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"IJI RCC4(2/77) COMMONWEALTH OF PENNSYLVANIA
iU,NO.H 026009 DEPARTMENT OF REVENUE
:::. OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX
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= RECEIVED --------------ELEVER THOUSAJtD
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:= From: (FlaNnel B. It John W. Henzler)
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Kr_1" and Kramer, Attya. II
DOT.T.A 'A,S -...... .........,....,..-......-------.,.. ..'_..'--~mlars
representing Pennsylvania Inheritance or
Estote Tax due from the following estate:
2% Tax on
$
$
1 Irvine Row
6% Tax on
$
$
Carllale.Pa.
17013
I 5 % Tax 0 n $
$
,
~I
, Date of Payment
. :: .5. ')
21-78-285
Date of Death
5-1-1978
% Tax On $
Estate Tax, Act of
May 7, 1927
$
~
~41
July 31 ~1978
$
, Name of Decedent J. W. kttKTZT~
County
Cu..:rland.
TOT AL TAX CREDIT
Less five percentum of tax if
paid within three months after
date of death
Plus interest at the rote of
_ % from
to
$
11.578..95
~
$
51R.95
PAID OK ACCOUN'l'.
uOO ~ [p [L~ @ill u~
SEA L
TOTAL AMOUNT PAID
$
I
II
$
NOTE: Thi. Triplicate Receipt to be retained for audit purposes.
11
Received by
NOTE: In accepting the transfer inheritance tax on future estates, prior to the death of the life
tenant or tenant for years, as evidenced by this receipt, it is understood that the Commonwealth shall
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.
natl/re L
. Antleraon
011111,.
(Title)