HomeMy WebLinkAbout12-17-14 COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96)
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT.280601
HARRISBURG,PA 17128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 020036
FORNEY DAVID L
1601 K STREET NW
WASHINGTON, DC 20006-1600
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
-------- fold
__________ --------
101 $337.50
ESTATE INFORMATION: SSN:
FILE NUMBER: 2114-0005
DECEDENT NAME: FORNEY RAY K
DATE OF PAYMENT: 12/17/2014
POSTMARK DATE: 12/15/2014
COUNTY: CUMBERLAND
DATE OF DEATH: 12/18/2013
TOTAL AMOUNT PAID: $337.50
REMARKS:
CHECK# 119
INITIALS: DMB
SEAL RECEIVED BY: LISA M. GRAYSON, ESQ.
REGISTER OF WILLS
REGISTER OF WILLS
K&L GATES
1601 K Street,N.W.
Washington, DC 20006
December 15, 2014 David L. Forney
david.fomey@klgates.com
T+1202-778-9497
F+1202-778-9 100
Certified Mail-Return Receipt Requested
Register of Wills
1 Courthouse Square, Room 102
Carlisle, PA 17013
Re: Supplemental Inheritance Tax Return for Ray K. Forney
SSN
DOD: December 18, 2013
File: 2014-00005
Ladies and Gentlemen:
Enclosed in duplicate is Supplemental 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
$.337.50 payable to the Register of Wills of Cumberland County.
R spectful y s fitted,
David L. Forney, Executor
� q
Encl. t
r+ a
� rn
C
ri -71,
cn cn o
DC-9828689 vl
klgates.com
' � •..�r� pirmry eovvFs
. 02 1A $ 07.400
0004621312 DEC15 2014
7011 3500 00037-14 8507 — MAILED fROM ZIP CODE 20006
C"> o
m
C> C'>
C)
David L. Forney C-3 � tD
K&L GATES
m M
M CD
1601 K Street,N.W. - ca o
Washington, DC 20006 <7)
� rn
cn c i C)
Certified Mail CO rn
Return Receipt Requested
Register of Wills
1 Courthouse Square, Room 102
Carlisle, PA 17013