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I~ RCC 4\2117) i EALTHOF PENNSYLVANIA
UNo.H06377.i ... . DPARTMENT OF REVENUE
a · OFFICIAL RECEIPT. ePENfSYLVANIA INHERITANCE AND ESTATE TAX
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i RECEIVED
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IfIIIIPJ!'l'...TII1l .. 7q/lOO-...---........~allars
representing Pennsylvania Inheritance or
Estate Tax due from the following estate:
File No.
:_(C1a'PJr. 1WMAwI 1IINU)
,... 0Ifte. 1- f..JIJ
6% Tax on
$
$
2'7. Tax on
$
$
IAMYDe .Pa.
11M3
$
$
15'1. Tax on
sn...T8- U2
6-11..1918
% Tax On $
Estate Tax, Act of
May 7. 1927
$
~
$
Date of Death
z""'-,.,.,., 16 .19f9
.TItYT.A. .-. ."'1:
Date of Payment
,.n'J9-1'9
Name of Decedent
$
TOT AL TAX CREDIT
Less five percentum of tax if
paid within three months after
date of death
Plus interest ot the rate of
_% from
to
$
I!ua~t &1Id
$
arks:
'AID . ADCOIJI'I.
IY 00 ~ [p [L ~ @ flfIT [g
NOTE: Thl. Tripllcllte Receipt to be ,_Ineel fo, eualt purpoee..
SEA L
TOTAL AMOUNT PAl
Received by
NOTE: In accepting the tranlfer Inheritance tax on future estates, prior to the death of the life
tlnont or tenant for yean, a. evldenc.d by thl' re,elpt, It Is understood that the Commonweolth shall
not b. precluded or prevented from hereofter ollelllng additional Inheritance tox at the death of the
IIf, tenant or tenanl for years whenever It appears that such additional tax may be l.egally due and
collectIble for any reolon whotlo.....r.
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