 12-1211 ACN: 101 DATE: 08-04-2014
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: 07-14-2014
PRINCIPAL TAX DUE: 3,997. 13
PAYMENTS (TAX CREDITS) :
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID C-)
06-13-2013 CDO17750 .00 51000.00 'c~a
07-15-2014 REFUND .00 1,002.87- CZCD a
G7`
zo W '-gin
OJi L/O CD
CT -Tl
TOTAL TAX PAYMENT 3,997. 13
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.
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