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ill, . I ' 7 COMMONWEALTH OF PENNSYLVANIA
l'l;NO.H 06373 DEPARTMENT OF REVENUE
:= OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX
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= -----------~IRrY-FIVE HUKDRED TWO . 141100---------------------
1,* RECEIVED dollars
?l representing Pennsylvania Inheritance or
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Tom H. B . ac ,A ~aq. . so e ox ue rom e o oWing es 0 e:
F 'n: (Mar11n L. Rook at all 2 o/~ Tax on $ $
A"dress 7 Irvine Row 6% Tax on $ $
I Car11ale,Pa. 17013
! 15 % Tax on $ $
,
, 21-78-650 11-12-1978
File No. Dote of Death 0/" Tax on $ $
January 2.1919 Estate Tax, Act of
Dote of Payment May 7, 1927 $
Nome of Decedent CI.AlUDfCE J. ROOK TOTAL TAX CREDIT $ 3.681.09
Less five percentum of tax if
County Cumberland. paid within three months after
dote of death $ 184.35
R ':Irks: Plus interest at the rote of
PAm Olf ACCOUItr. _ % from
, to $
,
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, 0 0 \ .:l . ::N2. I 4
TOTAL AMOUNT PA D \
lYOO~[p~~@illlYrn SEAL
feUd sF
R1ChaJtd(SI~atW.r.on.
Reg1ater o~ Willa
(Title)
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NOTE: This Triplicete Receipt to be reteined for eudit purposes.
. Received by ~,
NOTE: In accepting the Iransfer inheritance tax on future estates, prior to the death of the life i
t.nant or tenant 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 Ihe
11ft tenant or tenant for years whenever it appears that such additional tax may be legally due and
collectible for any reason whatsoever.