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01-04-11
COMMONWEALTH OF PENNSYLVANIA REV-1162 EX~11-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 013857 BOCK LISA B 15 CEDARHURST LANE CAMP HILL, PA 1701 1 ACN ASSESSMENT AMOUNT CONTROL NUMBER -------- fold ---------- -------- 101 ~ $1, 341 .42 ESTATE INFORMATION: SSN: 192-30-0903 FILE NUMBER: 2110-0777 ~ DECEDENT NAME: BOURDETTE BARBARA S ~ DATE OF PAYMENT: 01 /04/201 1 ~ i POSTMARK DATE: 01 /04/201 1 ~ ~, COUNTY: CUMBERLAND ~ ', DATE OF DEATH: 07/ 25/ 2010 TOTAL AMOUNT PAID: $1,341.42 i REMARKS: ~ i i CHECK# 1850 INITIALS: DB SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS b-- ~j ~ ~ NOTICE OF INHERITANCE TAX pennsylvan~a ~~ ~ i~: "'" ~~ E~--~- APPRAI~T. ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE B 1J.,~OF I~IVIDUA~~ES p ~..~~- I~T~i4WCE TA~--DIVISION='~-, ~?~-~U' OF DE~IJ~STIONS AND ASSESSMENT OF TAX REV-1547 EX AFP C12-09) P0~°$f~X- 280601 _,... ~~~ _, ~~~~~J k ~~,~ '4 _ ~.._~~ NA~tR~ S8 UI~G PA 128 - 0 ^-~ ~, ' ' ~. `~ ~ ~~ '~ t .~ ~ ~; ~~ DATE 12-13-2010 , ' _, , ~ U-~-~ ~~ . ESTATE OF BOURDETTE BARBARA S ~ - ' , ~`` , ~-`~~~~ DATE OF DEATH 07-25-2010 g {.~_, ~.~ t~~ ,. :_ ~ O ~~E~~. car FILE NUMBER 21 10-0777 -"~ - <, (~~?;~}~'i,~';C`'~~{~ ~t~-'`-~~'T ~- COUNTY CUMBERLAND JAMES W KOLLAS f, A ((;; ~ A~~~ ~' ':~; ~ ~ ~~ ~ ~! ~ ~~ ~` ACN 101 1104 FERNWOOD AVE ~ APPEAL DATE: 02-11-2011 CAMP HILL PA 17 011 (See reverse side under Objections) Amount Remitted ~, MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 `\ *®1{ ,. '~ `~ ~ ~ ~ x~ ~r ~~ 0 ~~ I `~ t~• F~,~ ~„~. ;~i f,~~ ~. n ~ `_ ~ i~ '%:3 i=~ -may ... ~ ', r~ --i -'t';a •.~- ~~~. ...~ c.~ 'x'7 ~' ~ ~~ .F' ~ , ~ "~ -.~ i_ ._ ~!'~ (~ "~'"~ Fv J ~ c ~ 4 W E.f~t ~~ t'.~ ';~ ~` ~~ i` ~~~ ''~ ~~;,i ~~`~ f~-: i'i ,~/.:i ~.,` ;~; ` ~~~.~ il. _~ t,.: _„~ ~:. 5^'"