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;~! RCC4(2177) COMMONWEALTH OF PENNSYLVANIA
:"No.H 063471 DEPARTMENT OF REVENUE
=~ OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX
It
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= RECEIVED ------------...----NI!1EnD
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11
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"A 55
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I 21-18-262
..1 File No.
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Dote of Poyment
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James R. Humer, Esq.,
HUNDRED SEVENTY-EIGHT I: 96/1oo------.....-(1'01Iars
representing Pennsylvania Inheritance or
Estate Tax due from the following estate:
( Caroline Z. Brooks)
2 % Tax on
$
$
1 West B18h street
6% Tax on
$
$
Carlisle.Pa. 17013
15 % Tax on
$
$
County
Cumberland
TOTAL TAX CREDIT
Less five percentum of tax if
paid within three months after
date of death
Plus interest at the rate of
_% from
to
$
1.91'8.96
I
u
~.
Date of Death 5-10-1918
% Tax On $
Estate Tax, Act of
May 7, 1927
$
March 7,1979
$
Name of Decedent
BURR B. BROOKS. sa.,
I""
$
PAID ON ACCOUNT
$
\
\
1~1'8.96
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5 E A L
TOTAL AMOUNT PAID
$
NOTE: This Triplicate Receipt to be retained for audit purposes.
I
1~li
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 sholl
not be precluded or prevented from hereafter assessing additional inheritance tax at the death of the
life tenant or tenant far years whenever II appears that such additional tax may be legally due and
collectible far any reason whatsoever.