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~ I v_r--------~ BUD" ..1ftY-oa . 12/10o-------------~1iars
representing Pennsylvania Inheritance or
Estate Tax due fram the following estate:
~J:1Da 1I......11y
-- ....~ .~
....8111, ... 11011
~1y 10. 1'"
% Tax 0 n $
Estate Tax, Act of
May 7, 1927
$
$
$
$ I
$
$ 2S1...1.2
20/" Tax on $
6 % Tax on $
.1..~SO Dote of Death 1-11-1'"
15o/c Tax on $
~ .. .,IIIAD
C1lllbe..1aIId
TOT AL T AX CREDIT
Less five percentum of tax if
paid within three months after
dote of death
Plus interest at the rote of
_ % from
to
$
.... 011 1CCOUft-
$
lrOO 0 [p [LO @ffi lJ~
SEA L
TOTAL AMOUNT PAID
)51.12
Received by
NOTE: In Gcc~ting the transfer inheritance tax on future estates, prior to the death of the life
hlnOnt or tenont for years, os evidenced by this receipt, it is understood that the Commonwealth sholl
: not be pr~luded or prevented from hereafter assessing additional inheritance tax at the death of the
i hf.tenant or tenant for years whenever it appears that such additional tax may be legally due and
GiOIa.tib.. tor Gny reason whatsoever.