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HomeMy WebLinkAboutOC1969-0376 - ESTATE OF AMOS..~ i -:1."Ii i '1,...," "# LAST "dIll AND TESTAl"lliNT OF CLYDE R.AllOS I,CLYDE R.AMOS,a re~ident of the Borough of Bentleyville, Washington County,Pennsylvania,being of sound mind and memory, hereby revoke all w:ills and codicils,as well as all instruments or a te~tamentary nature heretofore made by me nnd do hereby make, pub11sh and declare this to be my Last Will and Testament in manner and form following: FIRST:I direct that all my just debts,funeral and testa- mentary expenses shall ~e paid by my Executor hereinafter named, as soon as conveniently may be after my death. SECOND:I hereby give,devise and bequeath all of my property,real,personal and mixed,of whatever nature and where- soever ai tuate,which I may ovm or have the right to dispose of at the time of my death,unto my wife,ADA MAY AMOS.If she should predecease me or should die at the same time that I should die, then and in that event,I give,devise and bequeath the said property unto my son,KENNETH R.AMOS,and my daughter,VIRGINIA B. CROW,in equal proportions,share and share alike,SUbject however, to the payment by them unto CYNTHIA L.CIZMEK of the Stun of Two Hundred Fifty ($250.00)Dollars and unto DARRYL G.CIZ}1EK of the sum of Two Hundred Fifty ($250.00)Dollars. THIRD:I hereby nominate,'constitute and appoint,my son, KENNETHR.A1'-lOS,Executor of this my Ls,st viill and Testament. ..,f; I'tl II Iifl., q 1 Hpr.~,.·.l...·•tl t1 flLjtj,, f ·.t····.,..'·1.'jI r'/'"Page 1. II.i' IN WITNESS \vHFJ~EOF,I have set my hand nnd seal to this my of two pages,to each of ~. havo affixed my signature,this A),J-Iday of January,1966. \ II IAH')t Will and Testament,which cons ists!I IIWhiCh I II " I I S.igned,sealed,published and declared by CLYDE R.AMOS, the above named Testator,as and for his Last Will and Testament, in the presence of us,who,at his request,and in his presence, and in the presence of each other,have hereunto subscribed our names as witnesses. 1l-';~;;;;"";..;:.r.....Jl-;:.~.c;;..-,--Re s Iding at 1Page2.• r~-----------------~--~--------------------,-- Porm No,RCC·62 (2·64)THIS FORM REQUIRED IN ALL ESTATES WITH GRoSS ASSETS UNDER $10,000,UNDER SECTION 701 OF ACT OF JUNE 18,1981,,/' EFFECT~EJANUARY I,1962.(PILE IN DUPLICATE WITH COPY OP WILL ATTACHED) OF.FIC~OF THE REGISTER OF W-lLLS County of ..~~~~~.~~~~. ............~~.~~~~'of ..~.~?.~~~~1?-.~t;~~.e:~!..l?~.~t;~.~~.~~~~.,..?~.' (Name),(Address) being duly ~~9..~~.according to law,deposes and says that he is the ~_~~~~_~~~~_~~_~=~_Clyde R.Amos,a/k/a.-,(Exec.,Adm.,Legatee,Etc,) C.R.Amos,.132 Sm1th Streetoftheestateof•.--------whose last residence was ----------.----------------------------------------------------(No.)(Street) ~~_~~_~:~~_~~_~_~~~_~_~..deceased,and that the whole of the estate of said decedent,who died _~~~_<:.~~_~!_~§} (City,Borough or Township)(Date) consisted of: REAL PROPERTY REAL PROPERTY IN PENNSYLVANIA,WITH STATEMENT OF MORTGAGE ENCUMBRAN<i:ES UPON EACH PARCEL AT DEATH OF DECEDENT, WHERE PROPERTY HELD AS JOINT TENANT OR TENANCY BY ENTIRETIES,GIVE NAMES,ADDRESSES Allm RELATIONSHIP OF OTHER OWNERS. Real Estate Estimated Value None. ..- I' I .JO.~.. ~Ili..~ ~k, ('Q ........... ~.11 ~ P~rsonal Property Distributive Share from the Estate of G.L.Amos,deceased, at No.949 of 1968••••••••••••••••••••••••••••••••••••••••••••$2,404.9~~\1~~;:;:::;::::~~~:::::;~~-==~:-:----=---===-~===--I--~'~~\WDist~uEYve Share from the Estate of o.C.Amos,deceased,u- 1,844.52$4.249.»TOT A L ••••••••••••••••••• at No.1322 of 1968••.•••••••••••.••••.••.•.••••••..•••..•.••• NOTE:You may expedite the processing of this return by filing with it,and as a part of the return, letters from financial institutions or mortgage holders,certifying to amounts on deposit or owed by the decedent as of the date of death.Such letters must be signed by a responsible officer of the financial institution or mortgage holder and indicate clearly amounts of principal and interest in the decedent's account at the date of death and the type of account,account number and the exact name or names in which the account is registered. Jointly Held Property Estimated ~lue None."'-"~,,- .\,, ,. ;.. ,.\ - Transfers within TWO YEARS Prior to Death ./None./. That at the time of death there was no safe deposit box registered ih decedent's individual name,or jointly with,or as agent or deputy of another,or in decedent's individual name,with right of access by another as agent or deputy,with the exception of the following:- NAME AND ADDRESS OF BANK OR OTHER INSTITUTION 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. - BENEFICIARIES .BENEFICIARIES ANn ADDRESSES , RELATIONSHIP SURVIVED AGE OF LIFE (If step-children or DECEDENT TENANTS OR INTEREST OF (State full names of all and their addresses who have illegitimate children STATE YES ANNUITANTS BENEFICIARY an interest,vested,contingent or otherwise,in estate.)are involved,set OR NO AT DEATH OF IN ESTATE.,('\...."..............~~......l>....•.f9rth.this .fact.),......."......,",.,..•DEGEDENT ,. Ada Amos ~\Tife Yes All -.,'"'"......<'-,.,..~........."'"..............."..~.,.....,C'l '"......"'"......"".. .,.,'"c ....{-........."..,...... .,. DEBT OR CLAIM NATURE OF SAME AMOUNT THIS COLUMN .KEGISTER ONLY Greenlee Funeral Home Funeral expenses paid $1,575~OC $ Ada Amos Familyexemption (will not be allowed unless 1,000 OC decedent died residing with a spouse or children.) Administration Expenses * J.D.costa Counsel fees *50 OC Fiduciary commission * OTHER DEBTS AND CLAIMS (*)See Note below Valley Memorial Cemetery Burial Lot 872 si Monongahela Monument Memorial 155 0°1 I ~ II Total $3,652 Si ~-----------------~-'~~-'~-----'l RESIR~NT DECEDENT DEBTS AND DEDUCTIONS CLAIMED NOTE'List first five items in the spaces so provided,observe notations thereon,and"instructions. Note:The estate agrees to advise the Register of Wills if the amount actually paid in settlement of any fee,commission or debt is greater 01'less than the estimated amount claimed and allowed. Subscribed and sworn to before me this ?~:t:J:l ..<.ad4!:J...~~. (Executor-Administrator) 132 Smith Street..............,..(St~~;i N~~b~;;'. Bentleyville,Pa• ••••••••••••••0 ••••••••••••••••••••••••••••••0 •••• (City or Town and State) ltit Cuil' ..~~~i.~~.~~~n/J.s~~~~l:~i.n.gd::::~'..1.~~.~~.~~~.~~~~~.~~~:.~:~e.::9i~conformit:;h law ~onthis ....~...J...L ....c~~..~.....~..~...~/..e----.. .ApprRI In the event that any future interest in this estate is transferred in possession 01'enjoyment to collatera eirs of the decedent after the expiration of any estate for life 01'for years,the Commonwealth hereby expl'essly reserves the right to appraise and assess transfer'inheri- tance taxes at the lawful collateral rate on any such future interest. REPORT OF TH~~9ISTER0 WILLS I,the undersigned duly elected Register of Wills in and ~~,.County,Pennsylvania,do respectfully report that I have allowed debts and deductions in the amounts claimed by deponent,etas to those items where a greater or lesser amount is set forth in the last column to the right in said schedule above,which greater or I amou~resents the sum~atlDwe~as a deduction. Dated:::f~.I.:~./~••/Y~/........(...t;"f~.(??:??~:~~~~·:·.~. . .Register of Wills 1''' J " Form No.RCC-62 (2-64) WillAdministration INo Year . IN THE MATTER OF THE APPRAISEMENT OF THE ESTATE OF CLYDE R.AMOS,also known as C.R.AMOS, Deceased La~of Bentle~ille............................... County of Washington.............................. Commonwealth of Pennsylvania REPORT AND APPRAISAL ·v</··0;)iN(}.jur~m~S'V1dS11U~d'O ~31Si'~3(1Ohli~VJi -n3SSfiti 01,J IIJ 52 eVil 69. '0"37/:J \, ;. t •. RCC-Bl (2-64) COMMONWEALTH OF PENNSYLVANIA·•·DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS INHERITANCE TAX DIVISION NOTICE OF FILING OF APPRAISEMENT IN YOUR REPLY PLEADE RIt,.IER TO 37-200-7 ADA AMOS Informant In Re:Estate of ....:C~L!:!::n>~E=_·~R~•..:.:iM~OS~..!:aI~k:L./=a _ ____---=.:W~AS:::.:HI~Ni=GT.:.:O~N~County -File No.63-69-376 You are hereby notified that the original appraisement in the estate of Clyde R.Amos a/k!a has been filed in the office of the Register of Wills qf Washington County on April 16 ,19 69.Said appraisement reflects the following valuations: Real Estate _ Personal Property ~4~,~24~9~.~4~3~--- Transfers ~--- Tota1 -.,..._----:4:t..i.L:2=4t.<l9:.:..4~3__ As to such tax that is paid within three months·from date of death,a five (5%)percent discount is allowable.As to any tax that remains unpaid after one year from date of death,interest at the rate of six (6%)percent per annum is charged. Any party in interest who is aggrieved by an appraisement may appeal therefrom as provided by law. Date ;:.:;Ap~r:..:1=·1=-=1:.;:.6.L.'....:1::..9:..;:6;..,;9 _signe~L~~~ Title W.R.CHANEY,C APPRAISER DATE OF DEATH:March 5,1967 Note:This is not a bill. ,I QCC-39 (6-67) ':O.1MONWEAL TH OF PENNSYLVANIA TR'ANSFER INHERITANCE TAX RESIDENT DECEDENT AJ.v108,CLYDE R.a/k/a AMOS C.R. FILE #63-69-376 March 5,1967 -. SUMMARY FILE #63-69-376 rlEPOnT OF INHEH.ITANCR TAX APPRAISER I.the undersigned duly appointed Inheritance Tax ~ppraiser in and for the County of #63 Washington ,Pennsylvania,do respectfully report that I have appraised the real and personal property as reported in the foregoing return at the values set forth opposite each item in the last column to the right in Schedules "A","B","c"and "E". Dated:04-16-69 03-05-67 REPORT OF THE REGISTER OF WILLS I,the undersigned duly elected Register of Wills in and for Washington County,Pennsylvania,do r'~spectfully report that I have allowed deductions in the amounts claimed by deponent,except as to those i terns where a greater or lesser amount is set forth in the last column to the right in Schedule "F",which greater or lesser amount represents the sum allowed as a deduction.~ Dated:04-16-69 '~~~0-J~'1/i-f.4 REGISTER OF WILLS VALUE AS REPORTED VALUE AS APPRAI SED VALUE AS REAPPRAI SED $.~-$*------4,242.h3 4.,249.43 INVENTORY Ileal Property (Schedule A) Personal Property (Schedule B) Transfers (Schedule C) J oint-Held Property (Schedule E) TOTAL GROSS ASSETS LESS Debts and Deductions (SCHEDULE F) CLE~R VALUE OF ESTATE 4,249.43 ..:lJ?Sg.8Z . 596.56 =3~,.~65~2=.f3'l::±==:_ 596.56 =======:= Valuation of life estates or annuities .•...•..$ ESTATE TAX ASSESSMENTS ~~~---- CO~WUTATION OF TAX d>.:-'~~---- ~%===:11:.:91===~=Paid in Full 3-28-69 $------ FOR USE OF REGISTER ONLY T ax on $~1)% Tax on $_________10% Tax on ~596.56 .------~ Tax on $.11)% Exemptions :-'-(::,) Total Estate __ TOTAL TAX Less tax preViously paid BALANCE Less 1)%of tax if paid within 3 months after death $-----$======:=$-~-~-- $======:= (::')As evidenced by Chari table Exemption Certificates issued by the Secretary of Revenue. $-'------- $------~$~----- $ TOTAL TAX BALANCE PAID i3ALANCE OF INHERITANCE TAX DUE $-------- Add interest at rate of 6%from to $_ ~MOUNT OF ESTATE TAX ASSESSED $~ Estate tax paid *__ BALANCE DUE Add interest at rate of 6%from to FOil USE QF REGISTER QNLY ADJUSTMENTS NOTE:Where subsequent adjustments are made to the above computation of tax by the Register of Wills,for proper reason,same should be noted below,with short explanation. Will t...No.Administration IN THE Year .. MATTER OF THE APPRAISEMENT OF THE ESTATE OF ..n.Cr.YP$.~,AMOR..1l./k!$,... Deceased Late of...BENTlEYVILLE County of ._.. .__.WMH.:ING'rQN..__._... Commonwealth of Pennsylvania REPORT AND APPRAISAL ,_r ---- Fonn'RCC-2 ~COMMONWEALTH OF PENNSYLVANIA DATE .......................m¥!mx:...4.=~.§:.§.~....... .DEPARTMENT OF REVENUE RESIDENT INHERITANCE T.I\X"WashingtonCOUNTYB\lltEAU OF COUNTY COLLECTIONS·..•••••••••••••••!............................................................................. HARRISBURG.PENNA.17127 APPRAISEMENT FILE NO................§?::.§..9.::?.7..§....................................... Whereas.................................~.~y.~.~...~.~....~C?~....~(~/~..................................................late of ..............................~~?~.~~.!..y.~~~.:...................................... in the County of ................................~~~.~.~.~~.~.................................................................Commonwealth of Pennsylvania.having died on the ...............................................5.....~.h.................................day of .......................~.c:h .....................................19....9.7..,seized and possessed of an estate subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore,I,.............................................w..~.~.!.....9..~.~y ...................................................an appraiser duly appointed according to law, having been designated to make a fair and conscionable appraisement of the said estate,and to assess and fix the cash value of all annuities and life estates growing out of said estate.hereby file the following appraisement: In the event that any future interest in this estate is transferred in possession or enjoyment to collateral heirs of the decedent after the expiration of any estate for life or for years,the Commonwealth hereby expressly reserves the right to appraise and assess transfer inheritance taxes at the lawful collateral rate on any such future interest. Unit Appraisement Description of Asset Values Made for Inheritance Tax Purpoles $ PERSONALTY: Distributive share form the Estate of G.L.Amos, deceased.at No.949 of 1968.2,404.91 Distributive share from the Estate of o.c.Amos, deceased,at No.1322 of 1968 1,844·52 L..2L.9.43 4.249 43 ,, Total 4,249 43 ; I I I ...............................•Penna. WASHINGTON........................................................County RESIDENT INHERITANCE TAX APPRAISEMENT Estate of .........9I...I:p.~I.'.~~.q.s...~/~/~. Deceased. Late of BENTLEYVILLE..'-. Date of Death,~.c:.~2.1.P1.~7 . Appraisemel!t Docket Vol.,37 . Page,2.~7 _No 63~69~37.6 . Filed in Register's Office,~p;r.g J:9..L.19 ..9.9 Amount of tax due,$. DEPARTMENT OF REVENUE Received, Examined and Approved,. Wrote abo.ut Appraisement, Appeal t,.om Appraisement,.. Entered and charged,,.. \ " ..,.. .,. Form No.RCC-62 (4-71)THIS FORM REQUIRED IN ALL ESTATES WITH GROSS ASSETS UNDER $10,000,UNDER SECTION 701 OF ACT OF JUNE 16,1861,J Ilf'1"EC'I'IVE olANUARY 1,1962,(FILE IN DUPLICATE WITH COpy OF WILL ATTACHED)V &'.3-(,9'-3 7? OFFICE OF THE REGISTER OF WILLS County of ~~~~~~~~?~...~:?~:~~,~..,.~~.~~'..,of .~~~..~t;n.~t:J:l..~t·.,..!3.~~~.~~YY:~+)..~c ..P,q.,.,. (Name)(Addretlll) being duly ~~?.~~according to law,deposes and says that he is the ~~~_ (Exec.,Adm.,Legat.:e.Etc,) of the estate of ~_~¥.?:~~_~~~?~whose last residence was ~~_?§.~~.~.~~~_;:.~~_~__. . (No.)(Street) --~-~!!~-!~Y~_~_!~_~!~~_~.deceased,and that the whole of the estate of said decedent,who died M~~.9..h S-.t._J•.9_61 (City.Botough or Township)(Date) consisted of: REAL PROPERTY REAL PROPERTY IN PENNSYLVANIA,WITH STATEMENT OF MORTGAGE ENCUMBRANCES UPON EACH PARCEL AT DEATH OF DECEDENT, WHERE PROPERTY HELD AS JOINT TENANT OR TENANCY BY ENTIRETIES,GIVE NAMES.ADDRESSES AND RELATIONSHIP OF OTHER OWNERS. Real Estate Estimated Value All that certain lot of ground situate in the Borough of Bentleyville,washington county,Pennsylvania,known and designated as Lot No.12 in the J.E.Richardson Plan of Lots, which is recorded in Plan Book 3,page 185.(See Deed Book 465,page 452.)Having a value of••••••••.•••••••••.•.~j;J;~$500.00 V~~tfl-k ~/»,A---'"7'-,, t7 {/?/~ Personal Property None.CJ I-I /, ! ,Ii .Ii, ,; NOTE:You may expedite the processing of this return by filing with it,and as a part of the return, letters from financial institutions or mortgage holders,certifying to amounts on deposit or owed by the decedent as of the date of death.Such letters must be signed by a responsible officer of the financial institution or mortgage holder and indicate clearly amounts of principal and interest in the decedent's account at the date of death and the type of account,account number and the exact name or names in which the account is registered._xKiA,."i:f Jointly Held Property Estimatecf Value , ~4 QNone •- . - Transfel'S within TWO YEARS Prior to Death V? None .J " That at the time of death there was no safe deposit box registered ih decedent's individual name,or jointly with,or as agent or deputy of another,or in decedent's individual name,with right of access by another as agent or deputy,with the exception of the following:- NAME AND ADDRESS OF BANK OR OTHER INSTITUTION 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 - BENEFICIARIES BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED AGE OF LIFE (If step-children or DECEDENT TENANTS OR INTEREST OF (State full names of all and their addresses who have illegitimate children STATE YES ANNUITANTS BENEFICIARY an interest,vested,contingent or otherwise,in estate.)are involved,set OR NO AT DEATH OF IN ESTATE forth this fact.)DECEDENT Ada Amos Wife Yes All. "----------------------------------------- N~TE'List firl.lt five items in the spaces so provided observe notations thereon and instructions--,, DEBT OR CLAIM NATURE OF SAME AMOUNT THIS COLUMN~EGISTER ONLY Funeral expenses paid $$ Family exemption (will not be allowed unless decedent died residing with a spouse or children.) Administration Expenses • Counsel fees •I FiduciarY commission • OTHER DEBTS AND CLAIMS (•)See Note below , . . Total , RE&IDENT DECE;DENT DEBTS AND DEDU~~IONS CLAIMED (Street Number) 138 Smith Street .?~~~.~~X~~.~~.f7.'~~.:..~.~~.~~.(City or Town and State) Note:The estate agrees to advise the Register of Wills if the amount actually paid in settlement of any fee,commission 01'debt is greater 01'less than the estimated amount claimed and allowed.,I Subscribed and sworn to before me this.. . . . . . . . . . . . . . . . . . . . .'l<'..j:;,~t ..~.(" -(Executor-Administrator)........../i.i:!.day of ~P.J;"~+,19?~. .........~~~~~~~. '.'~,;~jUTL C t-"wp "Ja''''~'''',-f~l"trr~p;hi',::,z~_(Jn .•,-=============,,:,;;"====;;:'~===;~================================M~CCr.:l..~~r.:.:AV',-.,..'" Having been duly,sworn_according to law,I do hereby c~fy~th.at t~~above appraisement is made in conformity with law on this.....................1.8.t1J day of ~,19..2)~~ ,;-;""~~"""'{?7'..~•••••••'~i~;r"'" In the event thl10t any future interest in this estate is transfel'1'ed in possession or enjoyment to collateral heirs of the decedent after the expiration of any estate for life 01'for years,the Commonwealth het'eby expt'ess]y reserves the right to appraise and assess transfer-inheri- tance taxes at the lawful collateral rate on any such future interest. REPORT OF THE REGISTER OF WILLS I,the undersigned duly elected Register of Wills in and for County,Pennsylvania,do respectfully report that I have allowed debts and deductions in the amounts claimed by deponent,except as to those items where a greater or lesser amount is set fortll in the last column to the right in said schedule above,which greater or lesser amount represents the sum allowed as a deduction. Dated:,. Register of Wills ...--Form No.RCC-62 (4-71) WillAdministration INo.. . . . . . . . . .Year ..... IN THE .~~ .\..., MATTER OF THE APPRAISEMENT OF THE ESTATE OF ~~:.·.l:):\·'·~·;:-..-,'.~..'...:;:~.../.'"._.C)~....",.,/,'".,.••'."'y ,,-;I"l T·,..,.'....,,,- '#,•G·\\\ "It",tl.,tt\t!\\ CLYDE R.AMOS Deceased Late of ..~~.ntleyville...................................................... County of ,~~shington....................................".. .Commonwealth of Pennsylvania REPORT ~D APPRAISAL 1".... _.~..., ,,- 9°.<-o;J ~,~--.I ......Q:''::-~f~)~~~-.J;',::i~l!.-Q' o~< --''"'a-.J 0::::l- ll.)4J <-:> C)h :k: (t)~--::,_.....e:::;;(;; £c.;;!.:::.. c:::~-~.....--'-~·:;t;: 9;:;C1...: to:::(; :::::• '\t :.";.; ~'lt" i..LJ i.......l..'.................. t~~~.-->l- J ..,......""....~ .-- J.D.Costa,Esq. ,/~. RCC-Bl (6-71) , COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS HARRISBURG 17127 NOTICE OF FI LING OF APPRAISEMENT KENNETH R.AIv10S (Executor or Administrator) IN YOUR REPLY PLEASE REFER TO Inheritance Tax Division j In Re:Estate of CLYDE R.AMOS __~.q_A_S_H_I_N_G_T_O_N County _File No.__6_3_-..:..6..:..9_-..::,.3-,-7..::,.6 _ Dear Mr.Amos, You are hereby notifjed that the__o....:::r:..;J.::.;·q:;L.J.='n=a:..=l'----_ appraisement in the estate of CLYDE R.Arv10S has been filed in the office of the Register of Wills of vlASHINGTON County on April 18 ,19...11.,Said appraisement reflects the following valuations: Real Estate -=5:...:0~0~.O~O~_ Personal Property _ Transfers _ J0 int Iy Own ed --:::-::-::--::-::-_ Total -=5-=0-=0-=_-=0-=0 _ As to such tax that is paid within three months from date of death,a five (5%) percent discount is allowable.As to any tax that remains unpaid after nine (9)months (fifteen months when death occurred from December 22,1965 to June 16,1971,inclusive; and twelve months when death occurred prior to December 22,1965)from date of death, interest at the rate of six (6%)percent per annum is charged. Any party in interest who is aggrieved by an appraisement may appeal therefrom as provided by law. Date April 18,1973 DATE OF DEATH:March 5,1967 Note:This is not a bill. S;gned ~V-~. Title ~~ RCC-39 (5-68) COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SUMMARY Estate of.=.AM:::.=O;...:S:::..-__--=::C=L:..=Y:..=D:.=E:::..-----=..:R:...!..DATE 0 F DEATH 3-5-67 (Last Name)(First Name)(Initial) FILE NO.63-69-376 REPORT OF INHERITANCE TAX APPRAISER I,the undersigned duly appointed Inheritance Tax Appraiser in and for the County of WASHINGTON Pennsylvania,do respectfully report that I have appraised the real and personal property as reported in the foregoing return at the values set forth opposite each item in the last column to the right in~SChedUles"A","B","C",and "E~" Dated:April 18,1973 ~~ INHERITANTAXAPPISER ~. REPORT OF THE REGISTER OF WILLS I,the undersigned duly elected Register of Wills in and for County,Pennsylvania,do respect- fully report that I have allowed deductions in the amountS claimed by deponent,except as to those items where a greater or lesser amount is set forth in the last column to the right in Schedule "F",which greater or lesser amount represents the sum allowed as a deduction. Dated:_ REGISTER OF WILLS VALUE AS REAPPRAISED $-------+--~()()")() 500 00 NONE 500 00 500 00 500 00 NONE VALUE AS REPORTED VALUE AS APPRAISED $500 t==$ INVENTORY Real Property (Schedule A) Personal Property (Schedule B) Transfers (Schedule C) Joint-Held Property (Schedule E) TOTAL GROSS ASSETS Less Debts and Deductions (SCHEDULE F) CLEAR VALUE OF ESTATE Valuation of life estates or FOR USE OF REGISTER ONLY Tax on $-----------4--@) Tax on $6% Tax on $5% Thxoo$lK Tax on $15% Exemptions * Total Estate -4-.__ TOTAL TAX COMPUTATION OF TAX $-------+-- $---------4-- $--------1--- $--------1--- $-------+-- $L.--_ (*)As evidenced by Charitable Exemption Certificates issued by the Secretary of Revenue. Less tax previously paid BALANCE Less 5%of tax if paid within 3 months after death :::::::::::::t==== BALANCE OF INHERITANCE TAX DUE $t= Add interest at rate of 6%from _____to $--------' AMOUNT OF ESTATE TAX ASSESSED $__~__L- Estate tax paid $L- BALANCE DUE $~l____ Add interest at rate of 6%from t= ------I.to-----$-------1 TOTAL TAX BALANCE $-------1PAID$....J FOR USE OF REGISTER ONLY ADJUSTMENTS NOTE:Where subsequent adjustments are made to the above computation of tax by the Register of Wills,for proper reason, same should be noted below,with short explanation. Will Administration f No. IN THE year . MATTER OF THE APPRAISEMENT OF THE ESTATE OF ....CLYDE ..R •..AMOS .. Deceased Late of County of BENTLEYVILLE WASHINGTON. Commonwealth of Pennsylvania REPORT AND APPRAISAL I " Form RCC-2 , ISEPARTIUENT"OF REVENUE BUREAU OF COUNTY COLLECTIONS HARRISBURG.PENNA.17127 COMMONWEALTH'OF PENNSYLVANIA RESIDENT INHERITANCE TAX APPRAISEMENT DATE !.\p.:r;JJ J.:.?.l .J..~.?J . COUNTY ~!.::.~.I.:..!:.~..?T?.~_.._. 63-69-XIDl 376FILENO__. Whereas,g!7.XP..~R..~N'19..$.late of J?~~.~~~.~~.~. in the County of .......................................WASHINGTQN........................................................Commonwealth of Pennsylvania,having died on the ............................f.i.f.tb............................................day of ..;......Mg,:t:.Gh...............................................19....§.7.,seized and possessed of an estate subject to Inheritanc under the la~e Commonwealth of Pennsylvania;., Therefore,I,................A ..~~.;................~..............,an appraiser duly appointed according to law, having been designated to make a fair and conscionable appraisement of the said estate,and to assess and fix the cash value of all annuities and life estates growing out of said estate,hereby file the following appraisement: In the event that any future interest in this estate is transferred in possession or enjoyment to collateral heirs of the decedent after the expiration of any estate for life or for years,the Commonwealth hereby expressly reserves the right to appraise and assess transfer inheritance taxes at the lawful collateral rate on any such future interest. : Unit Apprallement Delcrlptlon of Allet Valuel Made for Inheritance Tax Purpolel $ REALTY: BEE COpy ATTACHED TO APPRAISEMENT 500 00 - I _. fonn~~vi..':fh~a:::I:;'~WC>rll~~~~~~:~:;o~""'~:~~Y~~r~i,~e:~~i~~~~el~?~ ~~~!~C....Oftlllt). ·-..~ vlASHINGTON County RESIDENT INHERITANCE TAX APPRAISEMENT Estate of BENTLEYVILLE Date of Death,}.-:::.?.::-.6...7..,. Appraisemel!t Docket Vol.. .,. Page,No..6...~.~.§~::::.:??..6.. Filed in Register's Office,Apri.L..l.8....19 .73 Amount of tax due,$. DEPARTMENT OF REVENUE Received, Examined and Approved,:. Wrote'abo,ut Appra.isement,:.. Appeal t"om Appraisement,. Entered and charged,.'\ ,