HomeMy WebLinkAboutOC1968-1072 - ESTATE OF HOLMANForm RCC-33
RESIDENT DECEDENT
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
COUNTY OF
J
IN THE MATTER OF THE ESTATE OF
Late of W.9.:.~.h.:i,.P.:.gt..2.:P.:..
IMPORTANT:This return must be completed in det~~l and filed in duplicate,with will attached,with the
Register of Wills of the County where decedent resided;Return is due within one year after
date of death,unless an extension is granted by the Secretary of Revenue.(Section 703 of
the Inheritance and Estate Tax Act of 1961.)•-----~_.."• •--H •"'n ..h"'.i .
}
AFFiDAVIT OF
GERTRUDE W.HOLMAN a/k/a GERTRUD.........................................................................................................................,,.,',......EXECUTORWELCHHOlIMAN(State full name of decedent)
ADMINISTRATORCounty
Administrator
::.:'.:~I!".;~:::::~~~__:_:::::::_:}'"
......................................··,.wJ.+...!.!.9,.~?X.r...Q.n ~.Q..;L~9,P.:,..
of the estate of the above~muned decedent being duly sworn,depose S and say S
Eucutor
..JO.hIl.JV..~~gWCL:r..g$.,J:r.,.~$.qL....
P.O.Box 636
California,Pennsylvania'15419 .
DecedentdJed M9.:.y(£~h.)(j:;;;.~.i ,J9.(.~~~),{x:i~~~eaVing a last will,copy of which is hereto attached.}
Name and address of attorney or}
other authorized representative to
whom all correspondence should be
mailed.
That as such ..!..~.!.2..:r.me.g.:t deponent is familiar with the affairs of said estate and the property con-(x..x,:&UI6..X~~~.
h stituting the assets thereof and their fair market value.
That at the time of death th~re waf!n9 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
IN WHICH DECEDENT RENTED A SAFE DEPOSIT BOX
None
THIS SAFE DEPOSIT BOX RENTED
IN NAME OR NAMES OF
RELATIONSHIP OF JOINT
HOLDERS TO DECEDENT
That the contents of sald safe deposit box or '.boxes are itemized under Schedules of this---return,with the exception of the fol19wing,for the reasons hereinafter set forth:
That Schedl./le A attached h,eretp and made part hereof sets forth fullv and in'detail all the
real property in the Commonwealth of Pennsylvan~a 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 oolumns provided therefore the assessed valuation of each of said
parcels,the estimated market value thereof as of date of death of decedent.
That Schedl./le 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 tpe case of savings banks,and to the date of decedent's death
in all other cases;all bonds,postal savings,treasury certificates or notes and other evidence of in-
debtedness of,the United States to .the decedent;all obligations,whether by statute or agreement they
are designated as tax free,of the United States,or any state,or political subdivision thereof,or of
any foreign country,~hiCh are owned at the ~ime of death;all wearing apparel,jewelry,silverware,pic-
tures,books,works of art,household ~rniture,horses,carriages,automobiles,boats,and any and all
other personal chattels of whatsoever Idnd or nature,left bydecedent,together with the fairly estimated
market value tnereof;all bonds and jllortg&l!=es held by decedent and of all claims due and OWing decedent
at the time of death,and all prQmiSsory 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 pollci'es carried by decedent;all annuity and endowment contracts the
proceeds of which were payable u~on the death of the decedent;and all the corporate stocks and dividends
due thereon and unpaid as of the date of death,bonds and a'ccrued interest thereon to the date of dece-.
dent's death and other investment securities Qwned by the decedent at the time of death,with the market
value thereof at such time.
•
In the case of securities of close or family corporations,the values reported are as far as
possible substantiated by financial statements of the corporations,showing the assets and liabilities
thereof as of the'date of death.The schedule also sets forth the interest of decedent at the time of
death in any co-partnership or business,and in support of the value of such interest there is annexed to
said schedule,financial statements showing the assets and liabilities of said co-partnership or business.
A copy of the co-partnership agreement,(if oral,a statement setting forth the nature of the agreement)
together with a statement setting forth the character of the business,its location,and such other facts
pertaining to the business as may be pertinent to a fair and just appraisal of the decedent's interest
therein must be submitted.·It should also set forth in itemized form,together with.the fair market value
thereof,any other property owned or bequeathed by the decedent at the time of death.
The Schedule C attached hereto and made part hereof sets forth a true answer to each inquiry
contained therein 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 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.Ther,~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,or jointly with another,or any power of appoint-
ment vested in decedent,either individually,o.r 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 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 and unpaid at time of....death;taxes accrued chargeable for period prior to decedent's death (except.those allowed under Section
651 of the Inheritance and Estate Tax Act);together with a statement of collateral pledged for obliga-
tions,if any.It is agreed that the fiduciary will present proof of said claimed obligations upon re-
quest,that if the amount actually paid in settlement of any fee,commission or debt is less than the
estimated amount claiming and allowed,that the same will be reported to the Register of WillS,and that
the amount of tax assessed can be reassessed in accordance therewith.
That the totals of the appropriate columns in Schedules "A","B","en,"E",and "F"a.s directed therein,·
have been carried forward and properly registered in the Summary.
...........................................................day of.
Subscribed and sworn to before me this ....:</.-4??......?t:~~F~MANT
y--rl/l4.c..-<MV ~/.~r{/,~~'I-C--~.~..~.~~..~.~.!:.9:!?..t~.~.~..t .
PHVLL.IS L:SHROVER,tlotary .:blic (Street Number)
GaII~;n~m~~~:i~nn9t~~p~r~~a..~~.!..~..r?.!...gJ~.J ~.~.nP.:.§.yJ.Y.Q..p..1.a l ..5..41 9
January 29,1971 (City or Town and State)
NOTE:Before signing affidavit make sure all blank spaces in the affidavit and schedules annexed are
filled in with details or the word "None",and in case the assets include rare and unlisted securities,
securities of close or family 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.
RCC-34 (1-64)
COMMONWEALTH OF PENNS'fLVANIA
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 hfld 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 Commot'lwealth of Pennsylvania should be
described by lot and block number,street and street number,together with
a general description of the property,with a reference to the record of the
conveyance by which the decedent took title;If a farm state number of a-
cres;also statement of mortgage encumbrances upon each parcel at death
of decedent.Taxes,assessments,acciued Interest on mortgages,etc.,are
to be listed on Schedule "F"and must not be deducted from this schedule.
(1)(2)(3)I
DEPARTMENT
ASSESSED VALUE VALUATION
FOR YEAR OF ESTIMATED CAUTION
DECEDENT'S MARKET VALUE (Do not write
DEATH In this space)
ALL that certain piece or parcel of lane 2,365.00
situate in the Borough of California,
Washington County,Pennsylvarua and being Lot
No.20 which is of record in the Recorder's
Office of Washington County,Pennsy~vania
in Plan Book No.1,page 11 and being more
particularly described as follows:-
FRONTING forty four and one half (44~)
feet on the East side of College Street and
extends back of uniform width seventy two
(72)feet to an Alley and adjoin§Lot No.8.
UPON said premises is erected a two
story frame dwelling house.
BEING the same premises conveyed to
Renssela~r M.Holman and Gertrude W.Holman,
his Wife,by Washington County,by deed date
the 24th day of March,1943,and recorded in
the Recorder's Office of Washington County,
Pennsylvania,in Deed Book 667,at Page 357.
The said Rensselaer M.Holman died on Octobe
31,1957,and the fee simple title vested in
Gertrude W.Holman,as surviving tenant by
the entireties.
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 0010.000'&1 ~/JO .JG~1
/0 000.06
/
RCC-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 indivjdually
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 anyundis tributed
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 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.
RCC-36
CO\!:\ttl:\'I'E\LTH OF PENNSYLVANIA
.TH..\.NSFER INHElUTANCE TAX SCHEDULE "c"
TR.A.NSFErtS
..'.
n.ESIDE~T DECEDENT....;.;;.~~~~~~~--------------------------------'.·.
(1)Dirl rlecedent,within two years ofrleath,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 decedent,within two years of death,transfer property from himself tO~h~im~se-l-f-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 affirmative state:
(a)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?__
(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 enrl before his death:
(a)The possession or enjoyment of or the right to income from the property transferred?
(Answer yes or no)~n~o~_
(b)The right to rlesignate the persons who shall possess or enjoy the property transferred or
income therefrom?(Answer yes or no)~n~o~_
(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 prolnise to
pay income to or for the benefit of care of transferor?(Answer yes or no)no
(8)Did decedent,at any time,transfer property,the beneficial enjoyment of which was subject to change,
because of a reserverl.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)_~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 beneficiary reserved in the decedent alone or the decedent and others?
(Answer yes or no)n__o __
NOTE 1:The answers to these questions should be supporterl by affidavit by the attending physician as
well as a copy of the rleath 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 rlate 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
MARImT 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.
COMMONWEALTH OF PENNSYLVANIA
Tni\N~FEIl INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "E"
JOINTLY OWNED PROPERTY
-.
I NSTRrCTIOt<iS: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 lmder 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 percentage Estate
Address and Relationship of Co-Owners,and Place I Value Share Valuation
of Record of Instrument,where Real Estate.I
DEPARTMENT VALUATION
CAUTION-Do not Write
In This Space.
Value of Value of
Entire Decedent's
Property Interest
768.74
998.35Checkingaccount,Western Pennsylvania
National Bank,California,Pennsylvania,
in the names of Gertrude W.Holman
or W.Byron Holman.Total amount in
said checking account being $1,996.70,
one-half of which is taxable (W.Byron
Holman is a son of Gertrude W.Holman).
NOTE:All of the above accounts were
established over 8 years prior to the
death of Gertrude W.Holman.
Insert this total opposite "Jointly Owned Property",Schedule
in the "As Reported"column on the last page of this return.
Checking account,Western Pennsylvania
National Bank,California,Pennsylvania,
in the names of Wm.Byron Holman or
Merrell Holman or Gertrude Holman.
Total amount in said checking account
being $4,026.24,one-third of which
is taxable,(Wm.Byron Holman is a son
of Gertrude Holman).
Savings Account #7110,Pittsburgh
National Bank,California,PennsYlvani~,
in the names of Mrs.Gertrude W.Holma~
or H.Eugene Holman.Total nt 1
said savings account being 1,475.00
one-half of which is taxabl (H.
Eugene Holman is a son of Gertrude W.
Holman)OP;~N1fj)Ir PrzJ~,I.tJ y
Savings Account #197,Western Pennsyl-
vania National Bank,California,
Pennsylvania,in the names of Gertrude
W.Holman or Oren W.Holman.Total
amount in said savings account being
$1,537.49,one-half of which is taxable,
(Oren W.Holman is a son of Gertrude W.
Holman)•()fl~IY£'/)-I ~Uf)
~OC-'3'r :(12-63)
l'Om\l1~\\'E.·\I.,·tI OF n:;\;~~Y\'l.ANIATHANSr~;R l~m:HITA!\'l'r:TAX
RESmr:NT DEL'EDENT .
SCHEDULE "D"
BENEFICIARIES
\
h
,-
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,
William Byron Holman Son Yes 1/5
~3i'lhird st~eet..-a 1 orn1a.ennsvlvan1a \
Marv El i zabeth French Daughter Yes 1/5
Beach Dr1veMHi~lsmere ::;nor~sAnnanolis.arvland
Rensselaer Merwin Holman Son Yes 1 /p,
~en *ilfi Ro~d Ohioew1Cmon
Harry Eug:enp.Holman Son YP.~1 /p,
5037 Grove RoadPittsburghPennswlvania
Oren Welch Holman Son Yes 1/5
West Granville RoadWorthins:rton Ohio
Deponent further says that all the above-named beneficiaries are liVing at this time except below:
NAME DATE OF DEATH RESIDENCE
~
~IATTER OF THE APPRAISEMENT
GERTRUDE W.HOLMAN.....
Deceased
OF THE
ESTATE OF
4 ••"'.•,I.,
(Executor-Administrator
must complete "As
Reported"column #1.)
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R CC-B I (2-64)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE'
BUREAU OF COUNTY COLLECTIONS
INHERITANCE TAX DIVISION
NOTICE OF FILING OF APPRAISEMENT
WI11illl BYRON HOLHAN
(Executor ~~).
IN YOUR REPLY PLEA.E
REP'IER TO 37-135-5
In Re:Est ate 0 f --:G=::ER:::-::.;'T:.:;rllJ:.:::·..:;.D=E_W:.:.;E.L:::'::;:C::;H:-·.:.:H~O:::J1:..::4A~N..:...-__
______-.;,,;,.WAS_·_H_I_N_GT_O_N_-County - F He No.63-68-1072
De ar 14r.Holman:
You are hereby notified that the original
appraisement in the estate of Gertrude Welch Holman
has been filed in the office of the Register of Wills qf Washington
County on October 1 ,1968.Said appraisement reflects the
following valuations:
Real Estate _--'-l=O~,O~O::.;O;;_:.~O~O~-
Personal Property 3,t~8~4~6::.;.~6~7~_
Transfers -:-:__:--:---;~_
Total -:.--=l!:-o34,....l.8:.!::*4~6..L..6~7L.-.-
As to such tax that is paid within three months from date of
death,a five (5%)percent discount is allowable.As to any tax that
remains unpaid after one year from date of death,interest at the rate
of six (8%)percent per annum is charged.
Any party in interest who is aggrieved by an appraisement may
appeal therefrom as provided by law.
Date __~O::..::c:.::t~o..::::.b..::::.er~1:Jtt.......::l'-'9..::::.6..::::.8----
Title W.R.CHANEY
DATE OF DEATH:Nay 25,1968
Note:This is not a bill.
RCC·~(6-,67),
""':OMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
HOlkUlli,GERTRUDE WELCH
FI~#63-68-1072
May 25,1968
SUMMARY
rmponT 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 tjJe right in Schedules "A","B","c"and "E".
I.the undersigned
#63 Washington
the real and personal
opposite each item in
FILE #63-68-1072
Da ted:10-01-68
05-a5-68
REPORT OF THE REGISTER OF WILLS
I,the undersigned duly elected Register of Wills in and for Washington ...,
Coun ty ,Pennsylvania,do r',spec tfully report that I have allowed deductions in the amounts
claimed by deponent,except as to those items where a greater or lesser amount is set forth
in the last column fo the right in Schedule "F",which greater or lesser amount represents
the sum allowed as a deduction.
Dated:10-01-68
REGISTER OF WILLS
VALUE AS REPORTED VALUE AS _APPRAISED VALUE AS REAPPRAISED
$101 000.00 $10,000.00 $
'J !~·~-"'l-rl~·~-o""l ."'j 7 ,'-'{--------
_......-._~_~__.~._:..2~.__=_=....~...._~._................__
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
3,846.67
13,846.67
1,976.15 .~_
11,870.52
3,846.67
"--13,846.67
1,976.15===~:i=:==:.
11,870.52
======:=
Valuation of life estates or
annuities . . . . • • . .*----
ESTATE TAX ASSESSMENTS ~------
--------"
(:::)As evidenced by Ch'ari table'Exemptlon
Certificates issued by the Secretari
of Revenue.
,--
8-26-68
$------
$-------
$--------
$-------$
1t _
CO~WUTATION OF TAX
TOTAL TAX BALANCE
PAID
BALANCE DUE
Add interest at rate of 6%from
to
TOTAL TAX $___
Less tax previously paid $============~_.
BALANCE $-.......--~-L~ss 5%of tax if paid within
3,'months after death $======:=
3ALANCE OF INHERITANCE TAX DUE
Add interest at rate of 8%from
to
AMOUNT OF ESTATE TAX ASSESSED $~
Estate tax paid $__
FQR USE OF REGISTER ONLY
T ax on $________!"i;1a $_~~
Tax on $~~.~
Tax on ~~=:15.,870.52:~$_7,,-=1::;;.;:2.:..;..2=3,-,-,_.PD.In Full
T~x on $.__1!"i%$
Exemptions :=(:::)
Total Estate------
FOR USE OF REGISTER QNLY ADJUSTMENTS
NOTE:Where subsequent adjustments are made to the above computation of tax by the
TIegister of Wills,for proper reason,same should be noted below,with short
explanation.
Will (...No.Administration
IN THE
Year .
MATTER OF THE APPRAISEMENT
OF THE
ESTATE OF
G~TuUDE Vf~LCH HULMAN..........·····J)~d~~~ed
Late of ...
County of
CALIFORNIA
WASHINGTON...-..'..-.
Commonwealth of Pennsylvania
REPORT AND APPRAISAL
i
,f
-
Fonn RCC-2-RI ,
~.,
..............9..~~.9.?~!.....~L....~.?§.?..................-.....,COMMONWEALTH OF PENNSYLVANIA'DATE,
"DEPARTMENT OF REVENUE RESIDENT INHERITANCE TAX Washington
BUREAU OF COUNTY COLLECTIONS COUNTY ..,............................................................................................,.....
HARRISBURG.PENNA.APPRAISEMENT FILE NO.................??::::.2.§::::~g?.?..........................................
Whereas,........................................G.~r.t.r..)J.q.~....W.~.+.&h....H9..~P:...................................late of ..........................9.~.f.~.?~.Y.1~................................................
in the County of ........................................W.~.~.h~.~gt..9.D:.........................................................Commonwealth of Pennsylvania,having died on
the ............................??.....t.P..................................................day of .................~~.~..................................................68 seized and possessed of an estate19............,
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore,I,W.R.Chaney an appraiser duly appointed according to law,......................................................................................................................................,
having been designated to make a fair and conscionable appraisement of the said estate,and to assess and fix
the cash value of all annuities and life estates growing out of said estate,hereby file the following appraisement:
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 AppraisementDescriptionofAssetValuesMadeforInheritanceTaxPurposes
$
REALTY:
All t.hat.~8rt.ain niece or narcel of land situate in the -
Borough of California,Washington County,.ta.and being
Lot No.20 which is of record in the Recorders Offica.00WashingtonCounty,Pa.in Plan Book No.1,page 11 10,000.
I
JT.HELD:
Savings Acct.#7110,Pittsburgh National Bank,California
Gertrude W.Holman H.-r::>
Pa••in the names of Mrs.or .c.ugene.
~l"\lm.<ln lJ 737.50
Savings Acct.#197,Western Pe.National Bank,California
Pa.;n t.he nRmes of Gertrude W.Holman or Oren W.Holman 768.74
Checkinl!Acct ••Western Pa ••National Bank,California,
Pa.,in the names of Gertrude W.Holman or li.Byron
Hnlman 998.35...
CheckinQ'Acct••Western Pennsylvania National Bank,
California Pa.in the names of Wm.Byron Holman or
Merrell Holman or Gertrude Hoibman.1,342.08
Total 3,846.67 3,846 67
Total 13,846 67
fonn~~v~~fhbl:e:::~:.w~~/~toIa:.~a~o~~~~yC~~~?":~?ee?a;li~~
praIser .
!~~~i ••••••••••••••••••••••••••••••••••••····;:~~.
f
....'
...................Wh$tq:NG:~Qr-J ......Coullty
RESIDENT INHERITANCE TAX APPRAISEMENT
Estate of
GiltTRUDE wELCH HOLMAN
Deceased.
Late oj
CALIFURNIA
Date of Death,..l'!1~y ?5"J.o9.f>.~L .
Appraisclllellt Docket Vol.,.3..7..
Page,+3.5.~5.No 93.::7.$.$::7J.o9.7?.
Filed in Register's 0 fJice,.lJ..~~<:>.l:>.E3.:r:::J.:.'19 9f3,.
Amount of tax due,$..
DEPARTMENT OF REVENUE
Received,
Examined and Approved,..
Wrote abo.ut Appraisement,
Appeal j,.om Appraisement,..
Entered and charged,.
Form RCC·IO DEDUCTIONS ALLOWED IN /
,.......".......$.u4...~Z~.~u{.["..
OFFICE OF THE STATEMENT OF DEBTS THE SUM OF
c REGISTER OF WILLS
Washington AND DEDUCTIONS DATE 72'"........:(3Z:=~~OF COUNTY
~~/,T #'2;~~f;~~.Y~c;i)~%~~9h~"'££~
Reglater of Wills,Agent
Gertrude W.Holman a(kLa California Borough,PennsylvaniaESTATEOFGertrudeWelchHolmanLATEOF
DATE OF FII.ING APPRAISEMENT /0-/-&,2 OATIi OF DEATH May 25.1968
DATE NO.OF NAME OF PAYEE REMARKS AMOUNTVOUCH~"
Columbia Gas Company,Inc.Gas bill 47 47
Bell Telenhone Telenhone bill 18 72
West Penn Power Comnanv Electric bill 14 72
Malcom Morgan.County Treasl rer 1968 Countv taxes 35 95
Califorhia Water Company Water bill 17 43
California Sanitary Authori1 y Sewage bill 14 28
Caleffie and Greenlief Funeral bill 1,257 50
W.Leroy Jones Funeral services 25 00
ICh'a;r l:e:r,o·i!:::::MO.:g.·~.~s.,eo..~cI:I9.s~pij;~a:lc:.J.Hosnital bill 14 29
Dr.Josenh Young Me dical services 61 00
Dr.C.Ramaswamy Med~cal services 180 00
Connellsvile State Hospital Balance of hOFlpital bill 3.CIU
Adam Koncik 1968 Borough taxes 34 77
Adam Koncik 1968 School taxes 132 11
Russell Marino.Reg.of Wil s Probate of Will~~.16 00-.,
FiliI g Inventory and Appraisement
Russell Marino.Reg.Of Wil s and D:,_&D 3 00
P~+Y'nno Ceisler and Edward:Attornevs fees 100 00
-
-
TOTAL 1,976 15
COMMONWEALTH OF PENNS:'LVANIA }
COUNTY OF -ph A 1 -*.)~~./
I,.'7~//'.//b _./~A/.~./.~~.aife HEREBY CERTIFY.THAT.TO THE BEaT OF
MY kNOWL.EDGE AND BEL.IEF,THE F EGOING IS A J~,;:z.d;tmNT ~:ERAI.EXPENSES AND EXPENSES',?P'
ADMINISTRATION SUBMITTED TO THE ESTATE OF •1~DECIlA.ED.AS DEDUCTIONS FOR
INHERITANCE TAX PURPOSES.-~~~Yd~(I..S.l
SWORN ANaUBSCRIBED I!IEFORE ME THIS --.2:l(~AYOP'
..IA ....J.4~'L.,!f
t7 ......././/~I Jd.-:;-z-/._.n?A>
PH~IS L.SHROYER,Notary ~liC
aliforniu,Washington Co.,Pa,
My Commission Expiro8
Jan uary 29,1971
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Form RCC-4-RI-3-66 ~9 COMMONWEALTH OF PENNSYLVANIA JlESIDENT DECEDENTS
949094 OFFICIAL RECEIPT
No.Transfer Inheritance and Estate Tax File No.63.66...107
Date Angust:26.19~
Office REGISTE~F WIllS.•'.WASitI!iO!ON Pa,
t#ASHINGTON County,ss:Received from 11iam By:ron flolma.n
(Executora~.t)mlD..~)of the estate of MRTfttJDli;li,.HOLMAN
who died !.nv 2S j 19--.Ji$the sum of SIX HUNDRED SEvnNTY..SIX and 62/100 .......-Dollars,...w.,
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 $On Account G~2¥-$712.23
$
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 tax if paid 3$.61
Administration $within 3 months after date of death $
Clear Value of Estate $1NC01:t'Pt.ETB Amount of Estate TaxAssessedunder
Valuation of Life Estates or Annuities the Act of May 7,1927.$
Date 19__$Add interest at the rate of %1
19__$from
Estate Tax Assessments $to
Date 19__$676.62
Total $19__$*As evidenced by Charitable Exemption Cer.tificates 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.L.1757,effective June I,1957,as amended
the life tenant or tenant for years,as evidenced by this receipt,it is understood that the Cam-by Act No.381.approv:d r.,11,1957,and Act No.207,1961,Section 302.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.SEALL ,.,.
lrOOD [P)[LD @£LfTE 31....135...5 I :-'?~.'~icPt,<~.L A?,.4--·~·~#"'1~b
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
Docket 37 Page l3fine S
Estate 01-f __OE_R_1'fR_._U_D_E_!1'_·_-_H_O_IJ_~_tU_l
OFFICE OF REGISTER OF WILLS
UASmr:Ol'ON p-------1_0.
Date August 26,19~
SIGNED AND SEALED AS PROVIDED BY
SECTION 1201.ACT APRIL 9.1929.P.L.343
AS AMENDED BY ACT MAY IS.1945.P.L.528
RUSSELL )1AilDJO
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 amount receipted for.The original of each suchreceiptshallbesignedandsealedbytheRegisterofWillsandtransmilledtotheexecutororadministrator.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
To
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ATftS.PATR01JO t CBISLml &mYJAnDS
80 ·&\81 CHESTNlrl Sfmmt
t1ASHII~C'lOn,pmmsnvAmIA ;15301
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