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07-15-05
~{~, ~ ,. WI! ~.' -- t71' .r ) OFFIU ) C.r 1"fL. ,_ j , Vi! ,;,~.j . ;:!,:~'; '0" o. 15 PH 12: 57 . CL ERK OF o,v; 0 ; CO-- C :.Jf~, [' c(', ',' ~ .l '" '" ~ ~ 6 ~ Q:::::: ~ ~t"--. \.l.j%'-'....... ~~~~ ~'T:r::t..:l klG'kl~ ~Ea:::, cQIXl .".- '" ~;:~~ a .,..,~ ..., "'-..: :r:: '-... ''''''..' ..... ~~..... ~-... 0_- o~ .~>- 0_- --- 0- ...::' ~ 8 ~ UJ8 '" ~ Ole ~~UJ~ 5w,a: ~~g5p< ~i~~ ~~~~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT,280601 HARRISBURG, PA 17128-0601 REV-1162 EX(ll 961 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 005576 ROE JOHN A ESQ 2520 DOEHNE ROAD HARRISBURG, PA 17110 ACN ASSESSMENT CONTROL NUMBER AMOUNT uuuu folu 101 $2,452.37 ESTATE INFORMATION: SSN: 172-01-5255 FILE NUMBER: 2105-0008 DECEDENT NAME: GRUBB RUTH l DA TE OF PAYMENT: 07/15/2005 POSTMARK DATE: 07/15/2005 COUNTY: CUMBERLAND DATE OF DEATH: 12/22/2004 TOTAL AMOUNT PAID: $2,452.37 REMARKS: CHECK# 104 SEAL INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WillS REGISTER OF WILLS