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09-23-13
cOMMONWEnL1N oF cFNNSrWANia REV-1162 EX(11-9Ci1 DE�ARTMENT Of HP.+ENVE 5UFlEAU OF INDIVIDUAL TAx[$ nev�_zaoeoi HqRRI58URG.PA 1 T 28 0601 PENNSYI.VANIA RECEIVED FROM: �NHERITANCE AND ESTATE TAX QFFICIAL RECEIPT NC3. CD 018169 HRRRING VALERfE 2670 SPRING ROAD CAR�ISLE, PA 17013 AGN ASSESSMENT AMOUNT CONTROL NUMBER -- �a�r ------ --- 1Q1 � $165.33 ESTATE INFORMATION: Ssrv: � FILE NUMBER: 2112-0919 � DECEDENT NAME: QUINN EVELYN � DATE 4F PAYNIENT: C?9f 23f 2013 � POSTMARK DATE: 0912312Q13 � COUNTY: CUMBERLAND � QATE OF DEATH: 08/04f 201 2 i � TOTAL ,4MOUNT PA{D: 5165.33 RENIARKS: RECEIPT TO RTTY CHECK# 2987 iNiTiAGS: HMW sFn� RECElVED BY: G�ERIDA FARRIER STRASBAUGH REGISTER (3F WI��.S REGISTER OF WILLS