HomeMy WebLinkAboutOC1971-1021 - ESTATE OF KERRIGANRCC-43 (4-71)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
HARRISBURG
17127
NOTE: TO BE SUBMITTED IN rRIPLICATE
REPORTING FINANCIAL INSTITUTION
ADDRESS
Union Nationil Bank of Pittsburgh
P. o. Box 837
Pennsylvania Department of Revenue
Bureau ~f County Colle~tions
Pittsburgh, Pa.
.ZIP CODE 15230
Att: G. K. Steinbaugh
Ass 1t Vice President
Gable Building, 3rd, Floor
411 S. Second Street
Harrisburg, Pennsylvania 17127
Pursuant to Section 742, Pennsylvania Inheritance and Estate Tax Act
of 1961, we herewi-th submit the following reporto:
ACCOUNT NO. OF JOINT, TRUST OR
INVESTMENT DEPOSIT ______ __::#7_2..0_0_1_75:_8_-_l_:_(S_a_:v_in....:::g:_s_:_) ______ _
John W. Kerrigan • or
NAMES ON ACCOUNT OR Walter W. Kerrigan,
INVESTMENT ------------------------------------~----------------
DATE OF DEATH __________ A_ug_us_t_2_8_,_~9_7_1 ________ _
DECEASED JOINT DEPOSITOR, TRUSTEE John W. Kerrigan
OR INVESTOR ------------------------------------·-----------------
ADDRESS George Washington Hotel
washillgton, Pa •. ----------------------------
COUNTY Washington
ZIP CODE · 15301
SURVIVING DEPOSITOR,
BENEFICIARY OR INVESTOR __________ W_al __ t_er __ W_. __ K_er_r_i...::g_an ________________ _ " ·--~ . ·''
ADDRESS ______ G_e_or_g_e __ w_a_sh_ingt ____ o_n_H_o_t_e_l_, _w_a_s_h_in_g.:::_t_o_n_,_P_a_. __ l_5_3_0l __________ -:--
RELATIONSHIP TO DECEDENT _________ S_o_n ____________________________ _
7il:~~-~·,. DATE DEPOSIT OR INVESTMENT
WAS ESTABLISHED ________ F_e_b_r_uary __ 5_,_1_9_6_5 ________ _
BALANCE, INCLUDING INTEREST •
DUE, AT DATE OF DEATH $ ______ 5_,1_7_0_._6_5 ___________ _
TITLE
J
;·
(
RCC-l"J ( 1,-6,9)\">
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE BLU~f.AU;OF COUNTY COLLECTIONS
•• INHERITANCE TAX DIVISION
OFFICIAL NOTICE OF INHERITANCE TAX
APPRAISEMENT AND ASSESSMENT OF
ASSETS NOT SUBJECT TO ADMINISTRATION
TO=----~~:~ro~L~~~:r~~~l~,r~~~m~,~m~Rui~G~A~N __________ __
Georee lvashi.neton Hotel,
T;Jash.Jngton, Pa. 15301
Date: ___ S~E.;;.;:• PI'...::.:::ill::..::ffi::::ER~· ~9 ,~1:..!.97.!..:1=-----
County __ ____:.\':.:..:lA~Sl:.:.:U::::N.:..::G:.::..T.:::ON:.:.._ ____ _
County F i I e No. ---------------------
Bureau File No. ~ 3 -7( -/6 :2_. J
We have received hoti'c·e !hmiD.JtY.QC'r.f'~:wi.Xo:bt:lnrnt~XXXXXXXXXXXXXXXXXXXXXXXXXXXXXX..XXXXXXXXX
on Augu'3t 2S, · · · 19..2L, y'ou came into ownership of certain property t~·h009Eob~u,~~h
W;2J~xl8Ut~;tl(!}lX9JtQ1ritJOOcthoof'~~gg~L'C Transfer from John \'1. Kerrigan, deceased (\1ashington)
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 Savinr'.S //72-001758-1.
In the name of \'/alter W. Kerrigan. Opened F'ebruary 5, 1965. Balance as of date of
appraised by the Commonwealth, as of the date of death, at $ _5~,1.<:!1..,7~0:.a.~6""-5 ______ _
50 %of this amount is t~xable at the rate of 6 %
ORIGINAL ASSESSMENT . AMENDED ASSESSMENT
DATE OF ASSESSMENT
TAXABLE AMOUNT
LESS: ALLOWED DEBTS
NET TAXABLE AMOUNT
AMOUNT OF TAX DUE
0 If you pay the above amount within three (3) months
of the date of death of the decedent, or on or
before Nov. 288 19 71 you may deduct a
discount of 5% 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 rate of 6% of the
tax per ar.mum is also due as of*------
l9 __ 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
'
$---2~,~5.o:85...., • ..;J.)~J--;.;....· .. _~ ·; ... :·$--------
----'--------f
155.12
$ $ =============
f -,, ' /--
APPRAISED BY.:/;:;/, .c--,,_e-c.J/_(_/ ·.,. au ASSESSED BY:_.-----------------. - \ I' (Inheritance Ta'X JXppraiser} (Agent for the Commonwealth)
INSTRUCTIONS TO TAXPAYERS
Make checks or money orders paya~be .. _·:·~ . . -. To insure prope.r credit to your account [} · 11· this Official Notice must accompany \)~ 117_3 ? J~ · AL(~urpayment. Mailo<bdngitto:
. If you have already paid this tax to an executor, administrator, attorney or other personal representa~iv~.of;;.the
decedent for forwarding to the Commonwealth, list below the date pai.d, ngme and address·of . .tbe person.to whom.
you made payment, their official title and the amount. ' , ... ·;, ~. · ·
"' -:· :: : 1. --·-~ .-:
Date Paid Name and Address "of Payee ··Official Ti.tle. ;, ...
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, i.t is recommended that you itemize the payments below,
·execute the affidavit, and return this notice. The Register ~f Wills. will examine the debts claimed and all'ow.
those which he determines to be proper. The tcix will then be recomputed and yo~ will receive an amended
assessment of tax.
THE THREE TESTS WHICH MUST BE MET ARE THAT:
1-You were personally legally r~sponsible 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 required)
COMMONWEALTH OF PENNSYLVANIA}
SS:
COUNTY OF: ________ _
I, hereby certify that the foregoing is. a j~st and true statement of
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 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 WI~LS
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
~-
I I~ \o_lif -........... ~~~'·'·
'
1 ~ ... ··COMMONWEALTH OF PENNSYLVANIA
. RCC•43 t5-65)
DEPARTMENT OF REVENUE
HARRISBURG
,:~· : · NOTE:' TO BE SUBMITTED IN' TRIPLICATE
Penn~ylv~nici. D~partment of Revenue
Bureau of County Collections
26 S. 4th Street
Har·risburg, Pennsylvtmia
Dear Sir: ..
_I.
. •, Pursuant to Section 742, Pennsylvania Inheritance and ·Estate .Tax Act of 1961
' we herewith submit the following report: . ' . . "1
NAME OF REPORTING
FINANCIAL INSTITUTION Pittsburgh National Bank \ ·
ADDRESS 4 w .• Pike Strue~, Canonsburg, Pa. 15317
ACCOUNT NO. OF JOINT, ·.r
TRUST OR INVESTMENT DEPOSIT_...;:8:.::2~·:::.;.S~......:'7:,.;::.3;..:.,7.:..67.:...:7"---------
NAMES ON ACCOUNT
ORINVESTMENT John W. Kerrigan or Walter W. Kerrigan
DECEASED JOINT DEPOSITOR,
TRUSTEE OR INVESTOR Job~. W • Kerrigan
.. ·.ADDRESS __ ..:::!(;.._ . .=.Goo=r::.J· Sta.:e::......!:W:.:a:.:s:::h=in:::tliZ..t.o:::::·=.:n!:.....:::B:.:O~t~e.:.l _________ _
DATE OF DEATH AUCJus't. 28, 1971
1 SURVIVING DEPOSITOR, .
BENEFICIARY OR INVESTOR t~alter W. I<errigan
~-
.r
ADDRESS_· ____ ~-·~l.0~6~·~G~r~ad~dv~ie2w~·~D~·r~-i~v~e~,_M~e~~ur~r~a~y~,~P~a~·~l~5~3~1~7
RELATIONSHIP TO DECEOENT_~-=S:.:o~n:__ ____________ ..
DATE DEPOSIT OR INVESTMENT
WAS ESTABLISHED November 29, 1967
BALANCE, INCLUDING INTEREST
·· DUE, A"'f DATE OF DEATH $ ___ $~6~4=-=8~·=...:92=-·· -----------
{ i c. 'I 'i. 9' l-.:. .J 2-;' • 'I :
~;u ~J~'I·ilb:. :r·'l/t
s..% '/ ,/9. 'll . "' " '11
(lt-.r;{l-7} ) 0 I S'G· ,r
--·.·
,, · r1~ ~ f, • (, --~' l.'j ~-I '
A~.vf.;-.J 'Cfv! t!» · ' · ·
J Signature TITLE
Assistant Manager '' "':·
\
' J
... ·.·
! .
·,
.\'·.
\ :.
·I
-
. \, \
R c c-134 1 1-69)
CCJc~M~~\V.HL TH OF ";ENNSYLVANIA I
'#DEPARTMENT or,:· P.,EVENUE
BUREAU OF COUNT!f' COLL~'CTIONS
INHERITANCE TAX DIVISION
_,..:;;, .. -..
OFFICIAL NOTICE OF INHERITANCE TAX.,
APPRAISEMENT AND ASSESSMENT OF ,
ASSETS NOT SUBJECT TO ADMINISTRATION
wAtTEH t-1. KERRIGAN TO: _________________________ __
106 Grand vie"' Drive
Date: __ ....:S:=:.le""lpt~,l..liei.Lim.ll..hu;;;eu..:r_.;z9~, _lJ.,;W~lL.-----
County _ __;_w~:l\S.::..:H:.:.:D:::N.:..:aro=N::..:.._ _____ _
l•ld1urray, P~. 15 317 County File No. __________ _
Bureau F i I e No. _.:~:::-.'-.::...3~--.~-7.L./.=...t...../_IJ_Z....,..,/;.___
We ha){e re~~i~gl nofic'e t~~Uti ·.-· ·· ,..,. • 88"C' 88.~~;--"--·----v~v . . ugu .' 19----v\yo~ ~arne into ownership of,certain property th"to:-· ~:rt .!{.~{.W~l~ ' · · ~frffi~~~~ Transfer from John vl. Kerrigan, receased (N:cz.:Iurray)
. Under the Inheritance and Estate Tax Laws of the Commonwealth of Pennsylvania such transfers ore taxable.
and the liability for the payment of the inheritance tax due is imposed upon you, as transferee.
The P.roperty on which tax is hereby ossessetPconsists of: Jt. held in the Pittsburgh Natio:Rai
Bailk of Canonsburg., Canonsburg, Pa. In the name of WaJt.er w. Kerrig~.
Opened Noverrher 29 1967 1 • Balance as of date of death $64S. 9.2
opfaised by the Commonwealth, as of the dote of death, at $ __ ..::.64=8~.9&.:.2=-------
0 % of this amount is taxable at the rote of 6 %
DATE OF ASSESSMENT
TAXABLE AMOUNT
LESS: ALLOWED DEBTS
NET TAXABLE AMOUNT
AMOUNT OF TAX DUE
0 If you pay the above amount within three (3) months
.. o~ the d'M,e of death of the decedent, -or on or
before ov • 28 19 71 you may deduct a
discount of 5% .of the omo.unt of tax due, or
0 This tax became delinquent, fifteen (15) months
a.fter the dote 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 amount of
*If the tax is not paid by the above dote additional
interest is due at the rote of 6% per annum unti I
paid
ORIGINAL ASSESSMENT
324.46 '' $--------------
19.47
--_.!fl...------
AMENDED ASSESSMENT
$----------------
· ~OTAL AM UNT DUE $ 19.47 $ =============
APPRAISED BY: ~ASSESSED BY: __ wu_S_SE_L_L _H.:._AIII_O.....:.~--~·--.! .. J-----
(Inheritance ax Appraiser) (Agent for .the Commonweoltbl...
INSTRUCTIONS TO TAXPAYERS
Make checks or money orders payable to:
'R~II
.. To insure proper credit to your occovnt
this Official Notice must accompany A II • your payment. Moi I or bring it to: IW\~ . ·.
0· ... THE COMMfJNWEALTH
CGUhiJT H8USIE
,,ASHA:,GT•',N, P.ffU/A. 15311
--., -.~ -.., , ,. If you hove already paid this tax to on executor, administtilt6r;''t.Uorney or other personal re~fesentotive of the
decedent for forwarding to the Co,mmonwealth, list below the date paid, name and address: oft~~ person to.-~hom .
you made payment, their official iHie'and the amount. · . . . . :··:_<,( ;}\. · · ·-"'-
• ' • •. ' I .. ,(.:• ,..,. •••
Dote Paid Nome and Address of Payee Offici~l 'ritle
.. : ::if·i.· .
_._Amount Paid
. . .
Under certain circu.mstonces, if, after the dote 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,)n·.the c.omputotion of tax due. If any
such expenditures meet all of the three following tests, it is recommende.d:·thot yo!J 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 on amended
assessment of tax.
THE THREE TESTS WHICH MUST BE MET ARE THAT:
1 -You were personally legally responsible' for these debt~, and.
2-You actually paid these debts out of the account or property described. above and con· furnish proof
of such payment, if required, and
3-These same debts ore not cilso claimed, for tax purposes, by an executor, administrator or other
personal representative of the deced~nt handling the administration of the ge':lerol estate of the
decedent or any other transferee. · · '
SCHEDULE OF DEBTS
Date Paid N9me of Payee Description of Obligation Amount Paid
..
TOTAL $
(attach separate sheet if required)
COMMONWEALTH OF PENNSYLVANIA)
SS:
COUNTY OE--....,--""-'·--''----· )
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 pay out of the property herein taxed. I further certify, that to the
best of my knowledge and belief, these some debts will not be claimed by any other person, for inheritance
tax purp?ses.
SWORN_AND SUBSCRIBED BEFORE ME TLHIS ·i ·t ·
"'19"' . ·;.~~ f .· ..... _______________ .,. --DAY OF
1 ... r ·~
J .... ...., ;,J
... • . ,.
REPORT OF· RE'GISTEifoF WILLS
Signature of Taxpayer
I, the undersigned, duly elected Register of Wills in and for the above county, do respectfully report that I
hove allowed deductions listed above in the total amount of $ -------,....---o
Date of Approve 1: ____ S:r,£,...,P,....--9_1_9_7J__.R_U_SS_E_ll_M_A_R~IN~O·_
Register of Wills
, '..
~·
.I_ •. .... ·!:if. ~ ... ~
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT 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 1961,
. we herewith submit the following report: •
NAME OF REPORTING· Pittsburgh National Bank
FINANCIAL .INSTITUTION ______________ ....;._ __
4 W. Pike Street, Canonsburg, Pa. 15317. ADDRESS ____________________ ~---
ACCOUNT NO. OF JOINT I 82-2013577
TRUST OR INVESTMENT DEPOSIT.;_· --=---------------
NAMES ON ACCOUNT John W • Kerrigan or Walter Wo Kerrig~n
OR INVESTMENT ________ ~---------------
DECEASED JOINT DEPOSITOR, John W. Kerrigan
TRUSTEE OR INVESTO~ · ·
. I J ·' ,. •;·.
% Wash1ngton (George) Hotel, Washington, Pa. 15301
ADDRESS _____________ ~-----~4A"u~g~ums~t~2~a-,~r~9~/lr-~-------------------------~----------
DATEOFDEATH ______ ~~~;,~~==~=-----~---SURVIVING DEPOSITOR, Walter w • Kerr1gan
BENEFICIARY OR INVESTOR-------------------
106 Grandview Drive~ McMurray, ·Pa. 15317
ADDRESS __ ~--------------------Son <-
RELATIONSHIP TO DECE.DENT _________ .....;._ ______ _
DATE DEPOSIT OR INVESTMENT January. 28, 1965
WAS ESTABLISHED------------------
BALANCE, INCLUDING INTEREST $12,094.53
DUE; AT DATE OF DEATH.$_----:--~-------------
..}... t 1<2 tP 9 i' ,j~ J :;.. <; a:> •fl. :q
~ 71) 1 I(./ () '-/ 7' .J_ 7 :.. J &. ,:"k< '$)'
j-7u' 1 J' -y~ ij-::P I 7· !tf
. O 61-~<r·71) D1~c.
,, "--· ' .;::: ' .... ,
RCC-134 ( 1-69) I. ?-·~""
COMMONWEALTH OF PENNSYLVAN'h!;• .. ...,..
.PEPARTMENT OF REVENUE
.B'lJREAU OF COUNTY COLLECTIONS
INHERITANCE TAX DIVISION
OFFICIAL NOTICE OF INHERITANCE TAX
APPRAISEMENT AND ASSESSMENT OF
ASSETS NOT SUBJECT TO ADMINISTRATION
TO: -----'~~'IA=L=TE=-'R~\1;,-=.._;I=\C=RR='=IG=AN.;;;,;.._ ____ _ Date: _ ___..:::S::!:E:!..P..=T.E.t::··r~-m~· EI~t=----z9~, _.1!a.,;gzz..L.ol,1....._ __ _
106 Grandview Drive County _ __:.1';:.:JA:.=S~H:.=I::.:N.=.GT!:,;O:::.:' N~~-------
1'-icMurray, Pa. 15317 County File No. __________ _
1 ' Bureau File No. · '3-7f /0;1.. /
We lia'fe received nofit'exlxooxJ.goootu.tdt.X9JX!·h~x.cW9:!;oo~~~:GQQ •• ~;;g;g,;oo~~~I009f*~~oo~~---
on· August 28; 19~,· you came into ownership of certciin property · h
wtBD~pn.~; transfer from John H. Kerrigan, deceased (McHurray)
A • . .
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 ;in the PittS'blWgh DiatiGnal. Daak
of Canonsburg, Pennsylvania. In the name of vlalter l'l. Kerrigan. ·Opened November 291 J 971 •
Balance as of date of death $12,094.53.
appraised by the Commonwealth, as of the date of death, at $ 1.2,094,§3
50 % of this amount is taxable at the rate of 6 %
DATE OF ASSESSMENT
TAXABLE AMOUNT
LESS: ALLOWED DEBTS
NET TAXABLE AMOUNT
AMOUNT OF TAX DUE
D If you pay the above amount within three "(3) months
· of the date of death of the decedent, or em or
before FJov• 2S 19 71 you may deduct a
discount of 5% ~f the amount of tax due, or
D This tax became delinquent, fifteen (15) months
after the date of death and, in addition to the
tcix, 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 unti I
paid
TOTAL AMOUNT DUE
r-·-U:/ ! ' APPRAISED BY·:----1.;?'/t./( ;'-'·-c...r~...-J-J..Ld "-. l.a . .,.., 7 (I h . -.t \AI/ . • ) n entance·-1 ax_ ppra1ser
ORIGINAL ASSESSMENT AMENDED ASSESSMENT
$ ----16.J.:t,._.~.O.II.j/l-4-7 .... 2.:..71----·-> .. ''$---------
- - -.:...J.a..a>4----
$ $ =============
INSTRUCTIONS TO TAXPAYERS
Make checks or mooey orde.s payable~~ II
v~ /3£1470
;o--t:;>-71
To insure proper credit to your account
A I I d A./!~i~ Official Notice must accompany IIJV\--~payment .. Mail or bring it to:
1530U
If you ha.ve already paid this tax to an executor, administrator, atto·rlf'ey·oi-·ot~e/pen·~rn_.9!A((pr.esentative of the
decedent for forwarding to the Commonwealth, list belo.w the date pai.d, name artd sd.::l-r~-ss of..the· person.to w.hom
you mad~ payment, their official title and the amount. ·· ,;;~: ' ., · · · -. i..:: ; : .. · . .'i. ,!~.J . -.....
Date Paid Nome and Address of Payee '·. " Official Title
-~ •• '·. '• •t." . .
· 'A~ount Paid ... · ... '~ "'
Under certain circumstances, if, after the dote 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 th~ pr-~perty.,in,t~e computation of tax due. If any
such expenditures meet all of the three following tests, iUs r~COI'!Jmended:-that you itemize the payments below,
execute the affidavit,· and return this notice. The Register of Wills will examine. the debt~ 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 con 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
Dote Paid Nome of Payee Description of Obligation Amount Paid
. -
-
-
' TOTAL $
(attach separate sheet if requ .red)
COMMONWEALTH OF PENNSYLVANIA)
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 pay out of the property herein taxed. I further certify, that to the
best of my knowledge and belief, these some debts will not be claimed by any other person, for inheritance
tax purposes. ·· · 1 • ;. _.,.Jt. ll t . ,.
SWORN AND SUBSCRIBED BEFORE:·ME··,:fH.IS_.:_ .. _·. -----:.:D.~Y. OF:
------------------------· 19 ___ .
1 • ,,..
~ REPORT OF 'REGfSTER ·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 $ --------..
SEP 9 1971 RUSS'ELL MARINO Dote of Approval: ______________ __
Register of Wi lis
'•
Fonn RCC-2
COMMONWEALTH OF PENNSYLVANIA
RESIDENT INHERITANCE TAX
APPRAISEMENT
DATE .......... ?..~:..~?.::. ...... ~?. .. ~ ..... ::.?..~ ....................... .
P.EPARTMENT OF REVENUE .....=
WASHIOOTON ,
• BUREAU OF COUNTY COLLECTIONS COUNTY .......... : ..................................................................................... .
HARRISBURG. PENNA. 1 7 1 2 7 FILE NO. 63-71-1021 ·········································································-····················r
Whereas, ................................ ~9.~ ... ~~.~ .. ::.~.~9:~ .............................................................. late of ........ W~.;>.h.mgt.Qn .................................................................. .
in the County of .................................... ~~.~~~.~~?.~ ........................... : ...................................... Commonwealth of Pennsylvania, having died on
the ......................................... ~$.t.h ......................................... day of ..... ~~~~····················································· 19?.~ ..... , seized and possessed of an estate
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore, I, ...................... X.:r.~.~~.~ .... ~.~~ ......................................................................... , 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.
Appraisement Unit Description of Auet Values Made for Inheritance Tax Purpotea
Jt. held in the Pittsburgh National .Bankof Ca~on ~burg, Pennsylvania· $
In the names of Walter w. Kerrigan and John w. Ker~igan .• ,Opened
November' 29, 1971. Balance as of date of death $12,094.5~. 12,094 53 . -
Jt. Held Savings #72-0017.58-1. In i_he· ~e of _Walter w. ~J~~rigan
and John w. Kerr.ig~. Opened February 5, 1965. Balance as of date of
death $5,170.65 5,170 65 I
. Jt. held in the Pittsburgh NatiQnal Bank of Canonsburg, Canonsburg,
I
Pennsylvania. In the names of Walter w.-Kerrigan, and John w.
Kerrigan. Opened November 29,. 1967. Balance as of date· of death
$64$.92. r. ~b48~;"92 -...-.·'
I
Total 17,914 10 ..
I
.
fonn~~v!,':~hbl:~ ::~h~w~ "jJd~lo~=: ~~ :r~~~~~~~~~~~~":: '
. Appraiser
....................................................................................................................................................................
(Number and Street)
.......................................................................................................................................... ,
(Post O!Bee) Penna .
-
I
I
(.,
~ •.
WASHINGTON . ········-····································· ~ounty
RESIDENT INHERITANCE TAX APPRAISEMENT
Estate of
JOHN W. ~IGAN
Deceased.
Late of
vvASHINGTON
Date of Death, ..... .A."WN..~.t. .... ?.$., .... l.97.l ....................... ..
Appraisemel!t Docket Vol.,·
Page, ................................................ No. 63"':"71-1021
Filed in Register's Office, .......................................... 19 ........... .
Amount of tax due, $ ................................................................... ..
• ,':>
· DEPARTMENT OF REVENUE
Received,
~ ..
Examined and Approved,
Wrote abo.ut Appra.isement,
Appeal f1'om Appraisement,
Entered and charged,
.. !,'
RCC-\34 ( 1·69)
COMMONV(~AL TH OF PENNSYLVANIA
, DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
INHERITANCE TAX DIVISION
TO: l\TAJ,TER KERRIGAN
lQe GBANDVIElJ DRIVE
OFFICIAL NOTICE OF INHERITANCE TAX
APPRAISEMENT AND ASSESSMENT OF
ASSETS NOT SUBJECT TO ADMINISTRATION
Dote: October 13, 1971
County WASHINGTON
McMIIBRAY, PENNSYT.VANIA 1 5 31 7 CountyFileNo. ·tJ-7/-/6~ I
)
Bureau File No.----------
We hove received notice that, BI~~XXXXXXXXXXXXXXXXXXXX...Y-XX.XXY_x_y_xxxxxxxx.v..x
on August 28 · 19_11, you came into owners 1p o certain property through~JUc~BXXX
~~~.transfer from JOHN W. KERRIGAN, DECEASED. .
. \I.UDDH.IIK~ lvASHING'RN) Under the Inheritance and Estate Tax Laws of the Commonwealth of Pennsylvania sucTiransTerS.are taxaofe
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 Savings Bonds Serj es "E"
held in the Safe Deposit Box of .John JJ; Kerrigan. In the names of JOHM
W. KERRIGAN OR WALTER KERRIGAN. Pur 9-48 to 5-59. Balance as of date
of death, $30,695.65.
appraised by the Commonwealth, as of the date of death, at $ 30 '695 • 65
SO %of this amount is taxable at the rate of 6 %
DATE OF ASSESSMENT
TAXABLE AMOUNT
LESS: ALLOWED DEBTS
NET TAXABLE AMOUNT
AMOUNT OF TAX DUE
D If you pay the above amount within three (3) months
of the date of death of the decedent, or on or
before November 28 19 71 you may deduct a
discount of 5% of the amount of tax due, or
D This tax became delinquent, fifteen (15) months
after th~ dote 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 amount of
*If the tax is not paid by the above dote additional
interest is due at the rate of 6% per annum until
paid
$
ORIGINAL ASSESSMENT AMENDED ASSESSMENT
$ 15,347.82 $----------------
920.87
--___ 4.§!...0_3 __ _
920.87
$ =========== ..... '"":
TOTAL AMOUNT DUE
APPRAISED BY, 4{.-llA,,c. '-£:. ,.z..IL
· (Inheritance Tg'x 1Appr<fisir} ·
ASSESSED BY: RUSSELl: iiiAiiii:!"C'i
(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. Mai I or bring it to:
1<u.t«JI .lUll~
AlENT FOR THE COMMONWEALTH
COURT HOUSE
·lUSIIINGTOI. PERNA. ·11101
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 dote p_oid, nome ·and address, o.f the person t~ whom
you made payment, their official title and the amount. . •. ' . . . . . . . . ' .. . . r
' , • ' • • I •
Dote Paid Name and Address of Payee Offici.al Title . Amount Paid
Under certain circu.mstonces, if, after the dote 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 compu~atiqn ·of tax, du~. If any
such expenditures me.et all of the three following tests, it is r~commended,th~t you itemize the payments below,
execute the affidavit, and return this notice. The Register of Wills will examine the debts d~imed 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 on executor, administrator or other
personal representative of the decedent handling the administra.tion of the general estate of the
decedent or any other transferee.
SCHEDULE OF DEBTS
Date Paid Name of Payee Description of Obligation Amount Paid
r. ..
\
'-
'
..
. .
TOTAL $
(attach separate sheet if required}
COMMONWEALTH OF PENNSYLVANIA)
SS:
COUNTY OF: _______ _
I, hereby certify that the foregoing is a just and true state~ent of
funeral expenses and other debts of the decedent, · , for which I
was legally responsible and which I did pay out of the property her~in taxed. I further certify, that to the
best of my knowledge and belief, these same debts will not be claimed lly any other person, for inheritance
tax purposes.
SWORN AND SUBSCRIBED BEFORE ME THIS DAY OF
----------------~----~19 . . ~.· . t i §i: ~' \. ' C'J'---~-Signature of Taxpayer (1:-.~\.~ .... .r.~·j'../~ \ I . ~~.,'j•.;?. L \' ) ~· ~ ~ .l. . -»· ·~. \~. \.~· ;J . "·
~··
!.! . r. ··~t.:·~··~~.P·ifl.' •;u.n·· fin···. ,.i.f! •• t~~EPORT OF REGISTER OF WILLS t.r1J,., •.. ~.1.~.11!l~i;il.~ .~nl ,.,.,<$ fiH.::11• . ,
I, the undersign~3J.,i&\tlyfJtltcWdd Register of Wills in and for the above county, do respectfully report that I
have aH.Q'W.:'dd ded.~~~m'~'l~difJ.~~¥~1fri\ the total amount of $ g
Date of Approval=------------~--
Register of Wills
-----------!
I -
~ r-??~' ~
' .J?:-Ir PI 17~-.J I) 'rt:$!71 -eT-0 Jl
9~ '6f"/ ;s~~ J) ·7t-Jf7 ~S'-~ J}
O,Lf·~{Y f..9-i J, . 1i if/ t'Y-2
/) . _,"21$ '6T?' fS'-2 1 . ·/S'fh 7 . '(5'-ft 17
-~ft z-f7 }..0-fr I; . ·:JS''jj-7 ( -rs--c 1/
·g'1·;p7. hS'-{1 J{ -~ ··/~:Jf/ t:.Y-r )/
jl'/fY )~--c lJ . ··iS''j f/ ~ --9-7 9--17#
-·zc: ·o;r; ft -~-I 0--f/~ ···?Y:t/7 7 1-P-'t"/ IJ ..
·?"" .5" /721 9..("-C'/ /J ·;frzp-;-/Y-77
/I
-
P-o ·ps/ 9.5'-/1 )) -. f"(!,j>/ /--5'-0/ 1!
·0-o 'f'S/ 05'-0/ ,, ._g_g /5'7 /5'-b JJ
DC ·e, Sl Q~-3 l! . .!J /S'/ !5'·~ II
-·o -c ts/ . OS-.J It . ~.~ !5'1 /S' -{., ),
·o e ·tS'I 9.S-l, -
II . J_j /3Y I !7-c; Jj
0-.1/16
. . 9f "(JS'7 /51-5' · rrl:' iS'/ 0-f-/ /
)/
-, _h L "-Jl_)' ( . /JS'-5"
II . Of 6/.S'I !_S-f 1/
It __j' 5'_91 (J~-5" I' C5'f..9-1 IS'-f' )/
',p _g '_$'~/ oY-..s> /J . -es J-75'1 1->'-r IJ
·rl ·o/7 -.'
9_t:;-~ O-f/" .· C:.Sh-:9 IS'-I OJJ7!A
•. -.. 7:/·o;tT 9S-/ Hlp CJ?:-&ZZ OS-5' O-f5YI')
7: r·b II b.s'-5"
.
II or rJr7 LS'-Zl (HJ-{}w
Lft:·ec/ 6S'-f; 1/ (} /;sv0 1/ ,,
.t!e ·-eel 6s-r II
o?~r7 )) II
~e~e7 bS'-~ II 0~ 50--r'l 11 II
-LYC' CCI 6S-7 Hlf . o 1 :.so r-?-L S'-71 94-P/T
0/ '_S>fi/ rr:s-C:I /) r;,! l; t 't' 7 1/ A
h 7: 'S'h/ res-11 /1
(} _j' . ~~z-7
1} II
./7?: '-c;h I · res-(l/ II
7)J7:~r;-~T
II 1/
-cr ff/ r:s-6 )f OJ/~/ ,, ,}
C'r-J>r 7 rS'-t NIJ o-:Jt:t:el 6s-7 .00-0 II-
•,
~r?7j/VfY7 ru> ~ -~
. -Jv-~-rrrn ~ / ;;,J ~ ~-~·(YT;
. /
t g ·o 't6 ::. e J if f s; ~ o ~I _s, 9 '-->-6 ·c; o ;;,......., ["0 ·-; fr .
~o~_s. L'& Lf~-Sl =-s1-·SJo 1 Of ~ o/ . r-
-·---c_ ----•----
;
• .
I I
' ·· ·V!f:i2 i/~~~~# -.J/tH C?-sf !_0_1 ~7 'rf~ ! -s_t ~: ,~):.. . -=· . -'-'t' ·.
_J_d$.rd_ rr·" ~-~ /I IJa~tSL I; /~ -Q"C ~· '\ . ;l ;2~-'§j-~ _:; ~~ .. ~· -~-~~ ,::: __ ,~:
It ;;-of jjs,(j I_ if;~ S/ I -K:/:;i:~;~f;~ii -
1-(/j_!_(}YJ &-~~ Ljffoi. (I ~-sl €!78.6~~~7 "' ~-..,.;.: ..... ·~.;:_;...-··.·~ ·.
It I ~-~?-76 3 ~~-·" 2 -c;5 lr sz adr&t:~~' ~ -fiJi~~-It !-s~ 1~7 Z£ lr f -s7
It s-·-sJ 31 ~ -S.S /JY, 7t If -~l(!..:1=· B~G ·
It I o -.ss Llo_:_~f. lr ~' ~. _C_-l.Sl yl)r;,~ • . .
tt d -ss !3_(). 'if . f( f'-sz ?:~;~ J?l/1;_ . "~--··::___ I
II 1t2-0S !_36, 2{__ I( t-s-z IL·1~~1i.~ I" -~ .:i.:--.. ~ ~ . ~ • ..... -. "' ,---. ·~. ·' ~···' ··=-~-;.~~.;;;\~s-·.
'i_!t-o L -LjJ_ /59.0~ 'f 1 -~z §J_~'f:,;;Lljff. '"~!::""-~ "' _, . <1!:'1-•
'I b2 ~ 1/-9 /S~.sto . I( /0 -s-7 /~6).1.
1( u -'-19 /_~0, K_o ~ !( --S? j_).S ?.1
'r ~ ~ <J9 ;_~o. fo ~ I:L -sz /~5-?f. ,, ' ~ --t/9 ;-Sr,f6 )f_lk> 7 -c/r ~~~.f-C. i
It It --19 /_ ~3. ;?'f. r-'-!r ) &_2~1-t.
'( 2 -L/9 /bJ,J_C/. f_-If /_J-f.;) 1_.
Y' f' ·-L/9 [63-:11 . ·vo -t/f )st a f.
-
It ~ 9-L/9 Lsi9:2, I I -'It )5!;;/.
l( ~0 -19 !Sf. t2. jj_-'if /6-1.-.s-t. '
r I lu-49 ) ''¥;19j '-#jHJ I -SI !_2_~ .. -.Jj I
tt YcLiL -i~o.a. It j .S? L:LG. :3:J--
1-)#_/H 1/ --Sb ;_jz 0o lr j -~f id.~-3J ..
_!_)?0o lr 1 -s-f _J_l~3_;)_ . L2 --St.
I J3 -~c L:l? h a ,,
0 -Ct LdJ-'-3 j I It v-s-~:, )J(). !j(j C, ~._s-y L:Jl._ffY ~-O"k _jja.1a · lr 7-,s-y J-2_i 2%_.
k -0£, J0a. 72 · lt o-r )~z/. )_f'-%' -
t / :J 7Sd. (I 9 C% L'dJ-/d.t. ~-~ -
/cJ?s-:1-y /0 -·SP J';)_(.J-f· f -s-r:s ~-a I J.. Zt.S:2. It -~? j()_/.J1 II
/_:(~():/_ It lc2-SF ;~! f"d' ro -sc '
'
f
I ~ I ~
(
I
--~-~-
\. . .
I . I
.
'-f/c2s q-t/{ t/0. si ~j0 r·3 -l?)c/ _31. 17 ,, ;:2 -LJr· (j 9-¥7 /( ~ -sl 01. c/s.
'"f!;)!:) .j ~sf ~f.~3 /I 1-r ·-s-1 (~,1 s?.
1( 6 --SI (3 7 (l? It I j -t5t/ 03 'Ytf
/( Cf-S! . JZ2? Virls-:J -0%. 0/.of'···
It I d.-S/ j 7. I<(. ,, t-sJ1 "Ja 9{.
1a1s 3 -.sr <3J-. yq I( ~ -~f d/07·
: 1(, ~~s /53~}1 It ;:J-ut? <Jo. ~s:
I
9-00 (3:1. '-11
I
11:2 .sS' t3 :J!o rt
')/-~0 6---s-i-. Jl c;o .
I' -s-t 3:!.~~ ' rl
II ~ -s-t 3 !-1t
II I/ c:L --0~ c3:; J1
'11:2s-5-1? 09.99
!I (p-11 <I 0. rt;J. . i
~ 9 ~17 Ljo_ ?J. . I
II ;;2-'1? 10.03. !
Y!~ 3 '-S-2 :3 7/1.
II ~ -s-·J ' l~ 7 .. of.
'( 9 -\Sd-0' .or:
I( (j_ -Sc:1 0b L/6
<:f :J..S' ~----.57 0:<_~(/ --(,~Q7 '-~/.W. I y -S/ dd. If.
!j-0-? <3/.</~ .. I
'#.2S 3 -0J c3o.s-7
o-s-f c29.Y3 .. i
'#c=Js ~-06 /fa. OJ.
b -s-6 3 9.30 .
9 --co 0~2£·
/ol-..so .Jru.
I £~~~ ~
\ (
.. I
•• RCC-87 ( 10-68)
.-:.../ ;~.,
COMMONWEALTH OF PENNSYLVANIA
Department of Revenue
SAFE DEPOSIT OOX INVENTORY ' j
_ (} ·9~~-~I Q1~~jVJI ~
( ..
i' f
·' z ~
1. Name of decedent.
3. Dat.e of death.
4. Name and address of person who requested t e opening of the box.
,C..,
if any,
) :;
of persons present at
6. Name and
8. Number of box. // 0 J ,
9. Title under which box is registered.~-.~~oo.AAa:~""<~U""')_._"""· ~"""l·""·"~··""'a-· """~"91'1~~<11;;.-.<----
awl ~~~*4> ~ 4
10. Names and~addre s of persons h~ving acc:ss to box.
__:___ .fc 04 I tk. fl.-.-J~
U. Name and title of """'!oyee c~ed with t~ of making the inventory •
. Q}::-z~ ,--tJL.U. 1a'f' ~ LL.
12-. Was there a will in the box? (Y.f3s or NG-) ~>· · ..
13. If yes, state date of will, name and address of personal representative, if
named in the will, and name and address of attorney, if any.
...
:
!
Instructions:
k/,~d ............
' .,_ '
SAFE DEPOSIT OOX 1NVENTORY
Page 2
(1) CASH: Report total only. (2) STOCK: List in detail every common or
preferred certificate, warrant or other rights found in box. Stocks are to
be designated by name of company, certificate number, date of certificate,
name in which stock is registered, number of shares and class of stock.
(3) OBLIGATIONS of u.s. GOVERNMENT: Number of pieces, dates of issue, face
value, names in which registered. (4) BONDS: Designate by name, amount,
serial number, or otherwise. (5) SAVINGS BANK or PASS OOOKS: State name
of depositor, number of book, last date appearing in book, name of bank and
branch, and balance. (6) JEWELRY, COINS, STAMPS, MANUSCRIPTS, ETC.: List
and describe as fUlly as possible. (7) List Deeds, Mortgages, Current
Insurance Policies or other evidences of indebtedness. (8' All other contents.
_,_ ';..-L)~ .,;_Efi-~->f../~~ v~A -~A/1 crv 1£o~)'IAOC .&.r.-A tJ '---" v U r , <7 -1 0 -
'
•,
_,!:):. J1 I tJ tJ o ....-I-t &)q \.j --d' Jt!} 0 _, ,s-"1) I r/ll n t1 .--~,_.Ji:y I d //') 11 -7-JL £"
I
I A-''1 I f)/)/1 :J -.<,7 I 'I /r .=? <;-Q'l I
., -d~ H L :U f.tJ" ~ x -LL.f"' -,,
~-.!... 11-9-.4LL } J Jan" -7-K? ."{ /! ~ -~<,--r'J 7 ,___ I' -':I, j·
I _.J ~-,.,,..,-~-~-"'2) I -/( /_ .~-'f) I '' -.LJ-1 -~ ,/ -,, -1 /J -ti.-51' -)~/{I'J/1 I "-r_,_, ...... , r 1·-7 -~---(} I ~J· -,-<---' :;:;. /-,, //-4-f -.._f_r _::.. Q -t.--1 I ' I -rl -I. LJ..q l --" L!:l Ll~ ,, ---. --...1(-,---o....-o
I q -~-, f _,,_ ., -~.o i _,. ---7 J/9 1---/(-I J:;-r I II
I I .JL I
,
I -1+---. P--tt1' } -/1-.;;., -.!J-r It ~I ~ ,, -/0 --:"'('1)
1-'t ~ I~"' I t;" I 1 '"'--t1 -/! -"<'"'n I _It-c;. J.J. q. ~~ -(I-~~-~
I
J -I• ___, .LL-~ 1 .__ II -L ~..,.-J I t, -;:;., ~.~n I -'l -Jo -J..I. Ci' ', --II-~
I /l 1 ~ 14'-JL I -,. ,.....---11 i.Jq I,--/1 ~-s-F 7 ~t.;-J -
·/-It r_ .l;" I J-,, ::J -~t,L I ---,, --1'1-11 c, 1-t I . t-s·x -
'j.--II -9 ~.,--, J ~~ -s-u. /....-,,_ I ;-,.:..' 1-/I 7-.'21L_ I• -
J-,, -jt!) Kl J~"-/-f.. -':J-t./_ J---I( -.:J .... --x J -r1 -f--!J-L
1 I -.h'/J I '--II -. 6-..j-Lj 1
~
J -1'-7-~ l-~ -I• --=?-t,--z_
I I I -J:J...-,~1 I ,,_ 1.. ~ c;-~ t-''-A-"l"Z' ~-1'_:._/o-I:JK
J I _:,-;).. /-1•-'7 ')"Lt. 1-,, -.IJ=.-~h J-/1-II £.,-£' It ____,
1-1'-::J ~ --c,"' 2-J __ ,, Jr-s~4-I '·-....,__ t)t; l-/1 ___.., J,J.. --,~
I-I• 3.-S:.:t J -JI-9-sL/-. 1-tr -'J(-.5-L ~ --~
J ._, fl ·-' 4.. ~:J } lr -J 0 -1-,-L/-J-11 ~ 4-5"6" ,_,,-L
I II ,......_ /J S4 /-''-lt'J -5.6 -.:)"-,)2.
}--"' --{ c::;":l. l-·I• -~-L-c;-'j-II -1 1-s£
')-'1-7-~:J.. . I ---'' -7 -h"c::-I -1' -IJ..-6;(
I -,, -r--, &) :;..... I _./1-r-.~t::; 1-I•-i -J>-1
I-II -. _Cj_-~). )' --""? {I -'1 -5''7
/ )-I• .__ A-6-?
f.-,, -I £1-t::i ..1. I_,,-JtJ _.,,-J-,, -~~-~~
I -,, -If ,I):;_ J-,, -If -5s-I -I/ -4-. .; 7
I -'r }<>!J ,5:!2_ f II -J:;... ---.,-,.,-~ t I -_'-f""'-~7 .J (I -/-571 I t,. s-7 I ~~ -
I II~ :7-.tr!9 -~ _f, y-'-)/} -I
l -1-;'1 /-1'-1 I' 9 ,t:;-'7 -
) -" -4-_6_;_9 1-f(-liD ...... ,...,-?
j ) -It ____., 0--!f"Cf }-,, -I I -.")7 ..
11 ___.. /2.-57 /1 '~ ;,~ d 1,-k And now thiQ~ ~day of ~~ ~. , 19u, I hereby
certify under penal-..y of per jury )~M.he above record is correct and complete
~to the best of ~owledge and bali • ~ ~
;R 3~1171 CJ~ D _ky} . Signature ~A... 'f;k; /o;s t
1 -fA. I AI Jz:~ Nxeft PTi~le. I:;._ .
NOTE: Use separate sheets if necessary.
~
t . "
Page 2
SAFE DEPOSIT OOX INVENTORY
only. STOCK: every common or
preferred certificate, warrant or other rights found in box. Stocks are to
be designated by name of company, certificate number, date of certificate,
, __
name in which stock is registered, number of shares and class of stock.
(3) OBLIGATIONS of u.s. GOVERNMENT: Number of pieces, dates of issue, face
value, names in which registered. (4) BONDS: Designate by name, amount, . .1~
serial number, or otherwise. (5) SAV:rnGS BANK or PASS OOOKS: State name
of depositor, number of book, last date appearing in book, name of bank and ~.-.· _
branch, and balance. (6) JEWELRY, COINS, STAMPS, MANUSCRIPTS, ETC.: List
and describe as fully as possible. (7) List Deeds, Mortgages, Current
ranee Policies or other evidences of indebtedness. 8 All other contents.
~...J.-...:::.-==---'-~ __ ---=:...:!....::.......l:::'--"-+--1----1-'---9~~-Lf. J-----l~~--:=~'-' ----..--,, --I i I
I
--II
,l_ ____ ,,
/t-
It_ ,,
I c
/.1-II
li ---.::_
,,_
-/1 I I
. ...: ·~
NOTE: Use separate sheets if necessar.y.
/t
It __
It ____.,
.)_-11 -/~-Sij-
11-
-/1
It
/1-
( I ~-..... ~
••
RCC-87 (t0-58)
COMMONWEALTH OF PENNSYLVANIA
·i\ '.•
Date of death.
Name. and address of person who reque13ted the opening of the box •
.. _ J) ":...-~. .. ..~ e
• , .J
if any, to~ decedent of persons present at
box is
. '
8. Number of box. II o 1 . ::;;:
9.
10. Names and addresses of persons having access to box.
~211 I ,.-'·•1,/ t;;, .. <" ... ...-~ 'h .. :.~"'k'=
v:
12. Was there a will in the box? (Y..e~N.e)
13. If yes, state date of will, name and address of personal representative, if
named in the will, and name and address of attorney, if any.
l"' :r, •• : ,~.:~
·• ·' ,, ,.
' I
-
Instructions:
.
~J,::. ..
Page 2
SAFE DEPOSIT OOX INVENTORY
(1) CASH: Report total only. (2) STOCK: List in detail every corranon or
preferred certificate, warrant or other rights found in box. Stocks are to
be designated by name of company, certificate number, date of c~rtifica~e,
name in which stock is registered, number of shares and class o~ stock.
(3) OBLIGATIONS of u.s. GOVERNMENT: Number of pieces, dates <?f\issue, faq.e
value, names in which registered. (4) BONDS: Designate by name:, amount,:
serial number, or otherwise. (5) SAVINGS BANK or PASS OOOKS: State name
of depositor, number of book, last date appearing in book, name of bank and
.branch, and balance. (6) JEWELRY, COINS, STAMPS, MANUSCRIPTS, ETC.: List
· and describe as fully as possible. (7) List Deeds, Mortgages, Current 1--~~~~--=In===:su::.r:.:an=c~e:.....:.P.:::ool::;.:l.:.:· c~i;::e;.:::s_o~r~o;.:::t::.:h::.er:....:e:.:v:.o::i~d:;:,en~c::::.:e::::s~o~f ... in=d~e:.:::b;.:::.t.::;edn=.:.:e::::s~s:.:.•-(~<8~t}~:.::All=.~o:.:::t::.:h:;:,er:...;:c::o~n:.::t.;en:::.t:::.:s;:.;:•:....-·
-A:tf_;j_ ·-)j~L<~du~.< 2f.! • ~~ ...,:;· -;-i./ ~ J V/1"':. j ~ :. / d7-j ;·l.{~ O '• -"',' '"""••••-<•-.rw--?f'"'·p.«t ·kF 8.....-.. , 7 -··-~-,.a:::J.P,*JL, .. (·,t, (4<4{~1'-~~~~~···~'!!~,., .,....:_,._, __ LM
---~------·----+'----------------4-~-----V---, t _-..-1i~ r)"'--Q -·.,;J.../" I~ .JI •j , .,..d' .. ":'! J-. .[ 'I.._-~ ~·--==·~· -.. ..,., .. ~ •. /('!-·_,~r:er . .. r... . . .. .... ......-~~~-~. +.,,J _... i.j;a~'r--f-4~-• f :::\ .wa t ..... ~~~_...,........._...-wt
-L -/ .I I --: l f _,, ! . ..!l-./.l ; 1 -,fJ -.-. tfl li' 1': f ·il -.I -... --~..._.__.._.._, "'·· I' . . . .• . --. j}'= -?llo , -.~ •.•. ~:_ ___ ..,...:._;.,:_ _____ !ir--~~~ .. "
I • --3 .-. .. S..,. / J .........,.., l' ·-·-·-c -· L ~ J -,. I -...... c i .... I . ,.. . 1 ~~ ·t---~~"': .. ---..:f~--.J!J-'Ii-..
I ·-· I • -·--...J./;..;;..,.,_-.;;._ .... ~,/1.,']' ..... _.i~ __ .,... i'_·----' -·· ---· /_ .2, _.. /,( 7 i ~ I,' -· .I "\ ..,.. I -.\ ' ~-... -·.....-... .......,;; # # --:--J ....,._ ~~~~,..,.;Mf-..,.'(•M --1. ·-~}-I
·~ ,, --~ ·-"!! ~ ..... . J
1-· ---~-!~-=
).;.-H ·-12 -,,~\ .. -/ -··~ . ? ~ 1! -· '!1. -a-
I ' -. t. ._. .iif'' I
! • ·-c;. -5t,'
!----~~~~~~==~~~--~~==~--~~~~~~~~~~~~~~~~~~------------~~-~~~~· ~<:;;;;~-~ -~~ =-=-~--:-_-_-_-_·-·_ ~~-~·~ =·--··-..-....-.:__····-··. ~~~~-
-/ ·.. ··--~----------.. -~.{~~L~~~1.1~···~~t('~~·~~~~~;-~--~)~~~t~·~./~V~.A~~------~--·------+------------~···---~-------.. •"71~ 7/' \ ../ \J c.~ -
~----~~----~----~------~._----·------------------------~~·--~~· ~-------------------~-~--__ .. #-)) L ... ~..., 11. I~/: .h • ------~~.~,~~~-~/~.~~.~~~~--~----~------------------~------~------------------------· --------------~~-)_._. _____ . ------------------------------·--------·---------~·-----~-··-~ .. ~~ ... ::::::== ·. ·. :=: .. ::::=:-,.,. .• -• ~------ll -----' ~'-i
I·.,. H ...••• _.,K I .. _....~·-·
~-~1 ~,.~
-----------.-.. ~-~=-~·=--~-~.~--~------------------------------~--------------------------------~\!
NOTE: Use separate sheets if necessary.
• • Page 2
• SAFE DEPOSIT OOX INVENTORY
Instructions: (1) CASH: Report total only. (2) STOCK: List in detail every common or
preferred certificate, warrant or other rights found in box. Stocks are to
be designated by name of company, certificate number, date of certificate,
name in which stock is registered, number of shares and class of sto·ck •
.-. " (3) OBLIGATIONS of u.s. GOVERNMENT: ·Number of pieces,-dates of issue, .. face
· ;·{; (1 .. :~~.value, ·names in which registered. (4) BONDS: Designate by name, amount,
-~~ ·:r•'•·~~J-~, ;~e~ial number, or otherwise. (5) SAVmGS. BANK or PASS BOOKS: · State n.ame
.-; ;' ~/ t · ·;!of depositor, number of book, last date appearing in book, name of bank and
~~J-~.:, . 1 branch, and balance. (6) JEWELRY, COINS, STAMPS, MANUSCRIPTS, El'C.: List
·.;:·.!f. and describe as fully as ·possible. (7) List Deeds, .Mortgages, Current '( . ;·,". i-::•. . •' if ' .•. Insurance Policies or other evidences of indebtedness. 8 ·· m· other contents~ . ,,
4
"") Print Name and Title l1~ I rl_tt 'JA J 4 ?.P .1>\ . Z,
NOTE:
. ·=.~-··~~-,..·
.--..__ ·--
... ,.
Form RCC-33
RESIDENT DECEDENT
(..~ .~~
[p.J -7 j'-/CJ zl
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
COUNTY OF
I '-
IMPORTANT: This return must be completed in detail and filed in duplicate, with will attached, wi.th 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.)
· State of ... l'.?..PD. $Yl..:V.:~.P.:l,.~ ........................................................... } ss.
Allegheny · County of ..................................................................................................................... .
-~~-~-~ .. ~.:. .... ~.~ ...... ~.~.:r::.:..~.g;~-~ .. '. ...... ?..?. .. ~.~ ....... ?.~EY..~ .. Y..~.~E:?; ....... I:f~.~E ..... C?..?.~.t ................................. _ .......................................... .. Eueutor
Administrator of the estate of' the above-named decedent being duly sworn, depose S
Decedent dJed ...... A~g~-~ .. 't. .... ?.§ .. , ........ ..
(Month)
Name and address of a'ttorney or}
other authorized representative to ··
whom all correspondence should be •
mailed.
and sayS
That as such ........... ?..~.~.!.: ........................... deponent is familiar with the affairs of said estate and the property con-~~
::~tituting 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 na~e, 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
Pittsburgh National Bank John w. Kerrigan and
Canonsburg Office Walter W. Kerrigan Son
canonsburg, Pennsylvania 15317
..t;OX l\JO, .LlUj
That the contents of said safe deposit box or. boxes are itemized under. Schedule~ E
return, with the exception of the following, for-the reasons hereinafter set forth:
of this
That Sc.hedule A attached hereto and made part hereof sets forth full v 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 8 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 moJieys 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, or in trust for
any other person or persons giving also separately the accrued interest thereon, if any, down to the last
interest day prior to decedent's death in the case of savings banks, and to the date of decedent's death
in all other cases;._all bonds, postal savings, treasury certificates or notes and other evidence of in-
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 thereof, 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 any 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.~es 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 i tern; all moneys payable
to the estate from life insurance polici-es carried by decedent; all annuity and endowment contracts the
11roceeds of which were payable upon the death of the decedent; and all the corporate stocks and dividends
tin~. thereon and unpairl as of the date of death, b9nds 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.
J
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 set-s forth the interest of rlecedent at the time of
death in any co-partnership or business, and in support of the value of such interest there is annexed to
s'aid 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 tile-agreement)
together with a statement setting forth the character of the business, its location, and such other facts
pertaining to the l;msiness as may be pertinent to a fair and just ap'praisal of the decedent's i~terest
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 ~o the schedule a co~y
of the deed, trust agreement or other instrument creating the trust. Thero~ 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 indi~idually, 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 0 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, and the 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 o·f 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 detai~ 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 anrl tmpaid 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 amo~nt 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.
Subscribed and sworn to before me this .. .,/r.P..z:.d. ..........
................ " ......................................... day of ...... 21...~. 19 .. 7....!.:-.
--~:-5.:!~--( Executor-Admin · rator)
.. ~.9.9 ..... G.T.~P.4.Y..~.~.~ ... P ....... ~.Y.9..(" ............................................. .
(Street Number)
"'d 'iJunoo ~uaQllanv qllJnqsmd .Mc.Mu.r.ray .. , ...... Penns.y.lv.a .. ni.a ..................................... ..
(City M Town and State)
NOTE: Before
'f~C!Ad ~IQON 'HDnH·Z!I:l ':l NA101JW
signing affidavit make 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.
.J ..... ,
RCC-34 (1-64),"
COMMONWEALTH OF PENNSYLVANIA
D~PARTMENT 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 porcel at death of dece-
dent. Where property held as joint tenant ci.r 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)
described by lot and block number, street and street number, together with
a general description of the property, with a reference to the record of the ASSESSED VALUE conveyance by which the decedent took title; if a farm state number of a-FOR YEAR OF cres; also statement of mortgage encumbrances upon each parcel at death DECEDENT'S of decedent. Taxes, assessments, accrued Interest on mortgages, etc.,are DEATH to be listed on Schedule "F" and must not be deducted from this schedule.
None
.. .,
.
•.
Insert this total opposite "real property" I Schedule "A" in the x· X X X X
"As Reported" column. on the last page of this return.
(2) (3)
DEPARTMENT
VALUATION
ESTIMATED CAUTION MARKET VALUE (Do not write
In this space)
.. :·;.;.::-
' {
I
0.00 I i
,._
RCC-35
-,
COMMONWEALTH OF PENNSYLVANIA'
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
I"
SCHEDULE "B"
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 decedent 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 or 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 -Qf 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, treasury certificates, cash on hand and in bank,
stocks, mortgages, notes, together with accrued interest or dividends, salaries or wages, insurance pay-
able to the estate or fiduciary in said capacity, partnership interests, interest in any~distributed
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 ITEM UNIT ESTIMATED DEPARTMENT VALUATION
NO• List and describe fully VALUE MARKEl' VALUE (Do not write in
this space)
Post Invalid Equipment Company
refund of over-payment 86.11
86.11
Insert this total opposite "Personal Property", Schedu:J.e "B" in X X <i tr 1/ the "As Reported" column on the last page of this return.
RCC-35 •
COMMONWEALTH OF PENNSYLVANIA.
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "B"
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 decedent 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 or 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, treasury certificates, cash on hand and in bank,
stocks; mortgages, notes, together with accrued interest or dividends, salaries or wages, insurance pay-
able to the estate or fiduciary in said capacity, partnership interests, interest in anyundistributed
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
AMENDED SCHEDULE "B"
Asset Reported
Post Invalid Equipment Company refund
of overpayment
Additional Assets
Medicare benefit on Doctor's bill
Medicare Over-Sixty-five Special policy
Medicare Over-Sixty-five Special policy
Total
Less previously reported
Insert this total opposite "Personal Property", Schedule "B" in
the "As Reported" column on the last page of this return, •
UNIT
VALUE
X X
ESTIMATED
MARKEr VALUE
86.·11
133 .6c
21. 5~ '
33. 40.~
DEPARTMENT VALUATION
(Do not write in
this space)
j.JJ. ~0
J/.~0
ci'd. </;0
274.64 '
86.11
188.53
RCC-36"
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX SCHEDULE "C"
TRA.NSFEil.S
RESIDE~T DECEDENT
( 1)
(2)
( 3)
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
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
If the answer to (1) or (2) above is in the affirrnp.tive state:
(a) Age of decedent at time of transfer ....:N'-'L[_J_..::A-=----
(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 theref~r which was to take effect in possession or enjoyment at or after his death?
(Answer-yes or no)~N~o~-----
(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) No
(b) What' was the transferee's age at time of decedent's death? N/A
(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) NO
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 ___ -=N~~A~-------------------------------------~--------
(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) -~N~o~----
(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) . No
(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) N/A .
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
Insert this total opposite "Transfers", Schedule "C" in the
"As Reported" column on the last page of this return.
MARKET V A.LUE
(Estimated)
Q.OO
DEPT. VALUATION
(Dept. Only)
RCC-38•
' COMMONWEALTH OF PENNSYLVANIA
THI\NSFER INHERITANCE TAX
RESIDENT DECEDF.NT
,.· f.' ~ ~.
SCHEDULE "E"
JOINTLY OWNED PROPERTY
Il'STRt:CTIOSS: 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 tmder 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-o-wners 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 Real Estate. 1
Series E Bonds, Total Value $30,747.4J
Checking Account, Pittsburgh National
Bank, Canonsburg Office, Total Value
$648.92
Savings Account, Pittsburgh National
Bank, Canonsburg Office, Total Va.lue
$12,094.53
percentage Estate
Share Valuation
1/2 J5,373-71
1/2 ·324.46
1/2. 6,047.27
DEPARTMENT VALUATION
CAUTION-Do not Write
In This Space.
Value of
Entire
Property
~)4.~~
~ o47.J-;1
I
Value of
Decedent's
Interest
Union Nationa.-1 Ba.nk of Pittsburgh,
McMurray Off1ce, Total Value
$5,170.65 1/2 . '~, r:{~J_j. 2,585.33 ~.2
All in joint name with son, Walter W.
Kerrigan
~14,330.77
Insert this total or>posite "Jointly Owned Property", Schedule -"E"
in the "As Reported" column on the last page of this return. L-..., ______ ....J o< ~ /3fJb) n
(
h
• ~ : .. ::: ..... 'JOt,.. . , ' . . ·~
RCC-37 (12-63t
COl\11\ION·WEALTH OF PENNSYYLANIA
TRANSFER INHERITANCE TAX
R€SIDENT DECEDENT
BENEFICIARIES AND ADDRESSES
State full names and addresses of all who
ave an interest, vested, contingent or other-
wise, in estate)"
Walter w. Kerrigan
106 Gran(iview Drive
' McMurray~ Pa. 15317
.. . . -..
SCHEDULE "D"
BENEFICIARIES
RELATIONSHIP SURVIVED (If step-children or DATE INTEREST OF
illegitimate children DECEDENT OF BENEFICIARY ·
are involved, set STATE YES IN ESTATE
forth this fact.) OR NO BIRTH
Son ' Yes Joint Tenant -
.Entire Estate
·.· .·
..
.
Deponent further says that all the above-named beneficiaries are living at this time except below:
NAME DATE OF DEATH RESIDENCE
No Exceptions
. ----· . :.
( 1)
SUMMARY (As Reported)
Real Property ......................................... : ............................ : ... (Sch. "A") $ ..................... .0.~ . .00,.
Personal Property .............................................. : ............... : ... ( Sch. "B") $ ............ : ... : .. ?.~. ~)~ ..
Transfers .................................................................................. ( Sch. "C") $ .................. · ... .9. ~ .0.9 ..... ·
. Jo.in.tly ... ow~ed ... Pr.oper.ty ....... : .. c: ........................ (S~.h., .. '.'.m" )$ ........ 2.!+.,.33.0.~.77. ... .
............. ,_, ......... · ............ ~............................................................ ....................... $ ........ · ............................ .
Gross Taxable Estate .. ......... ...... ..................... ..... ................................ $ ........ 2.4.,.!+.+.9..~.$.$ ... :.
. ::s:
..... ·o
.i::·
= 0 u
._.. -.
(2)
(As Determined)
$ .. , ................ .
$ .... /f'~-~3 .. .
$ .................................... . $.J..~.d3..Q. 2.?.. .
$ ................................... . •/!J<f,. $.~····t £/.q~d .
RCC-81 (6-71)
COM~ONWEAL TH OF 'PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
HARRISBURG
17127
NOTICE OF FILING OF APPRAISEMENT
WALT&tt W. KEP..RIGAN
(Executor or Administrator)
IN YOUR REPLY PLEASE
REFER TO
Inheritance Tax Division
38-213-7
In Re: Estate of _ ____.~J~O.u.HN.I.I.ll..._..i:.iw_._.--'KERR~~r~G~AN~-------------
WASHIIDTON County -File No. __ 6_3_-7_1_~_1_02_1 ___ _
Dear Mr. Kerrigan,
You are hereby notified that the------===-=o~r=.::i~g:.:=i:::na=1:..__ _________ _
appraisement in the estate of JOHN W. KERRIGAN
has been filed in the office of the Reg_ister of Wills of WASHINGTON
County on December 15 , 19_1!_, Said appraisement reflects the follo..:..ing
valuations:
Real Estate ______________ _
Persona I Property ___ -==1=B=B~ • .<!..53~-----
Transfers _______________ _
Joint I y Owned ____ 24~;,__3"""3~0~ • ..L7..L7 ____ _
T ota I ______ _!2::24*-J~u5~1J..9.L. 3~0:!....· ____ _
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 occur~ed 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.
DOMINIC R. DeMARIA
-Date ---"'D""'e~ce~mb=..:e~r-=1~5 ,L-...::1:...!9J.7=1 __ Signed ___ ~---------------
Title APPRAISER I
DATE OF DEATH: August 28, 1971
Note: This is not a bill.
J
_,
RCC-39 (5-68)
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
~·
. -
SUMMARY
Estate of KERRIGAN
(Last Name)
JOHN
(First Name)
w.
(Initial)
DATE OF DEATH 8-28-71 FILE NO. 63-71-1021
REPORT OF INHERITANCE TAX APPRAISER
I, the undersigned duly appointed Inheritance Tax Appraiser in and for the County of WASHINGTON
Pennsylvania, do respectfully report that '1 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: -~D""@,._..,c,..em .... b.....,.,er..._1~.J-5'*"' .........,1.J.97-l-olol __ _ ZJ~l?. Jj~~n . 1 INHERITANCE TAX APPRAlSE ~.
REPORT OF THE REGISTER OF WILLS
I, the undersigned duly elected Register of Wills in and for WASHINGTON County, Pennsylvania, do respect-
fully report that I have1 allowed deductions in the amounts claimed by deponent, except as to those items where a greater or
lesser amount is set forth in the last column to the right in Schedule "F", tch gr ter or lesser amount represents the sum
allowed as a deduction.
Dated: DEC 1 6 1971 RUSSEll MARINO'
INVENTORY VALUE AS REPORTED VALUE AS APPRAISED VALUE AS REAPPRAISED
Real Property (Schedule A)
Personal Property (Schedule B)
Transfers (Schedule C)
'$ $ $--------~~-T~~
Joint-Held Property (Schedule E)
TOTAL GROSS ASSETS
Less Debts and Deductions
(SCHEDU'LE F)
CLEAR VALUE OF ESTATE
Valuation of life estates or
annuities................... $ _____ ___,. __
ESTATE TAX ASSESSMENTS $ _____ -..,..-.....___
2%
Tax on $<i~62~~~~85:=~53:=...(6'%)>0 Taxon$-------------~----~
$ _________ 4---
$ ~ ~ ;... ~ ~ :? 31-so -,
$------------4----
Tax on$ 10% $ ________ ~--~~
fix~$ 1~ $----~---4---
Exemptions • (•) As evidenced by Charitable
Total Estate ________ _._ __ _
TOTAL TAX $--------------~~
Less tax previously paid $=======!==
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 $-------'--
BALANCE DUE
Add interest at rate of 6% from
----------~'0---~---
$---------~~--
$-----------4----
TOTAL TAX BALANCE $ -----------+---
PAID $------~---
FOR USE OF REGISTER ONLY ADJUSTMENTS
. Exemption Certificates issued
by the Secretary of Revenue.
NOTE: Where subsequent adjustments are made to the above computation of tax by the Register of Wills, for proper reason,
same should be noted below, with short explanation.
~
Will
Administration ! No ......... .
IN THE
Year
MATTER OF THE APPRAISEMENT
OF THE
ESTATE OF.
~'
· .
.. ~O.ffi'J.Jv~ .. I<:E.lmJ:(}AN
Deceased
Late of ..... Wl\$.llU.JQ'.r.ON ..
County of WASHINGTON
Commonwealth of Pennsylvania
REPORT AND ·APPRAISAL
, ....
..
/ .. Fonn flCCtJ
COMMONWEALTH OF PENNSYLVANIA ~. . . ~
DATE ..... De.cember. .... .l._5., ..... l971 ..... . DEPAkTM~!T OF REVENUE
BUREAU OF COUNTY COLLECTIONS
HARRISBURG, PENNA. 1 7 1 2 7
-RESIDENT INHERITANCE TAX COUNTY ..... WA$.HlNO.:'r..ON .......................................... .
APPRAISEMENT FILE NO •...... Q,?.:::7.J.:::J.:Q.?J .......................................... .
Whereas, ....... , ............................... J.OHN .... W~ ..... KERB.lGAN ...................................................... late of ........ WA$HJ..NG.'r.O.N .................................................................. .
in the County of ....................... : ............ WASHINGTON .................................................................. Commonwealth of Pennsylvania, having died on
the ............................. 2.8th. ................................................... day of ................... August ...................................... 19 ... 7.l. .. , seized and possessed of an estate
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore, I, ................................. .DOMINIC ... R. •.... DeMARIA ... : ................................. , 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.
Appraisement Unit Description of Asset Values Made for Inheritance
Tax Purposes
$
PERSONAL:
SEE COPY OF SCHEDULE "B" ATTACHED TO APPRAISEMENT. lBB 1)1
JT. HELD:
SEE COPY OF SCHEDULE "E" ATTACHED TO APPRAIS EMENI' 21.... .110 77
_total 21.... '>19 10
...
. .
~ l
.. .
.
. :
forrn~;"!::fhb,:: ::':h~w~ ~~0~~~· ~.~ :r·~~:z~;;:~i~~~·~~~~·:
·~/ Appraiser
···············l"·······;·~································<?C~····b~~····· .. d···si;;~·i·i···· ·······················································
............... ld_/................ .. . . ... .. ... ....... . ....................................... , Penna.
(Poat Ofllee)
.•,
.................... :VJAS.HINGTON .... County
RESipENT INHERITANCE TAX APPR~SEME~T .. ·.
Estate of
.......... J..OHN ... W .•.... KERRIGAN. ......... .
Deceased.
Late of
.... WAS.Hl.NGT.ON ......................................................... ..
Date of Death, .............. S...ZS,.,'fl .............. · ............................. ..
AppraisemeHt Docket Vol., · .................. .3-EL ....................... .
Page,· ...... 2l3.~~a.: .......... , ........... No .... 6.J.,7l .... l02.l ........ .
Filed in Register's Office, ... P.~.<?..~ ... JS ............ 19 .. 7l .. .
Amount of tax dtte, $ .. , ...................... : ......................................... ..
DEPARTMENT OF REVENUE
Received,
Exa.m:ined and Approved,
Wrote abo.ut Appra.isement,
Appeal j1'()m Appraisement,
Entered and charged,
\-.
,,
'
.:.,
·'.J
.\
Funn RCC-2
COMMONWEALTH OF PENNSYLVA!'~IA lecember 22 1971 DATE ....................................................................... 1 .......................... . . . " DEPARTMD!T OF REVENUE
BUREAU OF COUNTY COLLECTIONS
HARRISBURG, PENNA. 1 7 1 2 7
• RESIDENT INHERITANCE TAX COUNTY ............ ~.~ .. ~.h.~.!J:KtQ.!! .......................... .
APPRAISEMENT FILE NO ............. Q.J. .. ~ .. 7J.~ .. l..Q.2..l ........................... .
Whereas, .................... ~ ..... ~ .......... ! ........... ~.~.!'.!.g.~-~ .................................................................. late of ....................... ~-~ ...... ~-~g:t .. 9..I.l... ................................................. J h W K w h .
in the County of ...................................... ~Y.~.~.h?::.~_gt9..~ ........................................................ Commonwealth of Pennsylvania, having died on
the .............. ?..~ ..... ~.h ............................................................. day of ................. Augus.t. .................................... 19 ... 71., seized and possessed of an estate
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore, I, Dominic R. DeMaria 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 Appraisement
Description of Aaset Values Made for Inheritance
Tax Purposes
$
ADDITIONAL PERSONAL ASSESTS
PERSONAL PROPERTY
Post Invalid Eouinment Comnanv refund
of overnavment 86 11
Total 86 11
(This item was included bv.the Attornev on Schedule
"B" l1Thich was filed with the appraisement but it was .. ·missed b:y the clerk when the a~:grgi~ement Nas t~ped
·up) '
form~;v~~~h bl:e: ::~h~w~ .. -~d~~-~~:.'. ~:; o~e~~~-~ ... ~.~~a; ~~:.g~-~~ .... ~~p-~~-~-~-~.:.~.n~ ... i.~ ... ~~~e l~n .... 2./. .................. ~ .............. £.. ............ 22 ... ~~ ....... #.~-?(
Appraiser / . '
............................... , Penna.
,...---------------------------------··
·f
:•
County
RESIDENT INHERITANCE TAX APP~AI~EMEJil,T~>.: ·_ ..
Estate of
Late of
Date of Death,
Appraisemellt Docket Vol.,
Page,
Deceased.
Filed in Register's Office, ......................................... 19 ......... ..
Amount of tax due, $ ................................................. : ................. ..
. DEPARTMENT OF REVENUE
Received,
Era.mined and Approved,
Wrof!! abo.ut Appraisement;
Appeal f1'om Appraisement,
Entered and charged,
.·.
;_:
·. ~. i. . ... ,
i
rr
.
Form RC C·lO
OFFICE OF TME
REGISTER OF WILLS
STATEMENT OF DEBTS
AND DEDUCTIONS . DEC J6 1971 RUSSELL MARINO
OATF. . R VED . . . . . . . . .. ................................................. . OF' COUNTY
AGENT OF TME COMMONW&ALTH ~
-/0.2!
ESTATE OF John W • Kerrigan LATEoF _____ W~a~s~h~i~n~g~t~o~n~C~o~u~n~t~y ____________ __
CA'rE OF FILING APPRAISEMENT ---------------DATi OF DEATH ---------------
!
DATE HO. OF NAME OF PAYEE REMARKS Alo!OUNT VOUCHiiirt
Griffin Funeral Home Funeral E;xpense 1,430 00
( .... . , -
George WashinKton Hotel F'Uripa:ilid Biilili~X' 11!==\ 78
Opening of grave and use 120 Cemeterv !of chaoel 00
Dr. Stutz Medical Bill 170 00
Ambulance Company Last Illness 35 00
Washington Hospital Last Illness 61 1)0
Internal Revenue Service 3rd quarter payment estimated 1)0 00
Griggs, Moreland, Anderson Blair & Attorneys Fees . 100 00
Re:verend R Arnold . ~inister at funeral 25_ _Q_Q_
.....
Tavlor 1 s Pharmacv
'
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF • Allegheny
..
:u:r~12: Bill :6
I
,
I r
'2,313
I, _.__ __ To'-'Ta:.....~..J...,.to~;e;..J.r"""""'"!o!U-6f-~K~e;;..r,L;.Lr...J.j-€g~a:2.Jnu,_ _____ _;,_ ________ ,HEREBY CERTIFY, THAT. TO THE BE•T OF
CAROL'm C. FITZ-HUGH, ~ Pllft.t<a
Pittsburgh Allegheny County, Pl.
tAy Commission Expires Aogust 21, 1972
PENSES AND EXPENSES OP'
4q
,,
-
7.-7
"•: ••:J ~ .. •):"'> ,,,, --··•~•'''· ,..,. _ _,_w,,, .. -w .. _
\"',·
";•:' ~1X . ., -~ ... ···--· ............... -""·---..
I : I ; I-~_.. .... "" ......... __ .. _ .. _____ ._ ... __ .... _.. •• -.•. ~ ............. -....... ~---...... ~---......... t .......................... ~Q ·~-•• ··----·--·---·------·····-···---···-·--~ .. -........... T !
r,
•-·~--··--•"•·'_,.."': .• -..,-~,,,",.,,-,,-,..,_,_,.,,_: __ wo,,..:.,._.,,,_,,,}_, ___ -••••"'"_ .. _ ... _____ _.,_,,...,,, _ _,, ,.,.,..,.. __ ,,.,..,, .. , ... ,,~..,, •~• ~ ... --, .. ,_._.~,.. ·••••:-·~-, .. ~ •••-•
t ----.. ·------.. ---.. -····-··-------.. --.... -·.r-·--···---............ ---·· .. , ..... -·---~·-··-· ...... ... ______ .,. .......
I I
I
-··---·-····------·-··------·-.. ··--------... :.., .......... _ .................... -·---·-·· .. ... _. -------·-·-· ..... ····· ··:· .... 1·
I -. ·-···-·-·---·-····--·-·--·--__: ______________ j _________ .... _ ......... ---------· ·-:-· ·-·· --~ l. .....
'
·-i i
' ·---!
'.
-:·:.
_, ...... -+ ... -....................... :·
--·~-------· ----··---·-·----·----------···--l------·--
.oo r
114J0.00
115.18
120.00
170.00
35.00
6150 so.ao
3001}0
25.00
6.49
Z313J7S
Z3 1 3 .7 7 T
-------·--------. -........ _, ____ ..
·--,
!---·-
'
~ ...... -~
·--
8 611
113.60
2153
3 3.49
274.64 s
8611
1 8 8 53 s
15,373..71
3~li.46
6) 0 4 7 2 7
2)58533
2 4l5 19 J 0 s
Z313.77
ZZ20553S
2ZZ0553 T
........ _..; ....... ••+-
' .. \ .. -----·-·----·
.,. ____ .. __ . ·----··--·1"'--· --·--~ ....
j I
' -··~-~ ... ~-·--·-···~~ ....... , . -·---·····-
! ··--.......... --.-·--·---.. ·-·;..-~.-............... .
>•o'M Ob-• _, ..... _. 00 -·~---~ ......... ;.--···
·-_ ... ----.. ---·-· ... ---·· ..... -.. ·---.-
I '---··--·----------+-.
I
... ..! .. __ _
I
I .... -............ -...... ·-
1
·•
----------------------~--.............. --~ .... -~-··-----i-----. ..._, .......
I
-.. --.. · .. -··-···--~-·"'"*"-···· ... -___ , .. _,_,.., ___ ...... __ ..... ,. ...... ~ --·-----~------... ______ .. , .. __.,_.. ....... -.....
! . l .. __ , ___ .. _j__
' .
! : ,.,,,._-• ...... -----·~···--_,,. I ------· ---·-'--·-· -----····--·-------------;------------------·---------------.. ··----------I ' ----·-------------·-·------.. ---+-----------------____ .. ____ -----------------!~-. --·-·-r-r
"'::''!"!:.:.-:;.·. ;:. .... -:.:: ......... .~:--..= .... ·~-·-
. t:r. l •• ~ _ ..... ~------··----... -·------·-·-· --·-· ·1C
. '"
DEPARTMENT OF REVENUE N0.8 116 8 7 OFFICIAL RECEIPT • PENNSYLVANIA INHERITANCE AND ESTATE TAX
RECEIVED" FiVE HUNDRED TEN and 56/loo ..... _ ... ________ ......... ____ ,.. __ ...... .,. ___________ dollars
representing Pennsylvania Inheritance or
From: WALTER \v • KERRIOAN ... PAYINO ON IND. LlAB. Estate Tax due from the following estate:
Address_l_0_6_G_R_AN_DV_IE_l_i_D_R_IV_E ____ ----i
M<:MURRAY, PENNSYLVANIA 15317
File No. 63-71•1021 Date of
Date of Payment ___ O_c_t_o_b_e_r_l._2_·~, _1_9----'-71_· -----1
Name of Decedent __ J__;O_H_N_W_. ___ K_E_• RR_ . .;.;..IG_A_N _ ___;;::..__--i
County ___ W.:._.A.:.....:S....:..H.:....::IN:..:...;_G....:..T....:..O.:._N_: -----'---=---------1
Remarks:
JMO
y./
d!.¢-..
·: ., ·. ·.
·~ .., .'. ...... '
'. · .. '-.;_ l
~
S E A L/ '
2% Tax on $------''-------"'·---------lfli:i
6%Taxon $~-8~,_9_5_7_._0_6_~
15% Tax on $ ________ _
%Tax on $ ________ _
Estate Tax, Act of
May 7, 1927
TOTAL TAX CREDIT
Less five percentum of tax if
paid within three months after
date of death
Plus interest at the rate of
__ %from--------
to ___________ _
TOTAL AMOUNT PAID
537.42
$
$
$
$ 537.42
$ 26.86
$. ________ _
510.56 $=============== I'
NOTE: This Triplicate Rec-eipt to"be,'re;a}ned for.'audit purposes.' ( ... .----....., ~· t'--'1X ~
· 1 ' ,._/. I' ~fo.. . // Received by'·'-)~'~ · \0-t•...vv\-0
NOTE: In accepting the transfer ·rnherltance tax an future estates, prior to the death of the liJe' \:~'-" . (Signatuwe) w
tenant or tenant far years, as evidenced by this receipt, it is understood that the Commonwealth shall "'\ , t 'A.-~ • '. }
not be precluded or prevented from hereafter assessing additional inheritance tax at the death of the'--· •• ~ " )2..1'-..J IJ1 ' d./
life te~ant or tenant for years whenever it appears that such additional tax may be legally due and , \ (T~~,e)
collect1ble for any reason whatsoever. ·
.
.fU441!' -~·· ::::;--...-:-~· --------:----.__,.-__.. -,~--~ .. -~Rc;;;c-~4.(8~-6~8) ~~~~~Rl~EE~Ea :mCEOIII!i!i!IMCIM&O~N:a:W:mEG!AaLTEiiiiH~OliilF~PEaN~Na~S~YL~V!!!i1A!i:i!N~I~A!!iDEI~Iiliill!l!!!~~iB!&!!!!~~~~J
DEPARTMENT OF REVENUE No.8 118 4 4 OFFICIAL RECEIPT • PENNSYLVANIA INHERITANCE AND ESTATE TAX
XiHKX SEVEN HUNDRED FORTY-NINE and 34/100 ·-·--------------·--~--d 11 RECEIVED · · o ars
WALTER W. KERRIGAN representing Pennsylvania Inheritance .or
Estate Tax due from the following estate: From'------------------------------------~-.------------------------------~-----------------1!1
GEORGE l~ASHINGTON HOTEL
Address --------------------------------------1
tvASHINGTON, PENNSYLVANIA 15301
63-.71·1021 File No. · Date of
Ntlvember 19, 1971
Date of Po y me nt --------------------------------1
.. T 0~ \~, KERRIGAN Name of Decedent _________________________ _,
WASHINGTON County ________________________________ --4
rks:
. ' .. ... ' '
.i.
. . ' ,; .. , lr rn ~ [p [L'~ @ illlr{~ ,-/S EA L
. ' ' . . '8 ... 213·7 NOTE: This Triplicate Receipt to be retained-lor aucfi( purposes. . . ~
2 o/o Tax on $----------------.J>·----------------IIil
On Account 6 o/o Tax on $ ________________ _
15% Tax on $. _______________ _
o/o Tax on $ ______________ _
Estate Tax, Act of
May 7, 1927
TOTAL TAX CREDIT
Less five percentum of tax if
paid within three months after
date of death
Plus interest at the rate of
_. _o/o from--------------'---
to ____________________ _
TOTAL AMOUNT PAID
788.79
$
$
188.,79
$
39.45
$
$. _ _~'iHl4~9~ .. 434:&---
UilUX
$=======
Received by ):::7~~:=:::::::::::;:~'_!_~~~~~~----,,.--------~
NOTE: In accepting_ the transfer .,in.heriiance tax an future estates, prior to the death of the
tenant or tenant far years~ os~eiiiden''c'ed by this receipt, it is understood that the Commonwealth
not be precluded or prevented from hereafter assessing additionaJ inheritance tax at the death
life tenant or tenant lor years whenever it appears that such additional tax may be legally due
collectible lor . reason whatsoever.
-1·
1---
~~~~~~~~~~~--~~-~-~ .. ~~J'
"''"
0
"
1 COMMO~!~~T~ ~F.:v~~u~SYL VANIA ~·
No.8 11864 OFFICIAL RECEIPT • PENNSYLVAN~A INHERITANCE AND ESTATE TAX -~
TEN and 75/100 ..,..,_ ..... ._. _______ .., ........ __ ..,.. .. _ ......... _ .... _ .. ._ ......... _ .... _..,. ..... ~ .. ---..... ~ ....
RECEIVm it'* ll r.r . :i. dollars a . ""r • ~ex·r gan AND' ERS~"-'fpresenting Pennsylvania Inheritance or
ATTY. GRIGGS, MORELAl\'D, BLAIR & VEltate Tax due from the following estate: From: _____________________________ _,------------------~----------------~1
, HENRY OLIVE BUILDING Address ___________________________________ ~
PITTSBURGH, PENNSYLVANIA 1.522~
63-71·1021· , . s ... 2s<ijo71
· · Date of Deatb_' -------------i File No.
November 26;1971
Dote of Poym e nt -----'---------------------------1
J OHJ.~ li. KERRIGAN
Nome of Decedent -------------------------------i
WASHING110N
County _______ ~.------~-~--------------------1
Remark/!
. )l\ 1 ( ..
' r·I/:.D I •
1Nru ~ ~ [L ~ @ m v rn -~ E A L
2% Tax on $-----------------
On Account
6% Tax on $ _______________ _
1 5% Tax on $ ________ _.;.... ______ _
% Tax on $ _______________ _
Estate Tax, Act of
May 7, 1927
TOTAL TAX CREDIT
Less five percentum of tax if
paid within three months after
date of death
Plus interest at the rate of
__ %from--------
to __________ _
TOTAL AMOUNT PAID
$
11.31
$
$
$
$
11.31
$
.56
$
$. ______________ __
10.75
$=======
... !> ~ -. ' • l\l:t,.213-7 ,. ... -.......
NOTE: This Triplicat~ R_eceipt I~ ~~ ~et~ined far au~it pu~lltes. · ~ ...,...J () () '--":?1 "
. . . t . ·, ,' Received by _.-::Y~ I r \ct..ltuv"--o
NOTE: In accepting the transfer Inheritance tax an future estates, prior Ia the death of the life ,../~'~ j (Signatur~(J, ~-
tenant or tenant far years~ as evidenced by this receipt, It Is understood that the Commonwealth sliall .. ....., • ~ _ ""t'-." · ii { / \
nat be precluded or prevented from hereafter assessing additional Inheritance tax at the death of tiie-....~' ~ _!:.! .1. J:l,A_Q./':: .. _/ o-r . ~V _<:..)
life tenant or tenant far years whenever It appears that such additional tax may be legally due and .-~ '-,./\. (Title)\
collectible for any reason whatsoever. "-1_..,
'
... ~·
i