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HCC-1:J4(10'/61
('OM!I\l.'lilI'~I:1'II OJ' PENNSYLI'ANIA
IlEPAIlHIFN r OJ' 1l1':\'I':NIII'
11I11\1':,111 OJ' ('OllNT\' ("lI,I,I',("1I0NS
INlli'.IIITANI'Ji TAX 11I1'ISIllN
01'1'1<'1:\1. NIlTlt'!' OF INIII ':IlII :\N('!,
'1\\\I'I'IL\lSI'\II'NT \NIl :\SSI'SS\lI'NI
1I1'\SSI,'1 S :-'01 S\lILII'1 ''I
1II\I)\\INISlll\TIIIN
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------_.~_.,..~---_._---~._-~....._------' . ".---
TO: . .~lIlD..!o!_ "'g~J.~~......_.
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Dote:.
DlHMIM_.1Z. )'97!L..
Couoty ____.....,_. C-'l>ArlMlL._._______...,_...
County File NO'-...'._.m'."u..___,____~.___..
Bureou File No, ._...____u_u'_..n___________
We hove received notice Ihat, os a resull ollha deolh of.. ,Tri.1UI "~_~l1er..~l~--.....,,--.---n--.----.-
on. "'1" 31. 19~. you coma Into ownership of corldln proporty Ihrougl riglt 01 survlvorshlJl, which
was lormorly ownod by the docedont.
Undor tho Inhorllance nnd Estata Tax Lows of the Commonwoalth 01 Pennsylvonia-such Ironslors are toxoblo
and the liability lor Ihe pnyment of the Inherltonco tllX due Is Imposod upon yOll, os tronsferoe,
Tho property on which tax Is herohy ossossed consists af:_.!!'l)ln'_.~~t Illt2-1O'11~~_iM...._~_
__O.I~.altk ~.ti~~._~~!.~~tlJu1~~~.I!._1>>A__:l!.!~_:'~~. o!._~~__de!.cl.nt-'-"~d..~r..'!.....--
...AoClO\ll'lt 'It.bU.~__8/'i'3.~_.__._.._ ._~___..__.__., .,..-----.. ..--.-..--------.--
____..__.__~__..__.~_______.___~....~__.___._.._...._____m". ._,~_______... ,. ___no __ ...._._.~_ ~_or__ ...------~..-----....~-.----.-. .-..-~-~,-.------~------
~----~---,._---"_._._~----
~ ..__~.________~___4_______~._________..___________...
opproisod by Iho ComnlOlIwoallh, as of Iho date 01 dealh, ot $ ..........1.~---_.
_~ "; of thl s amounl Is taxablo 01 the ralo of__.~..__. 0; ,
. ORIGINA_~..A~~~_SSME~l
DATE OF ASSESSMENT
T AXABL E AMOUNT
LESS. ALLOWED DEBTS
NET TAXABLE AMOUNT
s
A M~ ~.P@....A S ~g~,SM fNT
~~~f~'r
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:< l.. 'i [" ?If:
$
AMOUNT OF TAX DUE
If you poy Ihe obove amount within threa (3) months of the
dato 01 death 01 the docedent, or an or boloro ...___,_,...._u~_.
19,---, you may doduct a discount of
5% of the amaun I of to x duo, or
I I
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- .... - - - - .... - _. ...
----------
This lax bacamo dollnquont nino (9) months nftordoalh
(one year II .loath occurred prior to Docombor 22, 1965
ond liftoen months II death occur rod on or after
Docomber 22, 1965 but prior 10 June 17, 1971) nnd In
addition 10 the tax, statutory Inleresl at tho rnto of 6% of
tho tax per annum Is olso due as of" , ,,__ 19__
In tho amo 1m t of
---------...--
-.-....----....--
*If the tax is not pold by tho abovo doto odditlonol
Interoslls duo allhe rato of 6% por onnum unlll poid
TOTAL AMOUNT DUE $
APPRAISED BY: ASSESSED BY:
(Inhatltanco TaM Attptols.ur)
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IAUMII' fen fha ComlllPllwfW II")
I.NHF..U_c.:I!9N.S.,I9..T~XPA'f E R S
Mo~o chocks or manoy otdors puyoble to: To Insure proper crodlt t.o your account
this Officlol Notico must accompan'y
your payment. Mail or bring It to:
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NOTE: Any party in Intorost who is aggrloved by this notice may abjoct thereto within sixty days after rocelpt of
said natlco as provldod by Section 1001 of tho Inhorllance ond Estoto Tnx Act of 1961, 72 P,S, 2485-1001, ','
"
QUAORurllCA n: -- REGISnR OF WiltS COPY
DeDUCTIO~S ALLDWI!D 117- .
TIlE SUM or __ S H,:(~.::..L~l.:L.
DAn Af'r~ovCl'.. G:.:f"c..'il'..N,'lV-
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1-'-'----' ._H' .-...... ._, .\.L 1'''''' . ....-" ._-~.- .- ...-......,.. ..... -.. U'.__
ESTATE or /le.4..11L.}}jdlM.L.- I.i:H oriff?.s---{Lef!t'L~/.tk<"f-~'-'-"'-'"
==-=.::-;;::~~:r.;-,"~,~/ I~~.n._.. APi' R~'~~~~'~_~:===-_':::'''7:;'"=:::::;', ~~..~~c.I~;~~,I-~-::'=i.~ft:.:.f}i!:.f-4f:::; ~~:-:~=-~;,:~;:.:.;
PAl r, V~I~CI~~'" HAMr, OF PAYEE _-// IlEMA~KS AMOllflT
Y/fftL dLo211fdJjk;'~l7J!A;;~:~: :"fi6~~~~~~~=~~~.~=--~=_::==~:../ti= .;---
"?J1!f1J!fP--,'j;;_L' 7:JI~L 0 00 0-';'-;------ "'-K~;~r
a raMl1 . .n!U>>.~OJr<jtL......._.- ........-.-.-.,..--.. ___..;12_ Lr.:-.
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STATEMENT OF DEBTS
AND DEDUCTIONS
!
IH! V-C&ft (I-al
OFl'le. 01' HIE
REOIHI'R OF WILLS
; ,
OP ,. . , . . . i ,. l ., I COU"TY
....,..r--..".J........4-J....".~_~- f'l,
A~D AOI!~'f OF lli! C:OMMDMWnAL TH
_ ....... _ ____._._.._~__._n_,.._________
___~~__, _, _._.~_~~__._.__.___, ........._',,"____... _H_
....-'~"'.."----...,, .."--..-F'...'''--~_.,......_---_._-,...~--_._-----_.- ...--.---- --~
iu_L,j}~J!i.:LiL-._-- _n___~_. "p"(!l-~~..L ,~L\
.._~~l_~_._.__u.-...._...___m _y___'_'~_'~ r.'., -....- .__~__._..~.._,_~._.._~_._______.._. ._~ -~----- .......---
,n~,__"~___,_",_____",,,____,"_,.'__'..m.,._~._ .._.,~.___. ..~ n___~__'___~ -----.
.._~_~_________..~. ....." .,,_..,___..__. "n___"'_~'___ __ ._.._.~._.. ____...._.______..__.__.. ...--- .----.-----..-.-
____._....,,_,._.. r ~~~.. ...,.~__.,.,..;.'____.---:-__-..~----__-.-.-~~ -...,------.-"---
_._ .._______.___... ___.. ..__..,~...._ _m"",',,' _..___~_..__..__.._.._~._n._. ..r_~_._. ______H..._ ..__.,_.~__
_.4'__L~," ."~.._..___~_ .T._.4~~__.___._,....__,~.~..______~_.__ 4__
______..~__."_ -+-O~_._._~._...__. n._....__,._,...__.n__~~._______~____~___ -~----_._--
____..""__._.. .,.'. ...._......______-- _._.,"._"~_4___._._.__~~___~__..___
__....._-,-..__.._ ___.._....,_."._.... ,.._,.._"._';'_~.______.___~~L__"'__"__"_'.~__*___'
.-.-- -.-.---. -.-
.__.___. .___.,. _.__.__.~..__......_... _.n,.~_____. _~._.._~_..._"'..__~...;___
....._......... .._._.~_h__' ._~___~~____._.______~
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-.:--~.=c_.~~._~~:~=_~---~-==~~~-::-=-~.~ _~:.._..?i1
COMMOI'lWI'.Al1?; 01' PEI'l~ YLVA'~'A 1 '
COUI'lIY (JF.'~fl!dl,.l'k.'/<ct-_ ~.. 5S'//AA
I,. . ,. _ _ &(._ -~.._Wtt.:'L.-...L._._..___....... H~REBY CERTIFY. THAT TO THE lIEn OF
MY ICl'lllWLrO(;E AIW IInl. Fl'. THE rO@GOIIIG 15 A JUST All[) TllUE ST~t'~l OF ~iTS, FJb)j,Ety;1, EXPEI'l5ES AI'lD
Expr;~sr's OF AIlMII'lI5T11A'If(lN ~,UIlMITT!:O 'fI) litE enATr! OF _ ' l.{.. _-P1L.i:J.'(J
OECFA51'0, A', OLDUr.lll1llS FOR IIlli~RITAt1CF lAX PURPOSES. 'r _ JJ
_jl&J:fA4. ,t:', j~/. J!M/ ,
SWOllH A~D SUIlSCRIUr.O IlI:Fl1RE ME THIS ' /. ''''''1 DAY OP
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';;'-'1 .\!Pl .t.:;~.:,:j.,';.~.:;...,,;:~.:.:". tr;',J;,rr,~ 'OF WI1I5 [,In.';/ .,'
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(L.S.)