HomeMy WebLinkAboutOC1969-0496 - ESTATE OF FALLGUISTjFormXo.neC-62 02-66)THIS FORM REQUIRED IN ALL ESTATES WITH GROSS ASSETS UNDER UO,OOO,UNDER SECTION 701 OF ACT OF JUNE 18,1981,
EFFECTIVE JANUARY I,1982.(FILE IN DUPUCATE WITH COPY OF WILL ATTACHED)..
..OFFICE OF THE REGISTER
~W!l.F;"~.r.l\~~qV~!'.'.!\q~;~~co~~tY.~f ::::::~::~~:;:~:~~~~~;.N'M..'f~l'.~~Y..~/'
(Name)(AddreOll)V'
being duly §~QXJL .according to law,deposes and says thatShe is the CQ_::Qwn§x _
(Exec.,Adm.,Legatee,Etc.)
F
______~~m_Q.n§J;m._:rg---------------------.deceased,and that the whole of the estate of said decedent,who died ~.I2*_i_(L_l)_~l..(City,Borough or Township)Date
~~~
REAL PROPERTY
REAL PROPERTY IN PENNSYLVANIA,WITH STATEMENT OF MORTGAGE ENCUMBRANGES UPON EACH PARCEL AT DEATH OF DECEDENT,
WHERE PROPERTY HELD AS JOINT TENANT OR TENANCY BY ENTIRETIES,GIVE NAMES,ADDRESSES Aim RELATIONSHIP OF OTHER OWNERS.
Real Estate Estimated
Value
NONE
Personal Property
NONF.
<>'.'
--
-
>.--
NOTE:You may expedite the processing of th~s 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.
i
#,i
i4
~i
Jointly Held Property Estimated
Valut!
Savings account No.5614 in Mellon Bank at Canonsburg.'In names of '.Mrs.Frances E.FallquiJst or Florence Fallquist Kosovec.Account
made JOlnt on November 15,.1961.Total amount on AprJ:l.'l.,'l.~b~was -
$5783.29.One-half.•....... ......... .. . ....2891.65~
Mellon Savings Certificate No.02184 in the names of Mrs.Frances E.
Fallquist or Florence Fallquist Kosovec.Made joint on February 13,
1963.Total amount on April I,1969 was $5 000.00.OnA-hrll f •••2500.0~
Checking account No.602-7458 in Mellon Bank at Canonsburg.In name~
of Mrs.Frances E.Fallqulst or Florence Fallqulst Kosovec.Account
made joint on December 16,1963.Total amount on April I,1969 was
$118.14.One-halt.. . .. .. ..... . .. .. ...... ..5~.UIm••
-Christmas Club in Mellon Bank in Canonsburg.Total amount.. . . .25.00
5475.72
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
MAllon Brmk -Canonsburo Decedent and d .,
her d;:mohter
-
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,contingentor otherwise,in estate.)are involved,set OR NO AT DEATH OF IN ESTATE
forth this fact.)DECEDENT
Pl Pi'll 1 rIll;st Kosove~d;:mohter ves Total
31 Aldrich Drive
Farminqdale N.J.
-
RCC-43 (5-65)
COMMONWEALTH OF PENNSYLVANIA RECEI"
DEPARTMENT OF REVENUE COUN tUREA tED
HARRISBURG )'COL LED[
AprU 2•.1969 .kJt 9 8 r,O/{S
57AN 'Eg
NOTE:TO BE SUBMITTED IN TRIPLICATE 1~(p 3 ~7
37·.;2./(p -.:;)
Pennsylvania Department of Revenue
Bureau of County Collections
26 S.4th Street
Harrisburg,Pennsylvania
Dear Sir:
Pursuant to Section 742,Pennsylvania Inheritance and Estate Tax Act of 1961,\
we herewith submit the following report:'
UutebbaGD Ball Apt.2-A,'CaD()Dsburg,1»8.1'311
DATE OF QJ=ATH -.:....!A~c:...=11:::....:.:2L..'..::1~96=-=9~~_
SURVIVING DEPOSITOR,
BENEFICIARY OR INVESTOR Florence 'aJJqu.i,\Ioso.veo
DECEASED JOINT DEPOSITOR,~
TRUSTEE OR INVESTOR 'nno.1 E.Fallq,l11sti V
AQDRESS
NAME OF REPORTING
FINANCIAL INSTITUTION HeUotl lIa'tlOl?Ql Bank it btlst ~mpag
ADDRESS '1 l~e&t Pike Street.Canonsburg,fa.1'311
ACCOUNT NO.OF JOINT,.'ChecJcUs ACcl't.#602..7M!t
.'TRUST OR'INVESTMENT DEPOSIT SaVings Aco't.I,MASU.Certttioote 102184
NAMES ON ACCOUNT E '-~
OR INVESTMENT 'l'8I1Ce&PallQuift,'..
'l:'
FloreDCe raUqu1st 1080".0 -c::::
,...,
I
ADDRESS
RELATIONSHIP TO DECEDENT_-...lDa=··=.D:h:.l!!t~.!l.....-_
,DATE'DEPOSIT OR INVESTMENT Cbecklng Acct.12..1~3 v,
,"wAs ESTABLISHED ,..hvtDge Mot.9-7.'1 v".SU CertUicate 2...1)00063
.BALANCE,INCLUDING INTEREST Ch~k1.Dg Acot.602-'14S8-tU8.U •
DUE,AT DATE OF DEATH $Sa"Aect."614-5,'183.29 Sa.,CertU1cate H0218~',OOO.OO(a •
TITLE
Date:__---=.:A:.t::p~rl=1!:--.:2=9..z,.,~1=-::9:..::::6:..::.9__
County __..-:W~A~Sl!!!{~I~N~G~T~O~~,,-,-_
OFFICIAL NOTICE OF INHERITANCE TAX
APPRAISEMENT AND ASSESSMENT OF
ASSETS NOT SU BJ ECT TO ADMINISTRATION
__C;;o.;;;;A!JONSBURG,PE1'f1fSYLVANIA 15317
TO:FLORENCE F4LLQUrST KOSOVEC
HUTCHINSON HALL API.2-A
County File No._
Bureau File No._
We have r':,.ceived notice thllt ~:xxxxxx:x:xxx~'tXXXXXXXXXX~o~n~$A~P~riii~.~~.~2~!iiPil~19~ibi~~y;0¥.u came into ownership of certain Q!operty throu.9h~~~~.transfer from FRANCl!iS E.FALLQUTsr-;-Deceas-ecr~----
RCC-134 (8-65)
COMMONytEALTH 01:PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
INHERITANCE TAX DIVISION
Under the Inheritance and Estate Tax Laws of the Commonwealth of Pennsylvania such transfers are taxable
and the liability for the payment of the inheritance tax due is imposed upon you,as transferee.
The property on which tax is hereby assessed consists of:Jt •.Bank Acets.(1,Cbecki ng Acct.
i602-7458 and Sav.Aceta.(2)#5614 held in the MELLON NATIo AL BANK,CAN-
ONSBURG OFFICE,CANONSBURG,PA.,.in the names of FRANCES E.iiALLQUIST or
FLORENCE FALLQUIST KOSOVEC.Opened (1)12-16-63,(2)9-5-51.ALSO Sav.
Certificate #88 02184 held in same bank,dated 2-13-63.Balance as of date of
death (1)118.14,(2)5,783.29 and Save Cert.$5 000.00.~praised by the Commonwealth,as of the date of death,at $10,901.43
o %of this amount is taxable at the rate of 6 %
ORIGINAL ASSESSMENT AMENDED ASSESSMENT
DATE OF ASSESSMENT
TAXABLE AMOUNT
LESS:ALLOWED DEBTS
NET TAXABLE AMOUNT
$5,450.72----=-----$---------
AMOUNT OF TAX DUE 327 ..04
o If you pay the above amount within three (3)months
of the date of death of the decedent,or on or
before July 2,19 69 you may deduct a
discount of 5%of the amount of tax due,or ____-16&.35 _
o This tax became delinquent one year after the date
of death of the decedent and,in addition to the
tax,statutory interest at the rate of 6%of the tax
per annum is also due as of *_
19 in the amount of
*1£the tax is not paid by the above date additional
interest is due at the rate of 6%per annum until
paid
TOTAL AMOUNT DUE
APPRAISED BY:__~--L~-=-=:"'--_--nt-:---
(Inheritance Tax Ap iser)
$327.04 $
ASSESSED BY:_...!'d:...==::::~='~..;4..t1.:::~le--c-)~7t:~.~t!11="""("::/-:;;;:~=:·:&::_=_=_=_=_·-
(Agent for the Commonwealth)
INSTRUCTIONS TO TAXPAYERS
Make checks or money orders payable to:To insure proper credit to your account
this Official Notice must accompany
your payment.Mai I or bring it to:
(over)
If you have already paid this tax to on executor,administrator,attorney or other personal representative of the
decedent for forwarding to the Commonwealth,list below the dote paid,nome and address ($f Ibe'ierson to whom
you mode payment,their official title and the amount."h
Dote Paid Nome and Address of Payee Official Title Amount Paid
Under certain circumstances,if,after the date of death of the decedent,you personally paid funeral expenses
or other just debts of the decedent,with funds derived from the property herein taxed,such amounts expended
by you may qualify as deductions against the gross value of the property in the computation of tax due.If any
such expenditures meet all of the three following tests,it is recommended that you itemize the payments below,
execute the affidavit,and return this notice.The Register of Wills will examine the debts claimed and allow
those which he determines to be proper.The tax will then be recomputed and you will receive an amended
assessment of tax.
THE THREE TESTS WHICH MUST BE MET ARE THAT:
1 -You were personally legally responsible for these debts,and
2-You actually paid these debts out of the account or property described above and can furnish proof
of such payment,if required,and
3-These some debts are not also claimed,for tax purposes,by an executor,administrator or other
personal representative of the decedent handling the administration of the general estate of thedeced~nt or any other transferee.
SCHEDULE OF DEBTS
Dote Paid Nome of Payee Description of Obligation Amount Paid
TOTAL $
(attach separate sheet if requ ired)
COMMONWEALTH OF PENNSYLVANIA)
COUNTY OE _
SS:
I,hereby certify that the foregoing is a just and true statement of
funeral expenses and other debts of the decedent,,for which I
was legally responsible and which I did payout of the property herein taxed.I further certify,that to the
best of my knowledge and belief,these some debts will not be claimed by any other person,for inheritance
tax purposes.
SWORN AND SUBSCRIBED BEFORE ME THIS DAY OF____________19__
REPORT OF REGISTER OF WILLS
Si gnature of Taxpayer
I,the undersigned,duly elected Register of Wills in and for the above county,do respectfully report that I
have allowed deductions listed above in the total amount of $•
Date of Approval:_
Register of Wills
_.-----------,J
RESIDENT DECEDENT
!
DEBTS AND DEDUCTIONS CLAIMED
NOTE'List first five items in the spaces so provided,observe notations thereon,and instructions
Funeral expenses paidSollonFuneralHome
.---=D:..::E:.:B:...:T=--.::O:..:R.:........::C:..::L:.:::A:.:I.:::M:--_._-----,-..---=.:.N.:::A:..:T:....:U:...:R:.::.:E=_O:..:F=----.:S:.::A.:..:M=E_.__-"-_---r_.:::A=.::M.:::.:::O.=U.:::N:....:T::.,--tRTHIS COLUMN
J.I~EGISTERONLY
$1114 25 $
Family exemption (will not be allowed unless
decedent died residing with a spouse or children.)
.,r
Administration Expenses *
Counsel fees *
Fiduciary commission *
OTHER DEBTS AND CLAIMS
(*)See Note below
P ike Pharmacy
J.S.Biesenkamp,M.D.
Bell Telephone Co.
Oak Spring Cemetery Co.
Meyer's Market
Mapleview Apartments,Inc
West Penn Power Co.
Register of Wills
Drug Bill
Doctor Bill
Phone Bill
Opening &Closing grave
Food Bill
Rent Due
Electric Bill
Filing Debts &Deductions
49
178
4
75
2D
87
5
3
D~
DC
7E
DC
2::;
DC
55
DC
Total 1536 8E
.Farmingdale ,..N•..J .
(City or Town and State)
.31.Aldr.icb..D.ri ve .
(Street Number)
~~4~T -m~.
0-ner
Subscribed and sworn to before me this ~.~;r:<;:i .
Note:The estate agrees to advise the Register of Wills if the amount actually paid in settlement of any fee,commission oi'debt is greater
or less than the estimated amount claimed and allowed.
Having been duly swom accOl'ding to law,I }o hereb.y certify that the above appraisement i~ade in conformity with law on this...................c;,...U.dayOf ~~,19..'2 /?~
...J ~4:.......~.....~Ap .er
In the event that any future interest in this estate is transfel'l'ed in possession 01'enjoyment to collateral he's of the decedent after the
expiration of any estate for life or for years,the Commonwealth hereby expressly reserves the right to appr . e and assess transfer'inheri-
tance taxes at the lawful collateral rate on any such future interest.
REPORT OF THE
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 amo s claimed by deponent pt as to those items where a greater or lesser amount
is set fort~in the last column to the right in said schedule above,which greater or I er amount rr?ts the sum allowed as a deduction.Dated:~~~../P~/............f~~/h~&.C(')J Register of Wills
Il
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Fonn :\0,RCC-62 (12-66)
WillAdministration };No Year ..' .
\"
IN THE
MATTER OF THE APPRAISEMENT
OF THE
ESTATE OF
.~~~..~~l\)~~9~R .~.•..¥M~QlP:;3.'~.....
Deceased
Late of .CanQ:(l~;Q\J+.g .
County of .~C!-~~.~I!9.t:on..................
Commonwealth of Pennsylvania
REPORT AND APPRAISAL
S11/fA ;10 ~31Sm3ij
ONiHV'£.J 113SSn~
9r :£:Wd EZ HeN 6961
031[:3
~
...'.
R CC-81 (2-64)
COMMONWEALTH OF PENNSYLVANIA
.DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTION'S
INHERITANCE TAX DIVISION
NOTICE OF FILING OF APPRAISEMENT
FLORENCE F.KOSOVEC Informant
IN YOUR REPLY PLEA8E
REFER TO 37-216-5
J
In Re:Estate of -:MRS=::..;.:......;:F..::;RAN=..:::CES=-...:E::.:·.;,...F::....:.:ALL=Q..::,U::.:I::.:S:..,:T=--_
_____W.:.::A=S:=.:H=ING~T:.::.O:.:..N C t F'1 N 63-69-496ouny -1.e o._
Dear MrS.K050vec:
You are hereby notified that the original
appraisement in the estate of Mrs.Frances E.Fallguist
has been filed in the office of the Register of Wills qf Washington
County on May 6 ,19 69.Said appraisement reflects the
following valuations:
Real Estate _--'-_
Jt.Held ~'--__....5:.L.=47.1...<5!...:.~7:::.2 __
Transfers ---,__
Tota1 --<t!.5~.:t.47.L..5~.u7..:::2~_
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 .:.:Ma::::.Ly.....:6=..1L....:l :.!.9..=.6L..9-----Slgney&/~f4 ¥~
Title W.R.CHANEY,CH PRAISER
DATE OF DEATH:April 1,1969
Note:This is not a bill.
;.
RCC-39 (5-68)
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SUMMARY
Estate of FALLQUIST,FRANCES
(Last Name)(First Name)
E.
(Initial)
DATE OF DEATH_~4--:.1=---=6~9__FILE NO.63-69-496
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 itern in the last column to the right in Schedules "A","B", "C",and "E".
05-06-69
04-01-69
Dated:--_....:=...<'---'=--=-~'--------
REPORT OF THE REGISTER OF WILLS
I,the undersigned duly elected Register of Wills in and for Washington 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.~._C2.
Dated:05-06-69 I ~y-/~~&/O
IREGiSTER OF WILLS
VALUE AS REAPPRAISED
$-------+--
1:i ..h7'i 72
5,475 72
1,536 86
3,938 86
$
;z-5 ~4'(')
5.475 72
1,536 86
3.938 86
VALUE AS REPORTED VALUE AS APPRAISED
$
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 $------='""""'="=-:::"--+':%"7"-
Tax on $-----""".L.-<.O<""::'-----4.::..::..-4
Tax on $---------+--
Tax on $-----------4--10%
Tax on $15%
Exemptions *
Total Estate ~--
TOTAL TAX
COMPUTATION OF TAX
$--------...........---4.......-$2...:::.....3-+..:..::....."13_
$--------+---
$_._------+---
$---------4--
$------_....1.-_-
(*)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 $t=
Add interest at rate of 6%from
to ---~C$----AMOUNT OF ESTATE TAX ASSESSED $.
Estate tax paid $I
BALANCE DUE $.....JL-
Add interest at rate of 6%from
to $-~t=TOTAL TAX BALANCE $-----~.PAID $.....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 !...No.AdminIstration
IN THE
Year .
-----1
MATTER OF THE APPRAISEMENT
OF THE
ESTATE OF
MRS.FRANCES E.FALLQUIST
Deceased
Late of .
County of
CANONSBURG
WASHINGTON
Commonwealth of Pennsylvania
REPORT AND APPRAISAL
,
p.
~"'~~
(...~DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS•
HARRISBURG.PENNA.17 127
COMMONWEAL1'H OF PENNSYLVANIA
RESIDENT INHERITANCE TAX
APPRAISEMENT . •
DATE ~..§.I...~.:.L..~.~.?..
COUNTY W~.l?h.~.~gt.~~.
FILE NO 63-:::..6.9.-=:.4..9..9..
E F II .t
formity WIth law on thIS ..
Whereas,....................N:r..~..,.....f.;r.~P.:~.~.~.........~.........~.......q~.~.............................................late of ........................................9~9.I:l~.Q.~g ....................................
in the County of ...........................w.~~h;Y:lg.~9P.:.......................................................................Commonwealth of Pennsylvania,having died on
the .........................;J"....~~..................................................day of ....................Ap;r.i.l......................................19..?9....,seized and possessed of an estate
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore,I,................................W~.R.~.....c..b.a.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 transfer
inheritance taxes at the lawful collateral rate on any such future interest.
Unit Apprallement
!Delcrlptlon of Allet Valuel Made for Inheritance
Tax Purpoles
$
JT.HELD:
Savi.nR:s Account in Mellon Bank at 6anonsburg.In
names of Mrs.Frances E.Fallquist or Florence Fallquist
KOlJovec.2,891.65
Mellon Savings Certificate in the names of Mrs.Frances
E.Fallquist or Florence Fallquist Kosovec.2,500.00
Checking Account in Mellon Bank at Canonsburg,In
names of Frances E.Fallquist or Florence Fallquist
Kosovec.59.07
Christman Slub in Mellon Bank in Canonsburg 25.00
5,475.72 5,475 72
Total 5,475 72
Having been duly sworn according t law,I do hereby certify that the above appraisement is made in con-
·.....WA$!.'tWG'I.'QN.County
RESIDENT INHERITANCE TAX APPRAISEMENT
Estate of
MRS.FRANCES E.F ALLQUIST......................................................................................
Deceased.
Late of
CANONSBURG..............................................................
Date of Death,.J.\Pr..~,:J,.)..,.J,9q.9 .
Appraisemel!t Docket Vol.,,).7 ..
Page,?~.?:?No....~~-::~§?~.4.?§.
Filed in Register's Office,~§,19..Q.9..
Amount of tax due,$..
DEPARTMENT OF REVENUE
Received,
Examined and Approved,.
Wrote abo,ut Appra.isement,
Appeal t,om Appraisement,..
Entered and charged,..
..