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HomeMy WebLinkAboutOC1968-0738 - ESTATE OF ROSATIRC C-BI (2-64) ~OMMONWEALTHOF PENNSYLVANIA, DEPARTMENT OF REVENUE ~UREAU OF COUNTY COLLECTIONS INHERITANC~TAX DIVISION NOTlC]i:OF FILING OF ~PPRAlSEMENr.r ANTHONlt!G.ROSATI (E~ec\ltor ~.' IN YOUR RliPLY PLEA•• REFER TO 37-1l9-4 I ;., In Re:Estate of......_-_-R~O!_A,;,....,.,~,....OS_A-T-I ....."..............._ __-.........._W-A,.;."S-HI....,N...,.,G;;,:T:....:,lli:..;....----County -FHe No.63-68-738 Dear Mr.Rosati: You are hereby notified that the .'.9ri~inal appraisement in the estat~of Rosa Rosati has been fHed in the offi,ce of the R,e~ister of WHls 'ellf WashiIWton County on Jangary,6 ,19~.Said appraisement reflects the following valuations: Real Estate ..,."".-.........---"':!"':"""'":::"~"'"l'""..,.,..,..­ Personal property~~~_'~i~b~.~O~5~8~.7~4~'~-- Jt.Held ~_~.....",....5~.~O~OO~.U:O~O~.,..,..,.- Tota1 __.,.-_----.........i....jr.".',~Q~5s.l.8.."..,.7/JJl...,'.-..,.. As to such tax that is p~id within three death,a five (5$)percent discount is allowab:i.e. remains unpaid after one year from date at deat~, of six (8$)percent per ann~is char~ed. months from date of As to anY tax that interest at the rate Any party in intere~t Who is agg~ieved by an appraisement may appeal therefrom as provided by law. Date __---:J~,an3i!.!..\uo!'=a~ry~6~,..,..l!o.946C11.9~·_.........__..,. DITE OF DEATH:April 17,1968 Note:This is not a bill. RCC-39 (6-6?J COMMONWEALTH OF PENNSYLVANIA- TRANSFER INHERITANCE TAX RESIDENT DECEDENT ROSATI,ROSA FILE #63-68-738 April 17,1968 SUMMARY YtEPOIlT OF INHERITANCE TAX APPRAISER duly appointed Inheritance Tax Appraiser 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 and personal opposite each item in FILE #63-68-738 I.the undersigned #63 Washington Da ted:01-06-69 04-17-68 REPo~r 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 b J'deponent,except 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./)...c:ih._L.._.'" Dated:01-06-69 ~,r~U/~v REGISTeR OF WILLS =======:= 12,181.74._12,181..111..__ 5,QQQ.OO.~_. __-15.,058.74.___ 4"8'Z1:~9Q:__-;- VALUE AS REPORTED VALUE AS APPRAI SED -,-,VA=L=U=E~A=S,-.;,;:RE=.=i\P~P,-"RA=I""S-,=,E=:.D $'~$'-$------10,058.74._10,058.74._._ 5.000.00._ 15,058.74._ ;;==::fl:eZ7e-QQ:- INVENTORY Real Property (Schedule A) Personal Property (Schedule B) Transfers (Schedule C) J oint-Held Property (Schedule E) TOTAL GROSS ASSETS LESS Debts and Deductions (SCHEDULE F) CLEAR VALUE OF ESTATE Valuation of life estates or annuities . • . . . • . •$_ ES~ATE TAX ASSESSMENTS $_ TOTAL TAX BALANCE PAID $------- $~------ $--------$ As evidenced by Charitable Exemption Certificates issued by the Secretary of Revenue. $----~-- $-------~ CO~WUTATION OF TAX $======1= ~.,----~---- $----- $=====~----'-$------ *------d>~)------ TOTAL TAX Less tax previously paid BALANCE Less 5%of tax if paid within 3 months after death 3ALANCE 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 T ax on $•__'5~1a $~~_ Tax on $..~~,.o ~___=~,__::,.."...- Tax on ~12,181.74 ~A4 $__~7~3_0_.~90 _ Tax on $.__1'5% Exemptions :=(:::) Total Estate __ FOR USE OF REGISTER ONLY ADJUSTMENTS NOTE:Where subsequent adjustments are made to the above computation of tax by the Itegister of Wills,for proper reason,same should be noted below,with short explanation. WAdill ...~No.. ..mlmstration ~ IN THE Year . ""-; MATTER OF THE APPRAISEMENT OF THE ESTATE OF ROSAT ROSATI........ Deceased Late of .MONONGAHELA.... ...._...-_..~,.. .".__..'.._..'. ~.I ,. ...... '/~ $ f\ ,yo .. County of ..WASHINGTON. Commonwealth of Pennsylvania REPORT AND APPRAISAL " ~ Form:RCC-2 ".,& DEPARTMENTOF REVENUE BtJREAU OF COUNTY COLLECTIONS HARRISBURG,PENNA.17 12 7 COMMONWEALTH OF PENNSYLVANIA "'r RESIDENT INHERITANCE TAX APPRAISEMENT DATE ~~.P.:~~:r.:y ..~.L ~.9..?f..,. COUNTY w.?~~~:r.!~~.~?. FILE NO...~.?:.§.?:.7.?..?._. Whereas,~g~.~~g!?.~~~late of l.1Q~Q.I)g~h~.+.~. in the County of w.?.~..t4..:gg:t..9D Commonwealth of Peimsylvania,having died on the ~7..~.~day of i.\pr..~l 19..9.~,seized and possessed of an estate subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore,I,W..~.R.L..G.l:1@.~,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 Purpol8s $ PERSONALTY: Western Pennsylvania National Bank,Monongahela,Pa. Checking Acct.No.Mo4-2-350520.318.19 Western Pennsylvania National Bank,Monongahela,Pa. Savings Acct.No.34697 9,667.65 Blue Shiedl of Penn.,Payment of benefits 43.20 4.80 , Blue Shield of Penn.,Payment of benefits , Blue Shiell of Penn.,Refunds IX 24.90 10.058.74 10,058 74' JT.HELD: c;_!t,1 ()()().00 CP.'Y't.ifi ~::l.t.a!'l of Denosit.Denosti.Mellon National Bank &Trust Co.,Donora,Pa.,registered in names of Rosa Rosati and Anthony G.Rosati (partent and child)dated -February 14,1967.5,000.00 5,000 00 Total 15,058 74 1 fonn~~V;::fhbl::::~;.w<>rJl~~~~~:~;o~e~~~~~=~en;¥j~~ AppraIser .........................................~.....................................................................................~,L .m'"ud S••", ..............G4lz...~................................................................,Penna. (Polit Offloel WASHINGTON............................................................County', ...",..~ -< <; 1"",1 RESIDENT INHERITANCE TAX APPRAISEMENT'..','._.t -:~,...,.;;..~-_.~ .Estate of ROSA ROSATI ............---. 1)eceased. Late of MONONGAHELA..--. Date of Death,:A.:p.r.::i.~..J7.'-~.9~.?. Appraisemel!t Docket Vol.,.3..7 . Page,::lJ.9:::-.4.No ??=§?.~7.)?.. Filed in Register's Office,.J..t¥.l.l,l.Cl:J:"Y 9..J...J9..9.9.. Amount of tax due,$. DEPARTMENT OF REVENUE Received, Examined and Approved,.. Wrote abo,ut Appra-isement, Appeal fl'o-m Appraisement,.. Entered and charged,. ., ('.. l FORM RCC-4-RI ,TRANSFER INHERITANCE and/or ESTATE TAX. RESIDENT DECEDENTS. RECEIPT 37 119 4 DocketL-__-J.Page Jjne,_ noSA nOSAfI Estate o!-f _ OFFICE 0l REGISTEROOF WILLS.,l\SHINGf N, ----...,-un-e~4------:6~8a. 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 RUSSEtt }1ARINO Register of Willa 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-cbarge the Registers receiving the moneywiththeamountreceiptedfor.The original of each suchreceiptshallbesignedandsealedbytheReg;ister of Wills and transmitted to the executor or admimstrator.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 deliveredl ArTY.JOSEPH L.BOFFilANN 242iJhSl'iDJ1SX 1:u'IN SiRUT r- To ---l,,*,'T4tft:"1::""i"I~~~~~r.t'fr'f'1t'l-e~~~-- L F~rm KCC'::4-RI-3-66 ~9 COMMONWEALTH OF PENNSYLVANIA RESIDENT DECEDENTS 948872 OFFICIAL RECEIPT No.Transfer Inheritance and Estate Tax File No.63..68,...138 Date .June"19 .68 ~~ --Office REGISTER OF WILLS.WA~Ln~TON;.Pa. tfASHINGTON County,ss:Received from __A__:tl_'t_h_O_llY-=--_G_.-R_o_S:;;...a._t..;...e_''.!:-'------------'---- (Executor,l!5t.f!:'!~~:A1OOl of the estate o'Lf--------.;.~O~S~A-·..;.;nhl)~S;.,!:,Al-iThI&-----,-------,-------------­ who died AprU 17.19 68 ,the su~of FOUR HUNDREll and no/lOO .........-...--Dollars. 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 $·oR 'Acecunt C.%U $421 ..OS Total $Tax on $15%$---------- Personal Property Exemptions *$============ Date Valuation Total Estate $_ $ .$Total Tax $_ Total $Less Tax Previously Paid (if any)$=========== Total Gross Assets $Balance $-'---------- Less Debts and Expenses of Less five per centum of taxifpaid Administration $within 3 months after date of death $21..05 'Clear Value of Estate $tNCOMP.tETE Amount of Estate Tax Assessedunder Valuation of Life Estates or Annuities the Act of May 7,1927.$----------- Date 19__$._ Add interest at the rate of %'___________19__$from Estate Tax Assessments --------------- to $===========Date 19__$, Total $400..00 ____________19__$*As evidenced by Charitable Exemption Certificates issued by the Secretary of ,NOTE:In accepting the transfer ~nherltance tax on future estates'prior to the death of Revenue under Act of May 28,1956,P.L.1757,effective June 1,1957,as amended the hfe tenant or tenant for years,.as eVIdenced by this receipt,it is understood that the Com-N d 5 .monwealth shall not be precluded or prevented from hereafter assessing additional inheritance by Act 0,381,approve July 11,19 7,and Act No.207,1961,SectIOn 302, tax at the death of the life tenant or tenant for years whenever it appears that SUCh,additional ,128'.'A Ltaxmaybelegallydueandcollectibleforanyreasonwhatsoever./'"'i.. 1rOOD[P)[LD©£Lr[E 31-119-4 ~:r;~~r~~..;."-_~:~~ NOTE:This Triplicate Receipt to be retained by the Register of Wills and filed in numerical Register of Wills sequence for audit purposes.MOORE BUSINESS FORMS,INC.,ELMIRA,N.Y. FORM RCC-4-RI TRANSFER INHERITANCE and/or ESTATE TAX•• RESIDENT DECEDENTS. RECEIPT DocketL-_37_"'-.r.Page l19 Une,__4__ Estate Of.l--_R!..;;.;;O,-S,-A_R!_O_SA_T_l _ OffiCE OF REGISTER OF WILLS ,\iASBI~"GTON--------'------'Pa. Date,......t~'~m....e....--'4"""19M- 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 lWUNO 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 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; A'ffY.JOSEPH t.HOFFMANN 242 tomSTllAIN STREET lmNONGABEtA.PENNSYLVANIA L 15063 -.J \, / Pa. RESIDENT DECEDENTS File No 6.3-6P.-'138 COMMONWEALTH OF PENNSYLVANIA OFFICIAL RECEIPT Transfer Inheritance and Estate Tax\ 19 6S ~9 979190 Form RCC-4-RI-3-66 Date Decembor :21. No. Office REGISTER OF WILLS.'iI\SHn~aTQJ t!A'.HnV~1.:rJt1 County,ss:Received from An.tbonyO.Rooot.1 (Executor,1.8.:qmifiii"$.trmoi:GKGtimolcm)of the estate of ronA POJ:\A.T! who died April 17,19 c;a.,the sum of tlINL end3SAOO -----.---Dollars, being TRANSFER INHERITANCE TAX and/or ESTATE TAX due the Commonwealth as follows: Appraisements Made and Filed Computation of Tax NOTE:In accepting the transfer inheritance tax on future estates prior to the death of the life tenant or tenant for years,as evidenced by this receipt,it is understood that the Com-monwealth shall not be precluded or prevented from hereafter assessing additional inheritancetaxatthedeathofthelifetenantortenantforyearswheneveritappearsthatsuchadditionaltaxmaybelegallydueandcollectibleforanyreasonwhatsoever. Estate Tax Assessments Date 19__$,----_ ________19__~$============= 11000 [P)[LO ©£lslE Total Gross Assets Less Debts and Expenses of Administration Clear Value of Estate Valuation of Ufe Estates or Annuities Date 19__ -....,--19__ 9.35 $======== $-------- $======== $======== $-------- $-------- $9",:.15Total Total Tax Less five per centum of tax if paid within 3 months after date of death Tax on $5%$ Tax on $10%$ Tax on $On Aceomrt.lt1 ~~$ Tax on $15%$ Exemptions *$ Total Estate $ Less Tax Previously Paid (if any) Balance Amount of Estate Tax Assessed under the Act of May 7,1927. *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. S~Ec·A.lL/J,...1?;:"-)...."~"£.".-&-,.,.-./.......;:.....<,;,_.......""-~//I d,7 t.,/;/>.-r.""/J Add interest at the rate of %from _ to _ 37....U9-4 LUt,.;OU,JIJ::..tE $------ $,--------,"",""$, $,------ $ $,------ $, Valuation VCifuation $~------­ $,------- Total $)------- $------ Total Date Date Real Estate Personal Properly NOTE:This 'triplicate Receipt to be retained by the Register of Wills and flIed in numericalsequenceforauditpurposes.MOORE BUSINESS fORMS,INC••ELMIRA,N.Y. FORM RCC-4-RI TRANSFER INHERITANCE and/or ESTATE TAX. RESIDENT DECEDENTS. RECEIPT Docket~.~3~?_~p.age 119 Une,,--'-=4~_ L Estate OfL._....:lW::::..::S.A=-RO==-S=.:"'\.:..:'::="I=---_ OFFICE OF REGISTER OF WILLS l:1ASHu::cron_______---..::..-..-.Pa. Date.__D,,-8C,--G_·I.:it_u-.,r_·__23""--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 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 ofWillsandtransmilledtotheexecutororadministrator.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 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 tax receipt is delivered: I To ATilt>J03!:?H L.nO~.Af.m 242 wsr r.AIn Z'IBi.tT L .. Form RCC-33 RESIDENT DECEDENT COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS 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 th~Inheritance_.~n!iEstate Tax ~ct of 1991.) Late of ROSA IN THE MATTER OF mE-ESTATE OF }AFFiDAVIT OFROSATI.........................··································i"St~t~··f~ll··~~~···;;fd~·~~~t·)···············EXECUTOR ......~?~?..!:1.<J:~J:~.~.~..'.~~.~.l.:1.~.~9..~.9..I?:County ~«BC Anthony G.Rosati Executor or the estate of the above-named decedent being duly sworn,depose S and say S Decedent died :?f.>E~.~!}L... (Month) Name and address of attorney or} other a~thorized representative to. WhOM all correspondence should be mailed. ...........,19 §..~.f testate leaving a last will.copy of which is hereto attached.} (lIay)(V"".)LX!]t*~<X Joseph L.Hoffmann 'l.\t:.:t:.:?.:s~~X ~.t:.Law,. 242 West Main Street,Monongahela,Pa."15063 That as such ~.:eg.9..g.t.Q;r.:deponent is familiar with the affairs of said estate and the property con- (Ex"cutor-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:- RELATIONSHIP OF JOINT HOLDERS TO DECEDENT .~.-. 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 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 nre desi~nated as tax free,of the United States,or any state,or political subdivision thereof,or of nny forei!!;Tl 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 fairly estimated market vaille thereof;all bonds and mortgae;es 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 whi.ch rlecedent died possessed,of whatsoever nature,with interest thereon,if any,giving the face value anrJ.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 payable 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 othe~investment securities owned by the decedent at the time of death,With the market value thereof at such time. a~"L.the-:$-..·..··..~~~~l~r ·..·····..··..·..·..·_..· 700 Lincoln Street....................................................................................................................................... (Street Number) ~<:>.J:l:?~.~.~~~.F~.'..~.~.~~.?.2..?..~. (City or Town and 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 sho'dng 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 deced;nt,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 co~y of the deed,trust agreement or other instrument creating the trust.TherH 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 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 a~d 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 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,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 and place of record of instruments 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 ami unpaid at time (If death;taxes accru~d 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 2.Qth.:.. ................................................day of ~.~.?~.~.~E.L..:19 §.~. .....................p~~~. j-'~/}"1 "...,r '''. :..Qn~l!lJ~l1eia,·\;a":.~~:1','.;'~.y, My Commission Expiru5 May 9,1972NOTE: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. ... Rr.C-34 (l-e4) COMMON~EAI,.,THOF 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 held as joint tenant or tenancy by entireties,report on Schedule "E".Property h"/d by the decedent 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!,wealth 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,accrued Interest on mortgages,etc.,are to be listed on Schedule "F"and must not be deducted from this schedule. None (1 ) ASSESSED VALUE FOR YEAR OF DECEDENT'S DEATH (2) ESTIMATED MARKET VALUE 0.00 (3) DEPARTMENT VALUATION CAUTION (Do not write In this spoce) 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.0.00 .RCC-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.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. ITEM List and describe fully UNIT VALUE ESTIMATED MARKEr VALUE DEPARTMENT VALUATION (Do not write in this space) 1 2 3 4 5 Western Pennsylvania National Bank, Monongahela,Pa.Checking Account No. M04-2-350520 Western Pennsylvania National Bank, Monongahela;Pa.Savings Account No. 34697 Blue Shield of Pennsylvania Payment of benefits Blue Shield of Pennsylvania Payment of benefits Blue SHield of Pennsylvania Refunds:$12.00;$3.20;$9.70 t>~~",9,667.I 43.20 4~80 24.90 Insert this total opposite "Personal Property",Schedule "B"in the "As Reported"column 1m the last page of this return. x x $10r058.74 cqm!O:\T?\LTIl OF PE:-.'N~YL\-ANI.\. T1UNSFFIl INHERITANCE TAX RESIDEXT DECEDENT SCHEDULE "e" T1UXc:FEltS (1)Did decedent,within two years of death,make any transfer of any material part of his estate,without receiving a valuable and adequa.te consideration therefor?(Answer yes or no)_N_o _ (2)Did decedent,wi thin two years of death,transfer property from hiIn.&elf to himself and another or others (inclurling a spouse)in joint ownership?(Answer yes or no)NO (3)If the answer to (1)or (2)above is in the a.ffirmative 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 ~hiCh was to take effect in possession or enjoyment at or after his death? (Answer yes or no)0 (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 enjoY!.'!ent 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 or others ---'="-"""""---,-_ (7)Did decedent in his lifetime make a transfer,the consideration for which wa~transferee's promise to pay income to or for the benefit of care of transferor?(Answer yes or no)__0 _ (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 cOllld revert to decedent under terms of transfer or by operation of law?(Answer yes or no)__N_O _ (9)If the answer to (8)above is in the affirmative,was the power to alter,amend,or revoke the inter- est of the beneficiarNreserved in th~decedent alone or the decedent and others? (Answer yes or no)0 _ NOTE 1:The answers to these questions should be supportecl by affidavit by the attewling 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 d.escription of the prcperty 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 (EsUmated) 0.00 DEPT.VALUATION (Dept.Only) __....J --'-~..__.. Insert this tot:d ojl[losi t"!"Transfers",Schedule "C"in the "As Reported"column on the last page of this return.0.00 RCC-38 ." CCMMONWEALTH OF PENNSYLVANIA Tl1ANSFER TNHElUTANCE TAX RESIDENT DECEDENT SCHEDULE "E" JOINTLY OWNED PROPERTY I NSTRrCTIONS: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 tmder 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 Acquisiti~n,Name I unit Address and Relationship of Co-Owners,and Place I Value of Record of Instrument,where Real Estate.! percentage Estate Share Valuation DEPARTMENT VALUATION CAUTION-Do not Write In This Space. Value of Value of Entire Decedent's Property Interest 5 -$1000.00 Certificates of Deposit, Deposit,Mellon National Bank and Trust Company,Donora,Pa., registered in names of Rosa Rosati and Anthony G•.Rosati (parent and child)dated -February 14,1967 Certificates Nos.14915 to 14919, inclusive OJ{f;.v.:/....J $5000.00 I$50 0.0.•.0O.l....-_-----.J Insert this total (ipposite "Jointly Owned Property",Schedule"E" in the "As Reported"column on the last page of this return. .~....''-:... RCC-37 (12-63) nnt:\llr',\\'E:\I.TII OF PE;'I;:,\SYYl.:\NIA TRANSFER I:'\IIERITANl'E 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 M::Irv ~,;-Ir;111 q...Corrin Avenue,Monongahela .... !''~Pa.15063 Dauqhter 1 t;9,yes sui iuris Anthonv G.RO!=:::Iti 700 Lincoln Street,Monongahel 11, Pa.15063 Son yes sui iuris 85% /- / - . \ h Deponent further says that all the above-named beneficiaries are living at this time except below:None NAME DATE OF DEATH RESIDENCE Deceased ~IATTER OF THE APPRAISEMENT OF THE ESTATE OF (Executor-Administrator must complete "As Reported"column #1.) ('):C-!>-3 '"d ~...'0 ~CD CD0...e:..CIl :.....::l CIl CIl :::s CIl 0 ~:rt CD'::l '"d~... ~:......;;l 0:><~'0~'"d CDC'"...... ~:0 0 ....'0 '-< tTl .~CD:::s .., CIl ........:CD '<~'0.....CD "0H0~ro Hrt'«: Year . P.Il"THE t No. ROSA RQSATI..................................1.... Will Administration ,Mononga.helaLateof... County of ·.Wa.shington. Commomw'alth of Pennsylvania REPORT AND APPRAISAL IolJopb L.rcf:rI'l~ I.ttorl':.-:-,'I 242 \:,:.•3et J:tlonongLafJl~,.......160GU Vl I I I. c:~ ~>- ~-.-............~ (J)Vl Vl Vl >-< n ()()() P'?"?"::r t::I g ~~ -00 -00 --00 ~-00 ~ ......:......>-\J1:01 0 CIl..:....~........0:0 b\J1:0 lJ1 'b~~00 d b 00..'""'.•...........:I,b b '"-J :o·~~.b 0 ,J:>.:0- -(F.+~.~~__~ .'\.. .~."- .~.,~.>-:r. ~.0 ()ti~- I ~.Q ..~~I-J ~.,0 '~.§.~ ~.CI .~~ "(J "c.. II e;., Form RC C·lO DEDUCTIONS ALLOWED IN ./ THE SUM OF $~E2lQo 0"'(2:;;Yh-:::::: Register of Will"Age"t Monongahela,Washington Co.,Pa. DATS OF DEATH April 17,1968 .. STATEMENT OF DEBTS AND DEDUCTIONS OF THE COMMONWEALTH ESTATE OF __...:R:.:.O=S.=.:A:......:;R..:.:O::;.;S=.;A:.::.=T..=I;,---,.__..."...LATE OF/-~-~9 DATE OF FILING APPRAISEMENTDee iii Q,199-8 OFFICE OF THE REGISTER OF WILLS OF _..:.:W:...::a~s::.::h:.:,;l.=:.·n::.:~gL..::t:..::o::.::n:=......._COUNTY DATE NO.OF NAM&:OF PAYEE REMARKS AMOUNTVOUCH"" 1968 May 25 Register of Wills Letters &short certificate:$17 00 25 GUy A.Rogers Probate of Will 15 00 25 Washington Record Co.Advertisement 12 50 25 Daily Republican Advertisement 12 50 June 1 Paul D'Altorio Funeral expenses 1538 '00 1 Father Paul Leger Honorarium 25 00 1 Memorial Hospital Hospitalization 182 00 1 Harry E.Isaac Lettering marker 14 00 1 Daily Republican Card of Thanks 2 00 Julv 5 H.J.Levin,M.D.Professional services 50 00 Dec.10 Betty E.Wenzel Notary fees 3 00 10 Russell Marino Inventory &Debts and DeductiaB 6 00 10 Anthonv G.Rosati Executor's Commission 500 00 10 Joseph L.Hoffmann Attornev's fees 500 00 Total t 2,877 00 - .. COMMONWEAL.TH OF PENNSYLVANIA } Washington s.:COUNTY OF !.Anthony G.Rosati,HEREBY CERTIFY.THAT.TO THE BEIlT OF MY I(NOWL!DGE AND BELIEF,TH!FOREGOING IS A JUST AND TRU E srATEMENT OF DEBTS.FUNERAL EXPENSES AND EXPENsa 01" ADMINISTRATION SUBMITTED TO THE ESTJ\TE OF ROSA ROSATI I ,DEC£AeED,A.DEDUCTIONS FOR INHERITANCE TAX PURPOSES.rl-J...fl:),'fI~ SWORN AND SUBSCRIBED BEFORE ME THIS 20th -f'AAh "'...-.......:/1 ~(L.S.l DAY 01'"ExejlutorDece!I!l:>er ,-9 @('i tY--::Clt'r;,~,i2~c;e L .-.."'1DNaryPub'c I j I E.\......-..'••'.c·."ry PIJL"c 2~::l ,~t.. nQ~,kl~It.lJa.':,:1 ~:011 -.;...:JI'~YI P'.•l'il01101..:;...14.,:_,.......1 (,\/63 .;y (;!I.",i"n ":Apires to'lJ ~f 't'42 I ~I I ...."'1",\I·'t .J ,J \ r:.'.~--1.1 ...',;':::0F:.:G:~';i ':i'~f..r \,I~LS -~--_.A .-.;.-:-.-~..;..",~ <••:;.l ..> WILl.OF ROSA ROSATI -/ t3-&{'738; r ,. ~. .f ~-I i;;. ~- I,Ros~Rosati,of the City of ~onongahela,Washington \tCounty,·Penm~ylvania,having full legal capacity in the premise§, tdo her~by makcthi.my Last Will and Testament,hereby revoking ~and making void any and all .ill~by me at any timeher@tofore I [;made,in manner and form as follows: 1.I direct my Ex~cutor,hereinafter named,to pay all , (my just debts,funeral exp@Dses,and th~costs of th@ administra- ~:tion of my estate,as soon after my deceas~as may be prop~r and 1\exp~di@nt. 2.All the rest arid residu~of my estate,both real ,and personal,and wh~r~soeYer situate or fo~nd,of which I may ;di~seized or possessed,or to whlch I may be entitled at the :time of my decease,and remaining after·the payment of the several • i:items set forth in the pre~eding paragraphher~of,I will,deVise, ',and bequeath unto my husband;Bernardo Rosati,in fee simple abd --I ;absolut~ly;provided,however,that my said husband shall survive -.me in life.In th~event that my said husband should predeceas~ me,or in th0 event that W~should me~t simultaneous deaths,then, .i and in eith~r of said events,I dir~ct my Executor to conv~rt all -my assets into c3.shand after paym~nt of debts,I dir~ct my .Executor to distribute my residuum estate as follows:Fiftserr p~r centum 05<-0 thereof to my daught@r,Mary Ro'sa ti F~rrari;and Eighty-fiv~p~r centum (85%)ther~of to my son,Anthony G.Rosati. 3.I hereby appoint my son,Anthony G.Ros~ti,to b~ the Executor of this my Last Will and Testament. Ill!lnTNESS WHEREOF,I I Rosa Rosati,th~Test1ttrix,have... h~r~untQ s@t my h~nd and seal to this my Last Will and T~st'::U:U-~i1t ~this first day of June in the year 6f our Lord one thousand nine (SEAL),,-,.---~------ ;;hundred and sixty-six. H~j ;:! .I/:./ --{r'.,))-1 //' A./"r·,f,"A/[jC /-,It 1.../1(),:iVY !i .!.,,))1'..'U(\L"iv :1"\.,C_,_'_._~"r ....r,'._ "i., f~.; {; f!1 ·The foregoing instrument was signed,sealed,pub11sh~d, ;iacknowledged and declared by Rosa Rosati,the above namedIi. i! i;Testatrix,as.and for her Last Will and Testam~nt,in the pr~sence ";;of us,who,at her request,and in her presence,and in the,.,. :jpresence of each oth~r,have hereunto subscribed our nam~s as:,. i' " ~; (..,: '. If. Affibuuit (@f iExrrutnr (@r A~minilltrutnr ~tate of 'ettttayluattia.t 55: Olouuty of 1I1!h15~tugtnu \ Personally before me,the undersigned authority,a ~.~~.~.:X :..~~.~.~.~in and for said County and State,appeared ~.~.~.~9.~.¥.g..~¥.:9..~~.~.~..!who,being duly sworn according to law,deposes and says that he is the executor or ~l§tFii~j{of the estate of ~9..~~!39..§~~.!.!.deceased,that the foregoing schedules constitute a complete inventory and appraisement of the real and personal estate of B9..l?.g.R.Q§.g..t.i.£, 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 made by the above named Executor Ag~f8K .day a~~.:i.~~.;~~b~;;~;:thi,...2..O'.~J:....),.."...a4£~I!~1?...~ ;.,,~~;~;;t~~~~X:F~J;;:~~~~;;~;:;~..·IN1TRUCTIONS y .. 1.Aii ihv~tory musf be filed within three months after appointment of personal representative. 2.A supplemental inventory must be filed within thirty days of discovery of additional assets. 3.1 Original and 2 Copies and 2 RCRI-34,Under $10,000;1 Original and 2 Copies and 2 RCRI-33, Over $10,000,including Copy of Will;1 Original and 3 Copies and 2 RCRI-33,Over $50,000,in- cluding 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 lJuneutnrg nub "pprnisemeut of the goods and chattels,rights and credits which ROSA ROSATI Monongahela,were of Jate of ;. Washington County,Pa.,taken and made in conformity with the above affidavit. ./ Western Pennsylvania National Bank,Monongahela,Pa. Checking Account No.M04-2-350520 Western Pennsylvania National Bank,Monongahela,Pa. Savings Account No.34697 Blue Shield of Pennsylvania,Payment of benefits Blue Shield of Pennsylvania,Payment of benefits Blue Shield of Pennsylvania,Refunds:$12.00;$3.20; DOLLARS CENTS .,~~ REALTY:None Personalty Realty 0.00 $9.70 24 90 II I$~~O,058.V4. II 0 100 ...Total Assets $10,058.74 C3-V"7.:38 &0.1383 h-11 ~-/{??r Inventory and Appraisement IN THE ESTATE OF :ROSA ROSATI ,deceased Filed ,19 . ,.( ( t ) "'r , "-1...) ~~ -'--j r ,"2 i I- ~___)u -.CJloJ .fcBf'J!b L.\!V~':':~:"m2 L.t"·-f'J !!:.2 ';; l::.~.._........-_,.A..;:;OD ~2