HomeMy WebLinkAboutOC1968-0041 - ESTATE OF ACKISON~.~'.....
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COPY OF .INVENTORY ,-'
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Washington County,Pa.,taken and made .in conformity with the above affidavit.. '
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DOLLARS CENTS
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'-'::E,'Ackl:$On.a.l1ft./a Acld.&onBotougn o~cha:tli!xoi'.?'_;: ::,;;~;,:late o{,,::..:.
Washington County,Pa.,takefJ and made in conf(jfflJuY with the above afJidavit.
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u.s.S~ries it Bond #t~u9931~2
X6~ued J(;lllUUY 2\).1942,':,
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Jpintly Held Property Estimated
V>!'fue '-'v.
Joint Sa~ing~·Account,First National Bank,Charleroi,held by the
d c dent and her dau hter Mar aret Jane Ackiso Shi e
0-1 t)-s;b
Joint Checking Account,Firs't National Bank,Charleroi,held.by .tlle
Transfers within TWO .YEARS Prior to Death
NONE
That at the time of death there was no safe deposit box registered in decedent's ·individual name,or jointly with,or as agent or deputy of
another,or in decedent's individual name,with right of access by another as agent or deputy,with the exception of the following:-
NAME AND ADDRESS OF BANK OR OTHER INSTITUTION
IN WHICH DECEDENT RENTED A SAFE DEPOSIT BOX
THIS SAFE DEPOSIT BOX RENTED
IN NAME OR NAMES OF
RELATIONSHIP OF JOINT
HOLDERS TO DECEDENT
BENEFICIARIES
e
BENEFICIARIES AND ADDRESSES
RELATIONSHIP SURVIVED AGE OF LIFE
.(If step-children or TENANTS OR INTEREST OF
(State full names of all and their addresses who have illegitimate children DECEDENT.ANNUITANTS BENEFICIARYSTATEYESaninterest,vested,contingentor otherwise,in estate.)are involved,set OR NO AT DEATH OF IN ESTATE
forth this fact.).DECEDENT
Sui Juris :.;)10 U..L ~.;:'U..L..L-
Ralph A•.Ackison Son Yes .Rand Co •Stock.K.D..
PennsylvaniaCharleroi
Austin Clark.Shipe Son-in-law Yes Sui Juris I=S/~or lngerSO.l.l-
Rand Co.S~-ock
421 W~.shington Avenue-,
Charleroi,Penasylvania
Suzanne Monier Shipe Cranddaughter Yes Sui Juris A.T.&T.Stock
421 Washington Avenue
Charleroi,Pennsylvania
ureal:
5300.00MarvLouiseSimonsCranddauqhterYesSuiJuris cash
Chattanooga,Tenessee ~
villiam Simons
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Grandson Yes Sui Juris 5200.00 cash
chattanooga,Tenessee
argaret Jane Ackison ,Shipe Daughter Yes f3ui Juris Residual ·Esta.t
421 Washington Avenue
Charleroi,Pennsylvania
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.OFFICE OF THE.REGISTERWW·
County of ..\~f\~~IU'!91-'.q~.,..'~
AUSTIN CLARK SHIPE.................................................of ~4l.:WQ~h:i.J;1.gton..J.\v.E:l).~.E:,..Cl).~;r.l.e~.Qi.,..Pi;3..
(Name)(Address)
b 'd swo'rn ..,,-,'d"~l'd d'7'h 'h"h ..Executor','"...'~..emg uly .accor mg to aV':,eposes an sa}stat e IS t e ' _
,Blanche P Ackison a/k/a '(Exec.,Adm"Legatee,Etc.)
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of the estate of_~J_~n-S:.9?_J~h-.:i1J_~p.~__A5=:~~'§'<.?.!!_"_~'whose last residence -was __:j_?-~L_W_~"~h_t..~g19(!LAY_§_l}!£~~·(No,),Street)
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_~_~~";_J~_~_2_~_)p-~_~,deceased,and that the whole of the e~tate of said decedent,who died 12~_<:"~~!?-~E~-?-l.._1967
(City.Borough or Township), •(Date)
consisted of:
Form No,RCC·62 (2·64)THIS FORM REQUIRED IN ALL ESTATES WITH GROSS ASSETS UNDER $10,000,UNDER SECTION 701 OF AC;OF JUNE 16,1961,../
~,~.F~E-JANU~RYI,196~,'(FILE IN DUPUC.ITH COPY OF WILL ATTACHED)',e '<'.'
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REAL PROPERTY
REAL PROPERTY IN PENNSYLVANIA,WITH STATEMENT OF MORTGAGE ENCUMBRAN0ES UPON ,EACH PARCEL'AT DEATH OF DECEDENT,
WHERE PROPERTY HEi.n'A~,JOINTTENANT OR TENANCY BY ENTIRETIES,GIVE NAMES,ADDRESSES AND RELATIONSHIP OF OTHER OWNERS.
Real Estate .Estimated
Value
NONE
.,
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P~rsonal Property •
U.S.Series E Bond #08993182 E Issued January 20 1942 25.00
148 Shares,Ingersoll-Rand Company,Common 6,327.00
64 Sha:J:'es,·American Telephone and Telegraph Company,Common 3,192.00
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~",'~~'~9TOTAL:..544.00
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NOTE:You may expedite the pr~cessing of this return by filing with it,and as a part of the return,
letters from financial institutions or mortgage holders,certifying to amounts on deposit or owed by the
decedent as of the 'date of death.Such letters must be signed by a responsible officer of the financial
institution or mortgage holder and indicate clearly amounts of principal and intere~t in the decedent's
account at the date of death and the type of account,account number and the exact name or nanies in
which the account is registered.
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Form N:o,RCC-62 (2-64)
Will'
Administration INo..'..Year .
't IN THE .......~
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MATTER OF THE APPRAISEMENT
OF THE
ESTATE.OF
BLANCHE P .'A,CKISON a/k/a
BLANCHE PHILLips ACKISON
:'..Deceased
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'L~te 'or:!3.QB9.L!GfI.:.Qf..<;::I;:IAI{I,-~.~0;1:•..•..
.County of :.':.Wl)$}rn.J~'{ON .
.Commonweaith Qf ~~n~sylvania.~,~~..~i;'.~,
REPORT AND APPRAISAL
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RESIDENT DECEDE~T "...BTS AND DEDUCTIONS CLAIMED
NOTE'List first five items in the spaces so provided,ohserve notations thereon,and instructions
.Funeral expenses paidHaroldL.Schrock
.-----D=E.=B-=.T-o.::..R=-C::..:L=A~I:.::M=-----_r--------=N.:;:A:.:..T=-U.:::-=.:R=E,__O=-F=--=S:.::A.::..:M::=.E=---,_--=A~M=O..=.U_=.N:....:T;.____1nTHIS COLUMNiKEGISTERONLY
$1,569 00 $
John E.Costello
Family exemption (will not be allowed:unless
decedent died residing with a spouse or children.)
Administration Expenses *
Counsel fees *
63.00
477 00
Austin Clark Shipe Fiduciary commission *477.00
,
OTHER 'bEBTS AND'CLAIMS 2,364.00
(*)See Note below
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001
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300
150
40
179
1,170
450
30
45
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Medical care,last illness
Grave Marker-
Medical care,last illness
Medical c~re,last illness
Ho~pita1 care,last illn~ss
Nuising care,last illness
Ambulance Service
Ambulance Service
•.-';~.,-,,t.~i·:~
Dr.Fred Brady
Simon White Sons
Dr.Ciccarelli
Jane P.Blythe,M.D.
~·1ercy Hospital
Charlene Ames
Harold R.Toner
National .Ambulance Service
Total 4,950 00
111.J r "I J 11 I,
ion or debt is greater
(Street Number)
(Executor-Administrator)
421-Washington Avenue
C;:~.9;r:).~~.q~.,..p.~~1!.~Y.~Y~n~.~" .
(City or Town and State)
I ,December -67.........................day of ,19 .
Note:The estate agrees to advise the Register of Wills if the-amount actually paid in se
(n'-less than the estimated amount claimed and allowed.-~.Ac..~~~~~e-J.iA~Subscrib~d and sworn to before me this.'"k.l.~.
Havi~g been duly sworn according to law,I~Oho~rtify that the above appraisement is made in conformity with law on thisc02'./-..7"r"l',./'v -
............:.-~dayof ,2 /J.~.,.(Q4 /)
..~/r.''''''...........~..~.t(e...~rRisel.
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,th~Commonwealth hereby expressly reserves the right to appraise and assess transfer-inheri-
tance taxes at the lawful collateral rate on any such future interest.
-_REPORT OF T~E9ISTEjOF WI
I,the undersigned duly elected Register of Wills in and~~4---£...1'./County,Pennsylvania,do respectfully
report that I have allowed debts and deductions in the amounts claimed by deponen xcept as to those items where a greater-or lesser amount
:::~O~:'=::;'h:;;:~;{;t...wh;,h .,..t"0'."~:.~..~~~~c.t~~~.....
~Register of Wills
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NOTE:TO BE SUBMITTED IN TRIPLICATE
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cOMrd~WertTH OF~PE~~lS~LVANIA
DEPARTMENT OFREVE~UE
HARRISBURG \
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"Decl'i''S'jr:
,.Pennsylvania Department of Revenue
_Bureau of County Collections
26 S.4th Street
Harri'sburg,Pennsrlvania
Pursuant to Section 742,Pennsylvania Inheritance and Estate Tax Act of 1961,
we h,erewith submit the following report:,.
l~NAME OF REPORTING
FINANC IAL INSTITUTION __=..:Fl::.:R=gr~,~~:=A::n.:;O::!:N~AL~·..,.JBI:!!ANK~~t...!:CRA~R~LE~R.!.!.oO];"",,'~,,:,,,~_,_.'
ADDRESS P.O.Box 97.,Fifth Street,'Cll.."lrlero1,·,pa:'15022 "
ACCOUNT NO.OF JOINT,.;...'
TRUST OR INVESTMENT DEPOSIT 817 050 039 .Checking
NAMES ON ACCOUNT
OR INVESTMENT MRS.BLANCHE P.ACKISOO OR
MARGARET A.SBIPE
DECEASED JOINT DEPOSITOR,:=-'.'./c
TRUSTEE OR INVESTOR MaS.BLANCHE P.AcnSOl~\../"
ADDRE SS 4_2_1_'\1_7a.:..::..s_hl_·n~g~t:..::..on..:..',_A:..::..~-=en=u=e:,z,-=Ch=a::r~l~er~o::i:.l.•...,;P~a::.!.:--....:1!:.:S~O~2~2 _
DATE OF DEATH nac:em))el'1,1961
SURVIVING DEPOSITOR,:
BENEFICIARY OR INVESTOR.MARGARB'l'A.SHIPE ('./,~,--------------------""--
ADDR ESS 4_2_1_'W_a_s_h_i._ngt=--o_n_A_~_El:..::..n:..::..ue.:..;',!:..._Cha-=.:.r:;.:l:.::e:.::.r:.::.oi.::.lt~P.=a:...--=1=.50::.:2::2=-.._
RELAtlONSHiP TO DECEDENT~-DA-..;;UGllT.;:;.;';:;;,;;;..=ER;=.-_
DATE DEPOSIT OR INVESTMENT
WAS ESTABLISHED April 5,1962
BALANCE,INCLUDING INTEREST
DUE;,,AT DATE OF DEATH $_9--"3...;..0.;;".;;.5...;..8 -'--=--+------
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RCC-SI (2-114)
!MONWEALTH OF PENNSYLVANIA e
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
INHERITANce,TAX DIVISION
NOTICE OF FILING OF APPRAISEMENT
AlliTIN CLARK SHIPE
(Executor ~)'
IN YOUR RIP~Y P~IA'I
RI'IR TO 31-7t./-'1
In Re:Estate 0 f ...::B=LA=:;.:.:..:N.=.C:.:.H...::P:...:.:.....::..:A.=.C.:.:.KI==S::..;:O:.:.N=---a~/:....:k::.!../...:a=---
_______W_a_sh_i_ng.=..t_on County -File No.1(72-0 ]
Dear Mr.Shipe:
You are hereby notified that the original
'appraisement in the estate of Blanche P.Ackison a!k!a
has been filed in the office of the Register of Will~qf Washington
County on _.:~.:W:O:?lo/~,19M.Said appraisement reflects·the
following valuations:
Real Estate _
Personal Property 9~.~5~44~.~O~O~_
Jt.Held ~5Lf.,.b2""'"5,..L1.....9;t.J;7--_
Total J..u/~1'H7:..;947.-....+94-7---
As to such tax that is paid within three months.from date of
death,a five (5%)percent discount is allowable.As to any tax that
remains unpaid after one year from date of death,interest at the rate
of six (6%)percent per annum is charged.
.
Any.party in interest who is aggrieved by an appraisement may
appeal therefrom as provided by law.
Signed ~4 Q ~Y}('
Title W.R.CHANEY,CHIEF APPRAISER
DAr E OF DEATH:December 7,1967
Note:This is not a bill.
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Will '.~N
Administration \o.
I~THE
Year ...
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~IATTER OF THE APPRAISEMENT
OF THE
EST.-\.TE OF
J:3~.N.G.~...fl·.A<::.Iq:~qN.a/i{1~..
Deceased
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:"1,Late of CHARLfflOJ :.
:County of WASHINQ'rON ...
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Commonwealth of Pennsylvania
REPORT AND APPRAISAL
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SUMMARYRESIDENTDECEDENT
:..:.AC~ON,BLANCHE ~7.a/k/a ACKISON,ii..ANCHE PHILLIPS
RCC-39 (6-67).•FILE #Y'T91-63 •
COMMONWEALtH'''O'F'1''CNNSYLVANIA ID:ecember 7 1967 .~
TRANSFER INHERITANCE TAX '.
FILE #c;</Y!-03 TtSPOTIT OF INHERITANC~TAX APPRAISER
I!the undersigned duly appointed Inheritance Tax Appraiser in and for the County of
#63 Washington ,Pennsylvania,do respect'fully report that I have appraised
the real and personal property as reported in the foregoing return at the values set forth
opposite each item in the last column to the right in Schedules "A","B","C"and "E".
Dated:{))-J/-01
12-07-67 VApPRAISER
Dated:
REPORT OF THE REGISTER OF WILLS
I,the undersigned duly elected Register of Wills in and for WashinRton ,
County,Pennsylvania,do respectfully report that I have 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",which greater or lesser amount represents
the sum allowed as a deduction.~~~~
.REGISTER OF WILLS
VALUE AS REPORTED VALUE AS APPRAISED VALUE AS REAPPRAISED
5;$$_
9.544.00.___9.544.00
INVENTORY
Real Property (Schedule A)
Personal Property (Schedule B)
Transfers (Schedule C)
J oint-Held Property (Schedule E)
TOTAL GROSS ASSETS
LESS Debts and Deductions
(SCHEDULE F)
CLE~q VALUE OF ESTATE 8.458.60._9.847.97
======:=
Valuation of life estates or
annuities ...•*------
ESTATE T.~X ASSESSMENTS s _
TOTAL TAX BALANCE
PAID
CO~WUTATION OF TAXIFORUSEOFREGISTERONLY
I.Tax on $._-f5%$
Tax $lOC1l cj>on
9,847.97:~':'
Tax on $$
Tax on $.__lPi%$
Exemptions (:::)
:=Total Estate
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(:::)As evidenced by Charitable Exemption
Certificates issued by the Secretary
of Revenue.
196.96
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TOTAL TAX
Less tax previously paid
BALANCE
Less 5%of tax .if paid within
3 months after death
BALANCE OF INHERITANCE TAX DUE
Add interest at rate of 6%from
to-------AMOUNT OF ESTATE TAX ASSESSED
Estate tax paid
.'BALANCE DUE
Add interest at rate of 6%from
to
I·
FOR USE OF REGISTER ONLY ADJUST~mNTS
NOTE:Where subsequent adjustments are made to the above computation of tax by the
Regi~ter of Wills,for proper reason,same should be noted below,with short
explanation.
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..........................WASHINGTON...............................County
RESIDENT INHERITANCE TAX APPRAISEMENT
Estate of
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.............................~LAN.C.HE....P.•....AC.KIS.QN....a/k/a..
Deceased.
Late of
..................................................9.l:y.\~P?:RQ::r...
Date of Death,D~.cemb.e.r 7.".1.967...
Appraisemel!t Docket Vol.,3.2 .
Page,/!..E..2.No 2.f.(P...7..~.~:l...
Filed in Register's Office,.6:.1 ~?.19..~,f
Amount of tax due,$..
DEPARTMENT OF REVENUE
Received,
Examined and Approved,..
Wrote abo.llt A ppra.isement,
Appeal j,.om Appraisement~;:..}.:):;:..r)-
Entered and charged,
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Form RCC-2'·I ......6"4"£..~..-?/j~..'!!/l/t(?~4
_MONWEALTH:!J,.J •OF PENNSYLVANI_DATE........,.,.
DEPARTMENT OF REVENUE r-..•
RESIDENT INHERITANCE TAX COUNTY .................W.?:.E3,.h~pgt...9.P.:.......................BUREAU OF COUNTY COLLECTIONS ~~'Jfl~NAPPRAiSEMENT!
HARRISBURG.PENNA..17·127 FILE NO•..............£.~z..=...q?!.........................
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Whereas,..................................B.lanc.he.....P......Ac.ki~9..n ...~j~j!?:...............................late of ....................................g.h~T.~~T~.~..........................................
in the County of ........................................W!?:.§.b.t.ngt.qn............................................................Commonwealth of Pennsylvania,having died on
the ....................................7....t.h.............................................day of ...............P:~.c:.~~1;>~T ...................................19..?7....,seized and possessed of an estate
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
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Therefore,I,.................:.;...t....W..~.R.~....G.h!?:.n~.y.......................................~.........................,an appraiser duly appointed according to law;
having been designated to make fair and conscionable appraisement of the said estate,and to and fix Iaassess
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 deeedent after
the expiration of any estate for l1fe 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 AppraisementDescriptionofAssetValuesMadeforInheritance
Tax Purpo.es
.•.
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-
REALTY:
NONE NONE
-IE RSONALTY:·
As per apprais~ent filed 9,544 00 ,
,
7TRANSFERS:
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"NONENONE .'7.,
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JT.HELD:
As per appraisement filed 5,253 97..
,
Total 14.797 97 ,
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DEDUCTIONS ALLOWED IN
.¥Cj SY)r (}f)
THE SUM OF $..
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STATEMENT OF DEBTS
AND DEDUCTIONS
#7
,LATE OF Borough of Charleroi I Washington County
,.'..-
OF THE CO...MONWIi....LTH
ESTATE OF _
OFFICE OF THE
REGISTER OF WILLS
Form RC C·lO
OF _W.:.:.'A=S:..:H..:.;I:::.;N:..:.=G;.:T:....:O::,:N:...:..-__CO~NTY
B.lache Ph1".'1pS ACK1S0n
DATE OF FILING APPRAISEMENT -c2--?C-tP ?DATi OF DEATH December 7th.I 1967
DATE NO.OF NAMi OF PAYEE REMARKS AMOUNT
VOUCH~""
Harold °L.Schrmck Funeral of Decedent $1,569 .00
nr H"ron Rr::l.nu IMon;(":>.1 C';:\.rp ,;:\.c:::;+;11nass 300.00
Simon White Sons Grave Marker 150.00
Dr.Ciccarelli Medical care,last illness.40~OO
.
Jane P.Blvthe.M.D.Medical care,last illness 179.00
Mercy Hospital Hospital care,last illness 1,170 .QG
Charlene Ames Nursing care,last illness 450 .00
Harold R.Toner Ambulance Service 30.00
National Ambulance Service Ambulance Service 45 .00
Register of Wills Probate and Letters 37 .00
i
Washinqton County Reports Advertisinq Letters 12 50
Valley Independent Advertisigg'Letters 10 50
Reaister of Wills Filinq Inventorv 3.00
Austin Clark Shipe Accountants Commission 477 .00
John E.Costello i'Attorney's Fees 477 .00
."~..--~(~/-~
'-....hly"'l...·LJ
:
,
TOTAL $4;950 00
,c,.;COMMONWEALTH OF PENNSYLVANIA }ss:0
~.J COUNTY oFWashington
.~I,.Austin Clark Sh1pe ,
HEREBY CERTIFY.THAT.TO THE BE.T OF
MY KNOWLEDGE AND BELIEF,THE FOREGOING IS A JtfT AN~TRU E SfATEMEJ'lT OF DEliS'FUNERAL EXPENSES AND EXPENSES OF
ADMINISTRATION SUBMITTED TO THE ESTATE OF B anc e P.Ack1son".a,k/a /1 __.•EA D,A E CTIONii FOR
INHERITANCE TAX PURPOSES.Blanche Ph111i s Atki.ion....,t;r £7 .
!.
t...
2~lth--;,...,_I:-DAY OP'
--"7"::..-.....:....~~:..:.;..----,.#-----I"_6__'
JOSE SITTE;NOTARY PUBliC
CH'KRLEROI BOROUGH:WASHINGTON NTY
MY CO~\MISSION EXPIRES JANUARY 7,1971
I
I,
JOHN E.COSTELLO
COUNSELLOR AT LAW
418 WASHINGTON AVENUE
CHARLEROI,PENNA.15022
HUDSON 3-5961
December 26,1967
~I
Register of
Court House
Washington,
ATT ENTION::,
Wills
Pennsylvania
Inheritance ~ax Division
Inre:EState of Blanche P.Ackison
Dear Sir:
Enclosed you will please find an original
and two copies of the Inventory Form and Two HCRI
Forms in the above captioned estate.I also enclose
herewith an original and one copy of a statement of
Debts and Deductions.'As you will note our estimate
of the value of the personal property.is $9544.00.
In addition there was jointl~hel~propeity between
the decedent,and her daughte'r with the tot~:):·valu.e of
the-jointly held property being $7730.00.The statement
of Debts and Deductions should be calculated for credit.
~check in the amount of $3.00 is enclosed to cover
the costs of filing fees.'
Very truly yours,/
JEc/pc
Cos tello
Enclosures
;1
RESIDENT DECEDENTS
File No.
COMMONWEALTH OF PENNSYLVANIA
OfFICIAL RECEIPT
Transfer Inheritance and Estate Tax
~9FormRCC-4-RI-3-66
No.924807
.~~..'"
\~.,~!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!.I:.'iF
I .'{~
!
.,~....Date.January'26,19 be
Office REGISTER OF WIUS,,·,i.l....SHH.!\:;'.l(;!'I Pa.
':ll..:3i;D:GTCN County,ss:Received from .~ustin Clark 3hi;:Jc.
(ExecutorXJXliiXiY.d(:mralDS['OC~of the estate of RLANCliE A.CKlSON
who died D'Jcember 7 19 67 ,the sum of Om:ElJ'NDRED EIGHTY-S!.',;1TEK and il!lOO
being TRANSFER INHERITANCE TAX and/or ESTATE TAX due the Commonwealth as follows:
,.
____Dollars,
Appraisements Made and Filed __________~C_=o..::m~p~utationof Tax _
Real Estate
Date Valuation
Tax on $_5"/0 $----.---~-
NOTE:In a:cepting the tran.fer inheritance tax on future estates prior to the death of
the life tenant or tenant for years,as evidenced by this receipt,it is understood that the Com-monwealth shall not be precluded or prevented from herea/ter assessing addilional inherHancetaxatthedeathofthelifetenantortenantforyearswheneveritappearnthatsuchadditional
tax may be legally due and collectible lor any reason whatsoever,'
196.96
187.11
MOORE BUSINESS 'ORM~.INC.,fLlIIl"".N.Y•
$=.==--==::=--=
$
$
$
$9.85
$
0'/0
2%$:96.96
10%$.
15%$---------
Total Tax $
Tax on $_
Tax on $_
Tax on $9,::47.97
Total
Exemptions *$:-===-=
Less five per centum of tax if-paid
within 3 months after date of death
Less Tax Previously Paid (if any)
Total Estate $_
Bal::mce
~AL ~.A...•.-~....,;E ,_,l--<••~,wm.
/,",~-Ro"...,,0'
*As evidenced by Charitable Exemption Certificates issued by the Secrelary of
Revenue under Act of May 2e,1956,P.L.1757,eilective lune J.1957,as amended
by Act No.381,aPl?ro';ed :0.;1,/II,195'7,and Act No.2U7,IS61,Se:::tion 302.
Amcunt of Estate Tax Assessed under
the Acf of May 7,1927.
to _
.Add interest at the rate of .,--_.
from _
.l4J '197097
37-74-7
$,------
$4,950.00
$9,f./47.97
$14,797.97
$.~
9,541..:..('0
valuciTIon----·----
$
$,-------
Total
.$
,."r]_0"'"$...,.:.).,I
Total
19__$,_
.19_!::$===--===:
<It.Held
,Total Gross Assets
Less Debts and Expenses of
Administration
Personal Property
·Date
Clear Value of Estate
Valuation of Life Estates or Annuities
Date 19__$_
19_$========Estate}ex Assessments
Date,_
®OOD~D~£[L
NOTE:To be delinred to tcrxpcry.er·by R~t.....of WiI..._.•.1·\-0<-
"•
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