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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX
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(Jo..ph E. Green)
ddress
5 South Hanover street
Car11a1e.P&.
17013
21-78-125
Date of Death
2-12-1918
II F;le No.
Date of Payment
Apl"H 26.1918
Name of Decedent
18ITT.Y AYRU mnnnr
County
c".'haP'A....l!
PAID ON ACComrr.
uOO~[P[L~@&u~
5 E A L
NOTE: This Triplicate Receipt to be retained for 8udrt purposes.
_____________ ________dollars
representing Pennsylvania Inheritance or
Estate Tax due from the following estate:
2'k Tox on $ $
6% Tax on $ $
15'7Cl Tax on $ $
% Tax 0(1 $ $ ~
Estate Tax, Act of
May 7, 1927 $ 141
I;
TOTAL TAX CREDIT $ 5.263.16
Less five percentum of tox if
paid within three months after
dote of death $ 2fi3.1(;
Plus interest at the rate of
_%from ~
to $
\
TOTAL AMOUNT PAID $ \ 1\.000.00
\ ...
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'til!
Ii
Received by
NOTE: In accepling tne transler innerltance lOll on future estates, prior to the death 01 tne Ii/e
tenant or lenant for years, os evidenced by Inis receipt, it is understood Inat the Commonwealth sholl
nol be precluded or prevented from hereafter assessing additional inheritance lOll at Ihe death of the
Iile lenont or lenant lor years whenever it oppeors that such addilional tall moy be legolly due ond
collectible for ony reoson wnol$oever.
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