HomeMy WebLinkAboutOC1969-0167 - ESTATE OF BALLENTYNEDATE 08-27-84
REV:'15~7EX (07-84)
CO,.MONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF ACCOUNTS SETTL;;MENT
P.O.BOX B903
HARRISBURG,PA 17105
NOTICE OF INHERITANCE TAX
APPRAISEMENT.ALLOWANCE OR DISALLOWANCE ACN
OF DEDUCTIONS.AND ASSESSMENT OF TAX
leI
ESTATE OF BALLENTYNE SARAH
DATE OF DEATH 12-29-68
J FILE ·NO.63 69-0167
COUNTY WASHINGTON
NOTE:TO INSURE PROPER CREDIT TO
PAYMENT TO THE REGISTER OF
AGENT".
YOUR ACCOUNT SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX
WILLS OF THE ABOVE COUNTY.MAKE CHECKS PAYABLE TO "REGISTER OF WILLS.
VICTOR H RIVA ESQ
512 FALLOWFIELD AVE
PO BOX 18
CHARLEROI PA 15022
\PLEASE RETURN THIS
PORTION TO REGISTER OF
WILLS IF PAYMENT DUE
Amount Remitted to Register of 'Nills
CUT ALONG THIS LINE ~RETAIN LOWER PORTION FOR YOUR RECORDS ~
NOTICE OF INHERITANCE TAX APPRAISEMENT,ALLOWANCE OR DISALLOWANCE OF OEDUCTIONS AND ASSESSMENT OF TAX
REV.1547EX (07-84)
ESTATE OF BALLENTYNE SARAH J FILE NO.63 69-0167 ACN 101 DATE 08-27-84
TAX.RETURN WAS:(X)ACCEPTED AS FILED )CHANGED
RESERVATION CONCERNING FUTURE INTEREST -SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON:1 SUPPLEMENTAL
1.Real Estate (Schedule A)
2.Stocks and Bonds (Schedule B)
3.Closely Held Stock/Partnership Interest (Schedule C)
4.Mortgages/Notes Receivable (Schedule DJ
5.Cash/Bank Deposits/Misc.Personal Property (Schedule E)
6.Jointly Owned Property (Schedule F)
7.Transfers (Schedule G)
8.Total Assets
RETURN
(1l --.;,0:....;0_
(2)--=....::0.;.0_
(3)---'.:....:O:....:O~
(4)--=....::0.;.0_
(5)---:•...::0--"0_
(6)__--..:..3-=-,...::;5.;;;;1...::;5-'-•..;:4.;;;;2_
(7)--.;,0:....;0_
(8)3,515.42
APPROVED DEDUCTIONS AND EXEMPTIONS:
(15)---:•..;:0..;:0_.X.06=....:.•..;:0...:;.C_
(16)13,230•76 X.15=__---:1""',:....09...::8:....;4;...;.•..;:6..::;;1'-
(17)1 ,984 •61
NOTE:
9.Funeral Expenses/Administrative Costs/Miscellaneous
Expenses (Schedule H)(9)-'-•...::;0-'-0_
10.Debts/Mortgage Liabilities/Liens (Schedule Il (lm •...:;.O...;;.O~
11.Total Deductions (11l
12.Net Value of Tax Return (12)
13.Charitable/G,:)vernmenta!Bequests (Schedule J)(13)
14.Net Value of Estate Subject to Tax (14)
If an assessment was issued previously.lines 14,15 and/or 16 and 17 will
reflect figures that include the total of~returns assessed to date.
ASSESSMENT OF TAX:
15.Amount of line 14 taxable at 6%rate
16.Amount of line 14 taxable at 15%rete
17.Principal Tax Due
.co
3,515.42
.00
12,092.2,)
TAX CREDITS:
(If Balance Due is less than $1.00 no payment is requi-ed)OF ADDITIONAL INTEREST
I PAYMENT RECEIPT DISCOUNT (+)AMOUNT PAID ,WiDATE#INTEREST (-)
03-07-69 033245 22.29 423.55
03-07-69 033244 33.49 636.40
11-17-69 051171 .00 170.78
07-23-84 073098 598.77-527.31
I /
INTEREST IS CHARGED FROM 07-24-84 TO 09-11-84 TOTAL TAX CREDIT L-v..'\1,215.05
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE \769.56
REVERSE SIDE OF THIS FORM.*INTEREST 5.72
."IF PAID AFTER THIS DATE SEE REVERSE FOR CALCULATION TOTAL DUE 775.28
RESERVATION:Estates of decedents dying on or before December 12,1982 --If any future interest in the estate is
transferred in possession or enjoyment to Class B (collateral)beneficiaries 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 Class B (collateral)rate on any such future interest.
PURPOSE OF
NOTICE:
PAYMENT:
REFUND (CR):
OBJECTIONS:
To fulfill the requirements of Section 1740 of the Inheritance and Estate Tax Act.Act 255 of 1982 (72 Pa.C.S.
Section 1740l.
Detach the top portion of this Notice and submit with your payment to the Register of Wills.
--Address information is listed on page 13 of the booklet,"Instructions for Inheritance Tax Return for a Resident
Decedent."
--Make check or money order payable to:REGISTER OF WILLS,AGENT,
A refund of a tax credit,which was not requested on the Tax Return,may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax"(Form REV-1313).Applications are available at the Office
of the Register of Wills,any of the 24 Revenue District Offices,or from the Department's Forms Service Unit
by calling (717)233-3443.
Any party in interest not satisfied with the appraisement,allowance or disallowance of deductions,or assessment of
tax (including discount or interest)as shown on this Notice may object within sixty (60l days of receipt of this
Notice as follows:
--by written protest to the Department of Revenue,Board of Appeals,P.O.Box 1874,Harrisburg.PA 17105 OR
--by election to have the matter determined at the audit of the account of the personal representative OR
--by appeal to the Orphans'Court
ADMIN-
ISTRATIVE
CORRECTIONS:Factual errors discovered on this assessment should be addressed in writing to:PA Department of Revenue,Bureau
of Accounts Settlement,P.O.Box 8903,Harrisburg,PA 17105.See page 3 of the booklet "Instructions for
Inheritance Tax Return for a Resident Decedent"for an explanation of administratively correctable errors.
DISCOUNT:If any tax due is paid within three (3)calendar months after the decedent's death,a five percent (5%)discount of
the tax paid is allowed.
INTEREST:Interest is calculated on a daily basis at the following rates:
Delinquent Date Interest Rate Daily Interest Factor
5/27/43 to and including 12/31/81 6%.000164
1/1/82 to and including 12/31/82 20%.000548
1/1/83 to and including 12/31/83 16%.000438
1/1/84 to and including 12/31/84 11%,000301
--Estates that became delinquent on or before December 31,1981 will maintain a constant interest rate until the
delinquent balance is paid in full.
--Estates that became delinquent on or after January 1,1982 are subject to a variable interest rate that changes
each calendar year.
--Interest is calculated as follows:
INTEREST =BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15)days
beyond the date of the assessment.If payment is made after the interest computation date shown on the Notice,
additional interest must be calculated..
J1-/f3-~,,
PEV.1500 EX+(8.8:1)•~..~INHERITANCE TAX RETURN
f.RESIDENT DECEDENTCOMMONWEALTHOFPENNSYLVANIADEPARTMENTOFREVENUE(TO BE FILED IN DUPLICATE 63-69-C167BUREAUOFEXAMINATIONFILENUMBERP.O.80X 8327 WITH REGISTER OF WILLS)HARRIS8URG,PA 17105
DECEDENT'S NAME (LAST,FIRST,AND MIDDLE INITIAL)DECEDENT'S ADDRESS...Z 811 I
III BALLENTYNE,SARAH JANE McKean Avenue0IIISOCIALSECURITYNUM8ERDATEOFDEATHCharleroi,Pennsyl vani a 15022UIII12/29/680193-01-9035 Counly Washinaton
...:.01.Original Return l&2.Supplemental Return 03.Remainder Return~CIl:'"UA.III~04.Life Estate . ( 0 4a.Future Interest Compromise 05.Federal Esbte TaxIII0...U:l:CIl:CO
Ii¥.~~~~7.DO<ede"mal"al,O<!a IM'9 ,...
Return ReqliredUA...IA.ID _8.Total Number of safe deposit boxesC(Attach copy of Will ,(Attach copy of trust)
ALL CORRESPONDENCEvAND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:...NAME ADDRESS
'Z Ri.va,512 Fal1ow£ield Avenue"'III Victor E.Esq.:0CIl:Z TELEPHONE NUM8ER P.O.Box 18
00 Charleroi,Pennsyl'Jani a 15022UA.(41 2)483-42~2 CITY STATE ZIP
1.Real Estate (Scl1edule A)(1)$00.00
2.Stocks and Bonds (Schedule ~)(2)00.00
3.Closely Held Stock/Partnership Interest (Schedule C)(3)00.00
4.Mortgages and Notes Receiv(lble (Schedule D)(4)00.00
5.Cash~Bank Deposits &Miscellaneous Personal Property(5)00.00
Z (Sc edule E)0
i=6.Jointly Owned Property (Schedule F)(6)3,515.42
~7.Transfers (Schedule G)(Schedule L)(7)00.00:::;)...$3,515.42iL8.Total Gross Assets (total lines 1-7)(8)CU 9.Funeral Expenses,Administrati·te Costs,Miscellaneous (9)00.00IIICIl:Expenses (Schedule H).00.0010.Debts,Mortgage Liabilities,Lillflls (Schedule I),(10)
-11.Total Deductions (rotaI lines 9 &10)(11)00.00
12.Net Value of Estate (line 8 minlS line 11)(12)3,515.42
.....13.Charitable and Governmental B"quests (Schedule J)(13)00.00
14.Net Value subject to tax (line 1~minus line 13)(14)3,515.42
15.Amount of line 14 taxable at 60,)rate (15)x .06 =
(include values from Schedule K or Scl1edule M)(16)$3,515.42 .527.3116.Amount of line 14 taxable at 15*'rate X .15 =
(include values from Schedule Ie or Schedule M)527 .31Z17.Principal tax due (add tax from line 15 plus tax from line 16)(17)0i=18.Total Prior payments:Amount Paid Discount Interest~+.-(18):::;)A.~19.If line 18 is greater than line 17,-enter the difference on line 19.This is the OVERPAYMENT.(19)
0 A.OCheck here if you are eequesting a refund of your overpayment.u
><20.If line 17 is greater than line 18,e-nter the difference on line 20.This is the BALANCE DUE.(20)527.31C,...A.Enter the interest on the balalce due on line 20A.(20A)
B.Enter the total of line 20 and 20A on line 208.(20B)
Make Check Payable to:~egllter of Willi,Agent
••BE SURE TO ANSWIR ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH••
~~derpenalties of perjury,I declare that I have examined this return,induding accompanying schedules and .statemenb,and to the best 01 my knowledge and belie!,
,t IS trU9,ect and complete.I declare that all real estate has been reported at true market value.Declaration of preparer other than the-personal representative IS;)a~,~I"!p}orma'io,!!of which prep er has any knowledge.15012 ,_~~.~Rostraver Rd.,Belle Vernon,PA v1-/C,-Ffc.l
''''NA"'I'OF FE'SON ",'FON'"''FOR ""NG RETURN AGO"'''~.DAli.~.
7,1 ira .Hierna -Informant ,..---'o~.;.~m
5'-6N'A ADDRESS DATE
..."
YES NO
1.Did decedent make a transfer and:
,a.retain the use or income of the property transferred,x
·b.retain the right to designate who sh~1I use the property transferred or its income,X
c.retain a reversionary interest or . .X
d.receive the promise for life of either payments,benefits or care'X
-----------------------------------------------------------------------------------------------------------------------------_.---_.
2.If death occurred on ,or before December 12,1982,did decedent within two years
preceding death transfer property without receiving adequate consideration'If death X
occurred after December 12,1982,did decedent transfer property within one year
of death 'without receiving adequate consideration'
-------------------------------------------------------------------------------------------------------------------------_._----------
3.Did decedent own an 'in trust for'bank account at his or her death'X
---_---------_---------_--..........•.................._-_-----.... .
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
,,
.'\..,
REV-l'09 EX+.(7-83)..
7,COMMONWEALTH OF PENNSYlVANIA
..INHERITANCE TAX RETURNRESIDENTDECEDENT SCHEDULE "F"
JOINTLY-OWNED PROPERTY
ESTATE OF
SARAH JANE BALLENTYNE
Joint t8nont(I):
FILE NUMBER
63-69-0167
NAME
A.Mrs.Ru th E.Falise
B.
C.
Jolntly-owned proporty:
ADDRESS
811 McKean Avenue
Charleroi,PA 15022
RELATIONSHIP TO DECEDENT
Sister
LmERITEMFOR DATE TOTAL VALUE DECD'S DOLLAR VALUE OFNUMBERJOINTMADEDESCRIPTIONOFPROPERTY
TENANT JOINT OF ASSET %INT.DECEDENT'S INTEREST
1.A 1/1963 $5,000 Series H United
States savings Bond $5,000.00 50%$2,500.00
A 1/1963 $1,000 Series H United
States Savings Bond 1,000.00 50%500.00
A 2/1952 $100 Series E Uni ted
States Savings Bond 129.04 50%64.52
A 3/1952 ?100 Series E United
States sa vings Bond 129.04 50%64.52
A 4/1952 $100 Series E United
States savings Bond 129.04 50%64.52
A 5/1952 $100 Series E United
States Savings Bond 128.52 50%64.26
A 6/1952 $100 Series E United
States savings Bond 128.80 50%64.40
A 7/1952 $100 Se ri eS E Uni ted
States Savings Bond 128.80 50%64.40
A 8/1952 $100 Series E United
States Savings Bond 128.80 50%64.40
A 9/1952 $100 Series E United
States Savings Bond 128.80 50%64.40
TOTAL (Also enter on line 6,Recapitulation)$3,515.42
(If more space is needed insert additional sheets of same size)
1593EX (02-84)
....../"..J~icALTH O~"PENNSYLVA~I~.
.RTMENT OF REvENUE
BUREAU OF ACCOUNTS SETTLEMENT
P.O.BOX 8903
HARRISBUR:;.PA 17105
INHERITANCE TAX
RECORD ADJUSTMENT
ASSESS"'lENT
CONHOl NO.101
DATE 11-1-84
j
ESTATE OF BALLENTYNE SARAH
DATE OF DEATH 12-29-68
J FILE NO.63 69-0167
COUNTY WASHINGTON
NOTE:TO INSURE PROPER CREDIT TO
PAYMENT TO THE REGISTER OF
WIllS,AGENT."
YOUR ACCOUNT SUBMIT THE UPPER PORTION OF THIS FORM WITH YOUR TAX
WIllS OF THE ABOVE COUNTY.MAKE CHECKS PAYABLE TO "REGISTER OF
VICTOR H RIVa ESg
512 FALLOWFIELD AVE
PO BOX 18
CHARLEROI PA 15022
PLEASE RETuRN THIS
PORTION TO REGISTER OF
WILLS IF PAYMENT DUE
CUT ALONG THIS LINE
**INHERITANCE TAX RECORD ADJUSTMENT**
ESTATE OF BALLENTYNE J FILE NO.63 69-0167 ACN 101 DATE 11-21-84
ADJUSTMENT BASED ON:SYSTEM CORRECTION
VALUE OF ESTATE:
1.Real Estate (Schedule A)
2.Stocks and Bonds (Schedule B)
3.Closely Held Slack/Partnership Interest (Schedule C)
4.Mortgages and Notes (Schedule D)
5.Cash &Miscellaneous Personal Property (Schedule E)
6.Jointly Owned Property (Schedule F)
7.Transfers (Schedule G)
8.Total Gross Assets
(1).0.:....0"--
(2).0.:....0'---
(3)•.:....0.....:0_
(4)......:....0:;..:0"---
(5)__----=.3-,-'=.2.=;.0..:..7..:..•..:..7.=;.6_
(6)_----=1::....:0'-'-,...:;,9..=;.5.:....3.:.....6;:;....4.:....·_
(7).0.:....0"--
(8)14,161.40
DEDUCTIONS AND EXEMPTIONS:
9.Funeral E>c:penses/Administr.ative Costs/Miscellaneous
Expenses (Schedule H)
10.Debts/Mortgages/Liens (Schedule Il
1 1.Total Deductions
12.Net Value of Estate
13.Charitable Bequests (Sch9dule J)
14.Net Va;ue Subject to Tax
(Sl •..:...0..:...0_
(1Q)__-=2:...!.,-=:0..::::6.::,.9.:..;.2::.,:0,,---
(11)
(12)
(13)
(14)
2,069.20
12,092.20
.00
12,092.20
TAX:
15.Amount of line 14 taxable 3t 6%rate
16.Amount of line 14 taxable .3t 15%rate
17.Principal Tax Due
TAX CREDITS ~
(15)•..:...OO-=---_.X.O6=-.:....•..:;:,.0..:;:,.0_
(16)12,092.20 X.15=__---=1'-'-,..=;.8=1.:....3.;....;.8::....;3=__
(17)1,813.83
PAYMENT RECEIP,DISCOUNT (+)AMOUNT PAIDDATE#INTEREST (-)
03-07-69 033245 22.29 423.55
&,oZ.7/~03-07-69 033244 33.49 636.40
11-17-69 051171 .00 170.78 7'.,-.4 V I )07-23-E:4 073098 452.29-527.31
INTEREST IS CHARGED FROM 07-2~-84 TO 12-06-84 TOTAL TAX CREDIT 1 i6i.\3
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE .t52.3'o
REVERSE SIDE OF TaIS FORM.*INTEREST 10.09'
*IF PAID AFTER DATE I;\IDICATED SEE REVERSE FOR CALCULATION TOTAL DUE 462.39
OF ADDITIONAL INTEREST lIf Balance Due is less than $1.00 no payment is required)RETAIN THIS PORTION FOR YOUR RECORDS
Discount:
Interest:
,(
If any tax due is paid within three (3)months after the decedent's death,a discount of
five percent (5%)of the tax paid is allowed.
·the discount period is calculated in calendar months.Example:date of death 1-15-82,
discount period expires 4-15-82.
Except for tax on a future interest.inheritance tax becomes delinquent at the expiration of
nine (9)months from the date of death.
·Inheritance tax on a future interest becomes delinquent at the expiration of three months
from:
-the date of election to prepay or
-the date of death of the life tenant or annuitant
Interest is calculated on a daily basis from
-delinquent date to date of payment on any tax unpaid on delinquent date
-date of last delinquent payment to date of payment on any unpaid balance.
Interest is charged at the following rates:
Delinquent Date Annual Interest Rate Daily Interest Factor
5/27/43 to and including 12/31/81
1/1/82 to and including.12/31/82
1/1/83 to and including 12/31/83
1/1/84 to and including 12/31/84
6%
20%
16%
11%
.000164
.000548
.000438
.000301
Those estates that become delinquent on or before December 31,1981 will maintain
a constant interest rate.The rate in effect when the tax first becomes delinquent will
remain constant until the delinquent tax balance is paid in full.
Those estates that become delinquent on or after January 1,1982 will contain a variable
interest rate.Thus,taxes that remain outstanding from calendar year to calendar year will
be subject to the different rates in effect on each January 1.
Interest is calculated as follows:
INTEREST =BALANCE OF UNPAID TAX X NUMBER OF DAYS X DAILY INTEREST FACTOR.
If a tax balance remains outstanding for more than one calendar year,a separate interest
determination must be made for each year at the applicable rate.(Only one calculation
is necessary if the estate maintains the constant interest rate.)
Any Notice issued after the tax becomes delinquent will reflect an interest calculation to
fifteen (15)days beyond the date of the notice.If payment is made after the
interest computation date shown on the Notice,additional interest must b~calculated.
To Remit Payment:Detach the top portion of this Notice and submit with your payment to the Register of Wills
of the county shown on the Notice.
"..Address information is listed on page 13 of the booklet,"Instructions for Inheritance Tax
Return for a Resident Decedent"
·Make check or money order payable to:Register of Wills.Agent.
•..~...._.._.._.
·1470 EX (5-84)'
.
~MO.NWEA.LTH OF PENNSYLVA.NIA
.•RTMENT OF ,REVENUE
EAtJ OF EKAMINATION -.
P.O.BOX 8327
HARRISBURG,PA 17105
INHERITANCE TAX
EXPLANATION OF CHANGES
'"-,..'"
DECEDENTS NAME FILE NO.
ACN
63-/t/j-O}67
ITEM
SCHEDULE NO.EXPLANATION OF CHANGES
._--;-----------
.'...;:...._-
._--~~--------
._-----
._-_._-
._-----------------
PAGE Iii'.,.
ESTATE OF BALLENTYNE
DATE OF DEATH 12-29-68
SARAH J
INHERITANCE TAX
STATEMENT OF ACCOUNT
cl1-lfJ--3
IACN 101
IDATE 12-31-8
FILE NO.63 69-0167
COUNTY WASHINGTON
j
NOTE:TO INSURE PROPER CREDIT TO YOUR ACCOUNT,SUBMIT THE
TO THE REGISTER OF WILLS OF THE ABOVE COUNTY.MAKE
VICTOR H RIVA.~SQ
512 FALLOWFIELJ AVE
PO BOX 18
CHARLEROI PA 15022
UPPER PORTION OF THIS FORM WITH YOUR TAX PAYMENT
CHECKS PAYABLE TO:REGISTER OF WILLS,AGENT.
PLEASE RETURN THIS
PORTION TO REGISTER OF
WILLS IF PAYMENT DUE
Amount Remitted to Register of Wills
**INHERITANCE TAX STATEMENT OF ACCOUNT **
CUT ALONG THIS LINE ...RETAIN LOWER PORTION FOR YOUR FILES ......-:----- - - ----- ----- -- ---- - ---- ---- - - --- - --- ---- --- ---- - -- ----- ---------- --REV.1607EX (11-84)
ESTATE OF BALLENTYNE SAP.AH J FILE NO.63 69-0167 ACN 101 DATE 12-31-84
THIS STATEMENT IS PROVIDED TO A~VISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE.SHOWN
BELOW IS A SUMMARY OF THE PRINC:PAL TAX DUE,THE APPLICATION OF ALL PAYMENTS,THE CURRENT BALANCE,AND,
IF APPLICABLE,A PROuECTED INTEP.EST FIGURE.
DATE OF LAST ASSESSMENT OR RECO~D ADJUSTMENT:11-21-84
PRINCIPAL TAX DUE:_
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT Dl SCOUNT (+)AMOUNT PAIDDATENUMBERINTEREST(-)
03-07-69 033245 22.29 423.55
03-07-69 033244 33.49 636.40
11-17-69 051171 .00 170.78
07-23-84 073098 452.29-527.31
12-03-84 112755 9.87-462.39
1,813.83
TOTAL TAX CREDITS 1,814.05
BALANCE OF TAX DUE .22CR
,INTEREST .00,
TOTAL DUE .22CR
(IF BALANCE DUE IS LESS THAN $1 OR IS REFLECTED AS A "CREDIT"(CR),NO PAYMENT IS REQUIRED)
*IF PAID AFTER THIS DATE SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST
PAYMENT:Detach the top portion of this Notice and submit with your payment to the Register of Wills.
- -Address information is listed on page 13 of the booklet,"Instructions for Inheritance Tax Return for a Resident
Decedent."
--Make check or money order payable to:REGISTER OF WILLS,AGENT.
REFUND (CR):A refund of a tax credit,which was not requested on the Tax Return,may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax"(Form REV-1313).Applications are available at the Office
of the Register of Wills,any of the 24 Revenue Field Offices,or from the Department's Forms Service Unit 24
hour Forms Ordering telephone lines in Harrisburg -(717)233-3443,in Philadelphia -(215)351-2065,
or in Pittsburgh -(412)565-3601.
REPLY
TO:Questions regarding errors contained on this notice should be addressed to:PA Department of Revenue,Bureau
of Examination,P.O.Box B327,Harrisburg,PA 17105.ATTN:Post Assessment Review Unit.
DISCOUNT:If any tax due is paid within three (3)calendar months after the decedent's death,a five percent (5%)discount of
the tax paid is allowed.
INTEREST:Interest is calculated on a daily basis at the following rates:
Delinquent Date Interest Rate Daily Interest Factor
5/27I 43 to and including 12/31/81
1I 1182 to and including 12/31/82
1I 1183 to and including 12/3 1/83
1/1/84 to and including 12/31/84
1/1/85 to and including 12/3 1185
6%
20%
16%
11%
13%
.000164
.000548
.000438
.000301
.000356
L
--Taxes that became delinquent on or before December 3 1,1981 will maintain a constant interest rate until the
delinquent balance is paid in full.
- -Taxes that became delinquent on or after January 1,1982 are subject to a variable interest rate that changes
each calendar year.
--Interest is calculated as follows:
INTEREST =BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15)days
beyond the date of the assessment.If payment is made after the interest computation date shown on the Notice,
additional interest must be calculated.
----~
.:-..
FORM 67
REV.1-50
REG.WILLS
Application for irttrr.a of AllmtntHtratton on thr
J
The'narr_es,and'addresses of the decedent's surviving spouse,(if any)and other heirs including•I
heirs by adoption)are as folbws.
RELATIONSIDP R}~SIDENCE
. ..............................-_;_~:,::.
........E;gJ.t.h...J!..Qlg.D :.,~:.~:-~h.?Jf.::.~.:1:§J.§.7 £~E.EY..1.._A-!:.?::~gh~~.Y..~g,~~.!.Y...L ..R~~!,1a •,,
........R~.t.h~...f.fil)lJ.§§.,~h.?J.f..~.~J.§.t.§;~!J tl·~.~~.~.~~.y.~~P~.¥!:E!.~:EgJ.,genna .
.........Rg.p.~.:r..t.~~J~.r.~H~.~§:r.~:h.?Jf.::.§:1:.§J.§:~gE.~g.:.?2b.!.~..L..R~~n~.::..
Kenneth R.Balientvne ;.full ..broth r R.D.2 Charlem i Penna .................................._ __1 ,.
.......R.9P..§1X.t ~JJ§.D.t.y..D.~_t1~lf~.p..r..Q.t.hl;.:r.M.Q.nQD~i=!J}g,lg.p.§.IJ.n~.,.
,...................................................................___.
That dep)nent is over 21 years of age,resides at......$.JJ....M~Ke~D....Ay..~..:.."....~~..r?::~.~9.L~....~.~.~p.~·
is a citizen of the United Sta.:es and a resident of Pennsylvania,and~espectfully applies for Letters of
Administration upon the Estate of said decedent,no letters having bern previously issued thereon.
Sworn and rubscribed before me thiS......7 'II...
day Of..•.....1.,e.'.:~_....,A.D.,:9 §.L .
............_..(i2~~..~..
REGISTER
....~~~.~.
Ruth Falise
COMMONWEALTH OF PENNS\TLVANIA }SS:
WASHINGTON COUNTY,
-"------..-:r---_--~.-
...!!.~.._..;;li.~.
Ruth Riise
A.nd now _ _:19..g.~,comes Rhtth..f..?J.;b.§.~..
who being duly sworn doth deposesmd saysthat...sb.e will well and truly administer the goods and
chattels,rights and credits of S..ar.~h J..?.n§J~.?..l;l§.D.t.y..n~_,deceased,
to the best of.....he.r....skill and judgment in strict compliance with the la"Vs of this Commonwealth,mind-
ful of the laws relating to inheritance taxes.
~
Sworn ~subscribed befor~me this 7 _.
dayA :t4~"1:_,A.D.,19 6.9........u.~~U:-::;-Lh~~..
REGISTER
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.ESTATE OF
....................................Sar.ah Jane Ballen.ty.ne ~DECEASED
The undersigned h.g.!.f..':.§,;b.§.t.~E.§.?!}.sl::f.!!.!.±.::.!?!:.~!!7..£..~~!.:.~~.~.~_~.:.~:.~.!~:.:and heirs
of §.g.r.ii':b J.§!.D.~~!!!l~.D-.t.y.n.~".late of 9~~.£!.~E.9.~..<..)~.~.~~.~.~f!!!.~~~.£~~.!.y..?~~·
deceased,hereby renounces tb.e.ir...right to administer on :hgr.estate
and respectfully asks that Letters of Administration be issued to...RJ.:!.t.h...f..alJ:.gg.:>....~...h~b.f..::§J...§.!~.!'_,.....Qt:......
/rT~;{2d~....,.-.
Edith Dolan
......................~~.
....?JL..r1.C;;JSe§!D;A-Y..~..~.."Q}.~.E;h.~.Eg.f.,~~?:§h-.~.~K~9.!2 ~9.~.~!y...~~.~..~:_ .
Signed in the presence of:
...........................................................................................;.
......................................................................................................................
'''Jl~~'''''';[L;;:;:::J''''''''''''''''''................··R:ob·e;·;;ta Gr·a'es·E;·r·· ·..·..·......·..
...........::/.2 ~::..~u--==__
~;~~....~enneth R.allentyne..m_~~1:::l~--··_··-
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Estate of ..~.~.~.~...~~.~.~...~~~~~.~.~.~~..............}. .
Cha 1 i No of 19 .late of !.~.r..()...............,Deceased
.KNOW ALL MEN BY THESE PRESENTS,
That we,.Rut:h...Fal.1.se.~.a r..r.J.n..9..+.P~.+.~Ilc1...yIl.~.~.e.~...~.~.~.~~~...!..~~~.~.~.~.I ~!1q ~.~.~;r'ail tj-
...........q~.~B..~.1..t..~~'?!.~..~P.1?.~~~.~.~.~.y.,..............................................................................
all of Washington County,Pennsylvania,are held and firmly bound unto the Commonwealth of Pennsyl-
vania,for the use of those interested in the estate,in the.sum of ,q.I1.e.~~~?~.~~:r!?Dollars,to
be paid to the said Commonwealth,to which payment,well and truly to be made,we do bind ourselves,
:'_~--.jointly and severally,£or-and in .t~~-who~;,ourheirs,execut.ors,-:~4.ministratois;rsuccessors=a-trd"""assigns;-and--
each and every of them,firmly by thes~presents.Sealed with our seals and dated the 7t.:n..~day of
....f~P.:r..IJ.~.:ry A.D.,one thousand nine hundred and s.J.~.ty.J\lJp.~.
THE CONDITION OF THIS OBLIGATION IS,That if the above'bounden ..
..............................................RIJ.tp.r.~;1J.~.~.
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Administrator or any of them,sha~l well and truly administer
Sealed and delivered in the presence of:
the estate according to law,this obligation shall be void as to those who shall so administer the estate;but
otherwise,it shall remain in force.
Uri~a~~i't~t'··and(~~k~ant:r
~~..~t~~...~q.~....~.~.r...........(SEAL)
B.y.~~....k1':~~~~j
Attorney in Fa~~
........................................................................(SEAL)
~tatttttrt1t of ~urtttl
I..-- ---..-..--......:,surety in"the -sum·of~$~.::..::..~:..._.:..on the'
administration bond in the estate of -........._......_.----~--__.__..~.....;:.._........_.:..._.....·say that I reside at
.------...-,Washington County.Pennsylvania;that I am the owner of real estate,the
title to which is in my own name and duly recorded.situated in : _,
Washington County,Pennsylv~~a.wo~th above all encumbrances $ _ _ ;and that I am worth the
amount expressed in said bond,over and above my just debts and liabilities.
/.
._-_.__._~_._---~--_._----_._--~~---------------------_..._-~--_._-~-_.._---------------------:-;
.._-_._-._----._-----._-----------------_.._-._----_._---.----_:_---
Co.
'1Street
!;tattmtt1t~of ~urdt!..
P.O.
.!...-..--.--,---.-..---....surety in the.sum of $,................on the".
administration bond in the estate oE:.._ __._______:.•say that I reside at
I . .
......:_,;:._ -Washington County.Pennsylvania;that-I am the owner of real estate,the
title to .which is in my own name and duly recorded,situated in ; ;.
Washington County.Pennsylvania,worth above all encumbrances $ -:..;.and that I am worth the
amount expressed in said bond.over and above my just debts and.liabilities.•...,,~~~....'....•....•~.',.",...~t.C____..-:!.~_.'-';;~~~..:.-.~__•_'..
..................................................__-~--.
COMMONWEALTH OF PENNSYLV~IA.}SS:
WASHINGTON COUNTY,
____._._--
Street P.O.
And now ,..............................19.............comes __.
who being duly sworn,says that he is acquainted with the financial standing of the securities to the within bond;that
the said obligors have ea~h .executed the said bond and th.3t the sureties'thereto are the owners of real estate in their
own right of value more than the penal sum of said bond over and above all incumbrances and exemptions.
Sworn and subscribed before me this _
day of _A.D.19__.._.._._-_._._--_._--------------------------_._---.__.----~-------~------_.
.-
II 2306
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1\~miui!1trutinu TSnub • I
IN THE ESTATE.OF
SARA JANE BA.J:.ImTYNE
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._.....:...._._..F.u~b.:1.~l;;.'_~~._.__...._~...,...,_.....oo•••_ •.-:.~::''''''_.'0:
And now ..¥.~~~~..~,19 _~?
Bond approved and:Letters issued to
Registerh)
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~;c-5 Russell Ma:rino
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ATTY:VICTOR E.RIVA
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BADZIK PRINTING ~9 DONORA
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3.
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"'ffi~auit (@f iExrrutnr ODr "'llwinistratnr
t;tatt of Jrntulyluanta.f lUI-
Qtountg of lIas4tll!Jton (-
Personally before me,the undersigned authority,a ~g.!~~y.P..~~.~.S in and for sa'id
County and State,appeared .R),!,t.h .f..9..1.JJ?.§_who,being duly
sworn according to law,deposes and says that s he is the exeomx:xor administr·aYi~~f the estate of
..............§~.~.~h ~:.~n~~9.:bJ.~.D.t.Y.D.~deceased,that the foregoing schedules constitute a
complete inventory and appraisement of the real and personal estate of B.a.:r.ah_.Jane Balle.ntyne ,
deceased,except real estate outside the Commonwealth of Pep.nsylvania;that the f.igures opposite each item
of real ·and personal estate in the foregoing schedules are determined and stated by the undersigned to
be the fair value of said items as of the date of the decedent's death,based upon a just appraisement of each
item made by the above named E~lt'~ro1E-Administrawttrix_}~.'.J~
"day a~:;:n~.:~b,tLedb:~"1t t~~(~--~~-.--~--.
......................V~~._····.···~····;····.··-:-::.&"-···f;;{A&::!.~2H&e:roJ4Dr-AdmlUlstrat«r lX
\.;ADDITIONAL INSTRUCTIONS
An inventory must :be filed within three months after appointment of personal representative.
A supplemental inventory must be filed within thirty days of discove:-y of additional assets.
1 Original and 2 Copies and 2 RCRI-34,Under $10,000;1 Original and 2 Copies and 2 RCRI-33,Over
$10,000,including Copy of Will;1 Original and 3 Copies and-2 RCRI-33,Over $50,000,including Copy
of Will and copy of Federal Estate Tax Return.,.
REFERENCE FOR ADDITIONAL COpy
Act of 1947 P.L.513 Sec.5.2,72 P.S.4844.2
l1nuentl1rg aub Appraisement of the goods and chattels,rights and credits which were
()1~.,_S.?T9..h J.~.D.~~.~JJ.~.D.ty.n~.late of··:······ ·.·..···.Charl..er.oi _
,
Washington County,Pa.,taken and made in conformity with the above affidavit.
j
REA L
PERSONAL
EST ATE
NONE
EST ATE
DOLLARS CENTS
,Cash,being proceeds to credit of account of within decedent
""ith Pittsburgh Steel Allenpor·t Employees Federal Credit Union,
balance as of date of death------------------------------.~657 79
Credit for Income Tax refund due from US Government,as de-
termined by 1968 Income Tax Return on Form 1040,in the amount ~
1966 Chevrolet Coupe motor vehicle,having Manufacturer's No.
17 58
166476Y129749 and.Title No.Al7882194-...-----------------------1,500 00
Cash,being gross pay from Pittsburgh Steel Company for
period ending December 21,1968-----------------------_
Cash,being gross pay from Pittsburgh Steel Company for period
ending January 4,1969,and.including 13 weeks'vacation gay--
261
770
46
93
TOTAL PERSONAL ESTATE----------------------3,207 76
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IN THE ESTATE OF
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VICTOR E.RIVA,ESQ.
P.O.BOX 115
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IN THE COURT OF COMMON PLEAS OF
WASHINGTON COUNTY,PENNSYLVANIA
OKPHANS'COURT DIVISION
NO.63-69-167
IN RE:ESTATE OF
SARAH JANE BALLENTYNE
~ceased.
ASSTr.NMBNT AND RELE~SE
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t(.f}£:{It =~0 (,~r:-=;
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VICTOR E.RIVA,ESO:
P.O.BOX 1l!:5
CHARLEROI.•.PA.15022
P.O.Na1y Co••425 Fourth Avenue,Pittsburgh.Pa.15219
,_..1 I
...
IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY,PENNSYLVANIA
ORPHANS'COURT DIVISION
RE:ESTATE OF SARA JANE
BALLENTYNE,d.eceased.
ASS I G N MEN T--------,--
)
)
)
AND
NO.63-69-167
RELEASE
MADE THIS 01f.day of _~_"---,_,1969,between
EDITH DOLAN of Curry,Allegheny County,Pennsylvania,ROBERTA
GRAESER of Coraopolis,County of ,Pennsylvania,---------
KENNETH R.BALLENTYNE of R.D.2,Charleroi,\'7ashington County,
Pennsylvania and ROBERT BALLENTYNE of Monongahela,Washington County,
Pennsylvania,hereinafter referred to as the First Parties;
A
N
D
RUTH FALISE of the Borough of Charleroi,Washington County,
Pennsylvania,hereinafter referred to as the Second Party.
WHEREAS the Parties hereto are heirs at law of Sarah Jane
Ballentyne,late of the Borough of Charleroi t ~~shington County,
Pennsylvania,who died intestate on December 29th,1968;
AND WHEREAS the said Second Party was duly appointed
Administratrix of the Estate of the said Sarah Jane Ballentyne by the
Register of Wills of Washington County,Pennsylvania on February 7th,
1969',and as a prerequisite to her said appointment,she duly posted
a fiduciary bond in the amount of $1,000.00,on which the~nited State
Fid'21ity&Guaranty Company was Surety,which bond is on file at the
above Number in said Office of the Register of Wills;and in such
capacity as'Administratrix,the said Second Party did duly file the
County and State Inventory,~Returns required by law,as well as a
Statement of Debts and Deductions,and has made payments on account of
Inheritance Taxes anticipated to be due and owing;
AND lllHEREAS it is the desire of the Parties hereto that
,'.
•
this administration by the Second Party be terminatedtin view of her
having seen to the payment or made provision for the payment of all
debts of the decedent and costs of administration t as well as funeral
expenses and Inheritance Taxes.
NOWt THEREFORE t THIS AGREEMENT:
In consideration of the sum of ONE AND NO/IOO ($1.00)DOLLAR
and other good and valuable consideration paid by the Second Party
unto each of the First Parties hereto t receipt for which is hereby
acknowledmed upon the execution of this Instrument t the said First
Parties de hereby assign and transfer unto the said Second Party all
their rig~tt title and interest as heirs at law of the said Sarah Jane
Ballentyne in her said Estate t and furthermore t that the said First
Parties hereto do release and exonerate the said Second Party from any
clai~they have whatsoever by reason of their being heirs at law t and
furthermore t that they do hereby waive their right to an official
accounting by the said Second Party of her administration of this
Estate t and furthermore t the said First Parties extend this release
and "exoneration as aforesaid unto the United States Fidelity &Guaranty
Company as the Surety on the fiduciary bond heretofore mentioned t and
in which bond the said Second Party is.the principal.
IN WITNESS WHEREOF t the said First Parties have hereunto
set their hands and seals the day and year first herein appearing.
In the presence of:
(SEAL)
/?--H:n:'AL)
-'---+--'----;:--;----:--:--::-;----,---r---(SEAL)
v---'-"""/G:...........·"U=:::=-=:=--=-~IQ~~-:;;;..:4aJ~_(SEAL)
mith Dolan
,/C1~/:J~
oberta Graeser
I
...2 -
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF /)}~~
)
)SS:
)
•
On this,the wit!day of @a~,1969,before
me,a notary public,the undersigned officer,personally appeared
E~ITH DOLAN,known to me or satisfactorily proven to be the person
whose name is subscribed to the within instrument,and acknowledged
that she executed the same for the purposes therein contained.
IN WITNESS WHEREOF,I
My Commission Expires:
Notary PubliC;,0/i -~.
"..•IVICTORE.RIVA,NOTARY PUBltC·"
CHARLEROI,WASHINGTON CO.,PA.
MY COMMJSSION EXPIRES JUNE 23.19 V
seal
)
)SS:
)
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF tJ)~.J
On this,the lid day of 0~),1969,before
me,alnotary public,the undersigned officer,personally appeared
ROBERTA GRAESER,known to me or satisfactorily proven to be the
person whose name is subscribed to the within instrument,and
acknowledged that she executed the same for the purposes therein
contai~ed.
My Commission Expires:
IN WITNESS WHEREOF,I hereun~srt my hand anq{official
~~----b2-cr'~. (
'-~c~/~~;".
Notary Pub ic
VICTOR E.RIVA,NOTAftV ~YftHe
CHARLEROI,WASHIN~fgN ~o;;PA:,1PMYCOMMISSIONEXPIlI~JYNE f3;II _
seal
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COMMO~~EALTH OF PENNSYLVANIA )
8/J./l,rr -:r-.)COUNTY OF Vt/~~)
SS:
On this,the /;<f:t day of c:?;z1J\~),1969,before
me,a notary public,the undersigned officer,personally appeared
KENNETH R.BALLENTYNE,known to me or satisfactorily proven to be
the person whose name is subscribed to the within instrument,and
acknowledge~that he executed the same for the purposes therein
contained.
IN WITNESS WHEREOF,
My Commission Expires:
o set my hand and official seal.
'f
VICTOR F.RIVA,NOTARY PUl3lrc /'
CHARLEROI,WASHINGTON CO.,PA,
MY COMMISSION EXPIRES JUNE 23.197.3
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF UJ J~70
)
)
)
SS:
On this,the jold day of ~~),1969,before
me,a notary public,the undersigned officer,personally appeared
ROBERT BALLENTYNE,known to me or satisfactorily proven to be the
person whose name is subscribed to the within instrument,and
acknowledged that he executed the same for the purposes therein
contained.
IN WITNESS WHEREmF,I hereunt hand
,,~:'/-"~,"
,~,
~-
seal.
My Commission Expires:
VICTOR E.RIVA,NOTARY PUBLIC
CH~RLEROI,WASHINGTON CO.,PA.
MY COMMISSION EXPIRES JUNE 23,19 7J
"
.6.,
Form RCC-33
RESIDENT DECEDENT
....77:./!'3-J
.~.3-(PJ-·/C7·
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
COUNTY OF
-,
IMPORTANT:This return must be completed in detail and filed in duplicate,with w~ll 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 Rev-enue.(Section 703 of
the Ini)erit!illce.an~.E.st;ate Tax Act of 1991.)
IN THE MATTER OF THE'ESTATE OF }AFFiDAVIT OF
...........);;.g.:rg.h J~.n§!J3..C!+..~..~n.t.Y.D.~...............................~~.
(State fun name of decedent)
Charleroi Washin ton ADMINISTRATCfB<.rixLateof,K.............................County
::,:.~~:::::::;:~:~~--~-----~--=~-~~},,'
.............R1J.t.h ~gJJ.$.§!~jX.
Administratll.1r'ix of the estate of the above-named decedent being duly sworn,deposeS and sayS
Name and address of att~rney or}
other authorized represent~tive to
whom all correspondence sr-ould be
mailed.
Victor.E Riva.,.52.4...F.all.o.w.fi.el.d Avenue •..Char.1er.oi ..
PenI1sylY?lnj,a...._ .
h hAdministratrix d t'f '1''th th if'f 'd t t d thTatassuc....."...............................................eponen IS amI lar WI e a aIrs 0 sal esa e an e property con-
(~;,.,cuf.or·Aclmini.lralor)
~tituting the assets thereof and their fair market value.
That at the time 011'death there was no safe deposit box registered in decedent's in,jjvidual name,or jointly
with,or as agent or deputy of another,or in decedent's individual name,with right of access by another as agent
or deputy,with the exception of the following:-
NAME AND ADDRESS OF BANK OR OTHER INSTITUTION
IN WHICH DECEDENT RENTED A SAFE DEPOSIT BOX
None
THIS SAFE DEPOSIT BOX RENTED
IN NAME OR NAMES OF
RELATIONSHIP OF JO~T
HOLDERS TO DECEDE)\;'":'
That the contents of said safe deposit box or boxes are itemized under S~hedules of.this
return,with the exception of the following,for the reasons hereinafter set forth:
That Sc.f>ec!ule A attached h,ereto and made 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
also sets forth the Dortgage encumbrances upon each parcel of real property at the date of death,giving
the amount still due at death,name of mortgagee,date,rate of interest,and b~ok and page of record
thereof.It also sets forth in the columns provided therefore the assessed valuation of each of said
parcels,the estimated market value thereof as of date of death of decedent.
That Schedule B attached hereto and made part hereof sets forth fully and in detail all personal
property wheresover situated owned by the decedent at the time of death;all moneys left by the decedent
at the time of deatt"whether in decedent's immediate possession,standing to decedent's credfi''in banks
,\".'"'~~of deposit,savings banks,trust companies,or other institutions,whether indivijuallyf~o~in trust for.."('0...',any other person or persons giving also separately the accrued interest thereon,if a~y~,~o~~to the las~
.~-interest day prior to decedent's death in ·the case of savings banks,and to the d.!l.te~ofdecedent'''s death),X ......),}'...~'~,'.;:"-in all other cases;all bonds,postal savings,treasury certificates or notes and o~her evidence of in-,.n 1 -....-.:'"--_~debtedness of the'U~ited States'to the decedent;all obligations,whether by statute or agreement they,\:'>.~are des~gnated as tax free,of th~United States,or any state,or political sUbjivi~ion thereof.,or of
,...-,~.'-'•I r ,...,-.any foreigri country,.which are oWned at the time of death;all wearing apparel,jewelry,_~i}verware,pic-
tures,books,works of art,household furniture,horses,carriages,automobiles,boats~'~..{lnd'ahy and all
4h':1otherpersonalchatlelsofwhatsoeverkindornature,left bydecedent,together with the fairl'y estimated
market value thereor;all bonds and mortgae:es held by decedent and of all claims due and owing deceder:t
at the time of deat~,and all promissory notes or other instruments in writing for the payment of money
of which decedent died possessed,of whatsoever nature,wi th 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 polictes carried by decedent;all annuity and endowment contracts the
proceeds of which were payable upon the death of the decedent;and all the corporate stocles and dividentls
due thereon and unpaid as of the date of death,bonds and accrued intere~t thereon to the date of dece-
dent's death and other investment securities owned by the decedent at the time of death,with the marke·t
value thereof at such time.
..............~~.~_.
(~x~dministTator;ix
.............?~.~~~.~~.?..D AY.~.IHJ~-.
,..
,._.,L ..
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 stat.ements 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 al~o.,.~:r~..f~~,th in itemized form,together ,with ,.,the.fa..1:r,ma~ke_~value
thereof,any other property owned or bequeathed 'by the decedent at the.time of death..
\-"~."..~.r::The Schedule C attached hereto and made part hereof sets forth a true arr~~er to~each inquiry
contained therein .and in the case of transfers ofproperty,real or personal,withi,!l tW.{l ye~rs o,f decedent's
death,in contemplation of decedent's death,or intended to take effect in poss;ssi~n or'enjoyment at or
after death,said schedule sets forth the nature and value of such property,to whom .t~~sferred,the
relationship of the transferees to the decedent,the proportionate share received by each-t~ansfe~ee and
.')';';a:11 other facts of a pertinent nature regarding said transfers.In the .case 'Q'f t~ansfers intended to
take effect in possession or"enjoyment at or after death,there is also attached to the ~l::he9ple a cOllY
;?L~.!;.~;xM~~~,(~~~.~t~~~f~~~e:~;~;c~.r:-::.?~~~~x~~t~r?~~~~t creating the etrust.Ther'~i!,,\~lso set forth in said
schedule a list of all property,real and personal,with its value,which passesJat decedent's death by
virtue of the exercise by decedent,either individually,or jointly with another,or any power of appoint-
ment vestedrin decelien1;,f eitJ1er iJ.!idividuaUy:~or .tl>i.ntl-y,by t~e dll,;<!:eed,or other instrument of another,
with a copy of the instrument creating such power attac~ed to ~h~sc~edule.
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 decederrt'sdeath~~thenaiture of their res-
pective interests,their relationship,if any,to the decedent,together with the ages at the time of
decedent's death of all minors,annuitants and beneficiaries for life under decedent's Will.It also
contains a statement showing which of the beneficiaries named in the decedent's will,if any,died prior
to decedent,the dates of their death,their issue,andthe relationship of such issue to the beneficiary.
That Schedule E attached hereto .and made a part hereof sets forth all property,real and per-
sonal,owned by the decedent jointly with another or others,including intangible,standing in the name
of the decedent and others,plus the date and place of record of instruments effecting the vestiture of
real estate and the date of acquisition of personalty,plus the name,address and relationship,if any,
of co-owners to the decedent.
That Schedule F attached hereto and made a part hereof sets forth fully and.in detail all debts
and deductions claimed for and on behalf of this decedent's estate,including funeral expenses paid;
family exemption,where applicable;costs of administration of this estate;counsel fees and fudiciary's
commissions paid or to be paid;cost expended for burial trusts,tombstones or gravemarkers,and reli-
gious services,in consequence of the death of the decedent;debts and claims owing and lmpaid at time of
'\..death;taxes accrued chargeable for period prior to decedent's death (except.those.allowed under Section
651 of the Inheritance and Estate Tax Act);together with a statement of collateral pledged for obliga-
tions,if any.It is agreed that the fiduciary will present proof of said claimed obligations upon re-
quest,that if the amount actually paid in settlement of any fee,commission or debt is less than the
estimated amount claiming and allowed,that the same will be reported to the Register of Wills,and that
the amount of tax assessed can be reassessed in accordance therewith.
That the totals of the appropriate columns in Schedules "A","B", "C","E",and "F"as directed therein,·
have been carried forward and properly registered in the Summary.
Subscribti!d.ftJld sworn to before me thiB·~r:.:.L....
__'~/'~'~';day Of':??}:!')'~4/l,J.;Cj--#.e:~..........._-
'.'VICTOR F..RIVA,NOTARY PUBLIC (StTe.et Number).
CHMlEROI,WASHINGTON CO.,PA ~.~.~E~.~E.?~..~?.~P!!:~y.~.Y..~.~.=!:.i::l ..
MY COMMISSION EXPIRES :JUNE 23,1969 (City or Town and State)
NOTE:Before signing affidavit make sure all blank spaces in the affidavit and schedules annexed are
filled in with details or the word "None",and in case the assets include rare and unlisted securities,
securities of close or family corporations or an interest in any co-partnership or business,that the
data and statements required under the paragraph above relating to Schedule "B"are attached.Also make
certain that column #1 in the "Summary"has been properly completed as above-directed.
~-.~
'RCC-34'(t-,64)
'COMMONWEALTH OF PENNSYLVANIA
DEPAR.TMENT.QF REVENUE
BUREAU OF COUNTYCOLLECTfONS
TRANSFER INHERITANCE TAX
RESIDENT DECEPENT'
SCHEDULE "A"
-REAL 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 tenant or tenancy by entireties,repo'rt on Schedule liE".Property held by'
the ,de,cedent as tenant in common with another or others,should ,be identified as to quantum of interest and
the estimated value should be that of the decedent's interest only.,
The real property located In the c.Jmmo!lwealth of Pennsylvania should be (1)(2)(3)/
described by lot and block number,street and street number,together with DEPARTMENT
a general description of the propeuty,with a reference to the record of the ASSESSED VALUE VALUATION
conveyance by which the decedent took title;If a farm'state number of a·FOR YEAR OF ESTIMATED CAUTIONcres;also statement of mortgage encumbrances upon each parcel at death DECEDENT'S MARKET VALUE (Do not write
of decedent.Taxes,assessments,accrued Interesl on mortgages,etc.,are DEATH In.th Is 5 pace)
to be listed on Schedule "F"and must nol be deducted,from this schedule.
1,,
NONE NONE NONE
,
:
,
I,
,
I
.
···,
t,.·,
·,
,
~
I
;,
,,
I·
';
..
,,
.
·
I ,
·
Insert this,:total opposite "real property",Schedule "A"in the X X X X X
"As Reported"column on the last page of this return,
NONE
RCG ..35
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "B"
PERSONAL PROPERTY
INSTRUCTIONS:This Schedule must disclose all tangible and intangible personal property owned individually
by the decedent,at the time of his fr~ath.Property owned by the decedent jointly with another or others
must be listed under Schedule "E".I~ta~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,jespite the fact that they are not of tje administered estate.
Tangible personal property should be.listed first (e.g.jewelry,wearing apparel,household
goods,and furnishings,books,paintiJgs,automobiles,boats,etc.)
Intangible personal proper~y,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 ~aid capacity,partnership interests,interest in anyundis tributed
estate of or income from any property held in trust under the will or agreement of another,even though
located outside of the State,at the time of death,should be lis~ed in this schedule.
,-,
Item
No.
1
2
3
5
ITEM
List and describe fully
Cash,being proceeds to credit of account of
within decedent with Pittsburgh Steel Allenporr
Employees Federal Credit Union,balance as of·
date of'death--------------------------------_
Credit for Income Tax refund due from US
Government,as determined by 1968 Income Tax
Return on Form 1040,in the amount of---------
1966 Chevrolet:.?Coupe mo-:or vehicle,having
Manufacturer's No.166476Yl29749 and Title No.
AI7 88219 4-------.:.-------.-------------------_...._
Cash,being gross pay from Pittsburgh Steel
Company for period ending December 21,1968~--
Cash,being gross pay from Pittsburgh Steel
Company for period ending January 4,1969,
and including 13 weeks'vacation pay----------
UNIT
VALUE
ESTIMATED
~lARKET VALlIE
$657.79
17.58
1,500.00
261.46
770.93
DEPARTMENT VALUAJrION
(Do not write in
this space)
'I~~
~
rr;Yoi¢
~
~
/
Insert this total opposite "Persona]Property",Schedule "B"in
the "As Reported"column on the lasT.page of this return.
x X $3,207.76
RCC-'3&
COmfON 1\'EALTH OF PENNSYLVANIA
Tfu\NSFER INHERITANCE TAX
~SSIDENT DECEDENT
SCHEDULE "c"
TRANSFERS
(1)Did decedent,wi thin two years of d~ath,make any transfer of any material part of his estate,without
receiving a valuable and adequate ~onsideration therefor?(Answer yes or no)no
(2)Did decedent,withi~two years of death,transfer property from himself to himself and another or
others (including a 3pouse)in joint ownership?(Answer yes or no)no
(3)If the answer to (1)or (2)above is in the affirmative state:
(a)Age of decedent at time of transfer Not applicable
(b)State of decedent's heail th at time of making the transfer.(Note 1).
(c)Cause of decedent's delllth.(Note 1).
(4)Did decedent,in his lifetime,ma~any transfer of property without receiving a valuable or adequate
consideration therefor which was tQ take effect in possession or enjoyment at or after his death?
(Answer yes or no)__~n~O~___
(a)Was there any possibility that the property transferred might return to transferer or his
estate o~be subject to his power of disposition?(Answer yes or no)_
(b)What was the transfereE's age at time of decedent's death?___
(5)Did decedent in his lifetime make any transfer without receiving a valuable and adequate consideration
therefor under which transferor e)~ressly or impliedly reserves for his life or any period which does
not in fact end before his death:
(a)The possession or enjorrnent of or the right to income from th~property transferred?
(Answer 7es or no)__~n~~~_
(b)The righ'~to designate the persons who shall possess or enjoy the property transferred or
income t.erefrom?(An3wer yes or no)DO
(6):If the answer to (5)(b)above is in the affirmative,state whether'the right was reserved in decedent
alone or others Not applicable
(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 )f care of transferor?(Answer yes or no)__~n~o~___
(8)Did decedent,at any time,trans~r 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)__~n~O~_
(9)If the answer to (00 above is in the affirmative,was the power to alter,amend,or revoke the inter-
est.of the beneficiary reserved in the decedent alone or the decedent and others?
(Answer yes or no)Not apD]i cable .
NOTE 1:The answers t)these quesUons should be supported by affidavit by the attending physician as
well as a copy of the c.eath certificate.
NOTE 2:If answer to ~ny of the above questions is yes,set 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 deced~nt,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 VALUE
(Estimated)
NONE
DEPT.VALUATION
(Dept.Only)
Insert this total opposite "Transfers",Schedule "C"in the
"As Reported"colurrm ,on the last pege of this return.
l
NONE
'.ncc-~;a
,.'
C(\M\ltmWFALTH 0F l'ENNSYLV;\N"IA
T'\L\:\S;::'Flt fKHFH.ITANCE TAX
I1FSrnENT DECEDENT
SCHEDULE "E"
JOINTLY OWNED PROPERTY
,'
nSTRtTTIO"S:This schecl.1le must disclose all property,real and personal,owned by the decedent ,jointly
wi th another or others,including intangibles,standing in the name of the decedent and others.List
real estate first,as entireties,or joint tenants,giving brief description,as indicated tmder Schedule
"A",plus the date and place of record of instrument effecting vestiture,but do not include entireties
or out of state real estate value in estate valuation column.Personal property should be listed as in
Schedule "B",plus date of acquisition,and the name,address ann relationship (if any)of co-awners to
the decedent.
Description of Property,Date of Acquisition,Name!unit'percentage Estate
Address and Relationship,of Co-Owners,and Place ;Value Share Valuation
of Record of Instrument,where Real Estate.!
x
X
DEPART~mNT VALUATION
CAUTION-Do not Write
In This Space.
Value of Value of
Entire Decedent's
Property Interest
Joint Bank Account No.64--,4-728 held in ,
the Mellon National Bank and Trust Com...,i ~f.:7 -7,-C?
pany,Charleroi Office,Charleroi,Penna.,
in the joint names of Ruth Falise or I'~e.~,#o3J d t/,F
Sarah Jane Ballentyne,which Account was
opened December 2,1955,and balance as '
of date of death was in the amount of ~
$5,94-4-.59,J;2 of which is being herein ITJ IiII JJ
reported for Inheritance Tax purposes----$2,972.3(,rL/
Savings Account No.7320 held in the Firs~
National Bank,Charleroi,of Charleroi,
Penna.,in the joint names of Sarah Jane ~~
BallentMH~~BPRif~l~;~urity No.193-01-~~-7 C;Y
9035),/wnlch Account was opened November
23,1955,and balance as of date of death ,
was in the amount of'$8,931.83,1/2 of ~~.../~/,?o.33...{'jlV ~(l
which is being herein reported for In...lrt ~i~
heritance Tax purposes-~-----------------4-,4-65.9 IV
Insert this to tEol opposite "Jointly Owned Property",Schedule ·"E"JI
in the "As Reported"collUTD1 on the last page of this return.$7 ,4-38.22L...~""""'"""_
.-._.
~.RCC-37 (12-63)
C'OI\1f\tONWEAi..fH OF PENNSYYLAt\IA-
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "D"
BENEFICIARIES
BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED(If step-children or DATE INTEREST OFStatefullnamesandaddressesofallwhoillegitimatechildrenDECEDENTOFBENEFICIARY
ave an interest,vested,contingent or other are involved,set STATE YES IN ESTATE
wise,in estate)forth this fact.)OR NO BIRTH
Edith Dolan half-sister yes ...---l/Sth
Currv Alleo-henv Countv
Penna.'.'...;
-
~
Ruth Falise 'r IT IT II-~---
811 McKean Avenue -
Charleroi,Penna..
I
Robert Graeser IT TT ....---....IT
COI'6rQgdis Penn;:!.
Ke,nneth R.Ballentyne full-brother TI -----TT ,
R.D.2.Charleroi Renn;:!
,
half-brotheT'Robert Ballentvne IT ...---..IT
MononQ:ahela.Penna.
I
,,
..,
.,
"
!',"
,I L')
'J
~)
.J
(
h
Deponent further says that all the above-named beneficiaries are liVing at this time except below:
NAME DATE OF DEATH RESIDENCE
N Ie
OF THE
ESTATE OF
~IATTER OF THE APPRAISEMENT
(Executor-Administrator
must complete "As
Reported"column #1.)
'.',.
.;,..c._
>-1 '"d ::c....Cb CbSl:>....e:..::l til
til 0-..::l '"dCbe:..........0til't:l'"d Cb........0 ~'t:lCb....r+'<
>-1~~;"
- . I('t):./;/
o....otiltil
t%1til...Sl:>...Cb
-
Year .
N THE
t No .Will
Administration
5.Ci.r.C3.ll .J.a.:n.~:S.a.~.~~I1t:YI1~.
Deceased
I
I
I
1
Late of Charleroi...........................-.
>:J
County of .tvCi.Eill.:i..TlKt:()11.......
Commonwealth of Pennsylvania
REPORT AND APPRAISAL
,-
"II ----..W en en
(')(')
.J ?'"::r ?'"
)ci ~~I
enc:~
~>!:l::l>-<:
(-
.1
"
·Vd ··oa NO.LfH~IHSV}A
Sll~t-\.:iO ~31Sm3U
ON~H~:;~T13SSn~
,.it
vl~tORl ~J~IV~,~69~
P.o.B'OX 115 Y
CHAnL-c"v".·\1 3°2f I ..:1
~-(,j9 -GO ~~-(,j9
~~..~.>'~:='.:til
'~'!:l::l--...:~Cb_,'N ;C),:'g-.,,~,.......~:.et''\i '::::...-:II :~,.
.J
.J I -(,j9 -(,j9 -GO -(,j9 -€P.--(,j9..,J
,1 -,1 (.'~i)1,1 )>':;l J ,J \:~-,\~,:r.
I )~'-,~tl/,JeJ
".~--V)1 ..J '.'-\'.1 .~!,'(";I.:J
"'1--II.:~3..1 \J '.".'~'::l
(";~:\J c..
{'\~
"
I,
"
Form Re,C·10 DEDUCTIONS ALLOWED IN J
Register 01 Wills.Age.t
THE SUM OF "..........$~o..~.fcl..0
·'''It·~;;::::/~/
STATEMENT OF DEBTS
AND DEDUCTIONS
COJNTY
OFFICE OF TME
REGISTER OF WILLS
OF Washington
AND AGENT OF THE COMMONW......LTH
~.
ESTATE OF Sarah Jane Ballentyne LATE OF _--=C;.:;h:..::a~r:..:::l::.:e;:.;r:::..o=i _
DATE OF FILING APPRAISEMENT _-'A:......::.u_/_.;?~o~-&::::...!-?OATi OF DEATH _-..:::D.=e~c~e~m~b::.::e~r:.-;2::.9~,-=1"",9~6~8~_
AMOUNT
13 00
14 00 I
10 75
10 00
1,197 00
37 10
10:00
15 'ad
146 Ot]
10 00
~0lL
35 00
5 00
I 16C -'Y5
.-40(00
e~al advertisin~
~ulance service.
~6tjm3twl lJiian~administra v
tion costs.
REM....RKS
reparatlon ot lnceom 'Tax
Return
Headstone
~ounsel fees,
~etters of Administration,Re~
~unciation,&3 short certif~~
~ccount of d.ecedent
AdministratrixTs bond nremium
~egal advertising,
thurch funeral service,
rhurch funeral service
romolete funeral
Victor E.Riva,Esq.
Rev •.Frank Bodnar
Rev.Charles K.Snowden
Charleroi Borou~h
NAM£OF P....YEE
Russell Marino,
Register of Wills
The Valley IndependentMonessen,Pennsylvania
Harold R.TonerFuneralHome
Russell Marino,Register of
Will~and Clerk of O.C.
Mic~ael A.Melinchak"PllT!~l"~1 Hnme
P.A.Caruso,Accountant
r},::...."lt:>Y'.....;'p Isvlvania
F.J.Buckley Agency _
r .,11l"'0 Pt:>nT!C"Ivania
Washington County Reports
w~~hinoton Pennsylvania
..
Rlli-'h "P~l;ct:>Ar'lmini
NO.OF
VOUCH"'''D....TE
S OT a:IrlQaVl·ts I'.
___+-__t-__pN~o~t:.::a~r..z.....v-=p~u:::b:::l:.:l=-·c=---_lto estate papers,----t-'-----+--
I
LX ndmini~imtY'ixTS ~ommic::sion·
i
----t---t----t------------------'tl---~--------·----·--,----+----t---i
-..I
----t---t----t-----------------41----------••--:---------'i-----+---i
---t---;-----j-------:-----------+----------------+----+--I
COMMONWEALTH OF PENNSYLVANIA }
COUNTY OF W'Shin~<..,
I,Ruth Falise ~_i HEREBY CERTIFY.THAT.TO THE BEaT OF
MY KNOWLf:D·:iE AND BELIEF,TH!:FOREGOING IS A JUST AND TRU E ST....TEMENT OF DEBTS,FUNERAL EXPENSES AND OPENSD OF
ADMINISTRATION SUBMITTED TO THE ESTATE OF Sarah ,Jane Ballentyne OECUSED.AS DEDUCTIONS;FOR
•INHE'RITJ.NCE,-{·....X PURPOSES.~
•>~~.~/'"5.!J J/~cft~,I (L.5.1
.8 S~RJBED!l 7RE ME THI5"~,/CAY Of"Ruth Falise ......
1e
oJ
.''VICTOR E.RIV.lI.,NOIA~Y PUBUO
CHfl.~LJ:ROI.VI'\<;Y!'\H~TI)'!W.,PA.
MY COMMISSli,Ji'j EXPlf(tS JUNE 23,1969U.
.....
R CC-8\(2-64)
COAlMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BtlREAU OF COUNTY COLLECTIONS
INHERITANCE TAX DIVISION
NOTICE OF FILING OF APPRAISEMENT
RUTH FALISE
(~Administrator)'
IN YOUR REPLY PLEA8E
RE"ER TO 37-193-3
(
V
In Re:Estate of =S;:;:AR:::,A::.:;H:.:...;:J::.:;A::.NE=-·.=BAL=LEN=.:..:TY:..=NE:=....__
_____-:W:.::,AS=.:,:H.=:IN:.:,:G::..,:T:.;:O:.::N County -File No.63-69-167
Dear Mr,.Falise:
You are hereby notified that the original
appraisement in the estate of Sarah Jane Ballentyne
has been filed in the office of the Register of Wills qf Washington
Count:,'on April 1.,19M.Said appraisement reflects'the
following valuations:
Re al Est ate _--'---::---::-=~-;-----
Pers ona1 Frope rty __~3:..111.=2:.:::07:...J...:.'...L7..::6~_
Transfers --------::---==-=--r----Total .....,..-~3o!.:.L.:2::.:0:.J.7~•.L76~_
As to such ~ax that is paid within three
death,a five (5%)perce~t discount is allowable.
remains unpaid after one year from date of death,
of six (6%1 percent per :mnum is charged.
months.from date of
As to any tax that
interest at the rate
An~party in interest who is aggrieved by an appraisemen~may
appeal therefrom as provided by law.
Dat e ~!!l~p~r.:!::il:.-.:!1!=.J1L....:1J...969:::..L·_Signe~A!La~C2~
Title W.R.CHAN;:G ~PRAISER
DATE OF DEA'IH:December 29,1968
Note:This is not a bill.
RCC·39 16-57)
C.'oMMONWEAL.TH OF PENNSYL.VANIA .."-,.._.
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
BALLENTYNE·,SARAH JANE
FILE #63-69-167
December 29,1968
SUMMARY
I~the undersigned
#63 Washington
the real and personal
opposite each item in
FILa #63-69-167
Dated:04-Dl-69
12-29-68
ftEPonT OF INHERITANCE TAX APPRAISEH
flul;!appointe.c,Inheritance Tax Appraiser in and for the County of
,Pennsylvania,do respectfully report that I have appraised
property as reported in the foregoing return a~the values set forth
the last column to the right in Schedules "A"~"B","C"and "E".
PPRAISER
REPORT OF THE REGISTER OF WILLS
I,the undersignecl o.ul,y elected llegister of Wills in and for ...
County,Pennsylvania,do "'sp(;(:tfully report that I have allowed deductions in the amounts
claimed by deponent,except as to those items where a greater OT lesser amount is set forth
in the last column to the right in Schedule "F",which greater or lesser amount represents
the sum allowed as a deduc tion..
Dated:
REGISTER OF WILLS
VALUE AS REPORTED VALUE AS APPRAISED VALUE AS REAPPRAISED
$0-$$_
3,207.76 3,207.76
INVENTORY
Heal Property (Schedule A)
Personal Property (Schedule B)
Transfers (Schedule C)
cT oint-Held Property (Schedule E)
TOTAL GROSS ASSETS
LE~~Debts and Deductions
(SCHEDULE F)
CLEA!{VALUE OF ESTATE
3,207.76
--0_-.
3,2r:Jl.'76
=====0-======:=
Valuation of life estates or
annuities . . • . • •...,*_
ESTATE T~~ASSESS~ffiNTS ~_
CO~WUTATION OF TAX
~---------
$-------
(:::)As evidenced by Charitable Exemptic·n
Certificates issued by the Secretary
of Revem.:.e.
$=====:=
$-----<!>'r======~=$-----~
$
d>.:'----.:..-~
*------$------
TOTAL TAX
Less tax previously paid
BALANCE
Less 5%of tax if paid within
3.months after death
3~'\LANCE OF INHERITANCE TAX DUE
Add interest at rate of 6%from
to
AMOUNT OF ESTATE TAX ASSESSED
Estate tax paid
VOR USE OF REGISTER ONLY
T?-x on $________!')%
Tax on $0 __10%
T.3.X on !l:2'1 $__--'-_
Tax on $:~$
Exemptions :=(:::)
Total Estate -
BALANCE DUE *_
Add interest at rate of 6%from
to *_
TOTAL TAX BALANCE $_
PAID $
FOR USE OF REGISTER QNLY ADJUSTMENTS
NOTE:Where subsequent adjustments are made to the above computation of tax by the
negister of Wills,for proper reason,same should be noted below,with short
explanation.
~~~inistration !No Year .
IN THE
MATTER OF THE APPRAISEMENT
OF THE
ESTATE OF
.........SARA.H..JANE..B.ALLENTINE .
Deceased
Late of c:~.~@q;r ,.
County of WASHINGTON....................................
Commonwealth of Pennsylvania
REPORT AND APPRAISAL
.':<
:..
:-t.
COUNTY W.~.~.h~~.~~u u
FILE NO..u uu..Q?.::.9..9..:!~Zuuu _.
DEPARTMENT OF REVENUE
BURE~U.OF COUNTY COLLECl'IONS
'·HARRISBURG.PENNA.J712 7
COMMONWEALTH OF PENNSYLVANIA
RESIDENT INHERITANCE tAX
APPRAISEMENT
DATE April"li'1969......_.
Whereas,9..~.~D ~~~..u~.~~~.~~.~!f.l.~u late of q.~.~~.I:.~~uu u .
in the County of ,w.~§.b.~gt..91.l Commonwealth of Pennsylvania,having died on
the xi 4.9 t.h _day of P.~.9.~mP.~.r.u 19..§~.,seized and possessed of an estat~
subject to Inheritance TE.X under the laws of the Commonwealth of Pennsylvania;
Therefore,I,W..~.R.!G.p..@.I3.Y.u u ,an appraiser dilly appointed according to law,
having been designated to make a fair and conscionable appraisement of the said estate,and to assess and fix
the cash value of all annuities and life estates growing out of said estate,hereby file the following appraisement:
In the event that any future interest in this estate is transferred in possession or enjoyment to collateral heirs of the decedent after
the expiration of any estate felr life or for years,the Commonwealth hereby expressly reserves the right to appraise and assess transfer
inheritance taxes at the lawful collateral rate on any such future interest.
Unit Appr.l.em.nt
De.crlptlon of Asset Value.Made for Inherltaoee
Tax Purpo8ll.
$
PERSONALTY:
Cash.beinR:proceeds to credt of account of within i
rlA~edent iwth Pittsburllh Steel Allenport Employees
Federal Credit Union 657.79
Credit for Incom 'lax refund due from US Governement
as determind by 1968 Income_Tax Return on Form 1040 17.58
1966 ~hevrolet Coupe motor vechile 1,500.00
Cash,being gross pay from Pittsburgh Steel Company 261.46
Cash.bew ~ross pay from Pittsburi8 Steel Company.770.93
.'3,2CYl.76 3,207 '76
,
,..;
,.
:.~.-;-,
i
.Total 3,207 76
form~;V;::fh7.:~:~:,w~~ceo~l~~:~;:re~~;r.~e~..t:t~:::~se=en~=~~~r t '
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(Poat OflC!e)
......................wMl:i.;I;,Ncz.rQ,N....................................Cou'Illy
RESIDENT INHERITANCE TAX APPRAISEMENT
Estate of
SARAH JANE BALLENTYNE.....................................................
Deceased.;
Late of
................................c..ijA~.Q:J:..
Date of Death,De.c.~mbe.r ~.9,l..96.e...
Appraisement Docket Vol.,3.7 ..
Page,.l.93.~.3 No ..f/J.:~.t>.9~~.t>.7 ..
Filed in Register's Office,Ap;r.~.~~.I.19..§9..
Amount of tax due,$..
DEPARTMENT OF REVENUE
Received,
Examined and Approved,.
Wrote abo.ut Appra.isement,
Appeal It-om Appraisement,..
Entered and charged,..
t,··
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AMOUNT ~
527.'1 ~101
m ACN
AssessmentControl No.
RECEI~ED BY J:dila ~e .~y.'I .";L .~
,.
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fi)'7-19~'
ALE NUMBER__~!!()j!!J~fR---l
NAME OF DECEDENT ~BaU.~Q.e,~3a3eaJk--J-.I--~FIRST MI
ESTATE INFORMATION:
DATE OF DEATH·.....:('"C-.De=tDllll8:~9+--19tiJB-__~RE~:RKS :.stl.19~1"'90"[!]TOTAL AMOUNT PAID ......5u2i&J7u·'''''-'L1.1 _
.....~~.It ];""...
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DATE OF PAYMENT ---4~.a.;y.."""",OJ..-.....:H:KII''''''''-------l
POSTMARK DAtE --------------..l
COUNTY -~IaJm:Lr14It'm..--------~
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1--v.....1~e~tol¥r..·-4.E:...I!---<aP.ltl~v~a~J~E;:H:s~q+-.----
'12 VttJ2owtlel4 A\'tmles-'---
~.O.Ic»l 18
REV·1162 EX 11/82
U .•.COMMONWEALTH OF PENNSYLVANIA
NoI'IO 73098 DEPARTMENT OF REVENUE
OFFICIAL RECEIPT •PENNSYLVANIA INHERITANCE AND ESTATE TAX
t R=CEIVED FROM:
.~
iHtt,
~~il
61
REGISTER OF WILLS UI~::=::t1"'BIS::=~&:::Il9YZ1_c:lr.IlI:I....:.....:WEE:A=-a:zUD..::iUa__:::IA:I:I__::IO:z:l..i::I.lL:I...i:::IO=z:::l_"'C::C=::IMW"'-C==:-E£l£sl:=_::II"
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U112755 COMMONWEALTH OF PENNSYLVANIA
NO.Pi·DEPARTMENT OF REVENUE
OFFICIAL RECEIPT •PENNSYLVANIA INHERITANCE AND ESTATE TAX
,I
mAMOUNT
AssessmentControl No.
RECEIVED FROM:
I Victor Ht Riva.E{1q.
512 Fallowf1eld Ave.
P.O.Box 18
Charleroi,Pat 15022
L
101 462.39
ESTATE INFORMATION:
~462.39~TOTALAMOUNT PAID _
,
FLENUMBffi 63-69-0167
NAME OF DECEDENT Ballantyne,Sarah
DATE OF PAYMENT De~%Tmber 4 ,F1Rf984
POSTMARK DATE December 3,1984
COUNTY tiashington
DATE OF DEATH 12-2 -68
REMARKSBM
-0"·Aw·0_0A A
MI
REGISTER OF WILLS...=
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