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:141 COMMONWEALTH OF PENNSYLVANIA
,I: NoH 025805 DEPARTMENT OF REVENUE
a OFFICIAL RECEIPT. PENNSYlVANIA INHERITANCE AND ESTATE TAX
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;~, RECEIVED
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}.(.vera ,MYera. IIlcInar &: Johnaon,L Att s.
------------------ dollars
representing PennsylvaniO Inheritance or
Estate Tax due from the following estate:
eK. E. Bertram)
2% Tax on
$
$
ddcess Post Ot't'1ce I/: 125
6%Tax on $
$
LeIllOyne ,Fa.
17~3
J5%Toxon $
$
I File No. 21-18-101 Dote of Deoth
1-31-1978
% Tax On $
Estate Tax, Act of
Moy 7, 1927
$
Date of Payment
-.r 1,1<l18
$
I
Name of Decedent
PAID ON ACCOUJIT.
SOPHIA SUSAlf J:II!iK'l"11AH TOTAL TAX CREDIT
Less five percentum of fax jf
CUMher]."'" paid within three months after
dote of death
Plus interest at the rate of
_%from
to
$
6,A.h2.10
marks;
$
-,42.10
'iJOO~[P[L~@m'iJ~
$
Received by
NOTE: In oc<:epting the transfer inheritance tox on future estates, prior to the death of the life
tenant or tenant for years, 05 evidenced by this receipt, it is understood that the Commonwealth sholl
:'! ~at be precluded or prevented from hereafter assessing additional inheritance tax at the death of the
f, 'ife tenant or tenant for years whenever it appears that such additional tax may be legally due and
' collectible for any reason whotsoever
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~.
$
\ " l'W' /'In
\
5 E A l
TOTAL AMOUNT PAID ,_'
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NOTE: This Triplicate Receipt to be retained for audit purposes.
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