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.~ RCC4(~/77) COMMONWEALTH OF PENNSYLVANIA
" NO. ~-i 063483 DEPARTMENT OF REVENUE
i= OFFICIAL RECEIPT · PENNSYLVANIA INHERITANCE AND ESTATE TAX
H
~ ------------------ONE HUNDRED NINETY~O &: 641100--_--__________
'\II RECEIVED
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I File No. 21-78-455 Dote of Death
~- -~--_.-------_.~._-, -'---------,---
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representing Pennsylvania Inheritance or
Estate lax due from the following estate:
dollars
J. Robert Stauffer, Esq.,
(Rosella J. House &: raye A. Sourb el2}lc Tax on
$
$
ss
Market Square Building
6 % Tax on
$
$
MeChan1csburg,Pa.
17055
8-6-1978
15% Tax on
$
$
Dote of Payment
March 8,1919
% Tax 0[1 $
Estate Tax, Act of
May 7, J 927
$
~
.f
I,
$
Name of Decedent
BERNICE E. 8'l'RA.YER
County
Cumberland
TOTAL TAX CREDIT
less five percentum of fox if
paid within three months after
date of death
Plus interest at the rote of
_ % from
to
$
192.64
rks:
$
uOO ~ [P [l~ @illurn
SEA l
.64
NOTE: This Triplicate Receipt to be retained for aUdit purposes.
Received by
NOTE: In accepting the transler inheritance tax an luture estates, prior to the death of the life
tenant or tenant for years, as evidenced by this receipt, it is understood that the Commonwealth shall
not be pr.cluded or prevented Irom hereolter assessing additional inheritance tax at the death 01 the
life tenant or tenant lor years whenever it appears that such additional tax may be legally due and
collectible for any reason whatsoever.
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