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,~i~~f(1~;78). ..' .... .COMMONWEALTH OF PENNSYLVANIA
,~f'l0\1OD320' '.' DEF'AR'J'MENT OF REVENUE
=, '.' ." OFFICIAL:RECElPT. .PENNSVLVANIA INHERITANCE AND eSTATE TAX
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illt From:
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':=: Address
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~l,. Camp Hill.Pa.
~!FJNO' 21-78-127
; I of Poyment June 5.1979
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RECEIVED ______________FIVE JlUl())REI) TWDrY-NINE & B1/100----------------..--dollors
representing Pennsylvania Inheritance or
Estate Tax due from the following estate:
21st & Market streeta
29',10x on
$
$
17011
6% Tax on
s
$
Dote of Deoth2-24-1978
150/,10xoo
$
$
ZDWARD L. RYAll
% Tax on $
Estate Tax, Act of
Moy 7. 1927
$
~
II
Name of Decedent
$
County
Cumber1ancl
TOT Al TAX CREDIT
less five percentum of tax if
paid within three months after
dote of death
Plus interest at the rote of
_%from
'0
$
1)29.81
! Remarks:
$
PAID ON ACCOUlfl'
$
'IT rn ~ [p [L~ @ ill 'IT~
SEA l
TOTAL AMOUNT PAID
$
S:h
I
I
1
. ~~9
L- r 4 . \
{ i . ..~
Received by \ /' , I, .,.
NOTE. In o<<.pling Iii. Icon.l.c inh.cllon,. 10. on 'uluc. ..Iot... pcloc 10 Ih. d.olh o' Ih. Ii'. \ - (.,- l6f~'r I' .
t.nonl oc I.non' 'oc ,.0". o. .,id.n,.d b, Ihi. m.lpl, it i. und."lood Ihollh. Commonw.olth .holl RiCh~. Anclel'aOn
not be precluded or pre...ented from hereofter OSS8uing additional inheritance tox 01 Ine death 01 the ,~.. -t.,. Or "11).
life tenont or tenont for yeors whenever it appears that such additional tox may be legally due and (Title
collectible for ony reason whatsoever.
NOTE: This Triplicate Receipt to be retained for audrt purposes.
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