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COMMONweALTH OF P.ENNSYLVANIA
DEPARTMENT OF REVENUE
FFICIALRECEIPT. PENNSYLVANIA INHERITANCE AND ESTATET~X
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'File No.~Dote of Death 1...ao-l918
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iName of Decedent
I
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t
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SEA L
NOll!: Thle Tripllctlte R_lpt to be r.ained for audit purpo_.
89/lOO------------dollors
representing Pennsylvania Inheritance or
Estate Tax due from the following estate:
2%Taxon $
$
$
$
$
$
$ 10.._
$
6%Tax on $
15'1'0 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 after
date of death
Plus interest at the rate of
_ % from
to
$
'. ~.1l9
~ j (; MAi~j
B10tJut ~~w..r.-
........-ttMt at Vi t ...
(Title)
TOTAL AMOUNT PAID
-,'
Received by
NOTE: In accepting the fran,f.r Inheritance tax on futu r. ,ltat.s, prior to the death of the life
t.nant"'or t,non' for v.an, 01 evidenced by this r.'tlpt, It is understood that the Commonwealth shall
not b, precluded or prevented from h,reoft,r allelllng additional inheritance tax 01 the death of the
IIf. tenant or tenant for ylon whene...er It appears thot such additional tax may be legally due and
collectible for any reolon whatsoever.