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12-16-13
COMMONWEALTH OF PENNSYLVANIA REV-1162 EXI11-961 DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT,280601 HARRISBURG,PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 018529 GRUVER LETTI M 410 SCOTT DRIVE SHIPPENSBURG, PA 17257 ACN ASSESSMENT AMOUNT CONTROL NUMBER ------- f.ld — — 101 G $21 ,000.00 ESTATE INFORMATION: SSN: FILE NUMBER: 2113-1067 DECEDENT NAME: GRUVER DONNA N DATE OF PAYMENT: 12/16/2013 POSTMARK DATE: 12/12/2013 COUNTY: CUMBERLAND DATE OF DEATH: 09/23/2013 TOTAL AMOUNT PAID: $21,000.00 REMARKS: RECEIPT TO ATTY CHECK# 304 INITIALS: DMB SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS I Z t, o o 0 ao rn I $ p — - © C) c cry ca Now `t O+ J N V W �] b^ 1 , m n wi 0 m ao,C ° p ca 'n 0 OD rt ry rt O'r- y M Un ;a d H+p N ;z7 ° --- rt C7 Q N p C N � 7 ' 0 7 � y o N uNr&D@T. o 9n Goo "it+ I O 3 O `p V' t O q mC) m f�i�N� H i