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08-05-15
COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96) DEPARTMENT OFREVENUE BUREAU OF INDIVIDUAL TAXES DEPT.280601 HARRISBURG,PA 17125-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 021072 SHIELDS KELLY M 154 CONODOQUINET MOBILE ESTATE NEWVILLE, PA 17241 ACN ASSESSMENT AMOUNT CONTROL NUMBER -------- fold 101 � $200.00 ESTATE INFORMATION: ssN: � FILE NUMBER: 2114-0213 I �ECE�ENT ►vAME: HEBERLIG ALICE FAY � DATE OF PAYMENT: 08/05/2015 I POSTMARK DATE: O8/03/201 5 I COU►vTY: CUMBERLAND � DATE OF DEATH: 01/1 3/201 4 I � TOTAL AMOUNT PAID: $200.00 REMARKS: KELLY SHIELDS CHECK# 242275568 INITIALS: WZ SEAL RECEIVED BY: LISA M. GRAYSON, ESQ. REGISTER OF WILLS REGISTER OF WILLS Atdi .b3 � �' A C� RECO,�,,c n ,, _ c�� � � vr" ., t:;- �" , C. cA A. �E�;��4_,a _ ' 1c,E pF ::,, ? �c � . r;�' � S ,� � � � ?015 F��� S p � a a o :m �t � O� � C��i �'t_:_ tp f7� }--� '� pR p�,,,: - � �' rn ��M�E : o z � rn rn � � � . �n � � S � � � f _> � � ����„�'�� � V � � l. ,t�- � �,IWS7 t't.,4,";:3 � V ' �" * V�'��.;�' "��? � � ^a„ �= —�— ,��� ,� ,� �;. � , ,�;;�„�� PiA��,,��,�, � - � �a � � "fy C�. 4�f� '�-.. a.i .3r � . �;k �; f/? U t•� �,,""'"6 :;`i �� _� ,�:; � <-, �� `J� �_i ��� � �� � �7 ^ r�� , �f ' �t i r„