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RCC-84
(8- 77)
COMMONWEALTH OF PENNSYLVANIA
... ;;.c;;.:.:-08Mal'ME:N-T4)fc:REVENUE
tNHERrrANCE~AX-DIVrstON
OFFICIAL NOTICE OF
INHERITANCE TAX
ASSESSMENT
ilnl~
DAT~.. 9'~~ .r. ;;. ~ !.~ 'I,
.J\lJ ; iJo
ESTATE OF ... 1,.,,.\ C. j/lllU/ii--r,
FILE. NO. .;;;} - 'If;- /; 0 ..;;.,
( 1.1 I
COUNTY OF .ll~ }..!>-Jl.\~,("v, ,
- . . . . - ..,[ "'.
DATE OF DEATH4kiL(:1.... r) J (/ '7),/
TO:
~... .' . ,... .
, /:"'1 ~
.~. .'}~'\~'. ~I{ ..}tA}~'~ r:;.,
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For County Information purposes only
COUNTY FILE NO: I ('\~;,;{ n ;; - .7
-------.------------------------------------------------- -------- ---
Appraised Value of Estate:
Real Estate
..----::-.~~~~...peFS€J~J3efty_~~--.. -
Jointly Held Property /Transfers
$ ltd_t:; () 0 (llJ
31..,. 3 i!.:;9 !4~
$ '7 ~ :Y "79 1/... ~
./
~ 5u)5b
,
$ (__~/ .-15Y (j 9
Total Gross Estate
Total Approved Oeductions
.~..-___.cleaJ:...value of. Estate .. ..
. . .L.ess: Approved Charitable Exemptions
-
ill
/
.. .~~.Am.QY01I~~~bl~.@El% R~te
$ L i? 3..;/
$ ?,-~..-?f5? .9St
tax due
$'2., Q.:1) L/. Y
----- ,
I
j
I
$ 3 ~1.;]/ !.j ;Y'
Clear Value of Estate Su'flject to Tax
Amount Taxable @ 15% Rate
tax due-
TOTAL PENNSYLVANIA INHERITANCE TAX DUE
,/
Less. Credits:
DATE OF PAYMENT
l
AMOUNT PAID
DISCOUNT
INTEREST
TAX CREDIT
2., -7?=~Tj(r$~.::J.3;{j 1} () + $]f) n no
1- J-b- v9 .5dO ~ +
R -. Ii "3 - rye; I; J /.., +
$
r-
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~
=
=
$ ~tJ.o() Of)
~d6 ~d
J /i
t (0. c',( 0- ,1 ,,~
=
a-ALANCEOF PENNSYLVANIA tNttERtT-ANCe TAX DUE
Interest Will accrue at the rate of .six (6) percent per
Inheritance tax from
arinum'ori-ffii'-unpaid Dalance of
...... _t: .~hedate70f payme~. (i j
Asses-ed-C...i1?=...l.....- t1? t ^ N',.liUu'v.,....
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seE REVERSE SIDE FOR INSTRUCTIONS
REGISTER OF WILL'S COpy