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I~! RCC4(2/77) COMMONWEALTH OF PENNSYLVANIA
t1iNO,H063580 DEPARTMENT OF REVENUE
a OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX
iH
;: RECEIVED -------------------FORTY-FOUR
~I
~ 'm,
'iIl
~ I ress 22 kat Main street
I FH. No 2:::::.b:::~~.oth 1 :::.1918
~..
HUNDJlEJ) THIRTY-ftO . 56/l00---------dollars
representing Pennsylvania Inheritance or
Estate Tax due from the following estate:
~el R. Va1tera, III, KAq.,
2 cy~ Tax on
$
$
6 % Tax on
$
$
15% Tax on
$
$
Dote of Payment
April 2,1919
% Tax On $
Estate Tax, Act of
May 7, 1927
$
I
,.~
I I
!
$
Name of DecedentCARRIB BLAIR Ll'iBdf
i County
I
I
CUMberland
TOTAL TAX CREDIT
Less five percentum of tax if
paid within three months after
dote of death
Plus interest at the rate of
_ % from
to
$
-,-]2,56
$
~ .marks:
PAID OK ACCOUIT.
$
l]lR1~[PLl~@illu~ SEAL
TOTAL AMOUNT PAID
$
4,-32.56
NOTE: Thi. Triplicata Receipt to be retained for audit purpo....
Received by
,i . NOTE: In accepting the transfer inheritance to. an future ~states, prior to the death of the life
I tenant or tenant for years, as evidenced by this receipt, it is understood that the Commonwealth sholl
!lOt be precluded or prevented from hereoller assessing additional inheritance tax at the death of the
~ Jlfe tenant or tenant for years whenever it appears that such additional tax may be legally due and
collectible for any reason whatsoever.