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Ilj~ COMMONWEALTH OF PENNSYLVANIA
~! i 025708 DEPARTMENT OF REVENUE
!ii' . :F'. OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX
If'h''''?'
Si RE~~IVED
II
I 'mm, <Mal< W. Or1ftte & _....
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.....-..-...............'J.'WO HUNDRED NINETY ...ONE 6:
78/100..----..-~.w-.----.-.
dollars
representing Pennsylvania Inheritance or
Estate Tax due from the following estate:
,
,,~ ax an
$
$
ress
7 Irvine Row
$
6% Tox on
$
No.
Carll81e~Pa.. 17013
21-18-198
% Tax 00 S
Estate Tax, Act of
Moy 7, 1927
15o/,Taxon $
$
$ I
$ I
$ 291.78
4..2-1918
Date of Deoth
Date of Payment
september 19.1978
ClARA PO. cmmIE
TOTAL TAX CREDIT
less five percentum of tax if
paid within three mont~s after
date of death
Plus interest at the rate of
_%from
to
$
~
,
~
Name of Decedent
Cumberland
I County
Remarks:
$
'f 1* 'ITOO~[P~J@ffi'IT~ SEAL
~'~~~O~~E:.ThiS Trip,licate Receipt to be retained for,audit purposes.
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Received by
NOTE: In accepting the transfer inheritance tox an future estates, prior 10 fhe death of the life
tenant or tenant for years, os evidenced by this receipt, il is undersiood that the Commonweolth shall
not be precluded or prevented from hereafter assessing additional inheritance tOIr at the death of the
life tenon! or lenont lor years whenever II appears that such addilionoltox moy be legally due and
collectible for any reason whatso~ver.
lU.chlU'dSir.at'M.llerson
~~g'R~ftr o~ Willa
. (Title)
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