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~!,Rcc;'12ml , COMMONWEALTH OF PENNSYlVANIA
. \~;bY'001272 DEPARTMENT OF REVENUE
OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX
ress
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....--...........-.............PIPlEBH 'rHOUSAND
DOLtARS----.-.------..--~....-
dollors
representing Pennsylvania Inheritance or
Estate Tax due from the following estate:
o
(Gladys Graham,)
116 E'a8t ~treet
,
2 % Tox on $
$
6%10xoo $
$
Sh!ppenaburB,pa.
11257
15'70 Tox on $
'$
Dote of Deoth
1..20..19't8
$
File No, 21...7B..65
Dote of Payment
% Tox On $
Estate Tax, Act of
May 7, 1927
#
April 17,1978
$
C_eroland
TOTAL TAX CREDIT
less five percentum of tax if
paid within three months after
dote of death
Plus interest at the rare of
~%from
to
1~i789.47
Name of Decedenl GM~ P. D$,...
I County
$
$
7A9.h7
"
PAtD ONACCQUN'r.
$
'IT rn ~ [P[L~ @ illlJ'~
"
NOTE: This Triplicate Receipt to be retained for audit pUrpoM.s.
SEA L
TOTAL AMOUNT PAID
Received by
NOTE: In atc6pting the transfer inheritance tal( on future estates, prior to the death of the fife
tenant or tenant lor years, os evidenced by this receipt, it is understood that the Common......eolth sholl
II not be predvded or prevented from hereafter assessing odditionol inheritante tax oj the dealh of the
t .. life tenant or tenanl for years whenever 11 appears that svch additional tal( may be legally due and
collectible for ony reason whatsoever.
I 0 'Me)..
RlchAz'd E.lleraon
F"~$+~'" fir W111a
(Titlo)
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