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HomeMy WebLinkAboutOC1970-0664 - ESTATE OF DORNHAK;;.'.-' R C C-43 (5-65) COMMONWEALTH OF PENNSYLVANIADEP~TME~T OF REVENUE HARRISBURG· 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 REPORTING . .FINANCIAL INSTITUTION Sloveman Sav~ngs and Loan Association ADDRESS 107 Latimer Avenue,Strabane,Pennsylvania 15363 ACCOUNT NO.OF JOINT,6535 TRUST OR INVESTMENT DEPOSIT="--......--'--_ NAMES ON ACCOUNTSteve or Mary Dorchak or Eleanor McGowanORINVESTMENT__---'---'_ DECEASED JOINT DEPOSITOR,Steve Dorchak VTRUSTEEORINVESTOR _ ADDRESS 213 South Jefferson Avenue,Canonsburg,Pennsylvania 15317 DATE OF DEATH April 18,1970 SURVIVING DEPOSITOR,MAry Dorchak or Eleanor r~cGowanBENEFICIARYORINVESTOR _ ADDRESS 213 South Jefferson Avenue,Canonsburg,Pennsylvania 15317 RELATIONSHIP TO DECEDENT Wife-daughter DATE DEPOSIT OR INVESTMEN-T-o-c-t-o-b-er~6-l-9-6-9-~-------Jjj'_U WAS ESTABLISHED'rY( BALANCE,INCLUDING INTEREST 4 517.80DUE,AT DATE OF DEATH $ '_ 3 ~'3 ~p,'j~GL5C;;fSZ~I 6-/Signature TITLE7£~.~i.P (o!0 Albert L.Tomsic,Manager 45,If j.:1 (, OFFICIAL NOTICE OF INHERITANCE TAX APPRAfsEMEtiT AND ASSESSMENT OF ASSETS NOT SUBJECT TO ADMINISTRATION RCC-134 (1-69)",. COMMONWEALTH,OF PENNSYLVANIA _:D'EPARTMENT OF REVENUE .i'BUREAU OF COUNTY COLLECTIONS INHERITANCE TAX DIVISION TO:ELEANQR'HeGQWAN 213 •SOUTH JEFFERSON'AVENUE Date:.tnne·S.2970. County WAlhingtotl County File No.J t!'-!'-.s--cj' Bureau File No.C3 ~1 0 ...-&(,y i.~j •.,..' 1n .'the'"am4s ,of STE)"E·or MARY'nORCHAK:;or .EtEANOR MCGOWAN•. Under the Inheritance and Estate Tax Laws of the Comr:nonwealth of Pennsylvania such transfers are taxable and the liability for the payment of the inheritance tax due is imposed upon you,as transferee. A The property on which tax is hereby assessed consists of:~~~~~~~~rm~;!!~~--ll~f'.:~~~ A ASSOC·OSRA appraised by the Commonwealth,as of the date of death,at $'4.511.80 ~--'-_%of this amount is taxable at the rate of Ii % ORIGINAL ASSESSMENT DATE OF ASSESSMENT1/a of 4,51'7&80 ==1.505.93------ TAXABLE AMOUNT 1/2 otl.S0!h93 :;:152.96 $ ,.'S2.,96.. LESS:ALLOWED DEBTS NET TAXABLE AMOUNT AMENDED ASSESSMENT $-------~ AMOUNT OF TAX DUE D If you pay the above amount within three (3)months of the date ofl,deatba~f the decedent,or on or before ..Ju 1 IQ -19 70 you may deduct a discount of 5%of the .amount ~f tax due,or . o This tax became delinquent,fifteen (15)months after the date of death 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) $.//TOTA".AMOUNT DUE \ APPRAISED BY&e~/y",0- ...{Inheritance Tax A~aiser) ,.'..V INSTRUCTIONS TO TAXPAYERS .*If the ta'x is not paid by the above date additional interest is.due at the rate of 6%per annum until. ,../'paid",~r.- .,..,. Make checks or money.orders payable to:To insure proper credit to your account this Official Notice must accompany your payment.Mail or bring it to: 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 amount.....~ Date Paid Name and Address of Payee .Official Title Amount Paid Amount Paid $ of Taxpayer urnish proof of Wills r or other te of the tfu lIy report that I d true statement of __f for which I ertify,that to the on,for inheritance id funeral expenses h amounts expended on of tax due.If any e the payments below, s claimed and allow eive an amended Under certain circumstances,if,after the date of death of the decedent,you personally pa or other just debts of the decedent,with funds derived from the property herein taxed,suc by you may qualify as deductions against the gross value of the property in the computati, '.such expenditures meet all of the three following tests,it is recommended that you itemiz i"execute the affidavit,and return this notice.The Register of Wills will examine the debt J;,\~.those which he determines to be proper.The tax wi II then be recomputed and you wi II ree ,assessment of tax. I 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 f of such payment,if required,and 3-These same debts are not also claimed,for tax purposes,by an executor,administrato personal representative of the decedent handling the administration of the general esta decedent or any other transferee. SCHEDULE OF DEBTS Date Paid Name of Payee Description of Obligation ", TOTAL (attach separate sheet if required) COMMONWEALTH OF PENNSYLVANIA) SS: COUNTY Of ) I,hereby certify that the foregoing is a just an funeral expenses and other debts of the decedent, was legally responsible and which I did payout of the property herein taxed.I further c best of my knowledge and belief,these same debts will not be claimed by any other pers tax purposes. SWORN AND SUBSCRIBED BEFORE ME THIS DAY OF 19_. '.Signature '.'k,eEPORT OF REGISTER OF WILLS'r , I,the undersigned,duly elected Register of Wills in and for the cibo,ve county,do respec have allowed deductions listed above in the total amount of $"~'•........... Date of Approva I:-. Register RCC-43 (5-65) COMMONWEALTH OF P'ENNS'l'LVANIA DEPARTMENT OF REVENUE HARRISBURG . J NOTE:TO BE SUBMITTED IN TRIPLICATE Pennsylvania Department of Revenue Bureau of County Collections 26 S.4th Street Harrisburg,Pennsylvania Dear Sir: Pursuant to Section 742,Pennsylvania Inheritance and Estate Tax Act of 1961, we herewith submit the following report: NAME OF REPORTING FINANCIAL INSTITUTION Slovenian Savings and LoanAs~Qc1at1QO ADDRESS 107 Latimer Avenue,Strabane,Pennsylvania 15363 ACCOUNT NO.OF JOINT, TRUST OR INVESTMENT DEPoSIT__6.;...:53;...1 -'--_ NAMES ON ACCOUNT OR INVESTMENT Steve or Mary Dorchak or Anna Burchak DE~~~~~~~°ci~~~VE~~~~O_R_,__S_te_v_e_D_o_rc_h_a_k__.....l:~:::;...·._._._.__ ADDRESS213 South Jefferson Avenue,Canonsburg,Pennsylvanja 15317 DATE OF DEATH April 1$,1970 SURVIVING DEPOSITOR, BENEFICIARY OR INVESTOR Mary Dorchak or Anna Burchak ~rd~ Signature TITLE Albert L.Tomsic,Manager ~. ADDRESS213 South Jefferson Avenue,Canonsburg,Pennsylvania RELATIONSHIP TO DECEDENT Wife -daughter------------,-------:---- DATE ~AEt~;~~~~I~~~~STMENT October 6,1969 ~ BALANCE,INCLUDING INTEREST 4 17 d.DUE,AT DATE OF DEATH $,_5 0_0 '---tpt f:;drt r;5:2.,/' 5 2..1~/f ~.J ..2~ 15317 RCC-134 (1-69) CO~ONWEALTH OF PENNSYLVANIA DEPARTMEN,T OF REVENUE BUREAU OF COUNTY COLLECTIONS INHERITANCE TAX DIVISION 'OFFICIAL NOTICE OJ!INHE~ITANCE TAX APPRAISEMENT AND ASSESSMENT OF ASSETS NOT SUBJECT TO ADMINISTRATION TO:_-=A=N'-'-'N=A......ln~U~R~C.u.!HA~r\~~_ 213 SOUTH JEFFERSON AVENUE CANONSBURG.PENNSYLVANIA 15317 .,'.<,",.~••.-1';'},.:... Date:'luue S ~1970 County LWasbj nghH! County File No..3 %'-rs--~ Bureau File No.CJ -ZCJ-~'<../ Under the Inheritance and Estate Tax Laws of the Commonwealth of Pennsylvania such transfers are taxable and the liability for the payment of the inheritance tax due is imposed upon you,as transferee. The property on which tax is hereby assessed consists of:Jt.Held nank Account 1/65~1 f held ht THE SU1VENIAN SAVINGS AND LOAN ASSOCIATION,STRABANE OFFICE t STRABANE, PENNSYLVANIA.In the name$of SEVE or ~fARY DORCHAK or ANNA nURCHAK.Opened, OC1:ober 6,19()9"I.Balance as 'of"date ()f ditat'b,$4.537.80. apprai sed by the Common we a Ith ,as of the date of death,at $4.511i 80 ___%of this amount is taxable at the rate of ',6 % ORIGINAL ASSESSMENT DATE OF ASSESSMENT 1/3 of 4,511 ..80:=1~505.93......'_ TAXABLE AMOUNT '1/2 of 1,$05.93 =='152!96 $75".,96 LESS:ALLOWED DEBTS NET TAXABLE AMOUNT AMENDED ASSESSMENT, $------- AMOUNT OF TAX DiJ E D If you pay the abo~e amount within three (3)months ,>CoHhe'date of death of the decedent,or on or "'~bef~re"July-·IS.19 70 you may deduct a ,discount of 5%of the amount of tax due,or D This tax beca~e delinquent,fifteen (15)months after the date of death and,in addition to the tax,st~tutory)nt·erest at the rate of 6%o(the tax.per annum,is also due asof*__~_ 19__in the a.mount of *If the tax is not paid by the above date additional interest is due at the rate of 6%per annum unti I paid 45.18 2.26 ------.---- TOTAL AMOUNT DUE $4-s-;:o.L"$ If ============== I!J)~/IIAPPRAISEDBY",A ,Ie.~,~l ,.,;',-ASSESSED BY:_ (Inheritance Tax praiser)(Agent for the Commonwealth) '~STRUCTIONS TO TAXPAYERS Make checks or money orders payable to: .,_..-.....,..". " To insure proper ci"edit to your account this Official Notice must accompany your payment.Mail or bring it to: 1(:Z1l~~ ~G~NT FOR THE ro~~~r:~f':;i.A~f#eootJ H~!J~~ _~.n~tr(}il.'m.~..~:.5'~ If you have already paid this tax to an executor,administrator,attorney or other personal representative of the decedent for forwarding to the Commonwealth,l;.,st b~.I~w the date paid,name and address of the person to whe:m. 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 personal representative of the decedent hand Iing 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 PENNSYLVANIA) COUNTY 01=:_ 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_. Si gnature of Taxpayer REPORT OF REGISTER OF WILLS 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 6JLrf~ .sht!lQ.tu~e .TITLEAloervL.Toms1.c,Manager r --<.........--", COMMONWEALTH OF PENNSYLVANIA DEP~TMENT ,OFREYENUE HARRISBURG R CC-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 REPORTING .FINANCIAL INSTITUTION Sloven1.an Savings and Loan Association ADDRESS 107 Latimer Avenue,Strabane,Pennsylvania 15363 ACCOUNT NO.OF JOINT,6533TRUSTORINVESTMENTDEPOSIT=,,-'-_ NAMES ON ACCOUNTSteve or Mary Dorchak or Daniel DorchakORINVESTMENT,,__-=-_ DECEASED JOINT DEPOSITOR,XIv Steve Dorchak TRUSTEE OR INVESTOR ,p. ADDRESf13 South Jefferson Avenue,Canonsburg,Pennsylvania 15317 DATE OF DEATH Ap:-r_i_l_18_,_1_97_0 _ SURVIVING DEPOSITOR,Mary Dorchak -Daniel DorchakBENEFICIARYORINVESTOR _ ADDRESS 213 South Jefierson Avenue,Canonsburg,Pennsylvania 15317 RELATIONSHIP TO DECEDENT__W_i_f_e_-_s_o_n _ DATE DEPOSIT OR INVESTMENT Octob r 6 1969 ~WAS ESTABLISHED e_...;.,_ BALANCE,INCLUDING INTEREST 4 517.80DUE,AT DATE OF DEATH $ '_ ~Jb;.j~ 6 .9 3 D r:o 10I,~j5 1s-j ,7(., o·~45,{~ J./.<;i).<;.v.J.{11. RCC-134.(1-69) COMMONWEALTH OF'PENNSYLVANIA' DEPARTMEfH OF REVENUE BUREAti OF COUNTY COLLECTIONS ,INHERITANCE TAX DIVISION.' .,-~-1 "-'v OFFICIAL NOTICE OF INHERITANCE TAX. APPRAISEMENT AND ASSESSMENT OF ASSETS NOT SUBJECT TO ADMINISTRATION TO:DANIEL DORCHAK .'Date:,June 5,1970 i .21i SOUTH JEFFERSQNAVENUE County '\"aubiugton CANONSBURG,'PENNSYLVANIA 15317 County File No...3 g-ys-t/ ,;,;:"',"',,Bureau File No.~J -70-c t fi..>\/··~ ."~.{.r:-:11(':'"~""•"~:,".,"."~::,f,,"~~,~.~~·r'~_~"/:<:<' Wehaverece'j'vednotice that;H~IUJIXXXXX.XXXXXXXXXXXXXXXXXXXXXXXXXXXXXUU. on~.' '..''.'•..!~.....19~,you came into o~ner~hip of certain property ,through '. ~illl~·tran8ferfrom,STEVE DORCHAK,.deeeased. Unde~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 isimposed upon you,as transferee.. The'property on which tax is hereb~assessed consists of:Jt ,Held Bank ACcount I·6533,held in the SLOVENIAN SAVINGS &LOAN ASSOCIATION,STRABANE OFFICE,STRABANE, ,PENNSYLVANIA.':'Inth'names of.STEVE or MARY DORCHAK,or,DANIEL DORCIAK • Opened.'October 6,1969.Balance'asot date of death,$!.!II!4"",SoJ.I.1L.J7w·•....c8wO'l-/_ appraised by the Commonwealth,as of the date of death,at $4,511.80' ___%~f this amount is taxable at the rate of __6__% .ORIGINAL ASSESSMENT DATE OF ASSESSMENT 1/30£$4;!)17.80=ltSOS.93--,------- TAXABLE AMOUNT ~/2 -of 1,505".93;;=752.9,6 $7$2.96 ' LESS:ALLOWED DEBTS NET TAXABLE AMOUNT AMENDED ASSESSMENT $-------- AMOUNT OF TAX DUE 45.18 o If you pay the'above amount within three (3)months of the date of death of the decedent,or on or before'.'Ju.ly 18 19'70,you may deduct a discount of 5%of the amount of tax due,or 2.26- -------_._- $-============ ASSESSED BY:_ TOTAL AMOUNT DUE $ 1 This tax bec'ame delinquent,fifteen (15)months after the date of death a~d,in addition to the tax,statutory interest at the rate of 6%of the tax per annum is aiso due as of *.. 19__in the amount of *If the tax is not paid by the above date additional interest is due at the rate of 6%per annum unti I paid APPR AI SED BY:.u::;.~+--~-4f:,..~.,..a:...:.¥--- (Inheritance Tax A raiser).(Agent for the Commonwealth) 'v INSTRUCTIONS TO TAXPAYERS o Make checks or money orders payable to:To insure proper credit to your account this Official Notice must accompany your payment.Mai I or bring it to: ..-r:. I - I If you have already paid this tax to an executor,administrator,attorney or other personal representative of the decedent for forwarding to the Commonwealth,lie1-belo~the date paid,name and address of the person to whom 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 personal 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 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 ,,',..,<.'--' COMMONWEALTH OF-PENNSYLVANIA DEP!ffiTMENJ OF REVENUE HARRISBURG RCC-43 (5-65) J NOTE:TO BE SUBMITTED IN TRIPLICATE Pennsylvani"a Deportment 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 Slovenian Savings and Loan Association ADDRESS 107 Latimer Avenue,Strabane,Pennsylvania 15363 ACCOUNT NO.OF JOINT,6 3 TRUST OR INVESTMENT DEPOSIT=",,-.,_5_4 --'--_ NAMES ON ACCOUNT ORINVESTMENT Steve or Mary Dorchak or Steven Dorchak,Jr. DECEASED JOINT DEPOSITOR,Steve Dorchak l~TRUSTEE OR INVESTOR ---::...//_ ADDRESS213 South Jefferson Avenue,Canonsburg,Pennsylvania 15317 15317Pennsylvaaia et2Lrf~- Signature TITLE Albert L_Tomsic,Manager DATE OF DEATH ~=-=-_---A.:;..pr-i-l-1-8-,_1_9_7_0 _ SURVIVING DEPOSITOR, BENEFICIARY OR INVESTOR __Ma_r_y_D_o_r_c_ha_k_-_S_t_e_v_e_D_o_r_c_h_a_k_,_Jr_. ADDRESS 213 South Jefferson Avenue,Canonsburg, Wife -son RELATIONSHIP TO DECEDENT-:---------------n':2 DATE DEPOSIT OR INVESTMENT 0 b'6 1969 ../IIWASESTABLISHEDc_t_o_e_r_..:.,__--:v::::-.!- BALANCE,INCLUDING INTEREST 4 517 80DUE,AT DATE OF DEATH $ '__-_ ~1 Y2 »/J~ (c j{;, '1 5 )'~,~ 4s.Jr f)~J..~~ i r;•,_,t :~•t. CANQNSBURQ,IENNSnVANIA''15311· TO:STEVEJ)ORCHAI.JR. 213·SOUTH·UFFERSOH'mNUI Date:JWlet 5,1.91:0 County __i......I......$......b..::..:.bt~g!e.t:...::·o...::..n=-·_ County File No....37 -?..s--z! Bureau File No.t j -ZcJ -(;t ¢" },- OFFICIAL NOTltE'O~NHERITANCE TAX APPRAISEMENT AND ASSESSMENT OF ASSETS NOT SUBJ.ECT TQ ADMINISTRATION COMMONWEALTH OF PENNSYLVANIA ,DEPARTMENT OF REVENUE ~.BUREAU OF COUNTY COLLECTIONS INHERITANCE TAX DIVISION RCC-.134 (1-69)• We have received notice that,~;<-"'.•.,.• ~~.',19'70,oucame into ownersh.i.p of'.certain prop.,ert.y.thr.ough....'.''.'..'~' .'...'.,t.ransf,ertrom.,STEVE 1)ORCHA~.,deceascd. 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:,J,t,•.Btudt Aeeount.;;6S34.held !nth. SLOYENIAN SAVOOS &,LOAN ASSOOIAT!tUi.·STRABANE O.~!CE.·StRABANE.PENNSYLVANIA" 'In tbe'namei'·tf.STEVE 'or ·MARY .DORCHAler'STEVEN nORCHAK,'j!?..Opened,·10...6..69 DB1&ilC,·BI .of 'date,'0'·deatu.$4,.51'·.80.,': appraised by the Commonwealth,as of the date of death,at $4,,51"1 ~80 ___%of this amount is taxable at the rate of G % ORIGINAL ASSESSMENT DATE 'OF ASSESSMENT'1/3 ot-4,Sl?80;::l,1,.505.93o;L~------ TAXABLE AMOUIIIT':1/3,£1,iOj.~3 .;;;752.96 $','752.96", LESS:ALLOWED DEBTS'", NET TAXABLE AMOUNT.~.. AMENDED ASSESSMENT $-------- ..::AMOUNT OF TAX DUE ,.",..J;"" .~~r ~!.".itj If y~u pay)he.above amount within three (3)months .;';,'ofthe date ,of death of the deceqent,or on or ;ibefore July 1'8 19 70 you may deduct a 'di~·coun.t of 5%of the amount of t~x due,or o This tax became'delinquent,fifteen (1s)months -/after the date of death and,in addition to the tax,;tat~rOry interest at the'rate of 6%of the tax per annum is_also due as of *__--- 19__.in the.amount of ,."."', '.....~:" *If the tax is not paid by the above date additional interest is due cit the rate of 6%per annum until, paid TOTAL AMOUNT DUE $ ,.Ie:,"IC!l~ $================= APPRAISED BY:ASSESSED BY:_ -(Inheritance Tax Appraiser).'(Agent for the Commonwealth) INSTRUCTIONS TO TAXPAYERS Make checks or money orders payable to:' '",.'} To insure proper credit to your account this Official Notice must accompany your payment.Mail or bring it to: 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 be!,Qwcth<t date paid,name and address of the person to who.p1 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 dU,e.If any such expenditures meet all of the three following tests,it is recommended that you itemize the paym'ents below, execute the affidavit,and return this notice.The Register of Will's 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 personal 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 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 Wi lis RCC-43 (5-65) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE HARRISBURG 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 Slovenian Savings and Lean Association ADDRESS 107 Latimer Avenue,Strabane,Pennsylvania 15363 ACCOUNT NO.OF JOINT, TRUST OR INVESTMENT DEPOSIT__6...:.;..5.;;..-32_---'----'--_--- NAMES ON ACCOUNT ORINVESTMENT Steve Qr Mary Dorchak or Bette Witko DECEASED JOINT DEPOSITOR,~. TRUSTEE OR INVESTOR S;;;..t.::..;e;;..;v~e;......;:;.D.;;.;or=-c;:...:h:.:::.:a;;,;;;k=___----:~~·_._--'-_ ADDRESS 213 South Jefferson Avenue,Ca Dopsburg,Pennsyl:va;g,1a DATE OF DEATH Ap_r_i_l_1e_,_1-9-70------..-- SURVIVING DEPOSITOR,BENEFICIARY OR INVESTOR __M_a_r_y_D_or_c_h_a_k_-_Be_t_t_e_._W_i_tk_o _ 15317 ADDRES~13 South Jefferson Avenue,Canonsburg,Pennsylvania 15317 RELATIONSH IP TO DECEDENT __W_i_f_e-_da__ug~h_t_er ;.....;......-- DATE DEPOSIT OR INVESTMENT 0 b 6 1969·'/WAS ESTABLISHED cta er,v BALANCE,INCLUDING INTEREST DUE,AT DATE OF DEATH $__=4....,5'-=1:u.7...!...~eO~__---_---- 3~ih1d~~~~Co I C Signature TITLE :3 5 ?5 J.1~Albert L.Tomsic,Manager .~~1t;./g j0£4-G J.~<t RCC-134 (1-69) COMYA0tlWEAL Ttl OF PENNSYLVANIA < DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS INHERITANCE TAX DIVISION OFFICIAL NOTICE OF INHERITANCE TAX APPRAISEMENT.AND ASSESSMENT OF ASSETS NOT SUBJECT TO ADMINISTRATION TO:_......B"""~T.,A-oL'TlUlEO!.-U.W=!:u!T!..!JK~O _ 213 SOUTH JEFFERSON AVENUE CANONSBURG.PENNSYLVANIA 15317 r ,"......i ~u ~ Date:-=J...:;11::..:..;1l::..;:e:.....:::8:..J1t-=1:..=:9....:.7.=O _ County ...:..:'y:.=a:..::~:,::;:h~i~n;.lo:g~t.:o=n'_____ County File No.c3 %-1,s- Bureau File No.(...5 -70 -6 C <./ We ha-.:e 'rece'ivedrioticethat,Hx..~~ltIXXXXXXXXxxxxxxxxxxXXxXXxXXxXxXXXXXXXl on··April,18 "19~,you came into ownership of certain property through'.., .]1KH~~QB transfer from.nllEx STEVE DORCI-L\ll,deceawed. 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.Held,Sank aCCOllnt #6532,held in the SLOVENIANSAVINOS AND LOAN ASSOCIATION,STRAIANE OFFICE,STRABANE, PENNSYLVANIA.In the names of STEVE or MARl DORCHAK,or DETTE WITKO. appraised by the Commonwealth,as of the date of death,at $4 t 517.80 ___%of this amount is taxable at the rate of 6 % ORIGINAL ASSESSMENT DATE OF ASSESSMENT 1/3/of 4,517.80 ==1,505.9..;;;..3 _ TAXABLE AMOUNT 1/2 of 1,505.93 =752.96 $752d~6 LESS:ALLOWED DEBTS NET TAXABLE AMOUNT AMENDED ASSESSMENT $-------- AMOUNT OF TAX DUE 45.18 . D If you pay the above amount within three (3)months of the date of death of the decedent,or on or before JulY 18 ..19 70 you may deduct a discount of 5%of the ~mount of tax due,or 2.26 D This tax became deli~quent,fifteen (15)months after the date of death 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:_ I. (Agent for the Commonwealth) -tS'"..18 $==================$TOTAL AMOUNT DUE ~JI APPRAISED By:(lJ R~:t&=,~;:..-:..~'.=...:.C.(A-+-,__ (Inheritance Tax.Ap raiser) .*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 ~r mone'y orders payable to: I.'. To insure proper credit to your account this Official Notice must accompany your payment.Mai I or bring it to: ~.i If you hove already paid this tax to on executor,administrator,attor~~y'or other personal representative of the decedent for forwarding to the Commonwealth,list below the date paid,name 'and address of the per~on to \yh't)m you mode 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:, ~~:-You were personally legally responsible for these debts,and •-You actually paid these debts out of the account or property described above and can furnish proof ~ij of such payment,if required,and . i,l~3 -These same debts are not also claimed,for tax purposes,by an executor,administrator or other .hi ../:persona I representative of the decedent handl ing the admin istration of the general estate of the~Iv;--)__decedent or any other transferee. j J SCHEDULE OF DEBTS Date Paid Nome 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 $__-• Date of Approval:_ Register of Wills -~ Fonn RCC-2 COMMONWEALTH OF PENNSYLVANIA DATE ..............~.~.~.y.......§..'-.......!..~.?.9.............................~.~.DEPARTMENT OF REVENUE RESIDENT INHERITANCE TAX WASHINGTON.COUNTYBUREAUOFCOt~TY COLLECTIONS .................................................................................................... HARRISBURG.PENNA.17127 APPRAISEMENT FILE NO.................??.:.?..9.:.?...?.~.................................... Whereas,.............................................S.T.EVE....nOnCHAK..................................................late of ........................................................CANQ.N$.B.U.RG.............. in the County of .................................~~~.~~E~~!..?.~.............................................................Commonwealth of Pennsylvania,having died on the .......................................I.~.:t.h........................................day of ........Ap.~.P::.................................................19......7...9 seized and possessed of an estate subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore,I,VI.R.CHANEY 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 fi..'{ 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 1nterest 1n th1s estate 1s transferred 1n possess1on or enjoyment to collateral he1rs of the decedent after the exp1ration of any estate for Ufe or for years,the Commonwealth hereby expressly reserves the r1ght to appra1se and assess transfer inheritance taxes at the lawful collateral rate on any such future 1nterest. Description of Asset Unit Appraisement Values Made for Inheritance Tax Purpo18s $ JT.HELD PERS.: Jt.Bank Accts.(1)#6535 •(2)#6531,(3)#6534,(4) #6533,(5)#6532 held in the SLOVEN IAN SAVINGS &LOAN ASSN , STRABA:NE,PENNA.IN THE NAMES OF (1)STEVE or NARY DORCHA}of ELEANOR JI.1cGm~AN ,(2)STEVE OR MARY DORCHAK or ANNA BURCHA},(3) STEVE OR HARY DORCHAK or STEVEN DORCHAK,JR.,(4)STEVE OR MARY DORCHAK or DANIEL DORCHAK,(5)STEVE OR MARY DORCHAK or BET'E ~VITKO .Opened 10-6-69.Balance as of date of death,(1)q.,517.8'i'.I (2)$4,517.80,(3)$4,517.80,(4)$4,517.80 and (5)$4,517 80. Amount taxable on each one $752.96 $3,764 80 Having been duly sworn acco5di~g to law,I do hereby certify that the ab1ve appraisement is made in cCfo formity with law on this ..............................~..............................day of ......................................................········}~···!:.::?I...hf····..·......···.........19............... ~-'<cl2 Appraioer ...........................................................................,.................................................................................. (Number and Street) ...........................................................WASHINGTON ...............................,Penna. (Poet om"", ·..WASHINGTON...County Page,No. RESIDENT INHERITANCE TAX APPRAISEMENT Estate of STEVE DORCHAK............................................................... Deceased. Late of CANONSBURG Date of Death,.APRIL..I.8.,..l9.7.O'. Appraisement Docket Vol.,}.?. 63-70-664.....................................• Filed in Register's Office,?.:'::'..§.~..~70 Amount of tax due,?J . DEPARTMENT OF REVENUE Received, Examined and Approved,. Wrote abo.ut Appraisement, Appeal ft-om Appraisement,. Entered and ch<lrged,.. ~ ~ I