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,~. RCC412m) COMMONWEALTH OF PENNSYLVANIA
1,lliNo,H025909 DEPARTMENT OF REVENUE
: OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX
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!~ RECEIVED
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& 15/100---...-------------......--
dollars
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IlUNDRED FIFTY-TWO
Helen I. Halne.
439 Ronh EMU Drlve
BnoI.&,P8..
17025
21-78-137
3-1-1978
Date of Death_
June 15.1978
Date of Payment
SUSAIi I. SAClOWf
Nome of Decedent
County
Cuaberland
'[frn~ [P[L~@& '[f~
SEA l
NOTE: This Triplicate Receipt to be retained for audit purposes.
representing Pennsylvania Inheritance or
EstotE: Tax due from the following estate:
2o/,Taxon
$
$
6%Taxon S $
\5% Tax on $ $
% Tax On $ $ ~
Estate T ox, Act of
May 7, 1927 $ Ijl
~i
1'52 .1'5
TOTAL TAX CREDIT $ ~
Less five percentum of tox if
paid within three months after
dote of death $
Plus interest at the role of
_%from t!
10 $ ';
\
'; I
! ,r"'" " $ ~~.l'i
I
, I
I!
Received by
NOTE: In accepting the transfer inh.,ritance tax on future estates, prior to the death 01 the life
tenant or tenant far years, os evidenced by this receipt, it is understood that the Commonwealth shall
not be precluded or prevented from hereafter ossessing additional inheritance tax at the death of the
life tenant or tenant for years whenever it appears that such additional tax may be legally due and
collectible for any reason whatsoever.
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, RlchUd (~~nai',I\~!nOn
Reglner of "'VI l.S
(Title)
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