HomeMy WebLinkAboutOC1970-0208 - ESTATE OF KEMP/
To:
Deceased.
Personal property in County
..............................................................................................................................................................................asknown
(If not domiciled in Pa.)
Value of real estate in Pennsylvan'ia
..............................................................................................................,.
also
Inf,Js.tacy
PETITION FOR ~RANT OF LETTERS OF ADMINISTRATION
Estate of .(f2~~~.............................................................................................'?No......,..~.::::....7..9...:::......;(0 ~
.:Jf-'11-,/
Register of Wills for the
County of Washington in the
Commonwealth of Pennsylvania'7 Social Security No :..
The petition of the undersigned respectfully represents that:.f'.
Your petitioner(s),who is/::Ire 18 years of age or older,appI.~./E..D for letters of administratio{..
...................................................................................................., " ,on the estate of the above decedent.i (d.b.n.:iJcndente lite:durant..absentia:durante minoritate)
r •.a~~;;t?t.i;;.,/..~;~1~~;;~n ~;;eS~in..~S".k~~~~W~..~~~~.~7~.r ~~i~~i~~I..~~~i~~.~.~.~..~t..::::::::..:::.
'st street,number ana municipality)
Ace?rf:$~n tiL'years Of.age,died ~~~j.:..~J...q 6 9..=:;-::;;;,196.9atlX,.~:2 7 ~.l#(...~2n $I re~~?J.Ja:.~~~</~(?.7 .
~I:c::::C~:dd;l:t~a~;ned proper~l :::o~1s::::~:::)~lues as follows:$~.
(If not domiciled in Pa.)Personal property in Pennsylvania $..
~:::::~~::•...::::.....•..::::::::.
situated as follows:..
Petitioner......after a proper search ha../.Ll ascertained that decedent left no will and was survived by the following spouse (if any)
and heirs:
~.~.7::h1.~.~~~~...l:s..rN....7..Re tiO:~.~hIP J/d~£~.
.•Jj'l,JJ]f!~!f;.;~.':f./,'c.,'h1!;~.;y....~~.,....._._.f~~.f.YIJ~.t :,..~..I.~tfJL~~~.~it;.?:Jiff...(~;)..~.../..:3.1....2n.5..I.c~R,fl:/!!f~'S ']~J:;fJ;·J..7 ·..r..~..)..~~~~·lff;]f~·············...........................•......JY:'Yi1l~~..:.~¢'~~;fl:'::1z~Ti ~:......•.~...•.....•••••••••...••.••:••••....••.•........•....~:::.:......:::::::
I the grant of letters of administration in the appropriate f~rm to the undersigned,_\I
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF WASHINGTON
OATH OF PERSONAL REPRESENTATIVE
~ss
The petitioner(s)above-named swear(s)or affirm(s)that the statements in the foregoing petition are true and correct to the best of the
knowledge and belief of petitioner(s)and that as personal representative(s)of the above decedent petitioner(s)will well and truly adminis-
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APPLICATION FOR
Letters of Administration
ESTATE OF
Deceased
R $.
Letters ;..
P $.
Extra Alias $..
Certificates $.
Renunciations $.
$.
Total...
Attorney
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•
63-70-208No.
Ono KempEstateof ,Deceased
Grant of Letters of Administration
AND NOW AUP'llst 20 19 81 .'d'f h ".h 'd......9:-.. . . . . . . . . . . . . . . . . . . . . ....,10 conSI eratlOn 0 t e petition on t e reverse Sl e
hereof,satisfactory proof having been presented before me,
IT IS DECREED that ~?Y.tp.~~~.:fl.•..~~~I?.
is/are entitled to Letters of Administration,and in accord with such finding,Letters of Administration
are hereby granted to ~~~9~~..F;I~..~.~~p..
•••••••••••••••••••••••••••••••°0 "•••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••
in the estate of Qnp..K~JJ1p..
FEES.Cd~.....,".,
Letters of Administration $.I.~....C{.<:?
....x~..~.1-~.&~
Register of Wills'~If./3
.....................I!./A .
ATTORNEY (Sup.Ct.I.D.No.)
Short Certificates (
Renunciation -2 __
)$..
$.:<?19
ADDRESS
TOTAL -
- - - - $.
$./:<..f.Po .9 P£,
August 20 81FEedA.D.19 .
PHONE
"
•
...
63-q,(j)~208
ONO KEMP
And now,August 20,1981
Letters of Adminisbration
are hereby issued to
Raymond H.Kemp.
Who is duly qualified.
Kathleen Flynn Rada
Register
NO BOND REQUIRED
Bond Book 69 Pages 670-673
~
--------------
RENUNCIATION 63-70-2o~
In Re Estate of Q.i'l.a j.<.E.M ..f?deceased.
To the Register of Wills of Washington County,Pennsylvania.
The undersigned of
the above decedent,hereby renounce 7.1J..f..l.f{..right to administer the estate and respectfully ask that
Letter~Q.F.A.D.~m.J.I'I."...:5.r..8.t.\.7:.(,.0.d .
be issued to ,R.A..y..i.rJ.IJ.IJl..D.H.J .K.E.m..p..
WITNESS hand lhisd.<ld.day of ~,19..8..1
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RENUNCIATION
In Re Estate of 6..t1..Q K..I;;;,/YJ....P deceased.
To the Register of Wills of Washington County,Pennsylvania.
The undersigned of
the above decedent,hereby renounce TIf.(;'I.&right to administer the estate and respectfully ask that
Letters fj..F.A-.D.m..L.nf.t.$.X..;R..A.T.L.~.N .
be issued to 'fi.,A,y...frJ./J.N.IJ tI.l:<.£:.M r..
WITNESS hand thi.:J..~.-d.day of ~,193../..
Signed in the presence of:i?.
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(ADDRESS)
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RC C-43 (5-65)
NOTE:TO BE SUBMITTED IN TRIPLICATE
Pennsylvania Department of Revenue
Bureau of County Collections
26·S.4th Street
Harrisburg,Pennsylvania
Dear Sir:
Pursuant to Section 742,Pennsylvania Inheritance and Estate Tax Act of 1961,
we herewith submit the following report:
NAME OF REPORTINGFINANCIALINSTITUTION __--MP~i.l"r.tt...,s.._!b,rut_rrIt_9_t"h~N....a7't't1l!!r"·o_n_a_l_B_8_n_k _McDonald Offioe
ADDRESS M_c_D_o_n_"_ld_.,_p_a_·,,_1_5_0_57_._
ACCOUNT NO.OF JOINT,22831TRUSTORINVESTMENTDEPOSIT__·._
NAMES ON ACCOUNT Ono Kemp or Charles ~P _
OR INVESTMENT __--========--====_
DECEASED JOINT DEPOSITOR,Ono Kemp ~TRUSTEE OR INVESTOR V""'--_
Box 192,Cecil,Pa~.15321ADDRESS _
DATE OF DEATH December 1,1969
SURVIVING DEPOSITOR,
BENEFICIARY OR INVESTOR _C_h_a_r_le_s_K_e_ro_p _
Box 192,Cecil,.Pa.15321ADDRESS _
:3 -1-')()
SonRELATIONSHIPTODECEDENT _
DATE DEPOSIT OR INVESTMENT Open many years.-/WAS ESTABLISHED _
BALANCE,INCLUDING INTEREST 6S9.04DUE,AT DATE OF DEATH $_
JA}281970
If you have already paid this tax to an executor,administrator,attorney or other personal representative of the
decedent for forwarding to the Commonwealth,list below the date paid,name and address of the person to wFi'om .....
you made payment,their official title and the amount."
Date Paid Name and Address of Payee Official Title Amount Paid
Under certain circumstances,if,after the date of death of the decedent,you personally paid funeral expenses
or other just debts of the decedent,with funds derived from the property herein taxed,such amounts expended
by you may qualify as deductions against the gross value of the property in the computation of tax due.If any
•such expenditures meet all of the three following tests,it is recommended that you itemize the payments below,
"execute the affidavit,and return this notice.The Register of Wills will examine .the debts claimed and allow
those which he determines to be proper.The tax will then be recomputed and you will receive an amended
assessment of tax.
THE THREE TESTS WHICH MUST BE MET ARE THAT:
1 -You were personally legally responsible for these debts,and.,
2-You actually paid these debts out of the account or property described above and can furnish proof
of such payment,if required,and
3 -These same debts are not also claimed,for tax purposes,by an executor,administrator or other
person.al representative of the decedent handling the administration of the general estate of the
decedent or any other transferee.
SCHEDULE OF DEBTS
Date Paid Name of Payee Description of Obligation Amount Paid
TOTAL $
(attach separate sheet if requ ired)
COMMONWEALTH OF PENNSYLVANIA)
COUNTY Of _
SS:
I,hereby certify that the foregoing is a just and true statement of
funeral expenses and other debts of the decedent,,for which I
was legally responsible and which I did payout of the property herein taxed.I further certify,that to the
best of my knowledge and belief,these same debts will not be claimed by any other person,for inheritance
tax purposes.
SWORN AND SUBSCRIBED BEFORE ME THIS DAY OF____________19 __.
REPORT OF REGISTER OF WILLS
Si gnature of Taxpayer
I,the undersigned,duly elected Register of Wills in and for the above county,do respectfully report that I
have allowed deductions listed above in the total amount of $•
Date of Approval:_
Register of Wills
Fonn RCC-2....COMMONWEALTH OF PENNSYLVANIA DA1.'E Mar.2 1970......................................7...................................................".........
j,o DEPARTMENT OF REVENUE RESIDENT INHERITANCE TAX COUNTY WASHIN.G.I.ON..........................................BUREAU OF COUNTY COLLECTIONS
HARRISBURG.PENNA.17127 "-APPRAISEMENT
FILE NO............§..J..::..7.Q=..~.Q.e........................................
i ONO KEMP CECILIWhereas,.....................................................................................................................................................late of ..............................................................................................................
in the County of ....................~.~~~.!.~9.:!..9..~.........................................................................Commonwealth of Pennsylvania,having died on
1st December 19 .....~?seized and possessed of an estatethe...............................................................................................day of ...............................................................................
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore,I,·......................................·....W·.....R .....·GHANEy........·..·........·..·...............,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 AppraisementDescriptionofASletValuesMadeforInheritanceTaxPurpo.es
$
JT.HELD PERS.:
--.
Jt.Bank Acct.#22831 held in the PITTSBURGH
NATIONAL BANK,M"THnJA Tn u ....nnMATn oA .;...+-J..A --.,,,
names of ONO KEMP or CHARLES KEMP.Q'Oened many years.
Balance as of date of dea~59.04 One-half taxabl 329 52
-
-
.
fonn~;v~':fhbl::~:~i:W(.rl1~~~~:~:;:re~~~:.~~~raise;~i.~~~e1~~:;
......................................................................................................~:~......................
Appralaer
.................................................................'.........................................................................."..................
(Number and Strtet)
..............,...............................'.....................",................................,.".................,.............,Penna.(Poat GIBe!)
WASHINGTON County
RESIDENT INHERITANCE TAX APPRAISEMENT
Estate of
...ONO KEMP .
Deceased.
Late of
CECIL
Date of Death,-December T r ..··196.9
Appraisemel!t Docket Vol.,J.e..
63-70-208Page,No .
Filed in Register's Office,~.:..~.:19...!~
Amount of tax due,$.
DEPARTMENT OF REVENUE
Received,
Examined and Approved,.
Wrote abo,ut Appra.isement,
Appeal f"om Appraisement,.
Entered and charged,HH •••••••••••••••••••••••••••••••••••••••••••
\
~.I
,
-&'
Rev-464 EX+(7-80)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
INHERITANCE TAX RETURN
FOR ESTATES WITH GROSS ASSETS
UNDER $10,000.00
Date of Death J!Jz-c~0 /q b 9
Social Security No.I?()..-/1)-¥7 9 )
Bureau File No.~0~3--~Z.>o<:-()_-~;<-=---O-,",,-J _
County File NO!D;5 1-if q A tJ
1.Decedent died:~Intestate (without a will)·0 Testate (leaving a last will -copy attached)
2.Is the filing of a Federal Estate Tax Return required for this estate?Yes No
3.o Executor M Administrator o Trustee .Other _
,"D·o I ~9-6-5/'()!A_Social Security NoNa
Add::::J~~.
(Street)GA~4,..........=--------",G>=::J-_.Q~""Y1,--,-,/VI.:::;~tV~__----JJ----=:6",,-------!;cl--~O,--~=--_
(CittJ (State)(Zip)
4.All correspondence should be mailed to o Attorney ~.,Fiduciary.
5.If an attorney is representing the estate,indicate:
Name _Telephone No._
Address :-::-_-:-_
(Streed
(City)(State)(Zip)
ITEM
NO.
j,
:I.
R~AL PROPERTY -Identify real property located in Pennsylvania by lot and block number,street
address,township or borough and include a statement of mortgage encumbrances as of the date of
death.
Estimated
Market Value
vfl~
I )
Department Valuation
(Official Use Only)
If additional space is needed,please use 8%"x 11"blank paper.
:-
ITEM
NO.
ITEM
NO.·
PERSONAL PROPERTY -List all tangible and intangible personal property owned individually by
the decedent at the time of death.
Total
JOINTLY-OWNED PROPERTY-List all real and pp.rsonal property owned by the decedent with
with another party or parties as joint tenants with rightof survivorship.Include name,address and
relationship to the decedent of the joint ownerls)and the date the joint ownership was created.
Total
Estimated
Market Value
Estimated
Market Value
Department Valuation
(Official Use Only)
Department Valuation
(Official Use Only)
ITEM I TRANSFERS -List all real and personal property transferred within two years of death.
NO.
Total
Estimated
Market Value
Department Valuation
(Official Use Only)
List all safe deposit boxes registered in the decedent's name,or jointly with,or as an agent or deputy of another,or in decedent's individual name with right of
access as agent or deputy.Include the name and address of the bank or other institution where the safe deposit box is located,the name(s)in which the box is
registered and the relationship of the joint holders to the decendent.
Name and Address of Bank or Other Institution
In Which Decedent Maintained a Safe Deposit Box
Name or Names In Which
Safe Deposit Box Is Registered
.-
Relationship of Joint
Holders to Decedent
NOTE:You may expedite the processing of this return by filing with it and as a part of the return,letters from financial institutions or mortgage holders,
certifying to amounts on deposit or owned by the decedent as of the date of death.Such letters must be signed by a responsible officer of the financial
institution or mortgage holder and indicate clearly amounts of principal and interest in the decedent's account at the date of death and the type of account,
-.account number and the exact name or names in which the account is registered.
't,
--_.._------_._---
DEBTS AND DEDUCTIONS
ITEM
NO.
Date Name of Payee Nature of Debt Amount
Funeral expenses paid
Family exemption (will notbe allowed unless decedent died
residing with a parent,spouse or children.)
Administration Expenses
Counsel Fees
Fiduciary Commission
(Other Debts and Claims)
Under penalties of perjury,I declare that I have examined this return,and to the best of my knowledge and belief,it is true,correct and complete.
¥-;).,s-e:z/
Date
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.
___,~%tax rate.atDebtsanddeductionsareallowedinthesumof$d 9 ¥...c tI'-r1
I do hereby certify that I have appraised the assets contained herein in conformity with Pennsylvania law.~-A1pg~>=....
Zo
wen::l....«
(J,.,.o
INTEREST OF
BENEFICIARY
IN ESTATE
AGE dF LIFE
TENANTS OR
ANNUITANTS
AT DEATH OF
DECEDENT
BENEFICIARIES AND ADDRESSES
(State full names and addresses of all who have an interest
either vested,contingent or other interest)
BENEFICIARIES========================*=======;==~,F==r=========j===========~
RELATIoNSHIP SURVIVED
TO DECEDENT DECEDENT
STATE YES
OR NO
C -0 0 (')»m »~»0 0 0 en 0z(;)(')C 0 -i s:rmm'"Z Jl »r
Z Z m -i m -i Z Z z??-i -<en m ?en ?z 0 en 0 -i
?""Jl»::!0z
;T en ..:"~
lJ")--J ,........
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~\"-.;~~-<-<0 c...c ,',)m m
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"'-"Jl Jl-I U:lt.D ..,..-;-........1.1-(~OJ ~
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co...
INFORMATION
PLACE FOR FILING -The ,return is to be filed in duplicate with the Register of Wills of the county wherein the decedent resided,
,,
TIME FOR FILING -:The returriis due ~ine months after the decedent's death,unless an extension for filinghas been applied for and granted by the
Secretary of Revenue within the nine-month plll'iod,
FAILURE TO FILE RETURN -Section 791 of the 1961 Statute provides that". , .any person who willfully failes tofile a return or other report
required of him ...shall be personally liable,..to a penalty of 25%of the tax ultimately found to be due or $1 ,000 whichever is the lesser to
be recovered by the Department of Revenue as debts of like amount are recoverable by law."'
REV-5IS F'O (7-S0))
NOTICE OF FILING OF APPRAISEMENT
63-70-0208
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
Sepemmber 18,1981
Raymond Kemp
C>Jlo
RE:Estate of ---..I.....n_o.........K_e_m..,p~_
County of washJ.ngton
File No.
Dear Sir:
You are hereby notified that the ~_.TT:-:::-:::-_O~r_ig::::..i_n_a_l _
appraisement in the estate of Ina Kemp
has been filed in the office of the Regi~ter of Wills of _w_a_s_h_J..;...o_g_f_o_n _
County on September 18 ,19~.Said appraisement reflects the following valuations:
Real Estate
Personal Property
Jointly Owned
Transfers
Total
4,000.00
4,000.00
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 nine (9)months (fifteen months
when death occurred from December 22,1965 to June 16,1971,inclusive;and twelve months when
death occurred prior to December 22,1965)from date of death,interest at the rate of six (6%)percent
per annum is charged.
Any party in interest who is aggrieved by this notice may object thereto within sixty days
after receipt of said notice as provided by Section 1001 of the Inheritance and Estate Tax Act 0'
1961,72 P.S.2485-1001,P.L.373.
Date September 18,1981
DOD:12-1-69
NOTE:This is not a bill.
Signed ~),Q,~
Title ~
Date of Death 12-1-69------------------------
File Number 63-70-0208
~A'fJ
Estate Name -:I::.:n~o::........:;K~e~m.:J:p:..-._
,
.-REV.484 EX+(!l-80)
INHERITANCE TAX SUMMARY SHEET
(BUREAU USE Ot-lLY)Gl OriginaloSupplementaloRemainder
Social Security Number _
REPORT OF INHERITANCE TAX APPRAISER
I,the undersigned duly appointed Inheritance Tax Appraiser in and for the County of W:l~bj~n .,
Pennsylvania,do respectfully report that I have appraised the real and personal property as reportedin the foregoing
return at the values set forth opposite each item ii,the last column to the right in Schedules "A","B","C",and "E"
Dated,September 18,1981 ~~J1 ;..Q..Ju"...,u
HERITANCE \AX APPRAISER
ADJUSTMENTS REMAINDER APPRAISEMENT CODEINVENTORYVALUEASAPPRAISEDCODE(HARRISBURG USE ONLY)
Real Property (Schedule A)$I.()/"I/"I 1/"1/"1 00+92+
Personal Property (Schedule B)10+
Joint.Held Property (Schedule E)20+
Tronsfers (Schedule C)30+
TOTAL GROSS ASSETS 4,000.00
Less Debts and Deductions 2,945.00 40-93-
(SCHEDULE F)
CLEAR VALUE OF ESTATE 1 055.00oLifeEstateRATE'FACTOR PRINCIPLE VALUE CODE---o Annuity =-J ,I
FOR USE OF REGISTER ONLY £Q.RS COMPUTATION OF TAX
Tax on $1 O'i'i 00 6%$
Tax on $15%$
Tax on $$
Tax on $$
Tax on $$
Exemptions
Total Estate-1 /"10;0;/"1/"1 63.30
TOTAL TAX $
INTEREST FROM 3-1-71 10-1-81 $40.20TO
BALANCE $103.50
Less Credits 11J1"/DATE OF PAYMENT AMOUNT PAID DISCOUNT INTEREST TAX CREDIT
$+$$:;:$
+..
BALANCE $
INTEREST FROM TO $
BALANCE DUE $
RE;:V-457 (1-80)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
INHERITANCE TAX
APPRAISEMENT
oJ/o
Estate of I_n_o_K_e_m..:p:..-_
WashingtonCounty _
File No.__6....;3_-..;.,7.;..0-_o:.;:2:.;:o...;.8 _
12-1-69DateofDeath _
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 toappraise and assess transfer inheritance taxes atthe lawful collateral rate
on any such future interest.
PROPERTY REPORTED BY THE ESTATE DEPARTMENT'S
APPRAISED VALUE
1.TOTAL REAL PROPERTY -SCHEDULE "A"400000
2.TOTAL PERSONAL PROPERTY -SCHEDULE "B"
3.TOTAL TRANSFERS -SCHEDULE "C"
4.TOTAL JOINTLY OWNED PROPERTY -SCHEDULE "E"
TOTAL REPORTED PROPERTY 4,000.00
PROPERTY NOT INCLUDED IN RETURN BUT APPRAISED BY THE COMMONWEALTH
;
TOTAL UNREPORTED PROPERTY
TOTAL GROSS ASSETS 4 000.00
LIFE ESTATE OR ANNUITY CALCULATION
I do hereby certify that the above appraisement is made in conformity with Pennsylvania law and has been filed this day
with the Register of Wills.~~9-18-81
APPRAISER DATE
,
(OFFICIAL USE ONLY)
WILL
NO.YEAR _
ADMINISTRATION
NO.YEAR _
ESTATE OF Ina Kemp
ADDRESS McDonald
COUNTY OF Washington
DOCKET NO._
PAGE NO._
LINE NO._
COMMO.NWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF EXAMINATION
COUNTY FILE NO:_
TO:Raymond Kemp
OFFICIAL NOTICE OF
INHERITANCE TAX
ASSESSMENT
DATE
ESTATE
September 18 •]981
640loo Kemn
245 Ljncoln Aye.
Pi ttsbllrgb ~P8 15202
Appraised Value of Estate:
Real Estate
Personal Froperty
Jointly Held Property/Transfers
Total Gross Estate
Total Approved Deductions
Clear Value of Es:ate
Less:App.'oved Charitable Exe!f1ptions
Clear Value of Estate Subject to Tax
$4~OOO.OO
+
+
$4 000 00)
-2,945 00
$1,055 00
$
FILE NO.63-70-0208
COUNTY WAshington
DATE OF DEATH'_..J..1£..2-::...L.:1=.J6~97...-_
Amount Taxable @ 6%Rate
Amount Taxable @ 15%Rate
$1,055.00 tax due
tax due
$63.30
TOTAL PENNSYLVANIA INHERITANCE TAX DUE $::.._
* * * * * *A five percent discount totaling ..:;.$_
will be granted if the Inheritance Tax is paid by
Less Credits:
DATE OF PAYMENT
$
AMOUNT PAID DISCOUNT
+$..:..-_---
+
+
INTEREST
$
TAX CREDIT
=$..:..-_----
=
Interest accrues at the rate of six (6)percent per annum
on the unpaid balance of Inheritance Tax from --~3Hl~7f-.lr--'------
to date of payment.Interest due if paid by 10 1 81 is -""""",4'dO••it2~O---
BALANCE OF PENNSYLVANIA INHERITANCE TAX DUE $103 50
Assessedby:Ray niCkersoDIe 6
See Information on Reverse Side Agent fortheCommonwealth
REGISTER OF WILLS
,INFORMATION
To insure proper credit to your account.the nameaf the estate and file number should be clearly print-
~d on the check or money order.
This assessment is made in accordance with Section 708 of the Inheritance and Estate Tax Act of
1961 (72 P.S.§2485-708).
T~the extent that inheritance tax,is paid withinth~ee (3)months after the death of the decedent.a
discount of five (5)percent is allowed (72 P.S.§2~85~716).
'..,I 'Inheritance Tax.other than tax on a future interest.is due at the date ofthe decedent's death and becomes
delinquent at the expiration of nine (9)months aftei-the'decedent's dea'th (72 P.S.§2485-711).'InheritanceI.'.'.'.•'.'Tax on a future interest is payable within three·(3)rri~ntJJs after the transfer takes effect in possession and
enjoyment and is delinquent thereafter (72 P.S.§2485-7.1·2)..Calculate interest from the delinquent date shown
on the face of this form to the date of actual payment using the following interest table:
---------------------------------------------------------------------------
1 month .005 '4 months .020 7months .035 .10 months .050
2 months .010 5 months .025,8,months ~040 11 months,.055
3 months .015 6 months .030',9 months .045 '12 months .060
-'-1;
1 days .00017 11 days .00186 21 days .00352
2.days .00034 \12 days .00203 22 days .00369
3 days .00051 1~days .06220 23 days .00386
4 days :00068 14_days :.QQ237 24 days .00403
5 days .00085 15 days .00250 25 days .00420
6 days .00101 16'days .00267 26 days .00437
7 days .00118 17,days .00284 27 days .00454
8 days .00135 18 days .00301 28 days .00471
9 days .00152 19 days .00318 29 days .00488
10 days .00169 20 days .09335 30 days .00500
-----------------------------:a---...:;,-';........:..~.~-~-:-,-,-----.----- - -~----------..;..----
Any party in interest.including the Commonwealth and the personal representative.not satisfied with
the assessment may ~bject thereto within Sixty'(6bjl'days afte'~~recei~t'of this Noti2~as provided by Section
1001 of the Inheritance and Estate Tax Act of 1961 (72 P.S.§2485-1001).
Make check or money orderpayable to:,
"Register of Wills.,Agent"
Mail to the address listed below:
,'",'~,
I
.1
$-~~~~~~~·n
$---------1:1
$63.30
$------_.'-'-
$---------.
2%Tax on $_
6%Tax on $F'inal Payment
15%Tax on $_
%Tax on $_
Estate Tax,Act of
May 7,1927
15202
Dote of Death 12/1/69
Pittaburgh,Pa.
File No.63-70-208
Address 245 Lj ncoln Ave.,Apt.402
Dote of Payment September 23,1981
,Nome of Decedent _....0'-1n~o"-"-...J.K:...es:azm.l.jpfL-----------1
iI'
lH========
~i RECEIVED~~~~~~~~~~~~~~~~~~~~~~t~~~~~~~~~~~~~d~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~5~O~/~1~1O~O~~~~~~~_~~~_~_~_~dollars~f representing Pennsylvania Inheritance or~,From:---iR.;l-lhm.cmd--R_-K.e:ll.J:l'-------------.-------:Es:.:t.:a.:..:te=-..:..T.:ax::....::d:.:u:.:e:....f:..:.r.:o..:..:m..:......:..th:..:.e:...:.f:..:..:.oll:ow.::..:..:in.:.:g~e::.s.:..:ta::.te:.::-Il~!=;~;
U~
._-------------~~~-~~~-
County '¥laahington
I RemarksBM
I
TOTAL TAX CREDIT
Less five percentum of tax if
paid within three months after
dote of death
Plus interest at the rate of
-G-%from 3/1/7 1
to date
$63.30
$---------11
$40.20
$103.50TOTALAMOUNTPAID~lJrn~[p[L~@illlJ~SEAL
.38-49-4NOTE:This1"riplicate Receipt to be retained for audit purposes.
,,~.-
Received by f-JI.,-!-.+-+:-.-MF-F~~~;Z::+...L..,f.:::-t.,.-,7'+I_·~T'~··:""""'!/~~/--.II!
NOTE:In accepting the transfer inheritance tax an future estates,prior to the death of the Iifey"'''-''rej )'-.;.,,,
tenont or tenont for years,as evidenced by this receipt,it is understood that the Commonwealth shall
not be precluded or prevented from hereafter ossessing additional inheritonce tax ot the deoth of the:---JA'1g[;(iQ~I;;l~t~----------H
life tenant or tenant for yeors whenever it appears that such additional tax may be legally due and (Title)
collectible for any reason whatsoever.
I~
~~J