HomeMy WebLinkAboutOC1968-0248 - ESTATE OF BORTZ.;......
Testate Form
PETITION SUR AUDIT
IN THE ORPHANS'COURT OF WASHINGTON COUNTY
Estate of ~~~..~.!__J:~Q~?;~.,~/~/~_'..
MARY EVA BORTZ,
Deceased f
No _.6.3~6.8.~248 - .
Fiduciary ~~~~.~~~~~.~..!.~~.~~.~~~~.
F;l§;i..~....~.•....~~'y'~.,...~~~.g~.t.;r_~.g~.§.'l._._.._.._.._._..
~~~~~~
Decedent's death _p.~~.~~.~~.~..~.Q.L.~~.~'J.Grant of Letters ~:f.~.l?~~~~.Y.~_'___.~~.~~__ .
This is the !~~.~~~!:l.~~~.~~.~__account filed in this estate
If there have been former accounts filed in this estate,list file number or number and term.___::'_":'::':'_ .
Election to take
Under or Against will.(cross out one)
Date Election Place of;
Filed __.Record _;.
Name of surviving spouse ~.":":~..__ _.'..:;_ .
List issuet where material:
Did decedent marry after execution of will?(indicate~No_Any children born after execution of will?(indicate)
~o.If answer yest name them _ __~.
._.----.--.-------------_.---_..-------_.------.--.---_.-----.-_.--_.-_._.._.-_.----.-------.----------------_.-_.----------------_._.--_.------.-------_.----~_..-_------.---..
Leg.atees Relationship Interest Fiduciary,if deceased or not sui juris
Mary Edith Behrens
Elsie E.Keys
J.Lorraine·Thomas
daughter
daughter
daughter
1/3 entire estate
1/3 entire estate
1/3 entire estate
Listt if exceptions to above:
None
If partial intestacYt give facts:
None
Adeemed:Revoked:Lapsed:Abated:Give Cause:
.
Notice to interested parties.Have all parties,having either vested or contingent interests and-all crediors entitled
to notice (Court Rule No.9 paragraph C:Section 6:Subdivision c)received written notice of the filing of the account
and of call of audit?Yes.x:HlJ§x
If t··..NoneanyexcepIongivecause _ .
File copy of Notice
and date of mailing :M~.:r.~b...1 19.69 :.
Is estate subject to the filing of a Fede.ral Estate Tax Return?:l'.E;l§.
Actual payment made on Pennsylvania Transfer Inheritance Tax.Amount $...~,.500.•.QO...,......March..27.,....1968
On Account
If the Will makes any portion of estate subject to a life-estate,give name and birth date of life tenant .
Give Names and addresses of all unpaid creditors who are legally entitled to notice,together with the amounts
of such claims;state whether they are admitted to be correct;and whether the claim is denied.
None
Give reference to such parts of the will as require interpretation by the Court;a reference to all questions re-
quiring adjudication,and a statement of any other facts deemed necessary for the preparation of the adjudication:
None
Balance for distribution per account,
Itemize any additional debits not shown by account:
Total additional debits (Add)
Itemize any additional credits not shown by account:
Total additional credits (Subtract)
Balance for distribution
$2.9..).~4.~.#.~.Q .
$N~.~~.
$~~~~.
$29,543.90--...-...._.._-----....._-_......_....__...._..-
If balance for distribution is not in cash,list each item held in kind,giving appraised Value (or distribution Value);
'-.
If Family Exemption claimed by Petition,give place of Record:~:":".':':.
If Family Exemption is claimed at audit,give name,relationship and basis for Claim:::::':':::.
List any advancementpr distribution on account that has been made,and nature and amount of same:None
Suggested distribution of balance shown,both as to principal and income,attaching signed and itemized elections
to take in kind if balance is not in cosh:residuary shares being stated in proportions:
Mary Edith Behrens
Elsie E.Keys
J.Lorraine Thomas
daughter
daughter
daughter
1/3 entire estate
1/3 entire estate
1/3 entire estate
I
COUNTY OF WASHINGTON,55:
COMMONWEALTH OF PENNSYLVANIA.
The above named Fiduciary or representative thereof,
being duly ~~~~.~doth depose and say
that the facts set forth in the foregoing petition are true
to the best of th~1r.knowledge and belief.
S.wor.n to and subscribed before
~e thiS ~~.t~:day of M.~;t;'.~~0 ..~.~..
Signature of _Off,cer ~..~..~~
Title of OffjCer.~..:..~t?~.~:':¥~~c1~~p .Washington;'Washington 0.,a.
Office expires ,:{\P.r.;i.J ~.,J~.?~.!'"
And your petitioner will ever pray,etc.
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No.___§_~.~§.~:':'_~1:.~_..._
Estate of__.._~~¥....~.._...~Q~~_~J_...~I.~l~._..
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MARY EVA BORTZ,....._-_ ___------_.
Deceased
",.'-
Fiduciary J.LORRAINE THOMAS AND........-_-__-_-..
",.
ELSIE E.KEYS,Executrices.
PETITION SUR AUDIT
FROM WHERE DECEDENT LEFT A WILL
i'
...
Counsel of Fiduciary will submit herewith the
following,~,conformity with Court Rules
adopted effective December 3,1951,being
rule No.9:pa rag raph b-c;and divisions
thereof:shown on pages 23-24.
1.Written praedpes of all Counsel in the
case.
2.Copy of order appointing Guardian ad
litem,if pertinent.
3.Copy of Order appointing Trustee ad
litem,if pertinent..
4.Proof of service of above.
5.Letters Testamentary or Administration
C.T.A.or an attest copy of Will.
6.Copy of inventory and appraisement.
7.Proof of advertisement of grant of letters
if not filed with account.
8.Certificate of liens in case any of the
funds for distribution are from judicial
sale of real estate.
9.Signed and itemized elections if any
distribution in kind.
10.Copy of Federal Estate Tax return if es-
tate is subject thereto.
S1111A .:10 l:J31Sm3MONI~'tfL-J 113SS0ti
at!:1 Wd 1e:~dV 6961
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lin tIlt,(@rpl1nnn''(!tour!of llmnn11ington QIuuutl1
In the matter of the Audit of Account in
Estate of"'MARY E.BORTZ,a/k/a
MARY EVA BORTZ,Deceased,
TO THE AUDITING JUDGE:
No.,_-=6:....::3:.-~68-248
,J .Lorraine Thomas and Elsie E.Keys,Enter my appearance for _
Executrices of the above-captioned Estate.
N.B.-Counsel shall,by separate paper,present a concise statement of each
claim,with supporting calculation of any interest claimed.Objections
to an account as filed,shall be concisely stated in a separate paper.
Council suggesting proper distribution shall file a separate concise state-
ment in that regard.
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No.63-f)8-248 .'1lKXXX,xXJA.;'.:'~
In're Audit of Account in Estate of
MARY E.BORTZ,a/k/a MARY EVA,.
BORTZ,Deceased.
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Stuart E~Murphy,for J.Lorrairi,.
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53~
AUDIT
Jrarripr fur ~ppraraurr
FOR
Thomas and Elsie E.Keys,
Executrices.
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Q!nmmnUUtta1t4 nf ,tUUBYIUaUia,}!i!i.D1hUi~in!ltnl1 Qtnunty.
KNOW ALL MEN BY THESE PRESENTS:Whereas,at Washington,III the County aforesaid
on the 6th.day of February
Rus sell Marino
A.D.19 68 ,before me,
,Register for the Probate of Wills and Granting
Letters of Administration in and for the County of Washington,in the Commonwealth of Pennsylvania,
the last Will and Testament of
Mary Eva Bortz,.A/K/A Mary E.Bortz
late of City of Washington in the County aforesaid,deceased,
(a true copy whereof is to these presents annexed),was duly admitted to probate;and
J.Lorraine Thomas and Elsie E.Keys
rices
the Executm in said Will and Testament named,having appeared before me and taken and subscribed
the oath of office prescribed by law;
NOW,THEREFORE,I,Russell Marino
grant these LETTERS TESTAMENTARY,unto the said
J.Lorraine Thomas and Elsie E.Keys
,Register as aforesaid,do
committing unto Them the administration of all and singular the goods and
chattels,rights and credits,which were of said deceased,and requiring Them
to exhibit a true and perfect inventory thereof into the Register's Office,at Washington,within ninety
days from the date hereof,and to render a just and true account of said administration at the expiration
of six months from the date hereof,and to regard and comply with the provisions of the laws of this
Commonwealth relating to inheritance taxes.
IN TESTIMONY WHTEREOF,I have hereunto set my hand and the seal
of said Office at Washington,this Sixth
day of February III the year of our Lord one thousand
nine hundred and Sixty Eight
~\
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..............................................................................................................................- .
Register
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63-68-248
Affibauit OOf 1fxrrutnr (@r A~mini!itratnr
~tatr of Jrnnagluania,~ss:
C!tounty of DlIasl1ington \
Personally before me,the undersigned authority,a ~?~.~!..¥.p..~.~~.~.~.in and for said
County and State,appeared....J..~.....~.Q!".?::~:!:.~~....X~Q.~~~'1'~~.g ....~.!§J~.....~.~K~.Y.§who,being duly
sworn according'to law,deposes and says that they J§the executo1Sor~"Kl:XK of the estate of
P4~;r..Y.....~.I!..•J~~Q;r..~~.J.....~/~I..~....M~!".y.....~.y.~....~Q.!:~~..deceased,that the foregoing schedules constitute a
complete inventory and appraisement of the real and personal estate of...M~r.Y.....~.!.....~Q.:r.t~.l.~/~L.~.....~~ary Eva
deceased,except real estate outside the Commonwealth of Pennsylvania;that the figures opposite each item Bortz,
of real and personal estate in the foregoing schedules are determined and stated by the undersigned to
be the fair value of said items as of the date of the decedent's death,based upon a just appraisement of each
item made by the above named Executor Administrator.
Sworn and subscribed before me this ~.~~.~..l "Q"d~.~L
;;s;§~~~t[~~~..i~~~{tf:~:stit'f.::~~..~;~..:.,.,...i·"-l.~i~~..t12.-ra/·t·~;..·....·....
1.An inventory must be filed within three months after appointment of personal representative.
2.A supplemental inventory must be filed within thirty days of discovery of additional assets.
3.1 Original and 2 Copies and 2 RCRI-34,Under $10,000;1 Original and 2 Copies and 2 RCRI-33,
Over $10,000,including Copy of Will;1 Original and 3 Copies and 2 RCRI-33,Over $50,000,in-
cluding Copy of Will and copy of Federal Estate Tax Return..
REFERENCE FOR ADDITIONAL COPY
Act of 1947 P.L.513 Sec.5.2,72 P.S.4844.2
lIttuttttnry aUI)l\pprai.apmtttt of the goods and chattels,rights and credits which
Mary E.Bortz,a/k/a Cit f W h't .
were of Mal'-y Ev:a,B&P:t;.z,late of Y.:Q ~.~:!:.IJ:g Q~.
Washington County,Pa.,taken and made in conformity with the above affidavit.
REALTY:
DOLLARS CENTS
Lot No.25 in the Wilson Development Plan of Lots ,situ-
ate partly in the Sixth Ward of the City of Washington,
Pennsylvania,and partly in South Strabane Township,
Washington County,Pennsylvania,said lot fronts 72.8
feet on the North side of Leonard Avenue in the City of
Washington.Upon said lot there is erected a 7-room
Brick dwelling house and 2 car garage.For complete de-
scription see Deed Book 547,page"399,in the Recorder
of Deeds Office,Washingto~County,Pennsylvania.23,000 00
TOTAL REALTY:23,000 00
PERSONALTY:
Pittsburgh National Bank SAVINGS ACCOUNT No.182234 6,538 25
Pittsburgh National Bank CHECKING ACCOUNT No.
83-4-79-1479 778 11
TOTAL PERSONALTY:7,316 36
TOTAL REALTY:23,000 00
TOTAL ESTATE:30,316 36
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STATE OF PENNSYLVANIA,
WASHINGTON COUNTY,
The within named Accountant being duly sworn according to law,depose and say that the above account
as stated is true arid correct as ~~~verily believe,
Sworn and subscribed before me this ~.~~~.
.January 69dayaf~19 :.was~~~~~ft~~:·~~···,··
My CommiSsion"Exp,ires:·April.1,1972.
Washington County,ss:I do certify that I have given leg'al notice to all persons
concerned of the filing of the within account in the manner
prescribed by Statute and Rule of Court,as evidenced by proofs
th of Hied ta Na ..1dg..lP.,{Z .
Witness my hand and official 'seal thi~,
daYOL.~~19~1 .
';:'•••&••••••:•••••~~•••••••••••••••··/.~t~~egister of Wills
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"a+DlS S!4l U!uO!lnq!JlS!P JadoJd
au!wJa+ap 0l palSanbaJ All nH::>adsaJ S!lJnO)a4.l
The First and Final Account of J.LORRAINE THOMAS and
ELSIE E.KEYS,Executrices of the Estate of Mary E.Bortz,a/k/a
Mary Eva Bortz,deceased,late resident of the City of Washington,
Washington County,Pennsylvania.
PER INVENTORY AND APPRAISEMENT:
Additional Assets:
Sale of Real Estate
$30,316.36
Sold for:$28,000.00
Appro at:$23,000.00
Gain $5,000.00
Pittsburgh National Bank
4/1/68 -Interest on Savings Account $93.26
Pittsburgh National Bank
10/1/68 -Interest on Savings Account$155.50
Wash.-E.Wash.Joint Authority -Ref.$1.11
TOTAL ASSln"S
TOTAL AMOUNT OF CREDITS CLAIMED
BALANCE
$5,249.87
$35,566.23
$6,022.33
$29,543.90
--'
'.
The Accountants claim credits out of said Estate as
follows:
Piatt Funeral Home Funeral expense
Fred Thomas Labor re Yard work
Malcolm L.Morgan,Co.Treas.County Tax (1968)
Joseph Szopo Final pay't.-Income Tax
Ralph Piatt Three Death Certificates
I2l.50i
12.50
12.50
11.00
f3000
115.00,
16.00,
1,500.00
1,965.00
BALANCE
$65.00
15.00
25.00
1,432.05
87.92
11.46
9.501
47.25
6.00;
6.62
10.00
3.00
8.00
1.20
66.84
6.08
I118.79
l50~00.I400.12
tttttt
Filing Account
Inheritance Tax
Affidavits &Acknowledgment
Filing Inventory
Transfer Tax
Attorney's Commission
Letters Testa.&3 S.Cert.
Advertising Letters
1968 City and School Tax
Professional Services
"
Ambulance service,etc.
Medical care
REMARK
Russell Marino
S.E.Murphy,Esq.
General Motors Corp.
Russell Marino
Washington Co.Reports
Notary·Public
Observer Publishing Co.
Richard E.Hershey,M.D.
Harry R.Cook,City Treas.
S.E.Murphy,Esquire
Russell Harino
West Penn Power Co.Electric Bill
Wash.-E.Wash.Joint Auth.Sewer Bill
West Penn Power Co.Electric Bill
Washington Hospital Bill
Columbia Gas Co.Gas Bill
Citizens Water Co.Water Bill
Ambulance &Chair Service
Columbia Gas Gas Bill
NAME
D.M.Dunbar,M.D.
John C.Shaver,M.D.
Ashmore's Flower Shop Flower Bill
Postmaster,Washington,Pa.Stamps
TOTAL $6,022.33I
,"
.1
Washington Colty Reports
tJ3C~~Ili:XRma
WasbingtOD,Pennsylvania
(PUBLISHED ElY WASHINGTON COUNTY BAR ASSOCIATION)
PROOF OF PUBLICATION
In compliance with the Newspaper Advertising Act of May 16,1929,P.L.
1784 Sec.3,paragraphs (3)and (25).
COUNTY OF WASHINGTON )
STATF.OF PENNSYLVANIA (SS.
Personally appeared before me,a Notary Public in and for said County and
Commonwealth,CHARLES C.KELLER,who,being duly sworn,deposes and
says:that he is the Editor of the WASHINGTON COUNTY REPORTS,the
official legal periodical for said Washington County,publiShed weekly having its
place of business at Washington,Washington County,Pennsylvania,and is act-
ing as its agent in this behalf;that the said WASHINGTON COVNTY
REPORTS was established on March 31,1920,and was designated as the official
legal publication for Washington County,Pennsylvania,by orde,r of the several
courts o£said County,dated November 11,1920;that the printed notice or adver-
tisement attached hereto is a copy of a notice or advertisement,exactly as printed
or published,which appeared in the said legal periodical in its regular issues on the
following dates:
.......Feb.rua.r.y.....1S..,....2.2.,....29..,....19.6.8.......
that the affiant or the corporation in behalf of which he is acting is not interested
in the subject matter of said notice or advertising and that all of the allegations of
this affidavit as t,oOA%'e,Plac,e and charic5Cl',of t,he p7,rtioo are true./~C//,/)0,';JjJ ~.(/7 fl·I ,~.//)~//:~v(...:,L(:?.c:::._____."-J Editor
Sworn to and subscribed before me this ~...::;::--
h '-----29t .February 8::::::~==:;.e;;;··;;;L
Not ry Public
KATHERltJE C.YARD,Notar~blic
Washington,Washington Co.,Pa.
r.ly Cummi;,ion Expires
;lo~emiJl:;'I.i£69
EstANotlcesTllIe~isterc4 Wills h~s granted letters,
testamentary or of administration,in the
following estates.Notice is hereby given
to all persons indebted thereto to make
payment without delay and to those hav-
ing claims or demands to present t'hem
for settlement to the Executors or Admin-
istrators or their Attorneys.
• • • • •G •••••••••••
B~~~~Z~:t~~EVA.a/k/a MARY E.
L "to':1tec~~~n~}?~~:~hington.Washing-f;~~~~d'C':'S:J.Lorraine Thomas,415
15301;Elsi~nMr Washmgton,Penna.
Road.McMurray.~~,f:a 124 Old Oak
Attorney'Stuart EM'hBeauStreetWash'urt
p Y.33 West I15301•lng on.Penna.'~----,--_J
.1:------------------'W Obse!r -Reporter
WASHINGTON,PENNSYLVANIA
PROOF OF PUBLICATION
In compliance with the News,paper Advertising Act of 16 May,1929,
P.L.1784,as amended.
Commonwealth of Pennsylvania,County of Washington,SS:....•.......
Personally appeared before IDle,a Notary Public in and for said County
and State,Ric.ba.r.d S..•....c..o.wan ,who being duly sworn
according to law,deposes and says that he is th~~~.~..~.Y..!....~...~~~.~..~.•
of the Obsie-rver Publishing Company,a I'tenns,ylvania corporation,and its
agent in this behalf;that the said Company is,the owner and publisher of
the Observer·Reporter,successor to The Washington Observer,established
Se.pte'lllber 18,1871,and The Washington Reporter,established AuguSit 15,
1808,a daily newspaper of general circulation,printed and published and
having its place of busines's at Washington,Washington County,Pennsyl-
vania,where it or its predecessors have been established and.published
continuous'ly for more than six months,prior to the publication of the notice
hereto attached;th3lt the printed notice or advertisement hereto attached
is a 'copy of an official advertisement,official notice,legal notice or legal
advertisement,exactly a,s printed or published in the Obs1erver-Reporter in
its regular editions on the following date or dates;.
...........__J:lJ;~Q.~~.'-'.r.y t:?..,~.9.~p..g ~6..,l9.(t~L .
that neither tb!e affiant nor the Observer Publishing Company is interested
in the subject matter of said notice or advertising and that all of the allega-
tions'of this affidavit as to the time,place and character of publication
are true.~II c:!........_ _~·~-:~A_-~:~?-:uJJT~
..l!:~=:;C"_....~~Rr'-_.,;:-;t I\..:trICEEwTATE0;'.Iary L:Vil Bart:.all-!a
Mary E.Bortz,"''''',~aoed late'of Cit"of WashIngton "
1A!ttf'rS T~st~"'~"'.r:r UMn thaboveestatehavingbeengrantedt~
the.undersl/ined,all persons havin".
claIms agamst the estate are ro"
quested to.make known the same t~the underSIgned or his attorney and
all persons indQbted to the decedent
are requested to make payment totheundersignedwithoutdelay
3.Lorraine Thomas'
415 Leonard Avenue
Washington.Pa.15301ElSIeE.Keys
124 Old Oak Road
.McMurray PaSlUartE.Murphy.At'torn~v33W..~t Beau Street •
Washington.Pa.15301
_____.•"_B_3"_._M_o..:.".;.•..;,3t;::.
Sworn to and
'N.28752
SUbSC~before me thiS..2~..."of.P._~b.r.Ua.r.y 1968.#/~iZ~/~~.~.1':."i~97ri..pi;_1l"
, "'1",'tl~rT/\,"nl"·~'•.')0••.)J..1,·.1''J ~...IV"
In t4t Qtnurt nf OInmmnn 'ltuS nf lfu,611ingtnn OInunty.
Jltnnsylunniu.®rp4ttns'OInurt Biniswn
ESTATE OF
Mary E.Bortz,a/k/a
Mary Eva Bortz,
Deceased.
No.63 -68-248
In the matter of the First and Final
Account of J.Lorraine Tbomas and
Elsie E.Keys l Executors
ADJUDICATION AND DECREE
And now April _</,19.-illL,this matter came on for hearing,
audit and distribution at this session and testimony taken;and thereupon,upon due consideration
thwaof5the belance for distribution in the hands of the Accountant is determined to be
$G'v,4::5.\:)and the account is accordingly confirmed;and it is ordered,
adjudged and decreed that the said balance be paid out by the Accountant in accordance with the
sched~le of distribution hereto attached and made a part hereof,unless exceptions hereto be filed
sec.reg.or an appeal be taken herefrom sec.leg.
SCHEDULE OF DISTRIBUTION
Balance per account _
Balance _
Deduct Clerk's Costs &Receipts~_
Attomey ~S~tul.:l.!a.!<..rlo.Jt.....E...._l\J.lI.([.u.J.u.lr_+p.L.Lb.l.cl~T'------------.I
Internal Revenue Service,Federal Estate Tax per 706
filed,credit to be taken by the accountants for funds
advanced prior to distribution by the Court,
$29 543 00>
$29,543.90
::.<1•.113..00 -()J ..:<<;,HI.)
43 .50 ~t.4.4.L/U..-1Jt.o.JU.-(;.«}.~
_$29,500.40 .
5042.30
Russell Marino,Agent,transfer inheritance tax,
Interest from 3 -30-69 to 4-30-69,
Mary Edith Behrens,daughter,1/3 residue,
Elsie E.Keys,daughter,1/3 residue,
J.Lorraine Thomas,daughter,1/3 residue,
$24,458.10
$237.22
1.19 238.41
$24,219.69
8073.23
8073.23
,
18073.23
No balance
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63-68-248
'..
IN THE ORPHANS'COURT OF WASHINGTON COUNTY,PENNA.
IN RE:)
)No.
)
ESTATE of MARY E.BORTZ,)
a/k/a MARY EVA BORTZ,
deceased.
R E C E::I P T
AND,NOW THIS d»-..d DAY OF lA.vHl1.<
I,the undersigned,.Mary Ed!th .reDS
1969
hereby acknowledge to have rec€l.ived $8,073.23
.Q ---_:.-.._------
From Elsie E.Keys Executor~of the--------~----
above-captioned estate,being~he amount awarded to me in the
Adjudication and Decree filed at the above number and term...
../..~&I.d~-A3..L.",..>SEAL)
"t ~Ma Edith Behrens.~~
\
'V'd "0:)NOltJN1HSV/A
SlllM :10 e:HSI~3~
O'!'\lr1W 1~1·1SSn\JI'i!r.~n ._0
IS 2 Wd It Hd~OL
'03'liJ
63-68-248No.
IN THE ORPHANS'COURT OF WASHINGTON,COUNTY,PENNA.
IN RE:)
)
ESTATE of M.A:RY E.BORTZ,)
a/k/a MARY EVA BORTZ,
deceased.
R E C E I P T
AND,NOW,THIS c:!;DAY OF.~,19 69 ,
I,the undersigned,J.Lorraine Thom
$8,073.23h~reby acknowledge to have received
----~--------
from Elsie E.Keys
Estate,being the amount awarded to me in the Adjudication and
Decree filed at the above number and term.
Lorraine Thomas
SEAL)
EueutorS
Executrice
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
COUNTY OF
~~-\\,I'
Fo~RCt-33 ~ei '
IN THE MATTER OF THE.ESTATE OF
,"
IMPORTANT:This return must be completed in detail and filed in duplicate,
Register of Wills of the County where decedent resided;Return is e within
date of death,unless an e~tension is granted by the Secretary of Revenue.
__the_In~f.!ritance __an!i .E.!ilt~te .Xax:;\ct of 19§L)
AFFIDAVIT OF_.~Mt.!..~·!·..·..·~·~T~t;"f~~~~(~"d~~f ..·..~Y.~......~~?;~·t.>*lml{iiaRXIX
City of Washington,Washington ~Late of ,...........................county
State of :I?~~.~~~~y.l:l:~.~~:~Js:'}-1
County of W;;lSh=L.J::lKt;;QJ::l ;~"'~::::6
J.Lorraine Thomas and Elsie E.Keys
••••...-..••••••,.••...••••.•••••.....•!'\~""!',,.-•...•.............,..•- ,,-.•••..•....•-:
RESIDENT DECEDENT
or the estate of the above-na~ed decedent being duly sworn,depose and say
Decedent'died Dec.~.IIl~~.~~'?.~.~19 ..~'!..J testate 'leaving a last will,copy of which i.heret~attached.}
(Month)(HaY)"(Year)Lintestate
Name and address of attorney or}
other authorized rep.resentative to
whom all correspondence should be.
mailed.
Stuart E.Murphy,Esquire
.33 West Bea,iUStreet
Washington ,Pennsylvaniau
•·15301····
That as such ........~.fi!.Q.y.:t.r..;i..c..~.§!...d('lponent is familiar with the affairs of said estate and the property con-
~MX·XrK>XiK«l1fXX
stituting the assets thereof and their fair market value.
That at the time of death there was no safe deposit box registered in decedent's individual name.or jointly
with.Or as agent or deputy of another,Qr inc;lecedent'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
No
E
That the contents of sald safe deposit box or boxes are itemized under Schedules of this
return,with the exception of the follOWing,for the reasons hereinafter set forth:
That Schedule A attached h,ereto and made p/l-rt hereof sets forth full v and in"detail all the
real property in the CommonweaIth 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 dat~of death of decedent.
That Schedule B attached hereto and made part hereof sets forth fully and in detail all personal
property wheresover situated own~d by the decedent at the time of death;all moneys left by the decedent
at the time of death,whether in decedent's immediate possession,standing to decedent's credit in banks
of deposit,savings banks,trust companies,or other institutions,Whether indiVidually,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 o~in-
debtedness of the United States to the decedent;all obligations,whether by statute o~-agreement they
are designated as tax free,of the Uni ted States,or any state,or political subdivision thereof,or of
any forei~country,which are owned at the time of death;all wearing apparel,jeWelr~silverware,pic-o .-f
tures,books,works of art,household f4~niture,horses,carriages,automobiles,boats,and any and all
other personal chattels of whatsoever kind or nature,left bydecedent,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 item;all moneys payable
to the estate from life insurance polici'es carried by decedent;all annuity and endowment contracts the
proceeds of which were payabl~upon the ~eath of the decedent;and all the corporate stocks and dividends
due thereon and unpaid as of the date of death,bonds and accrued interest thereon to the date of dece-
dent's death and other investment securities owned by the decedent at the time of death,with the market
value thereof at such time.
!
\
• I..
In,the c'ase of securi ties of close or family corporations,the values reported.are as far as
possible substanti"ated'by financial statements of the corporations,showing the assets and liabilities
thereof as of the'date of death.The schedule also sets forth the interest of decedent at the time of
death in any co-partnership or business,and in support of the value of such interest there is annexed to
said schedule~financial statements showing the assets and liabilities of said co-partnership or business.
A copy of the co-partnership agreement,(if oral,a statement setting f~rth the nature of the agreement)
together with a statement setting forth the character of the business,its location,and such other facts
pertaining to the business as may be pertinent to a fair and just appraisal of the decedent's interest. r -r "."••~~•1thereinmustbesUbmit~e~•.It ~hould also set for~h il\l ·itemized'form,together,with llhe fair market'value
thereof,any other propE:rtyJow~ed'·6rbe!qiieathed by·\he decedent at the time of death.
,./'·~r ,....:rr t J :.'\.'~)
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,rell.l or personal,within,:tw<i,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 '~~ch'1'"pro~rty,to whom,'transferred,the
relationship of the transferees to the decedent,the pr~portio~ate sh~r~re~eived by each transferee and
all other facts of a p~rtinent nature regarding said 't~ansfers.In 'the 'case 'of transfers intended to
take effect in possession or enjoyment at or after death,there is also attached to the ~chedul~:~co~y
of the deed,trust agreement or other instrument cre.ating the,rtrust.Ther'~is :al,s~>lset forth in 'said
schedule a list of all property,real and personal,with its value,which passes at decedent's death by
virtue of the exercise by decedent,either individually,or jointly with another,or any power of'appoint-
ment vested in decedent,either individually or jOintly,'by the will,dee~,or other instrument of another,
with a copy of the instrument creating such p'owerattached to the·'schedule.
That Schedule D attached hereto and made part hereof sets fo.r~h the ':lames and addresses of all
persons beneficially interested in this estate at the time of deceden,t'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 Schedule E attached hereto ,and made a part hereof sets forth all property,real and per-
sonal,owned by the decedent jointly with another or others,including intangible,standing in the name
of the decedent and others,plus the date and place of record of instruments effecting the vestiture of
real estate and the date of acquisition of personalty,plus the name,address and relationship,if any,
of co-owners to the decedent.
"
That Schedule F attached hereto and made a part hereof sets forth fully and in detail all debts
and deductions claimed for and on behalf of this decedent's estate,including funeral expenses paid;
family exemption,where applicable;costs of administration of this estate;counsel fees and fudiciary's
commissions paid or to be paid;cost expended for'burial trusts,tombstones or gravemarkers,and reli-
gious services,in consequence of th~death of the decedent;debts and claims owing and unpaid at time of
death;taxes accru~d charge,able for period prior to decedent's death (except,those allowed under Section
651 of the Inheritance and Estate Tax Act);together with a statement of collateral pledged for obliga-
tions,if any.It is agreed that the fiduciary will present proof of said claimed obligations upon re-
quest,that if the amount actually paid in settlement of any fee,commission or debt is less than the
estimated amount claiming and allowed,that the same will be reported to the Register of Wills,and that
the amount of tax assessed can be reassessed in accordance therewith.
That the totals of the appropriate columns in Schedules "A","B", "C","E",and "F"as directed therein"
have been carried forward and properly registered in the Summary.
Subscribed and sworn to before me this ..
26th l1QecJ).GO.._.?/;.....~O?~:19 •.•.•
~~~~::COi~~·~;~;;;.(Executor-Administrator)
(Street NumbeT)
(City or Town and State)
NOTE:Before 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 as~ets include rare and unlisted securities,
securities of close or family corporations or an interest in any co-partnership or business,that the
data ,arid 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.
RCC-34 (1-54)
COMMO"NWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE itA"
-REAL PROPERTY f·,"
Real property in Pennsylvania,with statement of mortgage encumbrances upon each pClrcel at death of dece-
dent.Where property heid as joint tenant or tenancy by entireties,report on Schedule "E".Property h~ld 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 Commo!"wealth of Pennsylvania should be
described by lot and block number,str;et and street number,together wi th
a general description of the property,with a reference to the record af the
conveyance by which the decedent took title;If a farm state number af a.
cres;also statement of n',ortgage encumbrances upon each parcel at death
of decedent.Taxes,assessments,acqued Interest on mortgages,etc.,are
to be listed on Schedul~"F"and must not be deducted from this schedule.
(1)(2)(3\I
DI;PARTMENT
ASSESSED VALUE VALUATION
FOR YEAR OF ESTIMATED CAUTIONDECEDENT'S MARKET VALUE (Do not write
DEATH In th 15 space)
t'
Insert th is total opposite "real property",Schedule"A"in the X X X X X
"As Reported"column on the last page of this return.
"""'~,.;"vv •..Vv
,2 ~000,,/fie
()a~O
c:J 7t (;0 cJ.00
RC.C-.'35
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "n"
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".Intarigible 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 anyundis tributed
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 I ITEM UNIT ESTIMATED DEPARTMENT VALUATION
'No.'List and describe fUlly VALUE MARKEr VALUE (Do not write in
this space),.
%iJ1ttsbt!rgh No.~:f.onal B."\nk 6K~~Savings Account No.182234 $6,538.25
Pittsburgh National Bank ?JTr~Checking Account No.83-4-19-1419 178.11
I
,
,
V
Insert this total opposite "Personal Property",Schedule "B"in X X 7,S).6.3Elthe"As Reported"column on the last page of this return.Q
RCC-36
CO\DlO\"'IT<:\LTH OF PFNNSYLVAN I A
T1L\i\SFER INHElUTANCE TAX
RESIDFXT DECEDENT
-,",
SCHEDULE "c"
TRA.N SFETtS '.
(1)Did decedent,within two years of death,make any transfer of any material part of his estate,without
receiving a valuable and adequate consideration therefor?(Answer yes or no)no
(2)Did decedent,within two years of death,transfer property from himself to himself and another or
others (including a spouse)in joint ownership?(Answer yes or no)_O~QIlL._
(3)If the answer to (1)or (2)above is in the affirmative state:
(a)Age of decedent at time of transfer _
(b)State of decedent's health at time of making the transfer.(Note 1).
(c)Cause of decedent's death.(Note 1).
(4)Did decedent,in his lifetime,make any transfer of property without receiving a valuable or adequate
consideration therefor which was to take effect in possession or enjoyment at or after his death?
(Answer yes or no)DO
(a)Was there any possibility that the property transferred might return to transferer or his
estate or be subject to his power of disposition?(Answer yes or no)_
(b)What was the transferee's age at time of decedent's death?_
(5)Did decedent in his lifetime make any transfer without receiving a valuable and adequate consideration
therefor under which transferor expressly or impliedly reserves for his life or any period which does
not in fact end before his death:
(a)The possession or enjoyment of or the right to income from the property transferred?
(Answer yes or no).
(b)The right to designl\.te the persons who shall possess or enjoy the property transferred or
income,therefrom?(Answer yes or no)_
(6)If the answer to (5)(b)ab~ve is,in the affirmative,state whether the right'was reserved in decedent
alone or others _--'-__.,...-__----'---'---:-_
,(7)Did'decederit in his lifetime make a transfer,the consideration ,for which was transferee's promise to
pay i'ncome,to or for the benefit of 'ca~e 'of"tr~~sferor?(Answer yes,or no)'QO,'
(8)'Did decedent,at any time,transfer property,the beneficial enjoyment of which was subject to change,
because of a reserverI power to alter,amend,or revoke,or which cOllId 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)no
NOTE 1:The answers to these questions should be supported by affidavit by the attending physicfan 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 MAlUillT VALUE
(Estimated)
DEPT.VALUATION
(Dept.Only)
[nsert this total opposite "Transfers",Schedule "C"in the
"As Reported"column on the last page of this return.
---------------------------------------------
COMMONWEALTH OF PENNSYLVANIA
THANSFEIl INHERITANCE TAX
r~SIDENT DECEDENT
SCHEDULE "E"
JOINTLY OWNED PROPERTY
IXSTRrCTIOKS:This schedule must disclose all property,real and personal,owned by the rlecedent jointly
wi th 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-~wners to
the decedent.
Description of Property,Date of Acquisition,Name I Unit
Address and Relationship of Co-Owners,and Place !Value
of Record of Instrument,where Real Estate.I
percentage Estate
Share Valuation
DEPARTMENT VALUATION
CAUTION-Do not Write
In This Space.
Value of Value of
Entire Decedent's
Property Interest
1t "
n "
"It
$S,200.'~0 ~
~a,200.I~O .G~
$8•.200.~o
~24,600.j~O~
OIl"$la,300,,~O1/2 tenable
HAnY B.'BORTZ and DIm 8.BEHERNS.a/k/a HARY EDITH BEHRENS.joint tenants'
\"litb t~o I:lfJht ofsurv1vortl.thip:,I
100 Sbs"General Uo'to..-e·Corph...StoCk.82"0 l'
0P'125-583 Issued 1129/57
100 Sba.General lWtors Corp •StoCk
6"125-586 'Issued'7/29/S?
100 Sba.Qen<i)rel I1otora Corp tI StoCk
#1135-652'IsSUGQ 10/2/63
mAaY E~,Bt>!lTZ 'nnd LOWIRE B.'TII<e1AS,elkIn J.LOBRA1NB THOMAS,joint tenants
\"11tl1 thG ritJbt of eurvlvot'sh1p:
100 8be.Genoro.1 Cotore Corp.Stooh
OP72S-144 Issued 1126/51 82.01)$8,200.~O d-I\
100 Sits.General Hotors Corp.stock
#.P12S-1~7 Issued 1/26/67
n ..
""$8.,200.~O cr:
$24;600~.OO
J'/2 taaa~lG ..$12,300.OO~
100 Sbe.Ckaneral flotoJ'c Corp.Stock
tJP725-143 Issuod 7/26/51
"
i
II.
I
I$8,200,,~0 ~
,I
I08.200 "fO ()l-.(
,I '~
~8t200.0
$2<6,600.0
""
""
I i
s2.ob
Gen~~al Uoto~seo~.Stock
0P1269580 Issued 7/29/57
O3nOl'01 11otol"O Corp.Stock
0P12S-581 10011Gd 7/29/59
100 Sbo.
100 Shoe
100 ShOe G0neral l1otors Corp.,$took
~2S.579 ISQued 1129/&1
nARY E.JiWIlTZ and ELSIE B.UYS,a/k/aBLS!B B.BEtS,joint tGnants olth tbe
riGbt of surv~'Vorship,.
.,
1/2 tax·Ie.Q12 300.00'...
•.t
Insert this total opposite "Jointly Owned Property",Schedule"E"
in the "As Reported"column on the last page of this return.
.J~rOO 'OO
/
-_._------------------------------------....
RCC-3r'(i2:63)
CO:\nlt)':,\;WEAI.TII OF l'E:,\:,\;SYYl.:\NIA
TH ..\NSFER 1:'\IIEHITA!'\l'E T.-\X
RESIDENT DleXEDE:'\T
SCHEDULE "D"
BEKEFICIARIES
.
"
."
\
h
,..
BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED(If step-children or DATE INTEREST OFStatefullna~es and addresses of all who illegitimate children DECEDENT OF BENEFICIARY
ave an interest,vested,contingent or other-are involved,set STATE YES IN ESTATE
wise,in estate)forth this fact.)OR NO BIRTH
r:1otnJ IMtttl EsabrOllOI noo \/Q oofslt'O QtilQo~o...
Mt6 fAn IAftt"l
SottOaO~o...Jno~lda
l!'l"'I~""~1'r.o!ll1l'J'a
,is ~f!t An('lot ..A---..,-.,---,.-''''.1\I"l'l A """t..D ..........I---.~.......11n,r
..'f l'...........--.................'l.J~om~lS'O Ootnto--'"~'1i1l.•--....
'"-........n...-'1 Cl".J"''I
'I --~-_....--
,
.
,
Deponent further says that all the above-named beneficiaries are living at this time except below:
NAME DATE OF DEATH RESIDENCE-/
/'
~./
\/..
\
"
,-
Transfers .....~I((<f ..
(2)
(As Determined).~%OOo.c)c)
..2/.J'/{,:l~
SUMMARY
Real Property O.~.•.()(l.f>.,..~(Sch."A")
P I P t ft '1 316 SO (Sch."B")ersona roper y v.,~:..
............................(Sch."e")
./.xl~r..~
...........~.................
Gross Taxable Estate .tl..~.~~f?s.~
(1)
(As Reported)
$.
$
$ .
$
$
$
$
$
$
$3C,/9(jO -00
$
$2?A/t..3(.,
'..'.~.:a.,",..1.;(.)..',-
f ~;,:
.'~".~....'.."~';""'"";,j\(",
.....o
.....o
.c.::ou
."C:l:.Q).'"<'JQ).t).Q)
Q
:if..,,
ciZ
\
\
/
Form RCC-4-RI-3-66
No.948611
~9 COMMONWEALTH OF PENNSYLVANIA
OFFICIAL RECEIPT
Transfer Inheritance and Estate Tax
RESIDENT DECEDENTS
File No.63-68-248
Dollars,1;01).00-,
Date,_---'}::.t.I.fa.J...Ir£~b~2(Lj7L..___19_fi8.
Office REGISTER OF WILLS,----.:.:t·1.::..:h:..=SJ:.:..::I~I::.:.NG~T~O~N~,II__------JPa.
lvASUINOTON County,ss:Received from----lL!CIf.Oi.!.Lr..r Jilla.1.l.ln.s;el-.·.......T~bu.;o~m£wa.~s...·""'&~E~,l...Q...llrlcO':-·-lKl\,Joy~gB----'-------
(Executor,~~tI]~K.~of the estate of------~WiQ\,pj,R*Y-[_--,B~OI:flR~Tn'Za-----------------
who died December 30 19-!i7,the sum of OflIt::TI:lOllQAND FlVE iW1IIDPJrn
being TRANSFER INHERITANCE TAX and/or ESTATE TAX due the Commonwealth as follows:
Appraisements Made and Filed Computation of Tax
$=======
$---------
$=======
$---------
$=======7=8=_9=5==;=
$---------
Tax on $_5%$_
Tax on $10%$_
Tax on $On ACCOUDt 6;;~$__....1...,.....5'-&.7.......8.....~95w--_
Tax on $15%$_
MOORE BUSINESS FORMS,INC.,ELMIRA,N.Y.
Register of Wills
Balance
Less five per centum of taxifpaid
within 3 months after date of death
Exemptions *$===========
Less Tax Previously Paid (if any)
Total Tax
Total Estate $_
Amount of Estate Tax Assessedunder
the Act of May 7,1927.
Total $_.,..---=l:....:!.~....:::;;S_'_'_{'..:::.O..::...O.::;.O=--_
*As evidenced by Charitable Exemption Certificates issued by the Secretary of
Revenue under Act of May 28,1956,P.L.1757,effective June I,1957,as amended
by Act No.381,approved July 11,1957,and Act No.207,196!,Section 302.
._SEAL
I
1 1/,/'..-r r 'f.,..~_.&...~
Add interest at the rate OL-f %
from _
to _
n~COHPLETR
$,-------
$,-------
$
$-------
$
$,------
$
Valuation
Valuation
$,----"'----
$,------
Total
$------
$,------
Total
Date
Date
Real Estate
Personal Property
NOTE:This T~iplicate R'!celpi 10 be ~etained by the Register of Wills and fiI6?-9Sw81sequenceforauditpurposes.
Total Gross Assets
Less Debts and Expenses of
Administration
Clear Value of Estate
Valuation of Life Estates or Annuities
Date,19__
_________19__
Estate Tax Assessments
Date,19__$,_
________19_~$============
NOTE:In accepting the transfer inheritance tax on future estates prior to the death ofthelifetenantortenantforyears,as evidenced by this receipt,it is understood that the Com-monwealth shall not be precluded or prevented from hereafter assessing additional inheritancetaxatthedeathofthelifetenantortenantforyearswheneveritappearsthatsuchadditionaltaxmaybelegallydueandcollectibleforanyreasonwhatsoever.
FORM RCC-4-RI
TRANSFER INHERITANCE and/or ESTATE TAX.
RESIDENT DECEDENTS.
RECEIPT
Docket 37 Page 93 line:__3__
Estate of VARY E.BORTZ
OffiCE OF REGISTER OF WILLS
\?AS!IIr:CTOrJ ,-------I:Pa.
Date HlUlCH 27 19~
SIGNED AND SEALED AS PROVIDED BY
SECTION 1201.ACT APRIL 9.1929.P.L.343
AS AMENDED BY ACT MAY 15.1945.P.L.528
RUSSELL !¥ARINO
Register of Wills
1201 (g).Act of April 9.1929.P.L.343.as amended.viz:·"To receive from Registers of Wills all duplicate ,re-
ceipts for taxes paid to them by executors or adminis-
trators and to charge the Registers receiving the money
with the amount receipted for.The original of each such
receipt shall be signed and sealed by the Register of
Wills and transmitted to the executor or administrator.whereupon it shall be a proper voucher in the settlementoftheestate.In no event shall the executor or adminis-trator be entitled to a credit in his account by theRegisterunlessthereceiptissosignedandsealedbytheRegisterofWills."
Fill in below name and address of person to whom
tax receipt is delivered:
I
To ATIJIV.STUART Ii.!m!lPIIY"
33 UgS7 BEAU STRImT
I
t:1ASlllr!G?ON J PEHtlSYl,VMfIA
L
15.101
-l
RESIDENT DECEDENTS
File No.63-63-248
COMMONWEALTH OF PENNSYLVANIA
OFFICIAL RECEIPT
Transfer Inheritance and Estate Tax
Form RCC-4-Rl-3-66
No.948612
Date,__lia_r_c_h_2_?__19 68
Office REGISTER OF WILLS.~__U~~..;:.SlU=~N'G_T.::;..O.:...;N:...:...-----<Pa.
_____W_1l._S_U_I_N_G_T_ON ICounty,ss:Received from ff Edtth Behrons t PayinG Oll Ind.Liab.
~rA'dm1ni~~ftheestateof ~lARY n.·nORTZ
who died December 30 19_6_7_,the sum of SEVEN HUNDRED Ot'E and .10/100 -..-•--Dollars,
being TRANSFER INHERITANCE TAX and/or ESTATE TAX due the Commonwealth as follows:
Appraisements Made and Filed Computation of Tax
NOTE:This Triplicate Receipt to be retained by the Register of Wills and filed in numericalsequenceforauditpurposes.
$=======
$---------
$--_'Z~3a.........O....iO......__
$=======
$---------
36.90$=======
Tax on $~__
Balance
5%$_
Tax on $10%$_
Tax on $12,300,QO 6$$~$__-..I?,-""3",,,S....,....,O=()__
Tax on $15%$_
Total Tax
Less Tax Previously Paid (if any)
Less five per centum of taxif paid
within 3 months after date of death
MOORE BUSINESS FORMS.INC..ELMIRA,N.Y.
Total Estate $_
Exemptions *$===========
Register of Wills
Amount of Estate Tax Assessedunder
the Act of May 7,1927.
Total $7_C_l_.l_O_.__
*As evidenced by Charitable Exemption Certificates issued by the Secretary of
Revenue under Act of May 28,1956,P.L.1757,effective June 1,1957,as amended
by Act No.381,approved July II,1957,and Act No.207,1961,Section 302.
-S E AL
,-)/1 f
Add interest at the rate ol--f ~
from _
to -'-_
37-93-3
$,-------
$-~12=.;,~3:.::;O~O..L:.O::.::!O~
$
$-------
$
$---'-------
$
Valuation
Valuation
$,------
$,------
Total
$12,300 •QO
$,------
Total
Stoclt
Date
Date
Jt.Held
Real Estate
Personal Property
Total Gross Assets
Less Debts and Expenses of
Administration
Clear Value of Estate
Valuation of Life Estates or Annuities
Date'19__
_________19__
Estate Tax Assessments
Date,19__$,_
________19__~$========
NOTE:In accepting the transler inheritance tax on future estates prior to the death 01theliIetenantortenantforyears,as evidenced by this receipt,it is understood that the Com-
monwealth shall not be precluded or prevented Irom hereafter assessing additional inheritancetaxatthedeathoftheliIetenantortenantforyearswheneveritappearsthatsuchadditionaltaxmaybelegallydueandcollectibleforanyreasonwhatsoever.
UASHINGTON,PKliHSYLVAlUA l~
FORM RCC-4-RI
TRANSFER INHERITANCE and/or ESTATE TAX.
RESIDENT DECEDENTS.
RECEIPT
37 93.3DocketPageIme__
Estate of frIARY E..BORTZ
OFFICE OF REGISTER OF WILLS
t1ASHIr:GT()r-~,Po.
t-2arch 21,66Date19__
SIGNED AND SEALED AS PROVIDED BY
SECTION 1201.ACT APRIL 9.1929.P.L.343
AS AMENDED BY ACT MAY 15.1945.P.L.528
RUSSBLL !~rut:O
Register of Wills
1201 (g).Act of April 9.1929.P.L.343.as amended.viz:-"To receive from Registers of Wills all duplicate re-ceipts for taxes paid to them by executors or adminis-trators and te>charge the Registers receiving the moneywiththeamountreceiptedfor.The original of each suchreceiptshallbesignedandsealedbytheRegisterofWillsandtransmilledtotheexecutororadministrator.whereupon it shall be a proper voucher in the seltlementoftheestate.In no event shall the executor or adminis-trator be entitled to a credit in his account by the
Register unless the receipt is so signed and sealed bytheRegisterofWills."
Fill in below name and address of person to whom
tax receipt is delivered:
I
To Attn..mUAn?B.rronPIlY
33 fiE~t BWID ~t~i
L
I
-'
•••
Dollars,....
RESIDENT DECEDENTS
-
File No.63-68-248
eft Iftd.Llab.
-10/100
COMMONWEALTH OF PENNSYLVANIAFormRCC-4-RI-3-66
Date_....&M;u.n.ur~cUJhL...£!2!.!.7-t.,__1968
No.948613 OFFICIAL RECEIPT
Transfer Inheritance and Estate Tax
WASHINGTONOfficeREGISTEROFWIIJ.S,~__"Pa.
WASnn:CTON County,ss:Received from 1.0n-a1110 n.Themas j Payiag
(~\itq~~J£~§~of the estate of UAn'Y E.DORTZ
who died December 30 19-'i1..-,the sum of Sl'WEN IUlNDImn O'ts"f:and
being TRANSFER INHERITANCE TAX and/or ESTATE TAX due the Commonwealth as follows:
Appraisements Made and Filed Computation of Tax
736.00
$=======
$---------
138.00$---------
$=======
$---------
$=====3=6=:*9:=0===
5%$
10%$
6~~$
15%$
MOORE BUSINESS FORMS,INC.,ELMIRA,N.Y.
Register of Wills
Less Tax Previously Paid (if any)
Tax on $_
Tax on $_
Less five percentum of taxif paid
within 3 months after date of death
Exemptions *$===========
Tax on $_11llo.Q2...,3o.z;O!lif.Ow...L.Ow;OiIL-_---U,p....
Tax on $_
Balance
Total Tax
Amount of Estate Tax Assessed under
the Act of May 7,1927.
Total $~7..:;:1)~I:...:•...::1:...:O=____
*As evidenced by Charitable Exemption Certificates issued by the Secretary of
Revenue under Act of May 28,1956,P.1.1757,effective June I,1957,as amended
by Act No.381,approved July 11,1957,and Act No.207,1961,Section 302.
'SEALId.!'d~:(
Total Estate $_
Add interest at the rate 01..f ~%'
from _
to _
$,-------
$
$_.....1=.2,~3=O'-"'O..L;.001<.:-._
$
$,-------
$
Valuation
$,------
$,------
Total $,_
Stock
Jt e'Held
Date Valuation
$12,300 •00
$-------
Total
Total Gross Assets
Less Debts and Expenses of
Administration
Date
Real Estate
Personal Property
NOTE:This Triplicate Receipt to be retained by the Register of Wills and liled in numerical
sequence for audit purposes.
Clear Value of Estate
Valuation of Life Estates or Annuities
Date,19__
_________19__
Estate Tax Assessments
Date 19__$,_
________19__~$========
NOTE:In accepting the transfer inheritance tax on future estates prior to the death ofthelifetenantortenantforyears,as evidenced by this receipt,it is understood that the Com-
monwealth shall not be precluded or prevented from hereafter assessing additional inheritancetaxatthedeathofthelifetenantortenantforyearswheneveritappearsthatsuchadditionaltaxmaybelegallydueandcollectibleforanyreasonwhatsoever.
FORM RCC-4-RI
TBANSFER INHERITANCE and/or ESTATE TAX.
REsIDENT DECEDENTS.
RECEIPT
Docket 37 Page ~ne3_
Estate of nARY E.I::ORTZ
OFFICE OF REGISTER OF WILLS
t=1ASHIPX;TOtl,p
---------__-.1_0.
Date,l_18--:rc--=h=-=2..:..7__6819__
SIGNED AND SEALED AS PROVIDED BY
SECTION 1201.ACT APRIL 9.1929.P.L.343
AS AMENDED BY ACT MAY IS.1945.P.L.528
nUSsnLL r,m.nIl\1)
Register of 'Wills
1201 (g).Act of April 9.1929.P.L.343.as amended.
viz:-"To receive from Registers of Wills all duplicate ,re-ceipts for taxes paid to them by executors or adminis-trators and to charge the Registers receiving the moneywiththeamoUl1treceiptedfor.The original of each suchreceiptshallbesignedandsealedbytheRegisterofWillsandtransmittedtotheexecutororadministrator.whereupon it shall be a proper voucher in the settlementoftheestate.In no event shall the executor or adminis-trator be entitled to a credit in his account by theRegisterunlessthereceiptis90signedandsealedbytheRegisterofWills."
Fill in below name and address of person to WhODl
tax receipt is deliv.ered:
I I
To ATlY.STUAR1 E.t-tuRPIiY
33 't1E~"T nEAU S1RJL:IS'it
bAStrif~GI0iiJ f£N:iSl"L..t"A~;IA 1530l
L -.J
~---~~~---
---_._----~------------------------------------------
WASHIl:GTON C-------'.:.~===~~--ounty,ss:
Form RCC-4-RI-3-66
No.948614
Office REGISTER OF WILLS.WASHINGTON
Received from Elsie B.Keys,Paying on Ind.Liab.
Pa.
V
RESIDENT DECEDENTS
63-68-248FileNo~._
COMMONWEALTH OF PENNSYLVANIA
OFFICIAL RECEIPT
Transfer Inheritance and Estate Tax
l-inrch 21 t 19~Date
10/100 ..- ---Dollars,
(~~~tI).i~t&t.~Jiw~f the estate ol-f ---\;l~fA~RO_1Y_""'g.....---:..!.nO!oLRu.m.....1ZIL..-_
who died December 30 19 61,the sum of SEVEN HUNDRED ONE and
being TRANSFER INHERITANCE TAX and/or ESTATE TAX due the Commonwealth as follows:
Appraisements Made and Filed Computation of Tax
NOTE:This Triplicate Receipt to be retained by the Register 01 Wills and filed in numericalsequenceforauditpurposes.
'138.06
Register of Wills
IIOORE BUSINESS FORMS,tNC.,ELMIRA.N.Y.
i
Tax on $_
Exemptions *$===========
5%$_
Tax on $10%$_
Tax on $12.300.00·6~2¥$__.....;7:..,:3=8:-:;•..:::.0=0__
Tax on $15%$_
Total Estate $_
Total $7_0_1_._1_0 _
*As evidenced by Charitable Exemption Certificates issued by the Secretary of
Revenue under Act of May 28,1956,P.L.1757,effective June I,1957,as amended
by Act No.381,approved fuly 11,1957,and Act No.207,1961,Section 302.
SEAL
.///.t;"31-93-3
$-------
Total Tax $
$12,300.00 Less Tax Previously Paid (if any)$
$Balance $
Less five per centum of tax ifpaid 36.90
$within 3 months after date of death $
$Amount of Estate Tax Assessed under
the Act of May 7,1927.$
$Add interest at the rate of %'
$from
to $
Valuation
Valuation
$,__'-=1=2~;3=O=O~.=OO:..,
$
$,---'-------'--
$------
Total
Date
Date
Stock
Jt.'Hold
Total
Total Gross Assets
Less Debts and Expenses of
Administration
Real Estate
Personal Property
Clear Value·of Estate
Valuation of Life Estates or Annuities
Date 19__
---19__
Estate Tax Assessments
Date'19__$_
________19__~$=================-
NOTE:In accepting the transfer 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 hereafter assessing additional inheritancetaxatthedeathofthelifetenantortenantforyearswheneveritappearsthatsuchadditionaltaxmaybelegallydueandcollectibleforanyreasonwhatsoever.
FORM RCC-4-RI
TRANSFER INHERITANCE and/or ESTATE TAX.
RESIDENT DECEDENTS.
RECEIPT
31 93DocketPage_3Line,_
Estate of t:ARY E.DOmz
OFFICE OF REGISTER OF WILLS
t:ASHIt:GTOrJ Pa.
Date r:areh 27,19 56
SIGNED AND SEALED AS PROVIDED BY
SECTION 1201.ACT APRIL 9.1929.P.L.343
AS AMENDED BY ACT MAY 15.1945.P.L.528
nUSSELL MARlt10
Register of Wills
1201 (g),Act of April 9,1929.P.L.343,as amended,viz:-"To receive from Registers of Wills all duplicate ..e.ceipls for taxes paid to them by executors or adminis-
trators and to charge the Registers'receiving the money
with the amount receipted for.The original 01 each such
receipt shall be signed and sealed by the Register of
Wills and transmitted to the executor or administrator,whereupon it shall be Cl proper voucher in the settlement01theestClte.In no event shall the executor or Cldminis.trCltor be entitled to Cl credit in his Clccount by theRegisterunlessthereceiptissosignedandsealedbytheRegisterofWills."
Fill in below name ClDd Clddress of person to whom
tClX receipt is delivered:
llr1Y.S'lUAU?II.t1trnPror
33 {IDST ulUlU ~'rlmui
UASHI}I.'U'i'ON t l?rUINSiLVAIaA
L
15301
I
-1
·"cc-;()(6 -64)
COVMONWEAIJTH tW l'FNN~\'IN AN1.\
TRAN ~FEn I Ntmltl TAN CF.T1Y
RF.SIDENT J)ECEnF.NT
BORTZ,BARY EVA
FILE ,f 63-68-248
December 30,1968
SUMMARY -~.".~
FILE #63-68-248
I.the unrlersigned
it 63 Wasbjngt.on
HEPOR'!'OF INHERITAliGF.TAX APPRAISER
rtuly appointert Inheritance Tax ~ppraiser in and for the County of
,Pennsylvania,do respectfully report that I have appraised
property as reported in the foregoing return at the values set forth
the last column to the right in Schedules "A","B","c"and "E".
D ated:05-21-68
12-30-67 ~t1£ApPRAISER
REPORT OF THE REGISTER OF WILLS
I,the undersigned duly elected Register of Wills in and for __
County,Pennsylvania,do respectfully report that I have allowed deductions in the amounts
claimed by deponent,~xcept 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.
Dated:
REGISTER OF WILLS
VALUE AS REPORTED VALUE AS APPRAISED V.:..=A=LUE=<....;I='\S"'-,RE=AP~P~RA=I'-"S=E=D
$?J"OOO.OO $27,000.00 ._$_
7~31 6.36_7,3J 6.36.._
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
67,216·36_
=====:=
36,9a),OO ._-
71 ,2J 6,]6 .__
=====.-======:-
Valuation of life estates or
annuities . . . • . • . .$_
ESTATE TAX ASSESS~mNTS $_
(*)As evidenced by Charitable Exemption
Certificates issued by the Secretary
of Revenue.
COMPUTATION OF TAX
$-----
'1:=====\----'-$--------
*------*-------
$------
$---,----
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 *_
TOTAL TAX BALANCE $_
PAID $
FOR USE OF REGISTER ONLY
Tax on $________f)%
Tax on !I:,________10'10~-·.~~oTaxon*~""u
Tax on $.1R%
Exemptions :=('::)
Total Estate __
ADJUSTMENTS
are made to the above computation of tax by the
reason,same should be noted below,with short
FOR USE OF REGISTER QNLY
NOTE:Where subsequent adjustments
Register of Wills,for proper
explanation.
"'~~,.-"
Will ~
Administration ~No.
D1 THE
Year .
~IATTER OF THE APPRAISEMENT
OF THE
ESTATE OF
HARY...EVA.BOJ:1,TZ....
Deceased
Late of .y;p.s;T.n;GTON.
County of .....W.ASHINGTON .
Commonwealth of Pennsylvania
REPORT AND APPRAISAL
Fonn RCC-ir
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
HARRISBURG.PENNA.17 127
COMMONWEALTH OF PENNSYLVANIA
.RESIDENT INHERITANCE TAX
APPRAISEMENT
DATE J1.§lY ?:J".":J".9.9..~.
COUNTY 11.q§.hin.ct.Q.n .
FILE NO•.......................63.~.6B.~2.4B .
Whereas,...............................Hg;r.Y.:...E.y.g,...BQ.:r..t.~.....................................................................late of ...........................................U,as.hj.n[.to.n................................
in the County of ........................~i.g.§J:ri.ngt.Qn .............................................................................Commonwealth of Pennsylvania,having died on
the ......................3..Q...t ..D........................................................day of ...............DSi.G.~.:mb.~.:r....................................19...6..7..,seized and possessed of an estate
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore,I,..........................1'!.•.R.......Ghcn8.Y...................................................................,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 Appral.ementDescriptionofAlletValue.Made for Inheritance
Tax PUrpOI81
$
REALTY:
As per Schedule "A"27.000 00
PERSOFALTY:
As Schedule "BII 7,316 ,.,/per ,)0
':.R.i.NSFERS:
NONE NONE;
Jr.!EW:
As per Schedule "Ell 36,900 00
Total 71,216 36
I
form~~V~:hb;:::rh~~:2~~~~:~;~~~~~§~;I;;ei~~i!:
Appralaer...-P~~~j·;~~~·
RESIDENT INHERITANCE TAX APPRAISEMENT
...............J:;o.;mIIJG.TCIL .County
F\LED
Estate of 1959 APR 21 PM 1:48
......HA2.Y LVA..BORa'Z..
Deceased.
Late of
;~-'i.SHl"tliGTO}r _ _ .
Date of Death,D.e(:e.mh.er .30.,..l.96.7 .
Appraisemeilt Docket Vol.,3..7 .
Page,.93~3 No 63~.6e.""2.4e .
Filed in Register's Office,:t>:ay....21.,19.&<3.
Amount of tax d~(e,-$..
DEPAlTMENT OF REVENUE
Received,
Examined and Approved,.
Wrote abo.ut Appra.isement,
Appeal f1'om Appraisement,
Entered and chnyged,
RUSSELL MARINOREGISTEROfWILLS
DEDUCTIONS ALLOWED IN ,/'
THE SUM OF ....•.......$uCf{?lf~crz:
DAn "',"v lj~(t~f
a
..
S~ATEMENT OF·O,EBTS
AND DEDUCTIONS
MARy E.
OFFICE OF THE
REGISTER OF WILLS
AND AGENT OF THE COMMONWEALTH
OF __W..:.;.A=S=H:.=:I:::.N;..:G::.::T::..;:O::.::N:.:.-_COUNTY
Form RC C·IO
ESTATE OF MARY EVA BORTZ,dec:'d .LATE OF CITY OF WASHINGTON
DATE OF FILING APPRAISEMENT DATE OF DEATH DECEMBER 30,1967
DATE NO.OF NAME OF PAYEE REMARKD AMOUNTVOUCH","
?r7/68 Ambulance &Chair Service Ambulance service.etc.1$65 00
?''1/~R In M -M.D.Medical lS 00-r care
2 7/68 John C.Shaver.M.D.""2::00
9-t'1/~R ID;~i:i:-I'RnmA IFuneral exoensa 1.43~05_
2 r7/68 Columbia Gas Gas Bill 8'i 92
2 7/68 West Penn Power Co.Electric Bill 11 46
2 7/68 Citizens Water Co.Water Bill 9 50
'.
2 7/68 Ashmore's Flower Shop Flower Bill 4'4 25
2 rg/6R Postmaster.Washington,Pa.Stamps E 00 I
2 13/66 Wash.-E.Wash.Joint Auth.Sewer Bill E 62
2 15/66 Joseph 'Szopo Final pay't.-Income Tax lC 00
2 28/6B Raloh Piatt Three Death Certificates ~00
6 r3i68 Fred Thomas Labor re Yard work S 00
6 14/66 Washington Hospital Bill 1 20
2 il28/6~Columbia Gas Co.Gas Bill 6E 84
3 1/68 West Penn Power Co..Electric Bill E 08
3/68 M~,'Cu.,;...'.968""Coun"ty m __6 ~~c -,~
Richard E.Hershey,M.D.Professional Services ,fir 00
'R~rrv R Cook.Ci t~..!.~eas.•_~a-€4.'Wv ~D~ool Tax -4'O€1-12
,Attorney's Commission 1,96fS.E..Murphy,Esquire 00
2 V6/68 Russell Marino Letters Testa.- 3 S.Cert.21 50
2 V7/68 Observer Publishing Co.Advertising Letters l:l 50
2 1/7/68 Washington County Reports ""-"l:l 50
3 v26/6~Notary Public IA:I:I1aaV1ts -AcknowTeagmen't ~~~~1J1')'7la -."1...._~.......Iv;,;"no T
v13/6~General Motors Corp.Transler Tax .,.lf 009.--.--."".__.:_-I....~'~--..,a l"Il"I....~UI u Ii"
(;L .."~~--ct)$'fJ""'.v uvvv
COMMONWEAL.TH OF PENNSYLVANIA }
COUNTY OF WASHINGTON so:
I J.LORRAINE THOMAS and ELSIE E.KEYS
TOTAL
ry u 1
Washington,ashington Co.,Pa.
My Commission Expires:April 1,1972.
FORM 67
REV.1-50
REG.WILLS
1\pplication for 1J.jrttrr.6 of 1\raministratinn on thr
Estate of...~9.~~~.:~~.?.~.9..!~.!.~.9.~E~9.~D:~.?q.9.g~~.~.~.~.9..f .
late of ~~.~9..~.~.~.~.;:9"..~~.~P.:~.~.y.J.y.~.~.!.~,Deceased.
Before the Register of Wills of Washington County
REGINA MAE LESKOpersonallyappeared ..
..JOONN.~srowho,beIng duly s\vorn deposes and says that..
age ,having hJ.~last family or principal residence at 7.Q.5 f..QJJx.th S.:t.r.e.e.t .
(Street and Number)
..........................g.~.~2.~.?1?.~F..g ,Washington County,Pennsylvania,died intestate(City,BtH'tytigh,TGwn~hip,--"0----...=~.+--.---._.-
at...Y!~.~~.~.~.c;L~.9.P.:~9..~E~.:t::~..!:,Op the?.!},9...day of §.~P..t.~gQ?,.~£..
A.D.,19 ?.!.,at.....?..~..~.9.~..:M.,possessed of personal estate to the estimated value
$..?:.Q.Q.::.9..Q,and of real estate in the Commonwealth of Pennsylvania to the estimated value of
$?~..:?~?...:.g.9,situ ate in ~.~.~?~.~.~.~E.~.!.~~.:::E:.~.~.9.:~.9..~s:?.~.~~.¥..!g.~.~.~.?.y..!.y..~.~~.~..
The names and addresses of the decedent's surviving spouse (if any)and other heirs including
heirs by adoption)are as follows.
REI,ATIONSHIP RESIDENCE
.......~~.gJp..~M~.~~.~.~.J5.9..w.i.f~7..Q:?f.9..g£.:\;.h §.t.J;'.§.~.t.,(.~.9:.P.:9..P..;?.P..R:r.g I Pa .
........~9.~.~~.::~§:.~~9..!.~.;:.~I?.Q.D:~::.~.
.......~~.9.E.~.~~.::~~.~.~9.I?.Q.D:~:'.~.
........'!.~y.g.Qf?~.~t.~~.~.Js..Q §.9..~~~'.~..
.......~.9:.r..l~Ap..:n :Jrl~.§k9.P..~~gh.!:§:.;:~:'.~.
.......s;:.J:.~);!..9.;h~~~.~.J5.9.P..~.g9J}:!;;§.!:::.'.~..
That deponent is over 21 years of age,resides at ?.Q.:?.¥..9..~~.t.h ~..t.~.~~.t..!.9.9.:p.9.P.:§;Q);!..~g I
Pennsylvania
is a citizen of the United States and a resident of Pennsylvania,and respectfully applies for Letters of
Administration upon the Estate of said decedent,no letters having been previously issued thereon.
COMMONWEALTH OF PENNSYLVANIA}SS:WAS:::::~:~..,...~.....,19 §.'i,comes...............•~!\'.9.j,.!]~....Me.!:L."g§.KQ..._....__......•.....•
who being duly s~~'~oth depose and say that ?.h.~wi1l well and truly administer the goods and
chattels,rights and credits of..q,.9.~.~~..~~~~~2.!..~.~(~~9.~.~~.~~.~.9.,deceased,
to the best of...lt~J;'.....skill and judgment in strict compliance with the laws of this Commonwealth,mind-
ful of the laws relating to inheritance taxes.
,.
0-re me this .
.~-~................................................................~a..~..
.REGISTER
6-re me this .
.~.,A.D.,19 f?L
.......q~...J~.....~~.....
'f
"t
I
~.
(1-77 7fit;3-&P-~~i
APPLICATION FOR
Letters of Administration'
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ESTATE OF
JOHN N.LESKO ',.......................................................................................................I
Deceased
R $:.
....................~.'"ILetters..................................L ()r v---v
P $..
$..Extra Alias .('....'j:J/j ...~ct:J.~/4 ~.'..$L~.Certificates ...
.Renunciations $.
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Total ~:~~!.;~:.~.
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Attorney
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CHRIS 'VLACHOS
Attorney at Law~Law &Finance Bldg.)La If?-(,;Lan°fJ;:27!v
il(uoUt All flru iy wl1rsr Jrraruta
Estate of...J.Q.An Jh ~.~.k.Q }
No of 19 ..
late of...g~.~.9..~.~p..~r.g ,Deceased
KNOW ALL MEN BY THESE PRESENTS,
That we,.....~.g~.~.~......~~.....~..~.kQ ....~.~.....f.r..1.p.c..l.p~.1 ....~.P.4.....Vn1.t.~.d .....~t.~.t.Q.~.....F.l.d.e..l.l.t.y..s....nd.....q.~ran t y
CO.Baltimore,Md.Surety
all of Washington County,Pennsylvania,are held and firmly bound unto the Commonwealth of Pennsylvania,for the
...One ThouaandDollarsuseofthoseInterestedIntheestate,In the sum of....
Dollars,to be paid to the said Commonwealth,to which.payment,well .~nd truly to be made,we do bind ourselves,
jointly and severally,for and in the whole,our heirs,executors,administrators,successors and assigns,and each and
every of them,firmly by these presents.Sealed with our seals and dated the ~..~.~?:.~.............day of ~~.~.~~.~.l .
A.D.,one thousand nine hundred and ~.~~t..Y.~.g~.
THE CONDITION OF THIS OBLIGATION IS,That if the above bounden .
Regina Mae Le ako
Administrator..................................................................................................................or any of them,shall well and truly administer the estate
according to law,this obligation shall be void as to those who shall so administer the estate;but otherwise,it shall remain
in force.
czealedd delivered in the presence of:~,U\..J
,.
§tntrmrut of §urrtg
I,,surety in the sum of $on the
administration bond in the estate of ,say that I reside at
..................................................................................................................,Washington County,Pennsylvania;that I am the owner of real estate,the
title to which is in my own name and duly recorded,situated in __..
Washington County,Pennsylvania,worth above all encumbrances $;and that I am worth the
amount expressed in said bond,over and above my just debts and liabilities.
Street
§tntrmrnt of t;urdy .
P.O.
I,,surety in the sum of $on the
administration bond in the estate of..,say that I reside at
..................................................................................................................,Washington County,Pennsylvania;that I am the owner of real estate,the
title to which is in my own name and duly recorded,situated in ________..
Washington County,Pennsylvania,worth above all encumbrances $;and that I am worth the
amount expressed in said bond,over and above my just debts and liabilities.
COMMONWEALTH OF PENNSYLVANIA,l SS:
WASHINGTON COUNTY,(
Street P.O.
And now 19 ,comes .
who being duly sworn,says that he is acquainted with the financial standing of the securities to the within bond;that the
said obligors have each executed the said bond and that the sureties thereto are the owners of real estate in their own
right of value more than the penal sum of said bond over and above all incumbrances and exemptions.
Sworn and subscribed before me this .
day of..A.D.19 .
-
63 c;-68f\--249 t if-~}~'l:::::?q
No 1...7t .
Abmiuintratinu TSnub
IN THE ESTATE OF
"'Ia.'L_r.f'
...................~.9.g~~.!~~~Q ..
And now J.anuar.y.~.6.,19.6B ..
Bond approved and Letters issued to
....REGINA.MA.E L~){O .
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.l'Ibo w.a.s.r..d1ll.¥q,ua~1.f.1.e.d .
:'J 6::
..........................Rua.s.e~l!.:::.Mar..1.nQ.,..
•_~~-l Register
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Bond Book ~~.............Page.Q.7/.
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IN THE COURT OF COMMON PLEAS OF
WASHINGTON COUNTY,PENNSYLVANIA
ORPHANS'COURT DIVISION
NO.63 -68 -249
IN RE:
Estate of
JOHN N.LESKO,
Deceased.
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PETITION FOR DISTRIBUTION
CHRIS VLACHOS
ATTORNEY AT LAW
LAW &FINANCE BUILDING
CANONSBURG,PA.15317
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19-165
IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY,PENNSYLVANIA
ORPHANS'COURT DIVISION
IN RE:
Estate of
NO.63 -68 -249
JOHN N.LESKO,
Deceased.
PETITION FOR DISTRIBUTION
TO THE HONORABLE SAMUEL L.RODGERS,PRESIDING JUDGE OF SAID COURT:
The Petition of Regina Mae Lesko respectfully repre-
sents:
1.Regina Mae Lesko is an individual residing at 705
Fourth Street,Canonsburg,Washington County,Pennsylvania.
2.Oti September 2,1967,John N.Lesko,herein called,~
"Dece'dent"died domiciled in Pennsylvania,a resident of 705
Fourth Street,Washington County,Pennsylvania.
3.The decedent died intestate,survived by his wife,
Regina Mae Lesko,Petitioner herein and five children,namely:
John 'N.Lesko,Jr.,George A.Lesko,Jay Robert Lesko,Carla Ann
Lesko and Claudia Lesko as his only heirs at law.
4.Letters of Administration were granted to your
Petitioner on January 16,1968 and the advertisement of the
grant of letters was completed on February 29,1968,the proof
of publication being attached hereto and marked Exhibit "A".
5.All debts of the decedent within the knowledge of
your Petitioner have been paid by your Petitioner,including
expenses incidental to the last illness and burial of the decede t,
an accounting of such payments being attached hereto and marked
Exhibit "B".
r',.:
6.Your Petitioner hereby claims the family exemption
she having made her home with the decedent at the time of his
death.
7.No transfer and inheritance taxes are due the
estate of the decedent being insolvent for tax purposes a return
having been filed.
8.The decedent's estate at the time of his death
consisted solely of the following assets at a total valuation of
$3,200.00:
(a)Vacant lot 35 by 120 feet,known as Lot 329
Block 20,Cecil Imp.Co.Plan No.1 more particularly described
in DB 693,page 463.$1,000.00.
(b)1/3 interest in Lots 331,333 and 335 Block
20,Cecil Imp.Co.Plan No.1 more particularly described in DB
620,page 218.Lot 335 is improved with 1 story frame house.
$1,800.00.
(c)1964 Chevrolet Sedan.$400.00.
9.The 1964 Chevrolet Sedan has been previously
transfered by the Administratrix at the appraised value of $400.0 .
10.All parties in interest in this proceeding are Sui
Juris,and all the heirs have joined in the prayer of this
Petition.Their consents are attached hereto and marked Exhibit
"C".
WHEREFORE,the Petitioner requests the Court pursuant
to Section 3532 of the Probate Estates &Fiduciaries Code to
award distribution of the Estate of the decedent to your.
Petitioner,Regina Mae Lesko.
"
egina Mae Lesko
gina Mae Lesko,
Administratrix of the
Estate of John N.Lesko
'."
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STATE OFPEN'NSYLVANIA
SS:
COUNTY OF WASHINGTON
BefQre me,the undersigned authority,personally
appeared REGINA MAE LESKO,an individual and as administratrix
of the Estate of John N.Lesko,deceased,who,being duly
sworn according to law,deposes and says that the facts con-
tained in the foregoing Petition are true and correct.
Rgll1aMae Le§i(O~
Sworn to and Subscribed
before me this (5i~
day Of~~,1979.
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Washington County Reports
fK3C~~JSl(S'XRIl:EX
Washington,Pennsylvania
(PUBLISHED BY WASHINGTON COUNTY BAR ASSOCIATION)
Estate Notices
The Register of Wills has granted letters,
testamentary or of administration in the
following estates.Notice is hereby given
to all persons indebted thereto to make
payment without delay and to those hav-
ing claims or demands to present them
for settlement to the Executors or Admin-
istrators or their Attorneys.
• • •• •• •• • ••• •••••
PROOF OF PUBLICATION
In compliance with the Newspaper Advertising Act of May 16 1929 P L
1784 Sec.3,paragraphs (3)and (25).',..
COUNTY OF WASHINGTON t
STATE OF PENNSYLVANIA (SS.
Personally appeared before me,a Notary Public in and for said County and
Commonwealth,.CHARL~S C.KELLER.who.being duly sworn, deposes and
saJ:s;that he I~.t?e Editor .of the y.'ASHINGTON COUNTY REPORTS,the
offIcIal legal.penodlcal for.said Washm~ton County,publisbed weekly having its
place of.busmess a~Wa~hmgton,Washmgton County,Pennsylvania,and is act-
m~as I!S agent m .thIs behalf;that the said WASHINGTON COVNTY
REPORl ~w~s estabhshed.on March 31,1920,and was designated as the official
legal pubhc~tlon for Washmgton County,Pennsylvania,by orde·r of the severalc~lUrts of saId County,da~ed November 11,.1920;that the printed notice or adver-
tlsemen~attache?hereto IS a .copy of ~notice or advertisement,exactly as printed
or pu\;>hshed,whIch appeared m the said legal periodical in its regular issues on the
followmg dates:
Lt~~~:JOHN N.a/k/a JOHN LESKO,~
~o~tnety~fP~n;~0 nsburg,Washington
Administratrix':Regina Mae Lesk'I~~l~ourthStreet,Canonsburg,Penn~:
~t~~~ney:9h.ris Vlachos,Law & '15317 ee BUlldmg,Canonsburg,Penna.
February 15,22 29 1968......................................................~~.
~hat the affiant or the corl?orati~n in behalf <;>f.which he is acting is not interested
m .the ~ubJ~ct matter of .sald noUce or advertlsmg and that all of the allegations of
thiS affidaVit as to ttl,place and chara~the publicatioo are true.
--::--t?=--~~,K~~~T,.~
Sworn""d Wbe;:rn "",hi,~Ed,,,,
.....?.~.day of...tY:~!:Y.,196 ~..,"
.....~1..L~...@A ~
No'ry Public
KATHERI!IE C.YARD,Notary P.i!10
Washington,Washington Co"a.
f:.y Cvmmis~ion Expirils
fJo'iilmber 1,1969
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Feb.14,21,28,1968
~~~---....---.-.--.----._~.....~...
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ADMINISTRATRIX NOTICE ~Estate of JOHN N.LESKO.a/k/a
JOHN LESKO deceased,late of
Canons,burg Washington County,I
Penna.ILE'T'TERS of Administrationupontheahovee,state having beengrantedtotheundersigned,noticeiRherebygiventothoReindebtedtheretotomakeimmediatepay-'ment,and to those having claimsordemandstopresentthemforsettlement.
Regina Mae LeRko,Administratrix705FourthStreet'Canon-,~burg,Fa.1[,317
Chris Vlachos AttorneyLaw&Finance Bldg.Canonsburg',Pa.15317
--------------------------------------------------------------------------------_.
In compliance with the Newspaper Advertising Act of May 16,1929,P.L.1784,
Sec.3.paragraph (3)and (25).
State of Pennsylvania }
County of Washington ss.
Personally appeared before me,a Notary Public in and for said county and state,
.__._.__._...M.?-g_~l_...Z...!'..._..Day....-..-...-......-..-,who being duly sworn,deposes and says:that
___..sh~_._..__is th~'9..Q.Kk.e.~-P.e:Gf the Notes Publishing &Printing Co.,a Penn·
sylvania corporation,and its agent in this behalf:that the said company is the pub-
lisher of The Daily Notes,published daHy except Saturday and Sunday,having its place
of business at Canonsburg,Washington County,Pennsylvania;that the said Daily
Notes was established August 1,1875;that the printed noltice or adverltisement,attached
hereto is a copy of a notice or advertisement,exactly as printed or published,which
appeared in the said newspaper in its regular issues on the following dates:
.__._f_?-.Q,:rll:.9Xy._l~,_..-E.~Q.!:~~.:ry--..?1..L ..~.~.!?~~.~~Z._~?,~.2.?.?..
THE DAILY NOTES
CANONSBURG,PA.
PROOF OF PUBLICATION
that the affiant or the corporation in behalf of which ._.....§h~..is acting is not inter-
ested in the subject matter of said notice or advertising and that all of the allegations
of this affidavit as to t~~~~~~--.:~.:~:.-::~..~:.:~:.~-~:~~~:~:~-
Sworn to and subscribed before me this ~~pero -
28th February 68~&7g:-~~:t:,:~-..
T
Exhibit "A"
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RECEIPTS
Per appraisement filed
Contribution by Administratrix to preserve
real estate in kind
DISBURSEMENTS
$3,200.00
3,067.14
$6,267.14
Sollon Funeral Home
Regina Mae Lesko
Register of Wills
Malone's Flower Shop
St.Patricks Church
Washington Hospital
Dr.Bakewell
Dr.Proudfit
Dr.Berman
Daily Notes
Wash.County Reports
Pa Department of Revenue
Sollon Funeral Home
Register of Wills
Chris Vlachos
SUMMARY
Funeral Expenses
Family Exemption
Letters &2 She certificates
Funeral Flowers
Grave lot &services
Bal.of decedent's bill
Decedent's medical bill
Decedent's medical bill
Decedent's medical bill
Estate advertising
Estate advertising
Auto license transfer
Headstone
Administration expenses
Counsel fees
$1,088.50
1,000.00
11 .00
38.85
260.00
310.73
15.00
14.56
25.00
12.50
12.50
4.00
500.00
15.00
150.00
$3,457.64
,-
Receipts
Disbursements
Balance for Distribution
Balance consists of:
.\
Real Estate -$2,800.00
Cash 9.50
Exhibit "B"
$6,267.14
3,457.64
$2,809.50
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IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY,PENNSYLVANIA
ORPHANS'COURT DIVISION
IN RE:
Estate of
NO.63 -68 -249
JOHN N.LESKO,
Deceased.
JOINDER
We,the undersigned,being all the children of John N.
Lesko,deceased,and Regina Mae Lesko hereby disclaim,renounce
and assign all our interest in the estate of John N.Lesko,
deceased,to Regina Mae Lesko,our mother,and hereby join in
the prayer of the Petition for Distribution of the entire estate
of our father,John N.Lesko,deceased,to Regina Mae Lesko,our,•
mother.
•IN WITNESS ,WHEREOF,we have hereunto set our hands and
seals this sU)--day of September,1979.
1~~~-Sk-O-
Exhibit "C"
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REAL ESTATE TO BE CERTIFIED TO THE RECORDER OF DEEDS BY THE
CLERK OF ORPHANS'COURT DIVISION
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III
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,
I JOHN N.LESKO,intestate,grantor to Regina Mae Lesko,intestate,
grantee and assignee of children--assignors,all the right,title,
and interest of the intestate grantor in and to the following de-I
scribed real estate:I
IFIRST:ALL that certain lot of ground situate on the North '
side of Giffin Avenue,in the First Ward of the Borough of I
Canonsburg,Washington County,pennsylvania,known and designated;
as Lot No.329 Block No.20,in the Cecil Improvement Company I
Plan of Lots No.1 which plan is of record in the Recorder's .
Office of Washington County,Pennsylvania in Plan Book No.2,I
page 151.Bounded and described as follows,to-wit:1
FRONTING 35 feet on Giffin Avenue and extending back
northwardly therefrom of even ~idth,120 feet to Gum Alley and I
bounded on the East by Lot No.331 and on the West by Lot No.327~
BEING the same lot of ground conveyed to John Lesko by !
deed of Jeenie Falconi,et con.,dated July 28,1945 and recorded
July 30,1945 in the Recorder's Office of Washington County,
Pennsylvania in Deed Book Vol.693,page 463.
SECOND:ALL that undivided one-third interest in and to those
three certain lots of ground known and designated as Lots No.
331,333 and 335 in Block No.20,in a Plan of Lots laid out by
the Cecil Improvement Company,known as Plan No.1,recorded.in
the Recorder's Office of said Washington County in Plan Book No.
2,page 151,more particularly bounded and described as follows
to-wit:
, .
I
BEGINNING at a point common to the northerly line of
Giffin Avenue and the westerly line of Fourth Street,thence
westwardly along said Giffin Avenue 105 feet to the easterly line'
of Lot No.329 of said Plan;thence northwestwardly along said '
Lot No.329,a distance of 120 feet to a twenty foot Alley;
thence northeastwardly along said Alley 105 feet to said Fourth
Street;thence southeastwardly along said Fourth Street,120 feet
to Giffin Avenue;tp the point the place of beginning.I
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BEING the'same interest in lots conveyed to John Lesko,:
et aI,by deed of Mary Turco,et con.,by deed dated April 23,I
1938 and recorded April 25,1938 in the Recorder's Office of II
Washington County,Pennsylvania in Deed Book Vol.620,page 218.
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IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY,,PENNSYLVANIA
ORPHANS'COURT DIVISION
IN RE:
Estate of
NO.63 -68 -249
JOHN H.LESKO,
Deceased.
DECREE OF DISTRIBUTION
:d}?~
AND NOW,this 7d day of ACaq<'<i t<~,1979,upon
cons~derat~~n of the foregoing Petition for Distribution,and
it appearing that the only undistributed assets in the Estate
of John N.Lesko,consist of Real Estate.
IT IS HEREBY ORDERED AND DECREED that said real estate
shall be distributed to Regina Mae Lesko.
IT IS FURTHER ORDERED AND DECREED that the clerk of
Orphans'Court shall certify the distribution of the real estate
to the Recorder of Deeds upon payment by the estate of the
recording fee for such certification of real estate.
BY THE COURT:
J •
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For.m No.REV-464 RHIS FORM REQUIRED IN ALL ESTATES WITH GROSSASSESTS UNDER 510,000.UNDER SECTION 701 OF ACTOF JUNE 16,1961,EFFECTIVE JANUARY I,1962.(FILE IN~
DUPLICATE WITH COPY OFWILLATTACHED),--~
OFFICE OF'THE REGISTER OF WILLS C~3 -~B -~it
County of Wasbjngton f 0 .37-/O;;J..-f
-uR~e~~~j~n~a~~M~aue~I~,~e~s~k~QL-~__~of 705 4th Street,.Canonsbur~,PA
(Name)(Address)
being duly ...::S::..,:W.:....:O::::,.r.......n according to law,deposes and says that he is the_-'A:.:..::::d~m~i:.=.n:.::l::..:·s=t~r.:::a::...:t::.:r:-'l~·X:.::---::':--:-__
(Exec.,Adm.,Legatee,Etc.)
of the estate of _~J~o=..!h..:.:n~N.l....!.._::!L..::::ec=s:..:.k~o::....-whose iast residence was 705 4 t h S t r e e t
(No.)(Street)
~C~au.n.L.::o,<Jn~sJ./b~u~r-'~i>.=,1--=-P~A'__:;==:::;_---deceased,and that the whole of the estate of said decedent,who died _9...·_-.:=2...-...6....71,-.-_
(City,Borough or Township)(Date)consisted of:
REAL PROPERTY
REAL PROPERTY IN PENNSYLVANIA,WITH STATEMENT OF MORTGAGE ENCUMBRANCES UPON EACH PARCEL AT DEATH OF DECEDENT,WHERE
PROPERTY HELD AS JOINTTENANT OR TENANCY BY ENTIRETIES,GIVE NAMES,ADDRESSES AND RELATIONSHIP OF OTHER OWNERS.
.,EstimatedRealEstate.Value.
1 Vac:ant Lot 35 'by 1?n ft known as Lot l?q Block 20
('or-;1 Tmn (;0 Plan No 1 more n::lrt.i rlll ::l1"'lv descrihpo
;n TYP.hO'),n::lO'p 4h'),cR1 nnn nn
U/I nL1(},(
2.1/3 into in Lots 331-333-335 Block 20 Cecil Imp.Co.
Plan No.1 more narticularlv described in DB 620 page
?1R T.ntllt:i is imDroved with 1 storv frame house
(onp_t.hi 1"'0 ;nt,pY'pst aooY';:l i ~prl for Inheritance Tax Dur-
n(")c:!pc:!;n R~t.::lt.P of'Ann::l M T,p~ko hl-hR-qI:)1 in 1q(;R
at $1 ,Rno.oO).1 Rnn 00
eK -tv.)J f/(;;1 .J Ci~0 I
V ,f
Personal Property
1964 Chevrolet Sedan 400.00
U 1I ~OO.
NOTE:You may expedite the processing of this return by filing with it,and as a part of the return,
letters from financial institutions or mortgage holders.certifying to amounts on deposit or owed by the
decedent as of the date of death.Such letters must be signed by a responsible officer of the financial
institution or mortgage holder and indicate clearly amounts of principal and interest in the decedent's
account at the date of death and the type of account,account number and the exact name or names in
which the account is registered.
Estim~tedJointlyHeldPropertyVal,ge -
held iointlv as tenants in common 1.1i t.h mnt.hpY'C "
,Real Estate
and brother'listed beforehand at 111 IntpY'P~t in "Rp~l Rqt.~tp
\
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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 rightof access by anotheras agentordeputy,with theexceptionof the following:-NON E
=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
,
--
BENEFICIARIES
RELATIONSHIP SURVIVED AGE OF LIFE
BENEFICIARIES AND ADDRESSES (If step-children or DECEDENT TENANTS OR INTEREST OF
(State full names of all and their addresses who have an in-illegitimate children STATE YES ANNUITANTS BENEFICIARY
terest,vested,contingent or otherwise,in estate.)are involved,set ORNO AT DEATH OF IN ESTATE
forth this fact.)DECEDENT
Regina Mae Lesko wife yes 1/3
John N.Lesko Jr.son yes 2/15
George A.Lesko son yes 2/1~
Jav Robert Lesko son yes 2/1~
Carla Ann Lesko daughter ves 2/1~
Claudia Lesko daufrhter ves ::>/11;
All
70l:1 4th StY'Ppt
Canonsbur/;?;,FA 11;117·
-REsmfNT DECEDENT DEBTS AND DEDUCTIONS CLAIMED
NOTE:List first five items in the spaces so provided,observe notations thereon,and instructions.
DEBT OR CLAIM
Sollon Funeral Home
Regina Mae Lesko.widow
Chris Vlachos
NATURE OF SAME
Funeral expenses paid
Family exemption (will not be allowed unleSll
decedent died residing with a spouse or children.)
Administration Expense.•
Counsel fees •
AMOUNT THIS COLUMN
II\EGISTER ONLY
S 1088 50 S
1000 00
1'1 100
150 00
Fiduciary commission •
OTHER DEBTS AND CLAIMS
(•)See Note below
Letters and 2 short certificates
Funeral Flowers
Grave lot and services
Bal.of decedent's bill
Decedent's medical bill
""
Register of Wills
Malone's Flower Shop
St.Patricks Church
Washington Hospital
Dr.Bakewell
Dr.Proudfit
Dr.Berman
Daily Notes
Wash.County Reports
PA Department of Rev.
Sollon
"Estate Advertising
Estate Advertising
Auto License Transfer
Tombstone
"
11 00
38 85
260 00
310 73
15 00
14 56
25 00
12 50
12 50
4 00
500 00
Total 3457 64
.....G9-n9.!:!.~~.1:lr.g.,~[1 J.~~.17..
(City or Town and State)
I
Subscribed and sworn to before me this 2.0 :tb .
Note:Theestateagreesto advise theRegisterof Wills if the amount actually paid in settlement of anyfee,commission ordebt is greater or !
less than the estimated amount claimed and allowed..Re~)~..c4:~~, .I (E:zecutor-Adminutrator)
.....~9.~..~.~l)..~~.r:~.~~" .
(Street Number)
...........:,day of ..F:'~.Qr:\A.q.r.Y ,19.7.9.
_.'}1'JR~{j rfl..,..7.kIJO,f).
Dorothy i{\Urbas,"olary ;-"jilC
Canonsburg Borough,Washington County
My 'Commission Expires Jan.31.1983
Member Pennsylvania Association Df Notanes
......~~beendW.Y27 ac~~;~~.I OO~':trtifylhatthe ~00v~~;;'/lr~with law on th;s,
Inthe event that any fu_interestla th;s..late la translem.lla =~or\-.i:..~~~;~·..
~xpll"~tion of any estate for life or for years,the Commonwealth hereby expressly reserves the right to appraise and assess transfer
inhentance taxesatthelawful collateral rateon anysuchfuture interest.
REPORTOFmE;.~GlS~ROFWILLS
I,the undersigned duly elected Register of Wills in and fo~~..County,Pennsylvania,do respectfully report that I have J
allowed debts and d9ductions inthe amounts claimed by deponent,except as to those items where teror lesser amount is set forth in
the lastcolumnto therightinsaidschedule above,whichgreater or lesseramountrepresentsthe m allowed asa deductio .I
Dated:"d.::.21.-:..71 ".
.".\d tdf IJJ~.~\.\f ./1111
--:......:1\.)"'-~~,.......
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:..._~~;/."\."'J.:.f·i:
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IN THE
MATTER OF THE APPRAISEMENT
Form No.REV-464
WillAdministration INo year .
,!
OF THE
ESTATE OF
JD.HN,..N •.LE:SKO ...•..•.~~~..••
Late of ..c.GlP.QI)~.Ql.J.rg..............•..
County of .Wlashingt.Qo .
Commonwealth of Pennsylvania
REPORT AND APPRAISAL
.•\'Ij ••OI....l,'f'lC)ll"\lil,Swu\'1,g '_.-J ,tl\~J.\i c,.,0"~VItU
,!S''''';I''n1'II~h JI:O','1":L,S'\(\3\:!~\1 H1..I~\.-'.l,:,:t.·v .0
ji:i&r;~iinll,'£}).,"3M:l~;8
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dI (]3 '1 \\;\!
REV-SIS (S-78)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
P.O.BOX 2970
HARRISBURG
17105
NOTICE OF FILING OF APPRAISEMENT
Regina M_fa~~ko
(Executor or Adm inistrator)
IN YOUR REPLY PLEASE
REFER TO
Inheritance Tax Division
In Re:Estate of __J_o_hn==--_N_-_L_e=.:s=.:k=o _
___W_a_s_h_l._·n-,g~t_o_n__County -File No.63-68-249
Dear Madam,
You are hereby notified that the_~O~r~l.e:.·g~i~n:.!!!a"""l"--_
appraisement in the estate of John N-Lesko
has been filed in the office of the Register of Wi lis of Washington
County on 2-28 ,19..1.9..-,Said appraisement reflects the following
valuations:
Real Estate -"'2~,-=8:...::0:...::0~_'_.:::0:....::0~_
PersonaI Property 4-"-0:::..0=_.=0.=0 _
T ransfers _
J0 intIy Owned =---=-==-=----::--=--_
Tota I ---=3=,-=2:...:0-'-0-=_-=0-=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 occurred prior to December 22,1965)from date of death,
interest at the rate of six (6%)percent per annum is charged.
Any party in interest who is aggrieved by this notice may object thereto within
sixty days after receipt of said notice as provided by Section 1001 of the Inheritance and
Estate Tax Act of 1961,72 P.S.2485-1001,P.L.373.~
Date 2-28-79 S;gned ~L.e ~,,)
T;tle ~Ld.«/~-----Estate Insolvent
Date of Death:9-2-67
Note:This is not a bill.
RCC-39 (8-77)
SUMMARY
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT(INITIAL)
N.
(FIRST NAME)(LAST NAME)
_r
County,Number a~d Name,_--=-#:..;6=3---:W:..:a~s~h=i~n~g:Lt~O=n~_
File Number ....:6::...:3=--_6=8_-~2~4~9:..__
Date of Death 9_-_2_-_6_7 _
Estate Name Lesko John------------:-:::---:-:-:c--=---...:-~_=__:__:_
D d
2-28-79ate:_
REPORT OF THE REGIST,ER OF WILLS
I,the undersigned duly elected Register of Wills in and for CJJ-;1 d County,Pennsylvania,do respect-
fully 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 SChedUIZ"F"which greater or I/~~er amount represents the sum
allowed as a deduction.j/,?
Dated:2 -..;22,-7 t ~u//~--/\;;Z//77JJ //
)/fEGI51"ER OF WILLS W/
INVENTORY VALUE AS APPRAISED
ADJUSTMt'.DI'fsCOD~(HARRISBUR'G USE ONLY)REMAINDER APPRAISEMENT CODE
Real Property (Schedule A)
Personal Property (Schedule B)
Joint-Held Property (Schedule E)
Transfers (Schedule C)
$2,800 00
400 00
00+
10+
20+
30+
92+
TOTAL GROSS ASSETS
Less Debts and Deductions
(SCHEDULE F)
CLEAR VALUE OF ESTATE
3,200 00
3,457 64
Estate!..Inso ven
40-93-
annuities••••••••••••••••••••e $-------r-
ESTATE TAX ASSESSMENTS __$[=
Yaluatian of life estates or _'70__PRINCIPLE FACTOR VALUE CODE,-
(*)As evidenced by Charitable
Exemption Certificates issued
by the Secretory of Revenue.$1.-__
COMPUTATION OF TAX
$
$-------+--$
$
$
CODE
*
:----~~
TOTAL TAX
Less tax previously paid
BALANCE
Less 5%of tax if paid within
3 months after death
FOR USE OF REGISTER ONLY
Tax an $-4--__~
Tax on $~/-----
Tax on $15%_
Tax an $-4--__
Tax on $-4--__
Exemptions
Total Estate ...L-__
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
:------c
TOTAL TAX BALANCE
PAID _
$J
$/lt~
$'J/l ~~$
$
$
Supplemental Codes:(FOR USE IN HARRISBURG ONLY)
48-Adj ustment
49+Adjustment
56-Annuity
6O-Life Estate
92+Remainder Appraisal
93-Remainder Deduction
93C-Charity
94-Remainder Residue
96-Successive
Life Estate
FOR USE OF REGISTER ONLY ADJUSTMENTS
NOTE:Where subsequent adjustments are made to the above computation of tax by the Register of Wills,for proper reason
same should be noted below,with short explanation.'
Will )Administration No._
IN THE
Year_
MATTER OF THE APPRA1SEMENT
OF THE
ESTATE OF
Deceased
Late of _
County of _
Commonwealth of Pennsylvania
REPORT AND APPRAISAL
,,
,.
I
63-68-249FILENO._
WashingtonCOUl.'l"TY _IRCC-2 (2-64)
DEPARTMENT OF REVENUE
B~REAU OF COUNTY COLLE<;nONS
I HARRISBURG,PENNA,17127
COMMONWEALTH OF PENNSYLVANIA
RESIDENT INHERITANCE TAX
APPRAISEMENT
DATE tiS Feb.28,l979
Whereas,J obn N.Lesko late of _-=C,""a"",nA.:o=.An...swbotll!.lllu..r~gl--_
in the County of Washington Commonwealth of Pennsylvania,having died on
the 2d day of Se tember 19 67 ,seized and possessed of an estate
subject to Inheritance Tax under the law of "he Commonwealth of Pennsylvania;
Therefore,I,r '::0 f Tq:,~~.an appraiser duly appointed according to law,
having been designate'd-tc;'~ake a f~nscionableappraisement of the said estate,and to assess and fix
the cash value of all annuities and life estates growing out of said estate,hereby file the following appraisement:
In the event that any future interest in this estate is transferred in possession or enjoyment to collateral heirs of the decedent after
the expiration of any estate for life or for years,the Commonwealth hereby expressly reserves the right to appraise and assess transfer
inheritance taxes at the lawful collateral rate on any such future Interest.
Description of Anet
Real:
See Copy attached to appraisement
Unit
Values
$
Appraisement
Made for Inheritance
Tax Purposes
2.800 00
I -----------+--~--+
1?ers:
See copy attached to appraiSEment 400 00,-------....:::.=--.=.::.="'--..=;=....::::.==::.=--=:..::::....-=.I::.I::=..:=====---------------4-------1H---~~____I...!!!.:!!!!....-
I
I total 3,200 00i--------------------------------------+---____Iit------4--
."I
,
I
Having been duly sworn acco~n!Lto law,I do hereby certify that tb~above appraisement is made in con-
formity with law on this ~ti...:&!1d.day of ~.....fl-6./,J 19~.[-IX /u,A f.i ~
Washington COllilty
RESIDENT INHERITANCE TAX APPRAISEMENT
Estate of
John N.Lesko
Deceased.
Late of
Canonsburg
Date of Death,9-2-67
Appraise/ll~aet Vol.,37
Page,~-,No.63-68-249
Filed in Register's Office,2-28 19 79
Amount of tax due,$_
DEPARTMENT OF REVENUE
Received,
Examined and Appro-z,'ed,_
Wrote abo.ltt Appraisement,
Appeal j,om Appraisement,_
Entered and charged,_
~
t·