HomeMy WebLinkAbout09-02-14 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 019627
SEGAL SALLY LAYNE
3865 LONE PINE ROAD
UNIT 301
WEST BLOOMFIELD, MI 48323
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
-------- toga
14503453 $3,181 .22
ESTATE INFORMATION: SSN:
FILE NUMBER: 2114-0184
DECEDENT NAME: ROGERS KIM LACY
DATE OF PAYMENT: 09/02/2014
POSTMARK DATE: 09/02/2014
COUNTY: CUMBERLAND
DATE OF DEATH: 02/21/2014
TOTAL AMOUNT PAID: $3,181 .22
REMARKS:
CHECK# 111
INITIALS: DB1
SEAL RECEIVED BY: LISA M. GRAYSON, ESQ.
REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF INDIVIDUAL TAXES NOTICE OF INHERITANCE TAX
INHERITANCE TAX DIVISION gAPPRAISEMENT, ALLOWANCE OR OISALLONANCE � pennsylvania
PD BIZ URG, P RECORDED OFFICE VFFDEPUSECUR+YAACCOUNT. HELD IN TAX ON _- .
HARRISBURG, PA 1T12 B- DEPARTMENT OF REVENUE
REGISTER OF WILLS BENEFICIARY FORTS xev. saea evv �iz.ie�
DATE 07-28-2014
� Ctp 2 p� �2 ESTATE OF ROGERS KIM L
LU1UULL
LU BATE OF DEATH 02-21-2014
FILE NUMBER 21 14-0184
(1ppppC{{{{LEi.!? OF COUNTY CUMBERLAND
SEG'ACNCr COURT SSN/DC 266-02-7860
SALLY I�
AO r �; ACN 14503453
PT 301 CUMBERLAN
APPEAL BY DATE: 09-26-2014
3865 LONE PINE RD (See reverse side underObjeeBons)
W BLOOMFIELD MI 48323-2930 Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
- - -- - -- --•- -+ OCTATN I nWPR PORTION FOR YOUR RECORDS 4 "
;. sw
p
i
V
1
N
t
fa '
n
,,... i'`', rn
r cv
WA
�• � � sv , i N A
(i1 i O
Cs
Q
= a �
7
t
i t