HomeMy WebLinkAbout02-26-15 REV-1162 EX(11-961
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT.280601
HARRISBURG,PA 1 7 1 28-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
N0. CD 020288
ADRIAN BARBARA
26 E MAIN STREET
PO BOX 66
RICHLAND, PA 17087
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
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101 � 58,336.25
ESTATE INFORMATION: sstv: i42-22-0063 I
FILE NUMBER: 21 1 4-1 223 �
DECEDENT NAME: ADRIAN BETTY J I
DATE OF PAYMENT: 02/26/201 5 I
POSTMARK DATE: 02/24/201 5 I
CouNTY: CUMBERLAND I
DATE OF DEATH: 1 2/03/2014 �
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TOTAL AMOUNT PAID: 58,336.25
REMARKS:
CHECK# 1003
INITIALS: HMW
SEAL RECEIVED BY: LISA M. GRAYSON, ESQ.
REGISTER OF WILLS
REGISTER OF WILLS
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� Transmittal
Payment of Inheritance Tax
Name & Address of Attorney of Record/Financial Institution:
James K. Noel, IV
McNees Wallace & Nurick LLC
570 Lausch Lane, Suite 200
Lancaster, PA 17601
Name of Decedent (Last, First, Middle Initial)
Adrian, Betty, J.
File Number (if probate has begun) 21-14-1223
Date of Death: 12/3/2014
Social Security No.: 142-22-0063
Amount: $8,336.25
If probate has not commenced or if this is a non-probate estate, additional information listed
below is required.
Residence at Death
(City, borough or township) Mechanicsburg, Upper Allen Township
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