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,!II RCC4(2I77l COMMONWEALTH OF PENNSYLVANIA
\1~No.H026055 DEPARTMENT OF REVENUE
ii OFFICIAL RECEIPT · PENNSYLVANIA INHERITANCE AND ESTATE TAX
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" RECEIVED
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II . ,Ie No. 21,,18-31
___~---~----~-~.~-aII HUIDlID
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SI~atb . 42/100....---------------
dollars
representing Pennsylvania Inheritance or
Estate Tox due from the following estote:
Gurney B. Rub)", .,.,
,drl~SS
426 Market Street
Le1DOyne ,Pa.
11043
1-'..1918
Date of Death
Dote of Payment
Aupat 2. .1918
Name of Decedent
1WUlY BDGAa CLMl
, Cou nty
Oumberland.
Remorks:
PAID OK AOOOUlft'
1r00 ~ [p [L~ @ ill 1r~
5 E A l
NOTE: This Triplicate Receipt to be retained for audit purposes.
2%Toxon
$
$
6% Tax on
$
$
15%Taxon
$
$
% Tax On $
Estate Tax, Act of
May 7, 1927
$
I
I~I
, ;
,
$
TOTAL TAX CREDIT
Less five percentum of tax if
paid within three months after
date of death
Plus interest at the rate of
_%from
to
$
118..2
~
$
$
TOTAL AMOUNT PAl
.42
1
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~
Received by
NOTE: In accepting the transfer inheritance tax on future estates, prior to the dealh of the life
tenant or tenant for years, as evidenced by this receipt, it is understood that the Commonwealth shall
not be precluded or prevented from hereafter assessing additional inheritance tax at the death of the
life tenant or tenant for years whenever it appears that such additional tax may be legally due and
collectible for any reason whatsoever.
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