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12-18-08
REV-1162 EX(11-961 I COMMONWEALTH OF PENNSYL\/ANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NQ, CD 010656 SIMMERS DOROTHY S 120 KIM ACRES DRIVE MECHANICSBURG, PA 17055 ACN ASSESSMENT AMOUNT CONTROL NUMBER ---- told ESTATE INFORMATION: ssN: ~ 9s-3o-oo4i FILE NUMBER: 2108-0006 DECEDENT NAME: SIMMERS ROBERT L DATE OF PAYMENT: 12/18/2008 POSTMARK DATE: 1 2/ 1 8/2008 COUNTY: CUMBERLAND DATE OF DEATH: 12/22/2007 08008336 ~ 52,295.96 TOTAL AMOUNT PAID: REMARKS: SEAL CHECK# 2068 INITIALS: CJ RECEIVED BY: 52,295.96 REGISTER ~OF WILLS REGISTER OF WILLS ~ _ _ ._ ~ au8UJ~21 81lOA 2104 NOI1210d 213MO1 NIb1321 t~ 3NIl SIH1 9NOlV 1f10 £iOLi dd `3lSIl21b'0 3Sf10H 121f100 00 ONdl213flWf10 SHIM d0 2131SI9321 O1 1N3WAVd 1IW321 ONV 31fl11AVd ~03H0 3)I11W (suouaalgp sapun apps asaana.! aas) 6££ L i dd A 21213 fl S I M 3 l 6002-£i-ZO ~31b0 lV3ddV 021 13Z1N3fl OL9 9££80080 NOV ~d •~i'..~ (..1i''i~ i~~j~~.3V~'~~ Ih00-0£-86i OQ/NSS ~~~QJ ~'~d~ WWIS 3N321I ONdl213flWf10 A1Nf100 ~~ ~~~~~ 9000-80 iZ N3flWf1N 3lId LOOZ-ZZ-Zi H1V3Q d0 31V0 l 1213fl0a S213WWIS d0 31V1S3 g~ ;~~ ~~ g ~ ~~Q ~OOZ 8002-SZ-Zi 31V0 (50-90) ddtl X3 845I-A38 S13SStl 1Sf1211 b0 Ol3H Al1WI:QF': ~. ~~~ ~-+•, r.;; +, 1090-SZiLi tld 9?J09SI821tlH NO Xtll d0 1N3WSS3SStl ONtl ' SNOI ~~Q3Q-'d0'i ~ -•-~ •'-- - i0908Z Xo9 od 3QNVMOIltlSIO 210 3JN`dMOlltl `1N3W3$'I,Y2ldaa''; . NOISIAIO Xtll 30Ntl1I213HNI Xtll 3~Ntl1I213HNI ~0 30I-lUN"'""''° `~'""- "~" "" S3Xtll ltlfI0IAI0NI d0 f1tl321f1H 3f1N3A321 d0 1N3W121Vd30 dIN1lAlJlSNN3d d0 H1ld3MNOWW00 dam"' •"r'. A _ - ~ ~ z _ . .. -. '~' Kate Simmers ~ ~+ ,. 670 Bentzel Rd. ~~ ~t~.Lewisberry, PA 17339 -~~.-~.n.,~.~-' N ~-'°". ' " !'f'~ ~ - r_ r~ _.... -; ''~ oa /S C~ C ~ -_ C~rt~sl~ ~ P4. (•7ai3 ft! !!} !!!!!! !! !!f! ~!f! ! t !!!! F t Fi ! !}!} }