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HomeMy WebLinkAboutOC1971-0689 - ESTATE OF MARTIN.• ' Form RCC-33 COMMONWEALTH OF PENNSYL VAN lA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS RESIDENT DECEDENT COUNTY OF ... W~.$.b.i.n...g.t.on .............................................. . 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 and Estate Tax Act of 1961.) County of ... Wa!l.KiMl!I~-~~X ... J?e..nn.a ............. } ss: ..washington ................................................... . State of ..... ............................ DAN ~ ...... -'·'~.RT..J..N ........... . .. ............................. Eseeutor Administrator of the estate of the above-named decedent being duly sworn, depose and say Decedent died ............. AP~.t! . ~.§. (Month) (IJay) ... , 19(-J;;.;tj·····•{ ~::::::t~eaving a iast will, copy of which is hereto attached. } Name and address of attorney or} other author-ized representative to whom all correspondence should be mailed. Frank A .... Conte, Esq., .23l.. .. Was.hington ...... ..... . ... .. That as such ...................................................... deponent is familiar with the affairs of said estate and the property con- < Ex.,cu tor-Administrator) gtituting 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 That the contents of said safe deposit box or boxes are itemized under Schedules of this ---return, with the exception of the following, for the reasons hereinafter set forth: That Sc.hedule A attached hereto and made part hereof sets forth fullv 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 encumbrances 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, o.r\:.th trust f'or ~·. -any other person or persons giving also separately the accrued interest thereon, if any, -~~\:to the last.' interest day prior to decedent's death in the case of savings banks, and to the date of $cedent's de'ath "'!' ro"--~ in all other cases; all bonds, postal savings, treasury certificates or notes and other-evidence 9f in- IS 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 -ther'eof, 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 ~My and all other personal chattels of whatsoever kind or nature, left by decedent, together with the fairly estimated market value thereof; all bonds and mortga~res 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 estimated 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. •. 1 I • 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 showing 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 with the fair market value thereof, any other property owned or bequeathed by the decedent at the time of death. 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 two years of decedent's death, in contemplation of decedent's death, or intended to take effect in possession or enjoyment at or after death, said schedule sets forth the nature and value of such property, to whom transferred, the relationship of the transferees to the decedent, the proportionate share received by each transferee 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 passes 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 individually or jointly, by the will, deed, or other instrument of another, with a copy of the instrument creating such power attached to the 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, the 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/1edule 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/1edule 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 unpaid at time of death; taxes accrued chargeable 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. ~-)11!2!32___ -----····· (Executor-Administrator) (Street Number) (City M Town and State) NOTE: 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. ' ., II RCC-34 (1-64) COMMONWEALTH OF PENNSYLVANIA DEPAR'fME~T OF REVENUE •BUREAU OF COUNTY COLLECTIONS TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "A" 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 (1) (2) (3) described by lot and block number, street and street number, together with DEPARTMENT a general description of the property, with a reference to the record of the ASSESSED VALUE VALUATION conveyance by which the decedent took title; If a farm state number of a-FOR YEAR OF ESTIMATED CAUTION cres; also statement of mortgage encumbrances upon each parcel at death DECEDENT'S MARKET VALUE (Do not write of decedent. Taxes, assessments, accrued Interest on mortgages, etc.,are DEATH In this space) to be listed on Schedule "F" and must not be deducted from this schedule. NONE ·- 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. 'RCC-3s· COMMONWEALTH OF PENNSYLVANIA lRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE 11B11 PERSONAL PROPERTY 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 deeedent 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 o·r 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, treasur} certificates, cash on hand and in bank, stocks, mortgages, notes, together with accrued interest or rliy:i.dends, salaries or wages, insurance pay- able to the estate or fiduciary in said capacity, partnership Jnt.erests, interest in any undistributed 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. ITEM List and describe fully UNIT VALUE ESTIMATED MARKET VALUE DEPARTMENT VALUATION (Do not write in this space) 1 2 3 4. 5 6 7 8 Checking Account # 316-0851 at Mellon National Bank & Trust Company Savings Account # S-1383 at First Federal Savings and Loan Association Prudential Insurance Policies # 32-178-965; 40~182-168; 48-193-525; 106-386-370; 106-386-371 267.59 2,276.91 904.69 Prudential Insurance Policy # 1-813-981 ~~~-517.45 Prudential Insurance Policies, # 36-736-286; 36-736-287; and 36-736-288 ~r.n,~ 43.47 Metropolitan Insurance Policies, # 76-000-943 and #103-516-765 ~/l}c~ 603.31 Refund from Blue Cross of Western Penna. H<Y-n~~ 10.20 Refund from The Washington Hospital ~Jn;~ Extended Care Facility 238.35 Insert this total opposite "Personal Property", Schedule "B" in the "As Reported" column on the last page of this return. X X 4,861.97 :1 ;< 7~. 9t I /o. Jo 'RCC-'36 COMMONWEALTH OF PENNSYLVANIA TRANSFER H\HERITANCE TAX RESIDENT DECEDENT SCHEDULE "C" TRA.NSFERS (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) NO (2) Did decedent, within two years of death, transfer property from himself 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 health 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) NO (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 enjo~ent of or (Answer yes or no) ____ 0 _____ _ the right to income from the property transferred? (b) The right to designate the persons who shall possess or enjoy the property transferred or income therefrom? (Answer yes or no) NO (6) If the answer to (5) (b) above is in the affirmative, state whether the right was reserved in decedent alone or others ___________________________________________ __ (7) Did decedent in his lifetime make a transfer, the consideration for which was transferee's promise to pay income to or for the benefit of care of transferor? (Answer yes or no) NO (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) __ ~N~0~---- (9) If the answer to (8) above is in the affirmative, 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 attending 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 NONE Insert this total opposite "Transfers", Schedule "C" in the "As Reported" column on the last page of this return. MARKET VALUE (Estimated) DEPT. VALUATION (Dept. Only) RCC-.38· CCMMONWEi\LTH OF PENNSYLVANIA THAN~FER INHERITANCE TAX HESIDENT DECEDENT SCHEDULE "E" JOINTLY OWNED PROPEHTY INSTRFCTIONS: This schedule must disclose all property, real and personal, owned by the decedent jointly with another or others, including intangibles, standing in the name of the decedent and others. List real estate first, as entireties, or joint tenants, giving brief description, as indicated under Schedule "A", plus the date and place of record of instrument effecting vestiture, but do not include entireties or out of state real estate value in estate valuation column. Personal .property should be listed as in Schedule "B", plus date of acquisition, and the name, address and relationship (if any) of co-owners to the decedent. Description of Property, Date of Acquisition, Name I Unit Address and Relationship of Co-Owners, and Place I Value of Record of Instrument, where Rea! Estate. ! NONE percentage Estate Share Valuation Insert this total opposite "Jointly Owned Property", Schedule "E" in the "As Reported" column on the last page of this return. DEPARTMENT VALUATION CAUTION-Do not Write In This Space. Value of Entire Property Value of Decedent's Interest A --~ ••• -.• 1 (~ ··~ .t·:..- .. U) <( _j 0-__ ! ( h RCC-37 · fl2-63) . CO~fMO.l'\!W.EALTH OF PENNSYYLANIA/' TRANSFER INHERITANCE TAX RESIDENT DECEDENT ~ ~· ~ ) i BENEFICIARIES AND ADDRESSES State full names and addresse~ of all who ave an interest, vested, contin,ent or other . wise, in estate) Dan M. M t' ~?qhD~g~~n A ar 1n f;:=j~· ,; n :nn Emma M. Weirich 506 Hutchinson Ave., Canon Elsie L Combs Ll.lt; F.;'!~::+-Wheelinq St., W f"'h;=jrlt=>~=: F. M;:'!r+-in Harris Road, Brecksvil SCHEDULE "D" BENEFICIARIES RELATIONSHIP (If step-children or SURVIVED DATE INTEREST OF illegitimate children DECEDENT OF BENEFICIARY are involved, set STATE YES IN ESTATE forth this fact.) OR NO BIRTH ~i ·Son Yes Daughter Yes :;burg, Pa. Daughter Yes ~shington, Pa Son e, Ohio YeS Deponent fUrther says that all the above-named beneficiaries are living at this time except below: NAME DATE OF DEATH RESIDENCE ·'· Will ·:Administration ~ No. IS THE Year .................. . :\lA TIER OF THE APPRAISEMENT OF THE ESTATE OF BEULAH MAUD MARTIN Deceased Late of the C::~~y _()_~--~~~~-~~-~~~ County of Washington Commonwealth of Pennsylvania REPORT AND APPRAISAL ,, (Executor-Administrator. must complete .. As Reported" column #1.) GJ .... 0 ·tfl "' ~-~ C"' ;- ~ "' S' (b >-j 1-C :;:x:1 1:1 ~ (b ... "' ~ r;; 0 -...... :I '"t:t ~ ~ .... "' -.g ~ (b 0 .... '0 ~ $ Cl) c ~ ~ > :;:x:1 w CJ) CJ) >-<: ?" ?-?-q ~ ~ ~~~~~~ :o~::- "' > :z :co z "' :o :0'1 0 :;:x:1 :z :1--' z (b :: :t;r:j :. l:7j 'g '--' :1..0 .., ...,) it ~~~~~~ c.. > "' t:l ~-C'ti'V .., '--' 2. :::: ('t c.. - Form RC C-10 OFFICE OF THE REGISTER OF WILLS STATEMENT OF DEBTS AND DEDUCTIONS "'""'"" "'"]§ '~; ,L THE SUM OF . . . . . . . . . . . . $ . ) . . . • . OF _....:_W:....:a::.:S::.:h:..:..=i:.:.n::...:g:!..t.:.O...:....:..:n __ COUNTY AND AGENT OF THE COMMONWEALTH ~ j -7/-~ f/ / ESTATE oF BEULAH MAUD MAR ..... T...r.I..~.NlL._ __ LATE oF 4 70 Donnan Ave. , Washington, Penna. DATE April 26; 1971 DATE OF FILING APPRAISEMENT DAT!i OF DEATH -~''t-'-""-=.~~~----"~~.__ ____ _ NO. OF VOUCHEIII: NAM&: OF PAYEE Piatt. Fun.::>r;:~l Home Kurtz Monument Companv M. w. Graham Frank A C.ont.e Esa REMARKS l<'nne:>r~1 0~11 Cem,et.erv le:>++e:>r'inn J nnr"!tor hi 11 1l++nrne:>u -f.::>.::>c: AMOUNT iJ • 52q , c. so '\""/\ .., l,.,y v 00 (\(\ 00 1\1\ ..,.., ~ / 1'15"' d-0 I ----+---+---4-----------------------+-------------~-------;----~---- COMMONWEALTH OF PENNSYLVANIA COUNTY OF Washington 1, Dan M Martin HEREBY CERTIFY, THAT. TO THE BEIJT OF MY I<NOWLI!DGE AND BELIEF, THI! FOREGOING IS A JUST AND TRUE SfATEMENT OF DEBTS, FUNERAL EXPENSES AND EXPENSitS OP' AD•••••T•<>••• su•••n•o To TN< '""" •• Bell 1 ab ~ ~~ 0 ... •• ••au«•••• ••• INHERITANCE TAX PURPOSES. ~_4 m_ )??~ ·~~ ••• sua!'c~'"'j""o" "' TH>S ffi_t.fd ... .; -'4 ezi . <L. •·> {/ ka. o~ 77{ 18 ~ A~~ t0\'~f.KA~E·N M. SANFORD , NOTARY PUBLIC () \ ~;·~~;::,::WASHINGTON, WASHINGTON COUNTY . ." ' . MY COMMISSION EX,PIRES APRIL 14, 1975 Member, Pennsylvania Association of Notaries L_ ____________________________________________________________ . ~ ;::, )::>. fT1 :::0 (/) C) c ~-· ..... _ -en <n z -j (.rJ ,/ r·~ r~ 1 ,, ---i ;~_) ::::> :;:: ....._ '--' " -., ..... ("') ']. 0 :t: ---u::= >" . ([) 2: 0 .. ~~ _, ; i ~, ... _ ~ ... c:::: ........... _ <::7 -:l"<>: ~"'> ! ~ en z:.:: -o "" :::::;:: RCC-81 {6-71) COM.MONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS HARRISBURG 17127 NOTICE OF FILING OF APPRAISEMENT DAN M. MARTIN (Executor or Administrator) IN YOUR REPLY PLEASE REFER TO Inheritance Tax Division In Re: Estate of __ B_E_UL_A_H_M_A_U_D_MA_R_T_I_N _________ _ \vASHINGTON C F.l N 63-71-689 ounty-1 e o. _________ _ Dear Mr. Martin, You are here by n oti fi ed that the=;-;;-~o;=-r7i:-r;g~i~n~a=-:1=:-:--:===:--------- appraisement in the estate of BEULAH MAUD MARTIN has been file~in the office of the Reg.i~ter of Wills of_..:.;.W.=-:A=.S.::..:H=I:=..:N=G-=T.::..:N~------ County on ovemoer 26 , 19_-l_l., Said appraisement reflects the following valuations: Real Estate _____ ~=-=~~----- p ersona I P roperty ___ 4-!.,:..__8:..__6::..::1=-=-. 9.::_7..:.__ ___ _ Transfers ______________ _ Jointly Owned ----..---.,....,.....---...-..,------Total _______ 4~, _8_61_. _9_7 ___ _ As to such tax that is paid within three months from date of death, a five (5%) percent discount is allowable_ As to any tax that remains unpaid after nine (9) months (fifteen months when death occurred from December 22, 1965 to June 16, 1971, inclusive; and twelve months when death occurred prior to December 22, 1965) from date of death, interest at the rate of six (6%) percent per annum is charged_ Any party in interest who is aggrieved by an appraisement may appeal therefrom as provided by law_ , Date __ N_o_v_e_m_b_e_r_2_6_,_1_9_7_1_ Signed __ MA_D_E_L_I_NE_"'_FI_NN_E_Y ____ _ Title __ A_P_P_RA_I_S_E_R_I ______ _ DATE OF DEATH: April 26, 1971 Note: This is not a bi II. I . ,, . .. COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT BEULAH '63-71-689 JMO SUMMARY M. DATE OF DEATH 4-26-71 FILE NO. 63-71-6189 Estate of MARTIN (Last Name) (First Name) (Initial) REPORT OF INHERITANCE TAX APPRAISER I, the undersigned duly appointed Inheritance Tax Appraiser in and for the County of __ W_A_S_H_I_N_G_T_O_N _____ _ 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: November 26, 1971 17J2M.Ju,_,) J/.JAvr* 124)() . INHERITANCE TAX APPRlSER il r REPORT OF THE REGISTER OF WILLS WASHINGTON I, the undersigned duly elected Register of Wills in and for County, Pennsylvania, do respect- fully report that I have allowed deductions in the amounts claimed by deponent, exc as to those items where a greater or lesser amount is set forth in the last column to the right in Schedule "F", ·c greater r lesser amount represents the sum allowed as a deduction. NOV 2 9 1971 RUSSELL MARINO Dated:------------ 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 VALUE AS REAPPRAISED $ $ $ __________ ~---4,tSor ':n .d. ~hl Q7 4,861 97 4,861 97 1,845 00 1,845 00 3,016 97 3,016 97 annuities . . . . . . . . . . . . . . . . . . . $ _____ --+---- EST ATE TAX ASSESSMENTS $ FOR USE OF REGISTER ONLY Tax on$ 2% Tax on$ 3,0l6 97 C!Y Tax on$ 5% Tax on$ 10% Tax on$ 15% Exemptions * Total Estate TOTAL TAX Less tax previously paid $ BALANCE $ Less 5% of tax if paid within 3 months after death $ BALANCE OF INHERITANCE TAX DUE Add interest at rate of 6% from ------tO-------- COMPUTATION OF TAX $-------~~-4~~ $ 181 02 Pd. In Full $------------4---- $ ____________ -4---- $ ____________ ~ ___ $------------L---- (*) As evidenced by Charitable Exemption Certificates issued by the Secretary of Revenue. AMOUNT OF ESTATE TAX ASSESSED $-----------1--- Estate tax paid $ _____ --L.. __ BALANCE DUE $ _________ ___J. __ _ Add interest at rate of 6% from --------~·0---------$--------~---- TOTAL TAX BALANCE $ ----------+---- 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 BEULAH ~~UD MARTIN Deceased Late of WASHINGTON County of WASHINGTON Commonwealth of Pennsylvania REPORT AND APPRAISAL ' Fonn RCC-2 DEPARTMENT OF REVENUE Bt.ffl,EAWoF COUNTY COLLECTIONS HARRISBURG, PENNA. 77 12 7 COMMONWEALTH OF PENNSYLVANIA RESIDENT INHERITANCE TAX APPRAISEMENT DATE ....... ~~.Y..~.~.~.~ ...... ~.? .. t ..... !.~ .. ?~ ...... . NTY WASHINGTON cou '""""""""""""''"""""'""""''"""""'"""""""""'''''"'""""' FILE NO .... ?. .. ~.:::: .. ?..~.:::: .. ~.~ .. ~ ............................................ . BEULAH MAUD MARTIN WASHINGTON Whereas, ...................................................................................................................................................... late of ............................................................................................................. .. in the County of .............................. ~~~·~·~·~?..!..?.~ ................................................................ Commonwealth of Pennsylvania, having died on the ............... ~.?..~.~ .............................................................. day of .................. AP~.~.~ ....................................... 19 .... ?..~, seized and possessed of an estate subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore, I, .......................... J~P..~~.!.~ ..... ¥..!.~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. Oeser I ptl on of Asset PERSONAL: Unit Values $ Appraisement Made for Inheritance Tax Purpo.es SEE COPY OF SCHEDULE 11B" ATTACHED TO APPRAISEMENT 4,861 97 --~---------------------------------------------------------------------r------~----------+-·-- ------~--------------------------------------~-------------------------r-------H---------~--~ --~---------------------------------------------------------------------r-------fl-----·------4---- 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 ..................... c2..6..~ ....... day of ............................... ~ ... ~ ...................................... 19 .. ~2 ... . ...................... ~~ ..... ~ . ....L4(!.,A:!.L.Lf· .......... ~ ... ''.a Apprni • ............................. W.~' ................................. , Penna. WASHINGTON County RESIDENT INHERITANCE TAX APPRAISEMENT Estate of BEULAH ~~UD MARTIN Deceased. Late of WASHINGTON Date of Death 4-26-71 , ········································································ Apprtiisemel!t Docket Vol., ..... ..3..1... ...................... :::::::::.:: Page, .. /J.:~ ..... -::.7... ........... No. 63-71-689 Filed in Register's Office, .. N.~.Y..~ ...... ~.§ ......... 19 .. 7J. Amount of tax due, $ .................................................................... . ~ DEPARTMENT OF REVENUE Received, Examined and Approved, Wrote abo.ut Appraisement, Appeal f1'om Appraisement, • Entered and charged, IN RE: ES.TA'I'E OF BEULA!i<;MAUD MARTIN. ti:fdr; ·sef-bi~ffient of ~~~~yet': · .. ~eb.t::±oh .. :to ~t : o:E-•· ... ·-. ·. 'f '8{1~.49-,· ' .. ,., .. '-:"~'. 0 •••• '·\ ;·. '"' .•·' · . .. . .... I . .. IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY, PENNSYLVANIA ORPHAN'S COURT DIVISION IN RE: ESTATE OF BEULAH MAUD MARTIN, :No.. 4,. j-7 J .._ C,%9 o£ 1 9 j' 1 Deceas.ed PETITION FOR SETTLEMENT OF ESTATE UNDER SECTION 202 OF THE FIDUCIARIES ACT OF 1·9 4 9 I AS AMENDED TO THE HONORABLE P. V. MARINO, PRESIDENT JUDGE OF SAID COURT: ( o.c. AND NOW, comes DAN M. MARTIN, Petitioner, and represents to your Honorable Court as Follows: 1. Dan M. Martin is an adult individual who resides at 711 North Franklin Street, City of Washington, Washington County, Pennsylvania. 2. On April 26, 1971, Beulah Maud Martin, a/k/a Maud Martin, died intestate domiciled at 470 Donnan Avenue, City of Washington, Washington County, Pennsylvania. A copy of the death certificate of decedent is attached hereto as Exhibit "A". 3. The heirs at law of the decedent are: Dan M. Martin, your Petitioner; Emma M. Weirich of 506 Hutchinson Avenue, Canons- burg, Pennsylvania; Elsie L. Combs of 415 East Wheeling Street, Washington, .Pennsylvania, and Charles E. Martin of Harris Road, Brecksville, Ohio. The aforesaid heirs being the sons and daughte~s ' . of the decedent. 4. The gross value of decedent's estate, exclusive of real estate, wages, salaries or a:ccr.ued pensions payable under Section 201 of the Fiduciaries Act of 1949, as amended, does not exceed $5,000.00. The items of personal property in the estate are as follows: . . . (a) Savings Account at First Federal Savings and Loan Association # S-1383 · $2,221.04 (b) Checking Account at Mellon National Bank and Trust Company # 316-0851 267.59 (c) Metropolitan Life Insurance Policies payable to the Estate valued at approximately 500.00 (d) Prudential Life Insurance Policies (Nine in total) valued at approximately 2,000.00 TOTAL ASSETS $4',988. 63 4. The following expenses and debts of the Estate are admitted and are entitled to preference. (a) Funeral bill, Piatt Funeral Home (b) Cemetery lettering, Kurtz Monument (c) Frank A. Conte, Attorney fees (d) M.W. Graham -Dr. bill TOTAL LIABILITIES 5. Decedent died widowed. $1,529.00 16.00 250.00 50.00 $1,845.00 WHEREBY, your petitioner prays your Honorable Court to pay over to Frank A. Conte, Esq., all the assets of decedent's estate, and as such attorney for the estate, to distribute the assets to the creditors as set forth above and the balance to be divided equally among the sons and daughters of the decedent as set forth in the Petition. Frank A. Conte,. Esq. Attorney for Petitioner ... COMMONWEALHT OF PENNSYLVANIA SS; COUNTY OF WASHINGTON ~~··day of I ON this the before me, the undersigned authority, appeared DAN M. MARTIN, who, first being duly sworn according to law deposes and says that the facts set forth in the foregoing Petition are true and correct to the best of his knowledge, information and belief. Sworn to and subscribed before me this ·/~-day of ---~~..:;w..'l----' 19 71. ~y Commission Expires: M~EN M, SANFORD, NOTARY PUIILIC , 1 WASI'I1NGTON, WASHINGTON COUNTY UY COMMISSION EXPIRES APRIL 14, 1975 Member, Pennsylvania Association of Notarllll . . "_, ' . IN THE ORPHAN'S COURT OF WASHINGTON COUNTY, PENNSYLVANIA IN RE: ESTATE OF BEULAH MAUD MARTIN, No. of 1971 o.c Deceased ------- D E C R E E AND NOW, this ~y of consideration of the within Petition, it ·· AND DECREED that all the assets of decedent's estate be paid over to • FRANK A. CONTE, attorney for the estate, to distribute the assets to the creditors as set forth in the within Petition and the balance to be divided equally among the sons and daughters of the decedent, as set forth in the Petition. BY THE COURT: J.