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Home My WebLink AboutOC1969-0825 - ESTATE OF BRENKUS.'RCC-39 (&-68) COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SUMMARY Estate of BRENKUS,JOHN (Last Name)(First Name) C. (Initial) JATE OF DEATH 5-1-69 FILE NO.6.3-69-825 REPORT OF INHERITANCE TAX APPRAISER I,the undersigned duly appointed Inheritance Tax Appraiser in and for the County of Washing*on 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". 10-24-69 05-01-69 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 b~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 dedu.ction.~vh_\ Dated:10-24-69 .--/"/7~ REGISTER OF WILLS VALUE AS REAPPRAISED $-------+-- u-r4 12 .34 2,138 63 Insolvente 12 34 12 34 2,138 63 Estat VALUE AS REPORTED ';ALUE 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 $----------1--2% Tax on $@ Tax on $5% Tuoo$lK Tax on $15% Exemptions * Total Estate -+-__ TOTAL TAX COMPUTATION OF TAX $--------+--- $-------l-- $--------1--- $--------+-- $--------+--- $--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 $.---J AMOUNT OF ESTATE TAX ASSESSED $~I_ Estate tax paid $---Jl- BALANCE DUE S ----.JL- Add interest at rate of 6%from -----....(tIO-----S --------1t=TOTAL TAX BALANCE s ---__~. PAID s __-__...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 t No.Year . IN THE MATTER OF THE APPRAISEMENT OF THE ESTATE OF JOHN C.BRENKUS Deceased Late of .. County of McOONALD ! WASHIW'ION Commonwealth of Pennsylvania REPORT AND APPRAISAL .~':-.......... " II ,of'. '.' .. -'j " " •t 'I IN YOUR REPLY PLEA•• RE"ER TO ."6'7-242- ESTATE INSOLVENt' CLARA BRENKUS (~w.Administrator). COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE· BUREAU OF COUNTY COLLECTIONS INHERITANCE TAX DIVISION NOTICE OF FILING OF APPRAISEMENT Estate 0 f -,:...J:....O:..;HN.;:..·.:........;:O...:..--::.:BREN:;:.::::·;;.:KUS;;.:·:::'_ _____W_AS-=·:....:H.;;.;;ING1'O::;,..';'::':...::'.:.;1:;:.:'County -File No. October 24.1969 Real Estate Hel~.l!ICi~....;12~·=..'....3!:l4~_ Transfers ----.~""'"'-.....,...-_ Tota1 -,:....=1:=2:.:,.::.34:::---- Any party in interest who is aggrieved by an appraisement may therefrom as provided by law. Jt. In Re: .., t Ie '>appeal ! Inate i~ lDATE OF DEATH:'May 1,1969 I't··rriI.t:f Note:This is not a bill. f't..~'.'I'i.~.lJ~f!\~\i!~ar Mrs.Brenkulu ~..You are hereby notified that the origlDal ?ppraisement in the estate of John O.Brenku8 lhas been filed in the office of the Register of Wills qf WaeMngton I,county on October 24 ,1969.Said appraisement reflects the .following valuations: [: tl>'. tit!t I .I As to such tax that is paid within three months from date of j f''death'a five (5%)percent disc~unt L:;allowable.As to any tax that . ·..remainS unpaid after one year from daJe of death,interest at the rate ~f six (5%)percent per annum is char~ed. ~.. ~- ~--------------------------- Fonn RCC-2 I COMMONWEALTH OF PENNSYLVANIA DATE Wctober 24 1969..........................................................".............................................DEPARTMENT OF REVENUE RESIDENT INHERITANCE T,A]{.............~~.~~.~.€;~.~~.......................................,.COUNTY•'BUREAU OF COUNTY COLLECTIONS HARRISBURG,PENNA.171 Z7 APPRAISEMENT FILE NO.............................§,?:,~,?:,~,?,...............,............ Whereas.,........,"',.....,'~.9.~"',9.,~",..~~~~~,~"""',.....,..,'",...',..",'...,....""......,.....................,..late of ..,.........,...,',..........M.~P..9.A~J:(:i................,........,...,..,',........,,..""" in the County of ........................,"',.,"',W~.!?b,IDg.t~.QP..........."..................,.........""",.."""""......:Commonwealth of Pennsylvania.having died on -~19....~~..,seized and possessed of estatethe....",.,..,.....""""..,....,l",s.t,...,....,.....,.........................,......,day of ,...................,..,......-.......y,.."""..".....""",...........,an subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore,I,........,...,.....................w.",R""...,C..han..~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 transffrred 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 AppraisementDescrlpllonofAssetValuesMadeforInheritanceTaxPurposes $ JT.HELD: The Union National Bank of Pi~tsburgb Checking Account $73 705 150 with mother Clara Brenkus.12 34 - 1 ~- - I I Total 12 34 ESTATE ~SOLvmT form~;V:~hbl:~::rh~w~,di:Jt,t,o .~~~: I..!W..""."...·~::;'::Z~~~,),.............................,Penna. WASHINGTON County RESIDENT INHERITANCE TAX APPRAISEMENT Estate of JOHN..C~:e.m~~:t'JJ{JJ$........ Deceased. Late of McroNALD..............,..,. Date of Death,~J..:.I.1.:9..§9.. Appraisemcl!t Docket Vol 37.,. Page,?4.?~§No..~?~.~'r:~.??.. Filed in Register's Office,....2~~1:>.~~....?4.~9 ....~?. Amount of tax due $J ..••••••••••••••••.•••••.•••••.•••••••.•••••••.•••••••••••••••••••••• DEPARTMENT OF REVENUE Received, Examined and Approved,.. Wrote abo.ut Appraisement, Appeal f,.om Appraisement,-. Entered and charged,.. "t '..)' .. FORM 67 REV.1-50 REG.WILLS i\ppiirution for i4rttrrs nf i\~tttinistrutionon thr ·......."\. ;, J Estate of.~.9.P.:~9...~~.r..~E:.~~on·. late of ~.~p.9..~.~..~.~~~..~_ ,Deceased. Before the Register of Wills of Washington County personally appeared :.:.:.'.;;:.9.J.~.~.~~!'.~.~:~.~.. .John C.Brenkuswho,beIng duly sworn deposes and says that.. age ?.~,having ~.;.~last family or principal residence at 4.1.~Y..~!.~.~.1.~.~.~.~.~.~".. (Street and Number) ........~~.?~.:~.~.~.~.~~.~..:,Washington County,Pennsylvania,died intestate (City,Borough,Township)at...9.~£J..1 r;r.~..~~9.~.~.~?~g ,on th~~.~.!tlay of ~.~¥... A.D.,19 ~.9.,at.....~..~.!.9.p...~.~.~~.~.~..~.~.M.;possesseq.of personal estate to the estimate<t value $N.Qn.~,and of real estate in theComnonwealth of Pennsylvania to the estimated value of $N.Qn~,sit~ate in .. .........................................................~••••••••••••••••••••~:••••••••••••••••••••••••••••••••••••••••,u ••••~.. The names and addresses of the decedent's ;mrviving spouse (if any)and other heirs including heirs by adoption)are·as follows. REI,ATlONSHIP •It:l<JSIDENCE Clara Brenkus Mot1:.er 18 Valley st••McDonald.,'Pa.·(fh·ari·e·s J~·Bre·nkiis..···· ···..·F~·tt.;:~r ·..s·ame ·· · · ·..·..·· . .....................~~~. ................................................................................................................................................................................................................................................. ::::::::::::::::::::::::::::::::::::::::::::::::::::::I::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::.1::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::.:::::::::::::::::::::::::::::::::r::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: I . That deponent is over 21 years of age,resid~s at...41..e.Y.~Jl.~.y.@J!.;r..~.~~. McDonald,Pa. is a citizen of the United States and a resident of Pennsylvania,and respectfully applies for Letters of Administration upon the Estate of said decedent,:10 letters having been previously issued thereon. Sworn and subscribed before me this.........~.$..~~...... day of...~~~.l.,A.D.,19 ?.~. .............~~/l)..~. REGISTER COMMONWEALTH OF PENNSYLVANIA }SS: WASHINGTON COUNTY, And now J.y.ly.J.5.,19..9..9._.,comes Q1~.r..!!~!:~9.~~.~.. who being duly sworn doth depose an?say that...~..l~will well and truly administer the goods and chattels,rights and credits of J.'.Qh~Q..,~.;.~~.~~,deceased, to the best of..~.~.~......skill and judgment in strict compliance with the laws of this Commonwealth,mind- ful of the laws relating to inheritance taxes. Sworn and subscribed before me this.........J2.~h ...... July 69dayof,A.D.,19 ". :::·.::::::::s~::::::::m::::~:: REGISTER :0.,.. ....f:"U'lI .............~.,~ /"'-'-, .~ " ::/fd 3/1A63.·-G~-tJg~r .J' APPLICATION FOR Letters of Administration ESTATE.OF' John c.Brenkus Deceased Extra Alias $............................................ Certificates ./.,./.~$:.:..~..~.. Renunciations·,$. ""II '+~~"?,:;.~4i :E;:o ~q .........................~•••I:1:l ;r}.......................$...". (f.)~c:c.........,..-([)c::........................:::S0 <r"r:::::..';";::;['1:",!P;"!;~i//~~I.;J .',r--:---.~'"(I...~)FJ~.j ·71 r-c.n tyTotal.,.~:~;..~c:)',_tr1 G'-j ......~"-"'0-':";' o=iE ::::.r ;r--"'Q,....~ l>"c-")0 ....................................................................................................... Attorney ., I, Ii' \c j)1f7.~.:3 B15. ~2 1}./~5 1Knom 1\11 flrn iy IDl1est 'resents Estate Of.........~~~!:1.......~..~.....~~.~~.~!.....................................}N f 19McDonald,Pa.·0 0 ..late of ,Deceased KNOW ALLMEN BY THESE PRESENTS, That we,g..~~.~.~~~.~.!?:~.~~~g~.~.E.~J.p..~J ~.tl:9 J!.p.J.1;.~.g §.t.~.t..~.s F.i.de.lity.and . Guaranty Company,Bal timore,Marvland Suretv.........................................................................................................................1I:"ol . all of Washington County,Pennsylvania,are held and firmly bound unto the Commonwealth of PenLsyl- vania,for the use of those interested in the estate,in 1ille sum of..$S.O.Q.•.O.Q Dollars,to be paid to the said Commonwealth,to which payment,well and truly to be made,we do bind ourse1~es, jointly and severally,for and in the whole,our heirs,~xecutors,administrators,successors and assigns,and ..15th_each and every of them,firmly by these presents.Sealed wIth our seals and dated the da?of...............~~:.!.A.D.,one thousand nire hundred and S..1xty..~.nine . THE CONDITION OF THIS OBLIGATIOn IS,That if the above bounden .. Clara B~~kus Sealed and delivered in the presence of: ~tatrmrnt nf &urrty I,:,surety in the sum of $on :he administration bond in the estate of...~,say that I reside at ..............................................................................,Washington County,Pennsylvania;that I am the owner of real est2te, 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 try just debts and liabilities. J Co. Street ~tatrmrnt of §urrty P.O. I,,surety in the sum of $on tJ.e administration bond in the estate of..:,say that I reside at ..............................................................................,Washington Count;,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 enClmbrances $;and that I am MTor:h the amount expressed in said bond,over and above my just debts and liabilities. Street P.O. COMMONWEALTH OF PENNSYLVANIA,}SS- WASHINGTON COUNTY,' And now 19 comes _.. who being duly sworn,says that he is acquainted with th~financial standing of the securities to the withill bond;that the said obligors have each executed.the said Jond and that the sureties thereto are the owne:'s of real estate in their own right of value more than the penal sum of said bond over and above all incum- brances and exemptions. Sworn and subscribed before me this .. day of A.D.19 .. #2319 No.63-69-825 !\llmiuistrntion iloUll IN THE ESTATE OF JOHN c.BRENKUS 1'\1 ~.And now July~,19_6_9_ Bond approved and Letters issued to t:..~..C~..Brenku8.en ""Tl ,AlP ~L.c::l'i:,.;n::o ~ (f)G")c:==r:-~g:;lias duly-quaJ.ilied. -------;~~~~..~.n rrl r-LT'1I3::.J rRusse11 M&rfno :,~"-"'~~v. iT.,.....o .,.~:::oQ_-~r z:""'Qro>(1), #'t ::r '"'-1/ ~ fll7tl Register J Bond Book 63 ~2 Pag.e 135 "\. \.l-. •- IJ Form RCC-33 RESIDENT DECEDENT COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF R~VENUE BUREAU OF COUNTY COLLECTIONS COUNTY OF V~.$.h~g,t.qr,L . IMPORTANT:This return must be completed in detail and filed in duplicate,'with will attached,with the Register of Wills of the County where d~cedentresided;Return is due within one year after date of death,unless an extension is granted by the Secretary of Revenue.(Section 703 of the Inlll~ritlmce__an!i :E.~tllte .Tax A,ct of lQ~l.) IN THE MATTER OF mE .ESTATE OF } hn C B ku AFFiDAVIT OFJo•ren s..··· ·..·..····..·..· · ·..·..·i·~t~..f~li..-;;;;-;;:;~..·~i"decedent)..EXECUTOR Late of Y.!.~..~?~~~.~9.~County ADMINISTRATOR ::.:'.~-~~:;:~;:~~:=:::-~::J .., Clara Brenkus .................................liT"Hj\lljJ6'K and say 1 ,19 ?.~"f'te.tate 'leaving a la.t will,copy of which i.hereto attached.} (Day)(Year)Lintestate of the estate of the above-named deceden~being duly sworn,depose Decedent'dJed Administrator .......................~ra.:y. (Month) Name and addre••of attorney or} other authorized repre.entative to. whom all corre.pondence .hould be mailed. That as such Adminstrix deponent is familiar with the affairs of said estate and the property con- (II:X(~CUlor·AdminiRtrator) 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 indecedent'3 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 1'IlOne .... 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 ~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 mortgage encumbrances upon each parcel of real property at the date of death,giving the amount still due at death,name of mortgagee,.late,rate of interest,and book and page of record thereof.It also sets forth in the columns provid~d therefore the assessed valuation of each of said parcels,the estimated market value thereof as of da-:;e of death of decedent. That Schedule B attached hereto and made p3.rt 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 a:tso separately t:1e accrued interest thereon,if any,down to the last interest day prior to decedent's death in the case cf savings banks,and to the date of decedent's death in all other 'cases;all bonds,postal savings,trea;ury certificates or notes and other evidence of in- debtedness of the United States to the decedent;a~l obligations,whether by statute or agreement they are designated as tax free,of the United States,o~any state,or political subdivision thereof,or of any foreign country,which are owned at the time of ·:leath;all wearing apparel,jewelry,silverware,pic- tures,books,works of art,household furniture,ho :-ses,carriages,automobiles,boats,and any and al.l other personal chattels of whatsoever kind or nature left by decedent,together with the fairly estimated market value thereof;all bonds and mortgaj!es held ')y decedent and of all claims due and owing decedent at the time of death,and all promissory notes or ocher instruments in writing for the payment of money of which decedent died possessed,of whatsoever na~ure,with interest thereon,if any,giving the face value and estimated fair market value thereof,and Lf such estimated fair market value be less than the face value,it sets forth briefly the reasons for S.lch depreciation'as to each item;all moneys payable to the estate from life insurance policles carried ')y decedent;all annuity and endowment contracts the proceeds of which were payabl~upon the death of the decedent;and all the corporate stocks and dividends due thereon and unpaid as of the date of death,bonis and accrued interest thereon to the date of dece- dent's death and other investment securities owned ty 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 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 statelnent setting forth the character of the business,its location,and such other facts pertaining to the business as maybe pertinent to a fair and just appraisal of the decedent's interest therein must be submitted.,It should also set forth in itemized form,together with the fair market value thereof,any other property owned or bequeathed by the decedent at the time of death.- The Schedule C attached hereto and made part hereof sets forth a true answer to each inquiry contained therein and in the case of transfers ofproperty,real or personal,within two years of decedent's death,in contemplation of decedent's death,or intended to take effect in possession or enjoyment at or after death,said schedule sets forth the nature and value of such property,to whom transferred,the relationship of the transferees to the decedent,the proportionate share received by each 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 cony of the deed,trust agreement or other instrument'creating the trust.Thert~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 jointly,by the Will,deed,or other instrument of another, with a copy of the 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 n~led 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 Impaid at time of'"',death;taxes accrued,charge,ab1e for period prior to decedent's death (except.those allowed 1!IDder 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",liB",lie","E",and "F"as directed therein" have been carried forward and properly registered in the SUlllll1ary. Subscribed and sworn to before me thiB ."""'."..".".,,.,,"....... :::.:~:~:=~1:~~ PITTSBURSH.A'T~m ccum MY COMMISSION EXPiReS fEBRUARY It 19U d'0'vO..--J /1 -"L <2..-'....{'I...~£~,_. 4i~~;m~~~m) ..,~. (Street Number) .".",.",,.M.9.P9.;g.~.+.g.....;p§P.P.:.e.y.J.:y..?:.P.:,?:~.,.,.~.~.9.,?.7..... (City en-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 (1-64) 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 tenan:y by entireties,report on Schedule liE".Property held by the decedent as tenant in common with another or l)thers,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 Commonwealth of Pennsylvania should be described by lot and block number,street and street number,together wi th a general description of the property,with a reference to the record :If the conveyance by which the decedent took title;if a farm state number of a· cres;also statement of mortgage encumbrances upon each parcel at death of decedent.Taxes,assessments,accrued Interest on mortgages,etc.,are to be listed on Schedule "F"and must not be deducted from this schedule. NON E (1) ASSESSED VALUE FOR YEAR OF DECEDENT'S DEATH (2) ESTIMATED MARKET VALUE (3\ DEPARTMENT VALUATION CAUTION (Do not write In this space) Insert this total opposite IIrea l property",Schedule "A"in the X X X X X liAs Reported"column on the last page of this return. None RCC-35 COMMONWEALTH OF PENNSYLVANI,A '"'TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "Bn PERSONAS PROPERTY INSTRUCTIONS:This Schedule must disclose all tangible and intangible personal property owned individually by the decedent,at the time of his death.Propert~owned by the decedent jointly with another or others must be listed under Schedule "E".Inta~gible perscnal 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 lis~ed first (e.g.jewelry,wearing apparel,household goods,and furnishings,books,paintings,automobiles,boats,etc.) Intangible personal property,such as bonds,treasury certificates,cash on hand and in bank,..stocks,'mortgages,notes,together with accrued inte~est or dividends,salaries or wages,insurance pay- able to the estate or fiduciary in said capacity,~artnership interests,interest in anyundistributed estate or 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. t:le "As Reported"column on the last page of tins return, , Item ITEM UNIT ESTIMATED DEPARTMENT VALUATION No.List and describe fully VALUE MARKEl'VALUE (Do not write in this space) N 0 N E iI .. "...~... I::-...'.. ',.....',;.~~. .'.-;....-~ iI Insert this total opposite "Personal Property",Schedule "B~in X X None i RCC-3b CO\f'lfON\\'E.-\.LTH OF PENNSYLVANI·'\. .,.Tll\.NSFER INHERITANCE TAX !:1.,4;SIDE:-iT DECEDENT SCHEDULE "c" TRAN SFEllS (1)Did decedent,within two years of death,make any t:-ansfer of any material part of his estate,without receiving a valuable and adequate consideration th3refor?(Answer yes or no)-,N~o<--__ (2)Did decedent,within two years of death,transfer property from him~~lf to himself and another or others (including a spouse)in joint ownership?('\.nswer yes or no)l'~O (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 o~property without receiving a valuable or adequate consideration therefor:r~hich was to take effect in possession or enjoyment at or after his death? (Answer yes or no)~o (a)Was there any possibility that the prcperty transferred might return to transferer or his estate or be subject to his power of cisposition?(Answer yes or no)_ (b)What was the transferee's age at time o~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: (a)The possession or enjQyment of or the right to income from the property transferred? (Answer yes or no)~__Oo _ (b)The right to designate the persons who shall possess or enjoy the property transferred or income therefrom?(Answer yes or no)No (6)If the answer to (52 (b)above is in the affirmathe,state whether the right was reserved in decedent alone or 0 thers _..:I:;.Jo=n=.e=---:-_ (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 transf~ror?(Answer yes or no)N_o __ (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 cr 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 beneficiary reserved in the decedent alone or the decedent and others? (Answer yes or no)No NOTE 1:The answers to these questions should be supported by affidavit by the attending physician as well as a copy of the death certificate. NOTE 2:If answer to any of the above questions is yes,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 decedent,if any.Sutmit copy of any trust deed or instrument,if trans- fers are claimed to be non-taxable,also submit detai~ed statement of facts on which said claim is based. NOTE 3:List applicable property below in manner in ~hich provided in Schedules A,B,or E. ITEM NON E DESCRIPTION MARKET VALUE (Estimated)DEPT.VALUATION (Dept.Only) Insert this total opposite "Transfers",Schedule "C"in the "As Reported"column on the last pcl:.o;e ()f thls return., None ReC-38 C9MMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "E" JOINTLY OWNED PROPERTY INSTRllCTIONS:This schedule must disclose all property,real and personal,owned by the decedent jointly with another or others,including intangibles,standing in the name of the decedent and others.List real estate first,as entireties,or joint tenants,givirg brief description,as indicated under Schedule "A",plus the date and place of record of instrument efrecting vestiture,but do not include entireties or out of state real estate value in estate valuation c(·lumn.Personal property should be listed as in Schedule "B",plus date of acquisition,and the name,address and relationship (if any)of co-owners to the decedent. Description of Property,Date of Acquisition,Name I Unit Address and Relationship of Co-Owners,and Place I Valu.. of Record of Instrument,where Real Estate.I percentage Estate Share Valuation DEPARTMENT VALUATION CAUTION-Do not Write In This Space. Value of Value of Entire Decedent's Property Interest The Union National Bank of Pittsburgh Checking Account #73 705 150 with Mother Ca1ra Brenkus 12.34~W·V * I.i Insert this total opposite 'tJointly Owned Propert?",Schedule "E"12 .34 in the "As Reported"column on the last page of this return. RCC-3~.(12-63) COM~10NWEALTH OF PENNSYYLANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "D" BENEFICIARIES _.',~... ( h BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED INTEREST OF(If step-children or DATEStatefullnamesandaddressesofallwhoillegitimatechildrenDECEDENTOF BENEFICIARY ave an interest,vested,contingent or other are involved,set STATE YES IN ESTATE wise,in estate)forth this fact.)OR NO BIRTH Clara Brenkus Ivlother Yes Residue 418 Valley street J:vIeDonald Pennsylvania '':> Charles Brenkus Father Yes Residue 418 Valley Street He Donald Pennsylvania - veponent further says that all the above-named beneficiaries are living at this time except below: NAME DATE OF DEATH RESIDENCE Deceased REPORT AND APPRAISAL :\IATIER OF THE APPRAISEMENT Late of ...l1GP9I1~::Lq.J?E:;l1J.ls.Y::LY~I1:i.Cl......Washington County (Executor-Administrator must complete "As Reported"column #1.) 0 :'"--t ....,""d ~...:0 ~Cll Cll0...e.'":1-1'::l '"'":l:S '"0 :ct-it'::l '"C....,e.... ~:~;A 0xk""d'"~...Cll0-o ...~:§'"~tr:l Cll... '",......:(1)'<~:p,,.. Cll :'"0:1-;1:0 h::l,(1) 'I-J:ct- ~ enc::~ ~>~ .roW en en >-<: ()().0 ~?'"?'"'P'.. '1:J:j ci c5 >:';:::- ~~~~~~->.~'"~:~:2:::2:~.l\J l\J:0 :0 :0 Cll-:.•:l:$:l:S :l:S "'0 ....:(JJ (Jl:CO 'co :co ::;- :IP-IP-:'(t c..- Year . Dl THE No. .Tohn C.Brenkus ESTATE OF OF THE Commonwealth of Pennsylvania County of Washington~....."......................-.... Will l Administration ~ ~~~~..,..~ "~ ~,~N ~~. >-or. o~~<':1'-:>..,-2.::3<':c.. Form RC C·IO OFFICE OF TME REGISTER OF WILLS OF _W_a~s_h_in----::g::....t_o_n__COUNTY AND AGENT OF TME COMMONWEALTH STATEMENT OF DEBTS AND DEDUCTIONS / DEDUCTIONS ALLOWED IN TME SUM OF $.;;/;1/."'3 DATE APPROVED .••,,-~.:~L:::('.i~1h~u Register of Wilis,Agen' ESTATE OF ....;J::....O=.;ID='l--=.C....=B=..r.=e:=n:::::k'u=s'--LATE OF 418 Valley Street McDonald Pa. DATE OF FILING APPRAISEMENT October 17,196~ATE OF DEATH __M;;.;;_a"'-y---"'1.L,_1....;;.9....;;.6....;;.9 _ DATE NO.OF NAME:OF PAYEE REMARKS AMOUNTVOUCH"" JU1'1.e 11 689 Frank J.Nation Funeral Heme Funeral Expens ~1 259 25 Hay 21 664 Resurection Cemetery Grave Opening 120 00 June 20 693 Resurection Cemetery Grave l1arker 348 00 June 20 694 Resurection Cemetery Vault hO 00 :Hay 21 661 The Record outlook Printing 2 70 .Tune 6 683 Coramoni--Tealth of Pennsylvania Accident Renort f)00 l1ay 27 671 American Oil Company Gasoilne Charged 115 56 June 27 698 American Oil Company Gasoline Charged 27 50 July 23 711 American Oil Company Gasoline Charged 22 00 May 27 670 Lewis Bryant ~1erchandise 67 36 I·fay 21 659 Sears Roebuck &Company Herchandise III 26 I - 1$2.138 63 COMMONWEALTH OF PENNSYLVANIA } COUNTY OF WASHINGTON S8: I,CLARA BRENKUS ----le __