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RESIDENT DECEDENTS
File No.
COMMONWEALTH OF PENNSYLVANIA~9FormRCC-4-RI-3-66
No.948906
Date .June 11 19 68
OFFICIAL RECEIPT
Transfer Inheritance and Estate Tax
Office REGISTER OF WILLS.IfASHlNCTON Pa.
WASHINCTON Cou t ss·R"d f (MRS.)SUB HYSMIfH.PAtINO ON IND.t:IAB.n y,.ecelve rom ..--
~~I~)of the estate o1-f ~(.2Im~·S!!!£.-.!!:..,4)~......lmW!!·~·!!:lMA.~.~..!!:;oPAB~m_···l!L·__.,..--_
who died -JJay 21 '...19·~the sum of MNTY.SEWX and 34/100 Dollars,
being TRANSFER INHERITANCE TAX and/or ESTATE TAX due the Commonwealth as follows:
Appraisements Made and Filed Computation of Tax
Clear Value-of Estate
Vd1Uation of Ufe Estates or Annuities
27.34
5%$
10%$
2%.$
15%$
Exemptions *$=============
Tax on $_
Tax on $_
Tax on $XU ·455.15
Tax on $_
Total Estate $_
2-7.34TotalTax$._
Less Tax Previously Paid (if any)$===========
Amount of Estate TaxAssessed undertheActofMay7,1927.$_
Less five percentum of tax ifpaid
within 3 months after date of death $============
Balance $_
$------
$455.'5
$
$,------
$.
Valuation
$------
$)------
Total
Date
Jt:.Held
Biijal(Aect.
Real Estate
Date
Personal Prop~rty
Valuation
$455.75
$,-------
Total
Total Gross Assets
Less Debts and Expenses of
Administration
NOTE.This Triplicate Receipt to be retained by the Register of Wills and filed in numericalsequenceforauditpurposes.
NOTE:In accepting the transfer inheritance tax on future estates prior to the death ofthelifetenantortenantforyears,as evidenced by this receipt,it is understood that the Com-
monwealth shall not be precluded or prevented from hereafter assessing additional inheritancetaxatthedeathofthelifetenantortenantforyearswheneveritappearsthatsuchadditionaltaxmaybelegallydueandcollectibleforanyreasonwhatsoever.
$21.34
MOORE:BUSINESS FORMS,tNC.,ELMIRA.N.Y.
Register of Wills
Total $_
*As evidenced by Charitable Exemption Certificates issued by the Secretary of
Revenue'under Act of May 28,1956,P.L.1757,effective June 1,1957,as cnnended
by Act No.381,approved July 11,1957,and Act No.207,1961,Section 302.
~"p/.."",..J.'(.{I a;,,;;J'~~'~6~~t6o'·~tJ
Add interest at the rate of %1
from -_
to _
37-/~0/
19__$.
19__$.
19__$
19__$
Date,_
lJOOD [P)[LD @£TITE
Estate Tax Assessments
Date~_
,.<,
Register of Wills
15022
up..s ~\St'E tIfmllTfI
328 WASBINGTON AVENUE
CHARI..BROI,PENNSYLVANIA
L
RtJSSBLL "MARINO
Fill in below name and·address of person to whom
tax receipt is delivered:.
SIGNED AND SEALED AS PROVIDED BY
SECTION 1201.ACT APRIL 9.1929.P.L.343
AS AMENDED BY ACT MAY 15.1945.P.L.528
OffiCE OF REGISTER OF WILLS
WASBINOTON
FORM RCC-4-RI
TRANSFER INHERITANCE and/or ESTATE TAX.
RESIDENT DECEDENTS.
RECEIPT
1201 (g).Act of April 9.1929.P.L.343.as amended.viz:-"To receive from Registers of Wills all duplicate ;re-ceipts for taxes paid to them by executors or adminis-
trators and to charge the Registers receiving the moneywiththeamountreceiptedfor.The original of each suchreceiptshallbesignedandsealedbytheRegisterofWillsandtransmittedtotheexecutororadministrator.
whereupon it shall be a proper voucher in the settlementoftheestate.In no event shall the executor or adminis-trator be entitled,to a credit in his account by theRegisterunlessthereceiptissosignedandsealedbytheRegisterofWUls,"
_____======-__Pa.
VBLS&PARKB
Estate ofDIIJJUUIUUX
Docket .3 7 Page I?Y(j'ne y