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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
ADDAMS WILLIAM A
27 W HIGH STREET
PO BOX 261
3ARLlSLE, PA 17013
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ESTATE INFORMATION: SSN: 090-07-0343
FILE NUMBER: 2107-0185
DECEDENT NAME: GRA Y LILLIAN E
DATE OF PAYMENT: 06/01/2007
POSTMARK DATE: 06/01/2007
COUNTY: CUMBERLAND
DATE OF DEATH: 02/12/2007
NO. CD 008226
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $20.11
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS: RECEIPT TO ATTORNEY
CHECK# 3071
SEAL
INITIALS: AJW
RECEIVED BY:
REGISTER OF WILLS
$20.11
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS