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/I' RCC 4 12/771 '
IINo,HOO 1228 COMMONo~p~~J~TOo': :E~~~~YLVANIA
~.~., J OFFICIAL RECEIPT' PENNSYLVANIA INHERITANCE AND ESTATE TAX
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B RECEIVED ------...----..-----.-SIX HUNDRED DOLLARS---------------------------dollars
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Date of Payment
Name of Decedent M1CRART. C. ~F.Q1iI,
MICHAEL C. SEMYAN
, Caunly C!tnnb.....' A"'"
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Snelbakel'
McCaleb & Elicke%'
representing Pennsylvania Inheritance or
Estate Tax. due from the following estate:
Att
(Cecilia I. S~an)
2% Tax an
$
$
44 W. Main Street
$
$
6%Taxon
MechanlcsbUl".Ch Fa.
170S~
$
15'71tl Tax on $
21..78..27
Dale of Death 1..2..1976
$
% Tax 0('1 $
Estate Tax, Act of
May 7, 1927
$
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MAl'nh :;lA, 1978
arks:
a/k/f! TOTA.L TAX CREDIT
less .five perc~ntum of tax if
paid within three monlhs ofter
dote of death
Plus interest ot the rote of
_%from
to
611.>6
$
$
:usa
"PAID ON ACCoUN'TIt
$
'j]'OO~[p~~@ill'j]'rn SEAL
600.00
TOTAL AMOUNT PAID
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NOTE: This Triplicate Receipt to tJ:e ,fetained fOf audit purposes.
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Received by
NOTE: I", accepllng the trClI'tsfer inheritance tax on future estates, prior to the death of the life
tenant ar tenont for years, os evidenced by this receipt, it is undersiaod thaI the Commonwealth sholl
not be precluded or prevented from hereaffer assessing additional inheritance to..- at the death 01 the
life tenant or tenant lor years whenever it appears that such additional tal< may be legally due and
coUe-ctible- for ony reoson whatsoever,
ISjg~atwe)
Richlll'Q J!i. Andel'BOn
R~g1~~~r ~~ Will.
(Titl.) ,
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