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09-17-13
GOAAMONWEA�TN OF PEkNSYLVANik FfV-1 162 EXi719(;} 6EPARTMFidT OF REVENUE HUREAU OF WDtV�DVAITAkES DEFi.280Ent 4A13flIG8UFG,PA 1]128-06(71 PENNSY�VAt�SIA RECEIVEp FROM: iNHERI7ANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 018149 fAYBURN ANITA 23169 PATH VALLEY RQAD DOYLESBURG, PA 17219 ACN ASSESSMENT AMOUNT CONTRQL NUMBER --- - �o�,� ------ --- � 101 � S17,OOd.00 ESTATE fNFORMATION: SsN: 1 F1LE RIUMBER: 2113-Q$47 � DECEpENT NAME: FRAIN JAMES J � DATE OF PAYMENT: (79{17/z013 { POSTMARK DATE. 09/17/2013 � courvrv: CUMBERtAND j dATE OF DEATH: 06/23j2C713 { � TOTAL AfVIOUNT PA4D: S17,OOO.dO REMARKS: ftECEIPT TO ACCdUNT CHECK# 757 INITIALS: CJ SEA� RECENED BY: GLENdA FARNER_STRASBAUGH ftEGISTER OF WILLS flEGISTER OF WILLS