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DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX REV-1607 EX AFP (12-14)
INHERITANCE TAX DIVISION
PO BOX 2B0601 I ED CFFICE OF STATEMENT OF ACCOUNT
HARRISBURG PA 1712R-E&0lR'-'L
DATE 06-01-2015
ESTATE OF TRAYER SUSAN R
?015 8 Nr{ 12 00 t55, DATE OF DEATH 10-11-2013
FILE NUMBER 21 13-1105
C L E r"17 COUNTY CUMBERLAND
DANIELS
NWILLI-AM- S ACN 101
STE 2%� 7-
Amount Remitted
1 W H ST--
CARLISLE PA 17013-2951
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 (H-174)- - --I TAX STATEMENT OF C05if
i�V--liif 6X NHikffA�NE
ESTATE OF:TRAYER SUSAN R FILE NO. : 21 13-1105 ACN: 101 DATE: 06-01-2015
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: 05-04-2015
PRINCIPAL TAX DUE: 29,210.00
PAYMENTS (TAX CREDITS) :
PAYMENT RECEIPT DISCOUNT AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID
01-09-2014 CDO18629 96.05 1,825.00
01-09-2014 CDO18630 1 ,364.45 27,500-00
05-12-2015 REFUND .00 1,575.50-
TOTAL TAX PAYMENT 29,210.00
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. 0