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05-03-10
COMMONWEALTH OF PENNSYLVAfJIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TA}:ES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CC) 012682 BOWMAN LARRY 4704 CARRIAGE WAY FLOWERY BRANCH, GA 30542 -------- fold ACN ASSESSMEN-~ AMOUNT CONTROL NUMBER ---------- -------- ESTATE INFORMATION: SSN: 192-,30-4910 FILE NUMBER: 2109-0102 DECEDENT NAME: BOWMAN DORIS S DATE OF PAYMENT: 05/03/2010 POSTMARK DATE: 05/03/2010 CouNTY: CUMBERLAND DATE OF DEATH: 01 /01 /2009 REMARKS: SEAL CHECK# 1085 09182564 ~ 575.33 TOTAL AMOUNT PAID: REV-1162 EX(11-96) $75.33 INITIALS: SAP RECEIVED BY: GLENDA F~~RNER STRASBAUGH REGISTER c~F WILLS REGISTER OF WILLS w ~~ ~~...~~..{{ L,.,j '•.~xJ v:~ r:' ~ ~; p t'--' ~~~=~ ~~ ~~w~ C~ ~ P' ~tz7~ w ''~ ~1 v ~~ ~(^ ~ l I ~ r ~~ I _ ~ ~ ~r ~~ ,. ~, Q '~. Q ~~ c` ~"~ ~!" .J (til C.../ ~C~ ~') _ t ~. < ~ . ; ~---- -a; . ;_~~ i ` ~ ~ ~tM . ,. { .r n ~ ,_ . % ~ C~ T' ~- r- , r_ , j i.':~ l ~> (~ ) .M.~ ~D ~~