HomeMy WebLinkAbout09-24-09CC'a f. -.=A;_TH CF F~NNSVLVANIA
D.r',~i.. `,T ~=REVENUE
BURE~ = IN;, VIDUAL'AXES
DE=T. i01
HARK, ~:. ,,;, PA 17128-0601
RECEIVEC !=ROM:
REV-1162 EX(11-961
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 01 1797
PO-' - EIGER PAULA D
30 ~=~~~ITH CIRCLE
CAf;_ISLE, PA ~ 7013
ESTATE NFORMATION: SSN: 288-40-4517
FILE Nl.'P. 1BER: 2107-1068
DECEDEI.^ dT NAME: ADAMS SANDRA L
DATE CE PAYMENT: 09/24/2009
POSTM=- ,K DATE: 09/23/2009
couN- CUMBERLAND
DATE= ,- DEATH: 1 1 /06/2007
REM~~ " ;S:
~HECI<# 1695
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
08500031 ~ 5468.62
TOTAL AMOUNT PAID:
5468.62
INITIALS: JN
sE"` RECEIVED BY: GLENDA EARNER STRASBAUGH
i
', REGISTER OF WILLS
REGISTER OF WILLS
i -
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX ,`!
INHERITANCE TAX DIVISION _ pSAISElI~NT ALLONANCE OR DISALLONANCE
PD Bax zao6ol .: ~~" ;DEDUCTION" AND ASSESSMENT OF TAX ON
HARRISBURG, PA Iriza-osol - _ - -~ ~ .SECL~RI~'~i ACCOUNTS HELD IN Rw-154Bp pFP cos-o5~
~: BENEFICIARY FORM
"~- ~ J ~ DATE 12-08-2008
ESTATE OF ADAMS SANDRA L
!-3(~9 SEP L~+ ~f"4 ~' ~~ DF,TE OF DEATH 11-06-2007
FILE NUMBER 21 07-1068
COUNTY CUMBERLAND
~~ Ci~'=~'~~ ~.ii SSN/DC 288-40-4517
PAULA D POTTERGEN ~~n ~I,' ~ 1~,J(~i ACN 08500031
30 FAITH CIRCLE `J{~~ r i ~;`1 ~~;. APPEAL DATE: 02-06-2009
CARL I SL E ~ PA 17013 (See reverse side under objections)
Amount Remitted ~-- a
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
~-- RETAIN LOWER PORTION FOR YOUR RECORDS F-
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