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COMMONWEAL TH OF PENNSYLVANIA.
DEPARTMENT OF REVENUE
HARRISBURG
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REV-475 (8-78)
CERTIFICA TE
UNDER
REVENUE ACT OF 1926
Date April 1~, 197q
TO THE UNITED STATES COMMISSIONER OF INTERNAL REVENUE:
Grace Foge lsanger
THIS IS TO CERTIFY that in the estate of
FilA Nn~ 21-78-0403
late of
CunneT1and
County, Pennsylvan ia,
who died
Jtlly 4, 1978
, no refund of
inheritance taxes has been authorized by the Department and/or by the Board of Finance and
Revenue of this Commonwealth; and that there is no claim now pending for a refund of such
taxes in said estate~
Subject to additional tax, if any, under the Act of May 7, 1927, as amended~
Toto I Tax Amount Paid Discount Interest
Impos.~d in Cash Date Paid Allowed Charged
On Accomt $6,000.00 10/2/78 $315.78
6,803.57 4/12/78
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For
SEAL
Howard A. Cohen
Secretary of Revenue
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