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10-07-13
COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-961 DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT.280601 HARRISBURG,PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT � NO. CD 018212 ZACK WILLIAM FRANCIS 1504 CAPITOL VIEW DRIVE NEW CUMBERLAND, PA 17070 ACN ASSESSMENT AMOUNT CONTROL NUMBER -------- fold ---------- 101 � $15,000.00 ESTATE INFORMATION: ssN: ( FILE NUMBER: 2113-0943 � DECEDENT NAME: ZACK MARIE L � DATE OF PAYMENT: 1 O/08/2013 � POSTMARK DATE: 10/07/2013 � COUNTY: - CUMBERLAND � DATE OF DEATH: 07/22/2013 � - � TOTAL AMOUNT PAID: $15,000.00 REMARKS: CHECK#0054 INITIALS: HMW sEa� � RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS _ � � -- _ y � - - _ :� _ ` � W . - - ' � p - _ , � _ . � - - - - -- � - - - t/f � "` - .,. _ _- - - .3� � - - �. .. _- -- - � �.. -- .�� � � - - . � .� _ _ _ _ - : � �9 � — - - - - _ � _ _ __ � - - _ - r �► ' �„r,t � "` t^� '"` . _ _ - �+'`: .. - .+. � �'� -- -�,T"' °� (� � - - - � � � - _ � � � a .� -- _ - - ,� �r; v,� o .,. - - � - - - � ��-� � � �1 � ; - � � �� � _ - � � 3 3 .� _ -- - - - �� � s � � _ - _ _ _ � � � .� C� ,= ,� �b.. ,, „� - _ - � ��: . � .� - � � �„ -� � - _ � - „ -- _ Y � � � - - -_ � ^ � � -� _ - - _ � .o � � >� c� C.> � _ - _ _ .�Q � O 3 a - — -- r1 �,c — O� .o� - _ .� �U - - _ _ _ � � - _ - 3 �Z _ - - ui iiui � �i/+ - -. � - ..- s-. a e..'!: �. . . . - , - - �� . �� , ..— . -r� .�' � I �.' ,. r _. .. �.� P. t.'-,_ .: . . G�.I :.IL_itE_.f ,