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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-961
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
HANS HOLLY E
1706 NEWTON RANSOM BOULEVARD
CLARK SUMMIT, PA 18411
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ESTATE INFORMATION: SSN: 176-22-6026
FILE NUMBER: 2105-0908
DECEDENT NAME: MORGAN GENEVIEVE R
DATE OF PAYMENT: 04/05/2006
POSTMARK DATE: 04/05/2006
COUNTY: CUMBERLAND
DATE OF DEATH: 10/02/2005
NO. CD 006525
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $22,165.32
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I
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I
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TOTAL AMOUNT PAID:
REMARKS: HANS HOLLY E
CHECK# 118
SEAL
INITIALS: CM
RECEIVED BY:
REGISTER OF WILLS
$22,165.32
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS