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HomeMy WebLinkAbout11-04-05 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162i EXI11-96) i RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT I i NO. CD OO~975 A ACN SSESSMENT AMour ~T CONTROL NUMBER -------- 101 I $12,000 .00 I I I I I I I I AID: $12,000 .00 GLENDA FARNER STRASBAl ~GH REGISTER OF WILLS HOUSEAL PEGGY M PO BOX 7 DOVER, PA 17315 nn__n fold ESTATE INFORMATION: SSN: 184-12-2073 FILE NUMBER: 2105-0840 DECEDENT NAME: MELLINGER FRANCES W DATE OF PAYMENT: 11/04/2005 POSTMARK DATE: 11/04/2005 COUNTY: CUMBERLAND DATE OF DEATH: 08/06/2005 TOTAL AMOUNT P REMARKS: CHECK# 1019 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WILLS ,:)1-6) ~,b INHERITANCE TAX PREPAYMENTS SHEET FOR INFORMANT RETURNS LATER BEING FILED Full Name of Decedent FRANCES W MELLINGER Date of Death 08-06- Social Security Number Informant's Name and A Attorney's Name and Ad (If applicable) PA FILE NO. 21-05-0840 PREPAYMENT 12,000.00 CHECK 1019 (-~) -;,..,".1 . 2005 184-12-2073 ddress PEGGY M. HOUSEAL, EXECUTRIX P.O. BOX 7 DOVER, PA 17315 dress