Loading...
HomeMy WebLinkAboutOC1969-1156 - ESTATE OF MILLER. \ RCC-134 (8· 65) CO,I,IMONWEAL TH OF PENNSYLVANIA 'DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS INHERITANCE TAX DIVISION ~ ,3 -6f-~//S-t, ""-' --=.. OFFICIAL NOTICE OF INHERITANCE TAX APPRAISEMENT AND ASSESSMENT OF ASSETS NOT SUBJECT TO ADMINISTRATION / TO: MRS. JUNE COLIGAN BOX 102 Date: _ ___;S::....e:.....pt:..;:..:..:em::..b::....e..::..r....;3::...0:;.:.,~1..:....96_;9;__ __ _ CECIL, PENNSYLVANIA 15321 County Washington County File No.JY -/S--J Bureau File No. ~J -?9-//S& ~e have received notice that, ~·~ o-:~nRW~S~e~pt~eijmbWe~riii8~, W196~9~,~y~ou~came into ownership of certain pro_p~rt~iq~L~Rh-~ transfer from, MRS. AUGUSTINE · , deceased. Under the Inheritance and Estate Tax laws of the Commonwealth of Pennsylvania such transfers are taxable and the liability for the payment of the inheritance tax due is imposed upon you, as transferee. The property on which tax is hereby assessed consists of: Jt. Held Sav~s Accts. (1) #71-001342-6 (2) #03-009451-0, held in the UNION NATIONAL BANK OF PITTSBURGH, ITTSBORGH OF'F'IC.l!., PITTSBURGH PENi'SYLVANIA in the names o MRS. AUGUSTINE MILLER f MRS. JUNE COLIGAN. (1) 10-2-64, (2) 3-8-65. Balances as of date.of death,(l) $2,433.82., (2) $2,239.12. appraised by the Commonwealth, as of the date of death, at $ __;4:.!.,i,~6;.:.7.:::2.:..• 9!.:4!.,_ __ _ 50 %of this amount is taxable at the rate of __ 6 __ % DATE OF ASSESSMENT TAXABLE AMOUNT ; LESS:. ALLOWED DEBTS NET TAXABLE AMOUNT AMOUNt OF TAX DUE D If you pay the above amount within three {3) months of the date of death of the decedent, or on or before Dec. 8, 19 69 you may deduct a discount of 5% of the amount of tax due, or D This tax became delinquent one year after the date of death of the decedent and, in addition to the tax, statutory interest at the rate of 6% of the tax per annum is also due as of*------- 19 in the amount of *If the tax is not paid by the above date additional interest is due at the rate of 6% per annum until paid TOTAL AMOUNT DUE ORIGINAL ASSESSMENT AMENDED ASSESSMENT $ 2,336.47 $------------- 140.19 - - - 7 • .Ql_ ----- $ $ Jt-3J ,J 1' c . ASSESSEDJ~Y: ~~a~ -~~ ce-#' _,4 tJS /6 .?/' 0~ /0 -/..J--~/ ~..33/f (Agent for the Commo~weal!b) ....... "~J ..... \\ I ";. :.. ~ ~ .. INSTRUCTIONS TO TAXPAYERS ./ ·-'-":.~------... · ...... 'l ... ~· ,__ ~ '.,. .. ~ (over) ..; ,. ~· .......... ...., ·. To insure proper..:c:redft to your acc:ol!nt this Official Noffqe mgst:acctimpany· your poyment.~M.;aU of.brlng:it to: .. ".//· .... ~ •J ... -..... . . ... ,·r~· ... ~ ... ~··" - <J .:: If you have already paid this tax to an executor, ad~inisti'c:.tor, attorney or other personal representative of the decedent for forwarding to the Commonwealth, list.J,elov;:-the date paid, name and address of the person to whom you made payment, their official title and the amount. · · ~ Date Paid Name and Address of Payee • Offic.ial Title Amount Paid Under certain circumstances, if, after the date of death of the decede~t, y~u pers~nally .paid funeral expenses or other just debts of the decedent, with funds derived from the property herein taxed, such amounts expended by you may qualify as deductions against the gross value of the property i_n the computation of tax du~. If any such expenditures meet all of the three following tests, it is recommended that you itemize the payments below, execute the aff!davit, and r~turn this notice . .The _Register of W.ills will examine the debts claimed ~nd allow those which he determines to be proper. The tax will then be re~omputed and you will receive an amended assessment of tax. THE THREE TESTS WHICH MUST BE MET ARE THAT: 1-You were pe~sonal'iy legally responsible'for these debts, and 2-You actually paid these debts out of the account or property described above~ and can furnish proof of. such payment, if re,quir.e~, and 3-These same debts are not also claimed, for tax purposes, by an executor, administrctor or other personal representative of the decedent handling the administration of the general estate of the deced~nt or any other transferee. . · · · SCHEDULE OF DEBTS Date Paid Name of Payee Description of Obligation Amount Paid • . . ; ' TOTAL $ (attach separate sheet if required) COMMONWEALTH OF PENNSYLVANlA)·. SS: ... I, rtify that the foregoin is a ·ust and true statem~nt of funeral expenses and other bts of the decedent, ' ..e., · ~ , for which I was le_gally responsible and which I did pay out of the roperty herein taxed. I further certify, that to the best of my·knowledge·and belief, these same debts will not be claimed by any other person, for inheritance tax p~rpo:;s·~ .1... ..:"""; : _ ~ I...J DAY OF t.\y Commission Expires Sep. er 4, 1 .72 REPORT OF REGISTER OF.'WILLS I, the undersigned, duly elected Register of Wills in and for the above county, do respectfully report that I have allowed deductions listed above in the total amount of $--------a Date of Approval:_-------------- Register of Wills ~:, .. RC C·43 (4·69) COMMONWEALTH OE Pf:NNSYLVANIA DEPARTMENT.OF REVENUE HARRISB-URG NOTE: TO BE SUBMITTED IN TRIPLICATE. Pennsylvania Department of Revenue Bureau of County Collections 26 S. 4th Street Harrisburg, Pennsylvania Dear Sir: Pursuant to Section 742, Pennsylvania Inheritance and Estate Tax Act of 1961, we herewith submit the following report: . NAME OF REPORTING FINANCIAL INSTITUTION The Union National Bank of PittstW'gh Attention: H~ G. Miller ADDRESS P. 0, Box 837, Pittsburgh, Pe.. 15230 ACCOUNT NO. OF JOINT, TRUST OR INVESTMENT DEPOSIT Savings #71-001342-6 Savings #Q3-QQ9451-0 NAMES ON ACCOUNT OR INVESTMENT Mrs. Augustine Miller or Mrs. June Coligan / DECEASED JOINT DEPOSITOR, TRUSTEE OR INVESTOR Mrs. Augustine Miller ADDRESS AND COUNTY Box 102, Cecil, Pa. 15321 DATE OF DEATH September 8, 1969 ./ SURVIVING DEPOSITOR, BENEFICIARY OR INVESTOR __ Mr=-s;;..;.~Jun=e_, C;;..;o;_;;;li~g~an=---------- ADDRESS Box 102, Cecil, Pa. 15321 RELATIONSHIP TO DECEDENT_....,DaraWEug~hu.r.t.liUer:;:__ __________ _ . j ;y DATE DEPOSIT OR INVESTMENT WAS ESTABLISHED #71-00i342-6 October 2, 1964/.. #03·009451-0 March 8, 1965 / BALANCE, INCLUDING INTEREST . \ ') DUE, AT DATE OF DEATH$ #71-001342-6 $2,433.82 T #03-009451-$2,239.12) A~~~~rv . '7-ature-~E . . Cecil Offioe -#71-Q01342-6 wfp Ill~· Bridgeville Office -#03-009451-0 4 ... o;: 3J(,_ /l . Assistant Vice President /.?-f-c.t ' )' t t·-· RCC-134,(8-65) l J COMMON,WEAL TH OF PENNSYLVANIA OFFICIAL ~OTICE OF IN_H~RITANCE TAX ,,, BU~~!jAORFT~~~~To: ~;~:~~T~ONS APPRAISEMENT AN~ASSt:5SMENT OF ' INHERITANCE TAX DIVISION ASSETS NOT SUBJECT TO ADMINISTRATION --------~:----~ .. --------------~--~~--~------------------~--------------------------· !I TO: }; MRS. JUNE COLIGAN t BOX 102 1 t, CECIL, PENNSYW.NIA Dote: ___ ji~·~·~~~li~e~r~di;Jt~~,~9~-:,;3~0..~6~9 __ County ____ W.;.;_a:;.:s:.....:hin=:s!gt~o:::n=------ '15321 County File No. ______ _,_ __ _ .. I. . t , Bureau File No. 63-69-1156 ~e~ove~eceived notice that,~~~~~~~ on ~-Sept~ 9, , 19_62_, you come into ownership of certain property through~~~~ ~h'tHiilffiYXar~~ transfer from, AUGUSTINE ~1ILLER, deceeised. f' i . Unper;the Inheritance and Es!ote Tax Lows of the Commonwealth of Pennsylvania such transfers ore taxable and t~·e lia_bjlity for the payment of the inheritance tax due is imposed upon you, as transferee. l . . . Th~: property on which tax is hereby assessed consists of: Jt. Held Savings Account $194471 held in THj:. BRIDGEVILLE TRUST OOMPi1NY1 BRIDGEVILLE, PENNSYLVANIA, in the names of AUGUSTINE MitLER or ms. JUNE COLIGAIJ. Opened 3-9-65. Balance as of date of death, $5,383.73 r I • . . • oppr~i'sed by the Commonwealth, as of the dote of death, at $ 5;38,3. 73 I ~%of this amount is taxable at the rote of 6 % I • II . i ' ORIGINAL ASSESSMENT AMENDED ASSESSMENT I! DATE OF ASSESSMENT TWB~OUNT -~ ·' • -.~. 2..4~ ..... $~.£Y./ ~2_ . l LES~rJ _ ED DEBTS .-::.~..:,. -. ..~ -:~-'.::,~,-::·?:. ( ~< -~~~i.)t.r:s-j NET .:r'A'"V~l-.. .. A 0 T ~~.:~~~-. -... ,~~~ /. ·-~~~.'.S.>O..w)y~~~-.. -.. ·~ . WIWI.A'B..C M UN . ~,.:..c.» __ , ··,M<-~~-~~~-·-~... . ... , •. .,......-:ilt<i .. k:..~;i~ ·:.JIM·"·:.;.:c ... ~-· . -:_ . . -!... 0 ~'< . ~---·' '"'"~ ...... ---. ; ... ._._ 0~1?"~~"-. . AMO~NT ~~';AX DUE i. ~.~ ~ \~·-.~ /C/.SJ( --:~ ....... ·-:.".j~/, .. ;r-.~"·L--: -~-! . D If 'you pay the above amount with in three (3) months of the dote of death of the decedent, or on or before December 9 19 69 you may deduct a di~count of 5% of the amount of tax due, or · ' I , D THis tax become delinquent one year after the dote . of;deoth of the decedent and, in addition to the '. tax, statutory interest at the rote of 6% of the tax pe~ annum is also due as of* ____ __.:_ __ 19;·, in the amount of r· ~ ~t~~~~s not poiCI by the above date additional lr:tterest i\ due at the rote of 6% per annum until ,/ phid 8.07 -----------. ., ---~_t. _____ _ I TOTAL AMOUNT DUE $ 161.52 $ if I t:f APPLSED B~ 4~ASSESSED BY: e.:-""'/ ::::#"~ ~ ~ (Inheritance Tax praiser) (Agent for the Commonwealth) . INSTRUCTIONS TO TAXPAYERS i Make ~.hecks or money orders payable to: /RJ.;r-' ~ o s-I f:J 7 Y -~'JY19i~~~ _fko~~-.. (over) To insure proper credit to your account this· Official Notice must accompany your payment. Moil or bring it to: If you have already paid this tax to an executor, administrator, attorney or other personal representative of the . decedent for forwarding to the Commonwealth, list below the date paid, nome and address of th.e person to whom you made payment, their official title and the amount. · __ _::, ':·<.__ · • .,. .j _.... --.-..... Date Paid Name and Address of Payee • Offic;ial Title Amount Paid Under certain circumstances, if, after the dote of death of the decedent, you personally paid funeral expense·s_ or other just debts of the decedent, with funds derived from the property herein taxed, such amounts expended ~ by you may qualify as deduc;:tions against the gross value of the property in the computation of tax due. If any such expenditures meet all of the three following tests, it is recommended that you itemize the ·payments below, execute the affidavit, and return this notice. The Register of Wills will examine the debts claimed and allow those which he determines to be proper. The tax will then be recomputed and you will receive on amended assessment of tax. THE THREE TESTS WHICH MUST BE MET ARE THAT: 1 -You were personally legally responsible for these debts, and 2 -You actuo lly po id these debts out of the account or property described above and can furnish proof of such payment, if required, and 3-These same debts ore not also claimed, for tax purposes, by an executor, administrator or other persona I representative of the decedent hand I ing the admin istrotion of the general estate of the deced~nt or any other transferee. • . · . SCHEDULE OF DEBTS Date Paid Name of P9yee Description of Obligation Amount Paid 7'-:-/ 2 -/.. 9 /~ ~A. ~ 0 /~ r ... ::Z ;_,_.,./ ~ ~-,· ~L~ 79~ .52 v-/1--L-y _y ~..D' xd k ~----/. / .-Y.2. 0 0- '9--?a-c·Y V'.J ,_, .L.L.L .. _ ... _) ~:L--,,/ ~_/~ _£0.c;o · va "/a -c 7 .h ~ ~,._ .d.#.,/' ~L7A'A . _._ c./S oo . d / ~ .. . TOTAL $ ~/o?l37 {attach separate sheet if required) COMMONWEALTH OF PENNSYLVANIA) SS: COUNTY Of _______ _ I, . hereby certify that the foregoing is a just and true statement of funeral expenses and other debts of the decedent, , for which I was legally responsible and which I did pay out of the property herein taxed. I further certify, that to the best of my knowledge and belief, these same debts will not be claimed by any other person, for inheritance tax purposes. SWORN AND SUBSCRIBED BEFORE ME THIS ___ DAY OF _______________________ 19 __ . Signature of Taxpayer REPORT OF REGISTER OF WILLS I, the undersigned, duly elected Register of Wi lis in a~d for the above county, do respectfully report that I have allowed deductions listed above in the total amount of$-------" Date of Approva 1: -------'-----------Register of Wills RCC-134 (8-65) COMMONWEALTH OF PENNSYLVANIA " DEPARTMENT OF .REVENl.ll: BUREAU OF COUNTY COLLECTIONS INHERITANCE TAX DIVISION ~3-bt'-//-J"t, OFFICIAL NOTICE.Of..J~HJRITANCE TAX APPRAISEMENT'ANii ASStsSMENT OF ASSETS NOT SUBJECT TO ADMINISTRATION . - TO: __ _.:.;MRS==..;•:___;J:.;:U:..:.:NE=-..::C:..::.OL:::I==GA=N::.:..__ ___ _ Dote: September 30, 1969 BOX 102 County Wuhington ___ CECIL, PENNSYLVANIA 153ll County File No. _________ _ Bureau File No.&;'..J -t f'-//s-,C; ~e have received notice that, ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ September 9, lCJQL, you came into ownership of certain property through OCKtf~.XXXX AAAAJUU'i.i'UI..tuiJ.\All;:l'U\.AAA\A.II.Ali:/Ut.J.~i.l\·A transfer from, AI.X:HSTINE MILLER, deceased. Under the Inheritance and Estate Tax Laws of the Commonwealth of Pennsylvania such transfers are taxable and the liability for the payment of the inheritance tax due is imposed upon you, as transferee. . . The property on which tax is hereby assessed ~onsists of: Jt. Held SavinSs Account #19447, held in THE BRIDGEVILLE TRUST COMPANY, BRIDGEVILLE, PENNSYLVANIA, in the names of AUGUSTINE MILLER IDXX of MRS. JUNE COLIGAN. Opened 3-8-65. Balance as of date of death, $5,388.73 appraised by the Commonw~olth, as of the date of death, at $ 5,388, 73 50 % of this amount is taxable at the rate of 6. % DATE OF ASSESSMENT TAXABLE AMOUNT LESS: ALLOWED DEBTS NET TAXABLE AMOUNT AMOUNT OF TAX DUE 0 If you pay the above amount within three (3) months of the date of death of the decedent, or on or before December 9, J9 69 you may deduct a discount of 5% of the amount of fax due, or 0 This tax became delinquent one year after the dote of death of the decedent and, in addition to the tax, statutory interest at the rate of 6% of the tax per annum is also due as of*------- 19 in the amount of . *If the tax is not paid by the above dote additional interest is due at the rote of 6% per annum unti.l paid TOTAL AMOUNT DUE $ ORIGINAL ASSESSMENT ;c;, sJ-. y.o 7 8.ar --____ ,;:.]) ___ _ AMENDED ASSESSMENT >?t:£y',jt: )• l$1t I £7 J . ) 7'3; rf2 I > $ ===============-- APPRAISED B~ ~ ASSE~SED BY: c;;::;:2:deL~~ (Inheritance Tax Appraise INSTRUCTIONS TO TAXPAYERS Make checks ~;;s~b~ '9-,{ J /LJ~t~lt 1(u..m:tl AU~~~~ /Pce.-#" .#os-/o 7P y~ /O'/S-6'/ .tf jJ 7. / p (over) {Agent for the Commonwealth} If you have already paid this tax to an executor, administrator, attorney or other personal representative of the decedent for forwarding to the Commonwealth, list below the date pai.d, name and address of the person to whom you madp pay~ent, their official title and the a"'mqtJo.: .... .,..~-__ .,... .... ~ -.• Date Paid Name and Address of Payee • OffiGial Title Amount Paid Under certain circumstances, if, after the date of death of the decedent, you personally paid funeral expenses or other just debts of the decedent, with funds derived from the property herein taxed, such amounts expended by you may qualify as deductions against the gross value of the property in the computation of tax due. If any such expenditures meet all of the three following tests, it is recommended that you itemize the payments below, execute the affidavit, and return this notice. The Register of Wills will examine the debts claimed and allow those which he dete'rmines to be proper. The tax will then be recomputed and you will receive an amended assessment of tax. THE THREE TESTS WHICH MUST-BE MET ARE THAT: i-You were p~rsonally legally responsible for ·these debts, and 2-You actually paid these debts out of the account or property described above and can furnish proof of such payment, if required, and 3-These same debts are not also claimed, for tax purposes, by an executor, administrator or other person.al representative of the d~cedent handling the administration of the general estate of the decedent or any other transferee. SCHEDULE OF DEBTS Date Paid Name of Payee / Description of Obligation Amount Paid Cf//iV/61 ( ''d~./YY? _, "'.:11r/ • ,; .. /IL,, .ot-t~-~A-A_/ r('l~ /~~ _,tJ /c2/7.~ 4 1/o !£.-1 ( J.-r""'..l>"" L...f,d" A::'b.--r // ~3 ,._-<; ¥/.3o I' tb q ~.£._·~~-b. ~ .d./V? j 7?z/_,/,_, --~ .£...'// hc:J. Cl--*' 1'/J/// I 0 . '1 ~a 1:; ~>--"711 A-rl ~ .. fil?_ A -J. ./: _// ~ .~ .:2.~~ / I #' ,c . -- ; TOTAL $ ;sc;s.~ (attach separate sheet 1f requrred) ., REPORT OF REGISTER OF WILLS I, the unders-igned, duly elected Register of Wills in and for the above county, do respectfully report that I have 'allowed deductions listed above in the total amount of$ ., · ~ ' ., r Date of Approval: ______________ _ Register of Wi lis "/ , •• #'" • • ...~ ~ •" ... COMMONWEAL Ttl ffF1~~MSYL VAN It 8 t~c <IV to DEPARTMENT 0~ REVENUE . 0Utqy c&f,U OF • . H:ARRISBURG . · .-,.£CTfONs RCC•43 (5-65) SEf /9 3 . , ". 42 FH 'G9 NOTE: TO BE SUBMITTED IN TRIPLICATE. \ Pennsylvania Department of Revenue Bureau of County Collections 26 S. 4th Street Harrisburg, Pennsylvania Dear Sir: Pursuant to Sectio.n 742, Pennsylvania Inheritance and Estate Tax Act of 1961, we herewith submit the following report: \ NAME OF REPORTING • FINANCIAL INSTITUTION ·The Br:1dgeville Trust Company ADDRESS Bridgeville• Pa. 15017 ACCOUNT NO. OF JOINT, TRUST OR INVESTMENT DEPOSIT savings Account tt19447 NAMES ON ACCOUNT OR INVESTMENT Augustine Miller: or Mrs. June Ooligan DECEASED JOINT DEPOSITOR, . /' TRUSTEE OR INVESTOR __ ____,A=u=g=u=s=t i=n=e=-=M=il=l=e .... r_....:V~------ ADDRESS _____ S_o_x-=10~2~•~Ce~c~i~l~,~P~a~·~~l5~3~2~1~-------- DATE OF DEATH Sept. 9, 1969 v SURVIVING DEPOSITOR, BENEFICIARY OR INVESTOR Mr:s • .June Coligan --------~---------- ADDRESS ______ B_o_x-=l0~2~·~Ce~c=i=l~;_P~a=·~=l5~3~2~1~---------- RELATIONSHIP TO DECEDENT _ __;;D=a=ug=b=t=e=-t ----------- DATE DEPOSIT OR INVESTME~T WAS ESTABLISHED Mar. a, 1965 BALANCE, INCLUDING INTEREST DUE, AT DATE OF DEATH $ ___ $:;....S..,&,_38_..3...;;;•~73;;;...._ _________ _ ~-~<~- Signature Savings Teller TITLE I . /£ ~ Form RCC-2 COMMONWEALTH OF PENNSYLVANIA DATE ....................... ..9.9.t..«:>.:t'..~.~ ... J.7.1 ....... ~9..~9. ......... •DEPART~IENT OF REVENUE RESIDENT INHERITANCE TAX Washington BUREAU OF COUNTY COLLECTIONS COUNTY .................................................................................................. HARRISBURG, PENNA. 7 712 7 • . .AfPRAISEMENT FILE NO ...................... 6..3. .. ~6..9.~J,J.:5..~ ................................. Whereas, ...................... ~ ... A~.~.t..;.n~ .... ~P:.~~-~ ............................................. late of ................................ 9..~.~-~~ ............................................................. in the County of .................................. ~~~~-~-~~-~ .................................................................... Commonwealth of Pennsylvania, having died on the ............................. 9. ... ~~ ...................................................... day of ...................... S..e.pt .. e.mP..~.r. ......................... 19 .. 9.9. ... , seized and possessed of an estate subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore, I, W.R. Chaney an appraiser duly appointed according to law, ....................................................................................................................................... , having been designated to make a fair and conscionable appraisement of the said estate, and to assess and fix the cash value of all annuities and life estates growing out of said estate, hereby file the following appraisement: I In the event that any future Interest In this estate is transferred In possession or enjoyment to collateral heirs of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance taxes at the lawful collateral rate on any such future Interest. 'I : Appraisement Unit I Description of A net Values Made for Inheritance 1. Tax Purpoaes $ JT. HElD: Jt. held Savings Account #19447, held in the BRIDGEVIlLE TRUST COMPANY, BRIDGEviLLE, PENNSYLVANIA, in the names of AUGUSTINE MILLER or MRS. JUNE COLIGAN. 2,691.S7 Jt. held Savings Accts. held in the UNION NATIONAL BANK OF PITTSBURGH, PITTSBURGH OFFICE, PITTSBURGH PENNSYLVANIA, ' in the names of MRS. AUGUSTINE MILlER or MRS. JUNE COLIGA N2 1 :2:26. ~l I ' 5,028.34 5,028 34 ' I ' I ' Total 5,028 34 I ' formft;•:~hbl:~ ::~~w:'~~~~~:: ~.~ o~·~~~~:?":~~~~ A laer ........................... "'2 .................................................................................................................. ~~--...... t. ..... : .. ~ .... ~.:;;.::z~~~-~ .................................... , Penna. j .............................. W.~~tl.~9:o:r.<?.~..................................... County RESIDENT INHERITANCE TAX APPRAISEMENT Estate of .......................... ffi.~.~ ..... J\lJ.G.V.~.1'J.~ .... M~ ......................... . Deceased. Late of CECIL Date of Death, ............ ~.43.I'.t.43..JIJ..l?.43.r. .... ~, .... J.9..l>.9 ........... . Appraisemel!t Docket Vol., Page, No. 63-69-111::6 ............................. :!. ............... . Filed in Register's 0 ffice, . .9.9.:t99..~.~ ... J7., . .19.9.9 .. . Anwunt of tax due, $ .................................................................... . DEPARTMENT OF REVENUE Received, Examined and Approved, Wrote abo.ut Appraisement, Appeal ft'om Appraisement, Entered and charged, r l" q . " . ' ~ .. ._ ...;