HomeMy WebLinkAboutOC1970-0282 - ESTATE OF CAMPBELLNOTE:rOBE SUBMITTED IN TRIPLICATE
Pennsylvania Department of Revenue'
Bur~au of CQunty Collections
26 S~'4th Street':-.:,-.i.......,
Harrisburg,Pennsylvania
.:..:....,
Dear Si r:
Pursuant to Section 742,Pennsylvania Inheritance and Estate Tax Act of 1961,
we herewith submit the following report:
)
~
\/DI:CEASED JOINT DEPOSITOR,.--
TRUSTEE OR INVESTOR Ibt-tit (:'-..b'U
NAME OF REPORTING
FINANCIAL INSTITUTION.",.HartolJ.II,..,..'''''''0''11_
'••htaaton.,ei.__IJ'.tS301ADDRESS4t)loutb JfdD'ttMt .
ACCOUNT NO.OF JOINT,
TRUST OR INVESTMENT DEPOSIT_'_...;JJu.16~~-o~_Ial&"!!llIiI··~J....2,-....,1IDL.JO!J'l:I,-'--....•••<QoJGI:IIiIPl-.---
NAMES ON ACCOUNT
OR INVESTMENT__':::,:·lI=··.::t.i!:....··=11...~C__~··="~l~l _
.~'-.....-
...t•.••",el1
ADDRESS ale '-.1...1C~••bla&_",'...uf,lvol·"IoS)O!
DATE OF DEATH ''-'''uY ll,1,_
SURVIVING DEPOSITOR,..'.
BENEFICIARY OR INVESTOR ChMle'••C!qtktl
ADDRESS!l'Woo"".hie HUhta,taD,,."..,.....IS3,t
TITLE
",-,.'
RELATIONSHIP TO DECEDENT...,;,.'.........;...,~---$IMON1.I0-,,;,..---------
DATE DEPOSIT OR INVESTMENT
WAS ESTABLISHED,'12114J62
BALANCE,INCLUDING INTEREST
DUE,AT DATE OF DEATH$_·~~~=~~-f-,f--_..,....-;_
~S6g.0-0..~h;Itchn .°/6 fl1JL".1o ..~'7fIJ1-11-70.1/;.
J,
•
Julfll,1974
D(tQI1~.fi,)sumetU;
'It,hn now been 48Cma~ttM above ~d deCed~at
death,le91l1'roatdtdin ~.~acn.m.t,.
m.nee Wut1l!Ot"$land Count"was not the ~wt1 of r$d.dence~
10U ate authonzed to ¢ancel me bber 6S-7~a.stpdthel'eOn.
ou:r Buroau record3 of roe RUm'be1"6S-7J:,...2B wUl be eanc:'e1ed.
A.U"matteJ'a eonc:em!ng tbia estatG 1dl1 bJ recorded and a~
1n.Jl~CountY.th."cc:mntl (It do1!1e1le and &-e.Udente,Ul'l<!erFile..•...3-7lr28._
p=
.~E.Ion
Jnher1tanC&!ax Div;t.a1on
Fort P&ter J ..HeHale.~
~u of County Colleetiont
---------~-_.~-------~---~----~-~--
Form RCC-33
RESIDENT DECEDENT
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
COUNTY OF
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 Inheritance_an~EEitate J'ax Act of 1~!31.)
.....................~'.g~~E~~.~y!.s.:..':~p.?~..~.~.
of the estate of the above-named decedent bcing duly sworn,depose and say
Eueutor
Decedent·died
Name and address of attorney or}
other authorized representative to
whom all correspondence should be
mailed.
Clla,:r1E:)..f?...W..CCI,illPb~U,AttQx.!l.~y.!~t ...J.,.a,\Y..
219 WoC?~sicle Dri\Te,Wa.-shirrg~9n,I:>~.15301
That as siIch ~.~.~.s:.~t9..!:deponent is familiar with the affairs of said estate and the property con-
(Executor·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
None
That 1-.he contents of said safe deposit box or boxes are itemized under Schedules of this
return,with the exception of the following,for the reasons hereinafte·r set forth:
That Schedule A attached hereto 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 enc\wbrances 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,~r'in trust for
any other person or persons giving also separately the accrued interest thereon,if any,down to the last
interes·t day prior to decedent's death in the case of saVings banks~and to the da:te of dec~dent'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 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,with interest thereon,if any,giVing the face
value and estimated fair market value thereof,and if such .~stimated 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 sho'dng 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_.wi th the fa\r J!larket value
thereof,any other property owned or bequeathed by the decedent at the time of death•
.'[ei;':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 t,wo years of decedent's
death,in contemplation of decedent's death,or intended to take effect in possessi~n or enj~yment at or
after death,said schedule sets forth the nature and value of such property,to w~~~tp~lsferred,the
relationship of the transferees to the decedent,the proportionate share received by each transfe~ee 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 co~y
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 passe~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 inliividually•.or jpintly,by the.will,deed,or other instrument of another,
with a copy of the instrument ?reat~nej~~?~i~?~e:~ttached to th~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,rthe 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 Sc~edule 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 Sc~edule 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 (If
~.,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•
._:~::Z.S:~f:;::L::::::~~&t2.~..:...._._..,~..
·~E~~··,~j€~:~~~-.-
PlttS~;g~~:~~s~::~Y£~:~I~~,Pa."~~7.'C~..~./:!..:!....'!.I...
AU9ust 2/,19;3 .(City or n 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 PENNSYLVANIADEPA~TMENTOF REVENUE
BUREAU OF COUNTY COLLECTIONS
TRANSFER INHERITANCE TAX
RESIDENT DECEpENT
SCHEDULE CIA"
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 with
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,as'sessments,accrued interest on mortgages,etc.,are
to be listed on Schedule II F"and must not be deducted from this schedule.
An undivided 1/3 interest in:
ALL that certain tract of land situate in Mount
Pleasant Township,Westmoreland County,Pennsyl-
vania,being and lying along a public highway known
as Legislative Route No.64229,and bounded by
lands now or formerly of Porter McCurdy,Catherin
Checken,John Farkosh,J.M.Keck,John Ritter,
David Wilkins,James C.Stairs,Frank M.Ross,
and Dean M.Mayes.
(1 )
ASSESSED VALUE
FOR YEAR OF
DECEDENT'S
DEATH
(2)
ESTIMATED
MARKET VALUE
(3)
DEPARTMENT
VALUATION
CAUTION
(Do not write
In this spoce)
BEING part of the same tract of land described
at Second in deed of J.D.Porch,Executor of
Jacob Porch,deceased,to W.K.Porch,dated
October 5,1916,Deed Book Vol.588,page 130,
therein described as containing 62 acres,more or IE ss,
with the exce.ption of rour small parcels of the same
heretofore conveyed by deeds of record in the Office
of the Recorder of Deeds of Westmoreland County
as follows:Deed Book Vol.804,page 480;Deed
Book Vol.1163,page 492;Deed Book Vol.1515,
page 247,and Deed Book Vol.1586,page 215,said
conveyances containing in all a total of 7.15 acres,
leaving a net area remaining in said tract of land
of 55 acres,more or less.No.Improvements.$350.00 for
full interest
A 1/4 interest having been acquired from the
estate of W.K.Porch a/k/a Wm.K.Porch,
deceased,Number 129 August term 1957 in the
Orphans'Court of Westmoreland County,and a
1/12 interest having been acquired from the estate
of Charles L.Porch Number
in the Orphans I Court of Westmoreland County,Pa.
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.
$350.00 for
1/3 IDter~~
~1J,
J
RCC-134 (8-'65)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
INHERITANCE TAX DIVISION
OFFICIAL NOTICE OF INHE.RJ-TANCE TAX
APPRAISEMENT AND ASSESSMENT OF
ASSETS NOT SUBJECT TO ADMINISTRATION
TO:__C;:.;,H.:,..ARL....;,·.:,..ES_'....;,Vf.::..~--:C:....1\M.:..;l::..PB::..E..:'L1::..·_
219 WOODSIDE DRIVE
Date:J...:.an..:.;..:;u--:ar~y~2:.:6..!..,-:1::..9:,.:7...:0 _
County W_a_sh:.:.l=.:·ng::!:2..:,t:..:o:.:.n=--_
___W_A,~HINGTON,PENNSYLVANIA 15301 County File No._
Bureau File No._
We have recei ved notice that,~~XXXXXXXXXXXXX:xxxxxxx..u:xxx.xXXXXXXXxx:x:XXXXXXXXX
on January 11 19 70 ,you came into ownership of certain property through ~~
~~l~transfer from,ELSIE 1.CAMPBFLL,deceased.
Under the Inheritance and Estate Tax Laws of the Commonwealth of Pennsylvania such transfers are taxable
and the liability for the payment of the inheritance tax due is imposed upon you,as transferee.
The property on which tax is hereby assessed consists of:Jt.Savings Account #176-05-8012,held
in the IvlELLON NATIONAL BANK AND TRUST COHPANY ,1tJASHINGTON OFFICE,WASHINGTON,
PENNSYLVANIA.In the names of ELSIE 1.CAMPBELL or CHARLES W.CAHPBELL.Opened,
December 14,1962,~Balance as of date of death,$1,000.00
appraised by the Commonwealth,as of the date of death,at $1,000.00
50 %of this amount is taxable at the rate of 6 %
ORIGINAL ASSESSMENT AMENDED ASSESSMENT
DATE OF ASSESSMENT
TAXABLE AMOUNT
LESS:ALLOWED DEBTS
NET TAXABLE AMOUNT
$_--:::.5~00:..:.~cx)=---_$--------
AMOUNT OF TAX DUE 30.00
D If you pay the above amount within three (3)months
of the date of death of the decedent,or on or
before ~-11 19 70 you may deduct a
discount of 5%of the amount of tax due,or 1.50
D This tax became delinquent one year after the date
of death of the decedent and,in addition to the
tax,statutory interest at the rate of 6%of the tax
per annum is also due as of *_
19 in the amount of
ASSESSED BY:_
$===============-
(Agent for the Commonwealth)
30.00
--:;.,....---~"---:---.-,-----:-.--."'-
$
praiser)
APPRAI SED BY:UA..L:...C~-J.:.z~~Cl----
TOTAL AMOUNT DUE
*If the tax is not paid by the above date additional
interest is due at the rate of 6%per annum until
paid
INSTRUCTIONS TO TAXPAYERS
Make checks or money orders payable to:To insure proper cred it to your account
this Official Notice must accompany
your payment.Mail or bring it to:
(over)
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 whom
you made payment,their official title and the Ci'mbunt.!''
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 folIowing 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 wilI 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,a I representative of the decedent handl ing the admin istration 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 PENNSYLVANI·A)
COUNTY O~_
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 legalIy 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 wilI 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
Signature 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 $"
Date of Approval:_
Register of Wills
---------,-------------------------------
RCC-35
COiiMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE lie
P$:i'Q!I QI pnpPFBTY
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".Intangible personal 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 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.
1.
ITEM
List and describe fully
64 Shares American Telephone &Telegraph,
Capital 50.1875 $3,212.00
UNIT
VALUE
ESTIMATED
MARKET VALUE
$1,606.00
DEPARTMENT VALUATION
(Do not write in
this space)
2.40 Shares General
Motor s,Common 68.875 2,755.00 1,377.50
3.
4.
5.
60 Shares International
Harvester,Common 26.8125
80 Shares Mobil Oil
Conunon 45.1875
30 Shares Gulf Oil
Conunon 30.3125
1,608.75
3,615.00
909.37
804.38
1,807.50
454.69
6.
7.
Checking Account at Mellon National
Bank &Trust Co.,Washington Office
Account Number 220-0639 257.39
Savings Account Number 176-05-
8012 at Mellon National Bank &
Trust Co.,Washington Office 1,000.00
NOTE:All of the above stocks and bank account 3
were registered Elsie I.Campbell or CharlesW.Campbell
128.69~~
500.00J ~
Insert this total opposite "Personal Property",Schedule "B"in
the "As Reported"column on the last page of this return.
x X $6,678.7(
RCC-36
rO\t\{():\"'\i7 \LTIl OF PF~NSYLV ..1.NI 1
Tn...\N~FFll INHElUTANCE TAX
RESlnEXT nECEDENT
SCHEDULE "c"
TEL\XSFERS
(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)~o
(2)Did decedent,within two years of death,transfer property from hims~lf to himself and another or
others (including a spouse)in joint ownership?(Answer yes or no)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 heal th 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)~o
(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 enjoYIDent of or the right to income from the property transferred?
(Answer yes or no)l~o
(b)The right to designate the persons who shall possess or enjoy the property transferred or
income therefrom?(Answer yes or no)~~~O~_
(6)If the answer to (5)(b)above is in the affirmative,state whether the right was reserved in decedent
alone or 0 thers -:---:-_
(7)Did decedent in his lifetime make a transfer,the consideration for which was t»nsferee1s promise to
pay income to or for the benefit of care of transferor?(Answer yes or no)0
(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)~O
(9)If the answer to (8)above is in the ~ffirmative,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 attenrUng 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 MARImT VALUE
(Es timated)
DEPT.VALUATION
(Dept.()nly)
_____________________________.L...-.-4 ,-
Insert tilts tntld 0PP08j te "Transfers",Schedule "C"in the
"As Reporterl"column on the last page of this return.
"Rcd-37 (12-63)
COMMONWEALTH OF PENNSYYLANIA
TRANSFER INHERITANCE TAX -'
'RESIDENT DECEDENT
SCHEDULE "D"
BENEFICIARIES
BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED(If step-children or DATE INTEREST OFstatefullnamesandaddressesofallwhoillegitimatechildrenDECEDENTOFBENEFICIARYaveaninterest,vested,contingent or other-are involved,set STATE YES IN ESTATE
wise,in estate)forth this facL)OR NO BIRTH
Charles W.Campbell Son Yes 3/13/18 Entire Estate
219 Woodside Drive
Wa shington,Pa.15301
-
-
(
h
Deponent further says that all the above-named beneficiaries are living at this time except below:
NAME DATE OF DEATH RESIDENCE
(Executor-Administrator
II must complete "As
Will !No.
Reported"column #1.)
Administration Year ...................
II ,
'--'-CJ '""'3 '"t:I ::0.......ct>ct>II 0 ll)....e'....P.Il THE ::3 '"'"0'"'"....::3 '"t:III...,ct>e'.......;\IATTER OF THE APPRAISEMENT ....0ll''"x "'tl'Oll'...ct>r::r o ...OF THE ~~~'0 ~
t%j ct>....ESTATE OF .....'"'<....ll't ....ct>):
~lsieJ~C:;~.In;pbE)U ....
Deceased
Late of ..WCl.f3:h~!lg~<:>I1.C:;()lll:l~Y ..............~
\
\Vas:h~tlgt()t1 ."-enCountyof...........c:::~~
\~Commom\'ealth of Pennsylvania \)>
=::l--->-<:W rJ)ennn~.fJ;?"'=r =r
REPORT AND APPRAISAL g ~~
---------------
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Form RC C·10 DEDUCTIONS Al.l.OWED IN J
OFFICE OF TNE
REGISTER OF WILLS
OF _Washington COUNTY
.~.27T ""TN"CO••QNW....TH.#-GJ -yc:?
STATEMENT OF DEBTS
AND DEDUCTIONS
THE sUM OF ..••.•......$.uj/~~g£~
..3-/9-70DATfZ:L(~~
Register of Wills,Agent
ESTATE OF _--'E=ls:;:.l.....:·e::.-:I...........C;.::a""m"""'i'P...b..,e...lo.=l LATE OF South Strabane Townships Washington County
DATE Oil'FILING A"PRAISEMINT _......l;;""?_-_;:~9~-...2~(J~__DATI Oil'DEATH _.;;.J_a_n_u_a_r~y_l_l..::,_1...;9;,..7_0 _
..........-
O/.TE NO.01'NAME OF PAYEE REMARKS AMOUNTYOUCH...
-........w~
Annex Pharmacy Drugs $37 30-_.=...........'
Warrickls Flowers for funeral 44 95------.
Bell Telephone Company Telephone toll calls for funeI al 18 78-
Washington Hospital .Bills due on account 1 50
James P.Gaut Funeral Home Funeral 1,047 00
Dr•W.A.Prideaux,M.D,Medical services 10 00.-
Total $1 159.53
-
Partial payment of Family ExeIl~ption is claimed from decedent's -
only solely held property,real ~state appraised at $350.00
COMMONWEALTH OF PENNSYLVANIA }..:COUNTYOF~Cam.}h ellI,.Char s W.HUEBY CERTJI'Y,THAT.TO THE BEaT OF
NY KNOWLEDGE AND .ELIEP'.THE FOREGOING Ie AJUST AND TRU E STATEMENT 0,.DEBTS,P'UNERAL EXPENSES AND EXPENSES Of'
ACMINISTRATION .U.MlnED TO THE ESTATE OP'El s j e I cad:?~..o.INHERITANCE TAX PURPOSES.¥
SWORN AND SU••CRI.ED ~EFORE MIE THI./;L £AY OP'
~(L.s.)
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DOLORES D.HOOPER,Notary Publlo
Plttsl1urgh,Allegheny County,Pa.
My Commission EXlllraa
AUsulit 2.7,1913
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RCc-st (2-64)
CpMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
INHERITANCE TAX DIVISION
NOTICE OF FILING OF APPRAISEMENT
IN YOUR RIPLY P~EA.E
RIFIR TO
j'
ELSIE I.CMlPBELLInRe:Estate of .-;.._
W.tJ3HI!'n'l'ON /~rJr'\·2CY1_______________COUnt7 -File No.OJ"I~0<::;
Mr Cam.""~ell:Dear '.•1"""
You are hereb7 notified that the £1 1e ~1~a}.n
appraisement in the estate of "S ~1#,~PIJ~.
has been filedM.tilel,h19office of tee Register of Wills Qf WwAd:hgcon
County on ,19 •Said appraisement reflects the
following valuations:
Real Estate 350~OD
..J f;/IE /J)pe1$Ii r opu "r '.:;.to_l_6_,.,:_76 _
Transfers -------4.,.;::r;.:,~.q.;.,.....,.--Total -...---1.;..,-(;2-6-",_'_6 _
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 7ear from date of deatn,interest at the rate
of six (6.)percent per annum is charged.
Any part7 in interest who is aggrieved by an appraisement may
appeal therefrom as provided by law.
Date Ma_"·:r_eh_".'._1_9_.I_'_19_7_0 _
Note:This is not a bill.
RCC-39 (5-68)
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
,
SUMMARY
Estate of CANPBEIL,ELSIE.I--'-,DATE OF DEATH __1_-1_1_-....:..7_0_FILE NO.
(Last Name)(First Name)(Initial)
REPORT OF INHERITANCE TAX APPRAISER
63-70-282
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;~03~-_=1:...!9_-...!_7-=-0 _
01-11-70
REPORT OF THE REGISTER OF WILLS
I,the undersigned duly elected Register of Wills in and for vJashington 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 ater or lesser amount represents the sum
allowed as a deduction.~~
Dated:03-19-70
REGISTER OF WILLS
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
5,869 23
7 028 76
1 159 53
5,869 23
VALUE AS REAPPRAISED
$-------+---
COMPUTATION OF TAX·FOR USE OF REGISTER ONLY
Tax on $-+-__~
Tax on $l)~{..q?1 ~
Tax on $5%
Tax on $10%
Tax on $15%
Exemptions *
Total Estate ._-4-__
TOTAL TAX
$--------1---$..:..38=2'-1r=~'5~
$--------4--
$--------4--
$--------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 $l=
Add interest at rate of 6%from_____to $----J
AMOUNT OF ESTATE TAX ASSESSED $----~I-
Estate tax paid $-.lL-
BALANCE DUE $----ll-
Add interest at rate of 6%from
-------tto-----$------It=TOTAL TAX BALANCE $------1.PAID $.....J
FOR USE OF REGISTER ONLY ADJUSTMENTS
NOTE:Where subsequent adjustments are made to the above computation of tax by the Register of Wills,for proper reason,
same should be noted below,with short explanation.
Will
Administration !No.
IN THE
Year .
MATTER OF THE APPRAISEMENT
OF THE
ESTATE OF
.ELS.J$.I~...GAHPBEL L
Deceased
,,,,.~!;
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I ~J
,/...
Late of .
County of
1rJASHINGTON
WASHINGTON
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,
Commonwealth of Pennsylvania
REPORT AND APPRAISAL
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Funn RCG-2
DEI'ARTMENT OF REVENUE
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BUREAU OF COUNTY COLLECTIONS •
HARRISBURG,PENNA.17127
COMMONWEALTH OF PENNSYLVANIA
.RESIDENT INHERITANCE TAX..
APPRAISEMENT ",
DATE......1:1a.rch..1.9.,..J97.Q..
COUNTY·W9$.h.m.g1qr.L....'-
FILE NO..??::::.79.=?.$.?.
Whereas,E,;J.p.;j,...~±.,Q.~p.P.~J.),late of ~<:1.~.0..~g~.~.
in the County of Wa.s.biugt.on Commonwealth of Pennsylvania,having died on
the lLth day of ~.g,l11.JF.U:'Y 19 7.0.,seized and possessed of an estate
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
>[R CTherefore,I,.....................................J....................hg,DJ~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 CQmmonwealth hereby expressly reserves the right to appraise and assess transfer
inheritance taxes at the lawful collateral rate on any such future interest.
Unit AppraisementDescriptionofAssetValuesMadeforInheritanceTaxPurpoles
$
REALTY:
SAA ~nnv nf Sl"hAr'hl1 A "A"::It.t.:=lched to a nnraisement 350 00.-
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JT.HELD:
SAe ~nmr of Schedule liE"attached to anpraisement 6,678 76 I
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Total 7,028 76 ,
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form~~v;;:~hbl:~::~h~w~.~~~I'W'~:;o~e~~~~.p~r.ise:e~m.del~n?~
~L.............'J ............~~A Iller
/'...............................................................................................................................................~~~'-":.............................ip~~t·..Oiii~~·i·.............................,Penna.
WA$tUNCrl.\)N County
RESIDENT INHERITANCE TAX APPRAISEMENT
Estate of
ELSIE J..•..Gf.J.Xr..l3.~L..... .
Deceased.
Late of
WA$.BJ..NG.'r9.N
~ate a;;el~:~:J~o;~~~.~.~j~+97Q ..
ppr 0'.
Page,.~~=~.;;,No 9.3..~.7Q::::?$?.
Filed in Register's Office,...l'~~G.h..J.9.......19..7Q.
Amount of tax due,?>.
DEPARTMENT OF REVENUE
Received,
Examined and Approved,..
Wrote abo.ut Appra.isement,
Appeal f,.om Appraisement,.
Entered and charged,.
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