HomeMy WebLinkAboutOC1969-0474 - ESTATE OF BELLENOForm:'No.15 (1960)
•Will
.".'/2 ~.Q....~.',/.1.l_.'j -J I ~11/·Washington County Bar s30Clabon 'I
Washington,Penna.j
I,.J.Q.H.N A.:'..:..~.?.11.J;;NQ __:.___ _ _ _ _ ,
of _G.~.~J.!:r..$D.~.hi.p.,w.~~hi..ngt..QD CQJ.ID..t.y.~:P~.nIl.§.ylY..~P..i.9..._ _ _ _ _ ,
being of sound mind and memory and understanding,do hereby make,p-ublish and declare this to
be my Last "Vill and Testament,in manner and form following,hereby revoking any will or wills
heretofore made by me.
First..I direct that all expenses attributable to my last illness and funeral be fully paid and
satisfied,as soon as conveniently may be,after my decease.
Second.I giv~and bequeath unto David Belleno my beloved(~Uu.t~
I
the sum of $500.00 in cash.
Third.The balance of my estate real)personal and mixed I give,
bequeath and devi.se unto my beloved living children)namely Mary Rubis;
Ha~el Cassidy;Alberta Petronie;Mildred Cristner;William Belleno;and
George E.Belleno,share and share alike.
I do hereby make,constitute and appoint my beloved son,William Belleno
11I
I'
I
II
to be my execut or
.,
~,
of this my Last vVill and Testament .
IN WITNESS FflHEREOF,I JOHN A.BELLENO the Testat or
above n>J;d,have hereunto subscribed my name and affixed my seal,the '0 /~
day of I/..~··ut-7 in the year of our Lord one thousand nine hundred and sixty-three
(1963.i'cJ::t»f@iii-g d....4 :1:1d.P...(SEAL)
Signed,sealed,published and declared by the above named
JOHN A.BELLENO ,as and for his Last \Vill and Testament
in the presence of us,who have hereunto subscribed our names at his request as witnesses
thereunto,in'the presence of said testat or . ,and of each other.
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•
Form RCC-33
RESIDENT DECEDENT
.....j
COMM:ONWEAlTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
COUNTY OF W.Cl,~.h:i,.Ilg~(>.p:.
IMPORTANT:This return must be completed in detail and filed in duplicate,with will attached,with the
Register of Wills of the County where decedent resided;Return is due within one year after
date of death,unless an extension is granted by the Secretary of Revenue.(Section 703 of
the Inh~ritance_an~.Estate Tax Act of 19B1.)
County of
State of .
.......~..?~~I~~~~~~;1~;;?~.~a.;E/:ST~;~;F.~.e~.~.~~.?}::::;;:OF
(State full name of d 'C.dent)
Late of :w.~.§lhiIlgtqn .County ~~XXOO1C
.~~!l.1.?:§.Y=.L.Y..Cl,.p':.~.~:.}
Washington ss:......................,,.
William Belleno Executor
of the estate of the above-named decedent being duly sworn,deposeS and say S
Decedent dJed Marc.h..14.
(Month)
Name and address of attorney or}
other authorized representative to
Whom all correspondence should be
mailed.
......,19 .....6.9....,J testate leaving a last will,copy of which is hereto attached.}
(lIay)(Y~ar)LX'XOOXf!X<!X
.RichClEdI)iSall~~..?~q~.
Law &'Finance B:'-:lildin~,c:Clnonsb'l.l:t't;?;~Pa.
That as such ~~.~£JJ.t.Q.;r deponent is familiar with the affairs of said estate and the property con-
(Ex""ulor-Admini8lralor)
stituting the assets thereof and their fair market value.
That at the time of death there was no safe deposit box registered in decedent's individual name,or jointly
with,Or as agent or deputy of another,or in decedent's individual name,with right of access by another as agent
or deputy,with the exception of the following:-
NAME AND ADDRESS OF BANK OR OTHER 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
That the contents of said safe deposit box or boxes are itemized under Schedules of this
return,with the exception of the following,for the reasons hereinafter set forth:
That Schedule A attached hereto 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 mortgage encumbrances upon each parcel of real property at .the date of death,giving
the amount still due at death,name o~mortgagee,date,rate o~interest,and book and page of record
thereof.It also sets forth in the columns provided therefore the assessed valuation of each of said
parcels,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 death,whether in decedent's immediate possession,standing to decedent's credit in banks
of deposit,savings banks,trust companies,or other institutions,whether individually,or in trust for
any other person or,persons giving also separately the accrued interest thereon,if any,down to the last
interest day prior to decedent's death in the case of saVings banks,and to the date of decedent's death
in all other cases;all bonds,postal savings,treasury certificates or notes and other evidence of in-
debtedness o~the United States to the decedent;all obligations,whether by statute or agreement they
II re designaten as tax free,of the Uni ted States,or any state,or political subdivision thereof,or o~
nn:;forei!!;TI country,which ar~owned at the time of death;all wearing apparel,jewelry,silverware,pic-
tures,books,works of art,household furniture,horses,carriages,automobiles,boats,and any and all
o tiler personal chattels o~whatsoever kind or nature,left by decedent,together With the fairly estimated
markpt vallie thereof';all bonds and mortgaf(:es held by decedent and of all claims due and oWing decedent
,1 t the time of neath,and all promissory notes or other instruments in wri ting for the payment of money
of VIII i ell itecedent (lied possessed,of whatsoever nature,wi th interest thereon,if any,giving the face
value anrJ.estimated fair market value thereof,and if such estimated fair market value be less than the
face vahle,it sets forth briefly the reasons for such depreciation ·as to each item;all moneys payable
to the estate from life insllrance 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 stocks and dividends
due thereon and unpaid as of the date of death,bonds and accrued interest thereon to the date of dece-
dent's death and other investment securities owned by the decedent ~t the time of death,with the market
value thereof at such time.
....-
In the case of securities of close or family corporations,the values reported are as far as
possible substantiated by financial statements of the corporations,showing the assets and liabilities
thereof as of the'date of death.The schedule also sets forth the interest of decedent at the time of
death in any co-partnership or business,and in support of the value of such interest there is annexed to
said schedule,financial statements sho'H!ng the assets and liabilities of said co-partnership or business.
A copy of the co-partnership agreement,(if oral,a statement setting forth the nature of the agreement)
together with a statement setting forth the character of the business,its location,and such other facts
pertaining to the business as may be pertinent to a fair and just appraisal of the decedent's interest
therein must be submitted.It should also set forth in He.mized fo.rm,together with the fair marl<:et value
thereof,any other property owned or bequeathed by the decedent at the time of death.
The Schedule C attached hereto and made part hereof sets forth a true answer to each inquiry
contained therein and in the case of transfers ofproperty,real or personal,within two years of decedent's
death,in contemplation of decedent's death,or intended to t~ke effect in possession or enjoyment at or
after death,said schedule sets forth the nature and value of such property,to whom transferred,the
relationship of the transferees to the decedent,the proportlonate share received by each transferee and
all other facts of a pertinent nature regarding said transfers.In the case of transfers intended to
take effect in possession or enjoyment at or after death,there is also attached to the schedule a co~y
of the deed,trust agreement or other instrument creating the trust.Ther.~is also set forth in said
schedule a list of all property,real and personal,with its value,which passes at decedent's death by
virtue of the exercise by decedent,either individually,or jointly with another,or any power of appoint-
ment vested in decedent,either individually or jo~ntly,by the will,deed,or other instrument of another,
with a copy of t~e instrument creating such power attached to the schedule.
That Schedule D attached hereto and made part hereof sets forth the names and addresses of all
persons beneficially interested in this estate at the time of decedent's death,the nature of their res-
pective interests,their relationship,if any,to the decedent,together 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 unpaid at time pf
~.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.
"E",and "F"as directed therein,·
r
"e",That
have
the totals of the appropriate columns in Schedules "A","B",
been carried forward and properly registered in the Summary.
~'t!Subscribed and sworn to before me this .
'>...r:::..'Z day of ·············~······f19.99 t.Iddt?~M..~.._.._.i!!f::~:f~'~t~~.~GRAY N;~;;;~:~~!!~EQ;~;;~.._
c~n()'s~I-!(:&:·washinlton Co.,I'a..~~.~.~L ~.~..~..
My Commission Ex~ires September 19,1970 (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.
R6oc-34 (Hj4)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE."A"
REAL PROPERTY
Real property in Pennsylvania,with statement of mortgage encumbrances upon each parcel at death of dece-
dent.Where property held as joint tenant or tenancy by entireties,report on Schedule "E".Property ht:'ld by
thede.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 Commo!,!wealth of Pennsylvania should be (1)(2)(3)I
described by lot and block number,street and street number,together wi th DEPARTMENTageneraldescriptionoftheproperty,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 writeofdecedent.Taxes,assessments,accrued Interest on mortgages,etc.,are DEATH In this space)to be listed on Schedule "F"and must not be deducted from this schedule.
None
,.
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
-
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "n"
PERSONAL PROPERTY
INSTRUCTIONS:This Schedule must disclose all tangible and intangible personal property owned individually
by the decedent,at the time of his death.Property owned by the decedent jointly with another or others
must be listed under Schedule "E".Inta~gible personal property,titled in the name of the decedent,but
payable at death to another or others,including but not limited to P.O.D.U.S.Savings Bonds and tenta-
tive trust accounts,must be listed,despite the fact that they are not of the administered estate.
Tangible personal property should be listed first (e.g.jewelry,wearing apparel,household
goods,and fUrnishings,books,paintings,automobiles,boats,etc.)
Intangible personal Tll'operty,such as bonds,treasury certificates,cash on hand and in bank,N .
stocks,'mortgages,notes,together with accrued interest or dividends,salaries or wages,insurance pay-
able to the estate or fiduciary in said capacity,partnership interests,interest in anyundistributed
estate of or income from any property held in trust under the will or agreement of another,even though
located outside of the State,at the time of death,should be listed in this schedule.
Item
No.
ITEM
List and describe fully
UNIT
VALUE
ESTIMATED
MARKEl'VALUE
DEPARTMENT VALUATION
(Do not write in
this space)
1
2
Savings Account No.5646 in Mellon
Bank in Canonsburg,Pa.in the name
of John A.Belleno
Checking Account in Mellon Bank in
Canonsburg,Pa.
..
107.43 ~,
Insert this total opposite "Personal Property",Schedule "B"in
the "As Reported"column on the last page of this return.
x X
$.11se46:.79
I~f?!-Sl
11,r.:~InEXT DECEDENT
COmlO\T?\LTIl OF PF~N~YLY..1.NIA
Tll\NSFFH.INHElUTANCE TAX SCHEDULE "e"
TRANSFETtS
,.-..;.RCC-32
(1)Did decedent,within two years of death,make any transfer of any material part of his estate,without
receiving a valuable and adequate consideration therefor?(Answer yes or no)no
(2)Did decedent,within two years of death,transfer property from himself to himself and another or
others (including a spouse)in joint ownership?(Answer yes or no)......n...,ou-_
(3)If the answer to (1)or (2)above is in the affirmative state:
(a)Age of decedent at time of transfer _
(b)State of decedent's health at time of making the transfer.(Note 1).
(c)Cause of decedent's death.(Note 1).
(4)Did decedent,in his lifetime,make any transfer of property without receiving a valuable or adequate
consideration therefor which was to take effect in possession or enjoyment at or after his death?
(Answer yes or no)no
(a)Was there any possibility that the property transferred might return to transferer or his
estate or be subject to his power of disposition?(Answer yes or no)__
(b)What was the 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 expressly or impliedly reserves for his life or any period which does
not in fact end before his death:no
(a)The possession or enjoyment of or the right to income from the property transferred?
(Answer yes or no)_
(b)The right to designate the persons who shall possess or enjoy the property transferred or
income therefrom?(Answer yes or no)_
(6)If the answer to (5)(b)above is in the affirmative,state whether the right was reserved in decedent
alone or others --:-_
(7)Did decedent in his lifetime make a transfer,the consideration for which was transferee's promise to
pay income to or for the benefit of care of transferor?(Answer yes or no)no
(8)Did decedent,at any time,transfer property,the beneficial enjoyment of which was subject to change,
because of a reserved power to alter,amend,or revoke,or which could revert to decedent under terms
of transfer or by operation of law?(Answer yes or no)no
(9)If the answer to (8)above is in the affirmative,was the power to alter,amend,or revoke the inter-
est of the beneficiar1rr reserved in th~decedent alone or the decedent and others?
(Answer yes or no)o __
NOTE 1:The answers to these questions should be supporten.by affidavit by the atten<Ung -physician as
well as a copy of the death certificate.
NOTE 2:If answer to any of the above questions is yes,set forth below a description of the prcperty
transferred,it's fair market value at date of death,dates of transfers and to whom transferred,with
relationship of transferees to decedent,if any.Submit copy of any trust deed or instrument,if trans-
fers are claimed to be non-taxable,also submit detailed statement of facts on which said claim is based.
NOTE 3:List applicable property below in manner in which provided in Schedules A,B,or E.
ITEM DESCRIPTION MARKET VALUE
(Estimated)DF2T.VALUATION
(j)<>pt.Only)
None
__-J--'----'-.....
Insf!rt this tof,fd oppos1.tf!"Transff!rs",Schedule "C"in the
"As Reportf!rl"column on the last page of this return.
..~R@C~37 •(12-63)
COMMONWEALTH OF PENNSYYLANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
...'"
SCHEDULE "0"
BENEFICIARIES
(
h
BENEFICIARIES AND ADDR'ESSES '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
David Belleno
805 2nd St.,Canonsburg,Pa.Grandson yes $500.00
Mary Rubis
152 Main St.,Muse,Pa.Daughter yes 1/6th of residue
Hazel Cassidy
152 Main St.,Muse,Pa.Daughter yes " "
Alberta Petronie
176 Orchard St •.Muse.Pa.Daue-hter ves 'If "
Mildred Cristner
74 Locust St.,Muse,Pa.Daughter yes ""
William Belleno
Main St.,Box 1 ~3,Mus e , Pa •Son yes " "
George E.Belleno
IVlaln I::>"t.,IVluse,l'a •11::>,0n yes ""
(
-
Deponent further says that all the above-named beneficiaries are liVing at this time except below:
NAME DATE OF DEATH RESIDENCE
none
(Executor-Administrator
must complete "As
Will t T II Reported"column #1.)
'I ...No.Year.,-c mInistration
II C1 ...,'"0 ::0
........Cll Cll
r."THE II ~§0;;1 e:..til til...,Cb'~'"0~IATTER OF THE APPRAISEMENT II ~;;1 -.g
~'"0 Cll0""........
.OF THE I I (0 .g ~
trl ~ESTATE OF II~~~....
II Cll
John A.Belleno a/k/a
John Belleno Deceased
Late of....Cec:i).,':['()wIl$hip
\'\....
W .~County ofashlngton.~
~
Commonwealth of Pennsyly"ania_•g;
en 'i ........................0<<......<.0 ~~~
---#'ItJ -r\...--~()()()>~~~~~
RieqffG'"")ltC;;AND fipti\IsAL ri ;,;~
::;.{l}1'1'==•"'--l ,;"i lC;)rn r~-t="~;;Ur 0 II ~~-<n~~~
;;:w C1 _..-a '!II...-on ~',..~;~:
C).;};-:::r :1-':1-'::>o :::f;u ;.:",til:r:::-:~Z :~z ~----"'Or-o ~0 :~O '0 ~"f'"(/)C):~;:l:~:;:l Qc;n ,.(1):.(0 it II .,
":'1 c...~:~
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"'-S:~
DEDUCTIONS ALLOWED INFormRCC·10-RI
J 7-~1J Y-7
OFFICE OF THE
REGISTER OF WILLS
OF Washington COUNTY
/;,~-~r-O'?C/
STATEMENT OF DEBTS
AND DEDUCTIONS
J
THE SUM OF $4 ;t...~..qf
DATE APPROVED //::.-d.i=..~t
~~~
Regiller of Willi.Age~.
ESTATE OF John A.Belleno a/k/a Cecil Township
LATE OFJohnBelleno
2-/.3-(,,[DATE OF FILING APPRAISEMENT DATS OF DEATH March 14,1969,
DATE NO.OF NAME OF PAYEE REMARKS AMOUNTVOUCH""
William Belleno Executorts Commission 580 00
Sollonts Funeral Home Funeral bill 1795 50
Dr.Wilson Doctor bill 7 00
Dr.Inghram Doctor bill 65 40
Dr.Pizzi D.octor bill 9 00
St.Maryts Church Grave Opening 165 00
Citizens Water Co.Water bill 90 69
Register of Wills Probate 20 1)0
Register of Wills Fil.Inh.Tax Return 3 00
Richard DiSalle A.ttorney fees 600 00
Janet Scott 'Witness fee 5 00
Total ~3341 09
I!
I
COMMONWEALTH OF PENNSYLVANIA }ss:COUNTY OF Washington
I,WiJliam BeJJeno HEREBY CERTIFY.THAT.TO THE BEaT OF
MY KNOWLEDGE AND BELIEF.THE FOREGOING IS'A JUST AND TRU E STATEMENT OF DEBTS.FUNERAL EXPENSES AND EXPENSES OP'
ADMINISTRATION SUBMITTED TO THE ESTATE OF John A..Bellteno DECEASED.AS DEDUCTIONS FOR
INHERITANCE TAX PURPOSES..J/~/·&.,IdILa~;deLI'~(L.S,)
S~NAN~UB •BEFORE ~THIS ~DAY 01'
I.r~+Nit<.JI I '/l.v ~./
~:~./7
\.::;i:~:R~~1;'.':rff~S'M,GRAY,Notary Public
·r,:.~G~J:l.n~butl,W<lshinlton Co.,Pa,
I ,..ty,':CQ.ifjmtt~n Expirei Sepwmbir 19,1970
~,
r
911 1 \ttl f,l 9,O~16.9~
40 3 -~\.:\
-------------------------------------------------
~.
RCC-BI (2-64)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
INHERITANCE TAX DIVISION
NOTICE OF FILING OF APPRAISEMENT
WILLIAN:BEILENO
(Executor ~).
IN YOUR REPLY PLEA8E
REP'IER TO
37-208-9
I
In Re:Estate 0 f J_O.....;HN__A.....;o--.,;.B.....;EL--.,;.LEN_..:..O _
_____W'-A_S:..:.H:.:::IN=.:....:..G'ID.::...:...:N~County -File No.63-69-474
Dear Mr.Be11eno~
You are hereby notified that the original
appraisement in the estate of John A.Bel1eno
has been filed in the office of the Register of Wills qf Washington
County on August 13 ,19~.Said appraisement reflects the
following valuations:
Real Estate _
Personal Property ~1~1~.~8~7~7~o~5~7__
Transfers _
Total ---IJ....J+•.l.J.87+.7+......5.L..j7r....-_
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 A_ug-'='-u:s_t----'13:;..,~1-'9_6...:.9 _
DATE OF DEATH:March 14,1969
Note:This is not a bill.
RC"'C-39 (5-68)
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SUMMARY
Estate of BEI.IENO~
(Last Name)
JOHN
(First Name)
A.
(Initial)
DATE OF DEATH ~14-69 FILE NO.63-69-474
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".
~G:?7f2~iNHERI ANCE TAPPRAISER
08-13-69
03-14-69
Dated:-----::-::"~~~-----
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
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)
VALUE AS REPORTED VALUE AS APPRAISED
$$'--------4---li8
11 8
VALUE AS REAPPRAISED
$-------+--
CLEAR VALUE OF ESTATE
Valuation of life estates or
(*)As evidenced by Charitable
Exemption Certificates issued
by the Secretary of Revenue.
COMPUTATION OF TAX
$
r=.
$
$C
$
$------~-
$--------1--
$-------+--
$------.-....4--
$--------1--
$==-==~$-----~
$=====!:::==
20
6%'
o
10%
15%
*
___----11_
TOTAL TAX BALANCE :---_---l~..PAID $-1C
BALANCE OF INHERITANCE TAX DUE
Add interest at rate of 6%from_____to _
AMOUNT OF ESTATE TAX ASSESSED $------1
Estate tax paid $......1
BALANCE DUE
Add interest at rate of 6%from
------Ito-----
Less tax previously paid
BALANCE
Less 5%of tax if paid within
3 months after death
TOTAL TAX
FOR USE OF REGISTER ONLY
Tax on $---+__
Tax on $-----------+---l
Tax on $-----------+--Tax on $---+__
Tax on $---+__
Exemptions========I==Total Estate -I-__
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 (No.
IN THE
Year .
MATTER OF THE APPRAISEMENT
OF THE
ESTATE OF
.JOHN ..A•...BELLEON..
Deceased
Late of
County of
..CECJL 'IWT?.L
WASHJNOTON ..
Commonwealth of Pennsylvania
REPORT AND APPRAISAL
~.
"i-..t"
Form:RCC-2
~---
COMMONWEALTH OF PENNSYLVANIA DATE .........,......,.A.~.~l:I.~.....;Q..t .....:.!:.?§.9...............,.....
DEPARTMENT OF REVENUE RESIDENT INHERITANCE TAX ..................w..~~h.~~.g~2.~.................BUREAU 8F COUNTY COLLECTIONS "COUN1ZY ......."......
HARRISBURG,PENNA.17127 APPRAISEMENT FILE NO.........................63.=.6.9..=4.74.....................................
Whereas,........................................!J.9..hn...A,...Jl~l.J,.~.p..9..........................................................late of ............................Q.~9..~.+.....TwP.~..............................................
in the County of ...................................Wa~h.;j,ngt.o.n ..............................................................Commonwealth of Pennsylvania,having died on
the ......................................l4....t.h.......................................day of ...................Mar.ch........................................196.9.....,seized and possessed of an estate
i
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore,I,..............................:w.~.R.~.....C.t@n~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 transferinheritance,taxes at the lawful collateral rate on any such future interest.
Unit AppraisementDescriptionofAssetValuesMadeforInheritanceTaxPurposes
$
PERSONALTY :
Savings Account No.5646 in Mellon Bank in
-Pa in the name of John A.Be11eno 11.770.lk.
Checking Account in Mellon Bank in Canonsbure:•Pa.lO7.k.'3
11.877.57 11.877 1)7
".
"
'"
Total li,877 57
form~~v~~h~a~~:I:h~.w<>rn~e<:o~~~:~:;:re~..~;~~~~:~~i ...~~!
~;=;;::,;.~~~l.;~~;;...c:I"(Post Omee)
........................WA$HJ.NG1P..N........................COUllty
RESIDENT INHERITANCE TAX APPRAISEMENT
Estate of
......................JQHN A.~a.$.J.J..J.<;N.Q .
Deceased.
Late of
..G.;EG:q,'r.Wp..~.....
Date of Death,Ma.;rqh 1.4~:l,9.Q9 .
Appraisemellt Docket Vol.,37 ·..
Page,4.Q$.~.9 No..€>.~.Q.9::::.47.4..
Filed in Register's Ofjice,.Augu.st 13.,19.69 .
Amount of tax due,$.
DEPARTMENT OF REVENUE
Received,
Examined and Approved,.
Wrote abo.ut Appraisement,
Appeal jt-om Appraisement,.
Entered and charged,
r
~