HomeMy WebLinkAbout04-05-05
REV.lSOO EX (6-00)
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
'* COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
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FILE NUMBER
:2-L--2&;
COUNTY CODE YEAR
00303
- NLNBER - -
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DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Maurice, Betty J.
DATE OF DEATH (MM-DD-YEAR)
01/20/2006
SOCIAL SECURITY NUMBER
159-24-7982
DATE OF BIRTH (MM-DD-YEAR)
03/14/1930
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST. FIRST, AND MIDDLE INITIAL)
~ 1. Original Return
D 4. Limited Estate
~ 6. Decedent Died Testate (Attach copy of Win)
o 9. Litigation Proceeds Received
o 2. Supplemental Return
o 4a. Future Interest Compromise (date of death after 12.12.82)
o 7. Decedent Maintained a Living Trust (Attach copy of Trust)
o 10. Spousal Poverty Credit (date of death between 12.31.91 and 1.1.95)
D 3. Remainder Return (date of dealh prior 10 12.13-82)
D 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
D 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
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THIS SECTI()N.",UST..B~ C.()ftIIfJ~EteDtl~qIIIE;lplllllliL.;...Q;[IHI~ ;.::.ljllll;lllll~I:I~q"'P.'.DIR'C~O "(0: .
NAME COMPLETE MAILING ADDRESS
David A. Baric, Esquire O'Brien, Baric & Scherer
FIRM NAME (If Applicable) 19 West South Street
O'Brien, Baric & Scherer Carlisle, Pennsylvania 17013
TELEPHONE NUMBER
(717) 249-6873
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
(1 )
(2)
(3)
(4)
(5)
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3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
(11 )
(12)
(13)
2,131.00
4,825.00
6,956.00
(6)
":-')
(11
(7)
(9)
(8)
2,131.00
6,956.00
(10)
14. Net Value Subject to Tax (Line 12 minus Line 13)
(14)
4,825.00
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
x .0_ (15)
4,825.00 x.O~ (16)
x .12 (17)
x .15 (18)
(19)
217.12
16. Amount of Line 14 taxable at lineal rate
217.12
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
20.0
Decedent's Complete Address:
STREET ADDRESS
HCR ManorCare
Walnut Bottom Road
CITY Carlisle I STATEpA I ZIP 17013
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1 )
10.85
Total Credits ( A + 8 + C ) (2)
10.85
3. InteresUPenalty if applicable
D. Interest
E. Penalty
TotallnteresUPenalty ( D + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
206.27
A. Enter the interest on the tax due.
(5) .
(5A)
8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58)
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN II XII IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes
a. retain the use or income of the property transferred;.......................................................................................... D
b. retain the right to designate who shall use the property transferred or its income; ............................................ D
c. retain a reversionary interest; or.......................................................................................................................... D
d. receive the promise for life of either payments, benefits or care? ...................................................................... D
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ............................................................................... ............................... D
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. D
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? .................................... .................................................................................... D
No
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IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief. it is true, correct and complete.
Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNAT NSIBLE FOR FILING RETURN
.s/'~G-.s
/7007
DATE
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For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 P.S. 99116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)).
The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if
the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent.
or a stepparent of the child is 0% [72 P.S. ~9116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. ~9116(1.2) [72 P.S. 99116(a)(1)).
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 99116(a}(1.3}]. A sibling is defined, under Section 9102, as an
individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-IS11 EX+ (12-99)*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Maurice, Betty J.
FILE NUMBER
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
1.
FUNERAL EXPENSES:
Hollinger Funeral Home
1,220.00
B. ADMINISTRATIVE COSTS:
1 . Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City
. State
Zip
Year(s) Commission Paid:
2.
Attorney Fees Q' B r i en, Bar i can d S c her e r
750.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
~ Claimant
Street Address
City State .Zip
Relationship of Claimant to Decedent
4. Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Met Ed 18.00
8. HCR ManorCare 20.00
9. Carlisle Regional Medical Center 32.00
10. Three Springs Family Practice 91.00
TOTAL (Also enter on line 9. Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
2.131 .00
REV-1508 EX. (6-98) .
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDUU E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Maurice, Betty J.
FILE NUMBER
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jolntly-owned with right of survivorship mUlt be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
PNC Bank Savings Account #50-0369-6632 5,016.00
2 PNC Bank Checking Account #50-8057-5009 1,712.00
3 Miscellaneous Personalty 145.00
4 Aero Energy Refund 12.00
5 Sprint Nextel Refund 15.00
6 Erie Insurance Group Refund 18.00
7 Highmark 38.00
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
6,956.00
REV-1513 EX+ (9-00)
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SCHEDULE J
BENEFICIARIES
COMMONWEAlTH OF PENNSYlVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Maurice, Betty J.
FILE NUMBER
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS pnclude outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1 Glenn G. Maurice, Jr. SS # 195-38-9851 Son 1/3
2 Terry Ray Maurice SS # 162-48-1467 Son 1/3
3 Penny Lynn Yost SS # 170-60-1838 Daughter 1/3
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ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II NON- TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
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B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 0.00
(If more space is needed, insert additional sheets of the same size)
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lPST VVlLL AND TESTAtIENT
OF
BETIY J. MAURICE
I, BETIY J. MAURICE r:l ClJrberta1d ~ PernsyIva1ia, beOJ c1 sa.n:t ~
memory cn:J _, 00 hereby rrS<e, P-blish a1d decIae this as a1d fa" my UB Will a1d
Testal Slt, hereby re\d<rg all cAher 'Nills end cxxicils hefetctae rra1e by me.
FIRST
I direct the ~ d my cIEtjs a1d the expenses r:l my last illness a1d ft.neraI fiool my estate
as SOCl1 after my death as oonveniently may be dale. If there be no ametery leX availci>le fa' my
intemlent, 0M1ed by me at the time r:l my death, I authorize my personal repesentative to p..rd1ase
Sld1 ametery lei ~ a en dt cd fer perpetual CCJ"e, usirYJ thereftr fLnds from my estate, era I authorize
my personal repesentative to caJSe title to or OMleI"Ship ri such lot so pud1ased to be vested in Sld1
persa1 ~ my personal repesentative shall desiglate.
FLJ1her; in this oomedia1, I authorize my personal repesentative to experd fLnds from my
estate, in Sld1 arou1 as my personal repesentative shall cxnsider neressay cn:j c::JesiralIe, fa'the
pud1ase, eredia1 a1d insa ~ c1 a suitS:>le rraker fer my gfM3.
SECOND.
I give, devise and beq.Jeath my entire estate ri Wlatever ratue a'l1 vkerever situate to my
ttTee d1ikten, GLENN G. MAURICE, JR, TERRY RAY MAURICE a1d PENNY LYNN YOS-r, in
~ staas per stirpes.
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In the evert I em rd: so suvived by my ctlilcten, GLENN G. MAURICE, JR, TERRY RAY
MAURICE em PENNY LYNN YOS-r, em a portial ci my estate ~ to a1 heir lI1der Ire age d
twerty..five (25), then that portia1 ci my estate passing to the heir shall be ~ 'Nith GLENN G.
MAURICE, JR ci CLJTberta1d ~ PerrsyIva1ia, as TRUSTEE, lI1der the foIloMrg cxrdtials:
1. My Trustee shall pay prirdpal em incxme to a fer Ire benefit ci the heir clrirg his a
her life as my Trustee, frool time to time, shall deem advisct>le fer Ire health, rraint~, ~ em
corllJIete ed.ratia1 ci SLd1 heir cn::J the merrt>ers ci his or her inmediate fani~ In acttition, my
i Trustee in his sole disaetia1 may 00va1ce principal to said beneficiay against the fradionaI shcres to
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I be a:Jva'xBd hereu1der fer the oosts ci maTiage, or the p..rd1asirg ci a home or oosts ci erteril'ld a
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i. tlJsiness or profession if my said Trustee shall deem SLd1 expense reasonably prudent.
2. NolYJithsta1ding the foregoing provisions, after attairment ci twenty-<re (21) yeas,
I ecDl heir may 'NithctaN or&haJf (%) ci the principal ci his or her 1rust valued as d said birtrday a Ire
date ci divisial into sha-es, if later; cn::J after attaining age twenty-five (25) yeas, ecDl heir may 'NithctaN
the remainder ci said principal CI1d LJ1distritlled incxme.
3. In Ire evert ci the death ci a trust beneficiay prior to age twenty-five (25) then my
Trustee sh8I1"cflSlriOOte tnf remaining prirripal ard interest as SLd1 beneficiay shall appoint by specific
~ to this poM3r in his or her 'Nill, or if SLd1 poM3r is not exercised in full, the t..nappOirted
principal shall be distributed to his or her issue, per stirpes, or in defautt of SLd1 issue, to my issue, per
stirpes; provided, hcMever, cny portion of SLd1 prindpal, Wlid1 'MJU1d be disbitlled to cny beneficiay fer
W10m a trust is then held hereLnder; shall be added to SLd1 trust.
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4. StnJId the ~ i qa deny trust herein P'ovided fa" be a been I e too srnaI i1 my
Trustee's discretia1 to ~ estaJIistments a oontirua"lCB a the trust ac:t\Iisct)Ie, my Trustee may
distribute the rernainirg ~ cn:I EnJ cnuruIated cr l.I1disbitx.ted irmme aJrig1 to the
benefIciaies in the ~ to vllictt trey ere then entitled to. Tre recapts em rcIooscs d the
dislnbJees will terminate cDsoUeIy the riglts d all persons W10 miglt otf1er\Mse have fi.iue irterest in
the bust, \\tether vested a CXJ'ltirgent, wntnJt rdia:3 to them em wntnJt the r18CBSSity d filirg a1
acx:n.nt \Wh the CXXJ1.
FOURTH
I direct that no 1rustee, exEntor, g.adia1 cr other ficlJciay raned, raninated, a appoirted by
this my Last Will em Testa I Hi shall be recpred to post fnI bond cr give EnJ sea.rity d fnI type fa"
fnI pupose Wlatsoever; Sly law cr nJle d the 00LJt ci the CarmortvveaIth ci PemsyIvcnia a EnJ
other jJisdidial to the 00t dl fry nol'Nithsta1dirg. I direct that the law a the CarmortvveaIth ci
PemsyIvcJlia shall apply to Sly interpretatia1 cr appIicatia1 ci the validity ci this instnrnent.
FIFTH
I\hy exea.ior crd 1rustee srall have the foIloNirg poNerS in addition to ttme vested in them by
law crd by other provisia1s ci this Will, appIicci>Ie to all ~ real, persooaI cr mixed a1d
WleresoeVer situate, irdLdng property retd for miners, \\tether principal cr irmme, exerdsct>le wittYJut:
00LJt approval, a1d eIfedive, vvith respect to ead1 item of said property l.I1til aduaI dislriOOticn thereof.
A) To retain, as investments ci my estate cr trust, crry cr all assets d my estate, real,
persooaI, cr mixed, without regad to my prindpal ci diversification, and to pud1ase em 8CXJJire real a
persooaI property and to tdd Errf 0'" all r:i SLd1 real arx:t perscnaI property retained cr 8CXJJired without
~rg the same productive ci irmme.
6) 10 penri\ \tle c:hi~ CJ eI'J d \tlE3(l\. \0 ~ eI'J rea estae ~ CJ ~
~ SLd" \ell'OS a--d ~ as rrt<J ~ CJ~ sr8\ de8fO~'
C) 10 f1iJ'J aD ta)(eS. crages a--d ~d~'~' ~
~~~a--d~deI'J~CJ~reaCJ~
~. $Ld'I ~ \0 oe~~ei\h6f~ CJ~asrrt<J~CJ~shll\
~.
0) 10 ~ CJ..,...est eI'J a--d aU {lrds. ~ ~ CJ~' "eI'J rea CJ
~~~~\O\eg8\~.\O~~Ii~\O
~ a\ lYjiSd a~ t-o\d8f CJ srse \"(l\def" ~~; a--d \O~.~.
~. rjJe ~ ~ CJ se\\ a p.i>\iCCJ ~ sa\e a--d ~ ~ d eI'J a:JA eI'J real CJ
~~. CJ~ CJ~~' ~d\tle~CJ\tle~'c1/..,.,tich\tle
~was~'c1/ rrt<J said ~CJ~'
E) 10 ma<e payrrert CJ ~ necel' ~ fCJ in cash. \<ird CJ ~ in cash
a--d ~ in \<.ird. lit ~ 1\)ced 'c1/ rrt<J ~ CJ~ Ii \tle ume d ~
s\X01
~ p.rt/ a--d a\\ paymert CJ ~ d eI'J SlJ1'\ CJ SLfOS. ~ in cash CJ in \<ird a--d ~
fCJ ~ CJ~' ~ \0 9'\ nair. CJ ~ d \t'e(l\sha\\ be ~ ~ \tle ~ ~ d \tle
~ ~\OvJr'C$O \tlepaymenl is made. a--dtree~~ a\~ ~
~ a--d~' ~ tree~ CX)1\lO\ 'c1/\tle ~ d eI'J $Ld'I~'
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SEVENTH
I BRXri son. GLENN G. MAURICE. JR, ExeaJtor cl1Iis ~ LcS Will crd Testa, Bt StnJd
~ said Exea.ior fail to SlIVive me a fer crPf reason fail to q.aify as ExeaJa; then I awon
TERRY RAY fv\t\URICE a1d PENNY LYNN YOSl: Exea.ior crd Exec1JIrix ci this my Last VViIl crd
Testa ,S't
IN WITNESS VVHEREOF: I have hereLnto set ~ herd a1d seal to-1his. ~ Last Will
a1d Testanent, oonsisting ctfive (5) typeMitten pages. the first foLr (4) of'Atlich baa- my siglabse in the
rragin for Ihe f1IlXI5e r:i identiIicaIia1, tIis;7 day r:i ~ . 1 fHl.
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Sigled, sealed. ptbIished end decIa"ed by the above raned testatrix, BETTY J. Ml\URlCE. as
crd fer her Last Will end Testanent, in the preserre ci us. vklo, at her rec,.JeSt, in her sigt crd
preserre, a1d in the sigt a1d presero3 of eadl other, have hereLnto Slbsaibed a.r ranes as
wWlesses.
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/lDDRESS :n~ 4td Ii ~ (;/113 I
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ADDRESS l~ z:. CG\.~ j)1'. ~\'"~~ DA- ()O~
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CQVMONVVEALll-t OF PENNSYLVJ\NIA
: ss.
COUNTY OF CUWBERLAND
We, BETTY J. MAURICE, ~ a. ~
~ I- (), L&i.u.Jf ) , the teslaIrix a"'d the \\1tnesses, respediveIy,
cn:t
\\tlose ncrnes ere sigled to the cit:dled or faegoirg inslnrnent, being first cUy 9AOTl, cb hereby
decIa'e to the U1dersigled aJhaity that the testatrix sigled end execlJted the instnrnert ci her l.ac;t Will
a1d Testanent, end that she sigled 'Nillirgly a1d that she exeaJed as her free a1d voIu1tay ai fa' the
puposes therein e><pessed, a1d that ead1 ci the witnesses, in the presenoo a1d heaing ci the testatrix,
sigled the Will as \\1tnesses, a-xj that to the best ci their~, the testabix was at the time
eiglteen (18) yeers ci age ex- older, ci sa.nd mind a1d Lrder no oons1raint or lJ1d.Je infll.J8l"03.
$\\an 10 a"'d Slbsaibed bebe me this d 7 day ci ~ ' 1997.
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Notarial Seat . '
Jennifer S. Calaman, Notary Pt..ibhc
Carlisle Boro, Cumberland County
My Commission Expires Nov. 29.1999
Member. Pennsylvania Association of Notaries
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
DAVID A BARIC ESQ
19 W SOUTH ST
CARLISLE, PA 17013
__u____ fold
ESTATE INFORMATION: SSN: 000-00-0000
FILE NUMBER: 2106-0303
DECEDENT NAME: MAURICE BETTY J
DATE OF PAYMENT: 04/05/2006
POSTMARK DATE: 04/05/2006
COUNTY: CUMBERLAND
DATE OF DEATH: 01/20/2006
NO. CD 006522
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $217.12
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TOTAL AMOUNT PAID:
$217.12
REMARKS:
CHECK# 10927
SEAL
INITIALS: MG
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS