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;11/: RCC4(2/17) COMMONWEALTH OF PENNSYLVANIA
~~No.H02571. . .... . .. .... DEPARTMENT OF REVENUE
a OFfiCIAL RECEIPT · PENNSVLVANIAINHERITANCE AND ESTAtE TAX
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a RECEIVED ----------....Itliiitintt ftOVIAJID 1OLLAJlI--------------
'1
Date af Payment
Name af Decedent
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b From:
"
I
, Caunty
Remarks:
~lJ7
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dollars
V1U1_.. *".on.~.e.
representing Pennsylvania Inheritance or
Estate Tax due from the following estate:
ress
(Mu'1. II. ..,....)
10 an JI1Cb Itnft
C&l'11a1..... 11013
21-18-333 Date of Death 6-2'-1918
Sept...... _.1918
PAUL W. .Ioaa
$
21.051.63
2% Tax on $
$
6 % Tax on $
$
150/0 Tax on $
$
% Tax On $
Estate Tax, Act of
May 7, 1927
No.
$
$
4
PAD OJI ACCOUft.
TOTAL TAX CREDIT
Less five percentum of tax if
paid within three manths after
date of death
Plus interest at the rate o(
_%from
to
$
n.......,.....
1.05l.6L
lfOO~~[L~@illlf~
NOTE: This Triplicate Receipt to be ret.ined for eudit purpos...
5 E A L
TOTAL AMOUNT PAID
Received by
NOTE: In accepting the transfer inheritance tax on future estates, prior to the death o'f 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 h.ereafter assessing additional inheritance tox at the death of the
life tenant or tenant far years whenever it appears that such additional tax may be legally due and
collectible for any reason whatsoever.
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