HomeMy WebLinkAbout05-09-11 (2)COMMONWEALTH OF PENNSYLVANIA
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
BAILEY NORMAN
31 HICKORY ROAD
MOHNTON, PA 19540
----~---- fold
REV-1162 EX(11-96)
NO. CD 014437
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
---------- --------
ESTATE INFORMATION: SsN: ~ 87-56-3732
FILE NUMBER: 2'110-0672
DECEDENT NAME: BAILEY NICOLE MARIE
DATE OF PAYMENT: 05/09/201 1
POSTMARK DATE: 05/06/201 1
COUNTY: CUMBERLAND
DATE OF DEATH: 06/ 1 1 /2010
REMARKS:
SEAL
CHECK# 1021
1 1001806 $343.49
TOTAL AMOUNT PAID:
$343.49
INITIALS: DB
RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF INDIVIDUAL
INHERITANCE TqX TAXES ~'r ~~ ~"
PO BOX 280601 DIVISION .•'j _
HARRISBURG pA 17128- L M'`~'t~~ OF INHERITANCE TAX
0601 (. _ _ AF-!'RAISE ~ ALLOWANCE pR perms
O-F, DEDUC~rp~S, AND ASSES ylvania
DISALLOWANCE .
JOINTLY HELD pR T SMENr pF ~EPgRTMENT
RUST TAX pN REV- ~FREVENUE
1 U .._ ASSETS 1548 EX AFP C12-10) r,:
~ ~ -~ ~ ~ , ~u: ;_ ~ ;~~ DATE
ESTATE OF 04-25-2011
~l ~-;'~~ ,,r DATE OF BAILEY
`' ~ `~„ DEATH 06-
~~ ~ !, ~-
BRIDGET ?' `; `' FILE NUMBER 10- 2010 NICOLE M
31 L BAILEY C~;h' ~.^, ~~% .~ > ~: ~~~= '~' COUNTY 21 0672
HICKORY Rp,4D ,: ~ ! ,~ , ~~~ SSN/DC CUMBERLAND
MOHNTON ACN 187-
PA 19540 11001806732
APPEAL BY DATE:06-
(See reverse side under 24 - 2011
Amount Remitted ~bJectionS~
MAKE CHECK PAYABLE N`DM1 R,
REGISTER EMIT PAYMENT
1 COURTHOUSE wSQU S r0:
CARLISLE ARE
CUT-ALONG THIS LINE PA 17013
-------__ ~ RETAIN
-----___-LOWER ppRTIO
---'-N-FOR_Y~UR-RECORDS L