HomeMy WebLinkAbout05-07-10 (2)COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1 7 1 28-0601
RECEIVED FROM:
HOLMES TIMOTHY ANDRES
PA DEPT OF CORRECTIONS
55 UTLEY DRIVE
CAMP HILL, PA 1701 1
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
ACN
ASSESSMENT
CONTROL
NUMBER
fold
ESTATE INFORMATION: ssN: X95-07-4684
FILE NUMBER: 2109-0818
DECEDENT NAME: BAIR DAVID NOAH
DATE OF PAYMENT: 05/07/2010
POSTMARK DATE: 05/07/2010
COUNTY: CUMBERLAND
DATE OF DEATH: 08/ 1 7/2009
REV-1162 EX(11-96)
NO. CD 012715
AMOUNT
101 ~ 5666.50
TOTAL AMOUNT PAID:
REMARKS:
SEAL
CHECK# 1273
5666.50
INITIALS: SAP
RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS