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~IN'~CC4pm , COMMONWEALTH OF PENNSYLVANIA
Ill,~g~O'25917 OEPARTMENT OF REVENUE
a~!;j,;", ',", OFFICIAL RECEI~T · PENNSYLVANIA INHERITANCE AND ESTATE TAX
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5 RECEIVED
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ress
Dote of Payment
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--.---.----..----TWENTy-~HRE8
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(Beulah R~ Sheatter)
26 So. 8th Street
Lemoyne ,Pa..
11043
21-18-231 Dale of Death 3-29-1918
June 21,1918
Nome of Decedent
ROY A. PETERMAN
County
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CUIlIberlAnd
PAID ON ACCOUNT.
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5 E A l
NOTE: This Triplicate Receipt to be re1ain6d for audit purposes.
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HUNDREl)
DOLLARS.--~~--.-~-----.--
dollars
representing Pennsylvania Inheritance or
Estate Tax due from the following estate":
2% Tax on
$
6% Tax on
$
15% Tax on
$
% Tax 0('1 S
Estate Tax, Act of
May 7, 1927
TOTAL TAX CREDIT
less five percentum of tax if
paid witn;n three months ofter
dale of death
Plus interest at the r~fe of
_ % from
-
-
$
$
$
.
$
$
f
$
2Jh21.05
$
1l>1,OS
$
-
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