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HomeMy WebLinkAboutOC1968-0571 - ESTATE OF DELEGRAM~""Ii'dlJ."'~C-:9 (6'-""6J-l-' COV~ONWEAIJl'H OF PFNN~YIN,\NI.\ T~l:\.N~FF.n INHERITANCE TAX Rl:;;SIDENT DECEDENT DEIEGRAH,HARY a/k/a DELGFU\H,MARY FILE ,i 63-68-571 I-larch 4,1968-_. SUMMARY n..EPOHT OF INHERITAli.CF.TAX APPRAISER duly appointed Inheritance Tax ~ppraiser 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". FILE #63-6S-571 I.the undersigned _#63 Wa sbj ngt.an the real and personal opposite each item in Dated:OL-25-68 03-04-68 REPORT OF THE REGISTER OF WILLS I,the undersigned duly elected Register of Wills in and for J,Tashjp"'top 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 forth in the last column to the right in Schedule "F",which greater or lesser amount represents the sum allowed as a deduction.W ~A ' Dated:0/1-25-68 ~~ REGISTER OF WILLS VALUE AS REPOP~ED VALUE AS APPRAISED VALUE AS RE"~PRAISED $.-$*------ INVENTORY Real Property (Schedule A) Personal Property (Schedule B) Transfers (Schedule C) J oint-Held Property (Schedule E) TOTAL GROSS ASSETS LESS Debts and Deductions (SCHEDULE F) CLEA..1=l.VALUE OF ESTATE 5.31.O.Lt1._ 5,340,47._ 2,261.50:.:__ 3,078.9..'Z.._ 5,340.L.7._ 5,240.47.__ 4t69d .,5Q :-e-======:= Valuation of life estates or annuities .$----~ ESTATE TAX ASSESS~mNTS $------ (:::)As evidenced by Charitable Exemption Certificates issued by the Secretary of Revenue. COMPUTATION OF TAX TOTAL TAX BALANCE PAID ' *------d>~)~------ $--------- $------- *------- $------- $-------$ FOR USE OF REGISTER ONLY Tax on $,~.__5%$_ T ax on $,10'10 t'--:;;.-2S.$,-~--Tax on ~3,078.97 ~J84.3£, T ax on $.__lR%$_ Exemptions :=(:::) Total Estate __ TOTAL TAX $_ Less tax previously paid *~~========.__ BALANCE $__~__ Less 5%of tax if paid within 3 months after death $=====:= BALANCE OF INHERITANCE TAX DUE Add interest at rate of 6%from to AMOUNT OF ESTATE TAX ASSESSED Estate tax paid BALANCE DUE Add interest at rate of 6%from to _ FOR USE OF REGISTER ONLY ADJUSTMENTS NOTE:Where subsequent adjustments are made to the above computation of tax by the Register of Wills,for proper reason,same should be noted below,with short explanation. Will ~N Administration \o. P.I'THE Year . ~IATTER OF THE APPRAISEMENT OF THE EST.-\.TE OF 11ARY.DEIEGRAJ.'vLa/k/a Deceased Late of . County of ..CHkELEH.OI . ..1'lASHINGTON. Commonwealth of Pennsylvania REPORT AND APPRAISAL " .. .. ( '';I Form RCC-2'·,., ~ ,COMMONWEALTH OF PENNSYLVANIA DATE ...................Apr..il....25.~......19.6.$..... DEPI:afMEN70F REVENUEI RESIDENT INHERITANCE TAXI COUNTY .......................Jlashingt.o.n....................... I BUREAU OF COUNTY COLLECTIONS APPRAiSEMENTIHARRISBURG.PENNA.17127 FILE NO..................63-68....571................_...................._. Whereas,......................................Mar..y....Del.egr.am....a/k/a............................................late of ................................G.h.~r.J.,~.:r..9t................................................ in the County of ........................................1'l.ashin.gto.n........,..................................................Commonwealth of Pennsylvania,having died on the ......................J.i,...th........................................................~,day of ..................}{i:!:r..~.h ........"......................"........18 seized and possessed of an estate19...?......, subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore,I,·..·..·..................V·.·R·...··CHf}:Ey...................................................................,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: 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 AppraisementDescriptionofAssetValuesMadeforInheritance Tax Purpoles $ REALTY: NOl\JE NONE PERSONALTY: NOr..'E NONE TRANSFERS: .. NOl'rE NONE JT.HELD: As per Schedule tiE"I)i/,.O 1.,.7 'T'otal 1).11.,.0 J.,.7 . - form~V:~hbl:::~~~~1:~::~.~o~"':~~~~;~~~~~~p~~~~~~~e1~?:?~~...~.............,....~..........................~...............~4!? App r ,/~····..·....·....,..··..········~·······:..;;:;b~~·"~d··St~~~·t·;............................"..,........,.................... .'··~~·o;;;;;;i....··.....·...··......,Penna. ...................1~!ASHINGTON.COUtity RESIDENT INHERITANCE TAX APPRAISEMENT Estate of N.AB.y DE.IEGRAM a/k/a . Deceased. Late of ...CHARLEROI . Date of Death,.M..ar.c.h 4,l9.6.8 . Appraisement Docket Vol.,.J.'].. Page,107-1 ··No 63--68-57-1 ····· Filed in Register's Office,Apri.l 25-j .....19 ..68. Amount of tax due,$ _ _ _.._.._..___._.- DEPARTMENT OF REVENUE Received,~.~~-~,"__--_.....•......-_._-----_.._---- Examined and Approved, Wrote abo.ut Appra.isement, Appeal j,.om Appraisement,. Entered and charged,.i.., '; .'.\ Form RCC-33 RESIDENT DECEDENT COMMONWEALTH OF PENNSYLVANIA fJ.·~ DEPARTMENT OF REVENUE ~ BUREAU OF COUNTY COLLECTIONS COUNTY OF WA.$.HJ.N.G.TQN . 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 .thelnheritl:tnce..an9-.E!:!tateTax A,ct of 1l:!61.) MA..RY D~~~.~;:.:~:::.~:.:::~.;;L:RA.M }:::U:V~:OF (State full name of decedent) .ADMINISTRATORLateofWa.S.blng.t.Qn .....County he·ir s .....~r Decedent'died ...........................JQ..b.n...Del.eg.t.a.IlL..a.n.d......L.oui.s.ec...D.e:le:gr.am...S.ind..r.i.ch. }Jl'lfiHUj.ilIt¥:«cH/of the estate of the above-named decedent being duly sworn,depose and sayandJOlntpropertyowners ,.'.:MC!I.~h 4..,....,196..8.,)testate leaving a last will,copy of which is hereto attached.} (Month)(Hay)(Year)l.intestate otherNaam:t:::i:::r:::r:fse:tttao;:::~:}~~i ~::i 19b~§2~g~~~:ipr'oie:ss'i"o'na 1 Bu i Iding ::;;ed~ll correspondence should be Charle'IOi;Pehhsylvahlc\.. Heirs and joil1t prope:rty owne;;rs .,.. .That as such ./..deponentsHl famlhar wIth the affaIrs of saId estate and the property con- (I.'u:.,ll:!.ooo·Jl:d iooi.rld.)are: 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:-' NAME AND ADDRESS OF BANK OR OTHER INSTITUTION THIS SAFE DEPosiT BOX RENTED RELATIONSHIP OF JOINT IN WHICH DECEDENT RENTED A SAFE DEPOSIT BOX IN NAME OR NAMES OF HOLDERS TODECEDENT 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 Schedule A attached hereto and made part hereof sets forth fullv 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,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 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 companies,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 _p.:~.oI=~o=~eg~~e~~'.s=d~ath 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 thereo~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 .~airly estimated market value thereof;all bonds and mortgages held by decedent and of all claims due and..,owing decedent at the time of de~th,and all promissory notes or other instruments in writing for .the paym~nt 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 policles carried by decedent;all annuity and endowment contracts the vroceeds or which.were payable upon.the death of the decedent;and all the corporate stocks and dividends due thereon-cand unpa.id as of the da·te of death,bonds and aCCi'lJt:!d :l.l1tef'est thef'etm tu th@ d~t@ uf dece- dent's death and other investment securities owned by the deoedent at the time of death,with the market value thereof at such time. --------------------------- ~.d4~"",,~..~.~~!.._.f~~He:ir cll'fLl--f6I propef.!::ty owne'r ................B.o.x 3.4.1"".".."""".""".."."" """.._•.. (Street Number) ".".....".~.~.~.?.~.9.~"!.p...J.."..P.~.p..P.,,~..Y..Jy.9..D..;i.,9.,,.,,"""""..... (City or Town a.nd State) :..... 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 and 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 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 transfe~ee and all other facts of a pertinent nature regarding sa:J.d 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 co~y of the deed,trust agreement or other instrument creating the trust.The'r.~is also set forth in said schedule a list of all property,real and personal,with its value,which paEses at decedent's death by virtue of the exercise by decedent,either individually,or jointly with another)or any power of appoint- ment vested in decedent,either individually or joinpy,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 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 wit·h 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 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 and place of record of i.nstruments effecting the vestiture of real estate and the date of acqulsition 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 lmpald at time of"',death;taxes accrued charge.able for period prior to decedent's death (except.those allowed lillder 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 therewlth. That the totals of the approprlate 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 "..""..".".."".."..".." /0 t::~..........''...."...''....''''...''...''''.....,''''day of ....".".Ap:J;..iJ,,,,,...,,.,,,,,,..,,....,,,,19Q.a....". ··~·~~~~ci·~····················..........................•. (/CHARlfR~1 B0RQUGH.I'IIS~INGTON COUNTY MY COMMISSiON EXi'IRES JAiIUAR'I 7 1971NOTE:Before signlng 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 lillder the paragraph above relating to Schedule "B"are attached.Also make certatn that column #1 in the "Summary"has been properly completed as above-directed. edr and joint Box 282 Ellsworth,Pennsylvani~ <#<RCC·ft (1-114) .COMMONWEA,L.TH OF PENNSYL.VANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COL.L.ECTIONS TRANSFER INHERITANCE TAX RESIDENT DECEpENT .' .SCHEDULE "A" REAL PROPERTY 'I Real property in Pennsylvania,with statement of mortgage encumbrances upon each parcel at death of dece- dent.Where property held as joint tenant or tenancy by entireties,report on Schedule liE".Property hr-Id 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 Commo(lwealth of Pennsylvania should be described by lot and block number,street and street number,together wi th 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 encum~rancesupon each parcel at death of decedent.Taxes,assessments,accrued Interest on mortgages,etc.,are to be listed on Schedule "FlO and must not be deducted from this schedule. NONE (1) ASSESSED VALUE FOR YEAR OF DECEDENT'S DEATH (2) ESTIMATED MARKET VALUE (3\ DEPARTMENT VALUATION CAUTION (Do not write In this space) Insert this total opposite IIreal property",Schedule IIA"in the X X X X X liAs Reported"column on the last page of this return. •HCC.-35 COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT • SCHEDULE "n" 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.jewelry,wearing apparel,household goods,and furnishings,books,paintings,automobiles,boats,etc.) Intangible personal nroperty,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 ~he time of death,should be listed in this schedule. Item ITEM UNIT ESTIMATED DEPARTMENT VALUATION No.List and describe fully VALUE MARKEl'VALUE (Do not write in this space) NONE- ; Insert this total opposite "Personal Property",Schedule "B"in X X the "As Reported"column on the last page of this return. j '.' RCC-36 rm~fO:\'\'E\LTH OF PENNSYLVANIA TIUNSFFR INHEIlITANCE TAX ~SSIDENT DECEDENT SCHEDULE "c" TIU..NSFETI.S (1)Dirt rtecedent,within two years ofrteath,make any transfer of any material part of his estate,'without receiving a valuable and adequate consideration therefor?(Answer yes or no)NO (2)Did decertent,within two years of death,transfer property from himself to himself and another or others (inclurting a spouse)in joint ownership?(Answer yes or no)NO (3)If the answer to (1)or (2)above is in the affirmative state: (~)Age of decedent at time of transfer _ (b)State of decedent's heal th 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)~N~O~___ (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)NO (b)What was the transferee's age at time of decedent's death?Not Appli ca ble (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 ~act end before his death: (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)NO (6)If the answer to (5)(b)above is in the affirmative,state whether the right was reserved in decedent alone 0 r 0 thers _ (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)~N~O~__ (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)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 ceri;ificate. 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 NONE DESCRIPTION MARKET VALUE (Estimated)DEPT.VALUATION (Dept.Only) Insert this total opposite "Transfers",Schedule "C"in the "As Reported"column on the last page of this return. '.Cc'MM()~WE.\l.TH ("IF PENNSYLVANIA T1U~~l·"FH INHERI T,\NCE TAX PillSIDENT DECEDENT SCHEDULE "E" JOINTLY OWNED PROPERTY I;';STRrCTIOKS:This schedule must disclose all property,real and personal,owned by the decedent jointly wi th 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-awners to the decedent. Description of Property,Date of Acquisition,Name I Unit Address and Relationship of Co-Owners,and Place I Value of Record of Instrument,where Rea!Estate.I percentage Estate Share Valuation DEPARTMENT VALUATION CAUTION-Do not Write In This Space. Value of Value of Entire Decedent's Property Interest $9,107.~9 50% /~ 1. 2. Savings account No.8320, Pittsburgh National Bank, Charleroi office,in names of Mary De'le,gram or John De'le'gram $1,573.,4:z -I L/-1."'/ Savings account No.B~-169 Peoples Union Bank,Bentleyville in names of Mary Delegram or Louise Delegram (Sindrich) 50%$786.':J~~. ~4,553.7( Insert this total opposite "Jointly Owned Property",Schedule"E" in the "As Reported"column on the last page of this return.$5.340.47 ~....J ,---_. ..~C'c:37 '(12-63).....'_ COM!rlONWEALTII OF rENNSYYLANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "D" BENEFICIARIES BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED(If step-children or DATE INTEREST OFStatefullnamesandaddressesofallwhoillegitimatechildrenDECEDENTOFBENEFICIARY ave an interest,vested,contingent or other-are involved,set STATE YES IN ESTATE wise,in estate)forth this fact.)OR NO BIRTH T.nll;"P:npl p:(11";\m S;nih';r h Dauohte:r Yes He-;1"anti ;n;nt Box 341 prope:rty owne:r Ellsworth,Pennsylvania it)fJ JM~-J lI'rJ John De:1 e-oram Son VI=':"He-ir and ;oint Box 282 prope:rty owne-r Ellsworth.Pe:nnsvlvania , \ h Deponent further says that all the above-named beneficiaries are living at this time except below: NAME DATE OF DEATH RESIDENCE OF THE ESTATE OF :\IATTER OF THE APPRAISEMENT MARY DELEGRAM, a/kla MARY ..DELGRAM Deceased CJ ...,""0 ~..,:to...,co co0~..,~Vl 0 ::l Vl ...- Vl Vl 0:l-'.......::l ""0~.:t1 co e:...,.., :r+Vl 0x·""O"d~:1-'0-'<..,~ ;:0 .g ~ tTl :0 co.., Vl :~~....:t1~....:m(l):0. 'ti:H:0 ''0:m:H :r+ ~ (Executor-Administrator must complete "As Reported"column #1.) I' / Year . D<THE t No. Will Administration Late of .WClS.h.:i,pgt:c>IL County of Washington . Commonwealth of Pennsylvania REPORT AND APPRAISAL D.Keith Melenyzer Suite 200 Central Professional Building Charleroi,Pennsylvania S11lM .::10 ~nlS18)t1ONI(j\1I~llJSSn?i r~ enc:: ~l~•.>p...-~(f)~~~.....::~:()()()() ;S ?"?"?"::-(')~:> ti1 ••..........--00 -00 ~-00 -00 -00 :lJ1 lJ1....:w W >:.j:>.il:>-Vl :0 0 ~---..••(1)...... ~~5-:'""-J :.....l ..,.....(I)l:'c............ o3 '-l'-:J 91 Z l-/d OJ tldV c:"r -00 -00 ~-00 ~-00 V\'I ... "I''''1~\~~:.~ .1 :~ ,~, .~.~ >cr. u (1)---.r;1,:)3......... ::Ir.c... 4 ;. ,.j Form RCC·10 DEDUCTIONS ALLOWED IN OFFICE OF TME REGISTER OF WILLS OF _....lWWA~S""""HI.o!IoloN.l.:G"T=-O~N"--_COUNTY AND AGENT OF THE COMMONW5ALTH STATEMENT OF DEBTS.. AND DEDUCTIONS THE SUM OF $d:.'~?{..£q, )/-..<..F-,,p................................................... ~~ (L.S • ) Fe,bruary 4,1968DATEOFDEATH L.ATE OF -JW~aa·~s..!.h!.,;:i!:.:n~a~t~o~nl!-_MARY DELEGRAM,a/k/a MARY DELGRAM Notar Public JOSEPH SITH,IWTAW pusue CHARlERJI B0ROUGH,W'SHi'iGT0N COl!'lTY MY COMMISSION EXPIRES JANUARY 7,1971 ESTATE OF SWORN AND SUBSCRIBED SEFORE ME THIS _....;/...::~V~__DAY OP'~D Aril ,.QlL ~.4de~ DATE OF FILING APPRAISEMENT DATE NO,OF NAME OF PAYEE REMARKS AMOUNT VOUCH';" , ~/1 a AA IThomnson Funeral Home'- I Be'nt le:vvi lIe'.Pa.Fune:ral Expe:nse:s ~2 .164 50 I I ?/11 68 l(lui ne,t Monume:nt Comnanv - ,Be:n t 1 e,y viIIE:,Pa.Le'tt e:r i no Mon.e;tc.77 00 3/09 68 Re've:ra,nd Harry F.Pe:trie:Se:rvice:s 20 00 D.Ke:i t 11 Mele,nyze-r,Esquire:Attorneys Fe:es ""~~UU I . ,;-0;;., ." ;JJ;;,/~() "J;lk/-:/_A I"'l'.J r-IC'............ COMMONWEALTH OF PENNSYLVANIA }ss:COUNTY OF WASHINGTON I.John De:le:oram and Louise-De:le-oram Sjndricb HEREBY CERTIFY.THAT.TO THE BE.T OF MY KNOWLEDGE AND BELIEF,THE FOREGOING IS A JUST AND TRU E srATEMENT OF DEBTS,FUNERAL EXPENSES AND EXPENSES OF ADMINISTRATION SUBMITTED TO THE ESTATE OF Mary De'le'oram,a/k/a DECEASED.AS DEDUCTION$FOR INHERITANCE TAX PURPOSES.Mary De:lgram c7l .ok.(L.5.) ., (r, CC ··..1 fO0'; Q:l :0 )......f"r1;;o -C/-11we::::0-(J) V;<J') ........,~..1:;';!::2 ~l- y---::Oi-0 I°7 m'"'1:t;:-V§:5!::;: CJ"""2"""0 l\)<J') '",- -...; I IlESIDENT DECEDENTS File No.6:$-6S..i11 COMMONWEALTH OF PENNSYLVANIA OFFICIAL RECEIPT Transfer Inheritance and Estate Tax 1968 ~9FormRCC-4-RI-3-66 No.948682 Date AprU'10 _Office REGISTER OF WIllS,tiA.SlJING'rON-Par VASRI~1}TON County,ss:Received from J OM 'Dcletiram '&Louise D..Sinit,.'ekt Informant: xaHf$YJAlan:i$'nis~a~~~of the estate oLf------~)1J~A4!Pg,Y;_~D~f·~;L..!E~···fJ~n~w~.!i.j----------------- who died Mar¢h 4-'J 19 68',the sum of .ONE HUNDRED SlWtli!iI 65/100 _.._ _Dollars, being TRANSFER INHERITANCE TAX and/or ESTATE TAX due the Commonwealth as follows: Appraisements Made and Filed Computation of Tax NOTE:This TdpIicate Receipt to be retained by the Register of Wills and filed in numericcrl sequence for crudit purposes. NOTE:In accepting the transfer inheritance tax on future estates prior to the death ofthelifetenantortenantforyears,as evidenced by this receipt,it is understood that the Com-monwealth shall not be precluded or prevented from hereafter assessing additional inheritancetaxatthedeathofthelifetenantortenantforyearswheneveritappearsthatsuchadditional tax may be legally due and collectible for any reason whatsoever. MOORE BUSINESS FORMS,INC.,ELMIRA,N.Y. Register of Wills ~4.c.-""'j'.J,?r;,pi!:;."'..r-")"SEAL /'"'""r~',r?;,...:'.-..".'.._•.~f ,,,,..,,~,,,'t...{,4.-<i)-,&...A..;__.k:-. Exemptions *$============= Tax on $5%$--_ Tax on $10%$ -__-,-_ Tax on $on,Atc:oua:t'.6JS d%'$119~G3 Tax on $15%$~_ Total Estate $_ ,Total $'17C..65 *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. Total Tax $ Less Tax Previously Paid (if any)$ Balance $ Less five per centum of taxif paid 8.98within3monthsafterdateofdeath$ Amount of Estate Tax Assessedunder the Act of May 7.1927.$ Add interest at the rate of %1 from to $ 37-101·1 $,------ $.,'. $.INCOMP1.ETE $------ $, Valuation Valuation $._----- $._'------ Total $,------ $------ Total 1rOOD [pJ[LD @£1r[E Date Date Real Estate Personall'roperty Total Gross Assets Less Debts and Expenses of Administration Clear Value of Estate Valuation of life Estates or Annuities Date 19__$,------- ________19__~$====== Estate Tax Assessments Date 19__$,------- ________19_~$========== FORM RCC-4-RI TRANSFER INHERITANCE and/or ESTATE TAX. RESIDENT DECEDENTS. RECEIPT 31 101 1DocketLPage1wiIie'_ Estate oLf~_fA_RI_,_DE__LBO_,._'_iW_·'_1 _ OFFICE OF REGISTER OF WILLS WASIlINGTOI~t-------------J:Pa. Date,A--<lpL.=r-=i=l---:l:=...:O=-.,__1968 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 Register of Wills 1201 (g).Act of April 9.1929.P.L.343.as amended.viz:-"To receive from Registers of Wills all duplicate ,reoceiptsfortaxespaidtothembyexecutorsoradminis-trators and to charge the Registers receiving the money with the amoWlt receipted for.The original of each suchreceiptshallbesignedandsealedbytheRegisterofWillsandtransmittedtotheexecutororadministrator.whereupon it shall be a proper voucher in the settlementoftheestate.In no event shall the executQ1'or adminis. trator be entitled to a credit in his account by theRegisterunlessthereceiptissosignedandsealedbytheRegisterofWills," Fill in below name and address of person to wholll tax receipt is delivered: lATTY..D~UITH ttEtENYZER I To "'SU""",.'.....,It"""·t,t."....'"...,.,2......0.....0-.,""7CE'Il'iF','I'Tl'N':':I':nr.-:.~F"l:"'--P=t{U""V;:!1'J,t:-ESl'i"l'rrTSIT'Zu-NALnE,-r.-,BUlLDlz..ro \;fWttEitOI,nlil~lSlLVAr,L\150%2 L -' ~ RESIDENT DECEDENTS File No.6·3-68-Sfi COMMONWEALTH OF PENNSYLVANIA OFFICIAL RECEIPT Transfer Inheritance and Estate Tax ~9FormRCC-4-RI-3-66 Dme lmv 2 19 68 No.948766 Office REGISTER OF WILLS.WASHINGTON,Pa. WASHINGTON '",,"',"'..,County,ss:Received from "John Delcgram and 1;')1&1 se l>Alegram Suu.1r:1C:b ~ (~o."t .'of the estate of MARY DJI;J..EC;BAU aka MARl DEI-gOAM who died ).?arch 4#1 19 6~the sum of FOUR and '1/100·-...Dollars. being TRANSFER INHERITANCE TAX and/or ESTATE TAX due the Commonwealth as follows: Appraisements Made and Filed Computmion 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 ofthelifetenantortenantforyears,as evidenced by this receipt,it is understood that the Com- monwealth shall not be precluded or prevented from hereafter assessing additional inheritancetaxatthedeathofthelifetenantortenantforyearswheneveritappearsthatsuchadditionaltaxmaybelegallydueandcollectibleforanyreasonwhatsoever. 184.34 5%$ 10%$ IS $ 15%$ Balance $_ Tax on $.....,..._ Exemptions *$=============. Tax on $_ Tax on $3)018..97 61 Tax on $..:..-._...:-__ Register of Wills Total Tax $184.34 Less Tax Previously Paid (if any)$179..63 4.71 Total Estate $_ MOORE BUSINESS FORMS,INC.,ELMIRA,R.Y. Less five per centum of taxifpaid within 3 months after date ~f death $============ Amount of Estate Tax Assessedunder the Act of May 7,1927.$_ $======== ,Total $4..'11 *As evidenced by Charitable Exemption Certificates issued by the Secretary of Reventi:e under Act of May 28,1956,P.L.1757,effective June 1,1957,as =ended by Act No.381,approved July 11,1957,and Act No.207,1961,Section 302. S'E"j'ij L 't.:::-....,fl:t.i<i~-:._~tf?:?/.etl>~''-1",J:,.-i:' Add interest at the rate of %1 from _ to 31.101.1 $,------ $5.340.47 $,5,340.41 $2,261..50 $3,078.91 Valuation $,------- $,------- Total Valuation $5.340.41 $,------ Total isTffi 0[p)[LD ©£lYlE Date I,.Jt.."Held Real Estme Date Personal Property Total Gross Assets Less Debts and Expenses of Administration Clear Value·of Estme Valumion of Life Estates orAnnuities Dme 19__$1 _ ________19_~$====== Estme Tax Assessments Dme 19__$1------_ -----19__~$====== 1 FORM RCC-4-RI TRANSFER INHERITANCE and/or ESTATE TAX. RESiDENT DECEDENTS. RECEIPT 37~107DocketPage,_'__--1I....jne,_ Estate ofL....,.-"'--_ omCE QF REGISTER OF WILLS 'tfASHINCTON, -----------"'---__-"Pa. llay .2,68Date,-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 Register 01 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 01 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 To ATTY.D..KEITH MELENtZER 200 •CEf-1TltAt PROl')IESSIONAL 81C1~. L lS022