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Home My WebLink AboutOC1971-0197 - ESTATE OF FERNANDEZ. ,, . J COMMONW~ALTH OF PENNSYLVANIA Bfi?£;c£1/•.v,£ 6'3-7/-/f7 DEPARTMENT OF REVENUE COIJ,!J·r .. P,~.tA._i/0€ HARRISBURG L,OL t ·L-: '-t.::C TJ(/jJ.J.:J 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: .D(c II '"':s i j 4 5 ~.'•J:J :J~ :HI] fJ} Pursuant to Section 742, Pennsylvania Inheritance and Estate Tax Act of 1961, we herewith submit the following report: , NAME OF REP.ORTING FINANCIAL INSTITUTION Melle& NM4enel Baftk & TNs~ Gompeft7, Bertera etfice ' . . . . ADDRESS . $01 MclteaA . .Avenv.e; D~es, Pa. 150J3 ACCOUNT NO. OF JOINT I TRUST OR INVESTMENT DEPOSIT· ·Savini& 1165 .. 23170 NAMES ON ACCOUNT OR INVESTMENT Delfin Fernandez· or· Carmen Rodriguez ' . ' . ·, DATEOFDEATH __________ ~Nnw¥"A~m~he~P~2~Ja1~1~97~0~------------------- SURVIVING DEPOSITOR, BENEFICIARY OR INVESTOR -~C~arm:!:.!. ~e~nwRo~dr~i~g~u~ezliL---------- ADDRESS ---------------fRf.:.-BB=• .-i!{J.,.,l,-:-# -tQ;ea~bo~ .. ~Pr.. 1:-PP... &!!r.: • .-.-,!,1~69Bil2~)~------'----- RELATIONSHIP TO DECEDENT......uD&-.IW~SiDht~ej~:I'!:._._----------- DATE DEPOSIT OR INVESTMENT WAS ESTABLISHED Febwa:ry 23, 1~8 BALANCE, INCLUDING INTEREST .k If 4. !'i'i 3 3 DUE, AT DATE OF DE,AT_~ $ $B,3l6.6S :;l -.... I , •I, f I;../~-.~,., . • • .. ' ..... ·~·· .... -· --_ .. ,. .. _ If ~ ..iff, S6 !f!~} 11 Signature TITLE A t M. as • gr. '. .P ""'--!· - If you have alreQdy. pai.d this tax to an executor, administrator, attorney or other personal represe~;~tativ~-ott~~· decedent for forwarding to the Commonwealth, I ist below the date pa i.d, name and address ti'f 'the person to whom you made payment, their official title and the· amount. · ' Date Paid Name and .Address of Payee Official Title Amount Paid -...,.. ... ......... .. ... ..r ..... 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 propertr in the computation of tax due. If any such expenditures meet all of the three following tests, it is recommended that you it~mi.ze th~ poy!f1ents .below, execute the affidavit, and return this notice. The Register of Wills will examine the debts claimed and allow those which he deter~ines 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 ~ere 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 als'o claimed, for tax purposes, by an-executor·, administr.ator or other personal representative of the decedent handling the administrat.ion of the general.estate of the decedent or any other transferee. · . . SCHEDULE OF DEBTS Date Paid Name of Payee Description of Obligation Amount Paid I ,, -- ' . . . '. ' . TOTAL $ ,_ (attach separate sheet if required) COM_MONWEAL TH OF PENNSY.L VANIA) SS: COUNTY Of ________ _ I, . her~by certify that the for~going is a just-and t~~~ statement Qf funeral expenses and other debts of the decedent, , for which I was legally responsible and which I did pay out of the property herein taxed. I further certify, that to the best of my knowledge and belief, these same Clebts will not be claimed by any other person, for inheritance tax purposes. / ' SWORN AND SUBSCRIBED BEFORE ME THIS __ ____.;.· DAY OF ______________________ 19 __ Signature of Taxpayer REPORT OF REGISTER OF WILLS· , I, the undersigned, duly el~cted Register of Wills in and for the above county', do-respectfully report that I have allowed deductions listed above in the total-amount of$.;....· --------o Date of Approve I:---------..:...._--------.Register of Wills --.~. · ... iii I' '· -~~ .. ~ ..;·- .-......... _ ...... , __ ,... . ....;;., If you hqve alreoa('paid this tax to on executor, administrator, attorney or other person,t;:l•repfesentotiv~ of the decedent for forwarding· to the Co11,1monweolth, list below the dote paid, nome and address of the· person t'~ whom you made payment, their official title and the amount. Pate Paid Nome and Address of Poree Official Title Amount Paid Under certain circumstonce·s, if, after the dote of death of the~aecedent, you personally paid funeral expenses or other just debts of the decedent, with funds derived from the property herein foxed, such amounts expended by you may qualify as deductions against the gross value of the property in the computation of' tax due. If any s·uch 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 Reg1!>ter of Wills will examine the debts claimed and a.llow those which he determines to be proper. The tax will then be recomputed and you will receive on amended assessment of tax. · THE THREE TESTS WHICH MUST BE MET ARE THAT: 1. You were perso~ally legally responsible for these debts, and 2 • You actually paid these debts out of the account or proper-ty· described above and con furnish proof' I I \ · of such poym~nt, if required, and 3-These some debts ore not also claimed, for tax purposes, by on executor, administrator or other personal representative of the decedent hand I ing the .o.dmin istrotion of the general estate of the . decedent or any other transferee. . SCHEDULE OF DEBTS Date Paid Nome of Payee Description of Obligation Amount Paid. 12/31/70 H.J. Levin,M. D. Bal. due 64.20 '.12/70 T .::twson-R::thf> FnnPr::t Home Funeral Services . ' 1!734. oo. 1/14/71 Quinet Monument Co. Marker · ~u. uu ·.· .. 0 0 .. '\ ' ' .. ·TOTAL $ 1818.20 (attach separate sheet 1f requ~red) COMMONytEALTH.,.OF PENNSYLVAN·IA} SS: COUNTY Of Washin~ton .1' · CARMEN RODRIGUEZ hereby certif,y ,that the foreQoing is a just and .true stotem~nt of funerol e.xpenses and other debts of the decedent, De!fm Fernandez , for wh1ch I woa a.tty responsible and which I did pay out of the property herein taxed. I further certify, that to the best Of my knowledge and belief, these sonie debts will not be doimed by any other person, for inheritance toK. p~iposes :. · : ' SWatH AND SUBSCRIBED BEFORE ME THIS . bhtlUU'J . 19 2!._. ·__:~~~·U·"" ~ (~-~~( .. 19th DAY OF ~~/2~, .·. Signature of Taxpayer ~·Publk, Donora, Wash!. County l~'lliY>o(bMiiiisslilh EYrrres July 30 1973 ' .... ' REPORT OF REGISTER OF WILLS I, the ~ndersigned, duly elected Register of Wills in and for the above county, do respectfully report that I hove allowed deductions listed above in the total omqunt of$--------· Dote qf)'Approvol: ---....,....-----~------ ... ' . . "' "'""-·~ . Register of Wills . -·-..· ... ... " . --· l".l..: DATE ............ I.~:\:>:r.~ ..... ?.4 . .?. ..... ~ .. 7.7.:J:: ............... . DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS HARRISBURG. PENNA. 1 7 1 2 7 COMMONWEALTH OF PENNSYLVANIA RESIDENT INHERITANCE TAX APPRAISEMENT COUNTY ........ w.~~A~~.<?.!t ....................................... . FILE NO ...... ?.?.:?..~=~~ ............................................. , .... :. . _-.· ._..., .Whereas, ................................................. P~~R.tl~.N ...... .f..~.A~.P.~~ ..................................... late of ...................... P.9.N9.M ........ '., ........................................................ . in the County of ...................................... JiA$.HJ.NGT9.N.. ............................................................. Commonwealth of Pennsylvania, having died on the ............................................ ?.4.~h .......... : ........................... day of ... : ........................ N9.Y.~'P.~.:r. ...................... 19 ..... 7.9, seized and possessed of an estate subject to Inheritance Tax under. the laws of the Commonwealth of Pennsylvania; Therefore, I, ............................... A:JJ:.R~P ... .'J:.®.I ............................................................... , 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 foMowing appraisement: In the event that any future interest in this estate is transferred in possession or enjoyment to collateral heirs of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance taxes at the lawful collateral rate on any such future Interest. Description of Asset Unit Values Appraisement Made for Inheritance Tax Purpose& $ Jt &avilli2'S_ Ar.count #65_-2317_0 held in the MELLON NATIONAL BANK & TRUS,T COl-IPANY, DONORA OFFICE, DONORA, PENNSYLVAI\.TIA. In the names of DELFIN FERNANDEZ OR CARMEN RODRIGUEZ. Opened 2-23-68. Balance as of date of death, $8,316.65 8,316 65 total 8,316 65 ..... · .. Having been duly sworn according to law, I do h~reby certify that the above appraisement is made in con- formity with law on this .......................... ~~-;,cl .... L .... day of ................................ ~~ ............................................. () 19 ... :.7.'/.. , ....................... 6. 'PA?~; ..(. ..... ~~ ............. ~.~ ........... .. · ~-;-~ ... ~,... Appraiser ............................ t.J.~~~~~> .................................... , Penna . '•. -. ... I ·': '· \vASHINGTON County 4 , .. ~-RESIDENT INHERITAN~E TAX APPRAiSEMENT Estate of ................................... DELFIN ... FEB.NANDEZ ................................. . Deceased. Late of ............................................ P.ON.QRA ............................................................. . Date of Death, ............ )).:::?.4.-:.7.9 ......................................... . Appraisemel!t Docket Vol., Page, No. . .... A~.-:Z:l.::J:-.9.7 ........ . Filed in Register's Office, ........... ~:.?..~ .... ~.~ ..... .19 .. .?.~ .. . Amount of tax dtte, $ .... , ............................................................... . DEPARTMENT OF REVENUE Received,· .. Exa.mined and Approved; } ' Wrote abo.ut ApprD;.iseme1fl, Appeal fr'e»n Appraisement, Entered and charged, ... ;i ~-.. ,. •· ~· ' ,1' .•. . , -. \~ .. .. ., 7 '( I -, ,·