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RCC'llln8) COMMONWEALTH OF p"" "IA
if NoJ003199 OEPAII'TMENl'OF R~El4tlE ',', '
. OFFICIAL RECEIPT. PENNSYLVAN INHERITANCE AND ESTATE TAX
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= RECEIVED
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-----------TH.IR'l'Y -'l'WO HtJNDREn
TVRN'I'Y-THRD &: T7/100------------~0Ilars
representing Pennsylvania Inheritance or
Estate Tax due fram the following estate:
From:
lParmara Truat C~,
lo Address
~
.,
1 Veat Blah Street
2% Tax on $
$
car11ale..Pa.
Date of Death9-1-1978
17013
6% Tax on $
$
F
1'\l0.
21-78482
15 % Tax on
$
$
C of Payment
June 1,1979
% Tax 0 n $
Estate Tax, Act of
May 7, 1927
$
~
Nome of Decedent
AR'l'HUR RAncoR>> IPPLIY
$
County
ClUab.plant!
TOTAL TAX CREDIT
Less five percentum of tax if
paid within three months after
dote of death
Plus interest at the rote of
_ % from
to
$
Remarks:
PAm ON ACCOUIT.
$
$
1100 ~ [FJ [L~ @ill 11~
SEA L
TOTAL AMOUNT PAID
NOTE: This Triplicate Receipt to be retained for audit purposes.
L;l,
(Signature)
D~im~rBofAmr:
(Title)
$
':t . ~~ ~ It 77
Received by
NOTE: In accepting tne transfer inneritance tax an future estates, prior to tne deatn of tne life
tenant or tenant for years, as evidenced by tnis receipt, it is understood tnot tne Cammonwealtn snail
not be precluded or prevented Iram nereafter assessing additional inneritance tax at tne deatn 01 tne
lile tenant or tenant far years wnenever it appears tnat sucn additional tax may be legally due and
collectible for any reason wnatsoever.
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