HomeMy WebLinkAbout08-11-14 (2) COMMONWEALTH OF PENNSYLVANIA REV-1162 EX01-96)
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT.280601
HARRISBURG,PA 17128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 019521
FORNEY DAVID L
1601 K STREET NW
WASHINGTON, DC 20006-1600
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
-------- f0d
101 $2,047.79
ESTATE INFORMATION: SSN:
FILE NUMBER: 2114-0005
DECEDENT NAME: FORNEY RAY K
DATE OF PAYMENT: 08/11/2014
POSTMARK DATE: 08/11/2014
COUNTY: CUMBERLAND
DATE OF DEATH: 12/18/2013
TOTAL AMOUNT PAID: $2,047.79
REMARKS: RCPT TO ATTY
CHECK# 114
INITIALS: DB1
SEAL RECEIVED BY: LISA M. GRAYSON, ESQ.
REGISTER OF WILLS
REGISTER OF WILLS
1601 K Street, N.W.
Washington, DC 20006
August 8, 2014 David L. Forney
david.fomey@klgates.com
T+1 202-778-9497
F+1 202-778-9100
Certified Mail- Return Receipt Requested
Register of Wills
1 Courthouse Square, Room 102,
Carlisle, PA 17013
V C7
C Z
Re: Inheritance Tax Return for Ray K. Forneyu:
Cj c�
SSN a T,
DOD: December 18, 2013 N
File: 2014-00005 __— a
CD
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Ladies and Gentlemen:
Enclosed in duplicate is Form REV-1500 Pennsylvania Inheritance Tax Return with attachments
for the estate of Ray K. Forney. Also enclosed is a check in the amount of$2,047.79 payable to
the Register of Wills of Cumberland County.
spectful su itte ,
David L. Forney, Executor
Encl.
DC-9828689 v1
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