HomeMy WebLinkAbout06-17-15 _T 0 pennsylvania
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DEPARTMENT OF REVENUE
BUREAU „E,Gi-IivIDUft �TAX�EJCE OF INHERITANCE TAX REV-1607 EX AFP (12-14)
INHERITANCE TDLYISION 1�_+ILL J STATEMENT OF ACCOUNT
PO BOX 280 RE,,I,� , . :. i L
HARRISBURG PA 17128-0601 9 u
nis nN 17 jl 13 DATE 06-08-2015
ESTATE OF GARBACIK RAYMOND R
CLERK Or DATE OF DEATH 02-08-2013
0RPHAH:S' ;0UR T FILE NUMBER 21 13-0194
r }G, r COUNTY CUMBERLAND
f �a�iA�7D �_1 J, AIR`BAC�I1� ACN 14101755
221 N 17TH ST
Amount Remitted
CAMP HILL PA 17011-3911
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 (12-14) *** INHERITANCE TAX STATEMENT OF ACCOUNT 3e;;
ESTATE OF:GARBACIK RAYMOND R FILE NO. : 21 13-0194 ACN: 14101755 DATE: 06-08-2015
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: 03-13-2015
PRINCIPAL TAX DUE: 2,943.56
PAYMENTS (TAX CREDITS) :
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
05-08-2013 CDO17584 147. 18 2,796.83
12-23-2014 CD020068 .00 24.99
04-14-2015 CD020527 .00 291 .64
TOTAL TAX PAYMENT 3,260.64
BALANCE OF TAX DUE 317.08CR
INTEREST AND PEN. .00
TOTAL DUE
317.08CR
* 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.