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I, RECEIVED --------------'1'W.D1'1'Y-.ID BUlIDDD PUTY-810ft Sa 23/100---------~01Iars
iH representing Pennsylvania Inheritance or
i~, ... )I: . Estate Tax due from the following estate:
~i From: I'or(:;ac~.;~' Al~OD)
~, AdrJress 10" Be ICing street: 2% Tax on $ $
~
~: t No. 21-78-657
U
I Date of Payment Au9U.~ 14, 19'79
Ihippanabu1'9 *
P..
1'7257
6%Tax on
$
$
Date of Death 11-23-1978
15%Taxon
$
$
Name of Decedent G. JA~w) ~1"()IIG.1l
% Tax on S
Estate Tax, Act of
May 7, 1927
$
I
.~
$
County
CUmbtarl&D4
TOTAL TAX CREDIT
Less five percentum of tax if
paid within three months after
date of death
Plus interest at the rate of
_ % from
to
$
2,958.23
, Remarks:
- PAID OM ACCOUIft'-
$
$
uOO~[P[L~@illu~
SEA L
TOTAL AMOUNT PAID
/
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\,...,
NOTE: This Triplicate Receipt to be retained for audit purposes.
Received by
NOTE: In accepting the transfer inheritance tax on future estates, prior to the death of the life
tenant or tenant for years, os evidenced by this receipt, it is understood that the Commonwealth sholl
not be precluded or prevented from hereafter assessing additional inheritance lox at the death of the
life tenant or tenant for years whenever it appears that such additional tax may be legally due and
collectible for any reason whatsoever,
I!