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HomeMy WebLinkAbout11-28-11COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE REV-1162 EXI11-96) BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 015258 IRWIN & MCKNIGHT PC 60 WEST POMFRET ST CARLISLE, PA 17013 ACN ASSESSMENT' AMOUNT CONTROL NUMBER fold ESTATE INFORMATION: ssrv: 204-46-5s3i FILE NUMBER: 211 1-0745 DECEDENT NAME: LIBERATOR DIANNE K DATE OF PAYMENT: 1 1 /28/201 1 POSTMARK DATE: 1 1 /28/201 1 couNTY: CUMBERLAND DATE OF DEATH: 05/29/201 1 REMARKS: RECEIPT TO ATTY CHECK# 31090 SEAL 101 ~ 5622.31 TOTAL AMOUNT PAID: INITIALS: HMW RECEIVED BY: REGISTER OF WILLS 5622.31 GLENDA EARNER STRASBAUGH REGISTER OF~ WILLS INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA 1 COUNTY OF CUMBERLAND J SS File Number 21-11-0745 Personal Representative(s) of the Estate of DIANNE K. LIBERATOR deceased, depose(s) and say(s) that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said inventory represents its fair value as of the date of the decedent's death, and that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of tltis inventory. I verify that the statements made in this Inven- tory aze true and correct. I understand that false state- ments herein are made subject to the penalties of 18 Pa.C.S. § 4904 relating to unsworn falsification to authorities. Attorney -- (Name) DOUGLAS G. MILLER, ESQUIRE (Supreme Court I.D. No.) 83776 (Address) 60 WEST POMFRET STREET, CARLISLE, PA 17013 (Telephone) (717) 249-2353 ' DATE OF DEATH LAST RESIDENCE DECEDENT'S SOC. SEC. NO. 05/29/2011 170 E. PENN STREET, CARLISLE, PA 17013 204-46-5831 2011 CHEVROLET HHR (Attach additional sheets as needed) FIGURES MUST BE TOTALED 14,609.00 .=- O = xa ,-, n -- .c-~ , ~~ n "z= i c ~ n~ N _ _ I ::1 ~_J~-~,~ _- ~7( ~ n T _ _ ...i C. -._.„ . ~..~ - ~ -fit W ~d..... Tl C T} ~ ,_ - ~ TOT 14,609.00 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative include the value of each item, but such figures should not be extended into the total of the Inventory. (See 20 Pa. C.S. ,¢ 3301(b)) Form RW-09 rev. /0.13.06