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02-19-13 (2)
COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 017189 DEBRICK RICK 3560 SCOTLAND RD CHAMBERSBURG, PA 17202 fold ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ $ 2,100.00 ESTATE INFORMATION: SSN: FILE NUMBER: 2113-0199 DECEDENT NAME: KOST R NELSON II DATE OF PAYMENT: 02/ 19/2013 POSTMARK DATE: 02/ 16/2013 COUNTY: CUMBERLAND DATE OF DEATH: 1 1 / 21 / 2012 REMARKS: CHECK# UNNUMBERED SEAL TOTAL AMOUNT PAID: INITIALS: HMW REV-1162 EX(11-96) 52,100.00 RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS {..:. •.~ F„~t ~d~ ~' . ~~~ Rf~~s~y~~' ~~~~~ ~r~ ~o~ c? R~'P ~~~R ~~ ~v ~ ~ ~~~ :~~.~ Imo ~a c~~ ~~<3 ~E~3 19 ~ ~ 9 a # ~ ~ ~ N C i. ~ ~ RP~#~ • Ci~'BERL ° ~ ~= ' w .. 1~ ,~ K ~ ~ ~ p~~Jf' +14 1 Sslf .._ . r `- ~ ~ {v~~~iY.. ~w ~ ~ ~ ...r. ~ ~ ~ i r..... =: ~J ~. ~ ~i ~! °w ~ xpsc "' .~.r,. ...,,, ..r. I` ff ~ .:. '+'~yww.. s~s y ~~ ~ .~.... ~ ....,,. ~ ~ y (1 ~ ~ v ~I ~ !` ~. . w. ` ~ y ~r.~.. ~ ~ ~ ~ ~ `F 1F . . /T .r„ - IVI w o r.rr. ~ ~ ~~