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HomeMy WebLinkAboutOC1971-0538 - ESTATE OF MELVIN,, .. Form No. RCC-62 (6-70) THIS FORM REQUIRED IN ALL ESTATES WITH GROSS ASSETS UNDER $10,000, UNDER SECTION 701 OF ACT OF JUNE 18, 1981, EF'FEC'l'IVE .JANUARY 1, 1962. (FILE IN DUPLICATE tT30PY;/~3~ J OFFICE OF THE REGISTER OF WILLS County of .. tr~ ... ~~~~'~ ........... . . . . . . . . . . . . . . . ~~~.~ . ~ .... J:l~.~~~.~. . . . . . . . . . . . . . . . . of . ~.~~. ~~~~ · ~~~~~.~! · .~~~~~!~~+~.•. · ~.~~::tt; (Name) · (Addreoe) being duly _____________ !!!!! ______________ according to law, deposes and says thatllhe is the ________ l&f01.0.&GJ _____________________________ _ (Exec., Adm., Legatee, Etc.) of the estate of---~-~~~!~---~!~!-~-~------------·------------whose last residence was---~~~--~~~~---~-!'-~-~~-------------------------(No.) (St=:t) ~!-~~~-!~-~~~-! ___ !_~~~-~~-~!-~~·~eased, and that the whole of the estate of said decedent, who died--~~~-'-~-~'-'----~-~~-(Cicy, Borough or Township) (DarellfJJ. consisted of: REAL PROPERTY REAL PROPERTY IN PENNSYLVANIA, WITH STATEMENT OF MORTGAGE ENCUMBRANCES UPON EACH PARCEL AT DEATH OF DECEDENT, WHERE PROPERTY HELD AS JOINT TENANT OR TENANCY BY ENTIRETIES, GIVE NAMES, ADDRESSES Aim RELATIONSHIP OF OTHER OWNERS. ~ I Estimated Real Estate Value . \ \ 'I H 0 5 I " r\ I • i I Personal Property • 0. s 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 owed by the decedent as of the date of death. Such .letters m~st be Eigned by a responsible officer of the financial institution or mortgage hvlder 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. ' Jointly Held Property Estimated ·¥alue •~ •••t•lt•4 •••~t'''• •••••••~ la •••Sua• C•~tifl•••• lo. 1 Otl• . . .. .. . ....... . •••e ta.t•• ..... at •••· C••~'• Wel•i• •• J••• u. ••1•1• •• ceetrza J . .. •oo.oo J•lnt •aYI•I• aac.•••t ao. Sl7·06!t tu til• Hell•• lat4oa•1 laok . . ... ta the "•••• •I I••• tt: .. ·Ke1wto OC' •••• c ..... ,. tt•l•la. •t•••4 4•2S•J1; fa~e •••Qot •• 4ate of 4eet~. ISJA.B4 f•••~ook •••t•a• aocooat eo. 011•1541 ta ch• M•llea ••ctoual 1vaal \ ----------------------------~------------ Transfet~s, within TWO YEARS Prior to Death 501ll I I That at the time .of death there was no safe deposit box registered ih 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 ihe following:- NAME AND ADDRESS OF BANK OR OTHER INSTITUTION IN WHICH DECEDENT RENTED A SAFE DEPOSIT BOX THIS SAFE DEPOSIT BOX RENTED IN NAME OR NAMES OF BENEFICIARIES BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED AGE OF LIFE (If step-children or DECEDENT TENANTS OR (State full names of all and their addresses who have illegitimate children STATE YES ANNUITANTS an interest, vested, contingent or otherwise, in estate.) are involved, set OR NO· AT DEATH OF forth this fact.) DECEDENT J••• M. M•l•l•• 240 Mala .... ... .... ...... ____ ... ~.. ...... _ . ....... ••llll.•"ii•• ..,..,.., ..... ·-··· .. _ ... . .... • o ...... J. &•1•&.•. J.4J ,,. . .... ..... . . ---.......... ......... ...... 1 • ., ......... , •..... .... ~., RELATIONSHIP OF JOINT HOLDERS TO DECEDENT INTEREST OF BENEFICIARY IN ESTATE 4eltllt c.••••t - tetAt e•a••u: - I I RESIDENT DEGE;pENT DEBTS AND DEDUCTIONS CLAIMED NOTE:. List first five items in the spaces so provided, observe notations thereon, and instructions • DEBT OR CLAIM '•t••••· .c•••l••• ••••••• aliM' ¥Wlr.ti•·I>IJ OTHER DEBTS AND CLAIMS l. ••al •t•a4tlta u. D. l••btaa••• •••Plta1 NATURE OF SAME ... Fun~ral .. expenses paid Family exemption (will not be allowed unless decedent died residing with a spouse or children.) Administration Expenses • Counsel fees • Fiduciary commission • ( *) See Note below h•dlcc1 ••~•• .. 4awtaa 1••• 111•••• u.. .• ••t••«•• ··~· factlttt•• 4ariat la•t ill•••• ll&tlo1 ••r.••• tor •••••••• 4cwlce 1aal llloeaa AMOUNT $ '·''' ~0 .1.7 "' 1.soo )0 J c )0 10 ( )() 12J ('0 64 !5 54 ( 0 TH1S COLUMN ~EGISTER ONLY $ I Total 1.411 61 )'--f<t L -C 1 Note: The estate agrees to advise the Register of Wills if the amount actually paid in settlement of any fee, commission oi· debt is greater or less than the estimated amount claimed and allowed. . . !.~/ ·~~llill~~'::~ .. !lO M•trt It•••• Subscribed and sworn to before me this ..... :~ .Cf. .......... . •• , 11 ........................ day of ........ b ............. , 19 ... . . /'S/ /,rr _... ; ~ . .· ·~: ... r. ..... l.~.. . .~n-.-;,~~t~INE .. s.oR,cr:N~1~,;~~~~i .. ~m~ ~o E-Ch•~tnut St. . ($J,.reet Number) Cl•1••144•• ranaerl•aat• ..................................... ~~-·~~ ..... . (City or Town and State) t1 •' I ll ~" il I f f Cl t H . b d I d. t\w r~ommluld<:ll Ji.JiDit&9 J8~t~'f-i'ythfj jH~;g b . . d . f . . . h I h.· avmg een u y sworn accor mg' to ~law, 1 o nereuy cer 1 y at t e a ove appraisement IS rna e m con orm1ty w1t aw on t IS .. : ............... 6{~C/. ........ day of ···········~······················• 19.7( ~ A () ~ ............. ~ .. 'J.~···~ In the event th~t any futu1·e inte1·est 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·inheri- tance taxes at the lawful collateral rate on any such future interest. REPORT OF THE} R~GIS ER OE WILLS I, the undersigned duly elected Register of Wills in and for ... UJ.£;. . . . . . . . . ....... ·r;;· .... County, Pennsylvania, do respectfully report that I have allowed debts and deductions in the amounts claimed by depon t, except a t tn se items where a greater or lesser amount is set fortll in the last column to the right in said schedule above, which greater or lesser amoun re resents the sum tJ:f..ed as a deduction. Dated: ........... b. :-.d~.~ .7/. .. -.............. . .......... ~~. {. ( ........ ~~ ..... . Register of Wills I I. ·~ ~ l J Form No. RCC-62 (6-70) Will Administration }No. · · · ....... Year .... . IN THE MATTER OF THE APPRAISEMENT OF THE ESTATE OF Deceased Late of ..... :..=-· ...••...••• " •. ~·,·.; •.. , •• ""::::a -..1 •J :;:,.. "'..,.., -(/) ,_ . ...) ...... -0 c...:: ---;:> ::: (;; ;~ ~ ::..: ~ .. County of ... ;;-::. L• ....................... . CJ -·-,-I . -~~;r~~ ""' • :; :::' .. ~ , .. en Commonweal:Ui of Pennsylvania:-J ;; ~;: ;.~ ~~ ,_,-r <::>....:;:-, -<.. : ;:::: ~ t..u REPQn~ 4_ND APPRAISAL . -c- c...v R c l .. 43 I ....... ~ (l,M''U' ~· .~._ TH OF PE~tJ~'r"~ -,:·•1A DEPAR : .. !..,ENT OF R~VENU~: ti,~ RRISBURG NOTE: TO BE SUBMITTED IN TRIPLICATE Pennsylvania Department of RevenuP Bureau of County Collccti o:.s 26 S. 4th Street Harrisburg, Pennsylvc; .. l.•J Dear Sir: [.i I~ I L. -,_'It • .. , .. I t I • l i Pursuant to Section .742, Pennsylvania Inheritance and Estatt.> Tax Act of 1961 we herewith submit the folkwing report: ' NAME OF REPORTING FINANCIAL INSTITUTION · Mall• llnttenal IODk eDd tcuet ~ ADDRESS ZOO ~· ltnet Clq•vtlle. Pa. 153U ACCOUNT N 0. OF J'-::0-:-:-1 N-:-:T::-, -----;;CIMI0;;--:71Wti-:--Ac:--ccu___:.n_t__:_-:J27::-:-:-...,.~~--- T RUST OR INVESTMENT DE POS I T __ i:......:'da~..:.:...bec::-.o:..:.lk~:tli.a=-v:.:::i:..:.:llf~•=---C6::.:::a:.....·~1~542~---­ NAMES ON ACCOUNT OR INVESTMENT __ . __ le_e _M_._Me_l_.aB __ .. __________ _ DECEASED JOINT DEPOSITOR, ""• ~llnle Hel¥ia TRUSTEE OR INVESTOR ______________________________ __ ADDRESS ____ ~_ .. l_~~·~_l_l•_•~'-•·~~l~»~U~---------------------- DATE OF DEATH .il•at-71 SURVIVING DEPOSITOR, BENEFICIARY OR INVESTOR JN&l M. Kelvta ----------~----------------------- ADDRESS ________ cl_•_1_•Y.L __ l_l_•_•_f_a_. _____ l_»_._a ____________________ __ RELATIONSHIP TO DECEDENT Dauahtel' DATE DEPOSIT OR INVEST ME N'-=T:----rc~bi~A;;t;J"l..-"i;;-::tu::A::CO\Ul=:&;t--(4;'1':":.""1;Ji'E'o;...,s .. 'i,....., ---- WAS ESTABLISHED PaaaO.X ... ..1v1qe .:.•41•67 BALANCE, INCLUDING INTEREST --~-------- 0 U E, AT DATE 0 F DEATH $ ____ CttibeDllcldr'-na!lr~M.'"oow.nrh'rznt..--~f~t~~~»...,_.4'9j,. i4.-e,._-....!..'.-' ....!..'-' J /;) ~ ... l'AnbiiiR: !IINtnaa ... , .... ' .. Signature Hem.an r. tutl1Tf-"t " ...... _/ f "" f RCC-'1! ...... 1 COMMONWIA1.TH OF PENNSYLVANIA r·D£,ARTMEHT Of REVENUE &UR£AU OF COUNTY COLLECTIONS INHERITANCE TAX DIVISION . ' .... .... OFFICIAL NOTICE OF INHERITANCE TAX APPRAISEMENT AND ASSESSMENT OF ASSETS NOT SUBJECT TO ADMINISTRATION ' '* TO: JEAN 11. MELYIN --~CMLA~Y~S~Vul~L~LE.·~,-LPwEN~rnwS~Y~L~V~AwN~I~A--~15323 Date: _...:..}.;..;;;fa:..:;.r~c..:..:h_1=-6:::::.L, _:1::..:=9~7U!l:....-__ _ -. County __ W:.:...:a::..s::.;h=i:.:n.ag..:t.:::O:::n:...._ ____ _ County File No. ----------·,1 Bureau File No. __________ .l Under the Inheritance and Estate Tax Lows of the Commonwealth of Pennsylvania such transfers ore toxobfe and the liability for the payment of the inheritance tax due is imposed upon you, as transferee. appraised by the Commonwnftfl, as of the date of death, at $ 7 • 113 • 78 50 % of this amount is taxable at the rate of 6 % DATE Of ASSESSMENT T .AXABLE AMOUNT LESS~ ALLOWED DEBTS NET TAX ABLE AMOUNT AMOUNT Of TAX DUE 0 1f you pay the above amount within three (3) months of the date of death of the decedent, or on or befor~ Ma7 ·· 26 19 71 · you may deduct a disc~unt of s~ of the amount of tax due, or 0 This tax became delinquent, fifteen (15) months after the date of death and, in addition to the tax, statutory interest at the rote of 6% of the . tax per annum is also due as of *------ 19 __ in the ~mo.unt of *If the tax is not paid by the above date additional interest is due at the rete. of 6% per annum until paid ORIGINAL ASSESSMENT s _...;::3u•-=5~56;:::.:,~,..;:8=9;...__ 213441 10.67 --___ ..... ____ _ ---------- s 213.41 (Agent for the Commonwealth) INSTRUCTIONS TO TAXPAYERS Make checks or money orders payable to: To insure proper credit to yout account this Official Notice must accompony .. i . ·your payment. Mai I or bring it to: · ~:: ~·-. ... ·;;.;.;.. .... COi.lBT HOuSE . WASlimGn.m·, PcNf~A • 153.01_ ·-... CC\\-.\ONWE::. CF FENNSYLV,, th Rt --.J · .... ; DE PAR 1 · ·. u. r () F R E"v'f l{(; ~ HARR!SBJRG NOTE: TO BE SUBMITTED IN TRIPLICATE: Pennsylvan a Depnrtment of Revenue Bureau of County Col lee •ions 26 S. 4th Street Harrisburg, Pennsylvania Dear Sir: . .. 5 Pursuant to Section 742, Pe11nsylvania Inheritance and Estate Tax Act of 1961, we herewith submit the following report: NAME OF REPORTINC w.....1 ....., lf'n M .. tttonlll baT\~ .•Rd Tl'\\st ... c:.;o ... "nw FINANCIAL INSTITUTION----------------'--_, __ ADDRESS ~aoo~-·~~==D~S~t~~·~c~----~~~l=aLy•~vt~l~l~e~a~P~•~·~~lL)~l~zt._ __ ___ ACCOUNT NO. OF JOINT, TRUST OR INVESTMENT DE POS I T __ .s_ .. _.vt----.:"1=-'-ca_t.:_· t_1_ft.;:_c_;.:a~tc..:::..._...::I_O.U=:....::46.;;__ __ _ NAMES ON ACCOUtH OR INVESTMENT ________ H_t•_. __ c_a_r_r.L_o __ t_~ __ l_Y.t_n ____ o_r_J_•_~ ___ M~·-Me~l-... ~~o~~~--- DECEASED JOINT DEPOSITOR, Mra. W.nte Helvtn TRUSTEEORINVESiOR _______________________________ + ADDRESS ___ Clqnt.lla1 Po, _ _....ss~J..,.a~..:~l~--------------- J A 1 /. <'·r I l- ' I / tf-L·' I , ,, tl I ./'· DATE OF DEATH l•lt-71 1. " l/ ·--------------------------SURVIVING DEPOSIIOR, BENEFICIARY OR INVESTOR J•4 "• H. HelYI.A or "flOcp J, Melna I. t t!r f .f' ,l ' ADDRESS _______ Cl_ar_•_n_l_l_•_•_~_a_. ___ l_»_~ ___________________ ___ RELATIONSHIP TO DECEDENT DATE DE POSIT OR I NV EST MEN-::T--....,..n-.• -,_- 66 -------------- WAS ESTABLISHED BALANCE, INCLUDING INTEREST $6,400.00 , A DUE, AT DATE OF DEATHS_______ <::l .~ '/ I / ... / 1-) . f..;. . ' -1 • • • '· • ./_:; / .. -.... ... Signature 11antan r • Dteta TITL~ •••• _,-.. ;:-','.: r..-r .· f AC(>-~(~9) C-GA*.·l'ff OP '£NNSY L VANIA . :·M•A•TIIaMT OF REVENUE auttrAU Oit COUNTY COLLECTIONS INttiiUTAMC£ TAX DIVISION OFFICIAL NOTICE OF INHERITANCE TAX APPRAISEMENT AND ASSESSMENT OF ASSETS HOT SUBJECT TO ADMINISTRATION TO: CBORGE J. MELVIN CLAYSVILLE, PENNSYLVANIA 15323 Date: _ __::.~:..=::....:::.=..~L.-::.:..:~.A..-~~;,-. County --!!~l!:!.:!..Hii~IL.----......0: County File No. __ _.;... ____ ......... ...,.._. 1 <" ~ ~ •I .. -.. • 1 ~ ~ ' r. t , • ~ ' . • t ~ ., '! appraised by 'the CcNh~nweofth,-al of tht date of death; Cit s 6,400.00 J3 1/~·of this amo.-nt is taxable at the rate of 6 % . · -~ORIGINAL ASSESSMENT DATE oF •ss£=t\il/3J'' 6,-too.oo • .2tl33.:M~ .. . . . .. · -·· ·.·......a-,· ~-:--~. t~ ··or·:t;t33.M -1,064.67 r,oa&.-61 t .. TAXAILEAMibUMJ.... . ·. S-------- J -LESS: Ai..~OWEO 0.11'S ' . MEf'"tixii(E-AMOuMT ~-' -~·--· •. .• . .,-~ ' -• r --~t~F TA~DUE ---~. it .. • ,;~~~-·~ h? -, .- :.:;.... . 64.00 '' 3.20 --------~-- --------....... - AGE;•T FOri il;E COMMONWEALTH COURT HOUSE WASHINGTON, PENNA. ' . CORRECTED RILL .. ·- OFFICIAL NOTICE OF INHERITANCE TAX APPRAISEMENT AND ASSESSMENT OF ASSETS NOT SUBJECT TO ADMINISTRATIOM !)li;.iii[i[ilaiii*.io~uicame into ownership of certain pro,.rty through .... AM ..... _ • tranafer from, ~ms. CARRIE MELVIN, "''n~-.. •. l ...... itaac• .d Estate Tax laws of the Commonwealth of Pennsylvania such transfera .. far the pa,Mttt of the inheritance tax due is imposed upon you, aa tra~taflfft. ·: ..,_ised bj the C....._wdltlt, aa of the date of de.th, at S 6 .-•oo. oo LSJ 1131 af this omount i.s tualtle ~t the rate of 6 " . . . ORIGINAJ. ASS£SSMEL4T .:.--..···-· ~MINTl/3 of 6,400.00 • 2,133.34 .. . ••• ~l/2 of 2,133.~ • l,066.67s 1.066.67 ....,.._,_..:· .,=.,_-· ' .... ..c-. cleli..,ettt, fift .... (15) ......... . , the ..._ fl 4eetlt tMcf, itt ..Witt. to 1M ~etvterr i•t•est at the rate ef 6" of tlte ;er GM .. ia oiH .,. oa .of *----- '""·lt-in tM ... _. ef . . -:11 tt.. tax ia nOt peW lty the -., date additional "; 1a.M..a.M. Nile tl 61,. ....... until ' .. '" . t.·· ·· .. 64.00 •· .. -....... s 64.00 INSTRUCTIONS TO TAXPAYERS To insure proper credit. to ,., this Official Notice must ace•• your paymtttt·. Moi I 011 bring It AC:•;! ;<> ; .. ': ~.W·;~'iON~EA .. ·--,..,_,,, C-·;· il HOUSE WASU::~C rtm. FtNNA. RCC-81 (2-64) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS INHERITANCE TAX DIVISION NOTICE OF FILING OF APPRAISEMENT JEAN N • .t>1ELVIN-IN.FOlU1ANT IN YOUR REPLY PLEASE REP'IER TO In Re: Estate of ___ --=C=-::A.:..:H=RIE=~~l::='lli.=.;L=M..:..;I=N:..:...._ _______ _ ____ ___!\•!!:Ili~S.!.!:HI~f~·D~T~O~N'------County -File No. 63-71-538 Dear Hiss :Melvin, You are hereby notified that the ___ ~ou~~i~g~j~na~J~-------- appraisement in the estate of ___ ~C~A~R-R~IE~;~}~lli~I~J~Tr~rLJ ____________________ _ has been filed in the office of the Register of Wills qf WASHINGTON County on June 22 , 19~. Said appraisement reflects the following valuations: Jt. Held ~ ------"5'"'"',6,._,9""'0""",2::::..3.._ __ _ Personal Property ____________ __ Transfers __________________________ ___ Total -----------~5,~6~9~0~,~23~------ As to such tax that is paid within three months from date of death, a five (5%) percent discount is allowable. As to any tax that remains unpaid after one year from date of death, interest at the rate of six (6%) percent per annum is charged. Any party in interest who is aggrieved by an appraisement may appeal therefrom as provided by law. Date ___ ~J~un~e~2~2~,_1~97~1~---------Signed Title DATE OF DEATH: February 26, 1971 Note: This is not a bill. RCC-39 (5-68) COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SUMMARY Estate of !·!ELVIN (Last Name) CAHRIE (First Name) DATE OF DEATH 2-26-71 FILE NO. 63-71-538 (lni tial) REPORT OF INHERITANCE TAX APPRAISER I, the undersigned duly appointed Inheritance Tax Appraiser in and for the County of \·lashington 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: ___ J_un_e_2_2_,,<--l--=97c...:........cl'-----/ REPORT OF THE REGISTER OF WILLS I, the undersigned duly elected Register of Wills in and for _ ___:_ii:..::a:..:s:.:.hi=·:.:.ng=.::t:.:o:.:.n~---County, Pennsylvania, do respect- fully report that I have allowed deductions in the amounts claimed by deponent, to those items where a greater or lesser amount is set forth in the last column to the right in Schedule "F", w ch reater o lesser amount represents the sum allowed as a deduction. Dated: __ J_un_e_2_2'", _1.....:97o..:...;:;l'----- 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 VALUE AS REPORTED VALUE AS APPRAISED $ $. ________ ~-- annuities................... $------+---- ESTATE TAX ASSESSMENTS $ _____ .J.....__ FOR USE OF REGISTER ONLY COMPUTATION OF TAX Tax on$ 2% Tax on$ 2~197 62 ~ Tax on$ $ ____________ ~--~ $ ___ ~1 .... L1~l~-~g6 $-------------4--- Tax on$ 10% $ ____________ -4--- Tax on$ 15% $ ______________ ~---- VALUE AS REAPPRAISED $ ________ +--- Exemptions Total Estate TOTAL TAX * $---------~---- (*) As evidenced by Charitable Exemption Certificates issued by the Secretary of Revenue. Less tax previously paid $=======4== BALANCE $-----------+--- Less 5% of tax if paid within 3 months after death $=====~== Add interest at rate of 6% from ---------to -------- AMOUNT OF ESTATE TAX ASSESSED $------+-- Estate tax paid $ _______ ---I~___ BALANCE DUE $----------~--- Add interest at rate of 6% from ------~·0---------$---------~~-- TOTAL TAX BALANCE $ -----------+--- PAID $ -------1--- 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 GARRIE NELVIN Deceased Late of.. CLAYSVIU.E County of . ti"ASHIIIJTOIJ Commonwealth of Pennsylvania REPORT AND APPRAISAL .a .. Fonn RCC-2 DATE ........ June ..... 22., .... l971 ...................... . COUNTY ..... J:/9.;;?.h.~.;t.QI:4. .. .::. ..................... . DF.J'ARTMENT OF REVENUE • • .... ' l ... BUREAU OF COUNTY COLLECTIONS HARRISBURG, PENNA. 1 7 1 2 7 COMMONWEALTH OF PENNSYLVANIA RESIDENT INHERITANCE TAX APPRAISEMENT FILE NO •........ §~~7.*-~.2?.?. ................................................ . Whereas, ...................................... C.!~.mrm .. Jtt.;L.V.J..N .................................................................. late of .................. C.L.AXS.V.l..LL.E ....................................................... . in the County of .................................. W.A~.U.~~~1'.9N ................................................................... Commonwealth of Pennsylvania, having died on the .................................. ?.§.~}} ............................................... day of ............. Y~.l>.t~.r.Y.................................... 19 .. 7J.: ... , seized and possessed of an estate subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore, I, ........................... NAP..~J::.~~ ... X.±NN~'X ..................................................... , an appraiser duly appointed according to law, having been designated to make a fair and conscionable appraisement of the said estate, and to assess and fix the cash value of all annuities and life estates growing out of said estate, hereby file the following appraisement: In the event that any future interest in this estate is transferred in possession or enjoyment to collateral heirs of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer inheritance taxes at the lawful collateral rate on any such future interest. Description of Asset JT. HELD: See copy attached to appraisement Unit Values $ Appraisement Made for I nherltance Tax Purposes 5.690 23 Having been duly sworn according to law, I do hereby certify that the above appraisement is made in con- fonnity with law on this.............. j!J day of 1)/!}j:.j_;'i:,;::, :;;;;..;_; ; j ;;,;~ : . ( K umber and Street) ............................................ /.A!...C~i;;;i/oi:i'6-<····· .............................. , Penna. I l I·JASHINGTON County ,, • l RESIDENT INHERITANCE TAX APPRAISEMENT Estate of C.AP.Jll.E .... HELVl..N ............. . Deceased. Late of .CLAYS.VIL.IE. ............................................................. . Date of Death, ................... 2 .... 26-7~ ................................... . Appraisemel!t Docket Vol., ....... J....f... ............................ .. Page, ./.7~ .. ~ ... = .. {, ......... No ... 2J..~·:7.:I,~5.J? ............ .. Filed in Register's Office, .... ~~~ .... ?.?. .......... 19 ..... 7~ Amount of tax due, $ ................................................................... .. DEPARTMENT OF REVENUE Received, Examined and Approved, Wrote abo.ut Appra.isement, .................. . Appeal ft'om Appraisement, Entered and charged, ~