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I~'~~I~.;, COMMONWEALTH~m~N.5I:SY~ANIAT' .
Jfl ~1J"6~6~41!" DEPARTMEI':'Ji"o~EVEN~' ~c'
~~4': .... ."."l~;'OF~ICIAL RECE!P! . PEN.NSYLV;~N~~~C~ AND. ~~TA;rE TAX
S RECEI VE!............._.....-..sr.rJ!JN HUNDRED ~ SEVEN'l'Y-NINE 110 02/100..-......-..- .................. do 110 rs
~( :'1" " / representing Pennsylvania Inheritance or
t~ \.' . Estote Tox due from the following estote,
~, Fr.o~CoimnonWea1th Nat1onJ'~'
\!fi, iJre~ North He-novel' Stree't
~ .
Caz:l1a1e,Pa.
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No. 21":.7~-223 Dote of Deoth 4..5-1978
,0Wo(Poymen~ November 14,1978
: :,:'~:.r'~ ~:i~1f' . ~-~ '
! I~!:j;tent ,~L. nlOMPSON
,County ',j.,,: '. CWIlberland
~>>~-f~:<;:':"(~'1,4J' ' ,
~ ;',m.,.,"", ·
1;.:";. ..";; ~~ ' .
{':IAA!L:~~ ON ACCOt1lf!
,~"!> rlf<
;!~';:':IT,.OO ~ ~ [L ~ @ ill u m, SEA l
, -'.":Y',:"',",-:' .
OTe: -~t;'!'riP'~ate Recelpt'to be nrt~lned for audit purposes.
,
,
2% Tox on
$
$
:-
6%Taxon
$
$
.,.1>"
17013
15'71tl Tax on
$
$
% Tox on $
Estole Tox, Act of
Moy 7, 1927
$
$
l
TOTAL TAX CREDIT
Less five percentum of tax if
paid within three months after
dote of deoth
Plus interest at the rate of'
_%from
$
779.02
$
to
$
TOTAL AMOUNT PAID
,
,
. .'- Received by
NOTE: ,:acceptlng the transfer Inheritance tax an future esfales, prIor to the death of the Iile
lenanl. or tenont_ for;.,yeon, 01 evidenced by this receipt, Ii Is' understood that the Commonwealth &holl
/.'1,' nat be_ precl_~ded or. p'revented from herealter auenlng additional Inheritance ta)( at the death.of the
,I life tenant a! t,e']ofl.t Jar years whenever It appears that luch oddi_tlanal talC may be legall"y'due and
collectible for any~reoson whatsoever,
.
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