HomeMy WebLinkAbout12-10-12COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1 7 1 28-0601
RECEIVED FROM:
MAIDL VIRGINIA
1385 OVERLOOK ROAD
MIDDLETOWN, PA 17057
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1162 EX(11-96)
NO. CD 016899
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
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ESTATE INFORMATION:
FILE NUMBER: 2112-1290
DECEDENT NAME: FREE GERALDIN R
DATE OF PAYMENT: 1 2/ 1 0/201 2
POSTMARK DATE: 1 2/07/201 2
COUNTY: CUMBERLAND
DATE OF DEATH: 00/00/0000
101 ~ 52,257.14
TOTAL AMOUNT PAID:
REMARKS:
SEAL
CHECK# 1876
INITIALS: HMW
RECEIVED BY:
52,257.14
GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
JAMES E. HOLLAND, CPA
ESTATE OF GERLADINE R. FREE
MEMO FOR FILING THIS TAX RETURN -ESTIMATED PAYMENT
Attached is your PA REV-1500 Inheritance Tax Return
Please sign, date and mail the original return
TO: Cumberland Ccunty P.egister cf `~Nills
Courthouse
1 Courthouse Square
Carlisle, PA 17013-3387
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THE BOXES CHECKED BELOW APPLY TO THIS RETURN:
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( ) No Tax due/refund ~~~ ~
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( X ) Submit your remittance in the amount of $2,257.14 > •~~ ~ } ";
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( ) You have overpaid your tax by ~ ~`~
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( ) It will be refunded to you.
( ) It is being applied to your estimated tax for the current year.
SPECIAL INSTRUCTIONS AS FOLLOWS:
( X ) Make check payable to: Register of Wills, Agent
( X ) Be sure to include your account number/social security number on
your check. I~S~ i~z ,Zc~~i7
( X ) Other instructions: PLEASE SUBMIT YOUR PAYMENT ON OR
BEFORE DECEMBER 12 2012
7 West Main Street / Shiremanstown, Pennsylvania 17011 / (717) 763-6890
FORM:MISC-INS
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