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~Nol 00.3 323 ..........:"':~~TI\4E1'~T,O~~E~~)~"......
1~'; .. ,,'. OFFICIAI..R~g~~~~!t~i~~~~~~~~hE~!~TETAX
S RECEIVED -........---u-THtR'l'Y-THREE HUNDRED SEVENTY-THREE & 48/100......-....---.... dollars
~i representing Pennsylvania Inheritance or
; From. COllllllOnW'ea.lth Na.tional Bank. Estate Tax due from the following estate.
~ Address 10 South Market Square 2% Tax on $ $
ij
~
Harrisburg.Pet.
17108
6% Tax on
$
o. el..78..209
4-6-1978
15% Tax on
$
Date of Death
JUly 18.1Q7Q
% Tax on $
Estate T ox, Act of
May 7, 1927
Rn'A~ W. ROLAND
Cumberland
TOTAL TAX CREDIT
less five percentum of tax if
paid within three months after
dote of death
Plus interest at the rote of
3t-% from JAn11i.l"'.y 6.1979
to JULY V:t ~, 979
Nome of Decedent
County
Remarks:
PAID IN FULL.
t.032
uOO ~ [P [L~ @ill u~
SEA l
TOTAL AMOUNT PAID
NOTE: This Triplicate Receipt to be retained for audit purposes.
-
$
$
$
$
~
$ ~,268.78
$
$
1011.70
~.~i~.46
! I
I I
$
Received by
NOTE: In accepting the Iransler inheritance lax on future estates, prior 10 the death of the Iile
tenant or tenant lor years, os evidenced by this receipt, it is understood thai the Commonwealth sholl
j , not be precluded or prevented Irom hereafter assessing additional inheritance tox atlhe death of lhe
I life lenont or tenant lor years whenever II appears that such additional tox may be legally due and
colledible for any reason whatsoever.
/
Richard . Ud r
Restater of Wills
(Title)