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,..' . RCC4(2/71 COMMONWEALTH OF PENNSYLVANIA
UNo.H 063441 DEPARTMENT OF REVENUE
a OFFICIAL RECEIPT · PENNSYLVANIA INHERITANCE AND ESTATE TAX
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;; RECEIVED
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Widlll..1Rft ~.rTAIIIfI .. ,stIlOO---- dollars
representing Pennsylvania Inheritance or
Estate Tax due from the following estote:
IlaJ'k B. CIU'bU'
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11013
21-18-11-10 Dote 01 Deoth 6-a6-19'T8
File No.
Date 01 Payment
l'ebZ'Ual'Y 16.1m
Nome of Decedent vn.r:raY Ca eM.......
County .1 Tr'II."
29'. Tax on $
6%Toxon $
159'. Tax on $
% Tox on $
Estate T ox, Act 01
Moy 7, 1927
TOT AL TAX CREDIT
Less five percentum of tox il
poid within three months after
date of death
Plus interest at the rote of
_ % from
to
$
$
tr 00 ~ [? [L ~ @mtr[g 5 E A L TOTAL AMOUNT PAID $ _~12
NOTE: Thll Tripllclte Receipt to be retelned for ludit purpo.... :.l~' ~ ~ '
Received by L _)..-- ..<J-
NOTE: In accepting the tranlfer Inh.rllance tax on future estates, prior to the deatt-. of the life ... _........... rsrg - (
lonanl or lonanl for yoars, a. e.ldonced by Ihl. recolpt, It I. understood that the Commonwealth .hall ~, on
not b. precluded or prevented from h.rlafter onlnlng addltlonallnherltance tax at tne death of the -"pttaP ~ "".
I1f. tlnont or tenant for y.ars whenever It appears that such additional tax may be legally due and (Titt )
tollecUble for any reason whatsoever. e
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