HomeMy WebLinkAbout02-04-11COMMONWEALTH OF PENNS'ILVANiP.
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT.2&0601
HARRISB''JRG, PA 17128 Ci60
RECEIVED FROM:
SIMMONS KATHRYN A
65 SUSSEX RD
CAMP HILL, PA 1701 1
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PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
ESTATE INFORMATION: Ssty: ~ 82-22-8372
FILE NUMBER: 21 10-0447
DECEDENT NAME: SHANKS JANE M
DATE OF PAYMENT: 02/04/201 1
POSTMARK DATE. 02/03/201 1
COUNTY: CUMBERLAND
DATE OF DEATH: 02/03/2010
RE.\/-1162 EX111-96)
NO. CD (J1:3980
ACN
ASSESSMENT P,I`~IOUNT
CONTROL
NUMBER
10111153 $254.,40
TOTAL AMOUNT PAID:
REMARKS:
X254.40
CHECK# 1 1 1
INITIALS: DB
SEAL RECEIVED BY: GLENDA EARNER STR.A,SBA,UGH
REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
Po Box 260601
HARRISBURG PA 17128-0601
KATHRYN A SIMMONS `~-'~-'•, P,~,
65 SUSSEX RD
CAMP HILL PA 17011
penns~rlvan~a ~ k
DE'PaF~TMENT OF REVENUE
REN-1548 EX AFP t12-10)
DATE 01-31-2011
ESTATE OF SHANKS JANE M
DATE OF DEATH 02-03-2010
FILE NUMBER 21 10-0447'
COUNTY CUMBERLANI)
SSN/DC 182-22-83~~2
AGN 10111153
APPEAL BY DATE : 04 - 0 ]~ -• ;2011
(See reuerse side under Ohje~cti~ons)
1~"~ r1 ,., ~-~
_ •~ 17T'~ .9F INHERITANCE TAX
;`"j-• - APPRAIS h~~N-T~IALLOWANCE OR DISALLOWANCE
~~ OP-DEDOCt,TO~N~, AND ASSESSMENT OF TAX ON
._ .
JOINTLY~HELD OR TRUST ASSETS
Amount Remitted ~' ;~.~,°~~~ -
MAKE GHECK PAYABLE AND FtEMIT PAYMENT TO:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
BUREAU OF INDIVIDUAL. TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-06(11
KATHRYN A SIMMONS
b5 SUSSEX RD
__
F_r_ _~..• ; ..,~,~,,~ ~~ pennsy van~a c ~
~{~i ; 1~ ~. '. N~a7fC'E'-~0 'INHERITANCE TAX
•-~ ,• DEI~AF'TMENT OF REVENUE
r-; ~4d'PRAISEMEN'f',1,' b~~.OWANCE OR DISALLOWANCE
i`!:D'F-''EE~DUCf"IONS, -AND ASSESSMENT OF TAX ON REV-1!548 E:K AFP (12-10)
JOINTLY HELD DR TRUST ASSETS
'' (~W~ -~•{ ~i~Y f ~•'' DATE 01-31-2011
~- ~ ~ . ~ ESTATE OF SHANKS JANE M
DATE OF DEATH 02-03-2010
,-~,-
G~~~i`, -,,1'~1 r FILE NUMBER 21 10-0447
~~~~-;~"~-`'~1'~-'~ ~ ;~ii COUNTY CUMBERLAND
t~l 1~,, r ., ~ ~-';~. SSN/DC 182-22-8372'
ACN 10111152
CAMP HILL PA 17011
APPEAL BY DATE:04-O1-2011
(See reverse side under Objectr'ons)
Amount Remitted ,;)~~` ~µ,~- ~-?~.:
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE P~4 17013
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