HomeMy WebLinkAbout01-02-79
~____ .~ .._ -- ~- ~ lI2[v~
iF4~~ .
fli~~liO' 637' 36 COMMONWEALTH OF PENNSYLVANIA
NO,I] DEPARTMENT OF REVENUE
:~~~\~" . OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX
U'lJ' 1{~i'!~'Y~. ~
'0'1 RECEIVED
;: ...-.-.......-.....-_......._~
'I
,
r...,..
lltJNDRBJ) SIXTt....ormm:t 8: 87 /lOO----"-"-";rollors
representing Pennsylvonia Inheritance or
Estate Tax due from the following estate:
~.I'
~ ~ ress
Caryn A.Clark. I
2%Toxon $
$
9 Big Horn Avenue
6%Tax on $
$
Meehardc8burg.Pa..
17055
6-1-1978
15'!', Tox on $
$
File No.
21'78-2^h .
. .. ,f :P"f Dote of Death
Nome of Decedent
January 2;1979
ROBERT S. CLARK
0/0 Tox 00 $
Estate Tax, Act of
May 7, 1927
$
Date of Payment
$
#
I County
CUIlIbel"lAnd
TOT AL TAX CREDIT
les.s five parcentum at" tox if
paid within three months after
dote of death
Plus interest at the rafe of
_%from
to
$
1,763.07
$
Rlrk.,
$
NOTE: This Triplicate Receipt to be retained for audit purpoaes.
v
$
'[j'OO~[p[L~@ill'[j'rn
SEA L
TOTAL AMOUNT PAID
I
f
Received by
NOTE: In occaptlng IMe Ironsfer inheritance tax on future estates, prior to the death of the lile
tenant or tenonl for years, os evidenced by this receipt, It Is understood that the Commonwealth sholl
not ~e precluded or prevented from hereafter anessing addillonal inheritance tOlt at the death of the
life lenont or tenant for years whenever It appears that such additional lalt may be leg oily due and
collectible for any reason whatsoever.
R1c'bal:'d(SS~at~erSOn,
Register ot Wi] 1 R
(Title)
-