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HomeMy WebLinkAboutOC1968-0268 - ESTATE OF HAUSENForm RCC-2'· -DEPAkTMENTOF REVENUE BUREAU OF COUNTY COLLECTIONS' HARRISBURG.PENNA.77 7Z7 COMMONWEALTH OF PENNSYLVANIA RESIDENT INHERITANCE TAX APPRAISEMENT DATE A.P.~.~}?.§..l J ..~.§~.... COUNTY#..6..3.WA.S.H.IN.C..T.Q.N.,. FILE NO §..~.::::..§.~.::::..?.§.~. EDWARD C.HAUSEN CANONSBURGWhereas,,late of . in the County of ~~~.~.~~~.!.~~,Commonwealth of Pennsylvania,having died on31stOctober67.the uuu day of 19 ,seIzed and possessed of an estate subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore,I,:w...!R..!..G.HA:~.x ,,an appraiser duly appointed according to law, formity with law on'this """"""."."""a?,1f.~",,,,,.,,,day of .".""""""""""'~""""""."j'Z".~'~.....""""""""~""".."..""'/Ij.,,~~ "I"""'II""""""II"II""""."..'''........,I''~..'(~'II""''''''''''''''''''''''''''''''''''''''''~''.Appraller..... 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: In the event that any future interest in this estate is transferred in possession or enjoyment to collateral heirs of the decedent after I 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 AppraisementDescriptionofAssetValuesMadeforInherUance.Tax PurpolBs $ REALTY: NONE NONE I PERSONALTY: As per Schedule B attached 12,543 50 TRANSFERS:.. NONE NONE JT.HELD PERS.: As per Schedule E attached 2,55]00 TOTAL 15,09~50 Having been duly sworn according to aw,I do hereby certif tha~the above appraisement is made in con- Penna. .........#63 WASHINGTON Coimty RESIDENT INHERITANCE TAX APPRAISEMENT Estate of EDWARD C.HAUSEN Deceased. Late of CANONSBURG Date of Death,.o.c.t..ob.e.r ..3.1.,19.6.7. Appraisement Docket Vol.,~.? 94-2 r 63-68-268Page,!va .. Filed in Register's Office,.~P.F~~~?t19...?.~ Amount of tax due,$__-_.__.. DEPARTMENT OF REVENUE Received,••••••••••••••••••••.•••••••••••••••u •••••••••·····_·····.·_·_·····_···__•__···~_·_'- Examined and Approved,.. Wrote abo.ut Appra.isement,. Appeal f,.om Appraisement,. Entered and charged,. Form RCC-I0-RI DEDUCTIONS ALLOWED IN Register of Wills,Agent OFFICE OF THE REGISTER OF WILLS OF Washington COUNTY AND AGENT OF THE COMMONWEALTH STATEMENT OF DEBTS AND DEDUCTIONS THE SUM OF DATE APPROVED . $e:(Pa.S-0, 7-'<3-6'9' ESTATE OF _=E,->d~w<u::a~r:..:d""--,,,C,,-.!...-~H~a~u~s~e:::n~_LATE OF Canonsburg,Washington County,Pa. DATE OF FILING APPRAISEMENT ___..!:..?_~----,2~:7~---:C~~:'--_!DATEOF DEATH October 31,1967 DATE No.of Voucher NAME OF PAYEE .REMARKS AMOUNT 11/2 /67 \fcC abe Brothers,Inc.Funeral services 1,107 00 ?/g/€:8 "lerk of Orohans'Court Probate of Will and Letters 13 50 DQuahertv.Larrimer,Lee &Hickton ~ttornevs'fee 300 00 Mrlri p K.Hausen lFamilv Exemption 1,000 00 $2,420 50 - " •'i ~ COMMONWEALTH OF PENNSYLVANIA COUNTY OF Washington I,Ma ri e K.Hausen JOAN O~~III1/IIfO,NOTARY PUBLIC PlnSDUrtGH.ALLEGHENY COUNTY MY CGiv,!{.,SSlliN I:XPIRES HOV.1.1971 ...... ~~j I t.r::'0I....._ R1lSS::-i.L N/:R'.':Or:::,J.5;.~.:0,:\~'iLLS ., Form RCe-33 RESIDENT DECEDENT COMMONWEALTH OF PENNSYLVAN IA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS COUNTY OF IMPORTANT:This return must be completed in detail and filed in duplicate,with ~ill attached,with the Register of Wills of the County where decedent 'resided;Return is due within one year after date of death,unless an extension is granted by the Secretary of Reven~e.(Section 703 of .thE'!Inheritance,an!l.E.state Tax Act of 1961.) _EDW~::~:::..~~.;;=.~.·.~~~~~.~~.~};::UA:;:OF ~~ (State full name of decedent) Late of ...•....•.•..•""'•.Washingl:on.....'"ADMINISTRATOR ~ State of R~:tJI,l,.§y.b.Y.?.P.:.;h.~'!';} .~a£ ,.ss:.;c--~ County of Washing.ton :. .........Mc?:;x.::.:i.:~K..~J:I9.::q§~P:f.F.:.X.~.9.:q.t..~:i.:X.BlCtOO»X ~~ktH!kHN"X of the estate of the above-named decedent being duly sworn,depose S and say S Decedent 'died O.c.t.ob..e.r.3.1..,.......,19...6..7 ,f testate leaving a last will,copy of which is hereto attached.} (Month)(lIay)(Yf:llr)LH!»X(l(M o t herN:muet:::i:::r:::r:fse:\ta o ;;::::}J"alll~$C.Lg+J;imexf....E$q1J,j,xe.J:....PQqg:her.t.yL:r.9.:;x.:::J::j"I.Jl~::r::.11e~ whom all correspondence should be &Hickton,.90.lGrantBuilding,Pittsburgh,..P.a l.5.2.1.9.. mailed.. That·as such Exe~u.tr.i.x deponent is familiar with the affairs of said estate and the property con- (Ex"p.\1tor,Admini8trl1l.11r) stituting the assets thereof and their fair market value. That at the time of death there was no safe deposit bux 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:- NAME AND ADDRESS OF BANK OR OTHER INSTITUTION THIS SAFE DEPOSIT BOX RENTED RELATIONSHIP OF JOINTINWHICHDECEDENTRENTEDASAFED~POSIT BOX IN NAME OR NAMES OF HOLDERS TO_DECEDENT NONE That the contents of s~id 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 Schedule A attached hereto and made part hereof sets forth full v and in'detail all the real property in the Commonwealth of Pennsylvania of which decedent died haVing an interest therein.It also sets forth the mortgage encumbrances upon each parcel of real property at the date of death,giving the amount still due at death,n~me of mortgagee,date,rate of interest,and book and page Gf 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 B 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 Qompanies,or other institutions,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 decedent'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 ~,tate,~~!;p'ol,ttica"l s!lb<!,ivision thereof,or of any foreign country,which are owned at the time of death;all1lr"ea:.J'lng apparel,jewelry,silverware,pic- tures,books,works of art,household furniture,horses,car:~ia:~l''''aUt{)mobil'es,'boats,and any and all other personal chattels of whatsoever kind or nature,left by decedent,together with the fairly 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 policies carried by decedent;all annuity and endowment contracts the proceeds of which were payabl~upon the death of the decedent;and all the corporate stocks and dividends due thereon and unpaid as of the date of death,bonds and accrued interest thereon to the date of dece- dent's death and other investment securitie3 owned by the decedent at the time of death,with the market value thereof at such time. _~o~~~~~~~~~~~~~~~~~~~~~_____.. In the case of securities of close or family corporations,the values 'r'eported 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 imy co-partnership or·bu'siness,and in support of the value of such interest there is annexed to said schedule,financi.al statements sho~ing the ll."ssets and liabilities o'f s'aid c<;>-partnership or business. A copy of the co-partnership agreement,(if oral,a statement setting forth the nature of'the agreement) together with a stateme'nt setting forth 'the character of,the business,its location,and such other facts pertaining to the busihess as may be pertinent to a fair and just appraisal nf the decedent's interest therein must be submitted.It shoul'd 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 and ih the case of transfers ofpropeJ'ty,real or personal,within two years of decedent's death,in contemplation of dec~dent's death,or intended to t~ke effect in possession or enjoYment at or after death,said schedule sets forth the nature and value of such property,to whom transferred,the relationship of the transferees to the decedent,the proportionate share received by each transferee·and 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.Ther,~is also set forth in said schedule a list of all property,real and personal,with its value,which pa~ses at decedent's death by virtue of the exercise by decedent,either individually,orjointly 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. That Schedule D attached hereto and made part hereof sets forth the names and addresses of all persons ben~flcially 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 of all minors,annuitants and beneficiaries 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,and the relationship of such issue to the beneficiary. That Schedule E attac~ed 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 ~thers;plus the date and place of record of instrt~ents 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 dedl,lctiops claimed for and .on behalilof this decedent's estate,inclueUng funeral expenses paid; fa!Jiily exemption,where applicable;costs of administration of this estate;counsel fee's and fudiciary's commissions paid or to be paid;cost expended for burial trusts,tombstones or gravema~kers,and reli- gious services,in consequence of the death of the decedent;debts and claims owing and unpaid at time of ~..death;taxes accrued charge.able 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 UJ)on 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",nCR,"E",and "F"as directed therein,· have been carried forward and properly registered in the Summary. Subscribed and sworn to before me this . ................,.~day of ~19 6..a.. ~.........~..AYt&9&A oo ,..p .'000"o.Hi}'I '/Oij S31:ldlQ NOISSIW~OJ AQ AlNOOa AH!HlllllY 'HOllnOSllld :J118nd AtlVJ.ON 'Ota~"vcr ......,~~-&~-- ..?A.?l?..;L,~§..t..!:§,~.t... (Street Number) .Cq.p.Qn.s..b.:u.rg.,p..enns.y.l.v.ani.a l.5.3.1.7. (City Cw 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 corporations or an interest in any co-partnership or business,that the data and statements required under the paragraph above relating to Schedule "B"are attached.Also make certain that column #1 in the "Summary"has been properly completed as above-directed. RCRI.~33a COMMONWEALTH OF PENNSYLVANIA ·'I'RANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "A" REAL PROPERTY REAL PROPERTY'IN PENNSYLVANIA.WITH STATEMENT OF MORTGAGE ENCUMBRANCES UPON EACH PARCEL AT DEATH OF DECEDENT.WHERE PROPERTY,HELD ~S JOINT TENANT OR TENANCY BY ENTIRETIES,GIVE NAMES,ADDRESSES AND RELA- TIONSHIP OF OTHER OWNERS. The real property located In the Commonwealth 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 acres;also statement of mortgage encumbrances upon each parcel at death of decedent.Taxes,assessments,accrued interest on mortgages,etc., are to be listed on form RCRI-lO and must not be deducted from this schedule. NONE (KxcclItor·Administratar must total column :-\0.2 and carry total to column No.1 in"Summary"on revere-e side of Schtdu1(>D.) (1)(2) ASSESSED VALUE FOR YEAR OF ESTIMATED DECEDENT'S MARKET VALUE DEATH XXXX (3) DEPARTMENT VALUATION CAUTION (Do not write In this space) SCC-35 COMMONWEALTH 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".Inta~gible 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.jewelr'y,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 any undistributed 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. ITEM List and describe fUlly UNIT VALUE ESTIMATED MARKEl'VALUE DEPARTMENT VALUATION (Do not write in this space) 636.6.3. 2. 3. \.4. ,5. \...6. Checking Account,Pittsburgh National Ban East Liberty Office Certificate of Deposit,Mellon National Bank,Canonsburg Office,No.E01493 , "ITF Rev.William Hausen",due Septem- ber 27,1968 Certificate of Deposit,Pittsburgh National Bank,Canonsburg Office, No.14757 "ITF Carl C.Hausen",due August 9,1967 . Certificate of Deposit',Mellon National Bank,Canonsburg Office,No.E01362 "ITF Marie K.Hausen",due July 7, 1967 Savings Account,Franklin Federal Savings and Loan Association,Squirrel Hill," Pittsburgh,No.S-31153 "ITF Mari~K. Hausen"~~~. Savings Account,Chartiers Savings and Loan Association,Canonsburg,No.777 "ITF Mrs.Stella Kruhms" P&, f~. $ 1,000.00 3,000.00 4,80Q.OO 2,895.65 211.22 'Tf!t'm~ ~rl~ 4~~ ~v" P(£~~ Insert this total opposite "Personal Property",Schedule "B"in the "As Reported"column on the last page of this return. x X $12,543.50 ------------------------------------------------ rOmfON1IT<:,\LTH OF PENNSYLVANIA TIUNSFER INHERITA-l'iCE TAX ~~SIDENT DECEDENT SCHEDULE "c" TRANSFERS (1)Did decedent,within two years of death,make any transfer of any material part of his estate,without receiving a valuable and adequate consideration therefor?(Answer yes or no)_ (2)Did decedent,within two years of death,transfer property from himself to himself and another or others (including a spouse)in joint ownership?(Answer yes or no)__ (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)_ (a)Was there any possibility that the property transferred might return to transferer or his estate or be subject to his power of disposition?(Answer yes or 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: (a)The possession or enjoyment of or the right to income from the property transferred? (Answer yes or no)_ {b)The right to designate the persons who shall possess or enjoy the property transferred or income therefrom?(Answer yes or no)_ (6)If the answer to (5)(b)above is in the affirmative,state whether the right was reserved in decedent alone or others -----------------;-------- (7)Did decedent in his lifetime make a transfer,the consideration for which was transferee'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 subject to change, because of a reserved power to alter,amend,or revoke,or which could revert to decedent under terms of transfer or by operation of law?(Answer yes or no)_ (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 the decedent alone or the decedent and others? (Answer yes or no)_ NOTE 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 be non-taxable,also submit detailed statement of facts on which said claim is based. NOTE 3:List applicable property below in manner in which prOVided in Schedules A,B,or E. ITEM DESCRIPTION NONE MARKET VALVE (Es timated)DEPT.VALUATION (Dept.Only) Insert this total opposite "Transfers",Schedule "C"in the "As Reported"column on the last page of this return. CCM~il)\WR.\1.TH t1F l'ENN~YL\':\NI.\ rn.\.\~~:·:H rXHFH.l 'BNCE TAX rrr.SIDE~T DECEDENT SCHEDULE "E" JOINTLY OWNED PROPERTY DEPARTMENT VALUATION CAUTION-Do not Write In This Space. Value of Value of Entire Decedent's BSTRrCTIOKS:This schedule must disclose all property,real and personal,owner!by the r!ecedent 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 wIder 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-owners to the decedent.} Description of Property,Date of Acquisition,N~-m-e'l--u-n-i-t-r-p'~e~r~c~e'ntage Estate Address and Relationship of Co-Owners,and Place i Value Share Valuation of Record of Instrument,where Real Estate.! Insert this total opposite "Jointly Owned Property",Schedule "E" in the "As Reported"column on the last page of this return. I~--,Ii Property Interest 10.2C 5.le 10.2C 10.2C 10.,2C 250 ..of 250~OJ I 250.0C 250.0C 500.0C 500.0C 500.0C i I II I Ii I l2'551.0 50 50 50 50 50 50 50 50 50 50 50 50 50 500 500 ,000 0.40 I t,OOO I~0.40 u.s.Series H Bond,M 8903308 H "or Miss Mary Carol Hausen" Check--U.S.Treasury #42348882, dated July 1,1967 "or Miss Mary Carol Hausen",interest on bond u.s.Series H Bond,M8903306 H "or William Hausen" Check--U.S.Treasury #42348880, dated July 1,1967,"or William Hausen",interest on bond u.S.Series H Bond,M 8903307 H "or Miss Nancy Hausen"t,ooo Check--U.S.Treasury #42348881,. dated July 1,1967 ·or Miss Nancy Hausen",interest on bond I 0.40 u.S.Series H Bond D 7405268 H I "or Miss Agnes O'Neill"l500 Check--U.S.Treasury #42348857, dated July 1,1967,"or Miss Agnes O'Neill",interest o.n bond 0.20 U.S.Series H Bond,D 7350555 H I "or Miss Janet E.Hausen"1500 Check--U.S.Treasury #43913493, dated November 1,1967,"or Miss Janet E.Hausen",interest on bond~0.40 u.S.Series H Bond,D 7350556 H "or Miss Janet E.Hausen" U.S.Series H Bond,D 7405267 H "or Miss Janet Hausen" Check--U.S.Treasury #42348856,I dated July 1,1967,"or Miss Janetl Hausen",interest on bond to.20 I 2. 6. 9. 12. 1. 3. 8. 13. 7. 5. 11. 10. 4. . !'l.Ge-3?:(12-63) ·Cl1:'1t:\ln~\\·E:\I.TIl OF l'E~:'\SYYI.:\;,\I:\ TRANSFER 1~\lEHITA!'\l'ETAX RESIDENT DEl'EDE:'\T SCHEDULE "D" BENEFICIARIES BENEFICIARIES AND ADDRESSES \State full names and addresses of all who haYp an interest,vested,contingent or other- wise,in estate) RELATIONSHIP (If step-children or illegitimate children are involved,set forth this fact.) SURVIVED DECEDENT STATE YES OR NO DAT"E: OF BIRTH INTEREST OF BENEFICIARY I~ESTATE Marie K.Hausen 542 Elm street Canonsburg,Fa.15317 Wife Yes arl C.Hausen 6340 Al1re . Pittsbur h Pa.15206 Son Yes . m Hausen 340 Aurelia Street Pittsbur h Pa.15206 Grandson Yes Stella Kruhms 1 akmont Avenue Du uesne Pa.ister-in-law Yes Mar Carol Hausen YesGranddauhter 6340 Aureiia'Stree-t !--+-+----if----_ J:,i-t:tJ;;b4.t:ghfa pa.15206 6340 Aurelia Street Pittsbur h Pa.15206 Granddaughter Yes --1'---------- 15206 Granddaughter Yes Mrs.Puhl 1150 Tranter Avenue-=-=--=----=-=-=------------+-------+-----1--------+------------------- ---=.....--=-~~=...:;;:l-':.=...L__"P=_.:a:::::...:.....--..:1=...;5=...;2=...;2=...;0=---__+--+-+-+-._ -------- _.~..------_..._.. NAME DATE OF DEATH RESIDENCE .- -- Deponent further says that all the above-named beneficiaries are living at this time except below: OF THE ,:\IATTER OF THE APPRAISEMENT ESTATE or EDWARD."C.,.HAUSEN..., Deceased ~...,--0 ::tlo~~~'/-":::l til ...- .....'"0.........::::l --0$1"~e.aJ-'til '"0"<:--0 (I)..,., o .g ~~(I) tl :4-ro '<p. i-o~Ii iTI:<: (Executor-Administrator must complete "As Reported"column #1.) t%j '"....IIIct C1atiltil..., ~IIIa-~ Year . D<THE !No. Will Administration Late of <::c:lI1()Il$b.tl:r:-g,.,.",.... Commonwealth of Pennsylvania County of ,Washington -,) ..1 l IL'---' \. ::::Ir.c.. :»'"u·(1)_8"l-.J...~2. -fh-fh-OO-fh-fP.-fP. CJ)c::s::..--s::V-l :»n ::tl;:>-...-...-...--<::.CJ)CJ)CJ)C'l C'l ()?'"?'"?'"~~oj ~:=q :;......- -fh -fh -00 -fh -fh -fh +....:........:Vl N :tv ::»....,..til :0 U1 :Vl ::tl.:\.0 U1 :~(1)- :~i-':w "0-'.•'.o~... Vl 0 :Vl :....(I)0 0 :0 c..- -.l--r- rno L'J :r-.3:...u REPORT AND APPRAISAL,.,J :=...r.v -.:1~?:~:0 ~t.n,..:.2 ::~;­ C)-.,. -'.--to. "~~7)r---=rC5(j) James C.Larrimer,Esquire...., DOUGHERTY,LARRlMER,LEE &HICKTON 901 Grant Building Pittsburgh,Pennsylvania 15219 SUMMARY -..;.-» "::c-;~(6-64) COVMONWEALTH OF PFNN~YJN..:\N-l.\ TH.A~~FF.H INHFIUT1NC;':TAY RF.SIDENT nECE~RNT HAUSEN, FILE # October EDWARD C. 63-68-268 31,1967 FILE #63-68-268 TtEPOH'l'OF INHERI1'ANCF.TAX !\.PPRAISER I.the unrlersigned duly appointed Inheritance Tax ~ppraiser in and for the County of #63 WASHINGtON ,Pennsylvania,do respectfully report that I have appraised the real and personal property as reported in the foregoing return at the values set forth opposite ea~:/~~;6~n the last column to the right in Schedules "A\."~B'""C"and "E". Dated:r J. 10/31/67 REPORT OF THE REGISTER OF WILLS I,the undersigned duly elected RegiEjter of Wills in and for _ County,Pennsylvania,do respectfUlly report that I have allowed deductions in the amounts claimed bJ'deponent,~xcept as to those items where a greater or lesser amount is set forth in the last column to the right in Schedule "F",which greater or lesser amount represents the sum allowed as a deduction. Dated: REGISTER OF WILLS =====:-'--.-=====:= VALUE AS REPORTED VALUE AS APPRAISED VALUE AS RE,~PRAISED $$*12,54~.50 12,S-~= 2,55I:lJO --Z,551.00-- ---'--'1-5-.!-,-09-~·•50 15 ,094.5Q= INVENTORY Real Property (~chedule A) Personal Property (Schedule B) Transfers (Schedule C) J oint-Held Property (Schedule E) TOTAL GROSS ASSETS LESS Debts and Deductions (SCHEDULE F) CLE~q VALUE OF ESTATE Valuation of life estates-or annuities . . . • . • . • . .$--- ESTATE TAX ASSESSMENTS FOR USE OF REGISTER ONLY Tax on $•__!')~% Tax on $101 Tax on ~oS 9/1;'7.i-~<$ Tax on $;r;rAJ.._PLo 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 interes tat rate of 6%from to-------AMOUNT OF ESTATE TAX ASSESSED Estate tax paid BALANCE DUE Add interest at rate of 6%from .to------- COMPUTATION OF TAX <f>.;J _ $------- *=====\----'-$------ *=====:= *------$------ TOTAL TAX BALANCE PAID /~~ ~';Llfe/' As evidenced by Charitable Exemption Certificates issued by the Secretary of Revenue. ~-------~ $------- $------- $~-----­*-------$ FOR USE OF REGISTER ONLY ADJUSTMENTS NOTE:Where subse!]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 l Administration \No. DI THE Year . ~IATTER OF THE APPRAISEMENT OF THE EST.\TE OF EDWARD C.HAUSEN Deceased Late of CANONSBURG WASHINGTON County of . Commonwealth of Pennsylvania REPORT AND APPRAISAL 'I ~. ,/ Dollars, RESIDENT DECEDENTS File No.63-5S-268 -••-"* COMMONWEALTH OF PENNSYLVANIA OFFICIAL RECEIPT Transfer Inheritance and Estate Tax 19 68 ~9FormRCC-4-RI-3-66 Date April IS No.948720 OHice REGISTER OF WILLS,...>.!tl~'A..,..S:.LIH....I'""b"G"""C6.'i'....O....N+J ----"'Pa. ____t.:.:.1=..::A::l!S~HI~l~~.G~t~O~N~'County,ss:Received from Janet E.Hausen.Pnying on Ind.Trinh. ~';¥,~'hrl~~)of the estate ol-f --=E~D:..=l·i:.:;l\:=.RD=__"C"'_'...........nA.<£:.""'U""sr:=No..!...__ who died October S1,19-61,the sum of FIFTEEN and 3l/loo being TRANSFER INHERITANCE TAX and/or ESTATE TAX due the Commonwealth as follows: Appraisements Made and Filed Computation of Tax 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 ofthelifetenantortenant,for years,as evidenced by this receipt,it is understood that the Com- monwealth shall not be precluded or prevented from hereafter assessing additional inheritancetaxatthedeathofthelifetenantortenantforyearswheneveritappearsthatsuchadditionaltaxmaybelegallydueandcollectibleforanyreasonwhatsoever. Tax on $5%$ Tax on $10%$ Tax on $765.30 2%$15.31 Tax on $15%$ Exemptions *$ Total Estate $ MOORE BUSINESS FORYS,INC..ELMIRA.N.Y. Total $15Ii 31 *As ev-idenced by Charitable Exemption Certificates issued by the Secretary of Revenue under Act of May 28,1956,P.1.1757,effective June 1,1957,as amended by Act No,381,approved July 11,1957,and Act No,207,1961,Section 302. ~..SEALI:~w ~~.~;~.£.(::(3'.94-2 Total Tax $15.31 $765~30 Less Tax Previously Paid (if any)$ $Balance $ Less five per centum of tax ifpaid $within 3 months after date of death $ $Amount of Estate Tax Assessedunder the Act of May 7,1927.$ $Add interest at the rate of %' $from to $ Valuation $,------ $,------ Total $,_ Date Real Estate Personal Property Estate Tax Assessments Date'19__$,_ ________19__.!:$====== Date Valuation J t.Held 3 B &$_---.;..--'-__ in't.Tree.Bonds $765.30 Total Total Gross Assets Less Debts and Expenses of Administration Clear Value of Estate Valuation of Life Estates or Annuities Date 19__ ----19__ FORM RCC-4-RI TBANSFER INHERITANCE and/or ESTATE TAX. RESIDENT DECEDENTS. RECEIPT Docket 37 Page 94 Ijne,__2__ ~DNARD C..HADSEllEstateoLf _ OFFICE OF REGISTER OF WILLS UASIIIP.GiON. ---------__-J:Pa. Date April 18 19 68-- 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 MArtINO 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 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 theRegisterunlessthereceiptissosignedandsealedbytheRegisterofWills," Fill in below name and address of person to whom tax receipt is delivered: I I To ArTY.Jl\le2S C..LARRIimR OttAtl'l BUILDING ~IfiSBU.lWBJ PEUNSYLVANIA 15219 L ~ r-------~._-------------------,--------------------....,....-,/ Pas RESIDENT DECEDENTS File No.63-66-268 COMMONWEALTH OF PENNSYLVANIA OFFICIAL RECEIPT Transfer Inheritance and Estate Tax Form RCC-4-Rl-3-66 No.948721 Date April 1S t Office REGISTER OF WILLS.IiASltnmTON, ____~_'rA_S_·HI_NG_T_O_N ,County,ss:Received from Nancy Hannon,Pnyinu on Ind.l..lah. (E~.A~riiiI~lf~tX~G.~~j.ifthe estate OI-f ~~L!.Dt!::!JiJAUJRwDr.:..-~CLJi.'__·..uRIaI),cU.ltw:SENioIU-_ ~oili~Oc~~rn 1~~~oLf----~T~EDi-~a~ft~d~-~2~O~/~1~OAO~-.--~~--._~__.~__~~~ being TRAN,SFER INHERITANCE TAX and/or ESTATE TAX due the Commonwealth as follows: 10.?Jl 10.20 Computation of Tax Tax on $5%$ Tax on $10%$ Tax on $510.:20 2%$ Tax on $15%$ Exemptions *$ Total Estate $ Total Tax $ 510.20 Less Tax Previously Paid (if any)$ Balance $ Less five per centum of tax if paid 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 % from to $ $------- $,------- $ $,-"-------- $ $------- $ Valuation Valuation $,------ $,------ Total Date Date Appraisements Made and Filed Real Estate Personal Property Clear Value of Estate Valuation of Life Estates or Annuities Date,19__ _________19__ Estate Tax Assessments Date 19__$_ ________19_~$======= J t.Held H.&$,__51..........0"*-.2_Ul _ int,trent Dorid$_ Total Total Gross Assets Less Debts and Expenses of Administration 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 inheritance tax at the death of the life tenant or tenant for years whenever it appears that such additionaltaxmaybelegallydueandcollectibleforanyreasonwhatsoever. 31-94....2 NOTE:This Triplicate Receipt to be retained by the Register of Wills and filed in numericalsequenceforauditpurposes. Register of Wills MOORE BUSINESS FORYS,INC••ELMIRA,N.Y. FORM RCC-4-RI TRANSFER INHERITANCE and/or ESTATE TAX. RESIDENT DECEDENTS. RECEIPT Docket 31 Page MJ.ine 2 Estateof mr.-lAnD til HAusnN OFFICE OF REGISTER OF WILLS hAsrmroToDt po. Date April 18 19---ia. 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 nUS.sI;LL l~Ir;o Register of Wills 1201 (g).Act of April 9.1929.P.L.343.as amended.viz:-"To receive Irom Registers 01 Wills all duplicate re-ceipts for taxes paid to them by executors or adminis-trators and to charge the Registers receiving the moneywiththeamountreceiptedlor.The original of each suchreceiptshallbesignedandsealedbytheRegisterof Wills and transmitted to the executor or administrator.whereupon it shall be a proper voucher in the settlement 01 the estate.In no event shall the executor or adminis-trator be entitled to a credit in his account by theRegisterunlessthereceiptissosignedandsealedbytheRegisterofWills." Fill in below name and address of person to mODI tax receipt is delivered: I Tq\'l'i'Y.1ft?;ES C 1,l\RBlHER GMNT BUnJ)IIJG PITTSJURCH,P=NNSYLVMtIA L 15219 I ..J ./ COMMONWEALTH OF PENNSYLVANIA Office REGISTER OF WILLS.~l'l_A_S...;,.H;;.;;I~K~G-=T-=O:.::;N~.-...I:Pa. Form RCC-4-RI-3-66 No.948722 Date April 16 19 68 OFFICIAL RECEIPT Transfer Inheritance and Estate Tax RESIDENT DECEDENTS File Nc63-68....26G Dollars, ____li_'A_S_H_I_N_C...;,.T..:::.O.::..;N ---!County,ss:Received from_-=l~·fn=ry=...i·!..._..::C~£\~J:"~oU!ll..........JkE;;;l-wUwS"""c~n...~----K;.Pn"'7¥-·....1AQa:K-'OQAn--,llr!nEl4d:rr,·•......-:ILi:r.I!al:afblT:::.=---- lIXmts~idItJJ6f~of the estate OJ-f E....•DlL.ll......iA~n.....D.<......4rC.....,_r:_;}tjlHA~t1_SEiir.t!:'t_l------------ who died Octobor 31,19 61 ,the sum of TEN and 20/100 ..._...__...........,._ being TRANSFER INHERITANCE TAX and/or ESTATE TAX due the Commonwealth as follows:• NOTE,This Tziplicate Receipt 10 be zetained 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. 10..20 lO.ZO Register of Wills MOORE BUSINESS FORMS.INC.,ELMIRA,H.Y. 10.20Total$_ *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 amended by Act No.381,approved July 11,1957,and Act No.207,1961,Section 302. /JfEAL.....- (lc(.,,:.p--?t:;?(0 /Z~(,-t---4--V(,.,,-c.J Computation of Tax Tax on $5%$ Tax on $10%$510.20 Tax on $2%$ Tax on $15%$ Exemptions *$ Total Estate $ Total Tax $ 510.20 Less Tax Previously Paid (if any)$ Balance $ Less five per centum of tax ifpaid within 3 months after date of death $ Amount of Estate Tax Assessedunder the Act of May 7,1927.$ Add interest at the rate of % from to $ 37...94-2 $,------- $------- $ $,------- $ Valuation Valuation $,------ $~----- Total Date Date Real Estate Personal Property Clear Value of Estate Valuation of Life Estates or Annuities Date 19__$,_ ----19__~$============ Estate Tax Assessments Date,19__$,-----__ ________19_~$============ Appraisements Made and Filed J t •Held $,_---"S=l'-%-O.!!..!!"2!!U1iO~ Ii.fJ int.Traa.Domiu $------ Total Total Gross Assets Less Debts and Expenses of Administration FORM RCC-4-RI TRANSFER INHERITANCE and/or ESTATE TAX. RESIDENT DECEDENTS. RECEIPT 2~37 MDocketPage I ;ne'_ mniARD C.HAUSENEstateotf _ Date OFFICE OF REGISTER OF WILLS UASIU~"OTON, ----------__Pa. Api"il 16 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 nUSSELL nn.RIl'!O RegisteiOI Wills 1201 (q).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 suchreceiptshallhesignedandsealedbytheRegisterofWillsandtransmittedtotheexecutororadministrator.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 theRegisterunlessthereceiptissosignedandsealedbytheRegisterofWills." Fill in below name and address of person to whom tax receipt is delivered: II"ArTY.JANES c.URtW·£R To C;-';;;.RAN--;-;·;::;:;;T;;-;;s"'un;;;-;:;D:¥'IK;;;;;;:O...--------- PI-rtSGUt\CH.pmiUSYLVl'UUA15219 L ..J BESIDENT DECEDENTS File No63-68-26S COMMONWEALTIJ OF PENNSYLVANIA OFFICIAL RECEIPT Transfer Inheritance and Estate Tax Form RCC-4-RI-3-66 No.948723 Dme April IS,~8~--=--_~~_Ig:__UASlIINOTOrl,Office REGISTER OF WIIJ.S.'-"'----""Pa. Received from C_U_1_Ho._U_S_en......:...,_Ptt----'yi'--1'l.....;g~O_l1_I_Il1l_._L_i_a_b_._ ~OOi.W$JJar&~mof the estme o'L.f ----4.lEW!D~t.JLa'A£li.rm.lL--'c...........,.....J:.u:lA:;p;l.u..tSEiU.:I.\'N~:_ who died October 31 1967 ,the sum o'L.f S_IX_TY_'a_n_d__---:..Q.._o~/__l_0_0_-_,_-_-_'_-_'_-_-_-:_-_-_....,Dollars, being TRANSFER INHERITANCE TAX and/or ESTATE TAX due the Commonwealth as follows: t1ASHINGTON-----------,County,ss: Appraisements Made and Filed Computmion of Tax Date Valuation Date Valuation Register of Wills MOORE BUSINESS FORMS,INC.,ELIIIRA,R.Y. Total $_,:-6_0.._-O.:...O~__ *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 II,1957,and Act No.207,1961,Section 302. t i ;<5 E A L ~_~.f?'/0'....:-~;..L-,,,f ~a,r_f-.-t,~(;,.C-f!.) Tax on $5%$ Tax on $10%$ Tax on $3.000.00 2%$60.00 Tax on $15%$ Exemptions *$ Total Estate $ Total Tax $60..00 $3,000.00 Less Tax Previously Paid (if any)$ $Balance $ Less five per centum of tax ifpaid $within 3 months after date of death $ $Amount of Estate TaxAssessedunder the Act of May 7,1927.$ $Add interest at the rate of '}'~ $from to $ $,----=3"-",I...::..OO.:;;.,,;O:;...;e-=.O.=...O $------ Total Jt.Held $------ $------ Total $,------- Real Estme Personal Property Estme Tax Assessments Dme,19__$,_ ________19__~$================ Total Gross Assets Less Debts and Expenses of Administration Clear Value of Estme Valumion of Life Estmes or Annuities Dme,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 inheritancetaxatthedeathofthelifetenantortenantforyearswheneveritappearsthatsuchadditional tax may be legally due and collectible for any reason whatsoever. Bank Acct.. '-..J{OTE:This 'lripUcate Receipt to be retained by the Register of Wills and filed in numericalsequenceforauditpurposes. FORM RCC-4-RI TRANSFER INHERITANCE and/or ESTATE TAX. RESIDENT DECEDENTS. RECEIPT Docket 37 Page 94 I ine~ EDtllUU)C.HAUS!SNEstateoLf----'-_ OFFICE OF REGISTER OF WILLS fJASHINGTOr'1,___________-LPa. Date Ap~il 18 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 RUSS5LL l·~NO 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 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 theRegisterunlessthereceiptissosignedandsealedby the Register of Wills." Fill in below name and address of person to whom tax receipt is delivered: I A~TV lM~$Co.LARnIlmR Oru.\NT BUILDlreG I To ....At ••_,..-.....-_. L PITTsnuRGH ,PElmsnV,MUa 15219---' \ RESIDENT DECEDENTS File No~3-6e-268 COMMONWEALTH OF PENNSYLVANIAFormRCC-4-RI-3-66 Date,_£..lU=1"""l:t.--=:2=3 1~ OFFICIAL RECEIPT Transfer Inheritance and Estate Tax UASIIIKO?Ot:7OfficeREGISTEROFWILLS,--zPa. t I\suI"·OTO~narie f(.HauoinII,..n l>P L County,ss:Received from_=----'-_ (ExecutoL:{\~~~~)1).gn)of the estate o'----=E=~D:...:.t·'_"1A=n_==.;D'__"C"_'.'____"P=.ll;:....;U:..;,;S;...::I=N_'____::_-_:_::_r.::_:::_:::__------- h 1'\....31 /:.«7 Q1I:-c mmnmm FOUTY-fUrm and 92 100 --- -nollars,W 0 died vctOncr,19_v_,_,the sum oLf -u_ being TRANSFER INHERITANCE TAX and/or ESTATE TAX due the Commonwealth as follows: No.949025 Appraisements Made and Filed Computation of Tax NOTE:This Triplicate Receipt to be retained by the Register of Wills and filed in numericalaequenceforauditpurposes. .NOTE:.In accepting the transler inheritance tax on luture estates prior to the death ofthehietenantortenantloryears,as evidenced by this receipt,it is understood that the Com- monwealth shall not be precluded or prevented from herealter assessing additional inheritancetaxatthedeathofthehfetenantortenantforyearswheneveritappearsthatsuchadditionaltaxmaybelegallydueandcollectibleforanyreasonwhatsoever. 149.92 31.69 Register of Wills 149.92 118.23 MOORE BUSINESS FORMS.INC.,ELMIRA,R.Y. Total $--'-_ *As evidenced by Charitable Exemption Certificates issued by the Secretary of Revenue under Act of May 28,1956,P.1.1757,effective June I,1957,as amended by Act No.381,approv2e-rY.1.1'.1957.'and Act No.207,1.9.61'Section 302. S E;A 1·..,.,//'.~~tZ;(,~·l"lt lJ,.t-"""'"I'~~/ Tax on $5%$ Tax on $10%$ Tax on $5,911..78 2%$ Tax on $2U ..22 15%$ Exemptions *$ Total Estate $ Total Tax $ Less Tax Previously Paid (if any)$ Balance $ Less five per centum of taxifpaid within 3 months after date of death $ Amount of Estate Tax Assessedunder the Act of May 7,1927.$ Add interest at the rate of 'Yd from to $ $,-----'---- $-----08""1,,....'.....3......2......_28.....·__ $8.332.28 $2,,420.50,---=------ $5,911.18 $,------- $ Valuation $------''--- $,------ Total Date 4-26-68 Date Real Estate Personal Property Valuation $-.-.;:.a~2..::-33~,2_._2.a_ $,------ Total Total Gross Assets Less Debts and Expenses of Administration Clear Value of Estate Valuation of Life Estates or Annuities Date'19__ ----19__ Estate Tax Assessments Date'19__$,-----__ ----19_~$======== I FORM RCC-4-RI TRANSFER INHERITANCE and/or ESTATE TAX. RESIDENT DECEDENTS. RECEIPT Docket 31 Page 94 Une----;a- Estate of Elr::A!'eD C.B.WSGl1 OFFICE OF REGISTER OF WILLS ·7""'1r.-"'··G7t'TT Pa._..-0 _...t ...Q_j Date July 23 l>19---us- 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 ~tT~<L:1'Tt Vf\nT~"'.......-..............·''''!Ib§tbfet'''on,v'lls 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 suchreceiptshallbesignedandsealedbytheRegisterofWillsandtransmilledtotheexecutororadministrator,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 theRegisterunlessthereceiptissosignedandsealedbytheRegisterofWills," Fill in below name and address of person to whom tax receipt is delivered: I To --;'Ar.:·r'::::'l:':T,·i,.---rJ"""lllT".i.W:)-:7;-e'·'Lt"""·-.~Jd:r-:'~l~""'UT'!llll"':"',~~~.'OtT-'---.:._-- 910 Gi.vllii 3UIUlIl:e przT~~tpn'J ptmNSYlJlIlN't{\15?1 9L-O~V .~4'_-.,.-.1 /' Form RCC-4-RI-3-66 ~9 COMMONWEALTH OF PENNSYLVANIA RESIDENT DECEDENTS 978868 OFFICIAL RECEIPT No.Transfer Inheritance and Estate Tax File No.N...,"'.?"'''!> Date ty-pt...."''It I.,19.....t£.. Office REGISTER OF WILLS,,'.~._r,......t".r~t ...,Pa. ..."n'!':"County,ss:Received from :i~'",r~"T'C~(It',-'.l "."--....~....cr.Iz~~!.......-.--)~""'""lJ :c..~..;;:;;;1":'• (p~~~utor,h~IEinistrs.rt2~~oEG.uardi£B)of the estate of -~j'I [',~'• f ' 0. f ....'. who died n,.tf\hnr 11 ,19...!.:fl-,the sum of 'it,I ''r ,;,.;H'...·"':f.l.'""----..------..Dollars,t-, being TRANSFER INHERITANCE TAX and/or ESTATE TAX due the Commonwealth as follows: Appraisements Made and Filed Computation of Tax Real Estate Tax on $5%$ Date Valuation $Tax on $10%$ Tax on $2%$ $ Total $Tax on $25 •.to 15%$,n.2b Personal Property Exemptions *$ Date Valuation Total Estate $ ITt.•r,...1,q $~5t;·1l') u:z!?t ,'ccmmt.Total Tax $$ Total $"l1;t;.lO Less Tax Previously Paid (if any)$ Total Gross Assets $Balance $ Less Debts and Expenses of Less five per centum of tax if paid Administration $within 3 months after date of death $ , Clear Value of Estate $Amount of Estate Tax Assessed under Valuation of Life Estates or Annuities the Act of May 7,1927.$ Date 19__$Add interest at the rate of %19__$from Estate Tax Assessments to $ Date 19__$ Total $'jf\;;l) 19__$*As evidenced by Charitable Exemption Certificates issued by the Secretary of NOTE:In accepting the transfer inheritance tax on future estates prior to the death of Revenue under Act of May 28,1956,P.1.1757,effective June 1,1957,as =ended the life tenant or tenant for years,as evidenced by this receipt,it is understood that the Com-by Act No,381,approved July II,1957,and Act No.207,1961,Section 302.monweallh shall not be precluded or prevented from hereafter assessing additional inheritancetaxatthedeathofthehfetenantortenantforyearswheneveritappearsthatsuchadditional /i.A Ltaxmaybelegallydueandcollectibleforanyreasonwhatsoever. LlOOD [P)[LD ©£lYTE t L..ti~(-»\~!It '1...Hoe ~·r NOTE:This Triplicate Receipt to be retained by the Register of Wills em:i7tm~'/~~umerical Register of Wills sequence for audit purposes.MOORE BUSINESS FORMS,INC.,ELMIRA.N.Y. FORM RCC-4-Rl TRANSFER INHERITANCE and/or ESTATE TAX. RESIDENT DECEDENTS. RECEIPT Docket '1/1 Page <)1;I.ine,_-,,2~__ Estateof i;.I;.i'- OFFICE OF REGISTER OF WILLS .,--'r;":'"i Po. Date 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 -r '1.':_-._ 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 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 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 theRegisterunlessthereceiptissosignedandsealedbytheRegisterofWills." Fill in below name and address of person to whom tax receipt is delivered: I I ..t....ru'r,('~;-illToIffrut., L -l Pa. 63.68-268 BFSIDENT DECEDENTS File No COMMONWEALTH OF PENNSYLVANIA OFFICIAL RECEIPT Transfer Inheritance and Estate Tax FormRCC-4-RI-3-66 Office REGISTER OF WILLS,WASHINGTON Received from Rov.l'1il1inm Hannen t PAying on lad.L1ab. ~'Of the estate olLf -liJEm!JllJ·llL1\~R....DL-.JiCL.J.L.....J:H;:.l1\.)JIL1.aJm~..:.I.;~"'-j------------- who died October 31 19 67,the sum olLf T~m:~R~TY~·~__==and~~----.!!2~O".L/~1~O~O'_·--=..._-=--=....-:-=....-:.:=......:-~-=--=-~..=-...::-~--l.)Dollars, being TRANSFER INHERITANCE TAX and/or ESTATE TAX due the Commonwealth as follows: No.948719 Date,__A=-pr_i_l_l_8 19 68 t1ASnIl~G'i'ON-----.:County,5S: Appraisements Made and Filed Computation of Tax Real Estate NOTE:This Trlplicate Receipt to be retained by the Register of Wills and filed in numerical sequence lor audit purposes. 30.20 MOORE BUSINESS FORMS,INC••ELMIRA.N.Y. Register of Wills Balance $_ $=====:====~==30.20Total$_ *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 amended by Act No.381,approved July 11,1957,and Act No.207,1961,Section 302. jL //?;e;:;~;,..~;..,?#"'"~Mrz..-.·...-...--("'l/t~-rJ Less five per centum of tax ifpaid within 3 months after date of death $=========== Total Tax $3:;:.0::...:..-::.2....:.0 _ Less Tax Previously Paid (if any)$=========== Amount of Estate Tax Assessed under the Act of May 7,1927.$-_ Tax on $5%$ Tax on $10%$ Tax on $1.510,20 2%$ Tax on $15%$ Exemptions *$ Total Estate $ Add interest at the rate o!-.f-------'Yd from _ to _ $)------ $ $)_---=::1L..:.5=-=1~O",:..::2:..:..0_ $ Valuation $ $ Total $ Valuation Personal Property Date NOTE:In accepting the transfer inheritance tax on future estates prior to the death oftheliletenantortenantforyears,as evidenced by this receipt,it is understood that the Com- monwealth shall not be precluded or prevented from hereafter assessing additional inheritancetaxatthedeathoftheliletenantortenantforyearswheneveritappearsthatsuchadditional tax may be legally due and collectible for any reason whatsoever. Date Jt.·Held $1,510.20 Bank ACct..Ii BondIht•Troaoury Bodl'------- Total Total Gross Assets Less Debts and Expenses of Administration Clear Value of Estate Valuation of Life Estates or Annuities Date'19__$,_ ________19_~$==============- Estate Tax Assessments Date 19__$,_ ________19_!.:$============= FORM RCC-4-RI TRANSFER INHERITANCE and/or ESTATE TAX. RESIDENT DECEDENTS. RECEIPT Docket 3~e'94 T.ine 2 EDWARD C.HAUSENEstateoLf _ OFFICE OF REGISTER OF WILLS t:ASHINGTON, --------lPa. April 18 68Date19__ 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 r~RIhO 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 moneywiththeamountreceiptedfor.The original of each suchreceiptshallbesignedandsealedbytheRegisterofWillsandtransmilledtotheexecutororadministrator.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 theRegisterunlessthereceiptissosignedandsealedbytheRegisterofWills:' Fill in below name and address of person to whom tax receipt is delivered: I ATTJ.JAUJS C.LMRIt:~R I To -C1.1AN~-:-:-T=-=B-:-u-:-:·I-::-L-=-D=IhC-::-"-:---------- L nI'i'i'SDUOOH,PErUiSYLVANlA 15219 -I