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W: RCC4(11/78) COMMONWEALTH OF PENNSYLV
~ NOJ003115 DEPARTMENT OF REVENUE
: OFFICIAL RECEIPT · PENNSYLVANIA INHERITANC
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; RECEIVED-------------8IX HUNDRED SIXTY-FOUR II 28/l00----------------------aollars
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i Dote of Payment
TE TAX
in . Inin
Att
s.
representing Pennsylvania Inheritance or
Estate Tax due from the following estate:
44 South Hanover Street
2 % Tax on
$
$
$
$
$
$
$ 664.28
Car11s1e,Pa.
11013
6 % Tax 0 n
$
No,21-18-674
Dote of Death 12-5-1978
15% Tax on
$
April 23,1979
Nome of Decedent
DAISY FJ.ftUY
% Tax on $
Estate Tax, Act of
May 7, 1927
County
CUIlberland
TOT AL TAX CREDIT
Less five percentum of tax if
paid within three months after
dote of death
Plus interest at the rote of
_% from
to
$
Remarks:
$
uOO~[P~~@ffiu~
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 an future estates, prior to the death of the lite
i, tenant or tenant lor years, os evidenced by this receipt, it is understood that the Commonwealth shall
U not be precluded or prevented from hereafter assessing additional inheritance tax 01 the death of the
Jl life tenant or tenant for years whenever it appears that such additional tax may be legally due and
L collectible far any reason whatsoever.
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