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HomeMy WebLinkAbout06-03-14 COMMONWEALTH OF PENNSYLVANIA REV-11 Fit EX(t 1-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES OEPT.280601 HARRISBURG,PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 419235 FORKER DEBRA A 5082 CARROLTON DRIVE HARRISBURG, PA 17112 ACN ASSESSMENT AMOUNT CONTROL NUMBER -------- fold 101 $3,000.00 ESTATE INFORMATION: SSN: FILE NUMBER: 2114-0476 DECEDENT NAME: WERTZ JAMES R SR DATE OF PAYMENT: 06/03/2014 POSTMARK DATE: 06/02/2014 COUNTY: CUMBERLAND DATE OF DEATH: 04/07/2014 TOTAL AMOUNT PAID: $3,000.00 REMARKS: RECEIPT TO ATTY CHECK#4151 INITIALS: WZ SEAL RECEIVED BY: LISA M. GRAYSON, ESQ. REGISTER OF WILLS REGISTER OF WILLS SAMUEL L. ANDES ATTORNEY AT LAW 525 NORTH TWELFTH STREET P.O. BOX 168 LEMOYNE,PENNSYLVANIA 17043 MAILING ADDRESS: TELEPHONE P.O.BOX 168 (717)761-5361 LEMOYNE,PA 17043-0168 FAX E-MAIL:LaWAndes®aol.com (717)761-1435 2 June 2014 Register of Wills Office Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013 RE: Estate of James R. Wertz File No. 21-14-00476 Ladies & Gentlemen: I enclose a check for $3,000.00, payable to your office, as a deposit on the inerhtitance tax owed by the estate. Please contact my office if you have questions or need anything further to make this deposit. N � Sincerely, n rrn C-> CD C-� Cl I rrI= r r^ m o z rr W ' c.;) Samuel L. Andes ' `n. " -n a� co amh/ Enclosure C'>© C Y m "° s « $ k � g \% \ \ k�%\� . o � \ . § .. .