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~RCC4(2m) COMMONWEALTH OF PENNSYLVANIA
h\IiP.H001268 DEPARTMENT OF REVENUE
B'. OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX
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S. RECEIVED
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_~~~___~__~_____PIVI
~ BIOJI'l"f-FIVB I; 94/l00---------------dollars
representing Pennsylvania Inheritance or
Estate Tax due from the following estate:
_ r 'm:
If Jdress
,
lI_ t'h1.her1.an4,Pa.
170'10
File No. 21-18-48
Date of Death 1-14-19T8
Date of Payment
4prU .,1918
Name of Decedent
OkaltAuDB M. MVIS
I County ~1an4
'11orks:
PAID OJ( ACCOUI'f.
uw~[P[L~@illu~
5 E A L
NOTE: This Triplicate Receipt to be retained for audit purposes.
2%Taxon $
6 % Tax on $
15% Tax on $
% Tax On $
Estate Tax, Act of
May 7, 1927
TOT AL TAX CREDIT
Less five percentum of tax if
paid within three months alter
date of death
Plus interest at the rate of
_ % from
to
Received by
NOTE: In accepting the tronsfer inheritance tox on future estates, prior to the death 01 the life
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 lox at the death of the
life tenonl or tenant for yeors whenever it appears Ihot such additional tax may be legally due and
collectible for any reason whatsoever.
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