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It i!r.
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"' RECEIVED .........IlI.....I.,..~..
'(
..:
'I
~ From: -t.. a_II. ~
~- PIlMJI..... . ,.",...........__..... dollars
representing Pennsylvania Inheritance or .
Estate Tax due from the following estate:
2 % Tax on $
$
~
^-idress
CJ ~''"1' .t. aa.1
6% Tax on
$
$
..t.
........ -
. ....
17M1
15% Tax on $
$
e No._Il.~ Date of Death~""
lJate of Payment ---",.. 4""178
% Tax On $
Estate Tax, Act of
May 7, 1927
$
$
Name of Decedent
~J~. .... aa...~
TOTAL TAX CREDIT
less five percentum of tax if
paid within three months after
date of death
Plus interest at the rate of
_% from
to
$
l.n....
County
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., Remarks:
s
..,.
MIl. _.
TJ 00 ~[? [L~ @illTJrn
SEA L
TOTAL AMOUNT P
NOTE: Thi8 Triplicate Receipt to be mlliined for audit puI'JIOHa.
Received by
NOTE: In accepting the tran.ler inheritance tax an luture e.tates, prior to the deoth 01 the lile
tenant or tenant lor years. as evidenced by this receipt. it is understood that the Commonweolth shall
not be precluded or prevented Itom herealter as.essing odditlonol Inheritonce tax at the death of the
Illetillianl or tenant lor years whenever It appears that such additional lax may be legally due and
collectible lor any reason whatsoever.
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