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HomeMy WebLinkAbout10-31-06 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT 280601 HARRISBURG, PA 17128-0601 REV-1'162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 007371 LAROCCA JAMES N 5 WINCHESTER CT MECHANICSBURG, PA 17050 ACN ASSESSMENT AMOUNT CONTROL NUMBER n______ fold ---------- -------- 101 I $4.60 ESTATE INFORMATION: SSN: 171-03-4869 I FILE NUMBER: 2105-0168 I DECEDENT NAME: LAROCCA J ELSI E C I DATE OF PAYMENT: 10/31/2006 I POSTMARK DATE: 10/27/2006 I COUNTY: CUMBERLAND I DA TE OF DEATH: 09/16/2004 I I TOT AL AMOUNT PAID: $4.60 REMARI<S: CHECK# 6265 INITIALS: MW I SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS ) r" a i........~! COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT . .i..J D 0') 1- c_) a ~EAU OF I~VIDUAL TAXES tNHERITANCE~~IVISION PO--BOX Z806ll ~ ~RISBU~~ tAA'.inZ8-0601 L~c"5 ~];r &!i.' O"'-~ B~DGET M WHITLEY KEEFER ETAL PO BOX 11963 HBG REV-1607 EX AFP (03-05) '-'::I = .= '''-.J ESQ DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 10-10-2006 LAROCCA 09-16-2004 21 05-0168 CUMBERLAND 101 JELSIE C PA 17108 Amount Remitted fi7'~1.0 ] MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, submit the upper portion of this form with you;r tax payment. CUT ALONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS 4- :: :: 'ri l- t-I ::J :t- "'",," ,~ ,~ ..... ,?~ w. ~. r', V rt """'"", _J :t ~J;t Q , ) ~.l .J ;) '...J "". . "'~-~..J \-- "'-\ ---- y \' I:-: ~J ~--. 'oJ ?-:'-- { .) ;~'\.,.) .~ ., '-.J '---" " -. '--I ~ .-> '''~ ':--:s~ ~ (',' ~...... ,..j \V'> '.\~ ....... '-' - ~ '---:::... -~-~ ...., () i') t') .... ',~ ~ ~ '-- ._~- .', (.) 4,.."1 o r" ,,-I ...... t:---) ,~ <5 ;~ -8 '"" ,/''-.J --- .') ~--) *0 if> o ro r- ~d~ gt~ .3~oO 'fl'<:: t:l 'j u ~ g.::; rJ '": ?; '~ ~Vl~ ~