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'I RCC4(11178) COMMONWEALTH NSYLVA
~NoJ003192 OFFICIAlIIECEIPT. Pe=-;:':-~~lIi~"AND mAtt TAX
If
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= RECEIVED ---------------'rWELVE
'1
e From:
ij
~ AdrJress
11/
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A
~ F No. 21-78-513 Dote of Death 9-4-1978
i 0' of Payment
b Nome of Decedent
HUHDRED TWER'l'Y-01fE .. 78/l00----------------dollars
Robert J. YOCUll Es .
(lat Nat'l Bk-Shlppenaburg)
Poat Office Box # 336
Shlppenaburg,Pa. 17251
representing Pennsylvania Inheritance or
Estate Tax due from the following estate:
2% Tax on
$
$
6% Tax on
$
$
15% Tax on
$
$
May 30J1919
'7<> Tax on $
Estate Tax, Act of
May 7, t 927
$
~
,n
EDNA LOBO
$
County
Cumberland.
TOT AL TAX CREDIT
Less five percentum of tax if
paid withi n th ree months after
dote of death
Plus interest at the rate of
_%from
to
$
1,221.18
t
Remarks:
PAm ON ACCOUN'l'.
$
$
uOO ~ [p [L~ @ill u~
SEA L
TOTAL AMOUNT PAID
$
, 221A1e
-
nlOTE: This Triplicate Receipt to be retained for audit purposes.
Received by
NOTE: In accepting the Iransfer inheritance tax an future estales, prior to the death of the life
tenonl or tenanl for years, as evidenced by this receipt, it is understood that the Commonwealth shall
not be precluded or prevented from hereafter assessing additional inheritance tax at the death of the
lif. tenanl or tenant for years whenever it appears that such additional tax may be legally due and
collectible for any reason whatsoever.
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