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!~i' RCC;(2177l COMMONWEALTH OF PENNSYLVANIA
if I: NO. h 063800 DEPARTMENT OF REVENUE
i= OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX
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1=: RECEIVED -----------...-----NINE 'R'tJ'N'nR'F.n
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Ca.rl1$le..Pa. 17013
~ FHe No. <>J -78-~55 Dote of Deoth 5-1-1978
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EIGllTY-TWO &: 17/l00----------.........--ift>lIars
representing Pennsylvania Inheritance or
Estate Tax due from the following estate:
(SUl\.l.~ B. Ie. John W.Hert~ler)
2%Toxon
$
$
1 Irv1 nE' Row
6% Tax on
$
$
15% Tax on
$
$
Date of Payment
Febl"\lU'Y lJ01~79
% Tax on $
Estate Tax, Act of
May 7, 1927
$
~
;~41
$
Cumberland
TOT A,L TAX CREDIT
Less five percentum of tax if
paid within three months after
date of death
Plus interest at the rote of
_ % fr?m
to
$
9~. 37
Nome of Decedent
J. w. lfRRTZT.n..
Received by
NOTE: . In accepting the transfer Inheritance tax on future estates, prior to the death of the life
tenant or tenant for years, os evidenced by this receipt, it is understood that the Commonwealth sholl
not be precluded or prevented from hereafter assessing 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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k (Sj"Qnature)
ichard.lli. Anderson
R~1.~A? n~ Yilla
(Title)......
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$
PAID OIf ACCOUNT.
$
VOO~[p[L~@illV~
SEA L
TOTAL AMOUNT PAID
$
982 37
NOTE: Thil Triplicata Receipt to be retained for audit purpoles.
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