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HomeMy WebLinkAboutOC1968-7184 - ESTATE OF CHACKOForm RCC-33 RESIDENT DE'CEDENT COMMONWEALTH OF PENNSYL VAN IA DEPARJMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS COUNTY OF ./ A.I..' ........,WASHIN.G.TON.. and say I~WORTANT:This return must be ~ompleted in detail and filed in duplicate,'with will attached,with the' Register of Wills of the County where decedent 'resided;Return is due within one year after date of death,unless an extension is granted by the Secretary of Revenue.(Section 703 of the.Jnt:t~ritl:l.nce..l:l.n!i .1L.~tlite .:fax Act of 1~91.) IN THE MATTER OF THE'ESTATE OF }AFFiDAVIT OF ...............An..4.I~.w.G.h.9:.~Jq?.......~R..-,. Borortgl1 fU8f'meficfr1eettoi ~~HEIRS Late .of Wa.s.hingt.on County ~N~~ :.:.:-;::~~~~;:~~:-~:~~-~:_::_~}'" . .M.a.r.y Gh.acko.and B.a.r..b.ar.a C.ar.dina.le.,. ~hei lOt the estate of the above-named decedent being duly sworn,depose .. Decedent'dJed Ma.r.c.h :.2.,19 6..4 J ~~~~?:!9Cx~~x!-xIxx'fXx§c~x~~~~~Jx*'} (Month)(lIay)(Y~arj L.intestate o t herN:muet:::i::.:r:::r:fse:\tao;;::~:}~__~_O!..g~_.._l3._.~._.__Al.}:t:.hQ.\J,E.,?.q1.1j:_.r._~..-,-.._.... . whom all correspondence should be .F.:i 't:t:SJ:)'lJxgll..NatiQnal.Bank ...Bldg •.,..,CaUQUsb.:urg.,..:..P.enna.....1..5..317 mailed. That as such h~.i.r.s _deponent is familiar with the affairs of said estate and the property con- .(I·;)(!':N)N~~~!l<:~N stituting the assets thereof and thEir fair market value. That at the time of death there was no safe deposit box registered in decedent's individual name,or jointly with,or as agent or deputy of another,or in decedent's individual name,with right of access by another as agent or deputy,with the exception of the following:- NAME AND ADDRESS OF BANK OR OTHER r:NSTITUTlON THIS SAFE DEPosiT BOX RENTED RELATIONSHIP OF JOINT IN WHICH DECEDENT RENTED A SAFE DEPOSIT BOX IN NAME OR NAMES OF HOLDERS TO DECEDENT NONE That the contents of sadd safe deposit box or boxes are itemized under Schedules - - - -of t!lis return,with the exception of the following,for the reasons hereinafter set forth: That Sc.hedule A attached h,ereto and mado:!part hereof sets forth full v and in"detail all the real property in the Commonwealth of Pennsylvania of which decedent died having an interest therein.It al.so sets f:>rth the mortgage encunbrances upon each parcel of real property at the date of death,.giving the amount still due at death,name of mortgagee,date,rate of interest,and book and page of record thereof.It also sets forth in the columns provided therefore the assessed valuation of each of said parcels,th~estimated market value thereof as of date of death of decedent•. T~lat Schedule B attached hereto and made part hereof sets forth fully and in detail all personal property wheresover situated ownej by the decedent a.t the time of death;all moneys left by the decedent,1 .at the time of ~eath,whether in ·decedent's immediate possession,standing to decedent's credit in banks of deposit,savings banks,trust companies,or other institutions,whether indiVidually,or in trust for any other p~rson or persons giving al~o separ~tely the accrued interest thereon,if any,down to the last interest day prior to decedent's death in the case ~f saVings banks,and to the date of decedent's death in all other cases;all bonds,postal saVings,treasury certificates or notes and other evidence of in- debtednessof the Uni ted States to the decedent;Bill obligations,whether by statute or agreement they are designated as tax free,of.tbe United Stctes,or any state,or political subdivision thereof,or of any foreign country,which are owned at the time of death;all wearing apparel,jewelry,silverware,pic- tures,books,works 'of art,household furniture,horses,carriages,automobiles,boats,and any and all other personal chattels of whatso~ver kind or nature,left by decedent,together wi th the fairly estimated mar~et vallle thereof;all bonds and mortga~e&held by decedent and of all claims due and owing decedent a t the time of death,and all promissory notes or other instruments in wri ting for the payment of money of which decedent died possessed)of whatsoever nature,with interest thereon,if any,giVing the face value and estimated fair market value thereor,and if such estimated fair market value be less than the face value,it sets forth briefl!the reason&for such depreciation-as to each item;all moneys payable to the estate from life insurance polici'es cE.rried by decedent;all annuity and 'endowment contracts the proceeds of which were payable up·)n the death of the decedent;and all the corporate stocks and dividends due thereon and unpaid as of the date of death,bonds and accrued interest thereon to the date of dece- dent's deat~and other investment securities owned by the decedent at the time of death,with the market value there·)f at such time. have been carried forward and properly registered in the Subscribed and sworn to b~ore me t~F). ................:..,3..~day Of ~~~~19 ~f In the case of securities of close or family corporations,the values reported are as far as possible substantiated by financial statements of the corporations,showing the assets and liabilities thereof as of the'date of death.The schedule also sets forth the interest of decedent at the time of death in any co-partnership or business,and in support of the value of such interest there is annexed to said schedule,financial statements showing the assets and liabilities of said co-partnership or business. A copy of the co-partnership agreement,(if oral,a statement setting forth the nature of the agreement) together with a statement setting forth the character of the business,its location,and such other facts pertaining to the business as may be pertinent to a fair and just appraisal of the decedent's interest therein must be submitted.·It should also set forth in itemized form,together with the fair market value thereof,any other property owned or bequeathed by the decedent at the time of death. The Schedule C attached hereto and made part hereof sets forth a true answer to each inquiry contained therein and in the case of transfers ofproperty,real or personal,within two years of decedent's death,in contemplation of decedent's death,or intended to take effect in possession or enjoyment at or after death,said schedule sets forth the nature and value of such property,to whom transferred,the relationship of the transferees to the decedent,the proportionate share received by.each transfe~ee and all other facts of a pertinent nature regarding said transfers.In the case of transfers intended to take effect in possession or enjoyment at or after death,there is also attached ~o the schedule a cOllY 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 ~alue,which passes at decedent's death by virtue of the exercise by decedent,either individually,or jointly with another,or any power of appoint- ment vested in decedent,either individually or jointly,by t\1e will,deed,or other instrument of another, with a copy of .the instrument creating such power attached to the schedule•. That Schedule 0 attached hereto and made part hereof sets forth the names and addresses of all persons beneficially interested in this estate at the time of decedent's death,the nature of their res- pective interests,their relationship,if any,to the decedent,together with the ages at the time of decedent's death of all minors,annuitants and beneficiaries for life under decedent's Will.It also contains a statement showing which of the beneficiaries named in the decedent's will,if any,died prior to decedent,the dates of their death,their issue,and the relationship of such issue to the beneficiary. That Schedule E attached hereto .and made a part hereof sets forth all property,real and per- sonal,owned by the decedent jointly with another or others,including intangible,standing in the name of the decedent and others,plus the date and place of r.ecord of instruments effecting the vestiture of real estate and the date'of acqUisition of personalty,pl~~the ~ame,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 commis~ions paid or to be paid;cost expended for burial trusts,tombstones or gravemarkers,and reli- gious services,in consequence of the death of the decedent;debts and claims owing and unpaid at time of death;taxes accru~d charge.able for period p'rior to decedent's death (except.those.allowed under Section 651 of the Inheritance and Estate Tax Act);.togethe~with a statement of collateral pledged for obliga- tions,if any.It is agreed that the fiduciary will present proof of said claimed obligations upon re- quest,that if the amount actually paid in settlement of any fee,commission or debt is less than the estimated amount claiming and allowed,that the same will be reported to the Register of Wills,and that the amount of tax assessed can be reassessed in accordance therewith. That the totals of the appropriate columns in Schedules "A","B","en,"E",and "F"as directed therein,· S",""..y.~ ctPM!1J t.~o..~~'.."~. (n~f~~Jffl~M'@X He irs ..1...Q.9..~~.~..~.~.~.~Ay..~.P.:~.~~_..~_.. (Street Number) .~.~.~.!...~..~.!..?..~..~~.:.~~.~.Y..~.y..~.~.~.~!..?...Q..??... (City (Yf'Town and State) NOTE:Before signing affidavit make sure all blank spac~s in the affidavit and schedules annexed are filled in with details or the word "None",and in case the assets include rare and unlisted securities, \securities of close or family corporations or an interest in any co-partnership or business,that the data and statements required under the paragraph above relating to Schedule "B"are attached.Also make certain that column #1 in the "Summary"has been properly completed as above-directed. <'.:..-- RCC-34 (1-64~ COMMONWE.ALTH OF PENNSYLVAN~A DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS TRANSFER INHERITANCE TAX RESIDENT DECE.pENT· i ~~.• SCHEDULE II'A" teAL PROPERTY ~~ Real property in Pennsylvania,with statement of mortgage encumbrances upon each parcel at death of dece- dent.Where property heid as joint tenarit or tenancy by entireties!report on Schedule 'IE".Property held by ·the .de.cedent·as tenant in commcn with another or others,should .be identified as to quantum of interest and the estimated value should be t~at of the decedent's interest only. ------------------------~-----__r_-----___r-------,The real property located In the Commo!"weal-h of Pennsylvania should be described by lot and block number,street and street number,together wi th a general descrlp.tlan of the property,with a teference to the record of the conveyance by which the decedent took title;If a farm·state number of a. cres;also statem!!nt of mortgage encum~ranc..s upon each parcel at death of decedent.TOlles,assessments,accr.ued Illterest on mortgages,etc.,are to be listed on Schedule "F"and must not be deducted.from this schedule. (1 ) ASSESSED VALUE FOR YEAR OF DECEDENT'S DEATH (2) ESTIMATED MARKET VALUE (3)I DEPARTMENT VALUATION CAUTION (Do not write In this space) ALL that:certain lot of ground situate in Charleroi,Washington C6unty,Pennsylvania, known and described as Lot No.2 In the Plan of Lock Four Land Co~pany,fronting 22 feet on the West side of McKean Avenue, and extepding back along Tenth Street of uniform width 100 feet to Long Alley,and having e!ected thereon a two story brick mercantile and apartment building known as 1001 McKean Avenue. :... ( •" : , ~•. ,, I, ·..I · { Insert this.total opposite IIreal prc.perty",Schedule IIA"in the X X X X X liAs Reported"column on the last page of this return, If;{){)(j 06 RCC-35i COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDEN~DECEDENT SCHEDULE "n" PERSONAL PROPERTY INSTRUCTIONS:This Schedule must disclose all tangible and intangible personal property owned individually by the decedent,at the time of his death.Property owned by the decedent jointly with another or others must be listed under Schedule tEn.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 shou:d be listed first (e.g.jewelry,wearing apparel,household goods,ar<d furnishings,books,paintings,automobiles,boats,etc.) Intangible personal property,such as bonds,treasury certificates,cash on hand and in bank, ..stocks,·Mortgages,notes,together with accrued interest or dividends,salaries or wages,insurance pay- able to the estate or fiduciary in said capacity,partnership interests,interest in any undistributed estate of or income from any property held in trust under the will or agreement of another,even though located outside of the State,at the time of death,should be listed in this schedule. Item ITEM UNIT ESTIMATED DEPARTMENT VALUATION No.List and describe fully VALUE MARKEr VALliE (Do not write in this space) NONE , i i Insert this total opposite "Personal Property",Schedule "B"in X X the "As Reported"column on the last page of this return. .~CC-3~ cmmOt\:ll'EALTH OF PENNSYLVANIA T~~NSFER INHERITANCE TAX ~~SIDENT DECEDENT SCHEDULE "c" l'RA.NSFERS (1)Did decedent,within two years of death,:make any transfer of any material part of his estate,without receiving a valuable and adequate consideration therefor?(Answer yes or no)__ (2)Did decedent,within two years of death,transfer property from himself 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 making the transfer.(Note 1). (c)Cause of decedent's d~ath.(Note 1). (4)Did decede~t,in his lifetime,m~ke any transfer of property without receiving a valuable or adequate consideration therefor which was to take effect in possession or enjoyment at or after his death? (Answer yes or no)_ (a)Was ,there any possibility that the property transferred might return to transferer or his estate or be subject to his power of disposition?(Answer yes or no)__~_ (b)What was the transfer'Ole's age at time of decedent's death?_ (5)Did decede:Jt in his lifetime make any transfer without receiving a valuable and adequate consideration therefor u,der which transferor expressly or impliedly reserves for his life or any period whieh does not in fact end before his death: (a)The possession or enjJyment of or the right to income 'from the property transferred~ (Answer yes or no)__ (b)The right to designate the persons who shall possess or enjoy the property transferred or income therefrom?(Answer yes or no)_ (6)If the answer to (5)(b)above is in the affirmative,state whether the right was reserved in decedent alone or others ----=-__ (7)Did decedent in his lifetime make a transfer,the consideration for which was transferee's promise to pay income to or for the benefit of care of transferor?(Answer yes or no)_ (8)Did decedent,at .any time,transfer property,the beneficial enjoyment of which was subject to change, because of a reserved power to alter,amend,or revoke,or which could revert to decedent under terms of transfer or by operation of law?(Answer yes or no)_ (9)If the answer to (8)above is in the affirmative,was the power to al ter,amend,or revoke the inter- est of the beneficiary reserved in the decedent alone or the decedent and others? (Answer yes or no)__ NOTE 1:The answers to these questions should be supported by affidavit by the attending physician as well as a copy of the death certificate. NOTE 2:If answer to any of the above questions is yes,se~forth below a description of the property transferred,it's fair market value at date of death,dates of transfers and to whom transferred,with relationship of transferees to decedent,if any.Submit copy of any trust deed or instrument,if trans- fers are claimed to be non-taxable,also submit detailed statement of facts on which said claim is based. NOTE 3:List applicable property below in manner in which provided in Schedules A,B,or E•. ITEM DESCRIPTION NONE MARKET VALliE (Es timated)DEPT.VALUATION (Dept.Only) Insert this total opposite "Transfers",Schedule "C"in the "As Reported"column on the last page of this return. CC\M~lt)NWFi\LTH 0F PENNSYLVANIA T;\'I\N::;FElt TNHF1UTANCE TAX n.F~TnENT DECEDENT SCHEDULE "E" JOINTLY OWNED PROPERTY . " I:\SrRrCTIO~S:This scherlule must d.isclose all property,real anrl personal,owned by the decedent jointly wi th another or others,including ir.tangibles,standing in the name of the decedent and others.List real estate first,as entireties,or joint tenants,giving brief description,as indicated under Schedule "A",plus the d!ite and place of record of instrwnent effecting vestiture,but do not include entireties or out of state real·estate value in estate valuation eolumn.Personal property should be listed as in Schedule "B",plus date of acquisitic·n,and the name,address and relationship (if any)of co-O'wners to the decedent. Description of ?roperty,Date of Acquisition,Name 1 Unit perce~tage--E;tate Address and Rel3.tionship of Co-Owners,and Place ;Value Share Valuation of Record of Instrument,where Reali.Estate.I NONE Insert this total opposite "Jcointly Owned Property",Schedule ·"E" in the n As Reported"column on the last page of this return. DEPARTIJENT VALUATION CAUTION-Do not Write In This Space. Value of Value of Entire Decedent's Property Interest '. Reo-37'i 12-63)~ COI\1MON\\\EALTH OF PENNSYYLANIA .TRANSFER INHERITANCE TAX RESIDENT DECEDENT ..~ . ,SCHEDULE "D" BENEFICIARIES .~ ',I .~... BENEFICIARIES AND ADDRESSES .RELATIONSHIP SURVIVEDOfstep-children or DATE INTEREST OFStatef~ll names and a~dresses of all who il!egitimate children DECEDENT OF BENEFICIARY ave an interest,vested,contingent or other are involved,~.et STATE YES IN ESTATE wise,in estate)-forth this fact.)OR NO BIRTH Marv Chacko -wife yeS 11/2/190R nn t=>-h!J 14= ..Barbara Cardinale daughter ,yes . .7/26/1942 One-half . -. '., c .t , , ( h Deponent further says that all the above-named beneficiaries are living at ~his time except below: NAME DATE OF DEATH RESIDENCE \e \ .i' ~::.. \';'lo ~~.....1. ~>,;~.:r. .0~~­:~~~ .:0.3:.5'o r:(S~ -00 -£n -fiP-o -fiP-o .....,'"d ~...ct>ct>II>...e:..::l V> V>0.....::l '"dct>e:........0V> '"d"g......0 ~'t:lct>.......'< ... (I)c:~~>-~...-.....-..>-<W en (I) (")(") ?"?"?". n ~>;;:;:------ -00 -£n -£n -£n ...-..-.;.>-'..,V>II"'~~~ .:("D .-.. :e::c."0 -II J:(2Q -.....:Q (tc..--:(2 :~ -fiP-o-£n (Executor-Administrator must complete "As Reported"column #1.) t:r1V>....II>....ct> ;- -£n-£n CJ...oV>V> ~"'-~ :~ :~:~ :c; :~ :"'-.i..~:~:~~ .~o Q ': ...., ,II>XII> c:r'Cii \l ."- • ,,\.,..~~- Year . dBS 8Ea!s Deceased ..!\[':Lsll:~IlK1:()~... '" P.ol THE OF THE J3.CJT..()l,lg l~..91:...C:.l1.Gi:r.I er 0 i ANDREW CHACKO ESTATE OF $171,;1 :i0 ,~r)lSi9?U ONWVi J l/:SsmJ O.~l-ll:J REPORT AND APPRAISAL (r :17 1M ~IATTER OF THE APPRAISEMENT /' ! Late of Commonwealth of Pennsylvania COlmty of Will \(Tr-No .'Administra:tion,., ... '.,~. .'~. .' /DEDUCTIONS ALLOWED IN THE SUM OF •I ••••••••••$.~.c?.~?.:9..(? OA"~~ Register of Wills,Agent I.o./J 1~4 /9'~f. STATEMENT OF DEBTS AND DEDUCTIONS OFFICE OF TME REGISTER OF WILLS Form RC C.10 OF \\fa s~lington COUNTY ~';:;~-:-;~~;;>~. ESTATE OF --:,.AND=;;..:RE:.=W_-'C...;;.H....;;A...;;.C_K:_O LATE OF _-=.C_h~a~r_l_e_r_o_i...:,_p_e_n_n_s_"y'_l_v_a_n_i_a _ 9"-~o·-~;;March 2,1964DATEOFFILINGAPPRAISEMENTOATSOFDEATH DATE NC.OF "AMIi:OF PAYEE REMARKS AMOUNTVOUCHIOJf Michael A.Malinchak Funeral Expenses $1,890 00 I , I Catholic :emeterie·s Assn.Vault 87 00 I C~thnl ;c ."o,",of-eries Assn Burial Expenses 186 00 Mrs.Andrew Chackc Family Exemption 1,000 00 Russell Marino Filing Fees 3 00 .!George E.Anthou Attorney Fee 100.00 - I - .'j --t-.I .. \i \ , ,.I ---_.~I ; j I-------\ T °T A L ...... . .$3,266~00 INHERITANC;::TAX PURPOSES. 18EO I!IEFORE ME ,HIS =on .19 COMMONWEALTH OF PENNSYLVANIA COUNTY OF Washington I,George E Anthoa,Attorney for Estate of AI:ldra\t:RQ~:ltEJ«@Y.THAT.TOTHEBEllITOF MY KNOWLE;JGE AND BEl.IEF,THE FORE:;OING IS A JUST AND TRU E STATEMENT OF DEBTS,FUNERAl.EXPENSES AND :::XPENSr;s 01" ADMINISTRATION SUBMITTED TO THE ESTATE OF --.t::..l.LU-,I.-C:..lilI--1...LJ.i;iu.-D..}.9~:--_----_'OECIi:ASECAS DEOUCTIONli FOR ____~_iSL1.C1J£~u -(L.5.) DAY Of'orgeOE.Anthou,Esq. ,\) ....\.. ..,.~\ .; " .. . ........... ! C) ltJ --J---•1...L.. I ,RCC-SI (2-64) rt (OMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS .,INHERITANCE TAX DIVISION NOTICE OF FILING OF APPRAISEMENT IN YO~R REPLY PLEA8E REP'lER TO 37-145-4 ./ MARY CHACKO,&BARBARA CARDINALE Informant.~. •'t-, If,I, ~". f:~l~:In Re:Estate of ANDUrT CHACKO.i ..::::W.:..:AS:H:IN::G:TO==N:::::=:::::==-c-o-un-tY---F-i-le-No.63-68-1184 f-l'You are t.ereby notified tt_at the origi cal lappraisement in the estate of Andrew ChacKo lias been filed in the office of the Register of Wills qf Washington ;County on SeptEhnber 20 ,1968.Said appraisement reflects the ffollowing valuatior.s: fDat e_---'S~e~pt~'.~e~m~b~er~2::.::0~,:....=1~96~8,?-._ 1 RealEstate _---'--=1:.::8:.,z,.::O.::OO.=:'.!..,:,0,:,0__ Personal Property _ Transfers -----:----:--- Total --:-_.:...-...:!l~S:.:L,.:=:O.=:.OO~',:';:0O~O::..-_ ~ti Ft AS to such tax that is paid within three months·from date of I'Cieath,a five (5%)percent discount is allowable.As to any tax that remains unpaid after one year from date of death,interest at tbe'rate of six (6%)percent per annum is charged. t Any party in interest who is aggrieved by an appraisement may lappeal therefrom as provided by law. ~, 0:'. . f'DATE OF DEATH: tf . t' Note:This is not a bill. .' GEORGE E.ANTHOU ArrORNEY AT LAW PITTSBURG:-I NATIONAL BANK·BUILDING CANONSBURG,PENNSyl."vANIA September 2l~1968 Commonwealth of Pennsylvania Department of RevenueBu~eau of Cbunty Collections Washington Trust Building Washington,Pennsylvania Re:Estate of Andrew ChakJ File No.63-68-1184 Attention:William Chaney Dear Mr.Chaney: AREA CODE 412 TELEPHONE 745-1111 I received your tenative.statement regarding the Estate of Andrew Chako and find that the date of death entered thereon is erronious. The 'deceased,Andrew Chalco,died on March 2,1964 and;of course,this would make a difference in the tax to the Commonwealth.If you need. evidence of the date of death,please so i~dicate~ ~EA:mg Si::~;Z2itt~_ orge Anthou~ COMMONWE'AL TH OF PENNSYLVANIA DE PARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS HARRISBURG 17127 October 1,1968 William R.Chaney,Chief Appraiser Inheritance Tax Division 244 Washington Trust Building Washington,Pennsylvania 15301 Re:Estate of Andrew Chacko ~ile No.63-~8-1184 County of Washington Dear Mr,Chaney: We.acknowledge receipt of your letter of September 24,1968, whe,rein you advise that,the date·of death of this decedent was incorrectly shown on your appraisement filed in the Register's Office of September 20, 1968. Please be advised that'we have corrected our records changing the date of death from March 2,1968,to the correct date of death,' March 2:1964.This letter will serve as your authorization to amend your records accordingly. Very truly yours, For:Richard L.Witmer,Directo~ Bureau of~County Collectio~s RLS/llc cc:Russell Marino,Register ofWilVs "ICC-39 16-67) i I!the undersigned #63 Washington SUMMARY.~.. CHACKO,'ANDR.Kw FILE #63-68-1184 March 2,~Flfp Y,.",..., rtf<:POlU'OF INHERITANCE TAX APPRAISER clul~l appoint2d Inh5ri tance Tax Appraiser in and for the County of ,Pennsylvani9.,do respec tfully report that I have apprais,ed property as reported in the foregoing return at the values set forth the last column to th3 right in Schedules "A","B","C"and "E". ~~.G<7..V,L? ,INHERITANCE T X APPRAISE~'03-02-&Q.19{ 09-20-68 the real and pers?nal opposite each item in Dated: FILE #63-68-1184 COMMONWEAL TH OF PENNSYLVANIA' TRANSFER INHERITANCE TAX RESIDENT DECEDENT REPORT OF THE REGISTER OF WILLS I,the undersigned duly elected Register of Wills in and for Washington Coun ty,Pennsylvania,d0 c":spee tfully report that I have allowed deductions in the amounts claimed b.Y deponen t,exc(')]J t as to those i temE:'where a greater or lesser amount is set for th in the last column to the right in SC~1edule "F",which greater or lesser amount represents the sum allowed as a deduction.~~~.q.,0'<'__~_ Dated:09-20-68 ~~~~~-v~v REGISTtR OF WILLS VALUE AS REPORTED VALUE AS APPRAISED VALUE AS REAPPRAISED $18,000.00._$18,000.00 $_ INVENTORY Real Property (Schedule A) Personal Property (Schedule B) Transfers (Schedule C) J oint-He]d Property (Schedule E) TOTAL GROSS ASSETS LE~S Debts'and Deductions (SCt-EDULE F) CL'SAR VAJJUE OF ESTATE 18,000.00._ 3,266.00:__ 14,734.0°._ 18,000.Oer- 3,266.00'-'._- 14,734.0°._======:= Valuation of life estates or annui ties . . . .$----- , E~TATE T~~ASSESSMENTS (h.;'------ CO~{PUTAT~ON OF TAX (:::)As evidence\l'by Charitable Exemption Certificates issued by the Secretary of Revenue.$----'----'--(h'~====:::::::=._-$-----~ *=====1= i3~\:BANCE OF INHERITANCE TAX 'CUE Sl;...,.;-__ A~~interest at rate of 8%from to $--------AMOUNT OF ESTATE TAX ASSESSED *~ Estate tax paid $_ BALANCE DUE *_ Add interest at rate of 6%fromto $_ TOTAL TAX BALANCE $_ PAID $ fOR'USE OF REGISTER ONLY T ax'on $•__f5%$__~_ T ax:on $----=-:::-:--::-:::---~7'~.,1~.,oo :,','--=-';--'><"'l"'"- T ax.on ~_-=1::;:;4.L-'7.:...::3~4:..:._0_0_~,£"",~o~,--,=-"""'--\'o '"884.04 T ax'on $.__1f5%$__..,...;.,',--__ Exemptions .__(:::) Tptal Est9.te __ i TOTAL;TAX :.Less tax previo'usly paic'_', BALANCE Less 5%of tax .if paid within 3 nionths9.fter death FOR USE QF REGISTER QNLY ADJUSTMENTS NOTE:Wh5re subsequent adjustments are made to the above computation of tax by the ~egister of Wills,for proper reason,same should be noted below,with short explanation. Will l Administration .\ ..."..,i No :.:~..~Year.~ .., IN THE'.'?<',,.I MATIER OF THE APPRAISEMENT OF THE ESTATE OF AND1ili~CHACKO ...................•..................................••..............•• Deceased Late of CHARLEROI...... County of WASHINGTON-......••.......•................•..•...•......••.•.......•••.• Commonwealth of Pennsylvania REPORT AND APPRAISAL ,~ ....'~;. ". " , t ~.__._----------------------------------------------~ DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS HARRISBURG.PENNA. .. COMMONWEALTH OF PENNSYLVANIA RESIDENT INHERITANCE TAX APP~~ISEMENT DATE ?~pt~~p..~r ?.9..?J::9..9.?.. COUNTY ~a.:.~~.~~~~.??. FILE NO..9J..:.9..?:~.~.?4._. Wl".ereas,.Andr.~w Cha.c.kQ late of G.ootJ,.~r..9.t . in the County of W.~~h.;t.ngt.9.D..:Commonwealth of Pennsylvania,having died on the ?~4.-day of J1~!.9..h 19.~_$.(,seized and possessed of an estate subject t.O Inheritarf.ce Tax under the laws of the Commonwealth of Pennsylvania; Therefore,I,:~.~.~.~G.h~.~.y ,an appraiser duly appointed according to law, having been design~ted to make a fair and conscionable appraisement of the said estate,and to assess and fix the cash value of all annuities and life estates growing out of said estate,hereby file the following appraisement: In the event that any future interest in this estate is transferred in possession or enjoyment to collateral heirs of the decedent after the expiration of any estate for life (or for years,the Commonwealth hereby expressly reserves the right to appraise and assess transfer inheritance taxes at the lawful collat~ral rate on any such future interest. Description of Asset Unit Values Appraisement Made for Inheritance Tax Purposes $ REALTY: 18,000 00AsperSchedule"A"1-----------....:....--------------------------+----11.------+-.-- PERSONALTY:.. NONE , - TRANSFERS: NONE JT.HELD::1 . NONE.l NONE NONE NONE I----------------------------------------I------H------I---, Total 18,000 00 , ...............WAp.H.:J:NGT.Q,l'il .Coullty "'{ ,', \ ,"-\ ... .. '':... ,.,: ./ .. \' RESIDENT INHERITANCE TAX APPRAISEMENT Estate of ANDRE.W CHACKO...••..••••.•....•••......•••.......••••.•....•...••.. Deceased. Late of ...............Q~~~QJ:. Date of Death,'~Cl::r..9.h ?"'J.:..99.~.. ,1ppraisClIlcllt Docllet Vol.,3..7 ,. Page,145'::':.4 No 63:~~~Q$'::':.1l84 .. Filed in Register's Office,$.(:mt...~~8,,:J9..Q$. Amount of tax due,$.. DEPARTMENT OF REVENUE Receiv£'d, Exa.mined and Approved,:. Wrote abo.ut Appraisement, Appeal.'/"l?m Appraisement,. Entered and charged, ., ~•.:'n-.....-." '\'..~.".:" ,, J ~. ..... :~.. ...~. ,0, ~~~It::~···"~ t' ... -I FORM RCC-4-RI TRANSFER INHERITANCE and/ot ESTATE TAX. RESIDENT DECEDENTS. RECEIPT ..... 4Docket31Page145Iine'------'_ Estate of AlIDREW-clIlen • i OFFICE OF REGISTER _OF WILLS WASHn.~TIR •Po. Date October 25.19 68 SIGNED AND SEALED AS PROVIDED BY SECTION 1201.ACT APRIL 9.1929.P.L.343 AS AMENDED BY ACT MAY 15.1945,P,L,528' RUSSELL )!liDO .-"..,.1 ~ Register.o~Wills 1201 (g).Act of April 9.1929,P.L.343,as amended,viz:-"To receive from Registers of Wills all duplicate .re- ceipts for taxes paid to them by executors or adminis- trators and to charge the Registers receiving the mcneywiththeamountreceiptedfor.The original of each such receipt shall be signed and sealed by the Register ofWillsandtransmittedtotheexecutororadministrc:tor,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 beiow name and address of person to whom tax receipt is delivered: I Am•Gt:;ORGI AtmlOU t JR. -PITfWUROHNAfl0HAL.BAffli DLUU. I "J. L CANONSBURG,PENNSYLVANIA 1531' -'