HomeMy WebLinkAboutOC1969-1334 - ESTATE OF HAZLETT,
Rc'C-39 (5-68)
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SUMMARY
Estate of HAZLETT, CHARLES A.
(Initial)
DATE OF DEATH 10-2-69 FILH NO. 63-69-1334
(Last Name) (First Name)
REPORT OF INHERITANCE TAX APPRAISER
I, the undersigned duly appointed Inheritance Tax Appraiser in and for the County of Washington
Pennsylvania, do respectfully report that I have appraised the real and personal property as reported in the foregoing return at
the values set forth opposite each item in the last column to the right in Schedules "A", "B", "C", and "E".
Dated: --~9.=.-.!L9.=.-...!...7~0 _____ _
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 Prol)erty (Schedule E)
TOTAL GROSS ASSETS ..
Less Debts and Deductions
(SCHEDULE F)
CLEAR VALUE OF ESTATE
Valuation of life estates or
annuities . , .................
EST ATE TAX ASSESSMENTS
FOR USE OF REGISTER ONLY
Tax on$
Tax on$
Tax on$
Tax on$
Tax on$
Exemptions
'· __,.Total Estate
TOTAL TAX
Less tax previously paid
BALANCE
Less 5% of tax if paid within
3 months after death
VALUE AS REPORTED VALUE AS APPRAISED . 60;1;0 $·-------===~~~ 600 00
____12 '2 §. .4-12...661 e-Z4__
.. ~Jii . 6' "24 · ~ r · 1;·· · •I · .•. ,), ·. ,"'.2 7 " --· 13 ,.267.,._,24_ ':" . "l• .. ·-
--·-. 1'~ c_,1 .. Zfli ~L~~~
$
I I $
.
COMPUTATION OF TAX
c!:> $
0 $ '=1
$ -0
10% $
15% $
* (*)
$
$
I
$
$
BALANCE OF INHERITANCE TAX DUE $
Add interest at rate of 6% from
to $
AMOUNT OF ESTATE TAX ASSESSED $ I
Estate tax paid $ I I BALANCE DUE $ \ Add interest at rate of 6% from
I
•o $
TOTAL TAX BALANCE $
PAID $
FOR USE OF REGISTER ONLY ADJUSTMENTS
VALUE AS REAPPRAISED
$--------------+----
I
. '
As evidenced by Charitable
Exemption Certificates issued
by the Secretary of Revenue. -
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.
/
?IJ11.
I
(~
r
Will
Administration ~ No. ·:· .....
IN THE
Year ........... .
MATTER OF THE APPRAISEMENT
OF THE
ESTATE OF
. CliA.J:l:LE;~ !\. .. HAZLETT
Deceased
Late of. SP~:E-S.
County of WASHINGTON
Commonwealth of Pennsylvania
REPORT AND APPRAISAL
.,...___
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I, CHARLES A. HAZLETT, a widower, of Speers, Wash~ng.ton
~~.~ . " .
County, Pennsylvania, being of sound and disposing mind, memory
and understanding, do hereby make, publish and, declare this to. be
my Last Will and Testament, in the manner and form following, hereby
revoking and making void any and all oth~r wills made by me at any
time heretofore.
FIRST: I direct that all my just debts and funeral ex-
penses, including my gravemarker, shall be paid from my residuary
estate, as soon as practicable after my decease, as a part of the
expense of the administration of my estate.
SECOND: All the rest, residue and remainder of my estate,
real, personal or mixed, of whatsoever nature or wheresoever situate
. I
I I
I l !,~
I
at the time of my death, I give, devise and bequeath to my beloved I
daughter,· DOLLY ~~RGARET FULMER, PROVIDED, however, that if she doesl
I, bequeath said residue in two equal shares,. share and share alike, to
not survive me for a period of sixty (60) days, I give, devise and
my son WILLIAM A. HAZLETT, his heirs and assigns, and to my grand-
daughter, KATHLEEN G. MAKRIS, her heirs and assigns, both absolutely
and forever.
THIRD: I hereby nominate, constitute and appoint my
daughter, DOLLY MARGARET FULMER, as Executrix of this my Last Will
and Testament, however, should she be unable or unwilling for any
reason to act as Executrix, I nominate, cons.ti tute and appoint as
Contingent-Executors, my son, WILLIAM A. HAZLETT, and· my grand-
daughter, KATHLEEN G. MAKRIS, or either of them, should one of them
be unable or unwilling for any reason to serve, and I direct that
she, he, or they be permitted to serve without bond.
IN WITNESS WHEREOF, I have hereunto set my hand and seal
' I . """'. / '--1//J. / / .• the day of July, 1967.
The foregoing instrument, consisting of two pages, includ-
ihg this page, each page being typewritten only on 6ne side, was at
the date thereof by the said CHARLES A. HAZLETT, signed, sealed, and
declared to be his Last Will and Testament in the presence of us,
who, at his request, in his presence, and in the presence of each
other, have subscribed our names as attesting witnesses thereto.
Re-Siding at Chari'eroi, Pa.
f
. l..
i\ffi~nuit ®f ifxrrutnr ®r i\~ministrntnr
l'tat.r nf J.rnnnyluania, ~ 55:
C!J.nnnty nf llan4ingtnn \
Personally before me, the undersigned authority, a.: ............. N9..:t..~;t.Y. .... P..1!P..1.i9. ...................... in anq for said
County and State, appeared .................. D.Ql.l.;v. ... Mi'A.X:.Q.a.t.e.:t ... F.JJ..lm~.X: ........................................... who, being duly
sworn according to law, deposes and says that she is the executor or administrator of the estate of
.......... Cha.r:le.s ... Haz.le.t.t ............................................................... deceased, that the foregoing schedules constitute a
complete inventory and appraisement of the real and personal estate of... .... C.b.~J;".l.~.s. .... HP...~.l~J.:t. ................. ,
deceased, except real estate outside the Commonwealth of Pennsylvania; that the figures opposite each item
of real and personal estate in the foregoing schedules are determined and stated by the undersigned to ~ ~ ~ ~ be the fair value of said items as of the date of the decedent's death, based upon a just appraisement of each ~ § ~ ~ item made by the above named Execu1::Hr i~. ·
~ ~ ~ ~ Sworn and subscribed before me this ...... ;..f.:tJ... \l f) n n Q1' ~4
l ~ 2 ~ day "!J;;d""Jf':"'TJZ~:::tA/ ~~·· ~~ ....... ~ ~~ ~ ~ ................ ~.·~~···. . ~~~~;~·~~~·~· .. INSTRUCTIONS
~ ~ ~ z l. -~ ~ d ~
:z 8 2 ~ 2. :a ..... C"> -< 3. ~ N 0
An inventory must be filed within three months after appointment of personal representative.
A supplemental inventory must be filed within thirty days of discovery of additional assets.
m·~ c:~
UJ ~ ~ ~ ..... -< -
"" C">
1 Original and 2 Copies and 2 RCRI-34, Under $10,000; 1 Original and 2 Copies and 2 RCRI-33,
Over $10,000, including Copy of Will; 1 Original and 3 Copies and 2 RCRI-33, Over $50,000, in-
cluding Copy of Will and copy of Federal Estate Tax Return .
REFERENCE FOR ADDITIONAL COPY
Act of 1947 P. L. 513 Sec. 5.2, 72 P. S. 4844.2
lluurutnrg anill\pprai.!ltmrut of the goods and chattels, rights and credits which
were of ............. CHARLE.S .... l:JAZLEI.I .................................. Jate of .................. J~9..~.9.~.9h ..... QJ ..... §P..~~.!.~ .. , ................. ..
Washington County, Pa., taken and made in conformity with the above affidavit.
PERSONALTY:
1965 Dodge Sedan -(Proceeds from Automobile
Insurance Policy as car was totaled in
accident in which decedent died.) $550.00
plus $50.00 deductible
REALTY:
NONE
DOLLARS CENTS
600 00
)
..
' . , for~ RCC-33
. ' •, '
COMMONWEALTH OF l'ENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
j
RESIDENT DECEDENT COUNTY OF .......... WASHJNG.!ON ....................................... .
IMPORTANT: This return must be completed in detail and filed in duplicate, with will atta:ched, 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 Inheritance and Estate Tax Act of 1961.)
.................. C:R~::::_::L.::r~~~-~~-E. ~-~ ................................ }:::uA= .OF
(State full name of decedent) l.X
~ Late of .............. WASH! NGTON. . . . . ... ....... . . ........................ county
:.: -~-~::::::::~~~-~-=:----~::-=} '"
.................................... Do.l.l.y ..... Mar .. g.ar .. et ... F.ulm.er ...................... . Eueu~rix
of the estate of the above-named decedent being duly sworn, deposes and sa,S
Decedent dJed ........................... .0Gt?M~~7h~ ....... 2.. . <i;;;:;·) ., 19(.y~~ .. {;;;~:eaving a last will, copy of which is hereto attached. }
....... How9:r.d .... F. .•..... Carson., ...... .E.s.qu.i.r.e ................... . Name and address of attorney or}
other authorized representative to
whom all correspondence should be . 2.12 .Fourth .. Street, Charleroi, Penna. .. .. ......
mailed.
That as such .g~§.~.~.!.!'.?.:..~ ................. deponent is familiar with the affairs of said estate and the property con-
< J<:x.,cu tor-Administrator)
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
Mellon National Bank & Trust Co. Charles A. Hazlett or
Charleroi. Pennsvlvania Mrs nnllv MrtrnrtrP1:
Fulmer oauqhter
That the contents of said safe deposit box or boxes are itemized under Schedules E
return, with the exception of the following, for the reasons hereinafter set forth:
of this
That Schedule A attached hereto and made part hereof sets forth fullv and in detail all the
real property in the Commonwealth of Pennsylvania or 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 or 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
or 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 of the United States to the decedent; all obligations, whether by statute or agreement they
are designated as tax free, of the United States, or any state, or political subdivision thereof, or of
any foreign country, which are 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 bydecedent, 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, with interest thereon, if any, giving the face
value and estimated fair market value thereof, and if such estimated 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.
..
• ,' .1'' ..
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 may be 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. 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 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 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 ~ade 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
others, plus the date and place of record of instruments effecting the vestiture of
date of acquisition of personalty, plus the name, address and relationship, if any,
decedent.
of the decedent and
real estate and the
of co-owners to the
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 tmpaid at time of
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.
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 ................................ .
-~:~~:;:~;~··············19~~:
MY COMM:SSION EXPIRES MARCH 12, 1973
~~~r~~-
........... J...?..9. .... .R!.Y..~.'f ..... §.t!:.~.~J: .. , .......... §P.~.~E.?_. ________ _
(Street Number)
........... a.~JJ.~ .... .v~.~ . .09.n., ...... P~.n.n9: .. ~ ................................... .
(City or Town and State) Member Pennsylvania Assn. of Notarie;;
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 famil~ 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.
,F!CC-34 (.1"64)
'·COMMON~E'AL TH OF PENNSYLVANIA
,DEPARTMENT OF REVENUE .
Bl1REAU 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
described by lot and block number, street and street number, together wl th
a general description of the property, with a reference to the record of 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.
NONE
(1)
ASSESSED VALUE
FOR YEAR OF
DECEDENT'S
DEATH
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.
(2)
ESTIMATED
MARKET VALUE
(3)
DEPARTMENT
VALUATION
CAUTION
(Do not write
In this space)
·RCC-35' ·
COMMONWEALTH OF PENNSYLVANIA
TEANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "B"
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 anot~er or others
must be listed under Schedule "E". Intangible personal property, titled in the name of the decede~t, 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 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 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
MARKEr VALUE
DEPARTMENT VALUATION
(Do not write in
this space)
1 1965 Dodge Sedan -{Proceeds from Automo-
bile Insurance Policy as car was totaled
in accident in which decedent died.)
$550.00 plus $50.00 deductible
Insert this total opposite "Personal Property", Schedule "B" in
the "As Reported" column on the last page of this return.
X X
~1C/7 600.0/,~
600.00
COM\!ON'I'EALTH OF PENNSYLVANIA
T.Jl\.N~FER INHERITANCE TAX
~~SIDENT DECEDENT
SCHEDULE "C"
TR:\NSFETl.S
(1) Did decedent, within two years ofdeath, make any transfer of any material part of his estate, without
receiving a valuable and adequate consideration therefor? (Answer yes or no) ~0 ·
(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) YES
(3) If the answer to (1) or (2) above is in the affirmative state:
(a) Age of decedent at time of transfer 72
(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) ~0
(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
(6)
therefor under which transferor expressly or impliedly reserves for his life or any period which does
not in fact end before his death:
If the
(a) The possession or enNOent 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) ~0
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) ___ ~~0'----
(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)--------
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 MAIUCET VALUE
(Estimated) DEPT. VALUATION
(Dept. Only)
( 3) (b)
(c)
SEE ~TEMS 2, 3, 4, 5 and 6 on Schedule
"'E"'
Excellant.
Heart Attack.
Insert this total opposite "Transfers", Schedule "C" in the
"As Reported" column on the last page of this return.
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
., ~ ...
SCHEDULE "E"
JOINTLY OWNED PROPERTY
. '
INSTRtTCTIOKS: 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, 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-owners to
the decedent.
Description of Property, Date of Acquisition, Name I Unit
Address and Relationship of Co-Owners, and Place I Value
percentage Estate DEPARTMENT VALUATION
CAUTION~Do not Write
In This Space.
Share Valuation
of Record of Instrument, where Real Estate. !
1 All those certain Lots of ground in
the Borough of Speers, washington
County, Penna., being Lots Nos. 1, 2
and 3 in the Sarah A. Speers Plan of
Lots recorded in Plan Book 5, Page
182, with a 1 story frame house and
garage situate thereon, in joint name
with Dolly Margaret Fulmer as joint
tenants with right of survivorship;
Deed Book 1262, Page 172, July 17, 1%7
7. 55UOC
2 u.s. Series 11 E" Bond #M 89467344E, in
joint name with daughter, Mrs. Dolly
Margaret Fulmer; issue date Rbruary,
1968, in sum of $1,000.00; value at
50%
date of death 788DC 100%
3 u.s. Series "EH Bond #M 89467345E, in
joint name with daughter, Mrs. Dolly
Margaret Fulmer; issue date February
1968, in sum of $1,000.00; value at
date of death 788DC 100%
4 u.s. Series 11E11 Bond #M 8946~346E, in
joint name with daughter, Mrs. Dolly
Margaret Fulmer; issue date February
1968, in sum of $1,000.00; value at
date of death 78~0C 100%
5 U.S.Series 11E" Bond #R 40439696E, in
joint name with daughter, Mrs. Dolly
Margaret Fulmer; issue date February
1968, in sum of $200.00; value at
date of death 15~6C 100%
6 u.s. Series "E" Bond #C 485679983E, ir
joint name with daughter, Mrs. Dolly
Margaret Fulmer; issue date February
1968, in sum of $100.00; value at
date of death 788C 100%
7 Checking Account #329 9343 in Charle-
roi Office of Mellon N~onal Bank &
Trust Co., in joint name with daugh-
ter, Mrs •. Margaret H. Fulmer, opened V
~ ~ -!_une_l()_, 1964; amo_u!!t o!.l 10/2/69 _ 3 00_8.79
8 Savings Accnunt #194 12 7695 .in Char-
leroi Office of Mellon National Bank
50%
Value of
Entire
Property
3,775.00.
788.0C
788.0C
788.0C
157.6C
78.80
Value of
Decedent's
Interest
11,504.~9 ? ~ ..
~
------------------------•----···------·------!----
.·
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-RCC-37-· '( 12-6 3) ' -~ --C'OM~IONWEAL TH OF PENNSYYLANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
• ..
SCHEDULE "D"
BENEFICIARIES , .
BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED (If step-children or DATE INTEREST OF (State full names and addresses of all who illegitimate children DECEDENT OF BENEFICIARY·. < have an j_nterest, vested, contingent or other-are involved, set STATE YES IN ESTATE
wise, in estate) forth this fact.) OR NO BIRTH -
Dolly Marqaret Fulmer. nauqhter Yes l/2il922 Residue
120 River Street Speers
_B_elle Vernon Penna._
'
Deponent fUrther says that all the above-named benericiaries are living at this time except below:
NAME DATE OF DEATH RESIDENCE
. No ~ Will ~ 63-69-1334
~·······-~·-········"
Dl' THE
:\lA TIER OF THE APPRAISEMENT
OF THE
ESTATE OF
... CHARLES .. .A.. . .HAZLETT. ....
Deceased
Late of .... Speer.s ... Bor.o.u.gh .
County of W9.shington ...
Commonwealth of Pennsylvania
REPORT AND APPRAISAL
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HOWARD F. L.' ·.·. ;;N
ATTORNEY AT LAitil
212 FOURTH STREET
~RLEROI; PENNSYLVANIA 15022
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R C C-81 (2-64)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
INHERITANCE TAX DIVISION
NOTICE OF FILING OF APPRAISEMENT
DOLLY 1-1!\RGARET FUUtER
(Executor~
ti· ~ i
IN YOUR REPLY PLEA8E •
REFER TO
In Re : Estate of __ ___:C:::.:f:!.:.IAI.:::.R::::L1::::-'S::::.......:A:..:..:..• ....::H11.:::.t:.::ZU=·~TT~------
___ ---l\cll·J.Al;!:.S~H""=ING:..!.!I =!:...TQ~NL-------County -File No. Q3-69-J334
Dear 1-irs, Fulmer:
You are hereby notified that the ______ ~o~r=i~g=in~al~--------------
appraisement in the estate of CHJIRLFS '' • HA?:LETT
has been filed in the office of the Register of Wills qf WI'JHilllC'l!G~l
County on September 10 , 19~. Said appraisement reflects the
following valuations:
Real Est ate ---------------------
Personal Property _____ ~6~o~a~.~oo~-------Transfers _________________ __
Total ---------~~6AoAa~.~o~o~------
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 (8%) percent per annum is charged.
Any party in interest who is aggrieved by an appraisement may
appeal therefrom as provided by law.
Date_~S~e~p~t~em~b~er~al~01~1~97~0~---
Title yJ.F, CHt,NF:Y1 CHU;F' APPRAif'iER
ESTA'l'E INSOLVENT
DATE OF DEATH: October 21 1969
Note: This is not a bill.
J-
R C C-81 (2-64)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
INHERITANCE TAX DIVISION
NOTICE OF FILING OF APPRAISEMENT
DOLLY ~i.ARGARET FUU1En
IN YOUR REPLY PLEA8E~
REFIER TO
In Re: Estate of ______ ~C~lli~~~R=LES=~~,-~~A~·-H~U~~Z=LET~·~T~------------
____ .u.W.,..J\St.~.~H~I~..~.~)i.\.JGu.T.J.oO~N------County -File No. 63..69-13.34
Dear Mrs. Fulmer,
You are hereby notified that the------~0~~-i~g~jun~al._ ____________ _
appraisement in the estate of Ctl{IRTJ<:;; p,. HAZI.ETT
has been filed in the office of the Register of Wills qf WASHINGTON
County on Sept~ep lQ, 19~. Said appraisement reflects the
following valuations:
Jt. Held Personal Property __________________ __
Transfers __________ ~~~~~--------
Total 12,667,24
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 (8%) percent per annum is charged.
Any party in interest who is aggrieved by an appraisement may
appeal therefrom as provided by law.
Date __ ~S~e~p~t~e~mb~er~l~0~1~1~97LO~----Signed
Title
DATE OF DEATH: October 2, 1969
Note: This is not a bill.
RCC-81 (2-64)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
INHERITANCE TAX DIVISION IN YOUR REPLY PLEASE
RIEFBR TO
38-30-3
NOTICE OF FILING OF APPRAISEMENT
In Re: Estate of ____ C;;....:HA=R;,::.:L=E=S=--=A:.:...::-• _,HA~Z::..:!L=E~T!!...<T"-----
WASHINGTON 63 69 1334 ______________ County-File No. - -
Dear Mrs. Fulmer:
You are hereby notified that the original
appraisement in the estate of Charles A. H~z] fttt
has been filed in the office of the Register of Wills qfas 1ngton
County on September 10 , 19...1,0. Said appraisement reflects the
following valuations:
Jt. Held
Real Estate ---'----......,....,.,...,....--=-=-----
Person a l Pr ope rt y --:::--::--· ~6...,:0...,:;;0,..:;'.....;0;..;0;----
~~----~1~2~,~66~7~,~2~4~~--
Total ______ -=1~3~,~2~6~7~·~204~---
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 ____ ~S~e~p~t~e~m~b~e~r~1~0~,~1~9~7~0~
DATE OF DEATH: October 2, 1969
Note: This is not a bill.
-----
!
Fonn RCC-2
COMMONWEALTH OF PENNSYLVANIA DATE ----~--~-Pt..~~Q-~.:r. .... J.Q._, ____ 197 .............
~EI;ARTMENT OF REV~U~ .
. ................... W.~.-~.l.?:.~.!l..g.~-~-~-----. . RESIDENT INHERITANCE TAX ~ COUNTY BUREAU OF COUNTY COLLECTIONS ....................
HARRISBURG, PENNA. 1712 7 APPRAISEMENT FILE NO. ······----~--~.:.§ .. ~.:.! .. ~}.4 .....................................
I
Whereas, .......................... C.h.a..r.l.e..s. .... A.~ ...... Ha..~le.t.t ............................................... late of ..................................... S..pe..e..r.s .................................................
in the County of ................................ W.~.~.hJ.ng~.Q.~ ............................................................... Commonwealth of Pennsylvanla,,having died on
!
the .......................... 2 ..... nd ...................................................... day of ............... .Oc.t.o..b.e..r. ................................. 19 ..... 6.~ seized and possessed'of an estate
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore, I, ................ W ..... R. •...... Cha.n.e.y ...................................................................... , an appraiser duly appointed according to law,
having been designated to make a fair and conscionable appraisement of the said estate, and to assess and fix
the cash value of all annuities and life estates growing out of said estate, hereby file the following appraisement:
In the event that any future interest in this estate is transferred in possession or enjoyment to collateral heirs of the decedent after
the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer
inheritance taxes at the lawful collateral rate on any such future interest.
Unit Appraisement Description of Asset Values Made for Inheritance Tax Purpoaes
$
PERSONALTY:
See copy of Schedule "I" attached to aDDraisement 600 00
JT. HELD:
See CODY of Schedule "E" attached to appraisement 12.667 24
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Total 13.267 24
form~;·~~hbl:: ::7h:sw~~~~· ~:; o~~~raj~·~;;;:~~d
ldZZ'~~· ~= I
umber eet) . ,._,;y.4 ... 1~ ............... , Penna.
.................. WASJU:NGT.ON ........ . County
RESIDENT INHERITANCE TAX APPRAISEMENT
Estate of
CHAR:[..~S ~ •.. f.IA.~.:r..~'l'T
Deceased.
Late of
·' SPEERS
... ~
Date of Death,
Appraisemel!t Docket Vol., .......... 3..8 ................................ .
Page, 30-3 No ........ §.~.~ .. §-~~_1.~-~.4
Filed in Register's Office, §..~.P.~.~ ..... J-.9.., .. 19 .... 70 ~
Amount of tax due, $ .................................................................... .
DEPARTMENT OF REVENUE
~
Received,
Examined and Approved,
Wrote abo.ut Appra.isement,
Appeal f,-om Appraisement,
Entered and charged,
,
,;
-
-
Form RC C·lO Doc~ef 3 y'_ E?-0-R DEDUCTIONS ALLOWED IN J
THE SUM 0' ..•..•.....• $ :t.tJ6}, bj OFFICE OF TME
REGISTER OF WILLS
OF __ W.:..;;'A:..=S=.:H::.=I;..:;..N;..::GTO::;.:..::o.:;N.;___ COUNTY
STATEMENT OF DEBTS
AND DEDUCTIONS oAn:: APPROVED . . . . . . G~J..=.J .. { ...
AND AGENT OF THE COMMONWEALTH
ESTATE OF __ C=HA:..=.::::.:R:.=L:::BS:::· ;.._;:.HAZ=:;.;L:=:B=.TT=---LATE OF _ ___.,:S:;PBE:..==R=S~·------------
DATE OF FILING APPRAISEMENT ----!De~:l!!C~e~ml!beo!!i!Jr!!..-_ _..~l'-'i9!..L7Q..T5 OF DEATH ---l.Q.u.e._t~~o~Oo.lJbei.IJII:..Ior--"2""-!,~l.a.;9:&6u.::tQ~---
DATE NO. OF NAME OF PAYEE REMARKS AMOUNT VOUCHIO"
196~
Oct. 8 Bdwin Melenyzer Funeral Decedent's Funeral Bill 1,468 00
Home 13 AuthoritY of Borouab of Decedent's Final Bill 20 so
Charleroi 31 West Penn Power Co ·--Decedent's Final Bill 14 12
31 Columbia Gas Company Decedent's Final Bill 11 36
31 Bell Telephone Company Decedent's Final Rill 11 63
1970
Jan. 6 Russell Marino, Clerk Probate of Will 11 so
6 Guy Rogers Trip to Char ~Will lS 00
12 Washington Counv Reports Bstate Advertising 14 00
Feb. 19 Valley Independant Estate Advertising 10 75
Aug, 14 Russell Marino, Otrk Filing RCC #33 3 00
Dec. 18 CAthy Rosenthal Notary Fees on ROC #33, 7 00
fl!.!--~ Howard F. Carson Inventor~, Ril #10 1 Short ert ticate 1 00 ,;2~-r r
,;;-:;-UnM!:l"l'd F carson Attomeys Fees 466 68
d-~ Russell Marino, Clerk Filing Inventory 300
t:iJL _L I t ii '!'(_,A A J .iT11AA1.;;./V\ A..,d, -~ <...L_J -~ 11 _. . , AA~J.t;;; 7A. {. /0 ~
. .J ...
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l'"_.... I v '
TOTAL CREDITS .... ,.,,...,..,, .,.._;
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF WASHINGTON
I,
INHERITANCE TAX PURPOSES.
J?-d ~~~~v SWORN 1r&c!.\iBPD BEFORE ME THIS 0 /~ DAY Ol'~e ~ 7 w::z Oid4J~
(L. 5.)
Member Pennsylvania Assn. of No1aril!$
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