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COMMONWEALtH OF PENNSYLVANIA
".'i;' ............. '" . .'. DEPARTMENT OF REVENUE
;:iOfflCIAL.RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX
4-...-....-~.
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Joat Otfl.. lOX I 2"
.... 11111,".
lTOU
~~.~Date of Death 6-T-1gr8
.~/
~ af'Payment IIarOh 15.1919
, ....
11? 1'.tllIITtm OTT......a01l
~~...1~~
( .001
lYOO~[P[b~@illu~
5 E A l
II GO-..____.........--..--dollors
representing Pennsylvania Inheritance or
Estote Tax due from the following estate:
2'1< Tax on $
$
$
$
$ I
$
$ 1'".01
6%Taxon $
15'1< Tax on $
% Tax on $
Estate Tax, Act of
May 7, 1927
TOT Al TAX CREDIT
less five percentum of tax if
paid within three months alter
date of death
Plus interest at the rate of
% from _"" 6.1919
to .-...." )&....919
$
$
..10
l~
\
TOTAL AMOUNT PAID
: 1Na TrlpIicllt. Recelpt to be retelned for eudlt purpoee..
. Received by
~; In accepting tn. tran.f.r Inheritance tax on future estate., prior to the death of the life
",or tenant for yean, 01 evidenced by thIs receipt. It is understood that the Commonwealth sholl
~..'.' S p"ecluded or prevent.d from hereolter o.....lng additional Inheritance tax at the death 01 the
~nt or t.nont for years whlneyer It appears thot such additlonal tax may be legally due and
I"for: any realon whotloever. -