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DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX REV-1607 EX AFP (12-14)
INHERITANCE TAX DIVISIONPO BOX F STATEMENT OF ACCOUNT
HARRISBURG 6PA`1�E201 6�50�E D Q F .FICE
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REGISTER OF WILLS
DATE 07-06-2015
ZgISAl L J ili 1r) pfi 112 08' ESTATE OF WARNER FRANCES C
J t� DATE OF DEATH 09-05-2014
CLERK OF FILE NUMBER 21 15-0523
UB��JRT COUNTY CUMBERLAND
DORISCRPHAI'A
ACN 14162377
43Ii4W�f1 �RWI�.�C CO PA Amount Remitted
NEW �G PA 17241-9713
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 F�
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REV-11607 E- -2 - - N-HER -TACE -TAXSTAT-EMENT OF-ACC-OUNT - - -* - - - - - - - - - - - - - -
ESTATE OF:WARNER FRANCES C FILE NO. : 21 15-0523 ACN: 14162377 DATE: 07-06-2015
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: 06-08-2015
PRINCIPAL TAX DUE: 10.00
PAYMENTS (TAX CREDITS) :
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
06-22-2015 CD020888 .01- 10.01
TOTAL TAX PAYMENT 10.00
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.
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