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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG. PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
BULOT A ELIZABETH
2800 RUSSELL ROAD
CAMP HILL, PA 17011
-------- fold
ESTATE INFORMATION: SSN: 204-01-9516
FILE NUMBER: 2105-0989
DECEDENT NAME: BULOT A STANLEY
DATE OF PAYMENT: 01/24/2006
POSTMARK DATE: 01/24/2006
COUNTY: CUMBERLAND
DATE OF DEATH: 10/25/2005
NO. CD 006238
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $10,000.00
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$10,000.00
REMARKS: ELIZABETH BULOT A
CHECK# 288
SEAL
INITIALS: CM
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT.2B0601
HARRISBURG, PA 1712B-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
BULOTA ELIZABETH
2800 RUSSELL ROAD
CAMP HILL, PA 17011
-------- fold
ESTATE INFORMATION: SSN: 204-01-9516
FILE NUMBER: 2105-0989
DECEDENT NAME: BULOTA STANLEY
DA TE OF PAYMENT: 01/24/2006
POSTMARK DATE: 01/24/2006
COUNTY: CUMBERLAND
DATE OF DEATH: 10/25/2005
NO. CD 006239
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $4,000.00
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$4,000.00
REMARKS: PNC BANK ELIZABETH BULOT A
CHECK# 1004
SEAL
INITIALS: CM
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS