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DEPARTMENT OF REVENUE
BUREAU OFMqqa&E&AlEFICE OF INHERITANCE TAX REV-1607 EX AFP (12-13)
INHERITANCE SIO
PO Box 280611 ISMER OF WILLS STATEMENT OF ACCOUNT
HARRISBURG PA 1601 uu
21DATE 12-01-2014
ESTATE OF WILLHIDE ROBERT L
CLERK Or' DATE OF DEATH 01-30-2013
ORPHANS' COURT FILE NUMBER 21 13-0316
WEIO eEfQR L AI i lDj t�R'k y A COUNTY CUMBERLAND
ACN 101
126 E KING ST
AmountRemitted
SHIPPENSBURG PA 17257-1326
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
I 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 i[ STATEMENT£X AFP
LINE --I� RETAIN LOWER PORTION- FOR YOUR RECORDS 4— --- -
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3� H TAX
ESTATE OF:WILLHIDE ROBERT L FILE NO. : 21 13-0316 ACN: 101 DATE: 12-01-2014
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: 07-28-2014
PRINCIPAL TAX DUE: 961.81_
PAYMENTS (TAX CREDITS) :
PAYMENT RECEIPT DISCOUNT C+3 AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID t-3
03-24-2014 CDO18921 .00 961.81
11-19-2014 CDO19941 11 .44- 11 .44
TOTAL TAX PAYMENT 961.81
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.