HomeMy WebLinkAbout07-26-10COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1 7 1 28-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
CHYLACK LAWRENCE M
519 DELP RD
SOUDERTON, PA 1 8964-21 1 2
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ESTATE INFORMATION: SSN: ~ s6-22-3546
FILE NUMBER: 2110-0649
DECEDENT NAME: CHYLACK THEODORE W
DATE OF PAYMENT: 07/26/2010
POSTMARK DATE: 07/24/2010
COUNTY: CUMBERLAND
DATE OF DEATH: 05/ 1 8/201 0
REV-1162 EX111-96)
NO. CC) 013095
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
10132316 $66.12
TOTAL AMOUNT PAID:
REMARKS:
CHECK# 7679
SEAL
INITIALS: SAP
$ 66.12
RECEIVED BY: GLENDA EARNER STR.ASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
~.. ~, _ .
BUREAU OF INDIVIDUAL TAXES _ ~~~% t ~~ ,~~ AND
PD BOX 280601 ~~ ~-'T~J~XPAYER RESPONSE
HARRISBURG PA 17128-0601 .-;'~ ~~~ ,
REV-1543 EX AFP (OB-OB)
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FILE N0. 21'IQ` (J~L~~~fi
ACN 10132316
DATE 06-10-2010
CLEF
LAWRENCE M CHYLACK
519 DELP RD
SOUDERTON PA 18964-2112
EST. OF THEODORE W CHYLACK
SSN 186-22-3546
DATE OF DEATH 05-18-2010
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
TYPE OF ACCOUNT
SAVINGS
® CHECKING
TRUST
CERTIF.
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
complete t~o 'tyh~~e be t o y knowledge and belief . HOME ( ~ IS ) ~ ~ 3 ~ ~~
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