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DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX REV-1607 EX AFP (12-14)
INHERITANCE TAX DIVISION
PO BOX 2
S TAT E M E N T OF ACCOUNT
8 A�gHARRISBURGOFFICE OF
REGISTER OF WILLS)
DATE 08-10-2015
?015 AUG 17 PM 12 39 ESTATE OF MILLER HOWARD F
DATE OF DEATH, 08-21-2014
FILE NUMBER 21 14-0822
� i�_ COUNTY CUMBERLAND
I�`{2,P} A
MIL1)z (,:,GE-OFFREY G- ACN 101
3F LJM 6�C.KdNSON SCHL- RD
'� '. t✓ i i Amount Remitted
CARLISLE OA 17015
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 E--
REV-1607 EX AFP C12-14) *** INHERITANCE TAX STATEMENT OF ACCOUNT **
ESTATE OF:MILLER HOWARD F FILE NO. : 21 14-0822 ACN: 101 DATE: 08-10-2015
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: 06-29-2015
PRINCIPAL TAX DUE: 10,736.72
PAYMENTS (TAX CREDITS) :
PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID C-)
02-11-2015 CD020231 .00 9,403.75
07-27-2015 CD021013 6.67- 1,339.64
08-07-2015 SBADJUST .00 .65
TOTAL TAX PAYMENT 10,736.72
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