HomeMy WebLinkAboutOC1969-1056 - ESTATE OF HARRIS"j
Form RCC-33
RESIDENT DECEDENT
COMMONWEALTH OF PENNSYlVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
.COUNTY OF ~~.~?~n.:g!:<:).n.:.
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.Jnl).eritl'l.nce..l'l.n!i..Ef!tflte .Tax A,ctof 1!!61.)
IN THE MATTER OF THE ESTATE OF }AFFiDAVIT OF Marie H.Bush,
............E.l.SJ.E M.!~~~~..~~~"~i 'd~~~~t')""""""EXECUTOR
Late of Wa.sh:i-.pgtqn County ADMINISTRATOR
pennsylvania ..State of :.}
.Washington ss:County of .
......................................)yJ9.,.f..t..§H..~f3.~.§h ..!q.9...:.9.~~~F...
co-owner
Eueutor
Administrator of the estate of the above-named decedent being duly sworn,depose and say
N~me and address of attorney or}
other authorized representative to
whom all correspondence should be.
mailed•
.....BLOQM,..BLQOM,.RQSENB.E.RG ....~......a:J:,.QQM .....
209..wash~ngt:()l:lTru~t:.I3':l:i!~:il:'l(~r
Washington,Pennsylvania 15301
..That as such g.9..:::.9.~.n.:.~E.deponent is familiar with the affairs of said estate and the property con-
(.:x",,"tor·Administrator)
stituting the assets thereof and their fair market value.
That at the time of death there was no safe deposit bux 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:~
..-....
SAFE DEPosiT BOX RENTED RELATIONSHIP OF JOINTNAMEANDADDRESSOFBANKOROTHERINSTITUTIONTHIS
IN WHICH DECEDENT RENTED A SAFE DEPOSIT BOX IN NAME OR NAMES OF HOLDERS TO DECEDENT
,...~
-.--
..
...
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 l1ereto and made part hereof sets forth full v and in"detail all the
real property in the Commonweal th 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,date,rate of 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 givi.ng also separately the accrued interest thereon,if any,down to the last
interest day prior to dece?e.nt's death in the case of savings banks,and to the date of decedent's death
in all other cases;all bonds'cpostal saVings,treasury certificates or notes and other evidence of in-
debtedness of the United States to the decedent;all obligations,whether by statute or agreement they
are designated as tax free,of 1;he Uni ted States,or any state,or political subdivision thereof,or of
any foreign c~untry,which rare 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
other personal chattels of Whatsoever kind or nature,left by decedent,together with the fairly estimated
market value thereof;all bonds and mortgages held by decedent and of all claims due and OWing decedent
at the time of death,and all promissory notes or other instruments in writing for the payment of money
of which decedent died possessed,of whatsoever nature,wi th interest thereon,if any,giving the face
value and estimated fair market value thereof,and if such estim~ted fair market value be less than the
face value,it sets forth briefly the reasons for such depreciation 'as to each item;all moneys payable
to the estate from life insurance polici'es 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 at 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 statement 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 pos~ession 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 saidrtransfers.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 copy
of the deed,trust agreement or other instrument creating the trust.Therl~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,bythe 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 named in the decedent's will,if any,died prior
to decedent,the dates of their death,their issue,and the 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 of,.
death;taxes accrued charge,able for period prior to decedent's death,(except.those.allowed under Section
651 of the Inheritance and Estate Tax Act);together with a statement of collateral pledged for obliga-
tions,if any.It is agreed that the fiduciary will present proof of said claimed obligations upon re-
quest,that if the amount actually paid in settlement of any fee,commission or debt is less than the
estimated amount claiming and allowed,that the same will be reported to the Register of WillS,and that
the amount of tax assessed can be reassessed in accordance therewith.
That the totals of the appropriate columns in Schedules "A","B", "C","E",and "F"as directed therein"
have been carried forward and properly registered in the Summary.
Subscribed and sworn to before me this J.2.t.h .1.,··')?J..~...~..~~~W!l.~f ......_...
(:B;weutw:A~)
725 Summer lea Avenue
.....................................................................................................................u _••
(Street Number)
..,...'t:Y,~,~.lt,~.~g.~.9.~..~.......r..~,~.~.~y.~.Y.9:.~J.i?:....J.$.J.Q)..
(City or Town and State)
ROWENE EBELING.otary Public
My Commission Expires February 8,1973
Washington,Washingto:l County,Penna.
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.
................~,,,"""""",,.day of $.,~.Pt..~.~,§f:19J?.~L .
....................,~J.,~.,..
L
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 tenancy by entireties,report on Schedule "E".Property held by
the decedent 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 Commonwealth of Pennsylvania should be (1)(2)(3)described by lot and block number,street and street number,together wi th DEPARTMENTageneraldescriptionoftheproperty,with a reference to the record of the ASSESSED VALUE VALUATIONconveyancebywhichthedecedenttooktitle;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 fram 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.
RCC-35
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".Intarigible personal property,titled in the name of the decedent,but
payable at death to another or others,including but not limited to p.a.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 property,such as bonds,treasury certificates,cash on hand and in bank,..stocks,'mortgages,notes,together with accrued interest or dividends,salaries or wages,insurance pay-
able to the estate or fiduciary in said capacity,partnership interests,interest in any undistributed
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•.
Item ITEM UNIT ESTIMATED DEPARTMENT VALUATION
No.List and describe fully VALUE MARKEl'VALUE (Do not write in
this space)
None
,
Insert this total opposite "Personal Property",Schedule "B"in X X
the "As Reported"column on the last page of this return.
rCC-:J6
CmOfON1\'E.\LTH OF PENNSYLVAN"IA
T~\NSFER INHERITANrs TAX
RESIDENT DECEDENT
SCHEDULE "c"
TR.!\.NSFERS
(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)_
(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)_
(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)_
(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:
(a)The possession or enjoyment of or the right to income from thf.'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 decedentaloneor0thers--,-_
(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)_
(8)Did decedent,at any time,transfer property,the beneficial enjoyment of which was subject to change,
because of a reserved power to al ter,-amend,or revoke,or which cOllld revert to decedent under terms
of transfer or by operation of law?(Answer yes or 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 th~decedent alone or the decedent and others?
(Answer yes or 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.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
(Es timated)DEPT.VALUATION
(Dept.-Only)
Insert this total opposite "Transfers",Schedule "C"in the
"As Reporte~"column on the last page of this return.
COMMONWEALTH OF PENNSYLVANIA
rHANS}TIl INHmUT/\.NCE TAX
ru~SIDENT DECEDENT
SCHEDULE "E"
JOINTLY OWNED PROPERTY
INSTRrCTIOKS:This schedule must disclose all property,real and personal,owned by the decedent jointly
wi th another or others,including intangibles,standing in the name of the decedent and others.List
real estate first,as entireties,or joint tenants,giving brief description,as indicated under Schedule
"A",plus the date and place of record of instrument effecting vestiture,but do not include entireties
or out of state real estate value in estate valuation column.Personal property should be listed as in
Schedule "B",plus date of acquisition,and the name,address and relationship (if any)of co-~wners to
the decedent.
Description of Property,Date of Acquisition,Name I unit percentage Estate
Address and Relationship of Co-Owners,and Place I Value Share Valuation
of Record of Instrument,where_Rea!~state.!
DEPARTMENT VALUATION
CAUTION-Do not Write
In This Space.
Value of Value of
Entire Decedent's
Property Interest
1.Savings Account -First Federal
Savings &Loan Association of I
Washington -Elsie M.Harris and
Marie H.Bush,co-owners -
account established April 7,
1954 -$9,486.61
2.174 shares Wellington Fund -
unit value $13.25 per share -
Elsie M.Harris and Marie H.
Bush,co-owners -Total value
$2,305.50
3.House and lot located at 725
Summerlea Avenue,Washington,
Pennsylvania -Elsie M.Harris
and Marie H.Bush,co-owners,
rr(see Deed dated September 5,
.~nd recorded in Deed Book
Volume 1136,page 432 -$20,000.0
1/2
1/2
1/2
LJ66tJ;pfJ
1,152.7
10,000.a ~~.•.JYvrff-
Insert this total opposite "Jointly Owned Property",Schedule"E"
in the "As Reported"column on the last page of this return.$15,896.05L..==,-~....J
,;1 "~
FlCC-37 (12-63)
nnl\lt)~\YE:\I.TlI OF l'E:'\:\SYYl.:\NlA
TRANSFER E\IlEHlTA!\l'E TAX
RESIDENT DEl'EDE!\T
SCHEDULE "D"
BENEFICIARIES
BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED(If step-children or DATE INTEREST OFStatefullnamesandaddressesofallwhoillegitimatechildrenDECEDENTOFBENEFICIARY
ave an interest,vested,contingent or other-are involved,set STATE YES IN ESTATE
wise,in estate)forth this fact.)OR NO BIRTH
Marie H.Bush
1725 Summer1ea Avenue
Washinqton,Pa.15301 Daughter Yes 1/2 co-owner
-,_.~.--
)
\
h
Deponent further says that all the above-named beneficiaries are living at this time except below:
NAME DATE OF DEATH RESIDENCE
ELSIE M.HARRIS
~IATTER OF THE APPRAISEMENT
OF THE
ESTATE OF
•
(Executor-Administrator
must complete "As
Reported"column #1.)
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:'t1:rs:0''t1,(1):rs:rt
:"<:
Year
P."THE
Deceased
(.No.Will
Administration
Late of ""washington.....
REPORT AND APPRAISAL
Commonwealth of Pennsylvania
County of "wa s.J:1.ington..............-.
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Vl
Form RCC·10 DEDUCTIONS ALLOWED IN j
OFFICE OF THE
REGISTER OF WILLS
OF Washington COUNTY
STATEMENT OF DEBTS
AND DEDUCTIONS
THE SUM OF $q.{5I(;,rS0
I,
ESTATE OF __E_L_S_I_E_M_._HA_R_R_I_S LATE OF __W_a_s_h_i_n-=g:..-t_o_n~,_p_e_n_n_s_y=--l_v_a_n_l._·a _
DATE OF FILING APPRAISEMENT __~Y_-_o?..:.-..3~-_·.:l:C:,...g~_DATi OF DEATH _--=J...:u:.:n~e::;.-..::2;..:7-J,~=1-=9...:6:..:9~_
DATE NO.OF NAME OF PAYEE REMARKS A"'OUNTVOUCH""
7/7 69 Washinqton-Observer Death notice 2 00
7/14 69 Robert C.Gordon Ambulance 35 00
7/14 69 Robert C.Gordon Funeral Funeral 1,632 00
nUlW::::
7/24 69 Malcolm L.Morqan County Tax 79 51
7/25 69 Ben-iamin Super,M.D.Last illness 30 00
8/8 69 Warrick Four Seasons Flowers 65 51
8/20 69 Kurtz Monument Marker 110 00
8/21 69 Harry R.Cook School Tax 223 29
8/21 69 Harry R.Cook City Tax 149 94
8/25 69 Dames of Malta Dues 1969 6 25
9/16 69 Bloom,Bloom,Rosenberg &Attorneys''fees 75 00
Bloom
TOTAL 2,408 50-COMMONWEALTH OF PENNSYLVANIA }
COUNTY OF __----:W..:...a~s_h_i-n_g..:..-t-o-n___::__-liS:
Marie H.Bush-----..=..=::==-=:.....:::..:..-==:::.:.:.--------~-~---_HEREBYCERTIFY,THAT.TO THE BE.T OF
~Y KNOWLI!:DGE AND BELIEF.THI!:FOREGOING IS A JUST AND TRU E erATEMENT OF DEBTS.FUNERAL EXPENSES AND EXPENSES OF
ADMINISTRATION SUBMITTED TO THE ESTATE OF ELSIE M.HARRIS DECEASED.AS DEDUCTIONii FOR
INHERITANCE TAX PURPOSES.~-L!j~U h _~./7 IJ (L.S.l
--,:::~~__DAY Of'Mar l.e H.B£S~
/RO ENE EBELING,Notary Publid
My Commission Expires February 8,1973
Washington,WashingtC:1 County,Penna.
,.
(
R CC-81 (2-64)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE'
BUREAU OF COUNTY COLLECTIONS
INHERITANCE TAX DIVISION
NOTICE OF FILING OF APPRAISEMENT
lY,IARIE H.BUSH Informant
IN YOUR REPLY PLEA.IE
REFER TO
j
In Re:Estate of EL_·_S_1....;1_·'_M:...:,.--=.HA:...·..,.:fili:...'r:...:.1_S _
_____V:.:.:rVA;,;;::S::.:,;H~I;:.:N.:::.GT~O::.:I~::..T County -File No.63-69-1056
Dear Mrs.Bush:
You are hereby notified that the ori~nal
appraisement in the estate of Elsie M.Harris
has been filed in the office of the Register of Wills qf WashinRton
County on September 23 ,19~.Said appraisement reflects the
following valuations:
Real Estate ---'--------::;'-::--=-r-=--Jt.Held ~.:;;;1.:...5,!....8~9..:..6.;....O;..:::5__
Transfers ..,-_
Total ~..:!1....:5.L.8:.:.9~6"_!•..::::OJ...5__
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.
Dat e __.::S..:e..l:p..:t.:;em:::.b::..e.:.:r:.....;.2:.::3:...l,~1~9.::6..!..9 _
DATE OF DEATH:June 27,1969
Note:This is not a bill.
RCC-39 (5-68)
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SUMMARY
Estate of HARRIS,
(Last Name)
ELSIE
(First Name)
M.
(lnitial)
DATE OF DEATH_6_-_2_7_-6_9__FILE NO.63-69-1056
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".
09-23-69
06-27-69
Dated:___...=...L---'"'-..=...!._
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 ..a dedoction.~:\
Dated:09-23-69 ~*~~t.e>
REGISTER OF WILLS
VALUE AS REAPPRAISED
$-------+--
l.j,tl';lb u,
15.896 05
2,408 50
13,487 ~513,487 55
VALUE AS REPORTED VALUE AS APPRAISED
$$
CLEAR VALUE OF ESTATE
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)
Valuation of life estates or
FOR USE OF REGISTER ONLY
Tax on $--+__2%
Tax on $..J!ti..
Tax on $13.487 55 ®
Tuoo$lK
Tax on $15%
Exemptions *
Total Estate --+-__
TOTAL TAX
COMPUTAnON OF TAX
$---------1--
$-------,I"n'"IT..--l........-$tl----=-U';I--+.:G....;:,·:..--
$-------+--
$--------+--
$.---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 $~
Add interest a\:ate of 6%from $ -L
AMOUNT OF ESTATE TAX ASSESSED $------IL-
Estate tax paid $--'l-
BALANCE DUE $---_~~
A_d_d_in_te_r_e_st_at--(;:_te_of_6~_o_f_ro_m_$-------1t=',,
TOTAL TAX BALANCE $---_~.
PAID $-l
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.year .
IN THE
MATTER OF THE APPRAISEMENT
OF THE
ESTATE OF
ELS IE 111.HARRIS
Deceased
Late of .
County of
WASHINGTON. .
WASHINGTON
Commonwealth of Pennsylvania
REPORT AND APPRAISAL
!.
Fonn RCC-2
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
~HARRISBURG,PENNA.17127
COMMONWEALTH OF PENNSYLVANIA
•_RESIDENT INHERITANCE TAX.
APPRAISEMENT
DATE ?E:!.P~l:3.~?E:!.t ?}'.~.?.§?..
,~COUNTY ~~.~..~.~~.g;~.?~.
FILE NO..9)::::..9..9..-::1::.92..9..
Whereas,~J::~t.~~..~~9.:~!.t.~late of ~c::~.~.~.~.~?~.
in the County of W.~l?.ht.ng.~9..:g Commonwealth of Pennsylvania,having died on
the ?.7 th day of ~.~.~19.??..,seized and possessed of an estate
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore,I,.......................................w..~.E.r:.~.....9..h.?P.-.~.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 transferinheritancetaxesatthelawfulcollateralrateonanysuchfutureinterest.
I
Unit Appraisement IDescriptionofAssetValuesMadeforInheritance
Tax PurPOleS
$
JT.HELD:--
See copy of Schedule IIE"attached.15,896 05
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I
I
I
I
I
I
Total 15,896 05
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Having been duly sworn accord~ng to law,I do hereby certify~t t~~isement is made in con-
formity Mth ~w on thi.4S~day Of~~~~~~
~~.(Jj,-;;;-;.7')....................................Penna,
WASHINGTON County
(
.,;
RESIDENT INHERITANCE TAX APPRAISEMENT
Estate of
ELSIEM.HARRIS........__--~-.-_-.
Deceased.
Late of
v-JASHINGTON....................,...............•..~.
Date of Death,~.W1~?.7..L.)..99.9..
Appra£semcilt Docket Vol.,::2 ..
Page,.f..._.=~_No.....93:::-..99:::-J.95..9..
Filed in Register's Office,$~pt..~?3..L..19 q.9.
Amount of tax due,$.
DEPARTMENT OF REVENUE
Received,
Examined and Approved,,..
Wrote abo.ut Appraisement,..
Appeal f1'o-m Appraisement,..
Entered and-charged,..
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