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COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
HARRISBURG
REV-475 (8-78)
CERTI FICA TE
UNDER
REVENUE ACT OF 1926
Date March 5, 1979
TO THE UNITED STATES COMMISSIONER OF INTERNAL REVENUE:
Paul W. Snyder
THIS IS TO CERTIFY that in the estate of
Pile No: 2l~78~0333
late of
D.merland
County, Pennsylvania,
who died
June 24, 1978
, no refund of
inheritance taxes has been authorized by the Department and/or by the Board of Finance and
Revenue of this Commonwealth; and that there is no claim now pending for a refund of such
taxes in sai'd estate"
Subject to additional tax, if any, under the Act of May 7, 1927, as amended.
Totol Tox
Imposed
Amount Poid
in Cosh
Dote Poid
Discount
Altowed
Interest
Cho,ged,
On AccoUlt
$20,000.00
9/22/78
$1,052.63
For
Howard A. Cohen
SEAL
Secretary of Revenue