HomeMy WebLinkAboutOC1971-0743 - ESTATE OF PAULICK~
"I
RCC-43 (4-69)
~3-7/-7(j3
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 __\·_'e_st_e_m_P_e_n....na.....~Na;;;.;t:;..'=l.....;.B..:.;@=k=--_
ADDRESS Fourth &Main St.,Monongahela,Pa.15063
ACCOUNT NO.OF JOINT,
TRUST OR INVESTMENT DEPOSIT Savings account #0040026899
NAMES ON ACCOUNT
OR INVESTMENT Mary-c.Pm1Jick or ROIlal4 U.?al!1ielE
DECEASED JOINT DEPOSITOR,
TRUSTEE OR INVESTOR _.....;;,;M=ary~.::.;C.~Pa::;:u1=ic~k~_
ADDRESSANDCOUNTY Keenan HiU,New Eagle,Pa.rTashington County
DATE OF DEATH --e;6~.~30,p..o+71d=-----------------
SURVIVING DEPOSITOR,
BENEFICIARY OR INVESTOR _...&;B.....ou.nst:l..l'loLld....,MI:I.4.......PiMQ'..J]..,1cl;;,lk'--_
Assistant Manager
Signature
I~--.
TITLE
"OFFICIAL NOTICE OF INHERITANCE TAX
APPRAISEMENT AND ASSESSMENT OF
ASSETS NOT SUBJECT TO ADMINISTRATION
IRqC-134 (1-69),'
C9MMONWE;ALTH OF"'PE;NI,is"YLVANI'A
I,DE;PARTMENT OF REVE;NUE;
Bl,JRE;AU OF COUNTY COLLE;CTIONS
~:INHE;RITANCI:TAX D!VISION
I
lfO:RONt\.LDU •,PAULICK
i:KEE*A~HILL ',..,(
Dote:-~Jof't1l:l:1~'F-"-l1-44-=-,"':'lH9~Tq.l---
County --l.lW~A~S.Q.H..I,l,llING~T,LJOI,J.j~~l------
, I
I 'NEW EAGI.E,PENNSYI,vANIA 1506.1 County File No ..,..,_
Bureau File No.~J -2/-27"..3
:PENNSYLVANIA.,Inthe na.m~s.0 f:l.f1\RY C.PAULICK OR RONA!.D M.PAULICK.OnenedI'~
~'2-31-65.Bala1nceas,of date of death,$624.08
I We have received noticethat~l~~~,kr~.~~~~~.~~r~~~~~~~!.~r~.~~!on,,June 30,,19.,.U,y,qu come into ownership of <;:ertoin property t roug ~}t'
~B~I9du{.~Ii.e.x!iI transfer from ~fARY C.PAULICK,DECEASE''''D'''<Ul(~'''N''E'''''l''l\,J1v ·.A.EAIUOl.ALEAJ,)""""
:Under the Inheritance and Estate Ta,x Laws of the Commonwealth of Pennsylvania suc;:h transfers are taxable
rnd the Iiabi Iity for the payment of the inheritance tax due is imposed upon yov,as transferee.
I
i The property on which tax is.here:l~y ass.essed consists of:J t.Held Savings Acct.#004 00226809
ibeJd in tbeWESTERNPENNA.NATIONAL n'ANK,HONO:NCAHELA OFFICE,MONONGAHELA,
--,-~,~----""!~
18.90
I
lappraised by the Commonwealth,us Qf the date of death,at $624.08
t 50 %of this amount is ta!<aMe at the tate of ,6 %
I -ORIGINAL ASSESSMENT
!
OATE OF,",AS,SE,SSMENT
TAXABLE AMQUNT $312.04
I
'ILESS:ALl-OWED DEBTS
NET TAXABLE AMOUNT
I
IAMOUNT OF TAX DUE
iiD If you pay the above amoUiot w-itnin three (3)months
I 'of the dote of death of the decedent,Of on Of
I before Sept.30,,,19 71.,,you mo)'deduct a
,disc;ount of 5%of the amount of tl;lX due,Ofi
I,0 This tax became delinquent"fifteen OS}months
!"after the date of death and,in odd-Won to the
I tax,statutory interest at the rote of 6%of the
tax per onnum is olso due a-s oJ *
19_,_,in the amount of
AMENDED ASSESSMENT
$-.-,-~-...----
*If the tax is not paid by the above date additional
interest is due at the rote Qf 6%per annum until
paid /7f~
To insure proper credit to your account
this Officiol Notice must accompany
your payment.Mai I or bring it to:
$==::::;:::;:::========
INSTRUCTIONS TO TAXPAYERS
I TOTAL AMOUNT DUE $_~
IAPPRAISED BY:~LU<U YL.f"!J)WI.ASSESSED BY:
I (Inheritonce Tox Appraiser)(Agent for the Commonwealth)
I
IMake checks or money orders payoble to:
I'~&,//yt
•~of"!,/~?/
dfe,,1/d J yt/
If you have already paid this tax to an executor,administrator,attorney or other personal repres~ntative of the
decedent for forwarding to the Commonwealth,list below the date pai~,nrime and address""'o"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
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 wh ich I
was legally responsible and which I did payout of the property herein taxed.I further certify,thot 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_.
Signature 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
iFor RCC-2
I
II ~EPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
"~ARRISBURG,PENNA.17 127
II
·.~\,
COMM9NWEALTH OF PENNSYLVANIA
RESIDENT INHERITANCE TAX
APPRAISEMENT
DATE ~.~??;J.~9.Z.~.
COUNTY .w.J.\.~.Pi9.:~.~.
FILE NO•......Q3..~7l:::743..
I
I Whereas,MARl Q.!t P.~~J;.GK late of ~~G.~.
in the County of :WASHINGTON Commonwealth of Pennsylvania,having died on
the ..3.Qth day of June...........................................19.7.~,seized and possessed of an estate~ubject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
I Therefore,I,~~~9.~~,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 fixIthecashvalueofallannuitiesandlifeestatesgrowingoutofsaidestate,hereby file the following appraisement:
I In the event that any future interest in this estate is transferred in possession or enjoyment to collateral heirs of the decedent after
tpe 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.I
Unit AppraisementDescriptionofAssetValuesMadeforInheritance
Tax Purposes
$
Jt.Held Savws Acct./AOOk 60226809 held in the WESTERN PENN 'A ..NATIONAL
I
BANKJ MONONGAHELA OFFIr.E MllI\l 11\11 ~A WTA .vANTA Tn +'1...n~m..CI of'
MARY !C.PAULICK OR RlNALE M.PAULIr.K {'\......"""''''A 1?_11_hl\'R:ll :l.n,..~:l~of'date
i 624ofde~th,$624.08.08
II
I
I
I
I
I
!
I
I
,
I
I
I
I
I
I
I
I
I
I
I
I
I
I
~orm~v:.':~hb;::::fh:sw~~e<:or~~~~,~:;o~~~:~=~~~~~i;:tis~~:
.,I Appraiser
i ,.'I'(Number Street)I..W (·p;;;;t·..ojjj~~·)·..·,Penna,
II'
II
···········.··WASHINGTON ..County
RESIDENT INHERITANCE TAX APPRAISEMENT
Estate of
..........MA.a.X.C•....P.AVLXQK..
Deceased.
Late of
................................~~q~.
Date of Death,6...:3Q.",71 ..
Appraiselllel!t Docket Vol.,..
Page,No..??':7~::'J..'!:?.
Filed in Register's Office,y~g?:·19 7;:t,
Amount of tax due,$.
DEPARTMENT OF REVENUE
Received,
Examined and Approved,.
Wrote abo.ut Appra-isement,.
Appeal j,.om Appraisement,..
Entered and charged,.
,
..
Mrs.Jennie V1talbo
,;;.~
_.!r'
COMMONWEALTH OF PENNSYLVANIA
DEP~TMENT OF REVENUE
HARRISBURG
RCC-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 196'1,
we herewith submit the following report:
NAME OF REPORTING Mellon National Bank &Trust Co.,Donora Otfic
FINANCIAL INSTITUTION _-:-------:-----
SQl Meltean Avenue,Donora,Pa.1,0,33
ADDRESS --..,.-_--;:--:--_......-:-:::--::-=-::;--.
ACCOUNT NO.OF JOINT,Savings 1/65-1,80,
TRUST OR INVESTMENT DEPOSIT _
NAMES ON ACCOUNT.'OR INVESTMENT lntonto Granato or Jennie V1talbo
DECEASED JOINT DEPOSITOR,Abtonl0 GranatoTRUSTEEORINVESTOR-:--_
$11 Second Street,Donora,Pe.ADDRESS _
AprU 2$,1971DATEOFDEATH.--::--_
SURVIVING DEPOSITOR,
BENEFICIARY OR INVESTOR _---:--:.--_
418 Fiith Street,Rear,Donora,Pa.
ADDRESS ---
RELATIONSHIP TO DECEDENT Daughter--,.;;;,.--------------
DATE~:t~~~~~~I~~~~STMENT Sept.11,1953
BALANCE,INCLUDING INTEREST $7 337 77DUE,AT DATE OF DEATH $---'-,__'__-.
Signature TITLE
Assistant Mgr~
RCC-134 (1-69)
COMMONWEALTH OF PENNSYLVANIA
D£JO-ART·M,ENT OF REVENUE
SU'REAU OF COUNTY COLLECTIONS
INHE·RITANCE T.AX DIVISION
~~.~
;OFFlCIAlNOTICE OF INtiERITANCE TAX
APPRAISEMENT AND ASSESSMENT OF
•ASSETS NOT SUBJECT TO ,A'DMINISTRA TION·
,TO:MRS.JENNIE VI'l'AU:lO
~1S FIFTH StREET,REAR,
Date:----l}'ltfe:l5'~·o...,2~1h,r1-1!J!977111-------
County __.£tWAAS~H~INGUlWtJ,T,\;/.ON1L-_
~QN9RA,PENN&XLVANIA.15033 County File No.--:-_
Bureau FHe No.?:J -7/-;?s-Y'
We have received notice that,,~XXXXXxxXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
,on 19~,y'01II came 1'11100wners'hip of certain property through~aa.~ia&x..~xxx
DOOiJOOmBtJmlfdnotimu!b'tIl Transfer fronl ANTONIO GRANATO,Deceased.
Under the Inheritance and Est<lte Tax Laws of the Commonweahhof 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 t'ax is herehy 'Ossessed consists of:tIt.Weld.S~o A.c:;Olmi #6;-1]00)held.in,
the"MELLObl aAT:tONAL S~NK &c muSf COl4P.ANY."DO!lW OltFICE,DONOiA,PiNHSILl.l..UIA.In tbe Rames,
ef,AN'PONIO GRANATO OR JENNIE \'ITt.1.BO.Opel'isd SeptemBer 11,19S3.Balaaee a8 of date at Eleatfi,
$7,337.77
appraised by the Commonwealth,as of the date of death,at $7,337.77
SO%of this amount is taxable ot the rate of 6 %
ORiGINAL ASSESSMENT AMENDED ASSESSMENT
DATE OF ASSESSMENT
TAXABLE AMOUNT
lESS:ALLOWED DEBTS
,HET TAXA'BlEAMOUNT
AMOUNT OF TAX DUE
o If you pay the above amount within three (3)months
of the date of death of the d'ecedent,or on or
before ~r 25,19 71 you may deduct a
disco'unt of 5%0 the (Jmount of tax due,or
D 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
*If the tax is not paid by the above date additional
interest is due at the rate of 6%per annum until
paid
TOTAL AMOUNT DUE $
220.1,3
$--------
$==============
APPRAISED BY:~Zu.__.c.-I./.cc1 -<'-<"'.11/,£ASSESSED BY:_
(lnher"itance 'Tax A,{praiser)(Agent for the Commonwealth)
INSTRUCTIONS TO TAXPA YERS
ij·
"
l
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:
COURT HOuSE
WASHINGTON,PENNA.15301
If you have already paid this tax to an executor,administrator,attorney or other personal representative of the
decedent for forwarding to the Commonwealth,li~belo~the date paid,ntlme "and address of the person to whom
you made payment,their official title and the amount..'..I"'
Date Paid Name and Address of Payee Official Title
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 comput9tion 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 clai~ed 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 I red)
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 wh ich 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 totol amount of $--------0
Date of Approval:_
Register of Wi lis
I
'.".
Fonn RCC-2
~COMMONWEALTH OF PENNSYLVANIA DATE ........}.~.!.Y........??..t ....J.~..?..~.......!,
»•••••••••••••••
I DEMRTMENT OF REVENUE RESIDENT INHERITANCE TAX ...........~.!.~.~.~~.~.g.~.?..~.............I •COUNTY;.-
BUREAU OF COUNTY COLLECTIONS ................
HARRISBURG.PENNA.17127 APPRAISEMENT FILE NO.............?..~.::::..?...~.:..?..?..~....................,...............,
Whereas,.....................A.n.t..Q.ni.Q.....G.:rRUa.:t.Q.................................................................late of ........................P..9.J19..r.~..............................................................,
,in the County of ..................W.~.~.h.i.P.:g,t..9..n ...........................................................................Commonwealth of Pennsylvania,having died on
I the .........................2..5.....t.h................................................day of ...................A.p.r.i.l.....................................19.....71,seized and possessed of an estate
I subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore,I,.................Fr.a.n.c..e.s.....Le.o........................................................................,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
I the cash value of all annuities and life estates growing out of said estate,hereby file the following appraisement:
I In the event that any future interest in this estate is transferred in possession or enjoyment to collateral heirs of the decedent after
I
'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.
I I Unit Appraisement
Description of Asset Values Made for Inheritance
i Tax Purpol8s I
I $
I JOINTLEY HELD
I Jt Hel d Sav;nrr~A('~nlln+Jl:h C;_,C;Rn C;h~'~
in the HELLON NATIONAL BANK &TRUST COMPAJ\TY
DONOHA OFFICE,DONORA,PENNSYLVANIA.In
,the names of ANTONIO GRANATO or JENNIE
I VITALBO.Opened 9-11-53.Balance as of
,As of dat:e nf clp:l+h $7,337.77.(1/2 taxable)3 668 89
I
,
,
,
I
!
,
,
I
Total 3.668 89
I
i
I
i
I fonn~;:~h~:::%:.w~a:rl~~·~a~o~~e~~tis~~~~l~??:
I
Apprai~r,(22;~~·;t;;:;b~~···~d···St~;~t;···.......................................................
Penna...........................{f~.....................................................................,
(Poat Office)
I
...............J~lASHING.TQN..County
RESIDENT INHERITANCE TAX APPRAISEMENT
Estate of
...........AN'J:'.Q.NJ-O Qrv.\.NA.T.Q..
Deceased.
Late of
DONORA
Date of Death April 25,1971J••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••
Appraisemel!t Docket Vol.,.
Page,..No.63-71-754
Filed in Register's Office,..J.:q.l.y 47..~19..7l.
Amount of tax due,$.
DEPARTMENT OF REVENUE
Received,
Examined and Approved,.
Wrote abo.ut Appra.isement,.
Appeal j,.om Appraisement,.
.,Entered and charged,.
r
.t
RC C-43 (4-69)
".,.
•{([r'COMMONWEALTH OF PENNSYLVANI~DUN BUR'f.fIVfO
DEPARTMENT OF REVENUE r'f C6/~(~/c
HARRISBURG JilL J."I."I,;.ON,'It 2 .~
Ju:q 9,1911 22 PII '7/
~'l~y
Signature .TITLE
Assistant ~!fanager
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 REPORTINGFIN'ANCIAL INSTITUTION Western Penna.Nat'l Bank'
ADDRESS Fourth &Main St.~'Monongahelaj Fa.15063
ACCOUNT NO.OF JOINT,'
TRUST OR INVESTMENT DEPcHSlravingS account II 004 0040516
NAMES ON ACCOUNT '¢.l~'"0ORINVESTMENTfJI.·'Plot aulick or l.fary Pauliclt
DECEASED JOINT DEPOSITOR,Mary PaulickTRUSTEEORINVESTOR _
ADDRESS n E 1ANDCOUNTYKeenanHillewage,Pae Hashington Oounty
DATE OF DEATH 6-30-71~=--------------_-:-_----SURVIVING DEPOSITOR,Carl PauliakBENEFICIARYORINVESTOR ...,.--_
Keenan Hill,'New Eagle,Pa~'15067ADDRESS --_
RELATIONSHIP TO DECEDENT......._so-D---......-----------
DATE DEPOSIT OR INVES8~~!t~WAS ESTABLISHED ._
BALANCE,INCLUDING INTEI~J6~l63DUE,AT DATE OF DEATH $:--_0 _
gJJ 13 f?cj0 X 9tt/-l'~3 =--6-9,0
I !of T"?Q-S-/,a x sr;,CJ 1 :'"'/.s
RCC-134 (1-691
COMMONWEALTH OF PENNSY~ANIAD~ARTMENT OF REVENUE ...,:,.
~UREAU OF COUNTY COLLECTIONS
INHERITANCE TAX DIVISION
.;...,-..
OFFICIAL NOllCE OF INHERITANCE TAX
APPRAISEMENT AND ASSE:SSMENT OF
ASSETS NOT SU BJ ECT TO ADMINISTRA TION
TO:CARL.EAJII,ICK
KEENAN HIl.I.,
Date:--.J..J-\I,ul:b:;)~r-:ll.-'l4.,.,-1~9~7~1b-----
County _...:.\":.:.A:::::S~H~I~N~G~TO~N _
.15067NE\{EAGLE,R'NNSYLVANIA County File No._
Bureau File No.~3-,2/-2</-3
We have received notice that,XKKIBJi)b~XXXXXXXXXXXXXXXXXXXXXXXxXXXXXXXXXXXx...y..x
on June 30 1971 .,you COme into ownership of certain property through ~lJ(I~~~X
~~~~~~t.transfer from MARY PAULICK,DECEASED (NEW EAGLE)
Under the Inheritance and Estate Tax Ldws of the Commonwealth of Pennsylvania such transfers are taxable
and the Iiabi Iity for the payment of theinheritance tax due is imposed upon you,as transferee.
The property on which tax is hereby assessed consists of:Jt.Savings Acct.#004 0040578 held
in the 't{J~STERN PENNSYI,VAN1A NATIONAl.BANK,MONONGAHELA OFFIC~~,MONONGAHELA ,
OPENNSYLVANIA.In the names of CARL PAULICK OR MARY PAULICK,Opened NiS
8-2-69.Bala1nce as of date of death,$984.63
appraised by the C()mrnonwealth,as of the date of death,at $984.63
IOO %of this amount is taxable at the rate of 6 %
ORIGINAL ASSESSMENT AMENDED ASSESSMENT
DATE OF ASSESSMENT
TAXABLE AMOUNT
LESS:ALLOWED DEBTS
NET TAXABLE AMOUNT
$_-=9:..:::8~4~.6~3~__$---------
AMOUNT OF TAX DUE 59.08
o If you pay the above amount within three (3)months
of the date of death of the decedent,or on or
before Sept .30 ..1971 you may deduct a
discount of 5%of the amount of tax due,or 2.95
o This tax became delinquent,fifteen (15)months
after the date of death and,in addition to the
tax,statutory interest at the rate ()f 6%of the
tax per ann,um is also due as of *_
19__in the amount of ----------
ASSESSED BY:_
(Agent for the Commonwealth)
*1£the tax is not paid by the above date additional
interest is due at the rate of 6%per annum unti I
paid
TOTAL AMOUNT DUE
APPRAISED BY:~(A.hL~M)fJiJ 'C.,J)UJi
(Inheritance Tax A~pra iser)
$59.08
$-===:============
INSTRUCTIONS TO TAXPA YERS
Make checks or money orders payable to:
~5"·/3
To insure proper cred it to your account
this Official Notice must accompany
your payment.Mail or bring it to:
. •......,...iVI_.I'l.~c.1-1..lI'i
COURT HOUSE
WASHINGTON.PENNA.J530J
If you have already paid this tax to an executor,administrator,att«?-!ney or other personal representative of the
decedent for forwarding to the Commonwealth,list below the..date pai.d,name and addre~~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 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__.
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 ............:g~1~.......1..~..~.7.~..1.1....
...-'DEPARTMENT OF REVENUE RESIDENT INHERITANCE TAX ........W~.~.h.;i.n.g.t..Q.P.:.................................BUREAU OF COUNTY COLLECTIONS COUNTY
HARRISBURG.PENNA.17127 APPRAISEMENT
FILE NO..........§.3..~..7.1.~..7.4..3.........................................
Whereas,..........................M~.IT.....P..~~.l:J:..~k.........................................................................late of ................N.~~....~~.g.~.~.........................................................
in the County of ......................Wa.l.h.i.ngt.o.n.......................................................................Commonwealth of Pennsylvania,having died on
the ......................3.0.....t.b......................................................day of ...........J..u.n~...................................................19.7..'1...,seized and possessed of an estate
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore,I,..............................Er.anc.es ....Leo..........................................................,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.
Unit AppraisementDeseriptionofAssetValuesMadeforInheritance
Tax Purposes
$
JOINTLY HELD:
Jt.Savin.e:s Accout.#004 0040578,held in
the WESTERN PENNSYLVANIA NATIONAL BANK,
MONONGAHELA ,OFFICE.MONONGAHELA.PENNA.
I
In the names of CARL PAULICK or MARY
PAtn.T~K n .~R_?,_*,Q R:a':anl"'p.
,
:a~..,
of date of death.$984.63.984 63
I
~---
Total 984 63
form~~fhbl:~::~h~Sw~a~~~~:~;o~~~~ti~=?~l~~?-
AppraIser......W ..........·................~..·........·......·..·..........................................................L .(llu r and Street)
.......................~.~.....'.........................Penna..--,-d (Post Omce)................................,
,-----
...............WASHINGT.QN County
RESIDENT INHERITANCE TAX APPRAISEMENT
Estate of
MARY PAULICK...........•................_-~---.
Deceased.
Late of
NEW EAGLE
Date of Death,J..M.n~3..Q..,l~.'tt .
Appraisement Docket Vol.,..
Page,No .9..3..~.7.1..~.7.4.3..
Filed in Register's Office,.J.uly 2.7 19..7.1.
Amount of tax due,$.
DEPARTMENT OF REVENUE
Received,
Examined and Approved,.
Wrote abo,ut Appra.isement,
Appeal ft-om Appraisement,.
Entered and charged,,.
i
!
f
"
'f