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,~ RCC 4 (2177) / COMMONWEALTH OF PENNSYLVANIA
':~1': NO. H 063496 DEPARTMENT OF REVENUE
;: OFFICIAL RECEIPT · PENNSYLVANIA INHERITANCE AND ESTATE TAX
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111I' RECEIVED ---------...----- 'ftA
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HtJNnR'RD T'DB'I'Y-THRD &: 15/l00---------------dollars
representing Pennsylvania Inheritance or
Estate Tax due from the following estate:
In..ph p. Al.xa. ~.q.,
2 % Tax on
$
$
ss
16 So. Market st.....t
6 % Tax 0 n
$
$
Meob_1'1 eeb1trg, pa.
11055
15'fc Tax on
$
$
File No.
21-18-'560 Date of Death 10-1-1918
Dole of Poymenl
~~J'l 1-5,1919
'fc Tax 011 $
Eslale Tax, Act of
May 7, 1927
$
$
.f
C~.:plaR4
TOTAL TAX CREDIT
less five percenlum of tax if
poid wilhin Ihree months after
dole of dealh
Plus interest ot the rate of
_ % from
to
$
123.1'5
Name of Decedenl
PLORDCE M. RAFART.
$
t
ks:
$
Ii
I
uOO~[P[L~@illu~
SEA L
TOTAL AMOUNT PAI~
/
I / "
\ ,i ._.,G1vv;(,{:I. ·
Richard i~gn~at'r.ori
Reg1_tep 0' Vi)l.
(Title)
$
123.15
NOTE: This Triplicata Receipt to be rstained for audit purposes.
Received by
NOTE: In accepting the transfer inheritance tax an future estates, prior to the death of the Iile
tenant or tenant far years, as evidenced by this receipt, it is understood that the Commonwealth shail
not be precluded or prevented from hereaher assessing additional inheritance tax at the death of the
life tenant or tenant far years whenever it appears that such additional fax may be legally due and
collectible for any reason whatsoever.