HomeMy WebLinkAbout07-13-06
COMMCNWEAL TH OF PENNSYLVANIA
L=PA.RTMENT OF REVENUE
BUREAu OF 'f,JCIVIDUAL TAXES
DEF'T 2306C 1
HARR!SBURC, 17123-0601
REV~ 1162 EXl11 ~96)
RECEIVED FROM:
PENNSYLV ANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
ADDAMS WILLIAM A
19 BROOI<WOOD AVENUE
SUITE 106
CARLISLE, PA 17013
------ fold
EST A TE INFORMATION: SSN: 197-10-8843
FILE NUMBER: 2106-0367
DECEDENT NAME: HOLLENBAUGH ANNA I<
DATE OF PAYMENT: 07/13/2006
POSTMARK DATE: 07/13/2006
COUNTY: CUMBERLAND
DATE OF DEATH: 04/18/2006
INO. CD 006964
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $768.16
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$768.16
REMARI<S:
CHECI(# 1
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
GLENDA FAf~NER STRASBAUGH
REGISTER OF WILLS
INVENTORY
Estate of Hollenbauqh, Anna K.
No.21
OG
0367
, Deceased
Date of Death 4/18/2006
Social Security No. 197108843
also known as
Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the
personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation
placed opposite each item of said inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no
real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I/We
verify that the statements made in this inventory are true and correct. I/We understand that false statements herein made are subject to the
penalties of 18 Pa, C.S. Section 4904 relating to unsworn falsification to authorities.
Personal Representative:
Name of
Attorney: William A. Addams
Shirley A. Heberliq/ James C. Hollenbauqh
1.0. No.:
Address: 27 W. Hiqh St.
Carlisle
Dated July , 2006
PA 17013
Telephone: 717-243-7638
Description
Value
Stocks & Bonds
,'.~
Closely-Held Corporation, Partnership or Sole-Proprietorship
J
Mortgages & Notes Receivable
Cash, Bank Deposits, & Misc. Personal Property
'-D
Checking Account No. 33-05236, F and M Trust Company, Newville, Pa,
19,343.45
CD# 15-2954602, F and M Trust Company
5,047.20
Total
30,636.02
(Attach Additional Sheets if necessary)
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative,
include the value of each item, but such figures should not be extended into the total of the Inventory.
RW-4
I "'."
Continuation of Inventory
Hollenbaugh, Anna K.
PaQe 1
Description of Inventory
Description
CD# 2954695, F and M Trust Company
Value
6,035.44
Sprint rebate
12.72
Highmark,Blue Cross/Blue Shield, health insurance refund
191.59
F and M Bank, interest on checking account
5.62
Real Estate
Subtotal $
Grand Total $
6,245.37
30,636.02