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HomeMy WebLinkAboutOC1968-0244 - ESTATE OF COSTELLO"\.C-';~ ( 6 -61.1.) · t'OvMONWEAl,Tl~ OF PI':NN~'YLV,\NI:\ T1\A~~FF.ll INimH.IT.\NCE TAX. R.:.~SIDENT 11ECE::J:<;NT COSTELLO, ROSALIE K. FILE # 63-68-244 January 16, 1968 SUMMARY .. ---, FILE # 63-68-244 TtEPOH'l' OF INHERI'l'A~GF. TAX APPRAISER I. the unrlersignect # 63 Washington duly appointed Inheritance Tax 4ppraiser in and for the County of , Pennsylvania, do respectfully report that I have appraised property as reported in the foregoing return at the values set forth the last column to the right in Schedules "A", "B", "C" and "E". the real ann personal opposite each item in Dated: 04-05-68 01-16-68 REPORT OF THE REGISTER OF WILLS I, the undersigned duly elected Register of Wills in and for Washington County, Pennsylvania, do respectfully report that I have allowed deductions in the amounts claimed by deponent, ~xcept as to those items where a greater or lesser amount is set fortl1 in the last colwm to the right in Schedule "F", which greater or lesser amount represents the sum allowed as a deduction. Dated: 04-05-68 INVENTORY Real Property (Schedwle A) Personal Property (Schedule B) Transfers (Schedule C) Joint-Held Property (Schedule E) TOTAL GROSS ASSBTS LESS Debts and Deductions (SCHEDULE F) CLEAR VALUE OF ESTATE Valuation of life estates or annuities ESTATE TAX ASSESSMENTS FOR USE OF REGISTER ONLY Tax on $ !)% Tax on $ ~ . Tax on ¢> ~0,779.18 ~~~ . $ . __ lfi% Tax on Exemptions ( :::) ·--Total Estate TOTAL TAX Less tax previously paid BALANCE Less 5% of tax if paid within 3 months after death BALANCE OF INHERITANCE TAX DUE Add interest at rate of o% from to ------- REGISTER OF WILLS VALUE AS REPORTED VALUE $ __ ...... 1..,~.5..,_, OMJOQ...QQ._ $ 27,728.2,3_ AS A.PPRAI SED V~r~\.L~U"-!E=-:.:A~S~.!o!RE~1 .~f\P~P'-"RA~I~S~E~D 15,000.0Q__ $ ______ _ 27,728.23.- 42.728 •. 41_ . l.949.,Qi_ _ ____!4~0..JJ.9~l8 - $ ____ ~ ~ ------ 42.728.2L_ 1, 949.0~ 40.779.1.$_ ======·= COMPUTATION OF TAX d> .. :J <!> •:• $ $ $ * $ $ 2,446.75._ Paid in Full Feb. 21, 1968 =====~= =====:= (':') As evidenced by Chari table Exemption Certificates issued by the Secretary of Revenue. $ ______________ __ $--~----AMOUNT OF ESTATE TAX ASSESSED $ _____ _ Estate tax paid BALANCE DUE Add interest at rate of 6% from to FOR USE OF REGISTER ONLY TOTAL TAX BALANCE PAID. ADJUSTMENTS $ ______ _ $ ______ _ $-~-----$ NOTE: Where subsef')uent adjustments are made to the above computation of tax by the Register of Wills, for proper reason, same should be noted below, with short explanation. Will Administration ~ No. I:S THE Year ........... . ~lATTER OF THE APPRAISEMENT OF THE EST.\TE OF . I\0$.1\:L.lE. K •.. COSTELLO .. Deceased Late of .. .. GFi.~Ol: ..... County of WASHINGTON Commonwealth of Pennsylvania REPORT AND APPRAISAL .I ~ ·- Fonn RCC-.A " ....... 1 .. ' PENNSYLV ANlA ' DATE ....................... AP:r..:i.:J:: .... 2J. ..... !9..~?. .... COMMONWEALTH OF DEPARTMENT OF REVENUE I RESIDENT INHERITANCE TAX COUNTY ........................ W.?..~.l.J:.~.g~9..I.l: ......... BUltEAU OF COUNTY COLLECTIONS .................. HARRISBURG, PENNA. 17127 APPRAISEMENT FILE NO. .................... 9.:3..::::.9.?.::::?.4.4 ................................ •'' Whereas, ................................... R9..~9Jj,.~ ... K.~ ..... G9..!?.t..~U..9. ............................................. late of ....................................... G.h.a.:r.+~-~.9.~""""""'""""" '"" "'"'"' in the County of ..................................... W.a.:~.~~.9.P: ................................................................ Commonwealth of Pennsylvania, having died on the ..................... :J,.9.t.h ............................................................ day of ...................... ~~.D.a..rY ................... , ............ 19 .. 9.1?. .... , 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 appraisetnent of the said estate, and to assess and fix the cash value of au· annuities and life estates growing out of said estate, hereby file the following appraisement: 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. .. - Unit Appraisement ··Description of Asset Values Made for Inheritance ! Tax Pur poles -· ' $ l v ' REALTY: ---·----.. As per Schedule II A II 15,00( 00 ----... .... .. - PERSONALTY: ... As Schedule nBtt .• 27,72~ 23 per ·-----··· TRANSBERS:t. i . -I NONE NONE I i -. ... .. ' ------ JT. HELD: . I 0 NONE NON.~:!: ----. ---- -~-- I Totcl.:l. 42,72~ 23 ' ----- ----- I _., : .. I '· ··., ... . . : ,,. I, . ·,· Having been duly swo.rn according to law, I do hereby cer y that the above appraisement is made in con-I I formtty with law on· this· ............. £~ ....... : ...... day of .............. ~.££ ............................. , .. c;:= .......... ,.~ .. ).9 ... ~ ' ' . _ .. ;:ti./ .... """""""""c.3.'~0"'""""'~<0 ...... ~ ... ~p·p~~-i~~'"""" ~ j2 . ""''' '~''''''''''''''"''"''(~;;;-b;·•·;;;•••St~~~·t·;••••••••••••••••"'''"''''''""""''''''''''''""'"""" .. .. 6;;; ................... y~·i·;,;,;;; .. o;;;;;;........... .............. ... .. .. , Penna . -~"'' \. .... . _.., ____ -·-... ~ ···"--_, --.. -~.;,.. •"• .._. <u., ~--.. L. -. ~--. _ .. --·- --·--- .,. .................... W~.ingtqn .............................. . County RESIDENT INHERITANCE TAX APPRAISEMENT Estate of ROSALJ:~ .. K~ .... G.Q.?.:J:'~LO .................................. . Deceased. Late of CHARLEROI Date of Death, ........... J.~n]..@..:r.y.l.6, .. l9.68 ..... _ ....... . AppraisemeHt Docket Vol., ................. -.3.7. .. _ .... ·-······-···-· Page, ......... ~.~$ .................. No ..... 63.~68~444 ......... . Filed in Register's Office, .AP:r..i.~ ... .5.., ........ 196..$. .. Amount of tax due, $ ............................................................. -.. DEPARTMENT OF REVENUE Received, Examined and Approved, Wrote abo.ut Appra.isement, Appeal f1'om Appraisement, Entered and charged, ' r ·• Form RC C -lr DEDUCTIONS ALLOWED IN OFFICIO UF Hit STATEMENT OF DEBTS AND DEDUCTIONS THE SUM OF ............ $ ,?f.f:(/_,;6 REGISTER OF WILLS OF WASHINGTOl'J COUNTY DATE APPROVED • .. . . • . . ..~~tfe! AND AGENT OF THE COMMONWEALTH I ------/ ~~ / ~-?-Cf-d~/v/ k/~~ c{iJ C::% ~~~ Register of Wills, Aaeol .. ESTATE OF Rosalie K. Costello LATE oF The Borough of Charleroi DATE OF FILING APPRAISEMENT __ L/-.:___...-_,S"'-._.--~c~z61-.;---DATS OF DEATH _J::;..:;:a:::D.:..U;:.;::;a:.;::.r;_.y!.,_...;:l:.;6:::...z.?__.:l=-.::.9..:6:..::8::._ ____ _ DATE NO. OF -----r--~._V_.;.OU(;HIO;IIIf NAM&: OF PAYEE REMARKS AMOUNT Harold L. Schrock .. Funeral 1,779 55 Quinet Nonument Company Cutting grave marker 12 00 Sonhia Kai£es R.N. Nursir1q care 27 00 Charleroi-Monessen Hospital Hospital care 45 00 Dr. J. J. Buch Medical care 55 00 24 50 Register o£ Wills -------+--Probate o£ Will Register o£ Wills Filing Inventory 3 eo Joseph Sitte Notary Fees 3 00 TOTAL $1,949 05 -----+-----~----~-----------------------·-------~------------------------------+-----~+---- ----+-----'----~-~---~---------------------~-------------·------~----+---- -----+----+------·--------------·---- -·--------------------1------+-- I I -------+---~------+~-----------------------·---+---·------------------1-----+-- ---+----i--1 ______ _1 _______________ 1 _________________ -+----!1--- 1 ~ COMMONWEALTH OF PENNSYLVAN'A } COUNTY OF WASHINGTON SS: I, John E. Costello _____ _..:;;;..:::.=.:__:::...::._;;::::..::...=...:::..::...=-::._ ______________ HEREBY CERTIFY, THAT. TO THE BEeT OF MY KNOWLI!:DGE AND BELIEF, THE FOREGOING IS A JUST AND TRUE STATEMENT OF DEBTS, FUNERAL EXPENSES AND EXPENSES 01" ACMINisTRATroN suBMITTED To THE EST-'TE oF Rosalie K. Costello ---"-"-=-='-='=:...=......:.;:.::...--"':.:::...;:;..::;..:::..;;=-==------DECEASED. AS DEDUCTION$ FOR INHERITANCE TAX PURPOSES. ~~~ 19 ---o-·-::::-4f=:.._~~~=--=-=-----=---------(L. s.) SWORN AND SUBSCRIBED DEFORE ME THIS~=-=:~----DAY 0P Feb~ ..?. ,/>8 .. ---:::::¥(./.:.J;;l·...,~~~/~'A1/-~(/,...d'-~~~:;.,:x~~./:__ ____________ _ 0'/.. ;S:PH SITTE, ~USLIC v CH~R!'Rll BOWJUG!i, VI1Slii'1GTON COUNTY MV COMMISSiON EXPIRES JM!U,\flY 7, 1971 ., . . ! _, ... ' ' ' ~­f r'"~·~ f 0 Form RCC-4-Rl-3-66 ~9 RESIDENT DECEDENTS 924826 OFFICIAL RECEIPT No. Transfer Inheritance and Estate Tax File No 0.J ciS---< rr Date January 31 19 68 Office REGISTER OF WILLS, WASHINGTON Pa. WASHINGTON County, ss: Received from _ _!!J:...!o~h~n~E~·~C~o!!..!s!!!.-'t!!..!e!!o!..ol.,ll!o.lo~------------- (Executor, A.Wi:!:iM~~ the estate of ROSALIE K. COSTELLO who died January 16 19_6s_· I the sum of FORTY and 61/100 - - -.... -- -.. -Dollars, being TRANSFER INHERITANCE TAX and/or ESTATE TAX due the Commonwealth as follows: Appraisements Made and Filed Real Estate Date Valuation $ $. Total Personal Property Date Valuation $. ______ _ $. ______ _ Total Total Gross Assets Less Debts and Expenses of Administration $ $. _____ _ $ $ _____ _ Computation of Tax Tax on $ ------------S~o $ Tax on $ ----------10% $ Tax on $ On Aceount ~ ~ $ 42 .. '7.§ Tax on $ ------------IS% $ Exemptions * $ ============= Total Estate $ ------------ Total Tax $ ----------- Less Tax Previously Paid (if any) $================ Balance $ ------------ Less five per centum of tax if paid 2 14 within 3 months after date of death $ ======· =·======= Clear Value of Estate Valuation of Life Estates or Annuities $ -------l.NCOMPLETE I Amount of Estate Tax Assessed under the Act of May 7,1927. $----------- Date 19 __ $. _______ _ ________ 19__ ~$============= Estate Tax Assessments Date 19 __ $, _______ _ ________ 19__ ~$ ============= NOTE: In accepting the transfer inheritance tax on future estates prior to the death of the life tenant or tenant for years, as evidenced by this receipt, it is understood that the Com- monwealth shall not be precluded or prevented from hereafter assessing additional inheritance tax 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. UOOD~rLD©£U[ NOTE: This Tziplicale Receipt to be retained by the Register of Wills and filed in numerical sequence for audit purposes. Add interest at the rate o % from _________________ _.:._ to -----------------$================ Total $ 40.61 * As evidenced by Charitable Exemption Certificates issued by the Secretary of Revenue under Act of May 28, 1956, P. L. 1757, effective June I, 1957, as amended by Act No.~38,.·!·, approved July ll, 195.7, and Act No. 20.7, 196!, Section 302. 1-. E A L #:?' / :;;:;~---~--::_ . , . ~ 9 . ~ ~ . ·~ (I;r~,p·~~·CA . ..;/(.:.. ~~--. t;.-·7'"1'.-$# Register of Wills MOORE BUSINESS FORMS, INC., ELMIRA, N. Y, FvRM RCC-4-RI TRANSFER INHERITANCE and/or ESTATE TAX. RESIDENT DECEDENTS. RECEIPT Docke Page line, ______ __ ROSALIE K.. COSTELLO Estate o,__ ________________________ _ OFFICE OF REGISTER OF WILLS WASHINGTON, --------------------------~0. Date January 31 19~ 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 RUSSELL MARINO Register of Wills 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 r~ceiving the money with the amount receipted for. The original of each such receipt shall be signed and sealed by the Register of Wills and transmitted to the executor or administrator. whereupon it shall he a proper voucher in the settlement of the estate. In no event shall the executor or adminis-trator he entitled to a credit in his account by the Register unless the receipt is so signed and sealed by !be Register of Wills." Fill in below name and address of person to whom tax receipt is delivered: I To ATTY. JOHN E. COSTELLO 418 WASHINGTON AVENUE tUAiUJ5i'i6I, PEJ;t:SlLVAIIA L I \ \ \ \ I 15022 _j \ --·~ / y Form RCC-4-RI-3-66 ~9 COMMONWEALTH OF PENNSYLVANIA \ .I RESIDENT DECEDENTS No. 924902 OFFICIAL RECEIPT , Transfer Inheritance and Estate Tax FileNo. 6,3-68-244 Dme February 21 68 ·------=~--19_ WASHINGTON, Office REGISTER OF WILLS, a. VASIIINGTON c John B. Costello ounty, ss: Received frorn-------------~---------- (Executor, &~~~~£the estate of ROSALIE 1\. COSTELLO who died' January 16 19 6S, the sum of TWO THOUSAND fHIUm HUNDRED TWELVE and 30/100 -Dollars, being TRANSFER INHERITANCE TAX and/or ESTATE TAX due the Commonwealth as follows· Appraisernents Made and Filed Real Estate Date Valuation $ $ Total $ p, ~rsonal Property L v E th me tax tax N Date Valuation $ $ Total $ Total Gross Assets $ ~ss Debts and Expenses of Administrmion $ Clear Value of Estate $ INCOMPLBTB rluation of Life Estates or Annuities Date 19 __ $ 19 __ $ tate Tax Assessments Date 19 __ $ 19 __ $ NOTE: In accepting the transfer inheritance tax on future estates prior to the death of life tenant or tenant for years, as evidenced by this receipt, it is understood that the Com-1wealth shall not be precluded or prevented from hereafter assessing additional inheritance at the death of .the life tenant or tenant for years whenever it appears that such additional may be legally due and collectible for any reason whatsoever. U000rP[L0©£lYCE J?-f'~-r TE: This T.riplicate Receipt to be retained by tbe lJegister of Wills and filed in numerical sequence for audit purposes. " Co.rnputation of Tax Tax on$ 5% $ Tax on$ 10'}'0 $ On Account 6% 2,434.00 ~$ Tax on$ . ' Tax on$ IS% $ Exemptions * $ Total Estate $ Total Tax $ Less Tax Previously Paid (if rmy) $ Balrmce $ Less five per centum of tax if paid 121.?0 within 3 months after date of death $ Amount of Estate Tax Assessed under the Act of May 7, 1927. $ Add interest at the rate of 'Yo from to $ 2,312.30 Total $ * As evidenced by Charitable Exemption Certificates issued by the Secretary of Revenue under Act of May 28, 1956, P. L. 1757, effective June I, 1957, as amended by Act No. 381, approved July 11, 1957, and Act No. 207, 1961, Section 302. SEAL ;;··) / /" t::.;;..,) ,1_ .. _.....,,_ ...... ..;..? -~~ ~ / .t::./ &: c"£-.J(Jf.~-~ < ~ .¥~-"' .... ~ - ' n -' --~ r "TT .. •H MOORE BUSINESS FORMS, INC., ElMIRA, N, Y. FORM RCC-4-RI TRANSFER INHERITANCE and/or ESTATE TAX. RESIDENT DECEDENTS. RECEIPT Docket . 3 'J Page f J I.ine_£ Estate of. ROSALJB K • CO SULLO OFFICE OF REGISTER OF WILLS WASHINGtoN 11 Pa. Date Februa:rv 21 19-68--- SIGNED AND SEALED AS PROVIDED BY SECTION 1201. ACT APRIL 9. 1929. P. L. 343 AS AMENDED BY ACT MAY IS. 1945, P. L. 528 RUSSELL MARINO Register of Wills 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 money with the amount receipted lor. The original of each such receipt shall be signed and sealed by the Register of Wills and transmitted to the executor or administrator. whereupon it shall be a proper voucher in the settlement of the estate. In no event shall the executor or adminis-trator be entitled to a credit in his account by the Register unless the receipt is so signed and sealed by the Register of Wills.'' Fill in below name and address of person to whom lax receipt is delivered: I L To ATTY •. JOHN B. COSfEttO 418 WASHINGTON AVBNUB CHARlEROI, PENNSYLVANIA ,. I 15022 _j ~tatr. nf Jruuayluauia. t na: C!rnuuty nf liJ!Ianqiugtnu \ P . 11 b f h d · d h · NOTARY PUBJ..I C · d f "d e~sona y e ore me, t .e un ers1gne aut or1ty, a ........................... : ................................................... : .... 1n an or sru County and State, appeared ................................ J..<?..h.~ .... g.~ ..... ~~.?..!.:?..~.~.2 ................................................ who, being duly sworn according to law, deposes and says that he is the executor or atlmtUr.atBtXof the estate of .... Ro.sal.i.e. ... K. ....... CQ.~.t.~.ll.Q ...................................................... deceased, that the foregoing schedules constitute a l t · t , d · f h 1 d 1 f Ro s a.l i e K. Costello comp e e mven or} an apprmsement o t e rea an persona estate o ................................. ; ............................................ , deceased, except real estate outside the Commonwealth of Pennsylvania; that the figures opposite each item of real and personal estate in the foregoing schedules are determined and stated by the undersigned to be the fair value of said items as of the date of the decedent's death, based upon a just appraisement of each item ~ade by the above named Executor Administrator. """" /':: ;::::: Sworn and subscribed before me this ...... ~ .. ?..!.!!:.~.. l ~ 8 : day of.f..~J?..?;'):l~.f.Y. .......... .' .............. 19 ... 2?. .. . --.1 "'"""' ,..y ~ ~ E= c:/ ~ ~I~ ?;r~,:;;;;;:;:;~;;~~--rNsTRu n s - :.: ~ ( 1. /An inventory must be filed within three months after appomtment of personal representative. 2 g 1'.5 '2. A supplemental inve)ltory must be filed within thirty days of discovery of additional assets. ; 2 ~ 3. 1 Original and 2 Copies and 2 RCRI-34, Under $10,000; 1 Original and 2 Copies and 2 RCRI-33, ~ c:; I§ Over $10,000, including Copy of Will; 1 Original and 3 Copies and 2 RCRI-33, Over $50,000, in-s;;~~ eluding Copy of Will and copy of Federal Estate Tax Return. · ~ ~ REFERENCE FOR ADDITIONAL COPY Act of 1947 P. L. 513 Sec. 5.2, 72 P. S. 4844.2 1Juueutnry aub .2\pprai.armrut of the goods and chattels, rights and credits .which . I 1 . -c ., -'-. ll . 'B u h -F r'h 1 i . . were of ...... w.s.a. .l..e. ... .t\........ o.s.J..e. o ............................. late of ... .Qr.Q .... Q. ....... Q.n.. .... ln-.\'41?.-.X:.+.-.!?:.r..o .............................. . Washington County, Pa., taken and made in conformity with the above affidavit. . REAL ESTATE 534 VJashington Avenue, Charleroi, Pennsylvania, being a 6 room brick and cdncrete block dwelling house. PERSONAL Checking Account, Charleroi Office, Mellon I'-Jationa.l Bank and Trust Company Savings Accc:mnt, Charleroi Office, Mellon National Bank & Trust Company Savings Account, d•arleroi Office, Pittsburgh National Bank Savings Account, d1arleroi Federal Savings and Loan Association Cash in Safe Deposit Box Cash a.t home U.S. Series E Bonds as follows Issue Date -January, July, October, November, December, January, February, IVIarch, April, May, .June, July, August.,. September, October, October, I~oveii1ber, Deceniber, gebruC\r . veptemD4't, October.,. 1942 1942 1942 1942 1942 1943 1943 1943 1943 1943 1943 1943 .1943 1943 1943 1943 1943 1943 1944 1945 1945 DOLLARS CENTS 15,000 00 508 08 7 345 76 , I 5,245.18 11,794136 1,7ooloo 214loo 42139 42!02 41!21 :~m 4lf34 40 54 40154 40J54 40J68 .4oJ68 40.!68 39.189 39)89 71j78 39)89 ·4o .lo3 solo6 37f. 40 37.40 ~az1~t·lo2.3 .J \'') Cl . ---. fY) I I i...: t~ -· _J ...., 1\)• c; I j L·_ . ·-· 1-' r '·' ., • Form RCC-33 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS RESIDENT DECEDENT COUNTY OF WASHINGTON IMPORTANT: This return must be completed in detail and filed in duplicate, ·with will attached, with the· Register of Wills of the County where decedent resided; Return is due within one year after date of death, unless an extension is granted by the Secretary of Revenue. (Section 703 of _the Inh_eritl'l.nce_~:~.n!l .E.!:! tate Tax A,ct of Hl61.) .................. gO~;~_;;: __ ;.;~;;;;,~-ES~~~~ -~~---···· ·············}::::u:v;: OF John E. Costello (State full name of decedent) Late of ... Q-1~~~~-roi, _washi~_2to.n_ .................... County ,.~ PE!'INSYL. VANIA State of ..... .. . . . .. ...... ....... ......... ...................... }ss: county of WASHHit;i.'f~?~ . ... . ....... ..... ..... .... ................. . JOHN E. COSTELLO ~-······ ............................................................................................................................................................................................ ········· of the estate of the above-named decedent being duly sworn, deposeS ............ Executor and sayS Decedent ·died J..fl.'.~l.:l~=;';;h) .. ].,~~?;-! . , 19~f~~-•{ ~~aving a last will, copy of which is hereto attached. } othe:8am:t:~:i:::r:::r:fsean\tao;;:: ::} ······· ~~~t~W:~h~~~~]/~~-e~~ .. ~ ...... whom all correspondence should be Charleroi f ·.Pennsylvania ··15022 mailed. That as such Executor deponent is familiar with the affairs of said estate and the property con- ( Ext~cu tor-Administrator) stituting the assets thereof and their fair market value. That at the time of death there was no safe deposit box registered in decedent's individual name, or jointly . with, or as agent or deputy of another, or in decedent's individual name, with right of access by another as agent or deputy, with the exception of the following:- N Ai.IE AND ADDRESS OF BANK OR OTHER IJiiSTITUTION THIS SAFE DEPOSIT BOX RENTED RELATIONSHIP OF JOINT •-· IN WHICH DECEDENT RENTED A SAFE DEPOSIT BOX IN NAME OR NAMES OF HOLDERS TO DECEDENT ~e~J.on l'la-cJ.ona.t tsanK L:t :rrus't c;;o. i{OSaiJ..e 1\.e · COS'te.liO anot son or John E .. Costello ____, B.; That the contents of said safe deposit box or boxes are itemized under Schedules ___ of this return, with the exception of the following, for the reasons hereinafter set forth: That Sc.hedule A attached hereto and made part· hereof sets forth full v and in' detail all the ·"feal property in the Commonwea1 th of Pennsylvania of which decedent died having an interest therein. It also sets fo~th the mortgage encumbrances upon each parcel of real property at the date of death, giving the amount still due at death, name of mortgagee, date, rate of interest, and. book and page of record thereof. It also sets forth in the columns provided therefore the assessed valuation of each of said parcels, the estimated market value thereof as of date of death of decedent. That Schedule 8 attached hereto and made part hereof sets forth fully and in detail all personal property wheresover situated owned by the decedent at the time of death; all moneys left by the decedent at the time of death, whether in decedent's immediate possession, standing to decedent's credit in banks of deposit, savings banks, trust companies, or other institutio~s, whether individually, or in trust for any other person or persons giving also separately the accrued interest thereon, if any, down to the last interest day prior to decedent1 .s death in the case of savings banks, and to the date of decedent's death in all other cases; all bonds, postal savings, treasury certificates or notes and other evidence of in- debtedness of the United States to the decedent; all obligations, whether by statute or agreement they are designated as tax free, of. the United States, or any -state, or political subdivision .thereof, or of any foreign country, which are owned at the time of death; all wearing apparel, jewelry, silverware, pic- tures, books, works of art, household furniture, horses, carriages, automobiles, boats,. and any and all other personal chattels of whatsoever kind or nature, left bydecedent, together with the fa.irly estimated market value thereof; all bonds and mortgages held by decedent· and of all claims due and owing decedent at the time of death, and all promissory notes or other instruments in writing for the payment of money of which decedent died possessed, of whatsoever nature, with interest thereon, if any, giving the face value and estimated fair market value thereof, and if such estimated fair market value be less than the face value, it sets forth briefly the reasons for such depreciation-as to each item; all moneys payable to the estate from life insurance polici·es carried by decedent; all annuity and endowment contracts the proceeds of which were payable upon the death of the decedent; and all the corporate stocks artd dividends due thereon and unpaid as of the date of death, bonds and accrlll!!d irttl!!f'l!!!it th13i'l3tJH ttl th@ diit@ or dece- dent's death and other investment securities owned by the decedent at the titito or death, with the market value thereof at such time. ... • In the case of securities of close or family corporations, the values reported are as far as possible substantiated by financial statements of the corporations, showing the assets and liabilities thereof as of the"date of death. The schedule also sets forth the interest of decedent at the time of death in any co-partnership or business, and in support of the value of such interest there is annexed to said schedule, financial statements showing the assets and liabilities of said co-partnership or business. A copy of the co-partnership agreement, (if oral, a statement setting forth the nature of the agreement) together with a statement setting forth the character of the business, its location, and such other facts pertaining to the business. as may be pertinent to a fair and just appraisal of the decedent's interest therein must be submitted. It should also set.forth in itemized form, together with the fair market value thereof, any other property owned or bequeathed by the decedent at the time of death. The Schedule C attached hereto and made part hereof sets forth a true answer to each inquiry contained therein an!f in the case of transfers ofproperty, 'real or personal, within two years of decedent's death, in contemplation of decedent's death, or intended to take effect in possesslon or enjofrnent at or after death, said ·sehedule ·sets for.th the nature and value of such prope~ty, to whom t'ransferred, the relationship of the transferees.to the decedent, the proportionate share received by each transferee a~d all other facts of a pertinent nature regarding said transfers. In the case of transfers intended to take effect in possession or enjoyment at or after death, there is also attached to the schedule a cony of the deed, trust agreement or other instrument creating the trust. Thero~ is also set forth in said schedule a list of all property, real and personal, with its value, which passes at decedent's death by vir.tue of the exercise by decedent, either individually, or jointly with another, or any power of appoint-. ment vested in decedent, either-individually or jointly, by the will, deed, or other instrument of another, with a copy of the instrument creating such power attached _to the schedule. Tha.t Schedule D·attached hereto and made part hereof sets forth the names and addresses of all persons beneficially interested in this estate at the time of decedent's death, the nature of their res- pective interests, 'their relationship, if any, to the decedent, together with the ages at the time of decedent's death 6'f all minors, annuitants and beneficiar~es for life under decedent's Will. It also contains a statement showing which of the beneficiaries named in the decedent's will, if any, died prior to decedent, the dates of their death, their issue, andthe relationship of such issue to the beneficiary. That Schedule E attached hereto and made a part hereof sets forth all property, real and per- sonal, owned by the decedent jointly with another or others, including intangible, standing in the name of the decedent and others, plus the date apd place of record of instnunents effecting the vestiture of real estate and the date of acquisition· of personalty, plus the name, address and relationship, 'if any, of co-owners to the decedent. That Schedule F attached hereto and made a part hereof sets forth fully and in detail all debts and deductions claimed for and on behalf of this decedent's estate, including funeral expenses paid; family exemption, where applicable; costs of administration of this estate; counsel fees and fudiciary's commissions paid or to be paid; cost expended for burial trusts, tombstones or gravemarkers, and reli- gious services, in consequence of the death of the decedent; debts and claims owing and 1mpaid at time of .. . death; taxes accrued chargeable for period prior to decedent's death (except. those allowed under Section 651 of the Inheritance and Estate Tax Act); together with a statement of collateral pledged for obliga- tions, if any. It is agreed that the fiduciary will present proof of said claimed obligations upon re- quest, that if the amount actually paid in settlement of any fee, commission or debt is less than the estimated amount .. claiming and allowed, that the same will be reported to the Register of Wills, and that the amount of tax assessed can be reassessed in accordance therewith. That the totals of the appropriate columns in Schedules "A", "B", "C", "E", and "F" as directed therein,. have been carried forward and properly registered in the Summary. Subscribed and sworn to before me this 19th • .................................................... (Street Number) • Charleroi, Pennsylvan1a. ······································································································································· (City or Town and State) NOTE: Before.signing affidavit make sure all blank spaces in the affidavit and schedules annexed are filled in with details or the word "None", and in case the assets include rare and unlisted securities, securities of close or family co·rporations or an interest in any co-partnership or business, that the data and statements required under the paragraph above relating to Schedule "B" are at.tached. Also make certain that column #1 in the "Summary" has been properly completed as above-directed~ RCC-34-(1-64) ,_ COMM,ONWEAfTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS TRANSFER INHERITANCE TAX RESIDENT DECEDENT .. SCHEDULE .. A" REAL PROPERTY Real property in Pennsylvania, with statement of mortgage encumbrances upon each parcel at death of dece- dent. Where property heid as joint tenant or tenancy by entireties, report on Schedule "E". Property held by the de.cedent as tenant in common with another or others, should be identified as to quantum of interest and the estimated value should be that of the decedent's interest only. The real property located In the Commor_1wealth of Pennsylvania should be described by lot and block number, street and street number, together with a general description of.the property, with a reference to the record of the conveyance by which the decedent took title; If a farm state number of a-. cres; also statement of mortgage encumbrances upon each parcel at death of decedent. Taxes, assessments, acciued Interest on mortgages, etc., are to be listed on Schedule "F" and must not be deducted from this schedule. 534 Washington Ayenue, Charleroi, Pa~ being a-6 room brick and cohcrete block dwelling house. (1) ASSESSED VALUE FOR YEAR OF DECEDENT'S DEATH Insert this total opposite "real property", Schedule "A" in the X X X X X "As Reported" column on the last page of this return. (2) (3) DEPARTMENT VALUATION ESTIMATED CAUTION MARKET VALUE (Do not write In this space) I $15,000.00 / RCC-35 GOMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "B" PERSONAL PROPERTY INSTRUCTIONS: This Schedule must disclose all tangible and intangible personal property owned individually by the decedent, at the time of his death. Property owned by the decedent jointly with another or others must be listed under Schedule "E". lntarigible personal property, titled in the name of the decedent, but payable at death to another or others, including but not limited to P.O.D. u. S. Savings Bonds and tenta- tive trust accounts, must be listed, despite the fact that they are not of the administered estate. Tangible personal property should be listed first (e. g. jewelry, wearing apparel, household goods, and furnishings, books, paintings, automobiles, boats, etc.) Intangible personal property, such as bonds, treasury certificates, cash on hand and in bank, • stocks, ·mortgages, notes, together with accrued interest or dividends, salaries or wages, insurance pay- able to the estate or fiduciary in said capacity, partnership interests, interest in anyundistributed estate of or income from any property held in trust under the will or agreement of another, even though located outside of the State, at the time of death, should be listed in this schedule. Item NO· 2. 3. 4 .• s. -.6 ·• 7. ITEM Lis·t and describe fully Checking Account, Charleroi Office, Mellon Nationa.l Bank & Trust Company Savings Account, Charleroi Office, Mellon National Bank .;. Trust Company Savings Account, Charleroi Office, Pittsburgh National Bank Savings Accm.mt; Charleroi Federal Saving~ and t,oa.n Association cash in"Safe Deposit Box :ash at· how,e u.s. Series E. Bonds as follows Issue Date-January, 1942 July, 1942 October, 1942 November,l942 December,l942 January, 1943 February, 1943 March, 1943 April) 1943 May, 1943 .June, 1943 July~ 19-'13 August, 1943 SeptembeJ;l943 October, 1943 October, 1943 November,l943 December,1943 February, 1944 September,l945 October, 1945 Insert this total opposite "Personal Property", Schedule "B" in the "As Reported" column on the last page of this return. UNIT VALUE 1 1 1 1 1 X X ESTIMATED MARKET VALUE 508.08" DEPARTMENT VALUATION (Do not write in this space) 7,345.76 5,245.18 ? ~ 11 '794.36 ~) . 1, 1oo.oo"' V~~o ..tJ 214.00 \)l'QJ" ~ 42.39 42.02 41.21 41.21 41.34 41.34 41.34 40.54 40.54 40.54 40.68 40.68 40.6o 39.89 39.89 71.78 39.89 40 •. 03 80 •. 06 3.1 .,40 37.,40 $27D728.23 r.cc-36 ... COmlON1\'E.\LTH OF PENN SYLVAN I A. TlUNSFER INHERITANrs TAX RESIDENT DECEDENT SCHEDULE "C" TR.A.NSFEil.S · ( 1) Did decedent, Within two years of deo.th, make any transfer of any material parta.of his estate, without receiving a valuable and adequate consideration therefor? (Answer yes or no)_~ __ <o ____ _ (2) Did decedent, within two years of death, transfer prop.erty from him.self to himself and another or others (including a spouse) in joint ownership? (Answer yes or no) 1'JO (3) If the answer to (1). or (2) above is in the affirmative state: (a) Age·of decedent at time of transfer---------- (b) State of decedent's health at time of making the transfer. (Note 1), (c) Cause of decedent's death. (Note 1), (4) Did decedent, in his lifetime, make any transfer of property without receiving a valuable or adequate consideration therefor which was to take effect in possession or enjoyment at or after his death? (Answer yes or no) No · . (a) Was ~here any poss~bility that the property transferred might return .to . .transferer or his estate or be subject to his power of disposition? (Answer yes or no) NO · (b) What was the transferee's age at time of decedent's death?------ (5) Did decedent in his lifetime make any transfer without receiving a valuable and adequate consideration therefor under which transferor expressly or impliedly reserves for his life or any period which does not in fact end before his death: No (a) The possession or enjoyment of or the right to income from the property transferred? (Answer yes or no) No (b) The right to designate the persons who~.shall possess or enjoy the property transferred or income therefrom? (Answer yes or no) 1~0 . (6) If the answer to (5) (b) above is in the affirmative, state whether the right was ~eserved in decedent alone or others ________________________________________________________________________ ~------------- (7) Did decedent in his lifetime make a transfer, the consideration for which was 1~gnsferee' s promise to pay income to or for the benefit of care of transferor? (Answer yes or no)------ (8) Did decedent, at any time, transfer property, the beneficial enjoyment of which was sub,ject to change, because of a reserved power to alter, amend, or revoke, orNwhich could revert to decedent under terms of transfer or by operation of law? (Answer yes or no) ____ 0 ___ _ (9) If the answer to (8) above is in the affirmative, was the power to alter, amend, or revoke the inter- est of the beneficiary reserved in th~ decedent alone or the decedent and others? (Answer yes or no) _______ _ NO.TE 1: The answers to these questions should be supported by affidavit by the attending physician as well as a copy of the death certificate. NOTE 2: If answer to any of the above questions is yes, set forth below a description of the property transferred, it's fair market value at date of death, dates of transfers and to whom transferred, with relationship of transferees to decedent, if any. Submit copy of any trust deed or instrument, if trans- fers are claimed to ~e non-taxable, also submit detailed statement of facts on which said claim is based, NOTE 3: .List applicable property below in m·anner in which provided in Schedules A, B, or E. ITEM DESCRIPTION NONE Insert this total opposite "Transfers", Schedule "C" in the "As Reported" column on the last page of this return. MARKET VALUE (Estimated) DEPT. VALUATION (Dept. Only) RCG-08 ... COMMONWEALTH OF PENNSYLVANIA THANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "E" JOINTLY OWNED PROPERTY INSTRUCTIONS: This schedule must disclose all property, real and personal, owned by the decedent jointly with another or others, including intangibles, standing in the name of the decedent and others. List real estate first, as entireties, or joint tenants, giving brief description, as indicated under Schedule "A", plus the date and place of record of instrument effecting vestiture, but do not include entireties or out of state real estate value in estate valuation column. Personal property should be listed as in Schedule "B", plus date of acquisition, and the name, address and relationship (if any) of co-~wners to the decedent. Description of Property, Date of Acquisition, Name! Address and Relationship of Co-Owners, and Place I of Record of Instrument, where Real Estate. ! ·~ ·~ X~ XX .X X ·~ ,X NONE Unit Value X percentage Rhare X Estate Val11at:i.on X :x X Insert this total opposite "Jointly Owned Property", Schedule "E" in the "As Reported" column on the last page of this return. DEPARTMENT VALUATION r.AUTJON-D(l not WrHe In This Space. Value of Entire Property NONE Value of Decedent's Interest ,-1 ( h RCC .. 37 (1,2-63) COMMONWEALTH OF PENNSYYLANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT BENEFICIARIES AND ADDRESSES State full names and addresses of all who ave an interest, vested, contingent or other- wise, in estate) John E. Costello ' 5.34 Washington A~eraue Charleroi}: p~.' ~15022 ·' '· SCHEDULE "D" BENEFICIARIES RELATIONSHIP SURVIVED (If step-children or DATE INTEREST OF illegitimate children DECEDENT OF BENEFICIARY are involved, set STATE YES IN ESTATE forth this fact.) OR NO BIRTH Son Yes ~/14/1918 100% ',· Deponent further ~ays that all the above-named bene~iciaries are living at this time except below: NAME DATE OF DEATH RESIDENCE '- Will Administration t No. D< THE Year :\lATTER OF THE APPRAISEMENT OF THE ESTATE OF ROSALIE K. COSTELLO Deceased Late of :th~ Bor()l19l:l o£ Charleroi County of Washington Commonwealth of Pennsylvania REPORT AND APPRAISAL John E. Costello, E~g. Attorney £or Estate ....... / (Executor-Administrator must complete "As Reported" column #1.) (") ..., 0 Vl Vl ...., "" X "" cr' ~ trl Vl .... "" .... ~ ...., '"d :::0 ..., ~ ~ "" ..., "" =:! Vl -Vl 0 ....... =:! '"d ~ "" ..., ~ -· 0 Vl "0 w ?" Ci '"d ~ .... ..., .g ~ ~ .... '<: U'J U'J (') (') ?" ?" ~ > : U'J c:: ~ ~ > :::0 ~ ~~-(~)~~~ :.J::>, :C\.') ~ •-...) :l\:1 (X) •• :l\) :w ~ ~ ~··· \.~. ·~· '( \ . ~ . I ~ ~. :r., ............... z :-..J 0'1 > 0 .. .. Vl :l •-..,) 0 4D :N C ~~ •oo ·o~~ ~ ~ ;.. :. 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