HomeMy WebLinkAboutOC1968-1099 - ESTATE OF BULLARDR CC-B'(2-64)
·COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
INHERITANCE TAX DIVISION
NOTICE OF FILING OF APPRAISEMENT
W'El\jDE:LL SiIvIPSON MOORE
(Executor o~~
IN YOUR REPLY PLEA8E
REFER TO 37-137-1
/'
In Re:Estate of ..;.,.AR:;.;.·C.:;,;;.H:.;:.;I:...;,;-B..;.,.A-=-L.:....D_H:..:..U..;.,.F_F_BU..;.,.L_LA_R_D--::<a/:...;k:.;;,!,/...,;;a_
______W_A_S_H_I_NG_T_O_N County - FHe No.63-68-1099
Dear Mr·Moore:
You are hereby notified that the original
appraisement in the estate of Archibald Hupp Bullard a/k/a
has been filed in the office of the Register of Wills qf Washington
County on October 10 1968 .Said appraisement reflects the
following valuations:
Real Estate _--'-......,..._
Personal Property ~4~.~1~0~5~.~5~6__'___
Transfers -..,.-.,..__
Total -;,.=4..,.,..:!:1..:::0~5.:...5~6~__
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.
Dat e ~Q..!.<c.l<.t~obl,l;e><Jr'___"l!o.l:O~•..........:1'""'9~6~8 _
Title W.R.GRANbY
DATE OF DEATH:July 19,1968
Note:This is not a bill.
;:
BULLARD,.AHCHIBALD HUPF'a/k/a BULLAliD,ARCH H•
FILE #63-68-1099
July 19,1968
SUMMARYRESIDENTDECEDENT
.../.;,.
RCC-39 (6-67)
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
I,the undersigned
#63 Washington
10-10-68
the real and personal
opposite each item'in
Tl.EPOllT OF INHERITANCE TAX APPRAISER
rluly 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 las t column to the righ t in Schedules "A","B","c"and "E"/-':.b&;~CL"":,,,-,-.J,~a...d:2:~=-pt..P-R-Ai 4'-,k0?-19-68
Dated:
FILE #63-68-1099
REPORT OF THE REGISTER OF WILLS
I,the undersigned duly elected Register of Wills in and for Washington
County,Pennsylvania,do r8spectfully report that I have allowed deductions in the amounts
claimed b;y 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.~
Dated:10-10-68 ~f2jL.C;ht~
REGISTrR OF WILLS
======:-
4,105.56
2,525.81 ._
1,579.75
~105.56
4,105.56
=g~l~22~,2~..8~1",,=.=;;;:....,...-_
1,579.75
VALUE AS REPORTED VALUE AS APPRAISED VALUE AS REAPPRAISED
$$$----~---
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 . • . . . . . .$---
ESTATE TAX ASSESSMENTS cI>.~------
TOTAL TAX BALANCE
PAID
$-------$-----~-
$
$-------
$_
$--~----
As evidenced by Charitable Exemption
Certificates issued by the Secretary
of Revenue.
CO~WUTATION OF TAX
$-----~'"C)~__~__
$=====:=
$-----
*=====~=
$------
TOTAL TAX
Less tax previously paid
BALANCE
Les~5%of tax if paid within
3 months after death
3ALANCE OF INHERITANCE TAX DUE
Add interest at rate of 6%from
to
AMOUNT OF ESTATE TAX ASSESSED
Estate ·tax paid
BALANCE DUE
Add interest at rate of 6%from
to
FOR USE OF REGISTER ONLY
T ax on *.__5)~$~~
T ax on $(§j64:c ~
T ax on !l;1.579.75 v.$---L.9=4..:...7J....,;8::.-.._,"--
Tax on $.15%$
E~emptions :=(:::)
T~tal Es tate------
fOR USE OF REGISTER QNLY 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.
Will lAdministration~No.Year .
IN THE
MATTER OF THE APPRAISEMENT
OF THE
ESTATE OF
ARCHIBALD .ltTJP.P...I3p:r..L.P.·.l1P ..a/k/a ..........................Deceased
~
Late of_.
County of
W.ALEXANDEH
WASHIl'GTON.....'.-.'.-...".'".'..-..~'-. -.-.-'.'.".-.....-..--,'.
Commonwealth of Pennsylvania
REPORT AND APPRAISAL
{'
'IPtllt"·Ofti~~'i"""""""""'''''''''''''·""",Penna.
Fonn RCC-2'·
"l"';':...COMMONWEALTH OF PENNSYLVANIA DATE ....................g.?~.??.~.~.....~9..:'.......~.?..§.?.............
DEPARTMENT OF REVENUE RESIDENT INHERITANCE TAX .................~c.t.~.!.?:.?~~??..................................BUREAU OF COUNTY COLLECTIONS COUNTY
APPRAISEMENT ....'
FILE NO...................??:.??:~.?.?..?.....................................HARRISBURG,PENNA.17127
Whereas,...................................Ar.gh;i..p..iU.d.....HJJ.p.P....;e.1ll.~.r..g .....................................late of .........................w..~.....A.+.~~~~.<::F ...........................................
i:~
in the County of ...................................,.......W?:§.t4..pg.t.9..P-........................................................Commonwealth of Pennsylvania,having died on
the .............................~.~....~~................'...............................day of ..........................~.~.~y.......................................68 seized and possessed of an estate19............,
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore,I,..............................~.~.~.~....9.h~<::.y ..............................................................,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
I the expiration of any estate for life or for years,the Commonwealth hereby expressly reserves the right to appraise and assess transfer
I
inheritance taxes at the lawful collateral rate on any such future interest.
Unit AppraisementDescriptionofAssetValuesMadeforInheritance
Tax Purpoles
$
R.EALTY:
NONE NONfJ
I PERSONA.LTY:
,
20 Shares of capital stock of Oakwood Estates,Inc.,a West
I
Virginia Corporation,registered in name of Arch H.Bullard 4,105 56
I
Total 4,105 56
I
fonn~;~"fJ,b~~~:~:.~~,'~~~~:~~o~:::i~~"=~;'~~~;~
/................................."Z ......~;.................................................................................(bor and Stnet)
/.A ./..-->/A 'A>.
............Yl~.§H.I..NG'r.9.N County
)~.,
RESIDENT INHERITANCE TAX APPRAISEMENT
Estate of
..........A?:9.1i~J3.A:l:'P....t.I.~:r.t.>.I?l!.~l!.':~J:)..~!~!c3.
Deceased.
Late of
W.~~lli.....•............•........•................••.
Date of Death,eJ..~y...+..9.-'~9~~.
Appraisemel!t Docket Vol.,.3..7 ..
Page,:L..:3..7~.:l,No ?J~.~.?-::::l,.9.9.9 .
Filed in Register's 0 ffice,..Q.Gt.9..Q.~r.),.Q".J9 f?$.
Amount of tax due,$.
DEPARTMENT OF REVENUE
Received,
Examined and Approved,..
Wrote abo.ut Appra.isement,..
Appeal fl'om Appraisement,..
Entered and charged,..
"
.J
J
LAST WILL AND TESTAMENT
OF
ARCHIBALD HUFP BULLARD
I,Archibald Hupp Bullard,?f West Alexander,·Washington Couzity,
Pennsylvania,being of sound and disposing mind and memory,do hereby.
make and declare this to be m{Last Will and Testan:ent,hereby revoking
First:I direct that all my just debts and funeral expenses be fully
paid out of my estate by my Executor,hereinafter named,as soon after
my decease as the sa~e may be convenient.
Bullard Moore,the sum of One Hundred Dollars ($100.00).
situated and located,to my beloved wtfe,Helen Ely Bullard,to be hers
and remainder of my estate,of whatsoever kind and nature and wheresoever
In the event my beloved wife,Helen Ely Bullard,
I give and bequeath to my beloved son,Archibald Hupp
I hereby give,devise and bequeath all the rest,'residue
I give and bequeath to my beloved daughter,Mary LouiseThird:
Fourth:
"t.
:Second:
absQlutely and forever.
predeceases me ~r,joins me in death'I hereby give,devise and bequeath
II
IIII Bu llard,Jr.,the sum of One Hundred Dollar s ($100.00).
I!
1
Ii
II~!I.
II
.11
,I
all the rest,residue and remainder of my estate,of whatsoever kind and
~,
.'
III
I
I.I
I
Fifth:. I hereby nominate,designate,constitute and appoint my
son-in-law,Wendell Simpson Moore,to be.the Executor of this my Last
Will and Testarrent,and direct that he be not required to furnish bond'
as such Executor.
I Moore,share and share alike.
IIIII!iII
I
II
II
.':',-.'....,.'
-,nature and wheresoever situate4 and located to my beloved son,Archibald,Ii
i.Hupp Bullard,Jr.,and to my beloved daughter,Mary Louise Bullard
·,
...,;;,"".....~.
._,-y"v...,.-'~;::~'~C-t
.,,;'".;~.-i;~t·-..__
IN WITNESS WHEREOF,I,Archibald Hupp Bullard,the testator
.-;.
herein named,have hereunto to this my Last Will and Testament,written
'Ion two sheets of pap~r,
.1
1
Ofh .1964.
I
affixed my signature and seal on this:?tl..day
The foregoing will of Archibald Hupp Bullard da ted the '"V
.'
,1964 was·signed,sealed,published and deClared by the
Archibald Hupp Bullard,·as and for his Last Will and
Testament,in the presence of us,the undersigned subscribing witnesses,
present at the same time,who at his request and in his presence,and
in the presence of each other have hereunto subscribed our names as
witnesses this }"V day of /~,(~_""1964.
j/(1
"-"".)
(
o
------------------------------....
Affi~auit (@f iExerutnr (@r A~mini!itratnr
KANSAS~tatt nf ~~t 55:
C!1nuuty nf JroitmcltlmlX\
Personally before me,the undersigned authority,a.N.Q.t.ar:;¥1?u.bli.c:in and for said
County and State,appeared N.§!.P..Q~.l.l S..i.IDP..$.Q.P.MQQx.e.who,being duly
sworn according to law,deposes and says that he is the executor oo~~~~of the estate of.H Bullard..AI:.cbib.al.d...HupP....B.ul~ar.d ...a/k/..a...AJ:cll/.....d.eceased,that {he foregomg schedules constitute a
complete inventory and appraisement of the real and personal estate of...AI:c.b.ib.ald...HUpp....B.ul~aJ;d
de~e.aeed,except real estate outside the Commonwealth of Pennsylvania;that the figures opposite each item
.'·r)l'~llJ ~~.rsonal .es~ate in the foregoing schedules are determined and state.d by the .undersigned to
/Q.f!e the'.falP.'of SaId Items as of the date of the decedent's death,based upon a Just appraIsement of eachI'-'lre~made ny,.above named Executor ~X
f ...'j~OT~I ",T'~..~I...('>c §.~~{.h'nzn~1ubscrzbed before me thzs.....::r................l '..._\~,.:daY aOft;~~~j~f:;r..C2'...19._..§.~v •••••••:•••••w.~~._....._
. . ....;:f.>..:II.~..{!~~·:/-2..3-7.2.-ADDITIONAL INSTRUCTIONS".
1.An.inve~tory must 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
lIuututnry aub i\pprais,rmtut of the goods and chattels,rights and credits which
were of h:E.9.h:t.p..~1.9 !:!.~l?.P.?..~-*.!.~!'.9..;Jate of .?.Q!'.9.Y.:g.h 9..t.:.w..~.:?..t.~-*.§;.~.~B.9§;.E.I...
Washington County,Pa.,taken and made in conformity with the ab01Je affidavit.
PERSONALTY:
20 shares of capital stock of Oakwood .Estates.,Inc.,a
west Virginia Corporation,registered in name of Arch
H.Bullard
REALTY:
NONE
DOLLARS
4105
CENTS
56
,.
1.4 .
I \.,,:_
'"....
~\,l :
"'-
63-68-1099
NO.~
Inventory and Appraisement
...-J
,.
?I 7
IN THE ESTATE OF
i ARCHIBALD HUPP BULLARD a/k/a
ARCH H.BULLARD
Filed ,19 .
"
=0rlj:-:JC)c::-
-(/)""'::1')--~-,ft....:...:..~.:
r-;"",
-"-..:a..=-':;-"
F::::-;
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(JW
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I..)-;
i ,
1O --'1"---J
-;:-.'1 j;--'_..::.:Ii!
f\)c::::J
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to
:J.J...YAGE ..1JJJ.~.oc)
SHERMAN H:'8!l'!:'iGEL,-;sf.ifi
215 Washington Trust Bldg.
Washington,Pennsylvania
INV.DKT
(2·64)THIS FORM REQUIRED IN ALL ESTATES WITH GROSS ASSETS UNDER $10.000.UNDER SECTION 701 OF ACT OF JUNE 16.1961.J
.NUARY 1.1962.(FILE IN DUPUCATE WITH COPY OF WILL ATTACHED).
OFFICE OF THE REGISTER OF WILLS
-WASHINGTONCountyof;.
. . . . . .WENDELL .SI.MJ?S.Q~.MOOM of .~~.~7.~~~;r:~~.,..~~.~I:~.t;<;i!..~?-~~~;;..?7.~~~..
(Name)(Address)
being duly SW_QJ;:Jl According to law,deposes and says that he is the ~~_~~_~!9E _./k/h 11 d (Exec.,Adm.,Legatee,Etc.)a a Arc H.Bu ar
of the estate oLAr9J1j,1;>_9.:1(~LJi~p.P ..!3_~;!._!~E~_fwhose last residence was ---------------------------------------------------------------Alexander (No.)(Street)
B_Qr.QUg.b..Q;L_W~_s_t __j ..deceased,and that the whole of the estate of said decedent,who died J.:JJ..l~---1.9-.,.---1~t6 8
(Ctty,Borough or Township)(Date)
consisted of:
REAL PROPERTY
REAL PROPERTY IN ·PENNSYLVANIA.WITH STATEMENT OF MORTGAGE ENCUMBRANGES UPON EACH PARCEL AT DEATH OF DECEDENT,
WHERE PROPERTY HEl.D AS JOINT TENANT OR TENANCY BY ENTIRETIES.GIVE NAMES.ADDRESSES AND RELATIONSHIP OF OTHER OWNERS.
Real Estate Estimated
Value
NON E
JAI.n~/()l P /C?f
".,t __
Tn-/31-/~7
I
Personal Property
20 shares of caDital stock of ()rl"..:I R~+-?It-.p~Tnf""rl W~t::+-
Virainia ~.;nn rea;..:I ;n nrlmp nf'2I.rf""h J,:f P."11",,rrl •,nlffY'
f(1Jv(
.,
NOTE:You may expedite the processing of this return by filing with it,and as a part of the return,
letters from financial institution~or mortgage holders,certifying to amounts on deposit or owed by the
decedent as of the date of death.Such letters must be signed by a responsible officer of the financial
institution or mortgage holder and indicate clearly amounts of principal and interest in the decedent's
account at the date of death and the'type of account,account number and the exact name or names·in
which the account is registered.
------.-~~---.-------=----~-~'.
Jointly Held Property .
NON E----------------------''-'---''<...---''-!----'''''-----------------------t--------
-----------------~---------------------------+-------
Transfers within TWO YEARS Prior to Death
NON E
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
IN WHICH DECEDENT RENTED A SAFE DEPOSIT BOX
THIS SAFE DEPOSIT BOX RENTED
IN NAME OR NAMES OF
RELATIONSHIP OF JOINT
HOLDERS TO DECEDENT
NON E
BENEFICIARIES
INTEREST OF
BENEFICIARY
IN ESTATE
SURVIVED
DECEDENT
STATE YES
OR NO
RELATIONSHIP
(If step-children or
illegitimate children
are involved,set
forth this fact.)
BENEFICIARIES AND ADDRESSES
(State full names of all and their addresses who have
an interest,vested,contingent or otherwise,in estate.)
===============================:::;:::::;:::;:;::::::;;:;::;::;::;::::;;;;:;:::::::;:========:::::;::::~~::::;:::;:;;:::;:=:=================
,-',($•/'
..",_i..1-
Leqacvson
Chattanooga,Tennessee
..-="='I::-T'Ir:-=-,---,..--:r;---=----:;--:;----:;-----:=-----l------------jf-------j--,.-------+-----------
....
,
"J •-','.~.:~'''.'''~··'f,[-·,,
Widow ,.-\...
-------------------l------------jf-------j--------+-----------
--------------------l------------jf-------j--------+-----------
-------------------+----------jf-------+--------+-----------
-------------------+----------jf-------j--------+-----------
----------'--------------l------------jf-------j--------+-----------
-------------------!-----------I-----'------+-------+-----------
RESIDENT DECEDENT
..
DEBTS AND DEDUCTIONS CLAIMED
NOTE'List first five items in the spaces so provided,observe notations thereon,and instructions
Funeral expenses paid'al Home'F'p-rrell ~
DEBT OR CLAIM NATURE OF SAME •'..AMOUNT THIS COLUMN,------------------,-------------------,------'--,--IDKEGISTER ONLY
$R7!:i!:iO $
Helen Elv Bullard Family exemption (will not be allowed unless
decedent died residing with a spouse or children.)1000 bo
,.,'H
Sherman H
~~
Sieael.Esa
Administration Expenses *Advanced
Counsel fees *
19 bo
200 bo
Fiduciary commission *
OTHER DEBTS AND CLAIMS
(*)See Note below
Louis C.Emeterio,M.D.Medical services
Peterson Nursing Home Nursing services
Wheeling,West Virginia
Stone &Thomas Merchandise account
Wheeling,West virginia
Ohio Valley General Hospi~al Hospital services
West Alexander Cemetery Opening grave
100 00
8 71 1I
10 00
104 70
100 00
20 DO
55 00
15 ~5
3 ~5
13 DO
"
"
"
"
Officiating at funeral
Medical services
Account due
Reverend Hawes
D.H.Hofreuter,M.D.
Bell Telephone Co.
West Penn Power.Co.
Columbia Gas of Pa.
Total 2525 n
(City or Town and State)
W~~a~,.A.._.~. ,~~j6~.
.8.927..w.a:r:r.en .
(Street Number)
Wichi~a,Kansas 67212
.,(.-:.
."Note:The estate'agrees to advise the Register of Wills if the amount actually paid in settlement of any fee,commission or debt is greater
.01'le~th~ah..~·&stimatedamount claimed and allowed.'~'.---.f •.:
"\..•....;J(''.:~....·····r ",
.~b~crihed..l\lld S~lq?t~before me this " .
-·..~OI~\C'l '7"~,..~:\'.''T.\-~C :_._,/r •._
...et>:'.,o'.~1.~diy of ..o~tqP.~;r:,19.E?~.~".'.0.~L~G..,;.:~.§.'...'i[.:'~~,.
.'.'*.',1..:::.:.,"'~~~.~.a..(.~.
'..-/....'\"'~"',·C'~C CJ·'•••,~.•_.a~M.t~··~At0<2·/-~3-?J..
Having been duly~or~_aC2?rding to law,I ~'ebY ~if~that the above appraisement is maf-n conformity with law on this
................A ..~dayOf ~..:4>!~....~~~uJ/.~...............~..fif.rAppr'el'
In the event that any future interest in this estate is transfeITed in possession 01'enjoyment to colla 'a heirs of the decedent after the
expiration of any estate for life 01'for years,the Commonwealth hereby expressly reserves the right to appraise and assess transfer'inheri-
tance taxes at the lawful collateral rate on any such future interest.
I,the undersigned duly elected Register of Wills in and for...~County,Pennsylvania,do respectfully
report that I have allowed debts and deductions in the amo s claimed by deponent,~.c t as to those items where a greater or lesser amount
is set forth in the last column to the right in said schedule above,which greater or 1~ft1'amo;£epresents the sum allowed as a deduction.
Dated:?!~../9/yb~.!••••••/J?~-<~..~~.
Register of Wills
,
,>
'y
/.~-,v •,-
,,,,\0 .")~'"'\)......'0
r~,-'..
~..~.,
\.,.J ."\,...
...J :-'./'1'r).--1L.",/~.•-.•",'...''-t-.'r-.,'
",i/l 1·1 Z~\,,'"'tJ,.,'i.,,\\'\
'r:ff'1Ii1tll\\
WillAdministration INo Year .
.r
IN THE
Form No.RCC-62 (2-64)
MATTER OF THE APPRAISEMENT
OF THE
'-
ESTATE OF
ARCHIBALD HUPP BULLARD a/k/a
ARCH H.BULLARD
Deceased
~Late of ~Qrp'q9h .Qf..~.~t.AJ..~~qJ.1s1.~r
22_0
I·~-J c..J~V;-!:,
County of ..wa~b.:JJng.t&n :..:..:..:.'.
~-;-I
()-..
Commonwealth qf:.PennsyJ.vania ilz--:')..---..~'.-;---,r-'-'-...IIW.....(.l'),""
REPORT AND APPRAISAL~v
I.D
SHERMAN H.SIEGEL,ESQ.
215 Washington Trust Bldg.
Washington,Pennsylvania
F Ree 4 HI 3 66 ~9 COMMONWEALTH OF PENNSYLVANIAorm- - - ---RESIDENT DECEDENTS
978989 OFFICIAL RECEIPT
No.Transfer Inheritance and Estate Tax FileNo.63....68-1.09..
Date Ot;tober.15 19~...••.....
Office REGISTER OF WILLS,WASHINGTON Pa.
!;]ASHINGTON County,ss:Received from t1endoll Si.mpson lioON
(Ex~c!-ltor,..z::~~iPfthe estate of ARCHIBALD HUPP.ButLARll,aka ARCH R.BULlABD
who died J·vl,.19 19~ethe sum of NINETY a.nd 05/100 _........- -.......- - -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 $1,579..:75 6~'it $'4v 78
Total $Tax on $l 15%$--------'---_
Personal Property Exemptions *$=============.
Date Valuation
1.0...10-68 $4,105.56 Total Estate $---------94".18
$Total Tax $_
Total $4~lO!h56 Less Tax Previously Paid (if any)$==========
Total Gross Assets $4,105.56 Balance $---------
Less Debts and Expenses of ..,tt4n 8'1·Less fi~e!'er centum oftax if paid 4 ..73
,.Administration $ .4 ......~iJ..withm 3 months after date of death $======'======
Clear Value of Estate $1.,519"'1.5 Amount of Estate Tax Assessed under
Valuation of Life Estates or Annuities the Act of May 7,1927.$---------__
Date 19__$_
Add interest at the rate of %__________19__$from
Estate Tax Assessments ----------------
to $============Date 19__$gO OS
Total $•.
____________19__$*As evidenced by Charitable Exemption Certificates issued by the'Secretary of
NOTE:In accepting the transler 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 Com-"b A N 381 d JIll 1957 dAN 207 .monwealth shall not be precluded or prevented from herealter assessing additional inheritance y ct o.,approve u y,,an ct o.,1961,SectIOn 302.
tax at the death of the lile tenant or tenant for years whenever it appears that such additional S E A~t)tax may be legally due and collectible for any reason whatsoever.I .
Lirn1D[P)[LO@£Li[E:37-137-1 /)~Z !J~<~.-1f-4~~~~~··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,H.Y.
J
FORM RCC-4-RI
TRANSFER INHERITANCE and/or ESTATE TAX.
RESIDENT DECEDENTS.
RECEIPT
Docketu3~7L'_Page 131 Ijnef_l,--_
Estate oLf_A_RC_Hm__"_A_LD_'_BU__P_P_B_ULLA_'_'RD~aka etc.
OFFICE OF REGISTER OF WILLS
tiASHINGTON Pa------'====;.;;:;..;=----'---_..
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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 )!ARINO
Register of Wills
1201 (g),Act of April 9,1929,P.L.343,as amended.viz:-"To receive from Registers of Wills all duplicatere-
ceipts for taxes paid to them by executors or adminis-
trators and to charge the Registers receiving the moneywiththeamountreceiptedfor.The original of each suchreceiptshallbesignedandsealedbytheRegisterof
Wills and transmitted to the executor or administrator.
whereupon it shall be a proper voucher in the settlement
of the estate.In no event shall the executor or adminis-
trator be entitled to a credit in his account by theRegisterunlessthereceiptissosignedandsealedbytheRegisterofWills:'
Fill in below name and address of person to whom
tax receipt is delivered:
A1T!~5HEm~t4 H.SIEGEL
215 1M ,5llIlffiTON TEUST BUILDING
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l1ASHINOTON,l'BNUSYLVAI'1IA '~15301
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