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i~ RCC4(2171) COMMONWEALTH OF PENNSYLVANIA
~~NoH0267"1 DEPARTMENT OF REVENUE
a OFFICIAL .RECEIPT · PENNSYLVANIA INHERITANCE AND ESTATE TAX
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$i RECEIVED -..... .....-------.......JI%II ~J!I'
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oars
representing Pennsylvania Inheritance or
Estate Tox due from the following estate:
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.. wen IIdD ftJreM
2% Tax on
$
$
6%Taxon
$
$
.."ba1de......JIa .
1T055
$
$
15% Tax on
% Tax on $
Estate Tax, Act of
May 7, 1927
Date of Death
$
$
~
!
Date of Payment
lIDJIIA.r I. ....
P1.J1
TOTAL TAX CREDIT
Less five percentum of tax if
paid within three months after
date of death
Plus interest at the rate of
_ % from
to
Name of Decedent
$
County ~1ara4
Remarks:
$
,.,.17
MID (II ADCG\rW4".
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Oll!: Thi. Tripllctlt. Receipt to be ..aineel for audit purpoa...
Received by
NOTE: In accepling the transfer inheritance tax on futvre estates, prior to the death of the lif.
tenant or tenant for years, as evidenced by tnls receipt,. it Is understood that the Commonwealth shall
not be precluded or prevented from hereafter assessing additional inheritance tox at the deoth of the
life tenant or tenant for years whenever It appears that such additional tax may be legally due and
collectible for any reason whatsoever,
.