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09-24-09
CO~~^. P. - ': EALTH OP PEN PJSY LV A'VIA DEPT,-~-"_ S.T OE REVEfJ L'E BURE:,'~J ~- ~.NDIVIDUAL TFXES DEPT. ~c c01 HAr,RI -. , ;. ~A 171 2°-0601 PENNSYLVANIA RECEIVE[) ~=ROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT IRVVIN ROGER B ESQ 60 ~~' POMFRET ST CAR:_ISLE, PA 17013 ,o~~ ESTAT':- NFORMATION: SSN: 170-32-3370 FILE Nl;f.1BER: 2108-0169 DECEDFriT NAME: BROUGHER ANNA V DATE OF PAYMENT: 09/24/2009 POSTMARK DATE: 09/24/2009 couN1 ~: CUMBERLAND DATE OF DEATH: 02/ 1 0/2008 REMA ~ :S: SEAL ~HECK# 6250 AMOUNT REV-1162 EX111-961 NO. CD 01 1796 ACN ASSESSMENT CONTROL NUMBER 101 ~ 560.01 TOTAL AMOUNT PAID: 560.01 INITIALS: JN RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS