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,ill RCC4 12!771 COMMONWEALTH OF PENNSYLVANIA
~1\No.H025972 DEPARTMENT OF REVENUE
a OFFICIAL RECEIPT · PENNSYLVANIA INHERITANCE AND ESTATE TAX
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'.' RECEIVED
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________~__~__SIX su-nR~
lI'OR'lY-ll'OUR .. 8l15/100---------------!Iollors
representing Pennsylvania Inheritance or
Estate Tax due from the following estate:
20/. Tax on
$
$
, S~h Wal'WWltl' S1:;.,
$
$
6% Tax on
car11a1a,Pa..
17013
$
15% Tax on
$
~
I
Date of Death :L-'J.3-1.9'fR
$
0/. Tax On $
Estate Tax, Act of
May 7, 1927
$
.Ju1y 19..1918
Date of Payment
$
~.85
Name of Decedent
sn~ c. DAICtAy
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
$
Cou nty
Rp'l1orks:
C'''-1>laDd
$
uOO~[P[L~@illu~
NOTE: This TripHcate Receipt to be retained for audit purposes.
SEA L
TOTAL AMOUNT PAID
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i,
Received by
NOTE: In accepting the transfer inheritance tox on future estates, prior to the death of the lite
tenont or tenant for years, os evidenced by this receipt, it is understood that the Commonwealth sholl
not be precluded or prevented from hereafter assessing additional inheritance tax at the death of the
llf. 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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