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08-06-13 (2)
� ^ COMM4NWEAlTHOFPENNSYlVAN1A R�V-1162EX(17-$6) I DEPARTMENT OF REVENUE BVREAU OF INDIVIDUAL TAXES DEPL 2808tl1 HARRISBURG.PA 17128-0801 PENNSYLVANtA RECENED FROM: 1NHERITANCE AND ESTATE TAX OFFICIAL RECEIPT N0. CD 017981 SHEIPE SUSAN CAROt� 25 NAILOR LANE NEWVILLE, PA 17241 ACN ASSESSMENT AMQUNT CONTROI. NUMBER —°--'- roa -'---'--'- '—'--_. 101 � $240.48 ESTATE INFORMATIqN: SsN: � FttE NuMBfR: 2113-0547 f DECEDENT NAME: REBEft EVA E � DATEOFPAYMENT: 0$j06j2013 � FOSTMARK DATE: 08(Q6(2013 � caun�rv: CUMSERLAND � DATE pF DEATH: 12j28j2C112 , i TOTAL AMOUNT PAiD: 5240.48 REMIARKS: SUSAN C SHEIPE CHECK# 3021 iNI7IALS: dB1 SEAI RECElVED BY: GLENDA FARNER STRASBAUGN REGISTER OF WIILS HEGISTER OF WILLS