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OC1968-1180 - ESTATE OF TAKACH
'1J <l!tnmmonUtta1t4 of ,tnnSYlvania,} .£1.£1••aa~ingtol1 monnty, KNOW ALL MEN BY THESE PRESENTS:Whereas,at WashingtJn,III the County aforesaid on the 10th.day of September A.D.19 68 ,before me, Russell Marino ,Register for the Probate of Wills and Granting Letters of P_dminist[~tion in and for the County of Washington,in the Com:nonwealth of Pennsylvania, the last Will and Testament of Andrew Takach,Ajx/A Andy Takacs late of The Borough of Donora in the County aforesaid,deceased, (a true copy whereof is to these present,annexed),wa,duly admitted to probate;and '~John A.Takach ;:he Executor 111 said Will and Testament named,having appeared ')efore :ne and taken and subscribed :he oath of office prescribed by law; No\V,THEREFORE,I,Russell Marino ,Register as aforesaid,do ........,.srant these LETTERS TESTAMENTARY,unto the said :::07l1mitting unto John A.Takach Him the administration of all and singu'l2r the goods and ch:lttels,rights and credits,which were or said deceased,and requirins Him to exhibit 4 true and perfect inventory thereof into the Register's Office,at Washington,within ninetl I \ days ·from the date hereof,and to render a just and true account of ~aid acminist;'~tion at the expiratio::l of six months from the date hereof,and to regard and comply witl:the provisions of the laws of thbs Commonwealth reb.ting to inheritance taxes. IN TESTIMO:;-.JY WHEREOF,I have hereunto set my hand and the seal of said Office at Washington,this 10th. day of September III the ye.'ll"of our Lord one ·thousand nine hundred and Sixt'y.Eight ., ./ .......,.,-........\.. .. :... t '•. " I?~~~...........................................~'_.~L~:_ . Register ..-.......~"~/ _~J .....~.'....................,-~ .....'oS ,"'~.....-...' --_.-- t'. OJ ~! '~"" .- ,l.~ : ). \' iiritrr.a wrstamrntary ESTATE OF ...............Andre.w Ta.ka.ch . ~/K/A And~11~1ar~-............................................................................................................................ " ,;\'(.~··I "f11 ~•.; t~ (. t~ .t. t ",', \ "I ...L " -r•",r ,. \~ '. ". :....., ~,!'~ •d ,~\ • ,p I. i. ~~ ~2 r-'., 1 ""~~..· I"I,".I, ~ I.. -\ J 'j't \~'.~. ,.....,.....-,"~.-'.--"..-'.-•..•'.','.'.'.,-_',~.....r~""-/-,:··,···~"···,,.;-....'~'\~-":..•.'.!.-......-:~~;i.~"._>-.J~'"~~'..i'·';:·-·"'·":'·l"-=.,...:'"..~;...-:..:,;.~,_'~.~•..-r....,~~,.::.:•••.•_-'",',:·~.'.,.it··_~·;-..._~:~,,;.tJ'.;;~;..~,~,~...;.:.;.~,:~•.,;-..;,'~...~f .'~'~••"_'.-' .-'••.••_~._:-_......:._..~.;.-...._,..;...;..;.1_..;.~_.• _ 'w ,-'_.-._....--~..'-..........-~--.,;,-,......--'-_.._.---.............-....._...__._---=_. ~1"· LAST WILL AND TESTAMENT ....""r r....i~.....,... .~:'.::~~-. ,, I)ANDREW TAKACH,al's'o'knotvIl:as ANDY TAKACS ,of the Borough of Donora,Washington County,P,ennsylv,?-nia,do hereby make my Last ~]ill and Testament and revoke all ~7ills by.me at any time heretofore made. FIRST:I direct that all my just debts ~rid'funeral expenses be fully paid and satisfied,as soon as conveniently may be after my decease. , I .,,...,.'~','.. ,..SECOND:I give and bequeath my real estat~known'as part of Lot 27 in Block 17 of'the Union Impro·vement.Company's Plan of Lots in the Borough 'of Doncra,Washington County,Perinsylvania, upon ~hich is erected a four room frame house,to my daughter, Susan Stimm<,her'heirs and assigns. ...-. I!Ii .-.......:,.'..'~:'':. ., ".~ I give ane bequeath my real estate kno~~as of the sam~plan in.Dpnora,Pennsylvania,upon double'gare:geto my son:,John A..Takach,,his • _to ~.'t ... ....':'..,.' THIRD: Lot 24 in Block 17 vhich is erected a heirs and assigns. ,-.FOURTH:I give and bequeath my real 'estate known as, parts of Lets 22 and 23 in Block 17 of the same"pllm of lqts in the Borough of Donora,'upon which is erected my'residence as follows: .(a)Four-sixths (4/6)intere'st therein ,to my son Taomas A.Takach; (b)One-sixth (1/6)int~rest ther~in to my.son John A.Takach;. (c)One -sixth (1/6)interest therein to-my daughter,Susan Stimak. ,FIFTH:All the rest,residue and remainder of my estate,real and personal,I give,devise and bequeath to my wife Zuzi Takach,also kno~m as Susie Takach,for life,with the right to consume so much of the principal as may be necessary for her maintenance and medical attention.Upon her death,I give,devise and bequeath such residue as follows: i III I! '.....,.' It "•\'I...... ,i.;,t£~.,~':';f:;,·'~"";"~)'~i.;,..,.~~..,..~:..;y.;;;.;,·';':'::';':'~~'~:~~':·_"':'~;';~·i:~":".~~.,~:T~'ii--~-«~"~I;'*":~~~ff~~i;";~~.....~~~:''t}f.t!'~:~'(~:'".'''''~~~/:':/';;':':~''''~~'' ~1 ..,..;...'I "".i .~ 'f i:., .~IIi.. ~:j _._P---.-----)__~_--~__.-..._--.-:__.,_,_.__.__~_._._.~:-_.._...-:_,.__--~-:-...-~_~.._.....""...---.~_:--..-------.!,-.-._,i (a)The'SUill of $1,000.00 to my daughter, Anna Sabol; (b)All the remaInder thereafter I give, devise and bequeath to my four chi1d-. ren,Susan Stimak,John A.Takach, Th omas A.Takach and Anna Sabol, their heirs and assigns,share and share alike. SIXTH:I constitute and appoint my son,John A.Takach Executor of this my Last Will and.Testament. IN .WITNESS ~mEREOF,I,ANDREW TAKACH,a1so known,as, Jt..NDY TAKACS,the Testator above named,·have 'here'unto subscribed. my name and affixed my seal to,this my Last Will and Testament, consisting ~f .tv70 (2}pages,this 13/:t:j--day .of September,1963. .Signed ,sealed,puhlished and dec,lared by the above- named,Andrel:v Takach,also knov.TI1 as Andy Takacs,as and for his Last Will 8:ld Testament in the presence of us;who have'he~eunto subscribed ·:mr names a~his request thereunto in the pre,sence ·of the said Testator and of each other.- ~~_./'Q .. /~~;;?,~~ /!,.~qJ!tJl~QAtIM 1.__ .f-=.1\ I r ;,.. _,j ......"-.. ~.~..-'" J Affiitunit (@f Executor (@r Abministrutor .• ~tatt of tbnnnyluania.!'55:,cn~unty of lIan~in!ltnn 0,Personally before me,the undersigned authority,a.N9.!;.f.l.F..y :f..y.Ql1f.in and for said I ''. County and State,appeared ::JO'HN....A TAKACH :v\,ho,being duly sworn according to law,deposes and says that he is the executor mom~D.iKM«M:HtKof the estate of ,ANDBEW T4KAC,H gDs/s ANP.Y.T.8KA..C.S deceased,thattte foregoing schedules constitute a complete inventory and appraisement of the real and personal estate oL..A,ND.REW 'IAKA.CH , 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 d·::cedent's death,based upon a just appraisement of each item made by the above named Executor :A1lmirrisoxtN't 'd"Y_~;.~~~;,JT~'·4.,l~~.. 1.An inventory must be'filed within three month3 after appointment )f 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 OrigiLal 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 B.L.513 Sec.5.2,72 P.S.4844.2 ,.'were lJuuentnry nUll "pprat.9PttlPut of the goods and chattels,rights and credits which ".TAKACS·',of ,ANDREW T.AKACH .aL.k!..a ANDY.liite of t.he B.Qr.olJg!l of D.o.uQr.a :;.. ;:'VVashington County,Pa.,taken and made in conformity with the above'affida'TJit. CENTSDOLLARS , I=================================:n====r==========:i .REALTY None PERSONALTY ....,I;,~ .Savings account,Pittsburgh National Bank,Donora',} Pennsylvania,No.561 10,737.40 Savings account,First Federal Savings ~Loan Association of Monessen,Mon0ngahela office • .100 shares I~ternational Paper'C0mpany stock 200 shares American Cyanamide 'Company I .oJ /100 shares Scott Paper Company i 100 shares Campbell Soup Company ~ 100 shares Air Reduction Company 9,473.52 'I 3,275.00~ ,5,775.00 2,800.00 3,000.00 2,925.00 I",..r3 '7/(rCf ?Sif ~"2..-' i, I ,- ,..'~'.I't ,,; " .~.~-~g;'//Jb No.80S Inventory and 1ppraisement IN THE ESTATE OF ANDREW TAKACH a/k/a ........................~ANDY.TAKAC.S . Fil~d ::.,19 Q.~.. j' " ~~·f. ,. ·" ••~t " .. ~ ;'-, fuit.,.......J ~.I"~_~n1:::D 0(7')C ...;::,--c.n I ic.,)c.n r;:~i'~....,--- .V r--::Qr-~-;oQ 0-"'1;:,-0 m~:::o ::3;; ;=~:CJ10f:Sc.n 'I ..... l\.) -...J -\. (, \{, ~2 ,. ".;;:.. --- ..,.~..".~.I •, I , .--.-• i IN THE ORPHANS'COURT OF WASHINGTON COUNTY,PENNSYLVANIA IN RE:) ) ESTATE OF ANDREW TAKACH,) a/k/a A)lDY TAKACS,) ) Deceased.) I I FIRST AND FINAL ACCOUN':'OF JOHN A.TAKACH,EXECUTOR OF THE .. ESTATE OF ANDREW TAKACH.a/k/a ANDY TAKACS I SUMMARY: Principal: ! i Receipts $39,365.85I Disbursements 8,937.80 2.-$30,438.05 Income: Receipts $696.62 Disbursements 0.00 696.62 I ;\..MOUN'I FOR DISTRIBUTION--------------------------------$3l,134.67 I • '\.-I RECEIPTS Inventory and Appraisement Filed Assets Converted at a Gain Proceeds of 100 shares International Paper Co.stock @38.375 Less expenses Inventoried @ Proceeds of 200 shares American Cyanamid Co.stock @32.23 Less expenses Inventoried @ Proceeds of 100 shares Scott Paper Co.stock @28.625 Less expenses Inventoried @ Proceeds of 100 shares Campbell Soup CO.stock @31.00 Less expenses Inventoried @ Proceeds of 100 shar2s Air Reduction C·:).stock @31.50 Less expenses Inventoried @ $3,837.50 43.27 $3,794·23 3,275.00 $6,450.00 83.39 $6,36'£),61 5,775.00 $2,862.50 38.37 $2,824.13 2,800.00 $3,100.00 39.57 $3,060.43 3,000.00 $3,150.00 40.47 $3,109.53 2,925.00 $37,985.92 519.23 591.61 24.13 60.43 184.53 $39,268.85 ·- , -,.>,lr' DISBURSEMENTS AdministratiJn Expenses Russell Marino,Letters of Administration $28.50 Valley·Independent,Advertising 10.50 Washington Co.Reports,Advertising 14.00 Russell Marino,Filing Inventory 3.00 Russell Marino,Filing Account 16.00 John A.Takach,Executor's Commission 1,968.00 Barna and Barna,Attorneys Fee 1,968.00 Notary ?ublic Fees 7.50 Preferred Debts $4,015.50 Paul Macik Funeral Home,Funeral Luketich Memorials,Gravemarker Msgr.Michael Durisin,Services Funeral Refreshments Haven Crest Nursing Home,Final nursing home bill Dr.Barr,Final physician's bill Dr.H.J.Levin,Physician's bill Dr.D.S.Haver,Physician's bill Dr.J.Everett McClenahan, Phys ician's bill Family Exe~ption Estate of Susie Takach, Pittsburgh National Bank, Guardian $1,715.00 20.00 75.00 147.00 19.50 10.00 47.00 25.00 70.00 $1,000.00 I 2,128.50 1,000.00 '.....-I I ;.J Inheritance Taxes Russell Harino,Agent Pennsylvania Inheritance Tax $1,789.47 Less Discount 89.47 Other Debts $1,700.00 ~. United States Treasury West Penn Power,Final Electric bill Columbia Gas,Final gas bill Monongahela Water Comp~ny, final water bill $41.00 12.20 31.00 9.60 93.80 .,.......... $8,937.80 INC 0 M E------ RECEIPTS Dividends International Paper,3rd qt. Air Reduction Company,3rd qt. Scott Paper Company,3rd qt. American Cyanamid Company,3rd qt Campbell Scup Company,3rd qt. International Paper Company,4th Air Reduction Company,4th qt. Scott P~per Company,qth qt. American Cyanamid ComI=any,4th Campbell Soup Company,4th qt. Interest Savings Acct.,Pittsburgh National Bank First Federal Savings &Loan of Monessen $33.75 37.50 25.00 62.50 25.00 37.50 37.50 25.00 62.50 27.50 $139.73 183.14 373.75 322.87 $695.62 DISBURSEMENTS None $0.00 .·r .f.(~:-:· I i Washington County Reports. 6~ Was~on,PeDllS}'lvania (PUBLISHED BY WASHINGTON COUNTY BAR ASSOCIATION) Estate Notl,c,es The RegisIe!'of Wills has granted letters, testG.mentary or of administration,in the follooving est<.tes.Notice is hereby given to all perso::s indebted thereto to make paynent witho'Jt delay and to those ha'l- ing claims or demands to present rhe:n for settlemerrt to the Executors or Admin- istra:ors or their Attorneys. e 0 •••••• PROOF OF PUBLICATION In com;>liance with the Newspaper Adve:-tising J.ct of May 16,15'29,P.L. 1784 Sec.3,paragraphs (3)ane (25). C01Jl~",Y OF W:IUlHINGTON) STI.Tlt OF PENNsnVANIA (SS. 'TAKACK:,AND.TAKACS;Dec'd.REW.a/k/a ANDY Late 'oj'th BWashin"tone C orough ot Dono-Exeeut.:r:.rOh~u.:t~Penna.-a"•.Ave.,D')nora Pa'akach,430 Muray'Attorne:-s:B'arna'.r'&McKean·Ave D &Barna.Seventh..',onora,Pa. Personally appeared before me,a Notary Public It and fOJ said Cc·ur::ty and Co:nrr.onwealth,CHARLES C.KElLER,wh.),being duly swon:,depores and says:that he is the Editor 0:the WASHIW:.rrON :::OUNTY REPORTS,the officia~legal i=eri~dical for said Washington Cc.unty,pllblis'hed ;,"/eekly ha\'rng its place of business:at Washingten,Washington County,Pennsyh.ania,and is act- ing al its agent in this behalf;that the said WASHINGTON eel-INTY REPC'RTS w<.s established on March 31,1920"and wa designated as tne ,)fficial legal :Jublicati·)n for Washington County,Pennsylvani..,by orOOr of the several courts 01 said County,dated November 11,1920;that tbe printe·:!notice or adver- tisement attac.,ea hereto is a ceopy of a notice or adver:isement,exactly <.s printed or published,w-hi·:h appeared in the said legal periodical in its regular issues on the following dates: ..._~~.p.!~.~1?~,r.:;,9..,~.9..s J.9..9.8 , . October 3,1968 Sworn to and sutscribed'-.e.:.kli~IIlS.l!:U.----~ that t'ne affiant cr the corporation in 'Jehalf of which he is aetin&is not interested in the subject matter of s ..no··ce or advertisir.g ,v:t1:t all th alle~ati·)ns of this alfidavit as tIl the t'e,ce ;;.r~;J?ra.ctel o@~ubli _i.".ar ,r~ __JLt:t1--'.::::...:::...:::....:::...::::...::__=....::::.."'....__.=::::1 ,:\ ._.~.r.~~.~ay of...~.tQ.Q~.~._,196.-.8.. ......~_..~..~ •~.ry Public KI\THERINE C.YARD,Notary P,Ie Washingtol,Washington.Co.,a. My Commission Explr-es November 1,1969 .. • I ~-:....,.. .....i... ,':' ""!,Proof of Publication of Notice in The.Valley Independent· Under Act No.587,Appro¥ed May 16,1929;P.L.1784, as amended by Act.No.51 ~f April 24,1931,P.L.67 State of Pennsylvania County of Westmoreland }ss: Personally appeared before me William H.Pore,Secretory of Mon Valley Newspapers,Inc"a Penn- sylv::mia corporation,publisher of The 'valley Independent,who,being duly sworn,deposes anci so'"s that The Valley Independent is a daily newspaper of general circulation in Fayette,Washington and Westmd'reland counties,Pennsylvania,and elsewhere,published in the City of Monessen,Westmoreland Co....,t~,Pennsylvania,that it was established June 28,1902,since which date The Valley Independent has been regularly issued in s:::lid county,and that Q copy of the printed notice or publication is attached heretc exactly as the same was printed and published in the regular editions and issues of The Valley Independent on the following dates,September 13,1968 September 20 and 27.1968 Affiant further deposes and says that he :is General Manager of The Volley Independent,a doily newspaper of general circulation,Qncl as swch is authorized to verify the foregoing statement under oath,and Affiant is rot interested in the subject matter of the aforesaid notice or advertise· ment,and that all allegations in the foregoing statements as to time,place and character of publico, tion are true.~L*,Jr?~b," COPY of NOTICE 1 L·,·tlers tesiamentarY on the estate (1' And 'ew Takach,a·k·a And\,Takacs lat.ot Eorough of Donora,Washington Cou... 1v,deceased,haVing 'been granted bl"the Register of Washington Countv,no>Itice is herebv given to all persons indebt:d to said estate to make immedi tj ete ,avment,and to those having claim~ j 1Egai'st the same to present them with·•out jelav to John A.Takac"executo·. 0430 Murrav Ave.,Donora,Pennsvlvania eorra and Barna,atlornev,Seventh 8-t CKean Avenue,Donora,'Pennsvlvania. I',.9;13.20:.;1 ----,---------- CHARLES I,t PfNb'fa'fytJpOBIi(:iblic Monessen,\·'estllltJr~."lld VII"ra, My Culom,ssion Expires~.My commission expires __',~.I,,~".""''"'''-!rv!_74·--'1''''9.t...71~------ STATEMENT OF ADVERTISING COSTS: Barna and Barna,Attorneys at Law Seventj &McKean Avenue Donora t Pa.15033 TO MON V,A,LLEY NEWSPApERS,INC.,DR. For publishing the notice or advertisement attached hereto in The Valley Independent on above stated dates $10.00.. Notary ,:.....................................$.50 .Total $10.50 '. PUBLISHER'S RECEIPT FOR ADVERTISING COSTS Man Volley Newspapers,Inc.,publisherof The Volley Independent,a doily newspaper of general circulation,hereby acknowledges receipt of the aforesaid advertising and publication costs and certi· fies that the same have been duly paid. MON VALLEY NEWSPAPERS,INC. By STATE OF PENNSYLVANIA, WASHINGTON COUNTY,~55: ,.~ \'~,\",\...... .\.... The within,named Accountant being duly sworn :Jccording to law,depose and say that the above account as stated is true and correct as b~_.verily believe,s. . I ~C.~T~PHANA tlO~~~Cf(,Notary Publl' .-00n017l,Washington County,Pa. .-"'";11 y Commis~ion Expirlls ,.Jan.2',1973 f1=.g.~kLL . ';', Washington County,ss: .'"', I do certify that I have given'legal notice to all persons concer~~d of the filing of tne within account in the manner ~:.:::ifb;~e~\~t~~~~.~~~.~~lrJ~~~'._~.~.~~.i.~.~~ceby :Jroo~s Witness my hand and (.fficial seal thiS..~_ _ . day,if :~~;;19.4!. ..-~.~~. Register of Wills-~~~~~--,....~---;--~--~.............--.-,_..:'--~---.....,..,.......... ....o ciZ .~'....,...,'~~\f:"l~..~.........._....-_.,",.0.·..,.ot~~...1-0 I'::··N .'~"::l 0 oj \\~h (~~"''''~,0 ...,,0 I'l"•.•~._.........'!f........0 ::lP1:.,,.Q)0 ~FIf l Er),.<:l ....'-'d ...,0 '-' H I 0 <""...,.!ll::J!...... 'C Q)0u3'l(Q)6 ....<:)~·69.APR 2.-M\11 ...,>.I'lQ)0 Q)~rn '<3 I'l~1 I 0:Q)co,... ~i ...18 0 1IIPoa:...,I I 0 ...,,rj E-!l ...,~$-I:<a ~:f.-'......'It •M~fU~~O I'l co:~H f('~IC .~.~.t...~::l [:il l:Q:·\U'Ul:'<l,oI:~'-..,Ft...0~:Wi O~WlllS '-''C f.~~.1REtasTER'-'I'l~i J•••r '..oj oj '"0:~~i WASHHHHON CO.~PA~.,;I'l 1-0 ai """-'~.:a =Q)co:~:>1 ...,.S ..., rn 0:I .~...,'bJJ co!..0 oj~~Itli ...,s 'Q),.Q)P::a:~:~.<:l ,!::$-Iizl..., 0 ....co:A~i I'l I'::~0 Itl!0:~1 'C '-' ~I'l <i ... <0!........ .,"";~,-1-,:., '.",.:,.~ .,.• , f A'I "!t f ,-. ·f ...I"'"l..... J l ,,,, ""'.f, " 11 I \t.3-~-)'-//?(ji . ~(IN THE COURT OF COMMON PLEAS 1 OF WASHINGTON COUNTY,PENNA. i ORPHANS'COURT DIVISiUN !IIIi II IN RE: II II ESTATE OF ANDREW TAKACH iII II Deceased IIIIIij t \ !, ,-'",.I..'"\1 ..i'.... ".,,1 "r~t,I JL --QRQER QF_CQ~T_- - - - I ~!:n "--t ~/,..,,~.,... I ~~~!r;)VJ <i)~ ,\-'~,JI~~~ 1 ~~~ 1 ~'~~rn !-f'&7 E6 l..J c:J I ,~~•• f ~~~I ~"!\~"" .~~~dl~~J BARNA AND BARNA I ~ATTORNEYS AT LAW~I II,""\)~EVENTH AND MCKEAN AVENUE I "~DONORA,PA. I-~I 1 /;u.-'I'If i ----==--------~1'l~..:. ·IN THE COURI DF COMMON PLEAS OF WASHINGTON COUNTY,PENNSYLVANIA ORPHA:t\S'COURT DIVISION JIN RE: ESTATE OF ANDREW TAKACH, Deceased. ) ) ) ) ) ORDER OF COURT AND NOW,August 27,1969,upon motion of Paul N.BaIna, Jr.,Esq.,Attorney for the Executor of the Estate of Andrew Takach and the Pittsburgh National Bank,Guardian of the Estate of Susie Takach,an ircompetent,it is hereby ORDERED AND DECREEp that the Guardian for the incompetent shall be granted an extension of time of~..-:;;i!;-((;0)days from rhis date ro file on behalf of the .incom;et:int en Election to deceased. PETITION SUR:AUDIT IN THE ORPHANS'COURT OF WASHINGTON COUNTY Testa:e Form / Estate of.....AND.REW...'J'Al<ACH,....9.1k!~...ANDY...TAKACS Deceased No 6J::ri8:':.l.t8.Q ~. Dote of "Dote of , Decedent's death.._.A}Jgq~.t..2~.LJ9..6Jt _._Grant.Of tLetters..~.~.p..1?~m1?~.~lQ.LJ.~Q~- _.. .I.',, This is the Fir.st and..Einal _account filed 'in this estate! ,.I If there have been former accounts'filed in this estate.list file number ,o.r/t'1u'Jlb~r and term N.QXH~:. "'!i:'f".,.I'/...~___-..-.-..---__._---__.._--_.__-_.._----------__ ___---___-..-_-------_~-(_.-..-__._..___-_.._---_._.._---____,___. E'lection 'to toke Dote Election Place of; XkmlmHG:~~it.x(crossout one)Filed Record ,;. Did deceden.t marry .after execution of will?(jndi.cate)~,No.Any children born after execution of will?(jn.dicate).,' Xilli No,'If ~n~~e;'yes:~ame them :~.:.:_;__:_.. ,t.I...,.. ~:.,"...--_-..--_.-_.._----.._..---.------ ---- -_ --_ -..---:'·.-1 :-:.---.:.--.-..--_. L.egatees '., (..'.t.cr.,:1.1 1;0 l .....(..• Relationship Interest I Fiduciary,if deceased or not sui juris Life ,."" Susie Takach John A.Takach ThoIIlas A.Takach Susan Stimak Anna Sabol Widow Son Son Daughtet" Daughtet" Pittsburgh Nation3l Bank, Guardian Remainderman List,if exceptions to above:Adeemed:Revoked:Lqpsed:Abated:'Give Cause: None "-."'l.••t.I'."" If par!i:JI,intestqcy,give facts:t Nqne ," "..... I'"f' .. t •..I ...~,,. Notice to interested parties.Have all parties,having either vested or contingent interests and all crediors entitled to ngti.ce,<C:ourt ,Rule No,9:p.qr.ClgrapD"C::"Section 6:'S;~,qdivision c)received writtE'rinotice of the filing of the account and of call of audit?Yes,':mtotx ,.'.... If O!!y exception give,c.a~se:.,: : : . .......~ File copy of Notice .\...' and date of mailing.o May l.,19.6.9.......................•........!;:.::...••..,.•-..'.>" .-"-:-1 .~~.,'---..;;jl I Is estate subject to the filing of a Federal Estate Tax Return?X~.~,. Actual pay~ent made on Pennsylvania Transfer Inheritance \Tax.Amount $..J.,.7.9.Q.~.9.Q:. .Individuals paid own liability.:!" H the Will makes any portion of estate subject to a'life-estate,'give name and birth date of life tenant . Susie Takach,Widow;March 29,1884 •••••••,~_-oo _'••oo oo Give Names and addresses of all unpaid creditors ,who are legally ertitled to notice,together with the amounts of such claims;state whether they ore admitted to be correct;and whether the c1,aim is denied. None,except the Federal Estate Tax has not.been calculated at this time;' see further discussion under suggested distribution . .' Give reference to such parts of the will as require interpretation by the Court;a reference to all questions re- quiring adjudication,and a statement of any other facts deemed necessary for the preparation of the adjudication: ,,.,.( Balance for distribution per account,($10.00 error in Account) Itemize any additional debits not shown by account: Dividends: Air Reduction $37.50 Scott Paper 25.00 $..3.l.,.l2.4 fJ.Z . ';J" Total additional debits (Add) Itemize any additional credits not shown by account: $".__,__..62.~.5.0................. '$'' .2.88 \,'".'.' oo••- __~...........• $JJ...,.l~~.:.tt . Additional Inv.& Appraisement Total additional credits (Subtract) Balanc;~for di~tribution _ $2000 I ; Co. -......-·r'J If balance for distribution is not in cash,list each item held in kind,giving appraised Value (or distribution Value); ..~.,. Distribution is in cash. 0',.( , ... : i't: I'•I BARNA AND BARNA ATTORNEYS .AT LAw SEVENTH a McKEAN AVENUE DONORA,PENNSYLVANIA 15033 PA.UL N.BARNA PAULN.BABNA.JR.February 7,1970 John Hana,Clerk Court House Washington,Pennsylvania 15301 Re:Estate of And~ew Takach No.63-68-ll8C Dear John: I am finally in the process of settling'the above estate.The Federal Inheritance tax could have been saved if tie wife's guardian, Pittsburgh National Bank,would elect to take agai~st the Will.Ho~ever, they balked at this.In the meantime,Susie Takaci died on December l6~ ~.John A.Takach was named Executor of her estate on January 13,*1970, by the Itegister of Wills of Washington County.' The following is a list of additional income and expenses since the audit: have 364.63."$ 439.42 170.46 $1,974.51 c..1.I S'42 ~1t 01 $3,166.46 To ta1 ..................•. Federal Estate Tax return..-... Interest of Federal Estate Tax return,2 months .... 1969 Fiduciary'Iricome Tax return. EXPENSES: INCOME: Pittsburgh National Bank,1969 interest.4 Federal Savings &Loan Assn.of Monessen,1969 interest 4 Mellon National Bank,1969 interest 4 31.67 157.56 Total $3,355.69 ~- I am enclosing a copy 6f the Federal Estate Tax r~t~I£~~Can we reserve for an additi@nal Federal Estate tax,if the Internal Revenue Service deems any due,in the amount of $1,000.00? Sin~erely you::'s, BAR~:BARNA ___PN_B_jr_/_nJ_·e BY_~_~_-_"__I}_l_~__~__~-_ If Family Exemption claimed by Petition,give place of Record:In..acc.ount ,.. If Family Exemption is claimed at audit,give name,relationship and basis for Claim:~. List any advancement or distribution on account that has been made,and nature and amount of same: Suggested distribution of balance shown,both as to principal and'"income,attaching signed and itemized elections to take in kind if balance is not in cosh:residuary shares being st?ted in proportions: The Executor requests the Court to keep the estate open in regard to the ... right of the widow to file her claim f~r family exemption,as there is a complication arising out of the Federal Estate Tax return due to the COUNTY OF WASHINGTON,55: COMMONWEALTH OF PENNSYLVANIA. The above named Fiduciary or representative thereof, And yourl.petitioner,:,vill ever pray,etc. being duly sW~Qx.n doth depose and say that the facts set forth in the foregoing petition ore true to the best of b.;i,..$knowledge and belief.(..'.\I,••.'.',t .......swa;'£+...i ,O a~d subscribed before ;:~~s ..'j,";,;;.day oL M~:>'19..9.2..~(j ..,,~~.......... :Xg~~.of?0f;~~r _NQ.t~.~y.~J~;_:'iSigna~ur~.':~:d~:~n-7!_~_cL/.xK~f Offrcer..,;,__..-__. i ....."':'"...~:..,,'".r I Of .')••STEPHANA NO~AeK,Notary Publi(Jficeexplres·.····.J·····eonaf&;·WaSIri~~t61r·&'\7I111ty;·t>a:·············..··J,.'_,My Commi5~IOil Expires __ . ':...,w ".Jan.29,1973 r,- No._Q_~._:_R.6.7_118.Q ..___. Estate of.._AND.REW._.TAKACH~__.alkl..a..__.. .-<, -:. ;'\ "'.,, .....r•~\ -. "",.ANDY...'IAKAC.S-··--········---·--···D·~~~~;;~d-··........ Fiduciary_...J.QRN....~_!~A~.CR,._'_...._ ... .~ '--; :c ;,/ .,~,/-to •• I.,)fj "_'.'/.. . ," EXECUTOR........- - -_----__. PETITION SUR AU'DIT .FROM WHERE DECEDENT LEFT A WILL ;>. J ,~J. ,;";. -.,..' !"":.•'.~ ....., .~!." ~~. " ..' .;,.- " ~. .,":. ~,..-.i .r ! ...>\"1;: :O~6 W~h2 83.1 OL6 .-- dO 3.1.I j -'-"'V'd ..0 Q NaIS NIH SVM'"....-. SlllM ;;10 ~3.lS!~3}J ONIB\1~~t Yl3SSnCl -.... ....'~~. .•~._:•.,",J"~'','.,;,_,__,,'0 -:-.,,......"!..~:__<_'Io....,.....~_,. ...:.~(O,:""..,-.13 ~-- ...,.1"'....A-'.~v._~..........tW..!v.J ,.Att noy . .~2~ '"JS ',.'!.c.'._"._-:.~_~_ Counsel of Fiduciary will submit herewith the following,in•.conformity with Court Rules adopted effective December 3;1951,being .rule No~9:'paragraph b-c;and divisions .,thereof:shown on pages .23-2~.. .~1.Wrjtt~n praecipes of.all Counsel in thecase.- ..., >'.... 2.Copy of order·appointing Guardian ad litem,if pertinent. 3.Copy of.Orde~appointing Trustee ad litem,if pertin~nt.'. 4.Proof'of servi!=e of above. 5.Letters Testamentary or'Administration .'C.T.A.9r on_attest·copy of Will.. 6:Copy of inventory and appraisement..,.~......•f 7.ProM of advertisement of grant of letters if not filed witn 'account.-,.~. .~"'..... 8.Cer.tificqte of-liens "in c~se"any of the:', funds for distribution are from judl.cial sale of real estate. ..;.9.Signed (ind itemized elections if any distribution in k.ind. 10.Copy bf~f:ederal Est~te Ta~return if es- tate is subjecfthereto. .- ,. •0, <'~ ",IN THE ORPHANS'COURT OF WASHINGTON CO~,TY,P~.,~." Estate of ANDREW TAKACH,a/k/a ANDY TAKACS, Deceased. ) )No. ) ) 63-68-1180 of 19 : I. A.A.'. NOTICE OF FILING ACCOUNT AND AUDIT t ,.,."~". " -......... To the heirs,creditors and other persons ttit'eres'i:'ed in'said,.-, ".,'\,( estate: . Please take notice that the First and Final Ac~ouni ~f JOHN TAIQXCH,Executor ,.of the above estate was filed in the ',. Office of the Register of Wills of Washington County,Pennsylvania; on April'2,1969, ~ and is docketed to the above number and term.Said account will be presented to the Orphans'Court of the said Washington County,Pennsylvania,for confirmation and will be audited by the said Court during the week beginning on the third Monday of May 1969 at 1:30 o'clock P.M.in 'its Court Room on the third floor of the Courthouse,Washington, Pennsylvania,where and when,you may appear if you so desire. BARNA AND BARNA BY__~-:::--_--:-_ Attorneys for the Estate Dated:May 1,1969 Sent copies to:.. John A.Takach 430 MUrray Avenue Donora,Pa.15033 Thomas A.Takach 210 Fourth Avenue Monongahela,Pa.15063 ,', Ann A.Sabol 18320 Hart Street Reseda,California Pittsburgh National Bank Guardian of Susie Takach c/o Charles Enlow· Trust Officer Washington Trust Building Washington,Pa.15301 Susan Stimak 424 Fourth Street Donora,Pa.15033 ".... .. C';) LLJ,w..• " ,t .,,.,..~ .~-~r -l ..:~, '0.=:r ESTATE OF In t1Jt Q!nurt af Qtl1UU1Utn 'has nf lfaslJingtnn Q!nunty, Jtuusyluaniu,(@rpqans'Q!nurt linisinn 63-68-1180No._ Andrew Takach a/k/a Andy Takacs, deceased, In the matter of the First and Final Account of John A.Takach Executor ADJUDICATION AND DECREE ,. " 3~57.69 $31,124·67 2037.01 I $33,161.68 SCHEDULE OF DISTRIBUTION ,. 'r' And ,now ?ebruary at./J ,19....lQ..,this matter came on for hearing, audit and distribution att.,is session and testimony taken;and thereupon,upon due consideration :hereof the balan~for,:?stribution in :the han~s ~f the Ac.countant.is deter~i~ed to be $.'29,tJ03.'1 ,and:the account IS accordingly confirmed;and It ,IS ordered, adjudged and decreed that the said balance be paid out by the Accountant in accordance with the schedule'of distribution hereto attached arid made 'a part hereof,unless exceptions hereto be filed. sec.reg.:or'an appeal be toke!"herefrom sec.le9.', Balance per account 'as corrected, Additional debit asked at audit Additional credit asked at atidit Balancll::.e _$29,803.99 44.00 $29,759.99PJL4'1.Od r :<..~1-7~ L~~'~eU0.(. 1000.00 $28,759.99 52.66 $28,707.33 $27,707.33 I~_$'.t.'-/,.-~-ll-70 ,1940.70 7(~,~ $25,766.63 6441.66 6441.66 6441.66 6441 •65 No balance Deduct Clerk's Co~ts &Receipts,_ Attorney__--=B~a:..:::r~n~a:........::&::......;:B::.::a:..:::r~n:::::a::..,_ Zohn A,Taka.ch,Executor of the estate of Susie Takach,life tenant,now deceased,balance accrued income,to death of life tenant, ~ohn A:Takach,son,1/4 remainder, Thomas A.Takach,son,1/4 remainder, Susan Stimak,daughter,l/~,remainder, Anna Sabol,daughter,1/4 remainder, Anna Sabol,daughter,legac~l, John A.Takach,Executor,reaward for Federal ':Ua contingencies.After the tax is fully settled and the accountants liability ceases,the ba.lan e of this award remaining shall follow the balance herein distributed and no further formal acco t- ing to the Court,shall be necessary.1000.00 Russell Marino,Agent,transfer inheritance tax, "o.::r .en ," '.(" " I. .. •'f 1'.(- 1 , \J~ 0.....~~ :J Z tv n -+? i 0 :r ;-·c CD :J 3..,.0 -+ .........0 0 ~ .....~ ~ .., ~ 0..... -+ = :rCD ~& s~~~~ 2 the In preparing/Federal E;state Tax Return this weekend,we jll,st got the Forrr.;712 from the insurance company,:i discovered that the "tax would aIr,ount to $4,002.00.But if the guardian would elect to take against the will in this case,it would give us approximatel another $10,000 family exemption,and reduce the Federal Tax recorded by the stenographer). just seem a shame to use thiE much money. feasible.I have talked to the Executor anc Thomas Takach,he's A pparently,the life estate,from my investigation,would net Because we would like to save this $1700 . We will consider those matters. their mbther's welfare. this with the guardian and possibly with the Court to see if this is (At the direction of the Court,off-the-reeord discussion wC.s not qualify for the marital deduction under Se:::tion 2,056,and it would own trust fund,in agreement to ha'lle it as a back-up security for tOl $2300.00,approximately.And we would like time to discu3s balance that would go to the children,if they could create their in Court today,about this;and what we also propose is that the :5z0( ~~1IIZZIII II. iol-e>z :r1II0(~ ,.: ~lI: ti o oJ:5u C :l., :rl-I'N iiia:IIIl-ll:oII. IIIa: I-THE COURT: lI::loU oJ C u ii:lI.o I~ THE COURT:There are no claims against this estate? MR.BARNA:No,Your Honor,with the exception of the Feder I Estate Tax. THE COURT:Yes.Is there anyone else in Court interested in this decedentIs estate ? 3, -,"'".L (NO RESPONSE) ,TH;E COURT:....The audit of this account is markedclbs ed,by <'c'-,-'" • th~Court,with 'the:exception 6f the matter!?ai'ready mentloned in' the r"ecord. A UD~T CLOSED ~, z~..~~IIIa. i0l-"zi,.III..~ .?ti•EQ ~~ ij , ,.ii::J"\ ~< 01 " .....,.... .-"..";' •.'.'~",",.,".". ..'f......1...,•..:'I hereby certify that the proceedings and evid~rice.a:re cont~fnec;l,....,. use; c:~edings up?n the hearing of the .'Tbefore'going recotclOf the Ii ;,,/.II:•Ill,t',o',.,.,."i fully ar)~accUrately "in the notesta'ken.by me on the hearing of the abovec ,t&and ·thalthis ~§py 1s a cor~ect transc t o{the same: ~.'·i·~~~i -.nographer ;{.., •above catse is'hereby.appr<>ved and directed to be filed; '. -, '. ".i ,'. t'\,..-~,,~)' \J~-'''''. /,:;";. lJn tqr (@rp~anB··aInurt nf maB~in!ltnn C1!nunty In the matter of the Audit of Account in v Es.tate of .ANDREW TAKACH,a/k/a ANnv TAKACS TO THE.AUVl'l'lNLT JUDGE: ... .~, No.,63,-68-1180 ~ ,19__·_.A.A. of Andrew Takach.a/k/a Andy Takacs Ent~~':our appearance for John A.Takach·~·Executor of the Estate ". ;!... 'I ..........7 1-.19~ N.B.-Counsel shall,by separate paper.present a coucise statement of each claim,with supporting calculation of any interest claimed.Objections to an account as filed,shall be concisely stated in a separate paper. Council suggesting proper distribution shall file a separate concise state- ment in thllt regard. ,... No ~'63-68-1180 ~.. .19__•A.A. ",,",",r~ .~~ ~.~ fi. j In re Audit of Account in Estate of ANDREW TAKACH,a/k/a ANDY TAKACS \ ~'~"F .....:.-: ..AUDiT r, 'r~rripr fnr ~ppraranrr FOR .. -.J:OIDLA.TAKACH ~..c..uTQB.~_ ;....:'*~:: OF THE ESTATE'OF ANDREW TAKAGH,, a/kia ANDY TAKACS ., " ( i~;;.. I ~ • I ; r' ., .I Barna ariel'·Barna ," ~.2, " Attorney "(v "" .,...r Form RCC-3:J RESIDENT DECEDENT COMM:ONWEALTH OF PENNSYLV.'NIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLlECTI:>NS COUNTY OF .........WASHIN.G'rQN... IA~RTANT: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 dea~~,unless an extension is granted by the Secretary of Revenue.(Section 703 of th~.Jnl:).erit!ince...~n~:l.E.!!t!lte .'rax ~ct of 1~6L)'\. and sayS ..A.N.P.R~W...~.;~~.;.~.~:;'.:~~.;;'~.;:~C.S }::::u:v~:OF (State fuJI name of dec~ent) Late of .._Wa.shin.g.t.ou _Count3i ~ diY~·'f).·c:\/"--/1 ).....1./dr19-t.~'f ,tf3();h;,.A-tW-~. ..........................JOHN A..•.......TAKACH "~:.~:~::::::::....Eucutor '.of the estate of the above-named decedmt being duly sworn,d~pose S • S....of ._.J~g!l!l~Yll1_~l!.i"L_._.._._-_.._._.._.__.__.}SS: County of vla.s.h.l.ng.t..on... Decedent'dJoo Augu.s..t.28 ,19 6.8 ,f testate leaving a last wiH,copy of which is hereto attached.} (Month)(lIay)(V )·Lintestate o t herN::t:::i:::r:::r::e:tttao;;::;:}Barna..andBa'rna _........................ whom all correspondence should be...71::b.&..,.McKe.a.n..Avenue,DollO:ra.,Penns.ylvania ,.. mailed. That as such EX!itc.ut.O.r.deponent is familiar with the afhirs of said estate and the property con- (Jo:x"p.\Itor·Adminialralor). ,stituting the asset~thereof and :heir fair market value. That at the time of death there was no safe deposit bux registered in decedent's individual name,or jointly with,or'aa 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 , /'..i...,,None " That the contents of said safe deposit box or boxes are itEmized under Schedules of this .return,with the exception of the follOWing,for t:'e reasons hereinafter set forth: That Sc.hedule A attached h,ereto and made part hereof set;forth fullv and in"detail all tt~e real p~operty in the Commonwealth of Pennsylvania of which decedent :lied having an interest therein.It also sets forth the mortgage encumbrances upon each parcel of real property at the date of death,giving the amJunt still due at death,name of mortgagee,date.,rate of int.erest,and book and page of record thereof.It also sets forth in the columns prov~ded therefore the assessed valuation of each of said parcels,the estimated market '/alue thereof as of date of death of decedent. That Schedule B atta~hed hereto and made part hereof sets forth 'fully and in detail all personal property wheresover situated owned by the decedeT\t at the time of def.th;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 deposlt,savings banks,trust companies,or otter ins titutions,whether indiVidually,or in trust for any othe~person or persons giving also separately the accrued interest thereon,if any,down to the last interest day prior to decedent's death in t~e case of savings banks~and to the date of de~edent's death in all other cases;all bonds,postal savings,treasury c~~tific~tes or notes and other eV~d~nce or'in- debtedness of the United Stat~s to the decedent;all obligations,~hether by st~t~t~or agre~ment they are designated as tax free,of the United States,or any state,or political subdivision thereo~or of any foreign country,which are owned at the time o!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 by decedent,together with the fairly estimated market value thereof;all bonds and mortg8i:!:es hel,j by decedent and of all claims due and owing decedent at the'time of death,and all promissory notes or other instruments in writing for the payment of money' of which decedent died possessed,of whatsoever T.ature,with interest thereon,if any,giving the face value and estimated fair market value thereof,and if such estimated fair market value be less than the face vaLue,it sets forth briefly the reasons for such depreciation--as to each item;all moneys payable to the estate from life insurance policles carried by decedent;all annuity and endowment contracts the proceeds of which were payable upon the death of the decedent;and all the corporate stocks and divid.ends due thereon and unpaid as of the date of death,bonds and Elccrued iClterest thereon to the date of'dece- dent's death and other investlllent securities owned by the decedent e.t the time of death,wi th the market value thereof at such time. .Subscribed and'wo";'to b~ore me this ....:z:../~ ..~~~.:::~.~~~~....: In the ~ase,o~securities of close or family co~porations,the values reported are as far as possible substantiated.by financial statements of the corporations,showing the assets and liabilities the~eof ~s 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,~ts location,and such other facts pertaining to the l;JUsiness as may be pertinent to a fair and just appraisail.of the decedent's interest therein must be submitted.·It should also set forth in itemized form,-together'with the fair.market value•..•I 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 thereiry and in the case of transfers ofproperty,real or personal,within,two year~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 transf~rred,the relationship of the transferees to the deceden t,the proportionate share received'by.e~ch''transfe~ee and all otherfa,cts of a pertinent nature regarding said transfers.In'.th~'case"of,transfers intended to take effect in possession or 'enjoyment at or after death,there is also attached to the schedule'a ~o~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 ~aiue,which p:'l.5:ses ;~t decedent's death by virtue of the exercise by decedent,either individually,or jointly with anott.er,or any power of appoint- ment vested in decedent,either individually or join,tly,by tJ:1e w~ll,,.~eed,or other instrument of another, with a copy of,the in~trument creating such power attached to the s~hedule. I,•.1 l I ••"!1 J '•• 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 ~ith 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 show!ng which of the beneficiaries named in the decedent's will,if any,died prior to decedent,the dates of their death,their issue,and the relationship of such issue to the beneficiary. That Schedule E att~ched 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 "-'j '.'.of the.decedent and others,plus the date and place of record of instruments effecting the vestiture of .r.eal 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 orgravemarkers,and reli- gious servi~es,in consequence of the death of the decedent;debts and claims owing and·Impaid at time of '1lirlI '••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 a~y.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 amou~t 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 colunms in Schedules "A","B","en,"E",and "F"as directed·,therein,. have been carried forward and properly registered in the Summary• ....~..~:.:.,~~_.r::··"......(E;;ecutor-Administrator) ......'T3·c?····~:t~~b~~·..!··············_····_~,· ..........:»~.41..-..t ,£.{fL L . (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 unlisterl securities, .;ecuritie~·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 colunm #1 in the "Summary"has been properlY completed as above-directed. ,I.~ Rc.9-34 ('-64) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS TRANSFER INHERITANCE TAX RESIDENT DECEDENT' SCHEDULi:IIA'" /.~EAL PROPERTY Real property in Pennsylvania,with s~atement of mortgage encumbrances up.on each parcel at.death of dece- dent.Where property heid as joint tenarit or tenancy by entireties,report on Schedule "E".Property held by the .de.cedent·as tenant in common with another or ot~er.s,snouldbe identified as to quantum of interest and the es~imated value should be that of the decedent's interest only. ! The real propert),located In the Commo!'wealth of Pennsylvania shoul~be (1)(2)(3\Idescribedbybt:Jnd block number,street ane!street number,together wi th DEPARTMENTageneraldescri~tlon of the property,with a reference to the re,:ord of the ASSESSED VALUE VALUATION conveyance b)'which the decedent took title,:If a farm'state number 01 a·FOR YEAR OF ESTIMATED CAUTIONcres;also statement of mortgage encum~ranoesupon each parcel at death DECEDENT'S MARKET VALUE (Do not writeofdecedent.Ta,ces,assessments,accr.ued Interest on mortgages,etc.,are DEATH In this spoce)to be listed on S:hedule IIF"and must not b!l deducted.from thi s schedule. None',., I , . .' . , I I, , .. , . ... I "",. Insert this;total opposite "real property",Schedule HA"in the 'X X X X X "A's Reported"column on the la.st page of this return. ReC-55() COMMON~Et~TH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDlLE "n" PERSONAL PROPERTY .~'~ INSTRUCTIONS:This Schedule must disclose all tangible and intangible personal property owned individually by the decedent,at the time of his death.Property owned by the decedent jointly with another or others must be listed under Schedule "E".Inta~gible personal property,titled in the name of the decedent,but payable at death to another or others,including but not limited to P.O.D.U.S.Savings Bonds and tenta- tive trust accounts,.must be listed,despite the fact that they are not of the administered estate. Tangible personal property should be'listed first (e.g.jewelry,wearing apparel,household goods,and furnishings,books,paintings,automobile;,boats,etc.) Intangible personal property,such as bonjs,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,?artnership interests,interest in any undistributed es.tate 01'.or income from any property held in trust under the will or agreement of another,even though located outside of the State,at the time of death,should be listed in this schedule. Item No...,.. ITEM List and describe fully UNIT VALUE ESTIMATED MARKEl'VALOE DEPARTMENT VALUATION (Do not write in this space) 1QO shqres Campbell Soup Company 30 100 shares Scott Paper Company 28 200 shares American Cyanamide Company 28 7/~ 100 shares International Paper Company stock 32 3/4 9,473.52 t?Jt /~j. 3,275.00 !C <) 5,775.00 2,800.00 It~ 3 ,000 .00 rtJ 2,925.00' 10,~~~o/~~. 29 ]/4roosharesAirReductionCompany Savings account,Pittsburgh National Ban~ Doncra,Pennsylvania,No.561 - Savings account,First Federal Savings & Loan Association of Monessen,Monongahela office 1. 2. 3. .4. 5. ~,..6. ~~r'..~ Insert this total opposite "Personal Property",Schedule "B"in the "As Reported"column on the last page of this return. x X 37,985.92 !fRCC-3D comroN'I'E,\LTH OF PENNSYLVANIA Tfu\NSFER INHERITANCE TAX ~~SIDENT DECEDENT SCHEDULE "c" TIll\.NS?ERS (1)Did decedent,wi thin two years of death,make any transfer of any material part of his estate,without receiving a valuable and ade~uate consideration therefor?(Answer yes or no)__ (2)Did decedent,wi thin two years of death,transfer property from :limself to himself and another or others (including a spouse)in joint ownership?(Answer yes or no)_ (3)If the answer to (1)or (2)above is in the affirmative state: (a)Age of decedent at time of transfer _ (b)State of decedent's health at time of m'aking 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 the~efor which was to take effect in possession or enjoyment at or after his death? (AnsYter yes or no)No (a)Was there any pos3ibility that the property transferrec might return to transferer or his estate or be sUbj~ct 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 '/aluable and adequate considerat:lion therefor under which transferor expressly or impljedly reserves for his life or any period which does not 1n fact end before his death: o(a),The possession or enjoyment of or the right to income fram tht'property transferred? (Answer yes or no)N~o~_ (b)The right to designate the persons whc shall possess or ,enjoy the property transferred or income therefrpm?(An~wer yes o~no)No , (6)If the answer to (5)(b)above is in'the affirmati'le,state whether the right was reserved in decedent alone 0:-others -'------:-_ (7)Did decedent in his lifetime Jlake a transfer,the consideration for which was transferee's promise to pay income to or for the benefit of care of transferor?(Answer yes or no)_'~N~o~__ (8)Did decedent,at any time,tr9.nsfer property,the beneficial enjoyme:nt of which was subject to Change, because of a reserved,power t,)al te,r,amend,or l'~voke,or which cOl:ld revert to decedent under ter.ms of transfer or by operation of law?(Answer yes ')1'no)No (9)If the answer to (8)above is in the affirmative,was the power to E..l tel',amend;or revoke the inter- est of "he beneficiary reserved in the decedent alone or the decede~t and others? (Answer yes or no)__ NOTE 1:The answers to these questions should be supported by affidavit by the attending physician as well as a copy of the death cert.ificateo 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 vai.ue 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 ~re 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 ~hich provided in Echedules A,B,or E. ITEM DESCRIPTION MARKET V.I\LUE (Estimated)DEPT.VALUATION (Dept.Only) Insert this total opposite "Tr'ansfers",Schedule "C"ir.the "As Reported'"column on the last page of this return. C~M\I\''\vi,'\Ll'Il Ul.'1'l.::NN~YLV'\NI.\ ::\\:\:'::·:n r~HI':JU T.\NrE TAX ~CI!E[(JLE "E" ,JOINTLY O~\'NED PROPERTY DiSTlU'Crwxs:This schertuJe must disclose aU property,real ann personal,ol'nerl by the rlecedent Jointly "'ith tlnuther ur others,includinp;intangibles,sta,ding in the namp.of thE decedent II.nd others.List real t'state first,as entireties,or joint tenants,giving brief rtescripUon,as inriicated Imder Schedule "A",plus the date anri place of record of instrwnent effecting vestitllrp.,llllt rio not include entireties or out of st.ate real estate value in estate va]uatir:n column.PersonlJl prollerty shoulrt he listed as 1n Schedule "B",plus date of acquisi tion,and the namE,adrtress /tnri relationship (if any)of co-owners to the riecedent. • Descr1Ptio~of Property,-Date of A~quisit'ion,NRm~T[Jnit --1 perce-~t~ge E~'t~te Addre!>s anrt RelaUonship of Co-Owners,and Place ,Value Shure ValuaUon of Hccord of Instrument,where Real Estate.i DEPARTMENT VALUATION CAUTION-Do not Write In This Spaee. Value of Value of Entire Decedent's Property Interest l r-i ·,1 958.00 1(, [L,727.20 CiL ) ~,353.00 fI~nI468.40 938.40 i \\ 469.20 1,377.00 1,838.40 1,798.40 1,295.40 1.U.S.GOVERNMENT SERIESE BONDS IN FOLLOWING'JOINT NAMES,DENOMI-1NATIONS,&DATES OF PURCHASE I IA.Andrew Takach or Susan Stimak (Dalgh~e~) Thousand ($1,000)Dollar Denomina~ion 1 bond purchased Feb.1962 958.0) 2 bonds purchased August 1964 a63.6) Five Hundred ($500)Dollar Denominatiol 7 bonds purchased Feb.1962 ~'j'9.0) 1 bond purchased May 1962 ,~68.4) 2 bonds purchased July 1962 ~69.2) 1 bond purchased August 1962 ~69.2) 3 bonds purchased Sept.1962 ~59.0) 4 bonds purchased Jan.1963 ~59.6~ 4 bonds purchased May 1963 ~49.6D 3 bonds purchased June 1964 ~~1.8D One Hundred ($100)Dollar Denomin~tion I5bondspurchasedAugust196293.8~ 5 bonds purchased Sept.1962 91.8D 5 bonds purchased Jan.1963 I 91.9 0 2 bonds purchased Aug.1964 I e6.3~ IB.Andrew Takach or John Takach (So ) 469.20 459.00 I 459.60 i 172.72 t 1~,.783.92 ~4h-y , II I Thousand ($1,000)Dollar Denomin tion ! 2 bonds purchased Feb.1962 58.0 ~;916.00 2 bonds purchased Aug.1964 63 ..6 a.,727.20 I Five Hundred ($500)Dollar Den11'nati n I i 7 bonds purchased Feb.1962 79.0 ~,353.00! 1 bond purchased May 1962 ~68.4b I 468.401 2 bonds purchased July 1962 ~69.20 I 938.40 1 1 bond purchased Aug.1962 69.20 I 469.20. 3 bonds p~rchased Sept.1962 59.0~~,377.001 4 bonds purchased Jan.1963 59.6 1,838.40, 4 bonds purchased May 1963 49.6.~,798.40i 3 bonds purchased June 1964 31.80 ~,295.40i One Hundred ($100)Dollar Denomi,atioh !! 5 bonds purchased Aug.1962 I 93.8~469.201 I 5 bonds purcha~ed Sept.1962 !91.80 :459.00!i 5 bonds purchased Jan.1963 I 91.9~I 459.60;i 2 bonds purchased Aug.1964 1 86 .36 If!J\'172.72 1 I I 'X ~~,741.92 l~.,370.'hl,fMo-~'rn./~7 II/v '~~v '_____-'---'--_-.JL_·-.--I i I Insert this total opposite ",Joi.ntly Ownt'd Property",,",cl,edule "E"L I in the "As Heported"column on the last pa;.;p.of this return..~J ~I Rr~IDENT nrCEDENT CCMM0\WE \UII UF i'[::r\~~Y:.nN L\ THMi:-,n:n f\HEHI T \~(,F T.\\ RCC-38 ~.• •,#.." SCHEDULE "r'o JOINTLY OW~ED PHOPERTY I~STllrCTIO~S:This scht>,lule must disclose all pl'operty,real and personal,owner!by the rlecedent jointly wi th another or others,including jntll.n~ibles,standing in the name Qf the decedent and others.List real estate first,as entireties,or ,joint tenants,gtving brief r1escription,as indi.cated lmrler Schedule "A",plus the dute an(l place of -ecorrl of instr1UlIent effecting vestiture,but do not include entireties or out of state re<t.l estate vallie in estate valuutio"l column.Personal property shoulrl be listed as in Schedule "8",plus dllte of acquisition,and the name,address amj relationshlp ,(if any)of co-owners to the deceden t. >>>> Description of'Property,{;flte of Acquisition,-Nil-me I unit Address flIlrl Helationship of Co-Ol'ollers,and Place I Value of RecoNl of Instrumeflt,where Real Estate., -,"-;:;;:;:-X', v >( percentage Estate Share Valuation DEPARTMENT VALUATION CAUTION-Do not Write In This Space. Value of Value of Entire Decedent's Property Interest C.Andrew Takach or Thomas Takach ,(Son) rI.,916.00 [,727.20 115,783.92 }';~~~ 2,395.00 938.40 469.20 1,379.00 468.40 1,838.40 1,798.40 1,295.40 469.20 459.00_:-;0. -459.-60--.- ;172.72 , \ Andrew Takach or Anna Sabol (Daughter Thousand {$l,OOO)Dollar Denomination 2 bonds purchased Feb.1962 e58.0D 2 bonds purchased August 1964 863.6) Five Hund~ed (S500)Dollar Denominati)n 5 bonds purchased Feb.1962 479.0) 2 bonds purchased July 1962 469.2) 1 bond purchased Aug.1962 469.2) 3 bonds purchased Sept.1962 459.0) 1 bond purcbased May 1962 468.4) 4 bonds purchased Jan.1963 459.6) 4 bonds purchased.May 1963 449.6) 3 bonds purchased June 1964 431.8) One Hundred ($100)Dollar Denomipatio~ ,5·;ponds,;.pur.:hased Aug.1962 93.8~ 5-bonds -pur::based Sept'.19621 -91.sb".- 5 bonds purchased Jan.1963 i 91.9~· 2 bonds 'purchased Aug.1964 86.3) D. '~ ~-..-_.- Thousand ($1,000)Denomination 3 bonds purchased April 1967 772.8) Five Hund~ed ($500)Dollar Denomlnati~n 10 bonds purchased May 1962 ~68.4~ 6 bonds purchased Jan.1963 ~59.6D 2 bonds purchased May 1963 ~49.60 4 bonds purchased April 1967 386.40' One Hundred ($100)Dollar Denominatio~ 5 bonds purchased Jan.1963 91.9D II II II! 12,318.40 4,684.00 2,757.60 899.20 11 ,545.60 1459.60 1p,664.40 )/A~~~. )'1(1'I I I I !I I III i I i &{ /' l1' I I I I !iII Insert this total ,opposIte "Jointly Owned Pro]jlerty",Schedule "En,~."in the nAs :teporled"colUIm on the last page of this return. ~!, RCC-37 (12-63) COMMONWEALTH OF PENNSYYLANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "0" .. BENEFICIARIES BENEFICIAR~ES AND ADDRESSES RELATIONSHIP SURVIVED(If step-children or DATE INTEREST OFStatefullnamesandaddressesofall~ho illegitimate children DECEDENT OF BENEFICIARY ave an interest,vested,contingent or other are involved,set STATE YES IN ESTATE Rise,in estate)forth this fact.)OR NO BIRTH ZUZl TAKACH Widow Yes 3-29-g4 La.'H; ,• Donora,Pennsylvania .. JOHN A.TAKACH Son Yes g-?1-?1 430 Murrav Avenue Donora,Pennsv1vania THOMAS A TAKACH Son Yes 1 ?-10-?0 Monongahela.Pennsv1vania f.rGi. SUSAN STlMAK Daughter Yes 10-14-24 4?4 Fourth Street· Donora.!Pennsylvania ANNA SABOL Daughter Yes 9-29-18 .18320 Hart St·reet ......:'::....."Res·eda,',.California , , , , ( h Deponent further says that all the above-named beneficiaril.es are living at this time except below: NAME DATE OF DEATH RESIDENCE " ~. Late of Do.no.r.a.,.Penns.ylvania... .~~~:..;~ ." tJ -. .", ,.' .)!.~j;.(Executor-Administrator must complete "As R~ported"column #1.) CO)....:j '"d ::c......ct>ct>0 I\>...e.VI ::l VI VI VI 0.....::l '"d....:j ct>e.......0I\>VI;.<'"d "dI\>ct>CT'...... r0-o q"d t'%:I ct>......~'<I\>...ct>' > ,." N~:'"en:~:c:~ ~:>l:J):~nW~~....c:f'?"~.~ M q ~>;:------ 000 ~.000 000 000 000 -:>VI \0 0'\\...>::c_:co a ,.....".ct>_ :..;....'5-...,1.1.\0 ~"-0 ...-:0'\"-J :co C1: :0 :.p..:VI o~.-..:.:.... :0 i-'\0 0 :·1 I :co 0\:N 0~I. ;, L Y~1. ;:) .~.. '\<\ ."),,? ~( S .'• '1.',''',,. I.} 1-., ,- ./t ,~ -'; ~.\'.·1 e- '~' .~~. .. r--\ \-',~ G -- ,.'t~ rv -<oj "':! r ....t.- Year '.1.. ..~ P.Il THE OF THE ... ::-::'Jr--~:rO if> ,--: ESTATE OF ~...., {--(.....,~(..0-"f ,.-7-.'- .... ..W.C!.~htpgt:qn .,....~.:.:;"..... REPORT AND APPRAISAL....( 1 (-<• ~IATTER OF THE APPRAISEMENT , I..'~ ANDREW TAKACH a/k/a ANDY TAKACS.·.....................De~eased .....; "Commonwealth of Pennsylvania County of Will t N Administration)o. ,. ~/ ."'".,: '~( s· ::,' '- .-,.. ....J ,.... -.' .--.... ..~:~.?L.o! "'~'-:... 000000 000 oOO-fP.'oOO '~r':~::>:r. ~~::..0:'~:.:~:~-:~:!~:C'::t--.:J..,- ~:,3 II 't •~<:~:~..~ ~c.. ~::~:,., I-----.-_...--.....C".o~·-') ~C(-8t (2-64) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF R!EVENUE • BUREAU OF COU/IITY COLLECTIONS INHERITANCE TAX DIVISION NOTICE OF FILING OF AFPRAISEMENT IN YOUR REPLY PLEA8E REFER TO 37-144-2 J I.~. f I II JOHN A.,:,AKCAGH (E~ecutor ~~. In Re:Estate of ANDiE~'"TAKACH ~aik/a _____.,-.:W..:.:.;A=S::.:H'-=I.:.:.NG::::.T:.:O~I'J::.......,County -F.ile.No.63:"68-1180, Dear Mr.Takach: You are hereby notified that the original appraisement in the estate of .Andrew Takach alk/a has been filed in the office of the Register of Wills qf Washington' County cn December 6 ,1968-.Said appraisemen~reflects the following valuations: Real Estate _--'-_---------- Personal Property -~37~,9~.8~5LL.9~2~.-- Transfers __---,-_-_---- Total ...,......_"""'"""3..L.7..L19~8~5:..:.~9.:::.2__ As to such tax that is pa1c within three death,a five (5%)percent discount is allowable. remains unpai~after one year from date of death, of six 16%)percent.per annum is charged. months·from date of As to any tax that interest at the rate . Any party in interest who ~s aggrieved by an appraisement may appeal Jherefrom as provided by ,law. Itat e _--=D::..:e::..:c::..:e~m~b~e~r-:::.6.L'.,...::1=-9c.6~8:::..-_...,....-__ DATE OF DEATH:August 28,1968 Note:This is not a bill. ·Sig~ed&RC'La<:J'Q ~ Title W.R.CHANEY.CHIEr:-APPRAISER ~---------~--------------~~ ................--.. SUMMARY TAt.:ACH,ANDREW a/k/a TAKACH,ANDY FILE #63-68-1180 August 28,1968 RESIDENT DE':EDENT RCC-39 (6-671 .....-'_..&4....", CO.MmoNWEALTH OF PENNSYLVANIA •TRANSFER INHERITANCE TAX I.the undersigned #63 Washington FILE #63-68-1180 the real and personal opposite each item in flEPOHT OF INHERITANCE TAX APPRAISER cl.uly appointed Inheritance Tax Appraiser in and for the County of ,Pennsylvania,do respectfDlly reT-ort that I have appraised property as reported in the foregoing return at the values set forth the la.st,column to the right in Schedules "A"~"B","C"and "E". 12-06-68 .08-28-68 Da ted: REPORT OF THE REGISTER OF WILLS I,the undersigned duly elected Register of Wills in and for _ COl,lnty,Penns.ylvania,do 1"~3pe(:tfully report.that I have allowed deductions in the amounts claimed by deponent,except 'l.S to those ~tems.where a greater OT lesser amount is set forth in the last column to the r:ight in Schedule "F",which greater or lesser amount repres.ents the sum allowed as a deduction. Dated: REGISTtR OF WILLS VALUE AS REPORTED VALUE AS APP~ISED VALUE AS REAPPRl,ISED $$$37,985.92 37,985.92 ---------------- INVENTORY Real Property (Schedule A) Personal Property (Schedule B) Transfers (Schedule C) J oint-Held Property (Schedliie E) TOTAL JROSS ASSETS LERR Debts and Deductions (SCHEDULE F) CLEAR VALUE OF ESTATE .. 37,985.92 =====.-=====.- ------_._- ======:= Valuation of life estates or annuities . tESTATE T.~X ASSESSMENTS ., $--- ~------ / -:=/ / $,,-~-------- $------ $------- $------- $-------$ As evider.ced by Cr_ari table Exemption Certificctes issued by the Secretary of Revenue.' COMPUTATION OF TAX =======.- TOTAL TA~BALANCE PAID FOR USE OF REGISTER ONLY T?.x on $•__f5%%_ T ax on $.~O%,.~.~ T ~x on ~~%__-+-_ T ax on ~._~_lFi%~ E~empti(Jns :=(,:,) Total Es tate _ BALANCE DUE .,'Add int·::!rest at rate of 6~fromIto TOTAL TAX $ Less tax previously paid $ BALANCE $ Less !:.%of tax if paid within 3''months after death $_. ..'.: 3:\LANCE OF INHERITANCE TAX DUE Add ir.teres t at rate of 6%from :,to '..A.MOUNT OF ESTATE TAX ASSE~SED *'Estate tax paid $ FOR USE OF REGISTER ONLY ADJUSTMENTS NOTE:Where subsequent adjustments are matle to the above computation of tax by the rregister of Wills,for proper reaso~,same should be noted below,with short explanation. MATTER OF THE APPRAISEMENT ..,. I ,.•+..-,~.,~....~'..,.. Will ~ Administration ~No Year IN THE . ", ~-~.... -..~.-"...',- ..- ~~ ~ , ......._...._r ."~. OF THE ESTATE OF .......j\~~W ':l:ll.l~9.~a:lk./~, ,,. Deceased Late of .DONORA . COllllty of ~~SHINGTON....................... Commonwealth of Pennsylvania REPORT AND APPRAISAL .....~,.. .. ~1..... Form:RCC-2 .lCOMMONWEALTH OF PENNSYLVANIA DATE ....................~.~.~.~~~.~.~.....~.'.......!.?.§~.......... DEPARTMENT OF REVENUE RESIDENT INHERITANCE TAX ..............................W~~h.mg~QP:...................""-COUNTY•BUREAU OF COUNTY COLLECTIONS HARRISBURG.PENNA.17127 APPRAISEMENT FILE NO...............................9..2.::.??::JJ..?.Q................... Whereas..................................An.d~.ew....T.akach...a/k/a...........:.....................................late of ....................................p.9.llQr..a........................._........................... in the County of ...............................~~.~.h.~gt.9.P.:...................................................................Commonwealth of Pennsylvania.having died on the .................................??....~.~.........................................day of .....................~~~.~....................................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 1n possession or enjoyment to collateral heirs of the d~edent after the eXpiration of any estate for Ufe or for years,the Commonwealth hereby expressly reserves the right to appraise and assess transfer inherite.noe taxes at the lawful collateral rate on any such fut".lre interest. Appraisement , UnitDescriptionofAssetVatuas Made for tnherllance Tax Purpoles . $I REALTY: Savings account,Pittsburgh National Bank,Donora 10,737.40 SAvinlJ'S account i"irst Federal Saviruzs &Loan Assn. of Monnessen,Monongahela 9,473.52 100 shares International PaDer Co.3,275.00 200 shares American Cyanamide Co.5,775.00 100 shares Scott Paper Co.2,800.0C ,",..shares Camnbell SOUD Co.3~OOO.OC 100 shares Air Reduction Co.2.925.0C 37.985 I37.985.9.2 92 I , ... • Total 37,985 92 fonn~v~fhb~:::rh~w<>rllaz~o~~:~a~:r~~~~~~~i~~~~ ,Appraiaer ;d2..~........................................................................_............................ (Ifu and Street) ..................................................._~..............................................._...Penna. IPoat Olllee) ----...,..------...,..--...,..--:---::;--:--;::----...,..---,:-------,-----...,..--~...,.....,.....,.....,.....,.....,..=...,..-...,..---...,..-;---~('~------------,...------...,..---~---.~,-~......':.',,'•V'~.t"...:: " ,~..-,:~::w,_, --tt ................"WASHINGTO'N..............................County ~.-'... RESIDENT INHERITANCE 'fAX APPRAISEMENT :-.... Estate·of ......................AN.P~.r.A.~.9.H ~I.}{,/~~".. Deceased. Late of DONORA Datc of Dcath,..A~.ffiJ.~t.?$.J J.,9.9.$":".".,," Apprat"semel!t Docket Vol.,3...7."""., Page,..J.4~::::4 "No.".9.3.:::9..$.::.U.$Q""". Filed in Register's OfJice~pl3,.9.l3,mP..l3,!':9...19..9.?.. Anwunl of tax due,$"..":.. DEPARTMENT OF REVENUE Received, 'Examined and Appruvetl,""::.. Wrote abo.llt Appraisement, Appeal ft-om Appraisement,;.. Entered and charged,.. ," ,--"-_" J I:~;~ ~~;....... ~....- ~,··l..l ,•....... .•~.l,."l'.''4< .. '1 '- .' .' .~. 1-, .' Fi'C C-72 (6-67) COMMONWEALTH OF PENNSYLVANIA DEPARn~ENTOF REVENUE BUREAU OF COUNTY COLLECTIONS APPLICATION FOR AND CONSENT TO TRANSFER SECURITIES REGISTERED IN TH E NAME OF A RESIDENT DECEDENT J APPL ICATION DATE a/l0/69 TO THE PENNSYLVANIA DEPARTMENT OF REVENUE:. Application is hereby made for CQ1sent to the transfer of the follow'ing securities of a Pennsylvania Corporation or a National Banking Association located ;in Pennsylvania:.' (a)100 (b)ScottPapel'Co.(c)Common/Ho Paar (NOTE:,In describing securities enter in (a),ab Ole,either the nu~ber ot shares of stock or the face amount of registered bonds,in (b),the name of the issuing company and in (c}the class of stock or the stated interest rate and maturit:f date,of registered bonds.)', ~anu~v ao,1.967,"., ISSUED ONJuly S.1967 ,and having a TOTAL MARKET.VAtLUE OF $..:;:2'-01.c..::;8..::00..;;;.'-=..eOO=-';::;....'_ •(Date)','. as of the date of death of the decedent,Andrew Takacb . ,~n-=8::LJ;-=a::..::'8:..L)..:;<6..::8_'_ (Name of Decedent)(Date of death) Washington,Pennsylvania (Street and,Humber),(Post Office)(County)(State) ,: Th~securi Ii es are registered as fo II ows:...:....A-.:.nd::.::..::Jt--=ow.:..-.:..-_T--=8...:....b-=..:...G.::....b _ i,(Narre or'names in 'whi'ch certificates are registered), ~fIR}John 'Ialuleh.430 ~I'ay A~emaa.DODOJr6,Pa.' EXECUTOR ,),.(Narne)(Address) .,/',,NAME OF JJ,PPUCANT eJohn rA.Tak~ch=,~'--"-- COUNTY FILE NUMBER63..68",,1180 ADDRESS OF APPLICANT 430 Uurray Ave.Donora.l"'a. 6c,...~ BUREAU FILE NUMBERS?144 9',SIGNATURE OF APPLICANT--m~~u...l~Ml~~~G!!W.,., NOTICE:IF YOU FAIL TO PROPERLY FILL IN ANY PORTION OF THIS APPLICATION,IT WILL CONSIDERED COMPLETE AND WILL BE RETURNED TO YOU.FOR COMPLETION. COMMONWEALTH OF PENNSYLVANIA -DEPARTMENT OF REVENUE CONSENT TO TRANSFER SECURITIES DATE Feb.19th.~1969 \I hereby consent to the transfer of the above securities '~ow registered in the name of the aforesaid J •I. Decedent ~nd waive the filing ora cert.ific~te cer~jfying to the p~yme.nt of the'tronsfe~inheritance tax to which \ the property of said Decedent is mode subject pursuant'to the'provisions of the Act of June 20,1919,P.L.521,:,i as amended and the Act of June 15,1961,P.L.373,as :Jmended.This is elso in accordance with the provision~ of the Act of April 9,1929,P.L.343. Th'is Consent to Transfer the herein described property operates only in referen~e to the estate of the above-named Decedent•.\ Wa shington ,(Signature) Regis~sr of Wills (Title)(County) Signed f rt e Secretary of ~nue BY_-+-l&1<':JL~::::::::~?=-7=--/?.:.--~=------=--=-_I J ______Term,19__•A.A. Dc<:ket 3 7 -""/4'!-~=--__ \Date of death . (NO.63-68-1180 I' )Deceased Takach,Andrew IN THE ORPHANS'COURT OF WASHINGTON COUNTY,PENNA. ~-~-~8, In the malter of :the Audit of Account filed in the Estate of TO THE AUDITING JUDGE: Enter my 'appearaillc~for the Commonwea~th of Pennsylvania.claiming transfer inheritance tID:in the above estate,as follows: DR. To appraised Vialue of Estate:Rea1ty_$------,O""'T----..---- Per30l1'alty__ ____$_3~7__·i_t_s_""_,_9_v _ Additioll!al Assets per Ac·:ount,Subject to TalL __ __$_ AddiTIonall Assets per Audit,Su'Jject to Ta!c - -$_ GROSS VALUE $_ TOTAL DEDUCTIONS,$. _ CR. Debts and Expenses per Account;see Note Additioll!al Debts and Expenses per Audit I \ $------ $------ $------ $------ $--_._--$------------ $------_._------ / It-V'?,13 $-------- $------ TAX ?AID ON ACCOUNT ._---_--::.........._--------_._- NOTE:'1100 following credits claimed ·in the A.."Count are held not deductible a'S against the tax: =~--- at '15%)___'X $-_.._--- /rV7//~Totd Tax __....................__..................$_. Les:;amount previc,us1y paid __._............' $--..L 7.n..!.ttl B 1 n . .'.6-:"2.;'"~Craace_ ___...................$--= Interest__yrs.-_mos __ooy,@ ~--- 12,~~ii~~ZDi~,RE~-::JL~l~ /?#'~o.AA.d"\;,,P~~GeR..:r;l.d tl/~~1!-il~.:J~t~/970 J~ CALCULATION Gross Value 7 7 9 f>..$",..7 V ~::.3'c,'.l../L HIe;,"'y ~}If 'I,70 •Less Ile<!ucliomL __./.2..go.3 /!?--o .~tf!f,'t4i-nt~:.~7 3,','v yC~"'VjO-70-t.rI't!!!-!./V.~1{l{2,g'!I-t-?,~...Y1J,f.'z.:*/!.'· ~tt11./~..1-2'1#·1/::::..S'Ol.,1-'{able.i _I 'at ; 2%\_,_ ,":1) ""~ J It{ No.,____~Tenn,19__,AA 'ESTATE OF DCCCQ3()d h \-.) PRA~CIP~FOR APPEARANCE FOR COMMONWEALTH OF PENNSYLVANIA ~5 .,' <.,- I Reghle,of Wills,Agenl ",)-::;:... "'-DiDUCTlONS ALLOWED IN 17/t3/tfJTHESUMOF$. l--~·V--1DDATE~PPROVE~~{"......I~~, STATEMENT o.F DEBTS AND DEDUCTIONSREGISTEqOFWILLS OFFICE UF TIo1~ "NO AGENT 0"THE COMMONWEALTH \:. F';,m RC;·If-..:i' OF _..¥JWu::A:uS.uH..L.I.LJNwG~T~ON.IJI..-_COUNTY ANDY '1'Al(A(~~ ESTATE OF ANDREW TAKACH a!k!a LATE OF Donora,pennsy]vanj a DAn:OF FILING APPRAISEMENT DAT&0,,"DEATH ......,.;;A;LIoudo,!g9Ju~s~t __2~8'-l,.........1~9'"6=8 _ "'MOUNT 28 50 10 50 14 00 I 3 00 I 16 00 1 968 ,00 1 968 00 7 1)0 1,715 00 20 00 71)00 147 00 1Q 1)0 10 00 u.7 ioo ,25 00 70 00 1 000 ioo ,..,,...,...11"\('l 41 100 1 ??O - 11 00 Q 1;0 q~ruJ t Final Electric Rill REMARKS Advertising Letters Advertising Letters ~ttcirnevs Fee Phv~i('i.qn'!=:Rill Executor"s Commission Funeral 1<';1inP'T 'P'torv Ietters of Administration •rh IV- .Tohn A.Takach Iffiited States Treasurv NA"'''OF PAYEE Rarna and Barna Dr U T T~,,;n P:1111 Macik Funeral Home T ., Rl1!=:!=:P11 M:=.ri no Va11ev Indenendent ~-11 Refreshments Rus se11 M.qB:i no 'West Penn Power ComDanv ·W~!=:hinp'ton Countv ReDorts NO.O~ YOUCHfOllfDATE I Dr.D.S.Haver·'Phvsician's Bill r 'Rll!=:!=:~ll M:llrino Pa.Inherit::JnC'P T::JX MononQ:ahela Water Comnanv IFin::J1 lA1::Jter Ri 11 Columbia Gas Company Final Gas Bill ---+---i-I .._---,;I-uDu.r.......---'-.TLo.'---oJEu..:VlLJe....r~e....t....,t--&.:.MLlooCo..i.,C.l.olllo.11e""'n..uaa.lhWl,:=.I;l,.·nU-.--+.....Phlywov·:!=:z...o:i~C'....';~.:='id.J1n~'w--!=:....R:....;:....1........1 -t__-L.J"'-+>L>oL-1 I F!=:r.qrp o-f ~l1!=:i p T:=.k:=.rh .Pp'h N::Jt R::JnkFaI]i1y ,~~~I!1Ption i __---l-__.~_--+-MMr:s.l!=::gp·..r.......r-.:MMi.i·C'c.:'htLla~1ea,1UDD.lllJ..lll'r~"iw!=:i]:iLInL__+1FJJll1lIln'lfe!~:r':a,aiLl.s~.er.t:llv·c..r'Pe.r<,!=:S-.~~-.£.4Lw...._ !---+----t----+-lJ.<U'!:Ia::I''\7~'~eDn,,--CJ:('Y':f·,~~c:~rL~N··w::sj·l.InlJl~~UHo.('lmmlL€.....,~_+H'E.·i.,·nn.a·.ql'-.Ll..1nll"l1lLY"!=:s.:i.,'nn,.g...0'..Jl!hI,('lllDJm~e..-hh'.i'·.ll.Ll__+-_--.J~plL_ __~--+---__..-"""D~r=-.=--.....B~a~r=:.;r=---+-=P:..:h~lvL..:.:s:;...~=-·c=ia=-n::.:.-'=-s-=B:.::i:.::1:.::1:...-+--_-=-~.=....;;;._ I " ==:!::::==::=:::::!===============:::::!===========:b====::b=' COMMONWEALTH OF PENNSYLVANIA "I"HEREBY CERTIFY.THAT.TO THE BEaT OF ,;';y.KN.O'lllll.j~5!..E,,:NO BELIEF.THE FOREGOING IS A JU AND TRU E STATEMENT OF DEBTS.FUNERAL EXPENSES AND EXPENSES OP' ,(;/:),A~"'ItH6T'lAT.~o'.!?~~BMITTED TO THE ESTATE OF ANDREW TAKACH a k a ANDY TAKA~EA8ED,AS DEDUCTION5 FOR .'':'''.I·NHERITA"'CE TA.!C"PURPOSE9.' . -"J',,~'=~\r a ..'S~O~~N.ll ~~9C·~IBED BEFORE NE THIS /P DAY OP'..&...............~~~-=-:...-~~~~~~~::::::::.---(L.6.) ..~~~~ ,-.STEPHANA NONAClC,Notary PubliO Donora,Wa~hln!ltoB County,Pa. My CommissloQ Expites Jan.29,1973 .." <t' " '.',,1 .,.\ "~ ....r ~,r ,J '.-~. J .) '.~..,\. l }('i." '....) r;r")l'.,.', i::£,1.',J".', " '-,-'"... ,(, " -, ," .\~.. f ,"I •~~ i;' I I, i, .1",f,1 1 ' I' " ,!,"l:L" ,r' ;,).."-" ,,'l)"J I, ",I,.."j'I , ','J"::),.-,.. "'.J:;.~I" ..i"'." -,..." ~."~I ".',T,,rT ,~:r j)1'.\ ,!j. .,~I ,'i ':.J j' :.\0: .'- 1"10,>:i'''r.n:::·~:: ..i';:,. ,J j l '1 ..f "' " ,. ';.'\, •1'"....... ,'('" '" ,, ••lJ.·t \ J.(ri(.~, of )•••• ,' I'J..,... -......./ FORM 706 (Rev.Jan.1966) U.S.TREASURY DEPARTMENT Internal Revenue Service UNITED STATES ESTATE TAX RETURN Estates of nor.residentB not citizens of the United States may generally file on For:n 706NA instead of this form.For details see page 39. DO NOT WRITE IN SPACE BELOW Date received ./ Decedent's first name and middle initia.! ANDREW Decedent's social security number Date of death August 28,1968 I Decedent's last name TAKACH Employer identification number for estate None Citizenship (nationality)at time of death U.S.A. Residence (domicile)at time of death 4116 NuI'S'ay AvenuG,Dono..a,W.abiQQtcm Count"Pennaylvard.a Did the de:edent die testate?I W.ere letters testamentary or of administration gra~ted for this estate?.I Date granted [j:Yes 0 No [jtYes 0 No 9/10/68 Case No.I Name of court I Locati:m of court 63-68-1180 ~.,COUl't otWatibibOton Cty••Washington,Pennaylvania To whom granted?(Designate whether executor,executrix,admi:1istrator,or administratrix.Explain if different from the person or persons filing return) NAME DESIGNATION ADDRESS (Number,street,city,State,and Postal ZIP code).10 ~ItGV AVGOUO.Donolta.Pa.15033 COMPUTATION or TAX(See instructions on page 38) Taxable estate (Item 5,Schedule P,or Ite:n 9,Schedule Q,whichever is applicable)$__.3fl,..:983A2B _ PART I 1.Gross estate tax (use table A,page 40).. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...$a_).1:6.6_A~6 _ 2.Credit for State death taxes (use Table B,page 40)1------\0,......00,,·¥_ 3.Gross estate tax less credit for State de:lth taxes (item 1 minus item 2).This is the net amount payable unless credit for Federal gift taxes,.tax on prior transfers,or foreign death taxes is claimed in P:Irt II $----!a;!1~~46----- PART U 4.Credit for Federal gift taxes $_ 5.Credit for tax on prior transfers ;,_ 6.Credit for foreign death taxes _1 _ 7.Total of credits under Part II (total of Items 4,5,and 6)1 _ 8.Net estnte tax payable (item 3 minus ilem 7)$13,,1166.46 (SFACE FOR USE OF INTERNAL REVENUE SERVICE) Assessment~Payments Type of assessment,.I(tax,intlrest,etc.)Amount list Page line Date Principal Interest --------------------------$-----------------------1------------------------------------------------------------------$-------------------------$-----------------..---- -------------------------------------------------------------------------------------------------------------------------------.----------------------------------.;.---- J ~~~TERMINATION BY INTERNAL REVENUE SERVICE a A;.;D CiMP CdV'd ~?c4l11~ Page 1 ~."r.,.·_" GENERAL INSTRUCTIONS Th'roughout these instructions all references to citizens of the United States are subject to the provisions of sections 2208 and 2209 of the Code which relate to decedent United States citizens who were residents of a United States possession on the date of death.If such a deccdep.t acquired his United States citizenship solely by reason of his connection with the possession"then for purposes of the Federal.estate tax such decedent is deemed a nonresident not a citizen of the United States.If such a decedent acquired his United States citizenship wholly independently of his connection with the possession,then such decedent is deemed a citizen of the United States. , I r"I A.Statute and general description.-The Federal estate tax is imposed by chapter 11 of the Internal Revenue Code.It is . not an inheritance tax.It is imposed upon the transfer of the entire taxable estate and not upon the share received by a particularbeneficiary.The taxable estate is determined by tak- ing the value of the gross estate (Schedules A to I,inclusive) and deducting therefrom the total amount of the deductions authorized by the Statute.' Different provisions control the determination of the tax lia- bility of the estates of citizens or residents of the United States and the estates of nonresidents notcitizens of the United States. (Generally,reference herein to the decedent's residence means the decedent's domicile.)For specific information on Federal estate taxation in the case of a nonresident not a citizen of the United States,see'''Additional Instructions for Estates of Non- residents Not Citizens of the United States"on page 39. B.,EstC!ltes for ,which return ,required.-A return on'this form must'be filed for'the estate'of every citizen or resident of the' United States whose gross estate as defined by the Statute exceeded $60,000 in value at the date of death.~,' Instructions relative to the requirement of a return for the estate of a nonresident not a citizen of the United States are set forth on page 39.' ._.,The value of,the gross estate at the date of the decedent's deatH:governs the'liabilityfor the filing Of the i'eturn,regardlessofanyvaluationasofasubsequenttimethatmaybeadopted by the executor under the provisions of section 2032 of the Code. C.Time and place of filing retutn.-The return is due 15 months after the date of the decedent's death.The return for the estate of a resident decedent must be filed with the District Director of Internal Revenue in whose district the decedent had his domicile at the time of his death.The return for the estate of a nonresident citizen must be filed with the Director of International Operations,Internal Revenue Service,Washing- ton,D.C.,20225,U.S.A.In exceptional ca.ses,application may be made to the Commissioner for permission to file in any other internal revenue district. D••Payment of tax.-The tax is due 15 months after the date of the decedent's'death,and must be paid within such period unless an extension of time for payment thereof has been granted by the ,District Director,or unless the executor has properly elected under section 6166 to pay in installments. Check or'money order in payment of the tax should be made payable to "Internal Revenue Service." E.:Supplemental documents.-If the decedent was a resident and ,died test,ate a certified copy of the will must be filed with the return. If the decedent was a nonresident citizen,the following documents must be filed with the return: (1)A copy of the inventory of property and the schedule of liabilities,claims against the estate and expenses of ad- ministration filed with the foreign court of probate juris- diction,certified by a p'roper official of such court. -,(2)A ,copy of the return filed under the foreign inherit- ance,.estate,legacy,succession tax,or other d,eath tax act, certified by a proper official of the foreign tax department, if the estate is subject to such a foreign tax. (3)If the decedent died testate,a certified copy of the will. Other supplemental documents may be required as herein-' after explained under the instructions for,the several schedules. F.Execution of return.-This form consists of 40 pages num- bered in consecutive order.For convenience in typing carbon copies,the sets as issued may be readily separated and the cor- ..responding sheets matched.When completed,the return must be permanently fastened together with all sheets in proper order. Anysuitabletype of paperfastener may be utilized for this pur- pose:"Ordinary,wire staples are recommended for the return of...average.size.'All pages provided,numbered 1 through 40. must be included. Write only on one side of each shed of paper.Ifthere is not sufficient space for all entries under any of the printed sched- ules,use additional sheets of the same size,and insert in the proper prder in the return.All information required as indi- cated under "General Information"must be supplied in the spaces provided.The questions asked under each schedule must be specifically answered,and if the decedent owned no Page 2 property of any ~lass specified for the schedule,the word "None"should be written across the schedule._ The gross estate must berset forth under the appropriate Schedules A to I.The 'deductions,except the amount claimed for the 'exemption,should be shoWn under the appropriate Schedules J to N.In die case of a resident -or citizen'the amount deducted for the exemption should be shown under Schedule P,and the taxable estate computed thereon. .For·every item of principal,any income.accrued tl1ereon at the date of the decedent's death,must be separately entered under the column headed "Value at date of ,death";and,if 'the alternate valuation is adopted,'any includible 'income with respect to each item of principal,as hereinafter explained, must be separately entered under the column headed "Alternate value." The items should be numbered under every schedule and a separate enumeration should,be used for each schedule./The total'for each :scHedule sliould be shown at the'bottom'of the schedule.~The'~totalsshould not be carried.forward from one schedule 'to'a'nother,'but the total or totals for each schedule ,should be entered under the Recapitulation,Schedule O. The information indicated by the columns headed "Subse- quent valuation .date"and "Alternate value"should not be showD.unless the executor adopts the alternate valuation authorized by 'section 2032 of the Code.If.such alternate valuation is not adopted,the space in the columns'headed "Sub- sequent valuation date"and "Alternate value"may be utilized for descriptive matter,as indicated in the example shown under the instructions for.Schedule A.,Similar informatJion should be omitted in the space provided therefor under the Recapitula- tion, Schedule 0,if the alternate valuation is not adopted. The computation of the tax must be shown in detail as indi- cated on page 1.If the executor determines no liability for tax,the word "None"should be shown at item 8 under "Com- putation of Tax." If credit for foreign death taxes is claimed,the'credit should be computed on Schedule S. The filing of Form 706 will not be considered the filing of a complete return as required by the Statute and the regula- tions issued pursuant thereto unless all the information as indicated herein is set forth. Roundins off to whole.dolla,'amounts.-'If you wish,the money items on your return may be shown as whole-dollar amounts; This means that you eliminate any amount less than 50 cents, and increase any amount from 50 cents through 99 cents to the next highest dollar.' G.Signature and verification.-If there is more than one executor or administrator,all should verify and sign the return. Such persons are responsible for the return as filed and incur liability for penalties provided for erroneous,false,or fraudu- lent returns. If there is no executor or administrator appointed,qualified, and acting in the United States,every person in actual or con- structive possession of any property of the decedent is consti- tuted by the .Statute an executor for the purposes of the tax (section 2203 of the Code),and is liable for the filing of the return.If two or more persons are liable for the filing of the return,it is preferable for all to join in the filing of one complete return,but if they are unable to join in making one complete return,each is required to file a return disclosing all the information he has in the case,including the name of every person holding an interest in the property and a full description of such property.If the appointed,qualified,and acting executor or administrator is unable to make a complete return,the Statute requires that every person holding an :interest in the property shall, upon notice ~rom the district dire,ctor,make a return as to such interest. The person or persons who file the return must,in every case, sign under penalties of perjury the first declaration on page 40.If the return is prepared by an attorney or agent for the person or persons filing this return,the second declaration on 'page 40 must also be signed under penalties of perjury by such attorney or agent. H.Representatio~by attorney.certified'public'accountant,or agent.-If the executor is to 'be represented by another before (Continued on page 4) j GENERAL I~FORMATION I.Address c,f decedent at time of death (Number,street,city,State,and Postal ZIP code)436 Murray Avenue Donora,Pennsy1vani.15033 which domicied a ttime of death I 3.Year in which this domicile was establishednsylvana1893 f c.eathCounty,Penna.I s.Cause of death \6.Length of iast illness11Twp.,Washington Cancer 5 months nt's physicians NAMES ADDRESSES (Number,sfreet,city,State,and Postal ZI Pcode) J.Levin,M.D.587 McKean Avenu,e,Donora,Pa.15033 ent was confined in a hospital during his last illness or willlin 3 years prior to his death,give name and address of hospital cy Hospital,Pittsburg,Pennsylvania arial Hospital,Monongahela,Pennsylvania f birth I 9b.Place of birth (City and State cr country,if other than United States) 30,1893 Phoenixville~PenDBy1vania l sr.&ccupation I lOb.If retirelstate former business or occupationSt..worker es~name II0d.,Decedent's employer identification number,if anyNone ss address (Number,street.city.State,and Postal ZIP code) I s~atus of decedent at date of death Married o Single o Legally separated o Widow or Widower o Divorced e 01 surviving husband or wife I 12b.Social security number of survivir.g husband or wifeiTakachNone of r!larriai to surviving husbanc..or wife I 12d.Domicile ::It date of marriage to surviving husband or wifeober'5,1912 Phoenixville,Pennsylvania ced:mt was a widow or widower,give name of deceased h\.Eband or wife I 13b.Date of death of deceased husband or wife N/A ua.s who receive benefits from the estate (do not include duritable beneficiaries shown in Schedule N or any heir receiving less 1,(00) Er.ter the name of each individual who receives benefits Amount.-Valueall interests on the date of death or the alternate state directly as an heir,next-of-kin,devisee or legatee or valuation date,whichever is l.:sed for estate tax purposes.The in-(for example,as beneficiary of a trust,shareho:der of a terest of each benefiCiary should be valued ir_the same manner asorpartnerofaPartnershipwhi::h is an heir,etc.). ecurity Number.-If the individual has no social security it would be valued for estate or gift tax purposes.Where precise se his taxpayer account number.values cannot readily be determined,a reasonable approximatfon n be date of the decedent's dealh.should be entered..The sum of the values of the interests of ::Ill ship.-Includerelationships by ::>lood,marriage,or adop-unborn or otherwise unascertainable beneficiaries should be sho'Nn 'cate NONE.on the last line (all unascertainable beneficiaries). Name Social Security number Age Relationship to Decedent Amount n A.Takach 185-16-6474 46 Son JleDlainderm_n...Takach 159..14-2487 47 Son It an Stiaak 186-20-0982 44 Daughter It a Sabol 200-01-7866 49 Dallghter It :i.Takach Hone Widow Life E.tate • rlainable beneficiaries.......................:...............................................1 F ___~_~~~_~~___~!'_~!~~___________________________________________Page 3ESTATEa All unasce Joh Tho Sus Ann Zuz 13a.If de N/A 14.Individ than $ Name.- from the e indirectly corporation Social S number,u Age.-O Relation lion or indi 12c:.Date Oct 12a.Nam Zuz 10e.J3.usineNORe 10c:.BusinNo_ 10a•...8.usir.Ret 9a.Date 0 Nov. 8.If deced Mer Hem H. 4.Place 0 Carro 7.Decede 2.State inPen ll.Marita ~ GENERAL INFORMATION-Continued ~. 15a.Did the :J.ececlent at date of death own property in any State or c:mntry other than that of his lastdomicile!--'0 Y···r.l.No .. If "Yes:'state place of ancillary prcbate proceedings es ~ 15b.Name of ancillary administrator or executor None I f ~ I, 15e.Addr9ss of ancillary administrator or executor (NwDber,street;dty,State,and Postal ZIF code) 16a;Did thedecedenf at the time of his de'J.th'have a safe dej:0sit bOI:held either alone or in fle joint names of himself and another? If "'(es:'state location ,. o Yes 'XI No 16b.If held jointly,give the name of the jo':nt depositor ,N/A 16d.If the,decedent had a s~fe 'deposit box at the time of his'death,'indicate'by scheCiule and item number under what schedules in,this return the contents are listed i6e.Relationship of joint deposito!to decedent N/A ,,',....' N/A 16e.If any of the c0l1te'nts of the safe deposit box are omitted f!om the schedules.explain fully why omitted ".... N/A 17.Did the undersigned person or persons filing return make diligent arid careful search for j:r'operty of every kind left by the decedent?/'iii Yes 0 No " 18.Did the ~ccie undersigned make diligent and careful search for informaticnas to any transfers (other than outright transfers not in trust)of the value of $5,000 or more made by the decedent ouring his lifeime without an adequate and full consideration in money or mor_ey's worth?til Yes 0 No 19.Did the same undersigned make diligent and careful search for tlie existence of any trusts,createe by the decedent during his lifetime or any trus-.s create,:,by other persons under which the decedent possesE-ed any power,beneficial interest!,o~trusteeship?.'k1 Yes 0 No ZOa.Name of attorney representing estate,if any Paul N.Barna and Paul N.BarnatJr:. ZOb.Address (Number,street,city,State,and Postal ZIP code) Seventh &McKean A!\'~nue Donor:a,Pennsylvania 15033 ZOe.Telephone No. ALTERNATE VALUATION (These instructions apply only if alternate valuation is elected.For further informatioll on'this subject,see General Instructionsonpage4). 21.An election to have the gross estate of the decedent valued as of me alternate date or da'.;6s is made by entering a check mark in the box set fo!th below.o The executor elects to have the gross estate of this decedent valuedin accordance with valu'9s as of a date or aates subsequent to the de- cedent's death as authorized by secticn 2032 of the Code.' ESTATE OF _AndX:ew._-T~Ch_--. .\..._..Page 5 \ \ ( GENERAL INSTRUCTIONS-Continued Federal gift taxes also are,under specified conditions,allow- able against the tax.See page 38 for information relative to the allowance of these credits. In the case of a citizen or resident of the United States, credit is authorized by statute and treaties,under certain con- ditions,for estate,inheritance,legacy,and succession taxes paid to a foreign country or possession of the United States. (See "Credit for Foreign Death Taxes"on pages 36 and 37.) Credit for tax on prior transfers is explained in the instruc- tions on pages 32 and 34. N.Credit for foreisn death taxes.-In the case of a citizen or resident of the United States,a credit is authorized under certain''circumstances for death taxes paid to a foreign coun- try,or a possession of the United States (See section 2014 (g) of the Code).The credit is authorized (a)by statute or (b) by treaty.See "Death tax conventions"below for the effective dates of the treaties which authorize the allowance of a credit for foreign death taxes.See "Instructions for Schedule S"on page 36 for a list of the foreign death taxes for which credit is authorized by treaties,and for information relative to the com- putation of the credit. O.Death tax conventions.-Death tax conventions are in effect with each of the countries listed below.The provisions of a convention apply in the case of a decedent dying on or after the effective date shown. Country Effective Date Australia .January 7,1954 Canada________________________________________________January 1,1959Finland: .December 18,1952 France ..October 17,1949 *Greece December 30,1953 Ireland :December 20,1951 Italy ------------------------.October 26,'1956Japan.April 1,1955 Norway ~December 11,1951 Switzerland :_:.September 17,1952 Union of South Africa .July 15,1952 United Kingdom .July 25,1946 "General Instruction J governs real properly. In addition to authorizing credit for foreign death taxes,the conventions provide situs rules which apply in the cases of certain nonresident aliens.Information relative to these situs rules is set forth on page .39.' Further instructions.-Detailed instructions pertaining to each schedule are included herein.Additional instructions for estates of nonresidents not citizens of the United States are given on page 39.For further information see the Estate Tax Regulations. INSTRUCTIONS FOR SCHEDULE A-REAL ESTATE Real estate should be so described and identified that upon mortgage,only the value of the equity of redemption (or'value investigation by an Internal Revenue officer it may be readily of the property less the indebtedness)need be extended in the located for Inspection and valuation.For each parcel of real value column as part of the gross estate,in which case no estate there should be given the area and,if the parcel is itn-deduction for the indebtedness is allowable under Schedule K. p'roved,a short statement of the character of the improvements.Real property which the decedent has contracted to purchase For city or town property state street and number,ward,sub-should be listed in this schedule.The full value of the property division,block and lot,etc.For rural ,property state township,and not the equity must be extended in the value column~The range,landmarks,etc.unpaid portion of the ,purchase price should be deducted under If any item of teal estate is subject·to a mortgage with Schedule K of this return. respect to which the decedent's estate is liable (i.e.,if the The value of dower,curtesy,or a statutory estate created in indebtedness is enforceable against other property of the estate lieu thereof,is taxable,and no reduction on account thereof or not subject to such mortgage,or if the decedent was personally on account of homestead or other exemptions should be made liable therefor),the full value of such property must be ex-in returning the value of the real estate. tended in the :value column.The amount of the mortgage in The basis for the returned values should be stated.If based any such case"should be shown under "Description"in this upon appraisals,copies of such appraisals,together with an schedule,and deduction taken therefor under Schedule K.If,explanation of the basis of the appraisals,should be attached however,the decedent's estate is not liable for the amountof the to the return. Examples showing use of Schedule A Example where the alternate valuation is not adopted;date of death,Ja.uary 1,1965 Item No.Description -I···:Subs~quent •.'."-1 'I Alterriate,value•,valuation date Vijlue at ~ate of'death \ 1 House and lot,1921 William Street NW.,Washington,D.C.(lot 6,square 48n.:.Rent of $90.0:due at end of eachquarter,February 1,May 1,August 1,and November 1.Value based on appraisal,copyof.which-is~attached~~_~_-':_~_:__-'"_~L.~__"_ Rent due on item 1 for quarter ending November 1,1964,but not collected at date'of death ~__: _Rent accrued on item 1 for November and December 1964 _ 2 House and lot,304 Jefferson Street,Alexandria,Va.(lot 18;square 40).Rent of $100 payablemonthly.Value based on appraisal,copy of which is attached ~~_ Rent due on item 2 for December 1964,but not collected at date of death _ Example where the alternate valuation is adopted;date of death,January 1,1965 ~$36,000 900 600 12,000 100 ItemNo.Description Subsequentvaluationdate Alternate vaIue Value at date of death 2 1 House and lot,1921 William Street NW.,Washington,D.C. (lot 6,square 481).Rent of $900 due at end of each quarter, February 1,May 1,August 1,and November 1.Value based on appraisal,copy of which is attached.Not disposed of withinyearfollowingdeath _ Rent due on item 1 for quarter ending November 1,1964,but notcollecteduntilFebruary1,1965 _ Rent accrued on item 1 for November and December 1964,col-lected on February 1,1965 _ HouSe and lot,304 Jefferson Street,Alexandria,Va.(lot 18, square 40).Rent of $100 payable monthly.Value based onappraisal,copy of which is attached.Property exchanged forfarmonDecember1,1965 _ Rent due on item 2 for December 1964,but not collected until Feb-ruary 1,1965 _ -----Page 6 1/1/66 2/1/65 2/1/65 12/1/65 2/1/65 $30,000 900 600 10,000 100 $36,000 900 600 12,000 100 OROSS :ESTATE SCHEDU:LE A REAL ESTATE Did the decedent,at the time ofhis death,own any real estate required b be included in the gross estate?'oSee Gene~cl1 Instruction J,page 4.0 Yes 0 No ItemNo. Non~ Description See SChe4ule B ,.'<'.,.cSubsequentvalua·tion date $ Alternate value Value at date 01 death $ TOTAL (also enter under'the ~:ec::lpitula1:ion,Schedule :») (II more space(s needed,insect aeditional s~eets 01 same size) ESTATE OF A~g~~~!!tJ'~~QJ:l_..._....._\.._._... \I.\ j $$0.00 Schedule A-Page 7 INSTRUCTIONS FOR SCHEDULE B STOCKS AND BONDS 1.Description.-Description of stocks should indicate number of shares,whether common or preferred,issue,par value,price per share,exact name of corporation,and,if not listed on a stock exchange,the post-office address of the principal business office,the State in which incorporated,and the date of incor- poration.If listed,state principal exchange upon which sold. Description of bonds should include quantity and denomina- tion,name of obligor,'kind of bond,date of maturity,interest rate,and interest-due dates.State the exchange upon which listed,or if unlisted the principal business office of the company. 2.Stocks and bonds subjec'to foreign death taxes to be grouped under separate heading.-Where any estate,inherit- ance,legacy,or succession tax has been paid to a foreign coun- try in respect of any stocks or bonds included in this schedule, the stocks and bonds subjected to the foreign death tax should be grouped separately on this schedule under the heading,"Sub- jected to Foreign Death Taxes." 3.Yaluation.-In the case of stocks and bonds listed on a stock exchange the mean between the highest and lowest quoted selling prices on the valuation date shall be considered as the fair market value per share or bond.If there were no sales on the valuation date,such value shall be determined by taking the mean between the highest and lowest sales on the nearest trading date before and the nearest trading date afterthe valua- tion date (both such nearest dates being within a reasonable period),and by prorating the difference between such mean prices to the valuation date,and by adding or subtracting,as the case may be,such prorated portion of the difference to or from the mean price obtaining on such nearest trading date be- fore the valuation date.For example,assume that sales of stock nearest the valuation date (June 15)occurred 2 trading days before (June 13)and 3 trading days after (June 18)and that on such days the mean sale prices per share were $10 and $15,respectively.The price of $12 shall be taken as represent- ing the fair market value of a share of such stock as of the valuation date.If,however,on June 13 and 18 the mean sale prices per share were $15 and $10,respectively,the price of $13 shall be taken as representing the fair market value of a share of such stock as of the valuation date.If the security was listed on more than one exchange,the records of the exchange where the security is principally dealt in should be employed. In valuing listed stocks and bonds the executor should observe care to consult accurate records to obtain values as of the ap- plicable valuation date. Dividends which are payable to the decedent or his estate by reason of the fact that on or before the date of the decedent's d:eath he was a stockholder of record (but which have not been collected at death)must be included in the gross estate as separate items.Dividends declared on shares of stock prior to the death of the decedent but payable to stockholders of record on a date after his death arenot includible in his gross estatefor Federal estate tax purposes;however,in a·case where the stock is being traded on an exchange and :s selling ex-dividend on the date of the decedent's death,the amount of the dividend should not be included in the gross estate as a separate item but should be added to the ex-dividend quotation in determiningthefairmarketvalueofthestockasofthedateofthedecedent's death. In the case of stocks and bonds which are not listed upon an exchange,but are dealt in through brokers or have a market,the fair market value shall be determined by taking the mean be- tween the highest and lowest selling prices as of the valuation date;or,if there were no sales on that date,such value shall bedeterminedbytakingthemeanbetweenthehighestflndlowest sales on the nearest trading date before and the nearest trading date after the valuation date (both such nearest dates being within a reasonable period),and by prorating the difference be- tween such mean prices to the valuation date,and by adding or subtracting,as the case may be,such prorated portion of the difference to or from the mean price obtaining on such nearest trading date before the valuation date.If quotations are ob- tained from brokers,or evidence as to the sale of securities is obtained from the officers of the issuing companies,copies of the letters furnishing such quotations or evidence of sale should be attached to the return..'If actual sales are not available during a reasonable period beginning before and ending after the valuation date,the fair market value may be determined by takiEg the mean between the bona fide bid and asked prices on the nearest trading date before and the nearest tradin~date after the valuation date Page 8 (both such nearest dates being within a reasonable period),and by prorating the difference between such mean prices to the valuation date,and by adding or subtracting,as the case may be,such prorated portion of the difference to or from the mean price obtaining on such nearest trading date before the valua- tion date.If actual sale prices or quoted bona fide bid and asked prices are available on a date within a reasonable period prior to the valuation date,but if no actual sale prices or bona fide bid and asked prices,are,available~ona-date:within a rea- sonable period after the valuation date,or vice versa,then the mean between such highest and lowest available sale prices or bid and asked prices may be taken as the value. Generally,shares of an open-end investment company (com- monly referred to as a"mutiIal fund)are to be valued at the asked price,but see section 20.2031-8 (b)of the regulations for exceptions and details. For the valuation of inactive stock and stock in close corpora- tions,see the regulations issued pursuant to section 2031 of the Code.Complete financial and other data upon which the estate bases its valuation should be submitted with thereturn,including balance sheets (particularly the one nearest to the valuation date),and statements of the net earnings or operating results and dividends paid for each of the 5 years immediately preced- ing the valuation date. Securities returned as of no value,nominal value or obsolete, should be listed last,and the address of the company and the State and date of the incorporation should be stated.Copies of correspondence or statements used as the basis for return at no value should be attached. 4.Interest and dlvldends.-Interest and dividends must be shown separately as explained in the General Instruction F, "Execution of Return." 5.Estate of nonresident not a citizen of the United States.-In the case of the estate of a nonresident not a citizen of the United States,stocks of foreign corporations are not to be included in this schedule or any other schedule.If such an individual was not engaged in business in the United States,there shall not be included in this schedule or any other schedule,obligations issued by the United States prior to March 1,1941.Except as provided in death tax conventions,discussed below,in the case of a nonresident not a citizen of the United States,stocks and bonds of the following classes must be entered in this schedule as situated in the U~ited States:(1)stocks of corporationsorganizedintheUnitedStatesregardlessofthelocationofthecertificates,and (2)corporate or other bonds if the certificates were situated in the United States at the time of death.Under the provisions of the death tax conventions with the following countries,the bonds listed after each country's name which were owned by a nonresident not a citizen of the United States are not situated in the United States and accord- ingly should not be entered in this schedule: (a)United Kingdom,France,and Greece.-If a decedent was domiciled in one of these countries,all bonds,regardless of location of the certificates. (b)Finland.-If a decedent or his beneficiary was a resi- dent (not domiciliary)of Finland,bonds issued by a corpora- tion not organized in the United States or by a noncorporate issuer who does not have a place of residence (not domicile) in the United States. (c)Ireland and Union of South Africa.-If a decedent was domiciled in Ireland,or was ordinarily resident (not domiciliary)in the Union of South Africa,all bonds,provided they were actually subjected to estate duty in Ireland,or in the Union of South Africa,as the case may be. (d)Australia.-If a decedent was domiciled in Australia, bonds issued by a debtor who does not have a place of resi- dence (not domicile)in the United States (see convention for exceptions),and bonds issued by any government,munici- pality,or public authority located outside of the United States.. (e)Japan.-If the beneficiary of a decedent's estate was domiciled in Japan,bonds (except bearer bonds)issued by a corporation not organized in the United States or by a non- corporate issuer who does not have a place of residence (not domicile)in the United States,provided such bonds were sub- jected to inheritance tax by Japan. (f)Italy.-If a decedent was a national of,or domiciled in Italy,bonds issued by a corporation not organized in the United States,or by a noncorporate issuer who does not have a place of residence (not domicile)in the United States. (Continued 'on page'10). j 'SCHEDULE B STOCKS AND BONDS - 1.Did the decede~t,ifa resident or citizen of the United States,own cny stocks or'bonds,regardless of physical location,..- at the t::me of his death?,"'---.--_.--Kl Yes 0 N:> ~~-~.....-'~-,," Z.Did the decedent,if a ~onresident not a.citizen of the United Stqtes~owI(at be time of his death,any stocks of corpo- rations organized in the U.hitedStates or bonds situated in the'United States asexplained in fr.e instructions?0 Yes 0 N:> Item No. '---'-_..----~...,---"Description (including lace.amountol.bonds or.numb.erotshares).,...Par _..,U~it val,1e Subsequent valua- tion date Alternate value Value at date 01 dea··h loo·shares ..Air ~educ'tiol\ Co.,commcm stock Net'{ltQrkStock exchan~~$1.0(29 .1l f4: 2 200 shares '!"AIneJdcan Cyana:o ai'd CQ..~O,~C?n s,1i;ock New York S1;;CJ.Ck Exc;:hange .'$5.0(287/8 a 100 s~res -,yamP~~~~Soup CO',.,¢~pital s'toc:k .Ne-w..y~~~.S~oc,k.~tl.~g9.E!" ":jQ.Ot 3.Qt'0<~• • 'f'•~ '.4 100 shares -Scott rap~t.Co. C(.':!C01DlUon stock "No..."",'. New Yo~k StQCk gXC;:ha.n9~Pat 26~'O(J 5 100 shares-InternationalPl1pei.co_;co~mQn 'stOClt '., NE!w Yo~k Stock.Exchange $ '.';I t 1\,,. $ 2,800.00 3,275.00 TOTAL (also enter l!nder the R03capitulation,Schedule 0)$ (IImore space is needed.inser:additional sheets 01 same size) ESTATE OF·l!~~_~~_.1~~~....._._._._,Schedule B-Pa~9 INSTRUCTIONS FOR SCHEDULE I-Continued (g)Canada.-If a decedent was domiciled in Canada,bonds I and bonds inscribed or registered by any government or issued by a corporation not incorporated in the United States,municipality outside of the United States. Examples showlns use of Schedule B Example where the alternate valuation is not adoptedi date of death.Jan~ary 1,1965 ItemNo.Description (inclu,jing face amount of bonds or number of shares)Par Subsequentvaluationdate Alternate value r ,. $ .______;:..-:........2_..._:~..~_100 $60,000-Arkansas Railroad Co.first mortgage 4%;20-year bonds,due 1976.Interest payable quarterly on Feb.1,May 1,Aug.1,and Nov.1;.N.Y.Exch,ange .___________________1,000 Interest coupons attached to bonds,item 1,due and payable on Nov.1,1964,but not cashed at..date of death....~_i ._~----~..;:.~__.;__..:_.;,~"::-::-..-------~.\ Intefest accrued on item 1,from Nov.1,1964,toJan.1,1965 .._•••••••••_.• _ 1 2 500 shares Public Service Corp.,common;N.Y.-.~-• Exchange ..._------------------------.---.--_.100·110 ----------,--.!--:_.:----------------1--.,.- Dividend on item 2 of $2 per share declared Dec._, ,.:'-10,1964,payable on Jan.10,1965,to holders.,of record on Dec.30,1964., . ...--._. Example where the alternate valuation is adopted;date of death,January 1.]96$."\_ lIemNo.Description (including face amount of bonds or number of shares)Par Subsequent valuation date S·Alternate v'slue '.,V~lue at dilte of death 400 600 1,000 65,000 1.• 400 1,000 46,000 29,400 _ -t.l J "'f .,:.: $ , l ..{'" 1/1/66 1/10/65 .'8/1/65'. 9/1/~5 :('"..'I 211766- 2/1/65 ---------------------------:!.,-T---3--~--~;"60,000 :",.29,7QO'_:~~_~•__ $60,000-Arkansas Railroad Co.first mortgage 4%,2D-year bonds,due 1976.Interest payable quarterly on Feb.1,May 1,Aug.1,and Nov.1;N.Y.Exchange___________________________________________1,000 100 $30,000 of such bonds distributed to legatees on".A\:lg.1.1965 --~--------_99 $30,000 of such bonds sold by executors on Sept.1,1965_______________________________________________________98 Interest coupons attached to bonds,item 1;due and payable on Nov.1,1964,but not cashed at / date of death.Cashed by executor on Feb.1, "1005-__~-------------------------------~-------------------------.------ -----------Interest accrued on item 1,from Nov.1,1964,to Jan.I,1965.Cashed by executor on Feb.t.1965 ~:_ ________-_-___ _ 500 shares Public Service Corp.,common;N.Y.Exchange :.'____________________100 110 Not disposed of within'year following death_________90 Dividend on item 2 of $2 per share declared Dec.10,1964,and paid on Jan.10,1965,to holders,of record on Dec.30,1964 ,_ 2 1 INSTRUCTIONS FOR SCHEDULE C MORTGAG~S,NOTES,AND CASH The classes of property under this schedule should be listedseparatelyintheordergiven. 1.Mortsages.-State (1)face value and unpaid balance,(2) date of mortgage,(3)date of maturity,(4)name of maker,(5) property mortgaged,and (6)interest dates and rate of inter- est.For example:Bond and mortgage for $9,000,unpaid bal- ance $6,000;dated January.1,1962,John Doe to Richard Roe; premises'22 Clinton Street,Newark,N.J.,due January 1,1970; interest payable at 6 percent per annum January 1 and July l. 2.Promissory notes.-Show similar data. 3.Contract by the decedent to sell Iand.-Show name of vendee, date of contract,description of property,sale price,initial pay-ment,amounts of installment payments,unpaid balance of prin- cipal,and interest rate. 4.Calh in poslession.-List separately from bank deposits. 5.Cash in bank.-State name of bank and address,amount in each bank,serial number and nature of account,showing whether checking,savings,time deposit,etc.If statements are obtained from banks they should be retained for inspection bytheInternalRevenueServiCE:.. 6.Estate of nonresident not a citizen of the United States.-In the case of a nonresident nat a citizen of the United States,a bank deposit is not regarded as situatedin the United States if the decedent was not engaged in business in the United States at the time ofhis death.In the event the decedent was so engaged in business,a bank deposit may,nevertheless,not be includible under the provisions of an applicable death duty convention. ........, • •~l Page 10 SC"ED.ULE,C.,_ MORTGAGES,NOTES,AND CASHt.~• ,.- Did the de::edent,at the time of his death,own any mortg~geS,notes,or cash?./-D'fes"D'Ne;'--_.f "/ ., ~Cash 1 .Pltt.$J)urgh National Bank,Dono'~,Pa,. OfficQ -Savings Account '#561 :ealance '8/29/68 value{t date of deatl1IAlternatevalue $ Subsequent valua· tion dateDescription .~;';i.,st Fed~tal Savings &Loan Assn• .of 'Mone'ssen,Monongahela,Pa,.Saving! Account #520Q902"Balance 8/~9168 ItemNo, TOTAL (also enter under the Re:::apitulation,Schedule 0)$ (Ifmore space is needed,inser1 additional shE!lts of same size)\~......\ESTATE OJ :Andx.evLrakach.........................•...................... I $20 2~~.~5 Schedule C-Page 11 5.Estate of nonresident not a citizen of the United States.- Ih the case of an estate of a nonresident not a citizen of the United States,the proceeds of insurance on his life need not be included under this schedule. INSTRUCTIONS FOR SCHEDULE D INSURANCE 1.Insurance.-Section 2042 of the Code provides for the in-ship,exercisable either alone or iI\conjunction with any person. clusion in the gross estateof (a)insurance on thedecedent's life .Incidents of ownership in a policy include,for example,·the receivable by or for the benefit of the est.ate and (b)certain right of the insured or his estate to its economic benefits,the .insurance on the decedent's life receivable by other beneficiaries.power to change the beneficiary,to surrender or cancel the The term "insurance"refers to life insurance·of every descrip-policy,to assign it,to revoke an assignment,to pledge it for a tion,including death benefits paid by fraternal beneficial loan,or to obtain from the insurer a loan against the surrender societies operating under the lodge system.·value of the policy,etc.A 7:'eversionary.interest {as,for ex- Life insurance not includible in the gross estate under the pro""I'ample,if(the proceeds:#ould -become paYable .to.the insured's visions of section 2042 of the Code,and the Estate Tax es~ate or pa:y':able,a~pe migh~.4i!ect,shQuld,the ~~eficiary pre-· Regulations pertaining thereto may,depending upon the facts decease hIm)constItutes an I~cIdent of ownershIp for the pur- ,of .tliepaJ.:t,i.¢lilar case,be includible under some other section of pose of the preceding paragraph only if imm~di~tely;before the part III of subchapter A of chapter 11 of the Code.For ex-death of the decedent the value of the reversIOnary interest ex- ample,if the decedent possessed incidents of ownership in an ceeded 5 percent of the value of the policy at that time. iI!-sura~ce policy !>n ~s life but ~atuitously transferred.all~~..t", . ':'".,'.:<,t I ti ,~.;:1 ." rights m the pohcy m contemplatIon of death,the proceedS 4.Execution of schedule.-Under "DescrIptIon"show the would be incluljible under section 2035.~;r,',~ame of ,the'inSurance'c6inpan~;~,:iIumbei~of,·policy,name of "-Th f 11 f h <\~neficiary,Jagej am~unt ?flthe.p,olicy,PIillc~p~1 am.ount of a~y,~.2.,Insur~n~e In favor of the ~state.e u amo~t 0 t e mdebtedness to the Insurance company deductIble'm determm- proceeds of msuranc~~n the hfe of the d~cedent receIvable by ing the net proceeds,the interest on the foregoing indebtedness the executor or admInistrator,or ~therwLSe,payable to or for accrued to the date of death,and the amounts of accumulated, ..the benefit .of the estate,should b~mclude1 m the gross estate.dividends (including interest payable thereon)cpost-mo,rtemInsu~ance m favor of the,estate mcludes Insurance effected to dividends,and returned premiums.The value to be entered in prOVIde funds ~meet the estate tax,~d any other taxes,debts,the valuation column of Scheule D is the net proceeds from theorc~arge~WhIch ar~en~orceable ~g~mst the.estate.The man-above items. !tel'm w~Ich.the pohcy I~dr~wn IS ImmaterIal s!>long as there The "Life Insurance Statement,"Form 712,for each insurance IS an obhJPltIon,legally bmdmg upon the benefiCIary,to use the policy listed in the schedule should be obtained from the insur- proceeds.In pl;'ymen~of such taxes,debts,or ~harges.The full ance company by the executor and filed with the returnamountISsomcludibleeventhoughthepremIumsorothercon-. . ..sideration wherewith the insurance was acquired may have been .In addItIOn to the ms~rance s~ownon the returI!as part of the paid by a person other than the decedent.~IOSS estate,complete mfor~atIO~must be submItte4 as t~any.msurance on the decedent's hfe whIch the executor beheves IS not 3.Insurance receivable by beneficiaries ottier thcin the estate.-includible in the gross estate. Insurance with respect to which the decedent possessed inci· dents of ownership at time of death.-The proceeds of all insur- ance on the life of the decedent not receivable by or for thebenefitofhisestatemustbeincludedinthegrossestateifthe ' decedent possessed at his death any of the incidents of owner- ~,...:J ....oJ ~••."i 1 .-~!.. Page 12 , I r SCHEDULE D 'I INSURANCE lao Was c.ny insurance on life of decedentreceivable byhis est·:Ite?I.lb.By b.ene£iciaries other than estate? DYes~No ~Yes 0 No ValuQ at d~te.oNlealhAlternatevalueSubsequentvalua·tion dateItem No. 2.Was there any insurance on the decedent's life which is not included in the return as a part of the gross estate?o Yes ~No If "Yes,"a complete explanation as "to all such insurance must be submitted.--=:-_-=:-..;.....-...._-:_~_=l.~~.~.~...,=.=..=~~~.=._'""....,.....;"...,....~..~;;;;...;;,=~.-.;..;~.;...;..,-~~;..;..,,;;;.;;;.;;;=.,.;.;..;;;.;......-----:------~_._--...'....",; -_,.I..,......~!" _...-.....~_. 1 flquitab1e Lf.f·e A$8Urance.SOc~~ty oi the Unit ed.State$.&certifitat41~No. 9'900"';].,,"06-3515;'beneficiaty"decedent"$ "1idqw (Form 712 attached) TOTAL (also enter qnder the Recapitulation,Schedule 0)$ .(If more spacelk needed,insert additional sheets of same size)' ESTATE OF ~~~~_~~_.'!~~~_.._.\_ l $1.400.,00' Schedule D-Pa.:;Je 13 \\ All property of whatever kind or character,whether real estate,personal property,bank accounts,etc.,in which the dece- dent held at the time of his death an interest either as a joint tenant or as a tenant by the entirety,with right of survivorship, must be disclosed under this schedule. The full value of the property must be included in the gross estate,unless it can be shown that a part of the property origi- nally belonged to the other tenant or tenants and was never re- ceived or acquired by the other tenant or tenants from the de- cedent for less than an adequate and full consideration in money oi'-rfloney·g worth;or unless it can be shown that any pait :6f, the property was acquired with consideration originally belong- ing to the surviving joint tenant or tenants.Where it is shown that the property or any part thereof,or any part of the con- sideration with which the property was purchased,was acquirEl4 by the other tenant or tenants from the decedent for less than an adequate and full consideration in money or money's worth,: there should be omitted only so much of the value of the prop-. erty as is proPClrtionate to the consideration furnished by such 1 other tenant or tenants.For the purposes of the.estate tax,a \relinqui'shment 'or promised relinquishment of dower,curtesy, or of a statutory estate created in lieu of dower or curtesy,or of other marital rights in the decedent's property or estate,is not to any extent a consideration in money or money's worth. Where the property was acquired by gift,bequest,devise,or inheritance by the decedent and spouse as tenants by the en- tirety,then only one-half of the value of the property should be INSTRUCTIONS FOR 'SCHEDULE E~-. J' JOINTLY OWNED PROPERTY ;"'. included.Where the property Vias acquired by the decedent and another person or persons by gift,bequest,devise,or inheritance as joint tenants,and their interests are not otherwise specified or fixed by law,then there should be included only such frac- tional part of the value of the property as is obtained by divid- ing the full value of the property by the number of joint tenants. .If the executor contends that less than the value of the entire property is includible in the gross estatefor purposes of the tax, the burden is upon him to show his right to include such lesser value,and in such case he should make proof of the extent, .origin,:and'nature Of·the deeedeni's'ihterest:and the interest of the decedent's cotenant or cotenants. In every instance a statement under the column headed "De- scription"must disclose whether the whole or only a part of the property~is included.in the gross'.estate./If only a paft of':the property is included in'the gross estate,the fair market value of -thelwhole must be shown uhder "Description."\).:. !Property in wnich the decedent"nel<:\·an interest as a tenant in common'should not be Usted ul).del:this schedule,butthe value of his interest therein should:be returned.uride.r Schedule A,if real estate,or if personal property,under 'such other appropriate schedule.Similarly,community property held by the decedent and apouse should be returned under the appropriate Schedules A to I.The d,ecedent's interest in a partnership should not be in- cluded under this schedule,but should be shown under Schedule F,"Other miscellaneous property." ,. Page'14 \ SCHEDULE E JOINTLY OWNED PROPERTY 1.Di,d th~decedent~at th~time of his de:.th,own any property as a ioint tenant or as a tenant by the entirety X wIth rlgh:of surVIvorshIp?'0 Yes 0If"Yes,"state the name and address of each surviving cotenant No NAMEZualTakach,widow 8u:rviving John A.Takach Thomas A.Takach Susan Stimak Anna Sabol ADDRESS (Number,street,city,State,and Postal ZIP code) 430 Murray Avenue,Donora,Pa.15033 210 Fourth Ave.j MOl'lOngahela,Pa.15063 424 Fourth St.,Monongahela,Pa.15063 18320 Hart Street,Reseda,California ItemNo,D3Scription Subsequent valua- tion date Alternate value Value at dateof death I Charleroi Federal Savings &LOan Assn.I Charleroi,Pa.-Savings Acct.#4960 il name of Andrew Takach or Zuzi T"kach, balance 8/28/68 2 Fust Federal Savings &Loan Assn.of Monessen,Monessen,Pa.,Savings Acct. 1IS2704 in name of Andrew Takach or ZUZI ie (wife),balance 8/28/68 3 Mellon National Bank &Trust Co.,Dono,a. Pa..Savings Acct.#65-5540 in name of Andrew Takach or Susie Takach,balance 8/28/68 4 Two-story frame house and lot at 436 Nurray Avenue,DOIlora,Pa.,being part of Lots Nos.22 and 23 in Block No.17. as per appraisal attached,jointly hel~ by decedent and Zuki Takach 5 Block garage and lot at Murray Avenue, Donora,Pa.,being Lot 24 in Block 17, as per appraisal attached,jointly hel~ by decedent and Zuki Takach ~ 6 Two-story frame house and Lot at 418 Murray Avenue,Donora,Pa.,being pari of Lot 27,Block 17,as per appraisal attached,jointly held by decedQnt and Zuld.Takach $$ 3,432.00 8,999.59 7,500.00 ~~:LmaK,... as per att. 165 Series jointly in E.U.S.Savings Bond,helc name o~decedent and Susan -_.--A ~.......,,....,.- sellt)TAL (also enter under the Rer.apitulation,Schedule 0)$ 60,974.16 $90,962.75 (If more space IS leeeled,insert ;dditional sheets of same size) Andrew Takacb \ESTATE OF . ._Schedule E-Page 15 INSTRUCTIONS FOR SCHEDULE F OTHER MISCELLANEOUS PROPERTY In case of an interest in a trust fund,a copy of the trustinstrumentshouldbesubmitted.' Where decedent owned insurance on the life of another,Form 938,Life Insurance Stl:.tement,may be obtained from the insurance company by the executor and filed with the return. Estate of nonre'sident not a citizen'of t~e United States.-In the case of a nonresident not a citizen of the United States works of art which were (1)importe'd into the United States solely for exhibition purposes,(2),loaned for such purposes to a public gallery or museum,TI)part of the netearnings of which inures to the benefit of any private stockholder or individual, and (3)at the time of the c.eath of the owner,on exhibit,or en route to or from exhibition,in such a public 'gallery or museum,are not includible in this schedule as situated in the United States. ./ Under this schedule list all items of the gross estate not returnable under any other schedule,such as the following: Debts due the decedent;interests in business;insurance on the life of another;claims (including the value of the decedent's interest in a claim for refund of income taxes or the amount of the refund actually received);rights;royalties;pensions; leaseholds;judgments;reversionary or remainder interests; shares in trust funds;household goods land·personal effects, including wearing'apparel;farm products and growing crops; livestock;farm machinery;.automobiles;etc.','•.~ When an interest i.~,a copartnershi,P or unincorporatedbusi~ ness is return~d,submit a'statement of"assets and liabmties as of the valu'!1tion date and for th:e 5 years preceding,and state'- ments of the net earnings for the same 5 years.Goodwill must be accounted for.In general,the same information should be furnished and the same methods followed as in valuing close corporations.See instructions for Schedule B on page 8. ,. .. )",. ;.-.\.\ ".. -, ,.. "r .)"; " \.4 "',I... r"-'... )'.' ',0 ,t , "':...I • ,/ " Page 16 ...t,.:l,. ·0'1~;.~~:.~:.,o '1b""'<) A.Andrew Takach or Susan Stimak .1.u.S.GOVERNMENT SERIES E BONDS IN FOLLOWrnC JOINT NAMES,DENOMI- NATIONS,,&DATES OF PURCHASE Ib ' Thousand ($1,000)Dollar Denomina~ion i-I '1 bond purchased'Feb.1962 958.00 2 bonds purchased August 1964 ~63.60 Five Hundred ($500)Dollar Denomination 7 bonds purchas'ed Feb.1962 479.00 1 bond purchased May 1962'$o:y~8 .~9...,~, 2 bonds purchased July 1962'~9.20 1 bond purchased August 1962 f!.69.2b 3-bonds purchased Sept.1962 ~59.00 4 bonds purchased Jan.1963 ~59.6b 4 bonds purchased May 1963'~9.6b 3 bonds purchased June 1964 ~31.80 qne Hundred ($100)Dollar Denomin~tion!' 5 bonds purchase<i August 1962 !93.8~ 5 bonds purchased Sept.1962 !91.80 5 bonds purchasec Jan.1963 i 91.9~ 2 bondE purchasec:Aug.1964 186.3p !,i I!'I B.Andrew Tckach or 'John Takach (Sop)i ,.I . Thousand ($1,000)Do1iar Denomin~1tiOnt' ,2'bonds purchased Feb.1962 58.0 2 bonds purchased Aug.1964 .63.6 . Five Hundred ($500)Dollar Denomlinati~n 7 ~onds purchased Feb.1962 r79.0~ 1 bond purchased May 1962 ~68.40 2 bo'nds purchased July 1962 ~69.29 1 bond purchased Aug.1962 ~69.20 3 bonds purchased Sept.1962 ~59.00 4 bonds purchased Jan.1963 ~59.60 .4 bonds purchased May 19~3 ~49.60 .3 bonds purchased June 1964 ~31.80 One Hundred ,($100)Dollar Denomir.ation 5 bonds purchased Aug.1962 193.84 5 bonds purchased Sept.1962 1 91.80 5'bonds purchased Jan.1963 191.92I2bondspurchasedAug.1964 !86.3p I ' 958.00 1,727.20 3,353.00!463'.40 :933.40 ,46:3.20 ~.,377.00 ~,83g.40 1,798.40 ;1,295.40 469.20 459.00 459.60 172.72 1)5,783.92 il,916.00 iIi11,727 .20 I i J.. i /.. ;3 ,353.00 I I 468.40 ! I i 938.40 I i 46'9.20! :1,37'7.00 ;1,838.40 11,798.40 ;';1,295.40 469.20 459.00 459.60 ·1172.72 16,7[11.92 I! p I· ,......". ~~-. C.Andrew Takach or Thomas Takach (Son)I I Thousand ($1,000)Dollar Denomin8.tion~! 2 bonds purchased Feb.1962 .958.0 2 bonds purchased August 1964 863.6, Five Hundred ($500)Dollar Denominatipn 5 bones pur.chasEd Feb.1962 .f79'OI 2 bonds purchased July 1962 ~69.2 1 bond purchasec Aug.1962 69.Q ' 3 bonds purchas~d Sept.1962 59.0 1 bond purchased May 1962 f,68.4p 4 bonds pu.rchased Jan.1963 ~.59.6p 4 bonds purchased May ,1963 '~49.6p 3 bonds purchased June 1964 ~31.80 One Hundred ($100)Dollar Denomiration J bonds purchased Aug.19.62 193.84·.I ,J bonds purchased Sept.1962 91.80I J bonds purchased Jan ..19~3 91.9~ 2 bonds purchased Aug.1964 86.36 I i D.Andrew Takach or Anna Sabol (DaL~hter! .·1 ,Thousand ($1,000)Denomination I I 3 bonds purchased April 1967 ~72.80 Five Hundred ($500)Dollar DenOl1l~nati~n 10 bonds purchased May 1962 ~68.4 6 bonds pur~hased Jan.1963 59.6 2 bonds purchased May 1963 49.60 4 bonds purchased April 1967 86.46 One Hundred ($100)Dollar Denomi atio~ 5 bonds purchased Jan.1963 91.9~ iII i JIi· iI j .I ~,~16.001 11 ,127 •20 I II .12,3~5.00 1938.40I469.20!iI,379.00 I i 468.40 I i I11,838.40, I.I:1,798.40, \1,295.40 I I I469.201, I459.00,J 459.60 i .172.72 1" liS,783.92, iI I,I :2,318.40 I ! .II'H-,E84.001 !I2,757.60 i I -!E99.2 0I \1,:45.60 I !i , !459.6011~,E64.401 I "~I ,il -'4 ~ .SCHEDULE r OTHER MISCELLANEOUS ,PROPERTY 1.Did the :iecedent,at the time of his death,own any interest in a copartners~ip £~unin(:orpqra,tedb-~siness(._ DYes z.Did the :iecedent,at the time of his death,own any miscellaneous p'operty not returnable under any other schedule? .,DYes [XNc 3.Was,ther$,any insurance which the decedent owned on the life of another which is not included in the return as a part of the gross esta:e? .\If "Yes,"full details must be submitted under this schedule.0 Yes ~Nc., 4.State w~!~th~r the de:cedeJ?fs estat~,his ,?ouse!or any other p~rson,hos;received,or ,will reci3iye"arw bonus or qward,as,a result'of file, decederi'semployment or his death.If "Yes,"full details IT"ust be submitte~under this schedule.0 Yes ¥J Nc ItemNo.Description Subsequent valua- tion date I Alternate value Value at date of deatb ., Amer,ie~RU$sian\'G'it~~ens "Club 'ox ODII1QJ:a:;.Pa,~:".bU)ilal'benefit to:w,idoWll~ 4ziTaltach '.'~-'"~~', 2 uDitedSt~t~e.Ste$l &.¢arnegie Pension ~d,Septembet check ,payable tQwl~QW $$ ,,300.00 147 "'76, .'70 ..00 ,TOTAL (also enter under the Recapitulation,Schedule C)$ (If more space is ,\:eeded,insertadditional sheets of same size) ESTATE 0'1 ~ng~@~__~~~~!t __~\------------------------- \ $517.76 Schedule F-Page 17 INSTRUCTIONS FOR SCHEDULE G TRANSFERS DURING DECEDENT'S LIFE In accordance with the provisions of sections 2035-38 of-the person (regardless of whether such person had Ii substantial Code,the following transfers made by the decedent during his adverse interest in the transferred property),or life,oy trust or otherwise,other than bona fide sales for an (e)In case the transfer was made after June 22,1936,re- adequate and full 'consideration in money or money's worth,gardless of whether the power was reserved at the time of the are subject to the tax,and must be included in the gross estate transfer or later created or conferred,and without regard to under this schedule:the source from which the power was acquired,regardless of (1)Transfers made in contemplation of death.-Transfers whether the power was exercisable by the decedent alone or by decedents are,unless shown to the contrary,deemed to have in conjunction with any person,and if in conjunction with been made in contemplation of death,if they were made within any person,regardless of whether such person had a substan- 3 years prior to death.However,no transfer made prior to the tial adverse interest in the transferred property. 3 years immediately preceding the decedent's death shall be (6)Transfers effected by the relinquishment in contemplation deemed a transfer in contemplation of death.of death of his power to alter,amend,revoke,or terminate a )f d d f S b 1916 t k'transfer of property previously made by the decedent under(2 Trans ers rna e on an a tel'eptem er 8,, a mg conditions set forth in the preceding subparagraph (5).Such effect at the decedent's death.transfers will not be considered to have been made in contem- A transfer J.llade by th~deceden~taking effect at his death is plation of death unless they,were made within.3 years prioroneunderwhIchposseSSIOnorenJoymentofthepropertycan•to death._.:'.,.• be obtained only by surviving the decedent.However,:such,a 'For more detailed information s.ee the Estate Tax Regu-transfer is not treated as a transfer taking effect atl death lations 't .(; .unless.the ~ece~ent r~tained a reve~sionary interest in t~e Tra~sfersincluded in the gross estate should be valued as of property whIch ImmedIately before hIS death had a value In the date of the decedent's death or,if the alternate valuation excess of 5 percent of the value of the transferred property.is adopted in accordance with section 2032 of the Code,.Ifo~ly In the.case o~such a transfer mad~beforeOctober 8,~949,*e a portion 'of the property:is so ti:a!nsferred as to.come within reVe!SlOnary Interest must have arIsen by the express t~rms.of.the terms of the Statute,only a corresponding proportion of the the 'Instrument of transfer.,J I.".'value'of the property should be includM in the value of the gross (3)Transfers whereby the decedent retained the possession estate.If the transferee makes additions to the property,or or enjoyment of,or the right to the income from the transferred betterments,the enhanced.value of the property atthe valuation property if the transfer was made:date,due ~such adclitions or.belJte.ftnents;should not~e included (a)After March 3,1931,and the retention is for his life,under thIS schedule..~owever,where only a portIon of the or for any periodwhich does not in fact end before his death·v~lue of the property IS mcluded,the valu~o~the whole must.be,dIsclosed under the column headed "DeSCrIptIon,"together WIth or(b)Aft J 6 1932 d th t t'"f h"I"f an explanation of the proportionate inclusion.er une,,an e re en iOn IS or IS I e,or T .te b fid I f d te d f IIforany·per"ad not ascertainable without reference to his .'0 c?nst~tu a ona e sa e or an,,a equa an u con-I . d h'h d "f d b f h'slderatIon In money or money's worth,It must have been madedeathorforanypenowICoesnotInacteneore~s in good faith,and the price must have been an adequate and dellith..full equivalent and reducible to a money value.Ifthe price was (4)Transfers (not otherwise includible)whereby the dece-less than an adequate and full equivalent,only the excess of the dent retained the right to designate the person or persons who fair market value of the property,as of the valuation date, shall possess or enjoy the transferred property,or the income over the price received by the decedent should be included in the therefrom if the transfer was made:gross estate.For the purpose of the estate tax the relinquish- (a)After March 3,1931,.and the right to so designatewas ment or promised relinquis!Iment of dower,curtesy,or of a retained by the decedent alone,for his life,or for any period stat';1tory.estat~created m he}!of dower or curtesy!or of other which does not in fact 'end before his death'or marItal rIghts m the decedent s property or estate,IS not to any.'.extent a consideration in money or.money's worth.(~)After June 6,1932,!lnd the rIght ~o so d.esl~ate ,,:as All transfers made by the decedent within 3 years priorto the retamed by the d~ed~nt,eIther alone o~In conJunctio~WIth date of his death of a value of $1,000 or more and all transfersa~y person,for hIS hf~or for any perIod no~asce~aInable (other than outright transfers not in trust)made by the dece- wlth,out reference to hIS,death or for any perIOd whIch does dent at any time during his life of a value of $5,000 or more not In fact end before hIS death.except bona fide sales for an adequate and full consideration, (5)Transfers whereby the enjoyment of the transferred in money or money's worth must be disclosed in the return, property was subject at decedent's death to any change through whether the executor regards such transfers as subject to the ' the exercise of a power to alter,amend,revoke,or tenninate,tax or not.If the executor believes that such a transfer is not as follows (unless the decedent was,for a continuous period subject to the tax a statement of the pertinent facts should beginning on or before September 30,1947,and ending with his be made.~eath.'after August 16,19~4,u~der a.mentaI disability to re-In case a transfer,by trust or otherwise,was made by ahnqUls~a power as descrIbed In sectIon 20.2038-1 (f)of the written instrument,a copy must be filed with the return.If of regulatIOns):•public record,the copy should be certified;if not of record,the (a)In case the transfer was made before 4:01 p.m.,east~copy should be verified.. ern standard time,June 2,1924,and the power was reserved The name of the transferee,date and form of transfer,and a at thetime of the transfer and was exercisable by the decedent complete description of the property should be set forth in this alone or'in conjunction with a person having no substantial schedule.Rents and other income must be included as explained adverse interest in the transferred property,'under "Execution of Return"in the "General Instructions." (b)In case the transfer was made after 4:01 p.m.,eastern Nonresident not a citizen of the United States.-If the decedent standard time,June 2,1924,and before June 23,1936.and was a nonresident not a citizen,the transfermust be included if the power was reserved at the time of the transfer and was the property was situated in the United States,either at the exercisable by the decedent alone or in conjunction ",ith any date of the decedent's death or at the date of the transfer. Page 18 SCHEDULE G TRANSFERS DURING DECEDENT'S LIFE 1.Did the decede'!)t make any transfer described in the first paragraph (including the six subparagraphs)of the instructicns for tris schedule?0 Yes ~:.-l'o Za.Did the decedent,at any time,make a transfer (other than an outright transfer not in trust)of an amount of $5,000or more without an adequate and full consideration in me·ney or money's worth,but not believed to be includible in the gross estate as indicated in the first paragraph (including the six subparagraphs)of the instructions for this schedule? If "Yes,"furnish the follOWing information:0 Yes ~:-ro 2b.Date 2c.Amount or value 2d.Character of tr,:msfer 3a.Did the decedent,within 3 years immediately preceding his dedh,make any transfer of his property without an adequate and full consideration in m:mey or money's worth? If "Yes,"and the transfer was of an amount of $1,000 or more,furnish the follOWing information: 3b.Date 3c.Amount or value 3d.Character of transfer 3e.Motiwe ',yhich actuated decedent in o:.aking transfer o Yes ~No r 4.Were there in existence at the time of the.decedent's death any :rusts created by him during his lifetime? /0 Yes 131 No 5.If a FedHal gift tax return(s)was eve::,filed,state the yeer(s)co.ered and the Internal Revenue dstrict in which filed. Not filed Item Description Subsequent valua·Alternate value Value at date of d~athNo.tion date-- I $$, , I ....,; I - / - TOTAL (also enter un::ler the Recapitulation,Schedule 0)$$ (If more space is oeeded,in~ert additional sheets of same size) ESTATE OF ---iAA-d~-t»ka@----------------------------------'---_c-------------Schedule G-Paqe 19 INSTRUCTIONS FOR SCHEDULE H POWERS OF APPOINTMENT 1.General.-There is ineludible in the gross estate under this only in conjunction with (a)the creator of the power,or schedule the value'of certain property with respect to which (b)a person having a substantial interest in the property the decedent possessed a general power of appointment at the slibject to the power,which is adverse to the exercise of the time of his death,or with respect to which he once possessed power iIi"favor of the decedent. a genera1 power of appoint!'1ent aJld exercised.or released that (4)If (after the application of (3»a power created power prior to his death by a disposition of such a nature that after October 21,1942,is a general power and itis exercisable if it were a transfer of property owned by the decedent,such by the decedent only in conjunction with another person prqper!y would be includible in his gross estate.A general but (in addition to being exercisable in favor of the decedent, power of appointment is described below.If the decede~t ever his estate,his creditors,or the creditors of his estate)is possessed a general power of appointment,the executor should exercisable in favor,of such other person,the power is deemed examine the re~lations issued pursuant to section 2041 of the a general ,power only in respect of a fractional part of the Code\to ascertain whether the value of the property subject to property subject to such power.The fractional part is that powe:t:is includible in the gross estate.determined by dividing the value of such property by the 2.Definition of a power of appo!ntment and a !Jeneral power number of persons (including the decedent)in favor of appointment.-The term "power of appointment"includes all of whom such power is exercisable. powers.which are in substance and effect powers of appointment 3.Date of creation of power.-Apower of appointment created regardless of the nomenclature used in creating the power or by will is,in general,considered as created on the date of the of local property law connotations.For example,if a settlor testator~s death;however,a power of appointment created by transfers property in trust for tj1e life of his wife,with a power a will executed on or before October 21,1942,is considered a in the wife to appropriate or consume the principal of the trust,power created on or before that date if the person executing the wife has.a power of appoiritment.the will died before July 1,1949,without having republished the The term "general power of appointment"means a power will,'by codicil or otherwise,after October 21',1942.A power which is exercisable in favor of the decedent,his estate,his of appointment created by an inter vivos instrument is con- creditors:or the creditors of his estate,.with the following sidered as created on the date the instrument takes effect.If exceptions:the holder of a p0'Yer exe,rcises it by creating a secC?nd power,.-n)A power to consume,invade,or appropriate property the s~cond power IS conSIdered as created at the time of th~ for the benefit of the decedent which is limited by an ascer-exerCIse of the first. tainable standard relating to health,education,support,or 4.Supplemental data.-If the decedent ever possessed a powermaiiI~nance of the decedent is not a general power of of appqintment,a certified or v~rlfied'co~y,ofi the iI!strument appomtment.grantmg t:he power,togethColr WIth a'certified or verIfied cOP:f. .(2)A power created on or before October 21,1942.which of any instrume.nt by which the power was.exercised or release , is exercisable by the decedent only in conjunction with an-mUl:;t b!!.fiJe.d WIth the return.These copIes must be filed even other person is not a general power of appointment.though It IS ~ontended that the power was.not a gene~al (3)A power created after October 21,1942,is not a gen-power.of ll;ppomtment,and that the property IS not otherwIse eral power of appointment if it is exercisable by the decedent m«luc\Ible m the gross estate. INSTRUCTIONS FOR SCHEDULE I ANNUITIES . 1.General.-Except as otherwise provided under "Annuities the decedent,if they were made by the employer b~reason of under approved plan,"there shall be included in the gross the decedent s em~loy~ent.For further mfo~m~tIOn see the estate under this schedule all or a portion of an annuity or estate tax regulatIOns Issued pursuant to sectIqn 2039 of the other payment receivable by any beneficiary following the death Code.. of the decedent under a contract or agreement which satisfies 3.Definition.-The term "annuity"includes periodic payments the folir conditions set forth below.It should be noted that for a specified ,period of time.The following are examples of condition (d)is satisfied'if the contract or agreement satisfies contracts (but not necessarily the only forms of contracts) either clause (i)or clause (ii)thereof.The co~ditions are:providing for payments which constitute !innuities or other .(a)The contract or:agreement is not a policy of insurance payments for the purpose of inclusion in this schedule: on the life of the d~cedent.(a)·A contract under which the decedent immediately (b)The contract·or agreement was entered into after before his death was receiving,or was entitled to receive, March 3,1931.for the duration of his life an annuity or other stipulated (c)The annuity or other payment is receivable by the payment,with payments thereunder to continue after his beneficiary by reason of the beneficiary's having survived death to a designated beneficiary,if surviving the decedent. the decedent..(b)A contract under which the decedent immediately (d)Under the contract or agreemen1:r-before his death was receiving or was entitled to receive, (i)all annuity or other payment was .payable to the together with another person,an annuity or other stipulated decedent,either alone or in conjunction with another,for payment payable to the 'decedent ,and the other person for his life or for any period not ascertainable without refer-their joint lives,with payments thereunder to continue to ence to his death or for any period which did not in fact the survivor following the death of either. end before his death,or (c)A contract or agreement entered into by the decedent (ii)the dece.dent possessed the right to receive the an-and'his employer under which the decedent immediately be- nuity or other payment,either alone or in conjun.ction with fore his death and following retirement was receiving,or another,for his life or for any period not ascertainable was entitled to receive,an annuity or other stipulated pay- without reference to his death or for any period which did ment,.payable to the decedent for the duration of his life and not in fact end before his death.thereafter to.a designated beneficiary,if surviving the dece-It is immaterial whether the annuity or other payments to dent,whether the payments after the decedent's death are the survivor are payable in a lump sum or in installments and,fixed by the contract or subject to an option or election exer- if payable in installments,whether the installments to the cised or exercisable by the decedent.However,see "Annui- survivor are in the'same amount as,or in a greater or lesser ties under approved plan," amount than,the annuity or payments to the decedent.The (d)A contract or agreement entered into by the decedent value of the annuity or other payment to the survivor is the and his employer under which at the decedent's death,prior value thereof immediately following the decedent's death.to retirement or prior to the expiration of a stated period of2.Portion includible.-Where the decedent contributed only a time,an annuity or other payment was payable to a desig- .portion of the purchase'price of the contract or agreement,nated beneficiary if surviving the decedent.However,'see there is included in the gross estate only that portion of the "Annuities under approved plan." value of the annuity or other payment receivable by the sur-.(e)A contract or agreement under which the decedent viving be!1eficiary which ~he decedent's contribution to the ,pur-immediately 1;>efore his death was receiving,or was entit!ed cha!;le prIce..of the annUIty or agree~ent bears to the total to receive,an annuity or other payment for a sta~d perIodpu~chase pr~ce t~ereof..For example,ma case where the value of time,with the annuity or other payment to cont~nue to a of the SurVIvor s annUIty was $20,000 and the decedent h<l-d designated beneficiary,upon the decedent's death prIOr to the contributed t~ree-f?urt~sof the pur~hase price of the contract,expiratioil'of that period of time,if surviving the decedent. the a~ount m~ludlble IS $~5,OOO .(l4.x $20,000).Except a~4.Annuity under approved plan.-Special rules are providedother~Ise.prOVIded under AnnUItIes under approved plan,in the case of an annuity or other payment under:contrIbutIOns made by the decedent's employer to the purchase price of the contract or agreement are considered as mad.e by (Conti~~,~d;?n p;age,2~):"'l!', Paqe 20 SCHEDULE H POWERS OF APPOINTMENT --,......._-- la.Did the decedent"at the time of deach,possess a general power of appointment created after :)c1ober 21,1942?0 Yes ltJ No lb.On or before such date?0 Yes ~No 2a.Did the decedent.at any time,by wJl or otherwise,exercise or release (Ic any 2b.On or before~ch date? extent;a g~neral power of appointment created after October 21,1942?0 Yes ~No 0 Yes ~No 3.Were tl:ere in existence at the time of the decedent's death any ":rusts not created by him under which he possessed any power.,beneficial interest,or trusteeship?0 Yes ~No (Ifmore space IS needed,lnsert addItIOnal sheets of same size) .-. Item Description Subsequent valua-Alternate value Value at date of ,jeathNo.tion date ' ~None $$ I . , , TOTAL (also enter llnder the Recapitulation,Schedule 0)$$000 ..., SCHEDULE I AlfNUITIES la.Was the decedent,immediately before his death,receiving a-:l annuity as described in paragraph 1 0:the il)structions?0 Yes 'tJ I No : lb.If "Yes,"was that annuity paid pursuant to an appro'/ed pla:l as described in parc.graph 4 of the instr~ctions?'.'0 Yes 0 No Ie.If the answer to "lb::is "Yes,"state the ratio of the deceden:'s contributi~n to the total purchase price of the annuity. 2a.If the decedent was employed at be'time of his death,did an annuity 0:other payment as des::ribed in p::xragraph 3(d)of the instructions become payable to any benefiCiary.by rimson of the beneficiary's having survived the decedent?0 Yes 2.tJ No Zb.If "!es,"state the ratio of the 1ecedent's ~on~i~ulion to the ~otal purchase price of the annuity. Schedules H and I-Page 21 Item I ',..Subsequent valua- No.Description •,tion date Alternate value Value at dateo!death 1 None $$ . ,.. ,.. ..:•. TOTAL (also enter unpet the Recapitulation,Schedule 0)$$QOO•...,(If more space IS n,ee.ed,Insert addItIOnal sheets of same sIze) -'Andrew 1;'~ch \ESTATE OF ";_ \ INSTRUCTIONS FOR SCHEDULE I-Continued (a)An employees'trust (or under a contract purchased by an employees'trust)forming part of a pension,stock bonus,or profit-sharing plan which met all of the require- ments of section 401 (a)of the Code,either at the time of the decedent's separation from employment (whether bY'death or otherwise)or at the time of the termination of the plan if earlier;. (b)A retirement annuity contract.purchased by an em- ployer (but not by an employees'trust).pursuant to a plan which,at the time of the decedent's separation from employ- ment (by death or'otherwise),or at the timeof the termination of the plan if earlier,was a plan described in section 403 (a); or (c)A retirement annuity contract purchased for an em- ployee by an employer which is an organization referred to in section 503 (b)(1), (2),or (3)of the Code,and which is exempt from tax under section 501 (a)of the Code.. Where the annuity or other payment described above is receivable by a beneficiary other than the executor and the decedent made no contributions under the plan toward the cost thereof,no portion of the annuity or other payment is includible in the gross estate.If the decedent made a contribution under the plan toward the cost thereof,there shall be included in this schedule of the return that proportion of the annuity or other payment which an amount A (the amount of the dece- dent's contribution underthe plan)bears to B (the total amount of all contributions under the plan).The decedent's contribu- tions under a plan which satisfies the requirements set forth in (a)or (b)do not include any amounts contributed by the employer under the plan,but in.the case of (c),employer's contributions in excess of the amounts excludable from gross income of the decedent under section 403 (b)are considered to have been contributed by the decedent.However,contribu- tions or payments on behalf of the decedent while he was a self- employed individual made under a trust or plan described in paragraph (a)'or (b)above shall be considered to have been made by the decedent.If any portion of the annuity or other payment is receivable by the executor,it is includible in the gross estate under this schedule to the extentthat it is receivable by the executor in his capacity as such.In general,the an- nuity or other payinent is receivable by the executor if it is to be paid to him or if there is an agreement (expressed or im- plied)that it will be applied by the beneficiary for the benefit of the estate (such as in discharge of the estate's liability for death taxes or debts of the decedent,etc.)or that its distribu- tion will be governed to any extent by the terms of the dece- dent's will or the laws of descent and distribution.If data available to him does not indicate whether the plan satisfies the requirements of section 401 (a)or 403 (a),the executor may obtain information relative thereto from the district director of internal revenue for the district in which the employer has his principal place of business.For further details,see the estate tax regulations issued pursuant to section 2039 of the Code. 5.Execution of schedule.-In describing an annuity,the name and address of the grantor of the annuity should be given,or if payable out of a trust or other fund,such a description as will fully identify it.If payable for a term of years,the duration of the term and the date on which it began should be given,and if payable for the life of a person other than the decedent,the date of birth of such person should be stated. INSTRUCTIONS FOR SCHEDULE J FUNERAL EXPENSES AND EXPENSES INCURRED IN ADMINISTERING PROPERTY SUBJECT TO CLAIMS \"V \\. ":'\ Funeral expenses and expenses incurred in administering property subject to claims should be itemized,giving names and addresses of persons to whom payable,and exact nature of the particular expense.Expenses incurred in administering property not subject to claims should not be listed on this schedule.In connection with such expenses,see the instructions for Schedule L. The total deduction for executors'commissions should be entered at item 1,the total deduction for attorneys'fees should be entered at item 2 and the deductions for funeral expenses and miscellaneous administration expenses should be itemized under·the designated sections of the schedule.An item may beenteredfordeductionthoughtheexactamountisnotknownat the time the return is filed,provided it is ascertainable with reasonable certainty,and will be paid.No deduction may be taken upon the basis of a vague or uncertain estimate.Retain all vouchers and receipts for inspection by the Internal Revenue Service. The executor or administrator,when filing the return,may deduct his commissions in such an amount as has actually been paid or which at that time it is reasonably expected will be paid,·but no deduction may be taken if no commissions are to be collected.In case the amount of the commissions has not been fixed by decree of the proper co.urt,the deduction will be allowed on the final audit of the return provided:(1)that the district director is reasonably satisfied that the commissions claimed will be paid;(2)that the amount entered as a deduc- tion is within the amount allowable by the laws of the juris- diction wherein the estate is being administered;and (3)that it is in accordance with the usually accepted practice in said jurisdiction in estates of similar size and character.If the commissions claimed have not been paid at the time of the final audit of the return.the amount deducted must be supported by an.affidavit,or statement signed under the penalties of perjury, of the executor stating that such amount has been agreed upon and will be paid. A bequest or devise to the executor in lieu of commissions is not deductible.If,however,the decedent fixed by his will the compensation payable to the executor for services to be ren- ., Page 22 dered in the adniinistration of the estate,deduction may be taken to the extent that the amount so fixed does not exceed the compensation allowable by the local law or practice. Amounts paid as trustees'commissions should not be listed on this schedule whether received by the executor acting in the capacity of a trustee or by a separate trustee as such.For the deduction of such amounts incurred in administering prop- erty not subject to claims,see the instructions for Schedule L. When filing the return there may be deducted such an amount of attorneys'fees as has actually been paid or which at that time it is reasonably expected will be paid.If on the final audit of the return the fees claimed have not been awardedbythepropercourtandpaid,the deduction will be allowed, provided the district director is reasonably satisfied that the amount claimed will be paid and that it does not exceed a reasonable remuneration for the services rendered,taking into account the size and character of the estate and the local law and practice.If the fees claimed have not been paid at the time of the final audit of the return,the amount deducted must be supported by an affidavit.or statement signed under the penalties of.perjury,of the executor or the attorney stating that such amount has been agreed upon and will be'paid. Attorney's fees incidental to litigation instit~ted by the beneficiaries as to their respective interests do not constitute a proper deduction,inasmuch as expenses of this character are properly charged against the beneficiaries personally and are not administration expenses as contemplated by the statute. For the deduction of attorney's fees incurred in administering property not subject to claims,see the instructions for Sched- ule L. Executors should note that executors'commissions constitutetaxable'income. Section 642 (g)of the Code provides t.hat amounts allowed under section 2053 or 2054 as deductions in computing the taxable estate of a decedent are not allowable as deductions in computing the taxable income of the estate for income tax purposes. " DEDUCTIONS SCHEDULE J FUNERAL EXPENSES AND EXPENSES INCURRED IN ADMINISTERING PROPERTY SUBJECT TO CLAIMS .. NOTE.-Donotliston.this scheduleexpensesof administering properl'{not subject to claims.In connection with such expenses,see Schedule L. If elI:ecutors'commissions,attorneys'fees,etc.,are claimed an::i allowed as a deduction for estate tax purposes,they are not allo.....able as a deduction in computing the taxable income of the estate for Federal income tax purposes.' . •/'. ItemNo. A.Funeral-expenses:, Description $ Amount 2 3 'ttUl~~tk l\u\e.rat:be 'l.;'l:$~OOLukec.tcb·~GlfJJ'pWGmafttlt 20,_ ..••lfOut'l$.~.·'.~lil eenlc;e .'?'"fM).hn.ttl)l 1r~fre~t8.~Total., . . . . . . ...x x x x x x x x B.:Adrninietration expenses: Executors'canmissions-amount estimated/agreed upon/pcid.(Strike out words notappli- cable)_ :' , , ''....x x x x x x x x Attor~eys'fees-amountestimated/agreed upon/paid.(Shike out'words not applicable)..x x x x x x x x Miscellaneous expenses: 4 Court:,cQste,tiling fee$,etc., ,. 131.50 • ,, -' Total miscellaneous expenses.. . . . . . . . .... . . ...x x x X.x x x x TOTAL (also enter under the Recapitulation,Schedule 0)·$ (II more space is needed,insert additional sheets of same sizo.) ESTAE OF '.m--liiIi.--reeefi.m--mm..mm.mm-m.mm-------u.Schedule J~Page 23 INSTRUCTIONS FOR SCHEDULE K DEBTS OF DECEDENT Itemize,under "Debts of Decedent"only valid debts of the decedent owed by him at the time of death.Any such indebted- ness secured by a mortgage or other lien upon property of the gross estate should be listed separately under the heading of "Mortgages and Liens."If the amount of the debt is dis.puted or the subject of litigation,only such amount may be deducted as the estate concedes to be a valid claim.If the claim is contested,that fact should be stated. If the claim against the estate is founded upon a promise or agreement,the deduction therefor is limited to the extent that the liability was contracted bona fide and for an adequate and full consideration in money or money's worth,except that any such enforceable claim founded upon a promise or agree- ment of the decedent to make a contribution or gift (such as a pledge or a sUDscription)to or for the use of a charitable, public,religious,etc.,organization is deductible to the extent that such a deduction would be allowable as a bequest under the applicable statute. The deduction for property taxes is limited to such taxes as accrued prior to the date of the decedent's death.Federal taxes on income received during decedent's lifetime are de- .dudible,but taxes on income received after death are not deductible. Ente"r in this schedule notes unsecured by mortgage or other lien 'and give 'full details,including name of payee,face and unpaid balance,date an'd term of note,interest rate and date to which interest was paid prior to death.Care must be taken to state the exact nature of the claim as well as the name of the creditor.If the claim is for services rendered over a period of time,state the .period covered by the claim.Example: Edison Electric Illuminating _Co.,for electric service during December 1964,$25. If the amount of the claim is the unpaid balance due on a contract for the purchase of any property of the gross estate, indicate the schedule and item number where such property is returned.If the claim represents a joint and several lia- bility,the facts must be,fully stated and the financial respon- sibility of the co-obligor explained. All vouchers or original records should be retained for inspection by the Internal Revenue Service. ALLOWABLE DEATH TAXES Where an election is made to take a deduction under section '20'53 (d)rather than a credit under.section 2011 or section2014,such deduction is subject to certain limitations.If any difficulty is experienced in computing the deduction,a request for the computation of the deduction may be submitted (a Page <24 reasonable time before the due date of the return)to the Com- missioner of Internal Revenue,Washington,D.C.,20224.Such request should be accompanied by a copy of the will and all relevant documents,a statement showing the distribution of the estate under the decedent's will,and a computation of the state or foreign death tax showing the amount payable bycharity. MORTGAGES AND LIENS Itemize under "Mortgages and Liens"only obligations se- cured by mortgages or other liens upon property included in the gross estate at the full value thereof,or the value of the property undiminished by the amount of the mortgage or lien. If decedent's estate is liable for the amount of the indebtedness secured by such mortgage or lien (i.e.,if the indebtedness is enforceable against other property of the estate not subject to such mortgage or lien,or if the decedent was ,personally liable therefor),the full value of the property subject to the mort- gage or lien must be included in the gross estate under the appropriate schedule.However,if decedent's estate is not so liable,only the value of the equity of redemption (or value of the property less the amount of such indebtedness)need be included in the gross estate.Where the decedent's estate is not liable for the amount of a'debt secured by a 'mortgage or lien and the amount of the debt is greater than the value of the property subject to such'mortgage or lien,it is not pos- 'sible to obtain a deduction for the full amount of the debt by entering the full value of the property as a part of the gross estate and then deducting tne full amount of the debt'under this schedule.Notes and other obligations secured by the deposit of collateral,such as stocks,bonds,etc.,also ,should be listed under "Mortgages and Liens." Identify,by indicating under the column headed "De"lcrip- tion,"the particular schedule'and item number where such pro,perty subject to the mortgage or lien is returned under the gross estate. In any case where real property situated outside the United States does not form a part of the gross estate of a decedent, citizen or resident of the United States,no deduction may be taken of any mortgage thereon,or,any indebtedness in respectthereto. Show the name and address of the mortgagee,payee,orobligee,and the date and term of the mortgage,note,or other agreement under which the indebtedness is established.Show the face amount,the unpaid balance,the rate of interest,and date to which the interest was paid prior to the decedent'sdeath.Mortgages upon,or any indebtedness with respect to,prop-erty included in the gross estate is deductible only to the extentthattheliabilitywascontractedbonafideandforanadequate and full consideration in money or money's worth. / SCHEDULE lK '\DEBTS OF DECEDENT AND MORTGAGES AND 'LIE~S .. 1 ' Item No.Debts,ol Decedent-Creditor and lature 01 dairr.and allol"able death taxes Amount ·a~ven:eres.t Nursi.ngHc:>tue,~inal,hill 2Ji)r!i,Ba'rr,tin~l;bill , 3 ·Dr.I)~.$.Haver t final bilt 4J)r.J.~'VE!J:'ett McClensha.n,final bill5l)r~.ll.J.~evin,final hi.li 6U.S.Trea$ury,19E)8tnc.otnet~~ 7 Wf3stl?enn POWE!:t:<:QIfipany,fine1.~1~ctrtcbil1,",",',''"."I'8Columbla'GS$,f~al g~s .bill .' t· $19.50 10.00' 2S.00 70.00' 41,.QO 41.00' 6.54 15.81 I • ItemNo. TOTAL ':a1$0 enter under the Recapitu1i::dion.Schedule 0) Mortgages and liens-De:cription $234.85 I :i Rorte, .'",="~., '. ,, .'.\...,:I . TOTAL (also ente:unde~the Recapitukltion.S~hedu1e 0)$ (If more space'is needed.nsert additionJI sheets of same size) ESTATE OF --..Andrl:lW---~J,taoh--------------.--------------------------------------Schedule K-P'J.ge 25 If the alternate valuation is adopted,deduction for any loss is limited to the extent that such loss is not in effect allowed in the valuation of the item in the gross estate. INSTRUCTIONS FOR SCHEDULE L Net Losses During Administration and Expenses Incurred in Administering Property Not Subject to Claims NET LOSSES DURING ADMINISTRATION EXPENSES INCURRED IN ADMINISTERING PROPERTY1 NOT SUBJECT TO CLAIMS . Losses ,are strictly limited to those arising from fire,storm,Itemize under "Expenses incurred in administering property shipwreck,or other casualty,or from theft,to the extent that not subject to claims!'amounts representing expenses incurred such losses are not compensated for by insurance or otherwise.in administering property included in the gross estate but not Losses <in order to be deductible must occur during the settle-subject to claims..Such an.lOunts are,deductible only'if paid ment\;,'f the estate.Such losses are not deductible if,at'the .before the expiration of the'period of limitation fdr assessment,"provided in section '6501 of the Code..'time br thlfiling of the estate tax return,they had been claimed The names and addresses of persons 'to'whom'payable and as aded~ction in a Federal income tax return.Depreciation the eX!1ct 'nature 'of.'the particular.ex.pense sh9uld be stated. in the value,of securities or other ,property does not constitute .~he prope:ty w:ith ~esp~ct,.to :vhi~h ~he expense wa~incurred d d t 'bl 'I I I't'I f 1'1 t'I ""t b 'should be IdentIfied-by 'mdlcatmg the schedule and Item num-a e uc I ~oss.n IS mg osses,u par ICU ars mus e ber where such property is returned under the gro13s ~state, "giveri as to·the loss sustained and the cause thereof.If insur-An item may be entered for deduction though the exact amount ance or Qtli~r compensation was received on account of loss,is not known at the time,provided it is ascertainable with 'reasonable certainty;and will 'be 'paid before the expirationstate;,the amount collected.The propertYj-with,respec,t .fO ,of the.period of limitation '.for :assessment referred to above. which"the loss is claimed should be identified ~y indicating the No deduction may be.ta,ken upon the,basil)ofa vague or uncer- particular schedule and item number where such property is tain estimate.:'Retain all,vouchers and receipts'for'inspection returned under the gross'estate.by the Internal Revenue Service." The expenses contemplated under this schedule include such items as principal commissions paid in respect of trust property included in the gross estate,and attorneys'fees incurred to contest the inclusion of trust property in the decedent's grossestate. ,".Pa..ge 26 SCHEDULE L~ NET LOSSES DURING ADMINISTRATION AND EXPENSES INCURRED IN ADMINISTERING PROPERTY NOT SUBJECT TO CLAIMS\ ItemNo. None .,''.. -------.'.•----Amount • $ ItemNo. None TOTAL (elso enter under the Recapitulation,Schedule 0) Expenses inamed in admillistering property not subja:t to claim;(ildicate whether estimated,agre3d upon,or paid.) $ $ 0.00 Amoun', Schedule L-?age 27 TOTAli.(also ent:3r under the Recapitul':Jtion,Schedule 0) (If more space is needed,insert additilll1al sheets of same size) ESTATE OF ~~~__~_~~~1__________________________., \ $0.00 INSTRUCTIONS FOR SCHEDULE M BEQUESTS.ETC.•TO SURVIVING SPOUSE (MARITAL DEDUCTION) 1.General.-In computing the taxable estate for Federal estate tax purposes in the case of the estate of a citizen or resident of the United States,a deduction from the gross estate (the "marital deduction")is authorized for certain property interests passing from the decedent to his surviving spouse. The marital deduction is authorized by section 2056 of the Code. The marital deduction may be taken only with respect to prop- erty interests which are included in the decedent's gross estate (Schedules A to I,inclusive).The deduction is g~nerally not available in case the gross estate consists exclUSIvely of the decedent's interest in property held by him and his surviving spouse under community property laws.(See the instructions for Schedule 0.)The marital deduction is not authorized in the case of the estate of a nonresident not a citizen of the United States,except where such decedent died a resident of Franc'e.For the sake of brevity,these instructions make use of the masculine gender in references to the deceased spouse and the feminine gender in references to the survivor,but the de- ductions are also authorized in the reverse situation. 2.Property interests passills from the decedent to his surviving spouse.-The property interests included in the gross estate which are considered to have passed from the decedent to his surviving spouse and as to which a marital deduction is author- ized should be listed on Schedule M.(As to certain interests, which are to be excluded from Schedule M,see paragraph 7hereof.)Property interests which passed from the decedent to his surviving spouse include any interest taken by her (a)as decedent's legatee,devisee,heir or donee,(b)as decedent's sur- viving tenant by the entirety or joint tenant,(c)as appointee under decedent's exercise of a power or as taker in default upon his release or nonexercise of a power,or (d)as beneficiary of insurance upon the decedent's life,and also include (e)her dower (or curtesy)interest or statutory estate in lieu thereof (including her interest under community property laws to the extent that such interest was,immediately prior to the dece- dent's death,a mere expectancy).For further information as to property interests considered to have passed from the dece- dent to his surviving spouse,see paragraphs 3 to 6,inclusive, hereof. 3.Life estate with power of appointment in survivins spouse.- A prop&rty interest whether or not in trust,is considered as passing from the decedent to his surviving spouse (and to no other person)if (a)she is entitled for life to all of the income from the entire interest;(b')such income is payable annually or at more frequent intervals;(c)she has the power,exercisable infavor of herself or of her estate,to appoint the entire interest; (d)such power is exercisable by her alone and (whether exer- cisable by will or during life)is exercisable by her in all events; and (e)no part of the entire interest is subjectto a power inany other person to appoint any part thereof to any person other than the surviving spouse.Where the foregoing 5 conditions are satisfied only with respect to a specific portion of the entire interest,see the regulations issued pursuant to section 2056 (b) of the Code for the determination of the portion thereof which qualifies for the marital deduction. 4.Life insurance.endowment,or annuity payments.with power of appointment in survivins spouse.-A property interest consist- ing of the entire proceeds under a life insurance,endowment, or annuity contract is considered as having passed from the de- cedent to his surviving spouse,if (a)she is entitled to receive such proceeds in installments,or is entitled to interest thereon, with all amounts payable during the life of such spouse pay- able only to her;(b)such installment or interest payments are 'payable annually,or more frequently,commencing not later than thirteen months after the decedent's death;(c)she has the ,power,exercisable in favor of herself or of her estate,to appoint all amounts payable under such contract;(d)'such power is exercisable by her alone and (whether exercisable by will or during life)is exercisable by her in all events;and (e) no part of the amount payable under the contract is subject to a power in any other person to appoint any part thereof to any person other than the surviving spouse.Where the fore- going 5 conditions are satisfied only with respect to a specific portion of such proceeds,see the regulations issued pursuant to section 2056 (b)of the Code for the determination of the portion thereof which qualifies for the marital deduction. 5.Common disaster or similar cause.-Where (a)a property interest was bequeathed,or otherwise disposed of,by the de- cedent to his surviving spouse subject to a provision that such property interest was to pass to another person (1)if such spouse should fail to survive the decedent by 6 months (or by a shorter period),or (2)if the dece~entand such spouse should Page 28 die as a result of a common disaster,and (b)the terms of the condition (that is,the survivorship of the surviving spouse or his failure to die in a common disaster)are fulfilled,then such property interest is considered to have passed from the decedent solely to,his surviving spouse.The fact that the exercise of a power of appointment over the interest is subject to one of the above conditions of survivorship will not disqualify the interest for the deduction if the terms of the condition (that is,the survivorship of the surviving spouse or his'failure to die in a common disaster)are fulfilled.' 6.Effect of disclaimer.-Any property interest disclaimed by the surviving spouse is considered as passing to the person entitled to receive such interest as a result of the disclaimer. Where the surviving spouse becomes entitled to receive a prop- erty interest as a result of a disclaimer by any other person, such interest is considered as passing,not to such spouse,but to the person who made .the disclaimer as though the disclaimer had not been made.. 7.Property interests to be excluded from Schedule M.-Certain property interests which passed from the decedent to his sur- viving spouse are to be wholly or partiallyexcluded from Sched- ule M,as indicated below: (a)In case interests in the same property passed from the decedent both to his surviving spouse and (for less than an adequate andfull consideration inmoney or money's worth)to some other person upon such conditions that the latter per- son may possess or enjoy any part'of the property following the termination or failure of'the interest therein which passed to the surviving spouse,then the interest which passed to such spouse is to be excluded from Schedule M. This rule applies even though the interest which passed from the decedent to a person other than his surviving spouse is not included in the gross estate,and irrespective,of when such interest passed.It is also immaterial whether the interest of the surviving spouse and the interest of the other person passed from the decedent at the same time.Property inter- ests which are considered as having passed from the decedent to a person other than his surviving spouse include any prop- erty interest (other than the interest which,under the rules stated in paragraphs 2 to 6,inclusive,are considered to have passed to the surviving spouse)'which passed under dece- dent's will or intestacy,or was transferred by him during life,or is held by or devolved upon any person as his joint tenant,as appointee under his exercise of a power,as taker in default upon his release or nonexercise of a power,or as bene- ficiary of insurance upon his life.Examples:ofdis:positiol'ls of property by the decedent which are to be excluded from Schedule Mare:(1)A bequest of property to his spouse for life,with remainder to his daughter,and (2)a bequest qf property to his mother for life,with remainder to his spouse, if surviving,and if not,to his daughter and her heirs.In each of these examples,the spouse's interest in the property may terminate or fail,and the daughter may thereafter pos- sess or enjoy the property. (b)In case the decedent directed his executor or trustee to purchase for his'surviving spouse an annuity,a life estate or estate for years in certain property,or any other property interest which may terminate or fail,the property to be used in the acquisition of such interest is tobe excluded from Sched- ule M.The ownership of a bond,note,or other contractual' obligation,the discharge of which would not have the effect of an annuity for life or for a term,is considered not to be a property interest which may terminate or fail. (c)Where any property interestpassingfrom the decedent to his surviving spouse may be paid or otherwise satisfied out of any of a group of assets,the value of such property interest is,for the purpose of entry on Schedule M,to be reduced by the aggregate value of any such asset or assets which,if passing from the decedent to his surviving s.pouse, would be excluded under subparagraph (a)or (b)hereof. Examples'of property interests Which may be paid or other- wise satisfied out of any of a group of assets are a bequest of the residue of the decedent's estate,orof a share of the resi- due,and a cash legacy payable out of the general estate. Example:A decedent bequeathed $100,000 to his ,wife.His general estate includes a term for years (valued at $10,000 in determining the value of his gross estate)in an office building,which interest was retained by the decedent under a deed of the building by gift to his son.Accordingly,the portion of t~e value of the specific bequest to be ~ntered on Schedule M IS $90,000..,'.r."~.'.(Contmued'ort page:30) " '1 ·1 1 SCHEDULE M BEQUESTS,ETC.,TO SURVIVING SPOUSE (MARITAL DEDUCTION) If the decedent died testate,the person or persons filing the return shouldanswer the following questions.Onlyquestion 4 should be answered in cQSe the decedent died intestate.If the answer to any question is ",yes,"full details should be submitted 'Rith the return. 1.Has any action been instituted to contest the will or any provision thereof affecting any property interest listed on ri'Jil,.,o .this schedule or for construction of the will or any such provision?0 Yes ~~ Za.Had the surviving spouse the right to declare an election between (i)the provisions made in his or her favor by the will anc;l.(ii)dower,curtesy,or a statutory interest?CKx'es Zb.Ifanswer to question 2a is "Yes,"hasthe surviving spouse renounced the will and elected IZc.Elected to take under to take dower,curtesy,or a statutory interest?0 Yes [)CNo the will.[RYes o No o No Zd.Does the surviving spouse contemplate renouncing the will and electing to take dower,curtesy,or a statutory interest? 3.According to the information and belief of the person or persons filing the return,is anyadion described under question I designed or contemplated? 4.According to the information and belief of such person or persons,has any person othe::-than the surviving spouse asserted (or is any such assertion contemplated)a right to any property interest listed on this schedule,other than as indicated under questions I or 3? Item No. . Des.cription 01 property interests passing to surviving spouse EqUitable Life Assurance.Society of the United'States of America;Schedule D (1) Charleroi Federal Savings &I,oan Assn.;Schedule E (1) .First Federal Savings &Loan Assn.of Mone$sen; Schedule B(2) Mellon National Bank &Trust Co.;Schedu1e2(3) DYes [}(No DYes CKNo DYes []cN"0 Value $ 1,400.0° 3,5.51,0° 3,43.2.0° 8,999.57' ~Am,Citizen's Club (Schedule F,1) ~VOl $.Steel pension check;Schedule F (2) )2.story frame bouse.;418 Mu:tray Avenue,Donora, Penn$y1~~nia;Schedule E (6) ~Wido~'s exemption •2.story frame house &lot;436 .Murray Avenue,Donot'a,· Pennsylvania;Schedule E ,(4) Block garage and lot;Donora,Pennsylvania;Schedule S (~) 7,500.00 2,900.00 3.600.00 1,000.00 300.00 147.76 '~. TOTAL.... . . . . . . . . . . . . . . . . .... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .... . . . . . . . . . . . . . . . . . . . ...$.--J2)~.836...u Less:(a)Federal estate tax payable out of above-l.isted property interests -,$---------..--O-~OO (b)Other death taxes payable out of above-!.isted property interests -----------------0...00 T·:>tal of items (a)and (b)_.0.00 fIt,Net value of above-listed property interests (also enter under the Recapitulation,Schedule 0). . . . . . . . . . . . . ...$3'2J'j>a~:L (If more space IS needed,Insert additional sheets of same size: ESTATE OF ------.Andr.ew--Tskaeh..----------...------------------Schedule M-Pcge 29 "';'.--. ".., seRE.DULE N 1_--- •..:"".'._- CHARITABLE,PUBLIC,AND SIMILAR GIFTS AND BEQUESTS If the tranaer was m'Jde by wil1- (a)H:Js any action been instituted tc have interpreted or to contest the will or any pronision therl?of affecting the cl:ar~table dedJctions claimed in Ihis schedule? (b)A.:cording to the information and belief of the persor,orpersons filing the return,is any su.ch action designed or cc,ntemplated?I .,." ,j ItemNo. None .-~----c.-. Name and address 01 beneficiary ~._--,---,~,.---••Character o!in~titution 1, I, reTAL _, . _~_. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...$__~__~_~~~~.__ Less:(a)Fe~eral estate tax pa~.ableout of above-I~sted pr.)perly ~nt6l'ests \$._._ (b)Otller death taJ!:es palable out of above-lcsted pr~perly mterests ........•........."_ Total of iteme (a)and (b),..- -··1------------------- Ne::value of 'Jbove-listed proper':y interests (also enf~r under the Recapitulation,SclBdule 0:,...............$0.00 ,(II more space is n~eded,insert additional :heets 01 same size) ..\ESTATE OF ..Andre.w takach_.__.._..~.._._.Schedule N-Page 31 \ INSTRUCTIONS FOR SCHEDULE 0 RECAPITU'LATION 1.Limitation of deductions under Schedules J and K.-The the aggregate amounts subtracted under subparagraphs (a), total apPearing on Schedule J should be entered as item 1 of (b),and (c)hereof)bears to the undiminished "Total Gro~ that part of Schedule 0 headed "Deductions."The totals ap-Estate." peanng on Schedule K should be entered as items 2 and 3.Example:The value of a decedent's gross estate is $300,000 of Enter total of items 1,2,and 3 as item 4.If item 4 does not which $200,000 represents his separate property and $100,000 'exceed the value (at the time of the decedent's death)of the represents his one-half interest in community property.The property subject.to claims,enter such total as item 5.If item 4 separate property was inherited from his father.The deduc- does 'exceed the value (at the time of the decedent's death)of tions allowed .under Schedules J to L (item 8 of Schedule 0) the property subject to claims,enter as item 5 the value (at the total $45,000.The "Adjusted gross estate"is computed astimeofthedecedent's death)of the property subject to claims follows: plus such excess as represents amounts paid before the dateprescribedforfilingtheestatetaxreturn.See section 2053 Value of gross estate $300,000 of the Code and the regulation thereunder.Reduction under subparagraph (a)$100;000 2.Computation of marital deduction.-The net value of the Reduction under subparagraph (d)(200,- property interests listed on Schedule M should be carried for-000/300,000 of $45,000)------------------------30,000 130,000wardtoitem9ofthatpartofSchedule0headed"Deductions."Adjusted gross estate :~$170,000 The marital deduction,which should be entered at item 11,is 4.Definition of community property.-For the purpose of com- limited to the smaller of (a)item 9 or (b)one-half of the "Ad-puting the "Adjusted gross estate,"the term "community prop- justed gross estate"(item 10).If the decedent and his surviv-erty"is considered to include the following categories ofingspouseneverheldpropertyundercommunitypropertylaws,property: ,the "Adjusted gross estate"is computed by subtracting item 8 (a)Property held by the decedent and surviving spouse from the total value of the gross estate.as community property under the law of any State or pos- 3.Cases involving community property.-If the decedent and session of the United States,or any foreign country (othe,r his surviving spouse ever held property as "community prop-than such property in which the surviving spouse had merely erty"(as defined in paragraph 4),an additional sheet must be an expectant interest). attached to Schedule 0 showing the computation of the "Ad-(b)Separate property acquired by the decedent as a result justed gross estate"(item 10).In 'such cases the "Adjusted of a conversion (after December 31,1941)of property held gross estate"is determined by subtracting from the "Total by the decedent and surviving spouse as community property Gross Estate"the sum of the following values and amounts:(as described in subparagraph (a)hereof)intotheir separate (a)The value of property included in the gross estate property.A conversion of community property includes a which was at the time of the death of the decedent held by partition thereof between the decedent and his spouse or a them as "community property."transfer to themselves in joint tenancy,tenancy by the en- (b)The value of property (included in the gross estate)tirety,or other form,of coownership,irrespective of whether transferred by the decedent during his life,if at the time of such partition or transfer was effected by a single transaction such transfer the property was held by them as "community or a series of transactions.Where the value (at the time of property."the conversion)of the separate property so acquired by the de- (c)The amount (included in the gross estate)receivable cedent exceeded the value (!It such time)of the separate as insurance under policies upon the life of the decedent to property so acquired by the spouse,then the part of the sepa- the extent purchased with premiums or other consideration rate property so acquired by the decedent which is considered paid out of property held by them as "community property."as held by the decedent and his surviving spouse as com- (Where a policy was purchased partly with property held by munity property is the same proportion thereof which the them as "community property"and partly with other prop-value (at the time of the conversion)of the separate property erty,the amount receivable under such policy is considered so acquired by the spouse is of the value (at such time)oftohavebeenpurchasedwithsuch"community property"in the separate property so acquired by the decedent.the .proportion thatthe payments made with such "community (0)Property acquired by the decedent in exchange (by one property"bearto the total amount paid.)exchange or a series of exchanges)for separate property (d)An amount which bears the same ratio to item 8 of resulting from a conversion of community property,as de-the Schedule 0 as the "Total Gross Estate"(diminished by scribed in subparagraph (b)hereof. 2.Property.-The term "property"includes any interest (legal or'equitable)of which the transferee received the bene-ficial ownership.The transferee is considered to be the beneficial owner of property over which he received a general power of appointment.It does not include interests to which the transferee received only a bare legal title,such as that of Page 32 .. ! ., INSTRUCTIONS FOR SCHEDULE R". CREDIT FOR TAX ON PRIOR TRANSFERS 1.General.-The term "transferee"as used in Schedule R a trustee.Neither does it include an interest in pl'operty over and in these instructions for that schedule means the decedent which the transferee received a power which is not a generalforwhoseestatethisreturnisfiled.If the transferee received power of appointment.In addition to property interests in property from a transferor who died within 10 years before,which the transferee received the complete ownership,examples or 2 years after,the transferee,a credit is allowable on this of property interests with respect to which the credit may be return for all or a ,part of the Federal estate tax paid by the allowed include annuities,life estates,terms for years,remain-transferor's estate with respect to the transfer.There is no der interests (whether contingent or vested),and any otherrequirem~nt that the property be identified in the estate of the interest which is less than the complete ownership of the prop- transferee or that it'be in existence on the date of the trans-.erty,to the extent that the transferee became the beneficialferee's death.It is sufficient for the allowance of the credit owner of the interest. that the transfer of the propertywas subjected to Federal estate 3.Maximum amount of the credit.-The maximum amount of tax in the estate of the transferor and that the specified period .the credit is the smaller of:,of time has not elapsed.Credit may be allowed with respect (a)the amount of the estate tax of the transferor's estate to property received as the result of the exercise or nonexercise pertaining to the transfer,or of a power of appointment when the property is included in the (b)the amount by which (A)an estate tax on the trans- I'gross ,estate of the donee of the power.Where the transferee feree's estate,determined without regard to the credit pro- .'was'the'transferor's surviving spouse,no credit is allowed with vided for in this schedule exceeds (B)an estate tax on the respect to property received from the transferor to the extent transferee's estate determined by excluding from the gross that a marital deduction was allowed the transferor's estate in ,estate the net value of the transfer.Where credit for a par- connection therewith.No credit on this return is authorized ticular foreign death tax may be taken under either the stat- for Federal gift taxes paid in connection with the transfer of ute or a death duty convention and on this return the creditthepropertytothetransferee.actually is taken under the convention,then no credit for that foreign death tax may be taken into consideration in comput- ing estate tax "(A)"or estate tax "(B)." The amount (a)is computed under part I of the computation of the credit. The amount (b)is computed under part II of the computa- tion of the credit.''\''<_,.:...~.~~.-''~" (Continued'on 'page 34)• -- SCHEDULE 0 REC~,PI'i'uLATION ISched·ule Gross estate Allernate value Value at dale of death B 'Stocks and bonds ,.",.',, •, . , . , , , ,•.,:,.......•...., ,'.---.---.....••--.---.--~------1-1-j 1;1!i-.-oO· c Mortgage~,notes,and cash.,.",••,•••-•.....••,.•..•..:,-------.-•.••---------.---------20"S~23_3 4S D Insurance ...i I'••••••••I""t:.I •••"1.'II ••••••••••••••••••••••••••••••••••••••••••••-----.....-.........-...-......---.------17 400..00 E ~oin~y owned property'.', •' •(,•'"." ,••, ,••••••..••,••••••••..•.•.•••••.•,•.....•.--•...••••.••.•..••..-.-------9.0"7%2:-...7-5· F ·:::>ther miscellaneous property,, , , , , , ,••,•..••, •, ,•••., ,.•••,'.•••. ••. . •. . ••••. . . . ...-••.•••••••.•••-••.••.•--.--~••.••-.Sl+.,+6 G Transfers during decedent's Ufe.":",,•...,....••••,•••.••••••.....................------••-----------.---------.•...-.....-.9-•.&0 H Pow~rs of appoinlInent:..,.",••'0 ••••;••••••.'••••••••••••••'••••••••••,••, ,0 0 , 0 , ,••--.-----.-.-.--------------------------.-o-•.()O I Annuities....",•••........................,0'•••••••:••0 , ,•••••'"0 , 0 0 0 0 0 • 0 , , •,.0 g.00 TOTAL GROSS.ESTATE ,_..:,0 0 0 , 0 ,0', , 0 0 0 ..O'000 ..,0'0 ..0 , 0 0 0 ..,..,$\39,888.96 L 6.Net losses during admir.istratioll o.:'.',,.........•.•••••••••••••••,•••.- _•.....~.OO:. K 3.Mortgages and liens.••,,",j••••,••••.••••••••••••••••••••••••••••••••••••••'.',.0'.,90' Schedule o-Page 33 12.Charitable,public,and similar gifts and bequests " ,0 0 0 0 0 0 ••,••••,••• 10.Adjusted gross estate (fee note··),oo ,--1-2't,,-:S98.#.l:1 11.Net amount deductible for bequests,etc"to surviving ~Wle (item 9 or one-hali of . ,item 10,whichever is smaller)::..(62,299.55)"-'3'2,'83'6';'33 4.Total of items 1 through 3 , ,,.....$6,259.35 8.Total of items 5 through 7,'.''.'.....••......~••••••.•.•....•....•... 5.Allowable amount of deductions-from item 4 (see:lote·), ,•••••:.0 ,,,,.$''''J~2-:i9 ••.3-S•. TOTAL ALLOWABLE DEDUCTIONS,except 6xempti(;)n (totals c.f lines 8,II,and 12)0 , ,••••••, • ,•••••" -••,•• J 1.FuneraiexPenses and e:tpen,ses,incurred':in administering property subject to claims,.$-6.;'()24i~S9-- L 7.Expenses incurred in administering'prcperty not s'Jbject to claims .•.'... .•.. . . . •. ...._"-{}-..-{}().~ .59-;-16~n760-1 K 2.Debts of decedent."",.,-,.",.".."••.••:•.•............................,...,..-.~..-..-234:.-8-S-- 1'1 ESTA1E OF -um--Andrew-JfakaMm-n---------------nnn-mn-----C----m.-m ·~~ote;~See paragraph 1 of tte instructions. 0 ••··Note.-Enter at item 10 the excess of "TOTAL GROSS 3STATE"over item 8,if the decedent and'his surviving spouse at no time held pIoopertyas communify property.If property was ever held as community property,compute the "Adjusted gross estate"(item 10)in accord- a~cs with the instructions and example on page 32,(lnd attach an additional sheet showing'such computation.' ,..M 9.Bequests,etc.,to surviv'.ng spouse............•.••••••••.'.•••••0•••••••••••••,••••$--33',:33&...35 INSTRUCTIONS 'FOR SCHEDUL~,~-;-C~ntinu-ed frctm'page 32 , 4.Percent allowable.-(a)Where tlransferee ,predeceased..half of a reduced adjusted gross estate computed by subtracting the tlransferor.If not more than 2 years elapsed between the the amount of item 1,Schedule R,from the amount of the ad- dates of death,the credit allowed'is 100 percent -of the maxi-justed gross estate entered at line 10,Schedule 0;and (2)any mum amount.If more than 2 years elapsed between the dates charitable deduction entered at line 12,Sched~le 0,should here of death,no credit is allowed.be reduced by a proportionate part thereof.Such proportion- --(br Where transferor predeceased the transferee.The per-ate part of the deduction taken on line 12 of Schedule 0 is that' cent of the maximum amount which is allowed as a credit portion thereof which an ronount A (the amount entered at depends on the number·of years which elapsed between the item 10f Schedule R)bears1ci:B.(thevalae of the total gross dates of death.It is determined in accordance with the estate less the amount shown on line 8 of Schedule 0).folJowj~gta~l.e,;.~Example.The following,entrie~appearon Schedule 0:Total Penod ortiine -,,.Pe'rcerit gross estate-$330,000;line~$30;OOO;line 9-$160,000;line Exceeding :Not exceeding Allowable 10-$300,000;line 11-$150,000;and line 12-$10,000.The '--2 years 1QO'amount appearing injttlIn..J,of Schedule R is $15,000.Under2years4years80'these'Circumstances if the'property entered under item 1 of 4 years 6 years 60 Schedule R were not included in the gross estate,the gross~years 8 years 40 estate would be $315!OQO"9W,?--djusted gross estate would be 8 years 10 years 20 $285,000,-and the marital"deducti6ft'would 'be $142,500.The 10 years none reduction to be made on account of the charitable deduction -h'h'h f II ' ($15,000 .....··1l1·0·000)--5.Computation-of the credit.-T e instructIOns w IC 0 ow Is$500 $330,000-$30,000X''l'"..are to be applied where credit is claimed for transfers received from one transferor only.See instructions under "Cases in-Item 8.Enter item 6 minus item 7. volving transfers from'two'or·more ·transferors"for the .Item 9•.,Enter the amount 'of the Federal estate tax on the manner of computing the credit in cases involving transfers reduced taxable estate (item 8),after deducting the credits,if from more than one transferor.any,which would be s,Uowable £.01'State death,taxe,s,gift taxes, ,..-',.····PART·I and foreign death tweeSiunder,thestatute,:if.the gross estate Item 1••Enter the value at which the property transferred were the amount of item 6 and the deductions were those used in was included in the transferor's gross estate reduced by the fol-determining the amount of item 7. lowing,'to the extent tha:1 'they affect the net value thereof to Item 10.Enter item 5'min~8~item 9'- the transferee,(i)the amount of any death taxes payable out PART III of or chargeable against the transferred property,.(ii)the Item 11.Enter .item 4 or item,10",:whil:hever,is the smaller. amouiIt of'any mortgage or other encumbrance to whIch It was Item 12.Enter the percent of the maximum amount which subject,(iii)the amount of any obligation assumed ~y the is allowable.See "Percent allowable",on this page.transferee in connection with the transfer,and (iv)If the I 13 E t th b ' d f I 'transferee was the transferor's surviving spouse,by the amount 11 t~mite~12~er e amount 0 .tame rom mu tIplying item of the marital deduction allowed the transferor's estate in 6.Coses involving transfers from two or more transferors.- computing its Federal estate tax,Where transfers were received from more than one transfero'r Example.Subject to the condition that B would pay $10,000 the credit is computed in a manner slightly different from thattoC,A left to B,his surviving spouse,real pro.perty and bonds outlined above.The name,date of death,and address of one which were included in A's grQss estate at values of ~200,000 transferor are entered on the Schedule R provided in the returnand$75 000,respectively.'The real property was subJect to a and the computation with respect to transfers from that tran$- mortgage of $50,000.B was required to bear the burden of feror is completed through part I.The same operation is' A's Federal estate tax to .the extent of $4,800 and to paY,State completed on a sepal'atEH:,QPX .of:..Schedule R for each ,of the death taxes of $4,000.A's estate was allowed a marital deduc-other transferors.The computation in part II is performed tion of $150,000 for the property which passed to B.The only once,regardless of thE!number of transferors.The en- amount entered in'item_1.is $275,000-$21,8,8PO ,($10,00Q+...tries for part II should be,"i'made on the cO.py of Schedule R $50,000+$150,000+$4,800+$4,000)=$56,200.provided in the return.The amount entered in item 6 is the Item 2.Enter the value of the transferor's taxable (net)total gross estate less the total of the amounts ente'red inestate,increased by -the.applicable exemption shown under ,items 1 of the computations made for all transferors.TheSchedulePorSched~le Q,and decreased by the total amount amount entered in item 10 is apportioned to each transferor in of all death taxes paid in connection with the transfer of prop-the proportion that the amount entered in item 1 of .the com- erty included in the transferor's gross estate.putation made in connection with his transfers bears to the Example.The transferor was a citizen of the United States.total of the amounts entered in item 1 of all of the computa- His taxable estate was $250,000.The Federal estate tax paid tions.Part III is computed separately for each transferor. thereon was $61,780."State death taxes paid by the execu~r Enter in item ·ll·theamount shown in item 4 or the amount,and the beneficiaries totaled $15,000.The amount entered In from item 10 which is apportioned to that transferor,which- item 2 is $250,000+$60,000-$61,780-$15,000=$233,220.ever is the smaller,and then complete the computation.The Item 3.Enter the'amount of the Federal estate tax'paid by total amount of the credit allowable is the total of the amounts the transferor's estate,increased by the .amounts allowe~,the entered in items 13 of all the computations.The additionaltransferor~s estate as (i)a credit fo!gIft taxes,a!1d (11)a copies ·of Schedule R on which computations are made should credit'for tax on ,prior transfers rece1V~d fro~a prIOr ~rans-be attached to the.Schedule R provided in the return. feror who.died during the lO-year perIod whIch ImmedIately Example.C received property from A having a net value of ' preceded the decedent's death~.$100,000 and property from B having a net value of $50,000. Item 4.Enter that pi:oportion of item 3 whI.'ch item 1 bears A's name;date of'death,and address are entered on the Sched-ule R provided in the return and the computation through part to item 2.PART 'II I is completed with respect to thetransfer from A.On an addi- ,tional copy of Schedule R (detached from an unused copy ofItem5.Enter the amount of the Federal estate tax,after the return form)similar identifying datafor B is entered,anddeductingthecredits,if any,allowable for State death taxes,the computation completed through part I.The computation gift taxes,and forei&;!death,taxes unde~the statute.The of part II is made only on the Schedule R used for the computa- amount to be entered IS the amount by whIch the gross estate tion of the credit on A's transfers.Except for item 6,ittax(item 1,page 1)exceeds the sum of the folIowing:The is made as though only one transferor were involved.The credit for State death taxes (item 2,page 1),the credit for amount entered in item 6 is the decedent's total grolls estate Federal gift taxes (item~,page 1),and so l?uch of the credit minus $150,000 ($100,000 from A plus $50,000 from B).If, for foreign death taxes (Item 6,page 1)as IS allowable under for instance,the amount entered at item 10 is $27,000,that the statute.amount would be apportioned to A's transfers as follows:Ite~6.Enter the value of the total gross estate less the $100 000amountenteredatitem1.$100,000+$50,000 x $27,000=$18,00~.Similarly $9,.000 is ap-: Item 7..The amount to be entered at item 7 is the aggregate portioned to B's transfers.The.amount entered In item 11 . of the exemption and the deductions entered in Schedule 0,of the Schedule R used for A's transfer is the amount shown in With the following adjustments,if applicable:(1)Any marital item 4 or the $18,000,whichever is the smaller.Part III of the deduction entered at line 11,Schedule 0,should here be reduced computation of the credit for tax paid by B's estate is completed by the amount,if any,by which such deduction exceeds one-in a similar manner.'_:'.;_,:.::'.:' Page 34 059-16-77700-1 8.Tota:l.deductions plus exemption (item 5 plus items 6 and 7).. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...$._ 9.Taxable estate (item 1 minus item 8)'',...$ \ $•...................... $,----- $,----- $ _ . 99,99:5,68 $30,983 28 Schedule P,Q,and R-Page 35 IDate of transferor's death SCHEDULE R CREDIT FOR TAX ON PRIOR TRANSFERS SCHEDULE P TAXABLE ESTATE-RESIDENT OR CITIZEN Instructions.-This Schedule Should be Used on.ly for the Estate of a R~sident.or Citizen of the United States Transfere,r's residence at time of death Name of transferor 1.Value of gross estate in the United States (Schedules A,B,C,D,E,F,G,H,and 1).......................•...••• 2.Valueof gross estateoutside the United States (must besupported by proof described in i::1structie·ns under "Deduction of administration expenses,claims,etc.,"on page 39)1------- 3.Value of total gross estate wherever situated (item 1 plus item 2). 4.Gross deductions under Schedules T,K,and L . S.Net deductions under Schedules J,K,and L (that proportion of item 4 that item 1 bears to item 3)•••.•••••••..•... 6.Charitable,public,and similar gifts and bequests (S::hedule N)....•..•••.........•.••••••••••.••••......... 7.Exemption of $2,000 (in estates qulJ.lifying for "prorated exemption,"use $2,000 or item 1 X $60,000,whichever is the greater):1 _ item 3 ." COMPUTATION OF THE·CREDIT PART I-TRANSFEROR'S TAX ON PRIOR TRANSFERS 1.Net yalue of transfers '.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...$_ 2.Value of transferor's estate (adjusted in accordance with instructions for item 2).. . .. .....$,_ 3.Tax on transferor's estate (adjusted in accordance with instructions for item 3).. . . ....... . . . ...$_ 4.Transferor's tax on prior transfers (proportion of item 3 which item 1 bears to item 2). .. $_ PART II-TRANSFEREE'S TAX ON PRIOR TRANSFERS S.Transferee's tax computed without regard to credit .:lllowed under this schedule ,.............$,_ 6.Transferee's reduced gross estate :...•..•....$....0.-__ 7.Transferee's deductions (adjusted in accordance wi~instructions for item 7)..........•...•••••.:...••••.••.•.1 _ 8~Transferee's reduced taxable estde (item 6 minus item 7)....•••••••••......•.•.......••••,'• • . • • . • ••••• • • •..$................•......• 9.·Tax on reduced taxable estate (-----_...... 10.TransfereE;l's tax on prior transfers (item 5 minus item 9)"... . . . . . . . . . . . . . . . . . . . . . . .... . . . . . . . . .....$,_ PART III-eREDIT ALLOWABLE 11.Maximum amount before application of percentage rOlquirement (item 4 or item 10,whichever is smaller).........$_ 12.Percent.allowable is ~.• 13.Credit'allowable(item~12 X item 11).. .... . ..... . . . . . . .... . .... . . . . . . . . . . . . . . . . . . . . .......... . . . . . . . . ....$ Instructions.-This schedule should be used only for the estate of a nonresident not a citizen of the United States.See instructions under "Deduction of administration expenses,claims,etc."on page 39.See also instructions under "Exemption"on page 39 for amount of exemption and names of countries,the estates of whose residents qualify for the "prorated exemption."If decedent was domiciled in Canada and died after December 31,1958,see'''Convention with Canada"c·n page 39 regardingspecial exemption and tax computation.Use Form 706g (Schedule Q 0(2»instead of Schedule Q in case of decedent who at the time of his death was domiciled in France or Greece and was not a citizen of the United States.(If the "prorated exemption"is claimed under the Japanese convention,the .numerator of the fraction setforth in item 7 is the value of the p::'operty situated in the United States and subjected' to tax by both Japan and the United States.)The value to be entered for item 2 includes real property situated outside of the UnitOld States if.required to be included in the gross estate by General Instruction 1.page 4. SCHEDULE Q TAXABLE ESTATE-NONRESIDENT NOT A CITIZEN OF THE UNITED STATES 1.Total gross estate '". 2~Total allowable deductions :...........$39-,905.68' 3.Exemption '.:................. ... . . .... . . . . . . . . . . . . . . . . . . ...60,GOO~00 4.Total deductions plus exemption ''. 5.Taxab~e estate (item 1 minus item 4)'. • INSTRUCTI~NS Fq~SCHEDULE 5' CREDIT FOR FOREIGN DEATH TAXESJ 1.General.-"Credit for foreign death taxes"is allowabie only in case the decedent was a citizen or resident of the United States.However,see section 2053 (d)of the Code and the reg- ulations thereunder for exceptions 'and limita:tio:h~dfan execu- tor has elected,in certain cases,to deduct such taxes from the value of the gross estate.'-In the case of a resident,not a citizen, the credit is allowable only if the country of which the'decedent was a national allows a similar credit to decedents who were citizens of the United States resident in that country.Credit is authorized (a)by statute or (b)by treaty.Where credit is authorized by a treaty,there is allowable whichever one of the following three is the most beneficial to the estate:(1)The credit computed under the treaty;(2)the credit computed under the Statute;,or (3)the credit computed under the treaty, plus the credit computed under the Statute for death taxes paid to each political subdivision or possession of the treaty country which are not dire'ctly or indirectly creditable under the treaty. Under the ,Statute credit is authorized for all death taxes (na- tional and local)imposed in the foreign country.Whether local taxes are the basis for a credit under a treaty depends ' upon the provisions of the particular treaty.If credit for death taxes paid in more than one foreign country is allowable, a separate computation of the credit must be made with respect to each foreign country.The copies of Schedule S on which the additional computations are made should be inserted immedi-, ately following the copy of Schedule S provided in the return. The total amount of the credit allowable in respect of any prop- erty,whether subjected to tax by one or more than one foreign country,is limited to the 'amount of the estate tax attributable to such property:';The anticipated amount of the credit :may be computed on the return,but the credit cannot finally be allowed until the foreign tax has been paid and a certificate on Form 706CE,evid~ncing paymentthel:eof is furnished.Section 2014(g)ofthe Code provides that for purposes of credits for foreign death taxes;each 'possession 'of'the''United'States shall''be' deemed a foreign country. 2.Credit under the Statute.-Inthe case ofa citizen or resident of the United States a credit is authorized for any estate,in- heritance,legacy,or succession taxes paid to a foreign country or its possessions or political subdivisions in respect of property situated in that country and included in the gross estate (Sched- ules A to I,inclusive,of this return).Where the decedent was a resident of the United States but not a citizen thereof,the Statute allows no credit unless the country of which he was a citizen or subject,in imposing such taxes,allows a similar creditinthecaseofaUnitedStatescitizenresidentinsuchcountry. For the pu'rpose of the credit allowed by the Statute,the ques-tion of whether particular ,property is situated in the foreigncountryimposingthetaxisdeterminedinaccordancewiththe same principles that would be 'applied in determining whether similar property of a nonresident not a citizen of the United States is situated within the United States for the purpose of the Federa-l estate tax.See "Additional Instructions for EstatesofNonresidentsnotCitizensoftheUnitedStates"on page 39.Applying such principles,a bond is deemed situated in the foreign country imposing the tax only if the certificate therefor is physically located in'that country:'A'share 'of 'corporate stock is regarded as situated in the foreign country imposing the tax only if the issuing corporation is incorporated in that country.An account with a bank in a foreign country of a citizen or resident of the United States .who is not engaged in business in that foreign country is not considered to be situatedinthatcountry..,.. 3.Computation of credit under the Statute.-Item 1.Enter the amount of the estate,inheritance,legacy,and,succession taxes paid to the foreign country and its possessions or political subdivisions,attributable to property which'(a)is situated in that country,(b)is subjected to such taxes,and (c)is included, in the gross estate.The amount entered at item 1 should not include any tax paid to the foreign'country with respect'to property not situated in that country and should not include any tax paid to the foreign country with respect to property not included in the gross estate.If only a part of the property subjected to such foreign ,taxes is both situated in the foreign country and included in the gross estate,it will be necessary to determine the portion of the taxes which is attributable to such part of the property.In such a case,an additional sheet showing the computation of the amount entered at item 1 must be attached. Page 36 Ite';'2.Enter'the value of the gross estate less the total of' the deductions sh~~on lines 11 and 12 of Schedule O. ,Item 3~',Enter the value of'the property'situated in the for- ,eign co:untry :which,i~subjected!to the foreign taxes and in-' cluded In the gross estate,less those portions of the deductions ,taken'on Schedules 'M 'and N'which 'are'attributable to suchpro,perty. Item 4.Subtract the amount shown at line 4 in "Computation of Tax"on page 1 from the amount shown at line 3 on that ,page and enter the result at item 4. Item 5.Enter that portion of item 4 which item 3 bears to item 2. Item 6~Enteritem1 oritem 5,whichever is smaller. 4.Credit under treaties.-laJ In general.-Where the provi- sions of a treaty apply to the es:ate of a citizen or resident of the United States,a credit is authorized for payment'made of the foreign death tax or taxes specified in the treaty.The circumstances under which the provisions of a treaty apply to an estate are set forth in General Instruction 0 on page 6. The fo'reign death taxes specified in the treaties are as follows: Gountlry Death TaxAustralia,.__Commonwealth estate duty Canada_________________________Canadian estate taxFinland.,Finnish inheritance tax,the com- munal.tax on inheritances"be- quests and devises,and the "poors,percentage"'France ,French inheritance tax Greece...__Greek inheritance tax,Ireland Irish estate duty " . Italy Italian estate and inheritance taxes, Japan Japalllese inheritance tax Norway_...Norwegian tax on inheritances,in- cluding death gifts .Switzerland.Estate and inheritance taxes im- posed by the cantons and their political subdivisionsUnionofSouthAfrica.Union estate duty United Kingdom ._..Great Britain and Northern Ireland estate duties Credit claimed under a treaty is in general computed on Schedule S in the same manner as credit is computed undertheStatutewiththefollowingprincipalexceptions:(1)Thesitusrulescontainedinthetreatyapplyindeterminingwhether property was situated in the foreign country;(2)credit may be allowed only for payment of the death tax or taxes specified in the treaty (but see Instruction 1 above relative to credit under the StaJute for de,ath taxes paid to each political subdivision orpossessionofthetreatycountrywhicharenotdirectlyorindi-rectly creditable under the treaty);(3)where specifically pro- vided,credit is proportionately shared for the tax applicable to 'property situated'outside both countries,or was deemed in some instances situated within both countries;and (4)the amount entered at item 4 of Schedule S is the amount shown at line 3 in "Computation of Tax"on page 1 less the total of the amounts shown at lines 4 and 5 on that pa~e.Credit for payment of theforeigndeathtaxesprovidedformthetreatieswithAustralia, Canada,the United Kingdom,Ireland,and the Union of South Africa must be claimed within 6 years from the date of the de- cedent's death (or within such further period as is provided in the case of postponement of tax attributable to a reversionary interest).Credit for payment of the foreign death taxes pro- vided for in the treaties with Norway and Finland must beclaimedwithin6yearsfromthedateofthedecedent's death. Credit for payment of the foreign death taxes provided for in 'the treaties with France and Switzerland must be claimed with- in 5 years from the date of the decedent's death.Credit forpaymentoftheforeigndeathtaxprovidedforinthetreaty with Greece must be claimed within 5 years from date return is required.Credit for payment of the foreign death tax in the treaty with Japan must be claimed within 5 years from due date of tax.For examples of computation of credits under the treaties,see applicable regulations. (Continued on page 37) ,ol5li':"16-7778&-2 .. , I mNSTRUCTIONS FOR SCHEDULE S-Continued, (b)Computa'tion of credit in cases where property is situated outside both countries or deemed situated within both countries.- In such cases consult the appropriate treaty for details. 5.Example of computation of credit under the Statute.-The decedent was a citizen of,and domiciled in,the United States at the time of his death.The gross estate consisted of real ,property in M country valued at $60,000;stocks of United States corporations,$90,000;bonds of corporations organized under the laws of M country,$45,000;and stocks of corpora- tions organized under the laws of M country,$75,000.On the date of death,all of the stock and bond certificates were in a bank vault in the United States.Debts and administration expenses total $20,000.The M country real property valued at $60,000 and $10,000 of the stocks of M country corporations passed to the decedent's surviving spouse and the latter items qualified for and were allowed as a marital deduction.The amount of the gross Federal estate tax less credit for State inheritance taxes is $25,820.The amount of the M country inheritance tax imposed on the widow's inheritance of $70,000 is $21,000.The value of the daughter's inheritance is $65,000, consisting 'entirely of stocks of M country corporations.The amount of the M country inheritance tax imposed on the daughter's inheritance is $19,500.M country did not impose inheritance tax on the bonds issued by the M country corpora- tions.' Schedule S isfilled out as follows: 1..Amount of estate,inheritance,legacy and succession taxes imposed in the above country attributable to property situated in that country,and subjected to such taxes,and included in the gross estate (asdefinedbystatute)$40,500.00 2.Value of the gross estate (adjusted)$200,000.00 3.Value of property situated in that country, and subjected to death taxes imposed in that country,and included in the grossestate(adjusted)$65,0(1)0.00 4.Federal estate tax before allowance of creditforforeign.death taxes________________________$25,820.00 5.Amount of Federal estate tax attributable to property specified at item 3 (proportion of item 4 that item 3 bears to item 2)$8,391.50 6.Credit for death taxes imposed in the above country (item 1oritem 5,whichever is thesmaller).'_____________________$8,391.50 SCHEDULE S CREDIT FOR FOREIGN DEATH TAXES List all of the foreign countries to which death taxes have been paid,credit for the payment of which is claimed on this return _ If credit is claimed for death taxes paid to more than one foreign country,com;:lUte the credit for taxes paid to one country on this sheel and use a separ·:lte copy of Schedule S for each of the other countries,The copies o)f Schedule S on which the additional computations are nade should be attached hereto. The credit computed on this sheet is for _ (Nemeof death taxor taxes) ______...,_______ ___imposed in ._ (Name ofcountry) Credit is computed under the '._ (Insert "treaty"or"statute") COMPUTATION OF THE CREDIT (All amounts and values shown hereunder must !::.e entered in United States money) 1.Amgunt of estate,inheritance,legacy and succession taxes imposed in the above country attributable to proper1ysituatedinthatcountry,and subjected to such taxes,and included in the gross estate (as defined by statute). . . .$~__ I Z.Value of the gross estate (adjusted,if necessary,in accordance with instrucions for item 2)..,..._., . ,...., , . ...$_ 3.Value of property situated in that country,and subjected to death taxes imposed in that country,and included inthegrossestate(adjusted,if necessary,in accordance "..ith instructions for item 3), . , , . : ,,.$.__ 4.Federal estate tax before allowance of credit for foreign deal!)taxes,, , ,.._ , , , . , . ,.., . , , ,..,,.$__ 5.Amount of Federal estate tax attributable to property specified at item 3 (proportion of item 4 that item 3 bears .to item 2), , , , , , , , , , . , , , , , , , . , , ,.._.., , . , , .".$.. 6.Credit for death taxes imposed in the above country (item I or item 5,whichever is the smaller)..., . ,....., . ...$c.. L ESTATE OF •._. _Schedule S-Page 37 CREDIT FOR STATE DEATH TAXES AND FEDERAL GIFT TAXES STATE DEATH TAXES Credit is allowed for estate,inheritance,legacy,or succession taxes paid as the result of the decedent's death to any State,or the District of Columbia.However,see section 2053 (d)of the Code and the regulations thereunder for exceptions and limita- tions if an executor has elected,in certain cases,to deduct such taxes from the value of the gross estate.The credit cannot exceed an amount which is computed by means of Table B on page 40,based on the value of the taxable estate shown in Schedule P or Schedule Q,as the case may be.An anticipated amount of credit may be claimed and the Federal estate tax computed on the return in accordance therewith before the State death taxes have been paid,but the credit cannot be finally allowed unless the State death taxes are actually paid and credit therefor claimed within 4 years after the return is filed (or within such further period provided by the Statute in a case where a petition is filed with the Ta~Court of the United .States,or in the case of an extension or postponement of time) and evidence that the tax has been paid is submitted. The following evidence should be submitted to the district director: (1)Certificate of the proper officer of the taxing State, or the District of Columbia,showing:(a)The total amount of tax imposed (before adding interest and penalties and before allowing discount);(b)the amount of discount al- lowed;(c)the amount of penalties and interest imposed or charged;(d)the total amount actually paid in cash;and (e)the date of payment. (2)Such additional proof as the district director may specifically request. If practicable the evidence outlined in (1),above,should befiledwiththereturn,but if that is not convenient or possible, it should be submitted as soon thereafter as practicable. Example.The decedent,a resident of the United States, died on January 31,1965.The total gross estate is $400,000. The value of the taxable estate shown under.Schedule P is $265,000.It is assumed that themaximum amount of the credit for State death taxes is allowable and that no other credits will be claimed.The a"mount of the gross estate tax shown in column (3)of Table A (on page 40)on a taxable estate equal- ing $250,000 is $65,700.Since $265,000 exceeds $250,000 and falls below $500,000,the amount of the gross estate tax on the excess of $15,000 is computed at 32 'percent,the rate shown in column (4)of Table A.The $4,800 computed on such excess, added to $65,700 equals $70,500,the gross estate tax. Using Table B (on page 40)it is determined that the maximum amount of the credit for State death taxes allowable in the case of a taxable estate of $265,000 is $4,400.The gross estate tax,$70,500,less credit for State death taxes,$4,400,equals $66,100,which is the "Gross estate tax less credit for State death taxes"and is the amount which should be entered at item 3.As no credit either for Federal gift taxes,for tax on' prior transfers,or for foreign death taxes is involved,that amount is the net estate tax payable.The computation of the tax in this example is set up as follows:" 1.Gross estate tax__________________________________________$70,500 2.Credit for State death taxes_________________________4,400 3.Gross estate tax less credit for State death taxes $66,100 FEDERAL GIFT TAXES Credit is allowed for "Federal gift taxes"imposed by chapter 12 of the Code and the corresponding provisions of prior laws, on the transfer from the decedent 0'£property which is included in the gross estate.The credit cannot exceed that proportion of the gross estate tax less State death taxes that the value of the included gift bears to the entire gross estate,reduced by the total deductions allowed for charitable,public and similar gifts and bequests and as a marital deduction.For further infor~ mation see the regulations issued pursuant to section 2012 of the Code. INSTRUCTIONS FOR COMPUTATION OF TAX For convenience the computation of the tax on page 1 is divided into two parts.Where no credit is claimed by the estate either for Federal gift taxes,for tax on prior trans- fers,or for foreign death taxes,only Part I (consisting of items 1 through 3)should be completed.Where a credit is claimed either for Federal gift taxes,for tax on priortransfers,or for foreign death taxes,Part II (consisting of items 4 through 8)should be completed in addition to Part I. PART I Item 1.Except as provided in "Convention with Canada"on page 39,"gross estate tax"is computed by means of Table A on page 40,on the value of the taxable estate shown under Schedule P or Schedule Q,as the case may be. Item 2.See above instructions and example relative to credit for State death taxes. Item 3."Gross estate tax less credit for State death taxes"is the amount remaining after deducting the amount entered at item 2 from the amount entered at item 1.This amount also represents the net estate tax payable unless credit is claimed either for Federal gift taxes,for tax on prior transfers or for foreign death taxes. PART II Item 4.See above instructions relative to credit for Federal gift taxes.- Item 5."Credit for tax on prior transfers"is the amount computed on Schedule R. Item 6."Credit for foreign death taxes"is the amount com- puted on Schedule S.If credit is claimed for death taxes paid to more than one foreign country,the credit for the pavment to each country should be computedseparately and the total there- of entered at item 6,subject to the limitation that the amount of the credit allowable in respect of property subject to death taxes by two or more foreign countries cannot ·exceed the amount of the estate tax attributable to such property. The following example illustrates the computation in Part II where credits for Federal gift taxes,for tax on prior trans- fers,and for foreign death taxes are involved. Page 38 Example.The facts are the same as in example above illus- trating the computation of State death taxes except that credits 'are claimed for Federal gift taxes,for tax on prior transfers,and for foreign death taxes.It is assumed for the purpose of this example that the decedent transferred on Decembe~1,1964,in conte~plation of death,certain real prop- erty to hIS daughter as a gIft.The value of this real property as of the date of the gift,and as of the time of death,was $143,000.As a resultof this gift,a gifttax of $17,775 was paid on a net gift of $110,000 ($3,000 excluded and the specific exemption of $30,000 deducted under the gift tax provisions of the Internal Revenue Code).As the value of the trans- ferred real property is included in the decedent's gross estate,a credit for gift tax is allowed against item 3.The gift tax credit is limited to the amount of the gift tax,$17,775,and also is limited to the proportion of $66,100,the amount of item 3,that the value of the included gift,$140,000,bears to the entire gross estate,$400,000.(It will be noted that the amount of the included gift is $140,000,which is $143,000 less $3,000,the amount excluded in determining the included gift for purposes of the gift tax.)Since $140,000 divided by $400,000equals0.35,the amount of this proportion is $23,135 ($66,100 multiplied by 0.35).Since the gift tax is less than $23,135, the fOl'mer amount,$17,775,should be entered at item 4.The credit computed on Schedule R for tax on prior transfers amounts to $1,100 'which should be entered at item 5.The credit computed on Schedule S for a foreign death tax amounts to $900 which should be entered at item 6.The total of items 4,5,and 6,or $19,775,should be entered at item 7.The net estate tax payable,$46,325 (item 3 less item 7),is shown at item 8.The computation in Part II is set up as follows: 4.Credit for Federal gift taxes $17,775 5.Credit for tax on prior transfers_________1,100 6.Credit for foreign death taxes____________900 7.Total of credits under Part II $19,775 .---8.Net estate tax payable $46,325 II :I 'I 1 ·1 I ADDITIONAL INSTRUCTIONS FOR ESTATES OF NONRESIDENTS NOT CITIZENS OF THE UNITED STATES These instructions should be read in conjunction with the "General Instructions"beginning on page 2 and the detailed instructions for the several schedules. Requirement of return.-An estate tax return must be filed for the estate of a nonresident not a citizen of the United States if the part of his gross estate (as defined by the statute) situated in the United States exceeded a value of $2,000 at the date of death. Form of r!Zturn.-A simplified form of estate tax return:Form 706NA,"United States Nonresident Alien Estate Tax Return,"has been provided for use in the case of a nonresident not a citizen of the United States.However,the return must be made on Form 706 instead of on the simplified Form 706NA under the following circumstances: (1)In case the decedent made any transfer during life or possessed,exercised,or released any power of appointment with respect ,to property situated in the United States,re- quiring any disclosure or affirmative answer under Sched- ule G or H of this return. (2)In case a deduction for charitable,public,and similar gifts and bequests (Schedule N),credit for Federal gift taxes,or credit for tax on prior transfers is claimed. (3)In case the decedent was domiciled in France,or was a citizen or subject of,or'domiciled in Greece and a pro- rated allowance authorized by treaty extends beyond the exemption,such as a prorated deduction for a bequest to a foreign charity. Place for filing returns.-The return must be filed with the Director of International Operations,Internal Revenue Service, Washington,D.C.,20225,U.S.A. Supplemental documents.-If the decedent died testate,a cer- tified copy of the will must be filed.Other supplemental docu- ments maybe required as explained below and under the instruc- tions for the several schedules. Death tax convention.-If a death tax convention is applicable, consult the provisions thereof and regulations issued pursuant thereto.See page 6 for list of conventions and effective dates. Property situated in the United States.-The entire gross estate wherever situated in the case of a nonresident not a citizen of the United States is made up in the same wayas that of a citizen or resident and,therefore,includes not only all property (see General Instruction J,page 4,for real property situated o'ltside of the United States required to be included in the gross estate) beneficially owned by the decedent,but also joint estates with right of survivorship,tenancies by the entirety,community property,life insurance proceeds,property transferred by the decedent during his life,and property subject to decedent's gen-' eral power of appointment,as more fully explained under the instructions for the several schedules.However,the taxable estate is the part of the gross estate situated in the United States,less the authorized deductions.Only the part of thegrossestatesituatedintheUnitedStatesshouldbesetforth under the appropriate "Schedules A to I and recapitulated under . Schedule 0."The term "United States,"when used in a geo-. graphical sense,includes only the States,and the District of Columbia.Property transferred during the decedent's life,and includible in the entire gross estate wherever situated,is deemed situated within the United States if such property was so situ- ated either at the time of the transfer or at the time of death. The following,rules are·applicable in determining whether property owned by a nonresident not a citizen of the United States is situated in the United States:(1)Real property and tangible personal property.-These items of property are within the United States if physically.located therein.(2)Insur· ance.-The proceeds of insurance on the life of a nonresident not a citizen of the United States are not situated in the United States.(3)Bank deposits.-See "Instructions for Schedule C" on page 10.(4)Works of art.-See "Instructions for Schedule F"on page 16.(5)Written evidences of intangible property which are treated as being the property itself.-Except as pro- vided for by treaty,these items of property are situated in the United States if physically located therein.For situs rules ap- plicable to bonds and to stock of domestic and foreign corpora- tions,see "Instructions for Schedule B"on page 8.(E·)In- tangible personal property,the written evidence of which is not treated as being the property itself,such as a simple debt or open account.-Such property,except as provided for by treaty, is within the United States if consisting of a property right arising from or enforceable against a resident of the United States or a domestic corporation (public or private). Deduction of administration expenses,claims,etc.-Deduction may be taken of the proportion of expenses,claims,etc.(Sched- ules J to L),that the value of the part of the gross estate situ- ated in the United States bears to the value of the entire gross estate wherever situated.Items of deduction may be set forth under the appropriate Schedules J to L,irrespective of whether they were incurred or expended within or without the United States.The marital deduction is not available in the estate of a nonresident not a citizen of the United States,except in the case of a resident of France.However.no deduction what·ever may be taken unless the value of the entire gross estate wherever situated is entered at item 3 of Schedule Q.See Gen- eral Instruction J,page 4,for real property situated outside of the United States required to be included.The entire gross estate must be valued as of the date of the decedent's death; or if the alternate valuation authorized by section 2032 of the Code is adopted,such valuation must be applied to the entire gross estate.Adequate proof in support of items 3 and 4 of Schedule Q must be submitted;otherwise,this deduction will be disallowed.For this purpose there should be submitted a certified copy of the foreign death tax return;or,if no such return was filed, a certified copy of the inventory of the estate together with the schedule of debts and charges filed with the foreign court of pro- bate jurisdiction.Additional proof may be required in specific 'cases. Charitable.public,and similar gifts and bequests.-Except as provided otherwise by treaty,a deduction may be taken under Schedule N only if the transfer was to a corporation or associ- ation organized in the United States or to trustees for use in the United States.For information relative to the deduction allowable under the Death Tax Conventions with France and Greece,see the regulations issued pursuant to the conventions. Exemption.-Except as hereinafter provided,an exemption of $2,000 is authorized in the case of a nonresident not a citizen of the United States.If the decedent was domiciled in Canada, see "Convention with Canada"below. In the case of a decedent who was neither a citizen nor a resident of the United States,but who was a citizen of or domiciled in Australia,Norway or Switzerland,a resident of Finland,was domiciled in France,was a citizen or subject of or domiciled in Greece,was a national of or domiciled in Italy,or in a case where a beneficiary was domiciled in Japan,the Death Tax Conventions with those countries authorize,under certain conditions,a prorated exemption in excess of $'2,000.Also,in the case of a decedent who was a citizen of the United States and who was a resident of a United States possession at the date of his death,and who acquired his citizenship solely by reason of his connection with such possession,and who is therefore considered a nonresident not a citizen of the United States,a prorated exemption in excess of $2,000 is authorized. The prorated exemption is the proportion of the exemption authorized for estates of citizens and residents of the United States that the value of the property situated in the United States bears to the value of the entire gross estate wherever situated.Supplemental Form 706g (Computations of Taxable Estates)has been provided for use in computing the taxable estate under the provisions of the Death Tax Conventions in the case of the estate of a resident of France or Greece not a citizen of the United States.In every other case the taxable estate of a nonresident not a citizen of the United States must be computed on Schedule Q.When Form 706g is used,it con- stitutes a part of the return,is to be substituted for Schedule Qand should be inserted as a partof page 35. Convention with Canada.-Our present convention with Canada exempts from Federal estate tax certain estates of non- resident alien decedents who were domiciled in Canada and died after December 31,1958.The convention also contains a provi- sion preventing the estate tax from reducing below $15,000 the value of the estate ofsuch a decedent which is subject to tax.If the value of the taxable estate,before allowance of the specific exemption of $2,000,does not exceed $15,000,the estate is exempt from estate tax.If the value,before allowance of the specific exemption is less than $15,932.59,the gross tax (item 1, ,page 1)is equal to the amount in excess of $15,000.For ex-ample,if the value is $15,500,the gross tax on the taxable estate is $500.If the value of the taxable estate before allowance of the specific exemption is more than $15,932.58,the estate tax istobecalculatedbytheuseofTableA,page 40,after allowance of the specific exemption.The prorated exemption (item 7, Schedule Q)is not allowable under our present convention with Canada,but may be allowable in cases where the prior conven- tion is applicable. Page 39 DECLARATION Under penalties of perjury,I declarethat this return,including any accompanying statements,has been examined by me,and is,to the best of my knowledge and belief,a true,correct,and complete return,made in good faith pursuant to the Internal Revenue Code and the regulations thereunder.. (Date)(SigIllltureof executor,lId:mlnistrator.etc.)(Address) ..----------------------------------------...---------------------_...- DECLARATION ,OF ATTORNEY'OR AGENT PREPARING RETURN Under penalties of perjury,I declare that I prepared this return for the person or persons whose signature(s)'appear(s)above and that this return,including any accompanyingschedules and statements,is,to the best of my k:lOwledge and belief,a true,correct and complete return based'on all the information relating to the matters required to be reported in this return of which I have any knowledge. ofl)~~...J,Q~_______"~2 ....:_~~_ (Date),_110:i;(~atureof pr"parer (Individual or firm)other than<::<.'"exeeutor,admlni~ator,etc.) (Address) TABLE B \ COMPUTATION OF MAXIMUl!I CREDIT FOR STATE DEATH TA~ES Taxable Rate of Taxable Credit on credit onestateestate~eS8 amount in excess overequaltoorthan-column (1)amount inmorethan-column (1) (1)(2)(3)(4) (Percent) 0 $40,000 0 None $40,000 90.000 0 O.8 90,000 140,000 $400 1.6 140,000 .240,000 1,200 2.4 240,000 440,000 3,600 3.2 440,000 640'.000 10,000 4.0 640,000 840,,000 18,000 4.8 840,000 1,040',000 27,600 5.6 1,040,000 1,540',000 38,800 6.4 1,540,000 2,040',000 70,800 7.2 2,040,000 2,5400,000 106,800 8.0 2,540,000 3,040,000 146,800 8.8 3,040,000 3,540,000 190,800 9.6 3,540,000 4,040,000 238,800 10.4 4,040,000 5,040.000 290,800 11.2 5,040,000 6,040.000 402,800 12.0 6,040,000 7,040,000 522,800 12.8 7,040,000 8,040,000 650,800 13.6 8,040,000 9,040,000 786,800 14.4 9,040,000 10,040,000 930,800 15.2 10,040,000 ---------------1,082,800 16.0 _-t- If' ., C""J ~W (_~ ....-1 -.-.U5 Fo ::2:~.OMPUTA't~9N~F.~OssEsTATE TAX =v y-~O;)}.c::::;~:[Jj ...-;: l.'Faxabl~~,~.Rate of estate Taxable Tax on tax on estate less amount in ,excess overequaltoor,,than-column (1)amount inmorethan-column (1) (1)(2)(3)(4) (Percent) 0 $5,000 0 3 $5,000 10,000 $150 7 10,000 20,000 500 11 20,000 30,000 1,600 14 30,000 40,000 3,000 18 40,000 50,000 4,800 22 50,000 60,000 7,000 25 60,000 100,000 9,500 28 100,000 250,000 20,700 30250,000 500,000 65,700 32 500,000 750,000 145,700 35 750,000 1,000,000 233,200 37 1,000,000 1,250,000 325,700 39 1,250,000 1,500,000 423,200 42 1,500,000 2,'000,000 528,200 45 2,000,000 2,500,000 753,200 49 2,500,000 3,000,000 998,200 53 3,000,000 3,500,000 1,263,200 56 \3,500,000 4,000,000 1,543,200 59 4,000,600 ,5,000,000 1,838,200 63 5,000,000 6,000,000 2,468,200 67 6,000,000 7,000,000 3,138,200 70 7,000,000 8,000,000 3,838,200 73 8,000,000 10,000,000 4,568,200 76 10,000,000 ----------------6,088,200 77 ESTATE OF . .•_ Page 40 *us.GO~'ERNMENT PRINTING OFFICE:1967-0-281-591 __F· ~9 COMMONWEALTH OF PENNSYLVANIA ~~~Form RCC-4-Rl-3-66 RESIDENT DECEDENTS 979121 OFFICIAL RECEIPT No.Transfer Inheritance and Estate Tax File No.63-&6-1180 Date Jio.,a..\.r 21 19 68 Office REGISTER OF WILLS.WASHn:r,TON Pa. WA.S~TON County,55:Received from llI.an Sti.-k,Paylll!on 1n1.tJab. ~YYAa~~..AJ.'D~lW TA.KACH...tOP,"mlmS{Wt~~~)of the estate of who died Aupa't 28 19 6~the sum of FOUR Htn.1>RED F('IE-TV-IlYN!and (1 ..../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 $10%$ 7,891.96 6~~473.52 $Tax on $$ Total $Tax on $15%$ Personal Property Exemptions *$ Date Valuc:rtlon Jt.Held $1,891.96 Total Estate $.-- Bond.Total Tax $413.52 $ Total $7,891,96 LIllils Tax Previously Paid (if any)$ Total Gross Assets $Balance $ Less Debts and Expenses of Less five per centum of tax if paid 23.68 Administration $within 3 months after date of death $ Clear Value of Estate $-_..........Amount of r:blul~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__$44~.:3'"Total $19__$*As evidenced by Charitable Exemption Certificates issued by the Secretary of NOTE:In accepting the transfer inheritance tax on future estates prior to the death of Revenue under Act of May 28,1956,P.1.1757,effective June 1,1957,as amended the life tenant or tenant for 1.ears,as evidenced by this receipt,it is understood that the Com-by Act No.381,approved July 11,1957,and Act No.207,1961,Section 302.monwealth shall not be prec uded or prevented from hereafter assessing additional inheritancetaxatthedeathofthelifetenantortenantforyearswheneveritappearsthatsuchadditional SEAL)tax may be legally due and collectible for any reason whatsoever. 1[000 ~[LD ©£1[[37-14AJ-2 I;,.;//////1 (.t (.'&.~.t #'41 ji.C-I NOTE:This Triplicate Receipt to be retained by the Register of Wills cmd filed in numerical Register of Wills sequence for audit purposes.•MOORE BUSINESS FORMS.INC..ELMIRA,N.Y. FORM RCC-4-Rl TRANSFER INHERITANCE and/or ESTATE TAX. RESIDENT DECEDENTS. RECEIPT Docket 3'1 Page 1441ine,_2__ Estate of ANDREWfAKACn OFFICE OF REGISTER OF WILLS WASHIKCTON---------Pa. ,Noveaber21 GSDate'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.52S RUSSELL MMlDO Register of Wills 1201 (g).Act of April 9.1929.P.L.343.as amended. viz:·"To receive from Registers of Wills all duplicate reo 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 ofWillsandtransmittedtotheexecutororadministrator. 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 A'rTY.BARNA &BARNA 1th I)MeltFAN AVE~1JE LtjiiORl,Im~;mVANJA L "l -~33 ..J " J .....'\.......'" -.~ " r" ... Form RCC-4-Rl-3-66 ~9 COMMONWEALTH OF PENNSYLVANIA RESIDENT DECEDENTS 979122 OFFICIAL RECEIPT No.Transfer Inheritance and Estate Tax FileNo.63-68-11~O Noveo"Jer 21 68Date19__WASItINC,;'o;rOfficeREGISTEROFWILLS,Pa. ~;1\$'rI:tGTON County,ss:Anna ~;:t!."r,::1.Paying on Ind.1..tab.Received from (Executor,Administrator or Guardian)of the estate of VmLrz."rI~~'(AF.DnmIJ TAKACH who died August 2S 19 68,the sum of Tb1','SE a:nmrCL ":.1:..TY...n'IVE anA 4(;/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 $(;,332.20 6%!~$364..70 Total $Tax on $15'7'0 $ Personal Property Exemptions *$ Date Valuation Jt.J'(lld 6.332.20 Total Estate $ $ ....~,.,- Donds Totw Tax $384.'10 $ Total $6,332.20 Less Tux Previously Paid (if any)$ Total Gross Assets $Balance $-- Less Debts and Expenses of Less hve per l:t:'lilum of tax if pnirl 19.24 Administration $within 3 months after date of death $ Clear Value of Estate $Amount of Estate Tax Assessed under VuluuLiol1 of Lifo EstntAR or Annuities the Act of May 7,1927.$ Date 19__$Add interest at the rate ot %19__$from Estate Tax Assessments to $ Date 19__$365.~:;Total $19__$*As evidenced by Charitable Exemption Certificates issued by the Secretary of .NOTE:In accepting the transler inheritance tax on futUTA estates prior to the death of Revenue under Act of May 28,1956,P.1.1757,effective June 1,1957,as amended the hfe tenant or tenant for r,ears,as evidenced by this receipt,it is understood that the Com-by Act No.381,approved July 11,1957,and Act No.207,1961,Section 302.monwealth shall not be prec uded or prevented from hereafter assessing additional inheritancetaxatthedeathofthehietenantortenantforyearswheneveritappearsthatsuchadditional S E A~1.tax may be legally due and collectible for any reason whatsoever.~('''';t4/;;L100D~[LD©£L1[37...144-2 I t;;~J-_r((' NOTE:This Trip!icClte Receipt to be retained by the Register 01 Wille COld filed in numerical Register of Wills sequence for audit purposes.IIOORE BUSINESS FORMS,INC..ELMIRA,R.Y. .' FORM RCC-4-RI TRANSFER INHERITANCE and/or ESTATE TAX. RESIDENT DECEDENTS. RECEIPT 31 144.2Docket.Page I me,_ ..•.d.}:ij~·.•·i·,.;.'(\:"t. ANDREti TAIWmJDlDXEstateof-'-_ OFFICE OF REGISTER OF WILLS VASnINOTOtl---------Pa. Date NC:)lrembor 21 19--!8 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 RUSSEtL lwtINO....., Register of Wills 1201 (g).Act of April 9.1929.P.L.343.as amended. viz:."To receive from Registers of Wills all duplicate reo 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 settlementoftheestate.In no event shall the executor or adminis- trator be entitled to a credit in his account by theRegisterunlessthereceiptissosignedandsealedbylbeRegisterofWills," Fill in below name and address of person to whom tax receipt is delivered: I ;\,!1'YS.n...\RNA "BAnNA 7tb&McKEAN AVENUE I L DOriO!!..PbtiS)L7ANIl 15033 -l ! ".... RESIDENT DECEDENTS File No 63...5~..1180 COMMONWEALTH OF PENNSYLVANIA OFFICIAL RECEIPT Transfer Inheritance and Estate Tax ~s 979123 Form RCC-4-Rl-3-66 No. VArbY1l.TC "C'yOfficeREGISTEROFWILLS,;,;7JU.l'f ,~•Pat WASHINGTON C ty R'd f Jo"",A.Te.~aC':boun,ss:ecelve rom_----=--=----=:..::.:~_ (Executor,Ad:otm1'srta1:Z!l~a~of the estate of .\\D3f,:·.·'1.\K lea who died AUGUST 28 19--1h~the sum of Oro:;Tt-:C't1S~\ND ~.;V ·~N HmmREJ,And noll on ...oollars, being TRANSFER INHERITANCE TAX and/or ESTATE TAX due the Commonwealth as follows: Date ~loYember 21 19 6~ I~ Appraisements Made and Filed Computation of Tax NOTE:This Triplicate Receipt to be retained by the Register of Wills and filed in numericalsequenceforauditpurposes. NOTE:In accepting the transfer inheritance tax on future estates prior to the death ofthelifetenantortenantforyears,as evidenced by this receipt,it is understood that the Com-monwealth shall not be precluded or prevented from hereafter assessing additional inheritance tax at the death of the life tenant or tenant for years whenever it appears that such additional tax may be legally due and collectible for any reason whatsoever. e9.47 $-------- $-------- $======== $-------- $======== , ~/'(~('.I (~~ Tax on $_ MoORE BUSINE~5 "utUI"INC.,ELiURA,N.Y. 5%$_ Tax on $10'10 $-------- On .•e~ount 6%~$1.789.47 Tax on $15%$----------- Register of Wills EXlimptil:m'l *$======:-:--~===== Tax on $ Less Tax Previously Paid (if any) Total Estate $_ $==~;:==:::~~~=1,7C('l.OOTotal$_ *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. 8;)L r !I-i...JV~.C Less five per centum of taxif paid within 3 months after date of death Amount of Estate Tax Assessed under the Act of May 7,1927. Total Tax Balance Add interest at the rate of %from _ to _ ,."",uMPLt.n 37...144-2 $------ $,------ $ $ $.'I'U,",/'I VCiIuation Valuation $,_ $>------ Total $,------ $,------ Total lJTRjD [P)[LD ©£If[E Date Date Real Estate Personal Property Total Gross Assets Less Debts and Expenses of Administration Clear Value of Estate Valuation of Life Estates or Annuities Date 19__$,_ _________19__!::$=================== Estate Tax Assessments Date 19__$_ _________19__!::$=================== FORM RCC-4·RI TRANSFER INHERITANCE and/or ESTATE TAX. RESIDENT DECEDENTS. RECEIPT Docket 3'Page·144 I ine'----=::2 _ Estate of .A.N1JREW TAKACH OFFICE OF REGISTER OF WILLS WAsmNUTON ~Pa. Date Novemher 21 19---i.-S SIGNED AND SEALED AS PROVIDED.BY SECTION 1201.ACT APRIL 9.1929.P.L.343 AS AMENDED BY ACT MAY IS.1945.P.L.S28 RU~Sm.,L MARINO Register of Wills I 1201 (g).Act of April 9.1929.P.L.343.as amended.viz:-"To receive from Registers of Wills all duplicate ret ceipts for taxes paid to them by executors or adminis.trators'and to charge the Registers .receiving the money with the amount receipted for.The original of each such receipt shall be signed and sealed by the Register of Wills and transmitted to the executor or administrator.whereupon it shall be a proper voucher in the settlement of the estate.In no event shall the executor or adminis. trator be entitled!to a credit in his account hy theRegisterunlessthereceiptissosignedandsealedbytheRegisterofWills:' Fill,in below name and address of person to whom tax receipt is delivered: ,AT?!S.BARNA &DMniA 7th C1 HeKFAll IiVENlm .... I I, t. .' L DONORA"PENNSYl..yi:,NIA 15033 -.l ,,-.) •,>'?<e."._~.s-\..-...~-".-~,.,~---::'"--~-.,-.:--'-:-:-,--;;-'~~........"'~~""'-'.__~1!: dollars $-HI 52.66 ~ $~ 1 ~ $-"......_--- 1,842.13 ~9?4'7 .,-- 52.66 Prev. representing Pennsylvania Inheritance or Estate Tax due from the folloWing estate: .-~~.--~...-~-.-- %Tax on $$II Esta.te Tax,Act of MQY 7,197.7 2%Tax on $$~I 30,102.12 1,842.13 6 %Tax on $$ .II~ 15%Tax on $$III TOTAL TAX CREDIT TOTAL AMOUNT PAID I..A~~fivo percerolurn of tox if paid within three months after date of death Plus interest at the rate of __%from _ 1o _ 66/100 8-28-68 I•" , \.J DONORA.PENNSYLVANIA 15033 63-68-1180 lYrn~[p[L~@lir[f~:SEAL __ NOTE:This .!ri~icate R~~eipt t,?b~ret~i.~~~j;;:audit pur""'l~144-2 (/),0--]..v{. ,>.,.....Received by".~t::...J1 ......//~....ljAO ·NOTE:In accepting the transfer inh.eritance tax on future estates.prior to the death of the hfe/·.....•(Slgnat~).Q tenant or tenont for years.as evidenced by this receipt.it is understood that the Commonwealth shall .'-\D 11 not be precluded.or prevented fr,om h.,.o".'0".'"''oddmoM',.h.,,,o,,.'m 0'".d.o.01 "."'.",,:zp-"\~I,{),IL-~ life t.enant or tenant for years whe.never it nppears that such uudltlonal tax may be legally due ond .....Ii('(\.</(Ti tel . collectibl..for any reason.whatsoever..I RCC.4(8:68')COMMONWEALTH OF PENNSYLVANIA ..'Ii: DEPARTMENT OF REVENUE ' NO.A085491 OFFICIAL RECEIPT.PENNSYLVANIA INHERITANCE AND ESTATE TAX . ......~: .JI File No.Date of Death I February 27.1970 nnt,:,of.Payment .I .ANDREW TAKACH aka etci. Nome of Decedent .". County ..WA~HINGTON I Remarks: R FIFTY.TWO andECEIVED.. Jolln A.,Takaeh.l...",cr. .From:C/O A1.'T,-S.BARNAY BARNA 7~h &McKEAN AVENUE,,,Address .I l-.............~_..~._____'--"~__,._:;;;;:JrO~~~.-:-r ...h •__~~....-.-....--~~_~_.__._~-'__-.:..0.......-'" • •-''.'-<? LA~T HILL ~-n TESTA,[~~::T I,ANDREi;TAKACH,.lisa knm..1 as A1\1DY TAKACS,of the Borough of Donora,W.?shington County)h:nnsylvania,do hereby oake my Last Will ani Testament and revJke all Wills by me at any time heretofore made. FIRST:i direct tlat all my just debts and funeral expenses be fully pc id and sat:,$'fied,as soon as conveniently may be a£ter my decEase. SECOND:I give ard bequeath my real est.ate knovffi as part of Lot 27 in B:ock 17 9=the Union Improvement Company's Plan of.Lots in the Borrn~h of Donata,Washington County,Pennsylvania, ·.lpon which is erect ~d a four r ):)m frame house,to my daughter,' Susan Stimak,her h 2irs and as ::igns . 1'.{ 1 "r,"\~i\~. THIRD: L~t'24 in Block 17 which is'erected a heirs a~d assigns. I give a~d bequeath my real estate knOyffi as of the s&~e )lan in ,Donora,Pennsylvania,upon double garag'to my son,John A.Takach,his ,..'\.'~ ,'---,';).:0 FOURTH:I giv~anc )~~ueath ~y real estate know~as parts of Lots 22 aId 23 in Block 17 of·the same plan of lots in the Borough of Donora,upon whic~is erected my residence as follows: (a~Four-six~hs (4/6)interest therein to my SO:1 T'iomas A.Takach; (b:One-sixth (1/6)interest the~ein .to my SO:1 JC1~A.,Takach; (c.:.One -sixth (L/6)interes t therein to my da~ght~r,Susan Stimak. FIFTH:All the rest,residue arid remainder of my estate:real and pI rsonal,I give,devise and be'queath to my wife Zuzi Takcch,also 1nOyffi as Sus~e 1akach,for life,with the right !,' ,to consume so mu~h )f the principaL as may be necessary for her maintenar,ce and med Lcal attent:'on'.Upon her death,I give,devise ~, and bequeath such r ~'sidue as £ollo"s:I ;. •1''' .1'&~~......~:t hWi ::,-J...",,",_~~~:.'......:,...---<>.;...:.....-I.-..~~'........"."-....~_'--"_~__"__• ,I,",. ~~,I •1 .'1/ ~~ (a)The Sum of $1,000.(10 to my daughter, Anna Saba='; (b)All.the remainder thereafter I give, devise and bequeatr:'to my four child- ren,Susan Stimak,,John A.Takach, Th omas A.Taka~h end Anna Sabol, their heirs and'as~igns,share and share aliKe. SIXTH:I constitu::eand aPFoint my son,John A.Takach Executor of this my Last Will and Testcrnent. IN WITNESS WHEREOF,I,ANDRI.W TAKACH,also known as, ANDY T..AKACS,,the,Tes tator abO"le naned,have,hereunto subscribed my name and affixed my seal to this my Last Will and Testament, consisting of twa (2)pages,this J~:~day ,of September,1963. ( Signed,sealed,published alld:,decla~ed by,the above- named,Andre~v Takach,also 'knJvln as Anrly Takacs,as'and forhi~.,.~ Last Will and Testament in the presencl~of us,'who have hereunto subscribed our names at his request thr?reunto in the presence of the said Testator and of each other. ,.,),,~~I;z,G1-=~~ /ro"Ii fJ[i<W..AM.t,I.~=·1\- 'II "•••0 _ • ".,--'<........-:',-.-.--:--."~~~""":-~A""'~,i,~_~.e.:~.:Y<~..e,..,~~i.~~A.i......;-'·:.._.·,~_..". . L ,.',\;~,,;,~<\:.:~.•:::~~:i:'.:f':;"'I'<::,::.,~t';,'";:'....~~.:~.j.':~"'"~'~'..-).:::.':.~._:~..::.~.~.:..:•..~::""-'~<'-:'"....>.,..,.>.g.'.,,~.-::.~;;'":':~:':":"'~"...:"~{':".,-:,,;~;,g.~t~~'1t::.,.:>'~.,~,,:,:~::~ " g,tnte of TttrUlt!it11uuuia.!.of!:J .65:. <!louuty of llfIunl1ittgtl111 P 11 b 'f b'd . d h'.Notary Public . d f .·.:Iiersonayeoreme,t .e un ersrgne aut onty,a m an or sarul County and State,appeared ~J.QHN....A.A 'IAKACH ~who,being duly swo::,n according to law,deposes and ·says that he is the executor·ll1'(xdroiltii~MlitXof the estate of .ANDRE~:l.:..T.AKAC.H....g/.kL.~....A..N.RX....r.AKA..G.$.....:.........deceased,that the.foregoing schedules constitute a complete inventory and appraisement of the ~'eal and personal estate of.....ANDREw.....T.AKACH : deceased,except real estate cutside the Commonwealth of Pennsylvania;that the figures opposite each item of ~al and personal 'estate :n the foregoing schedules are determined and stated by the undersigned tc be fJe fair value of said items as of the date of the decedent's death,based upon a just appraisement of each iterr:.made by the above named Executor .ARookristq{~K . S d b 'b'd 1..·f h'j./.<Y/!'worn an su scn e ".Je ore me t IS :::.:......a.~..:..'._...?/daY_~'§[!:::;t.i:~/iI4.~~tf?:._....·~4'62~;··..·.. ./(I,((j//J-.t2--...ADDITIONAL INSTRUCTIONS . 1.An inventory 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,includin5'Copy of 'Will;1 Original and 3 Copies and 2 RCRI-33,Over $50,000,in- cluding Copy of 'Will and copy of Federal Estate T.a."{Return. REFERENCE FOR ADDITIONAL COPY Act of 1947 P.L.513 Sec.5.2,72 P.S.4844.2 wer:: lfttttttttory uub i\p,prai.5pttttnt of the goods and chattels,rights and cl'edits which '....TAKACS .,of .AND.R:EW TAKACH aJ.kJ.a ANDY lCit~of the B.Qr.ough of D.o.n.Qr.a.._ : . Wa:shington County,Pa.,ta~en and made in conformity with the above affidavit......,:,; DOLLARS CENTS • I REALTY None: PERSONALTY ,., -II I Savings a'ccount,Pittsburgh National Bank,Donora, Pennsylvania,No.561 10,737.40 Savings account,First Federal Savings &Loan Association of Monessen,Monongahela office 9,473.52 3,000.00 3,275.00 5,775'100 2,800.100 2,925 ..00 . ../.--_...._-_.-:---_.... r31"''''Qp.,S ..~.It:.(.q 100 shares International Paper Company stock 200 shares American Cyanamide Company 100 shares Scott Paper Company 100 shares Campbell Soup Company 100 shares Air Reduction Company .. .:<::~,~i:.~'."~~?'..~."~~~~~~,"-''-c''~',_.'~'.::...:·~··...:..::..2:··'-_···c....·....:..;.;•.....:;..,":..;.;•....:-~.•..:....~..._.~;..."..-'-;:~c....t..-'-'-....:.:.~'--.""-.;...~-"--"~-'-',--'"c....:c.......'--.".."--:-'-."'-•..:.....~.."",,"--,'.-'_....~-'.•~.-'-.--'-'-,.~:--'•.-'-'-'-'-"------'---'''-'.'''-'-'----'.=..:...=...c..---''-c:~.~;'--',:-,~~co_. 1:' "~'...... •• -~. .' •I" " •, ." ", """.~-~......"..-;--,-...... •-- COpy OF INVENTORY l'U>tD~Y Public,. JOHNA.TAKAtfH Cia lsI Jo~A.TD~ceb zmmxxnx 3Jnurntnrg anb !\pprmsfmrut of the goods and chattels,rights and credits which were . .AND~1 ~gACH c/k/o ANDY TAKACS the Borouah of DonorDaf-_late of . .W as.~ington County,Pa.,taken Qnd made in conformity with the abOTJ,!atfidaTJit. DOLLARS CENTS -n!t<'L-'i1 ~"One '. ..) ~...- \., 9,47$-...sf 3,275.00 5,775.00 2,000.00 3,000.00 2,925.00 :r"...-~.....,:.- .::-),.-.... SDVtngO Dceount,Firat Fc~erol.SovingG,~Lo3n Aa~_ociation of Moneoocn.VLOnongllhola office ..-'. .)SaviDgo llCCOunt,Pittsbu;:nb ~1l3tioDtJt Dunk,Donora, PennsylveniD,No ..'561 ::~~.,10 t 737.:40, ~.. 200 Gharea t~rican C,y~nemide Company 100 shareo Scott Popar Company 100 Gbsreo Ccopbo11Soup Campeny 100 shores Air Reduction Comp~ny 100 sheres InternDttonal Poper Compeny stock