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08-19-10
COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: CHYLACK THEODORE J 42 PINETREE DRIVE AUDUBON, PA 19403 -------- fold PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ESTATE INFORMATION: SSN: 186-22-3546 FILE NUMBER: 2110-0649 DECEDENT NAME: CHYLACK THEODORE W DATE OF PAYMENT: 08/ 1 9/2010 POSTMARK DATE: 08/ 1 2/2010 COUNTY: CUMBERLAND DATE OF DEATH: 05/ 1 8/ 2010 REV-1162 EX(11-96) NO. CD 013233 ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ' S'12,283.78 TOTAL AMOUNT PAID: REMARKS: ;12,283.78 CHECK# 1 INITIALS: DM SEAL RECEIVED BY: GLENDA EARNER ST~RASBAUGH REGISTER OF WILLS REGISTER OF WILLS ur ~~ rip ~~: ~ ~A + . ~ ; L~ ~ ~ a ~^ .a,. '~ 4ti; _,, .",~ M ~ ; ~~ , z,. ~` d .tr y +' I ~w..~ ..1~. wed N;~ 'rw. ~ (f``yyam~'``' ~i~y ~_~ r R...,.~ ~f V~ ~ '~w... F rr.~a~ (:~y1' ~~ ~~'. v "'s ~, 1 1 ~1 I , 1 1 1 ~. r .. ..fix #~:. r.§ ~ ~ .. .. ~... ~f I~ ~A ~ ~ r AF'~i rt~~yr .F ~ a V