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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. ______(f~cL ~_ (. .-- , .t \,\' '0(.\)1 !/ No.___§_~.~§.~:':'_~1:.~_..._ Estate of__.._~~¥....~.._...~Q~~_~J_...~I.~l~._.. /' ,1 \.''-'C. 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 03ll.:l ,~... 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. "'~,..-....---~_.~<"".~-..~.....~.~••:-_.--~.--.--'--~.---.",.•._-- j ,"~, .:.~ jr,,." ','.,~':!., 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. ! J i '\ ,. Stuart E~Murphy,for J.Lorrairi,. co~ ••U)-O...J 0 ~~::i::!.f?0;;: UJ <lou..::E:o ....J .....-!a:::-!UJ.t\l LUi---Ul(f)U)- l.L 0::J~ ~a:::u.Ja:: 53~ AUDIT Jrarripr fur ~ppraraurr FOR Thomas and Elsie E.Keys, Executrices. :',i':,! i i·, " ,I I,.~.; , ,') ~. 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 ~\ .~~ ..............................................................................................................................- . Register j ! ~..., If .... l!1:......., Irl ~"'$iii ts:l«j ~In t !tiI=j en Glt;Ij -l•j~»..., -l ts:l "tl:l itl:l In .... 0 0 ~ 'i 10 "'II aei'1"'$..., N lei':::iN!o .... ilJ>~ ~~Sd co ~i ~ ••....(/) 0-10Z-I ::c 0::3;: W Q..«u...~o .--J ....:::~."J w~-(/)(,') 1.L a:(/)-=:><.::10-Q::W<0:: 0')to52J l 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 'f ,.A~t;.~i<b ~~ r ~..:tr-:l:.......~s:;2i ;:g ~S2 <:!CD1~<'ll ('):;:g <Dl::tl -~S111;/1 .:!G p~UWFiH ~0 CJJ~t-3 "'l~0'OIJI!jlv'~'J -(I3SSn~ I raN\(1);...~~~wtQil\)~;:g I~~0''"•........C'.l co£t :~r t:J L".'\'\1 !.'n ...,f'!....~~~I\0 _t..,L d t'~.I:........~~ I\)~N~~"'l +="~, ~~.co J"0 <'ll0:1 "1 (~-~~<'ll._1 ,;:g.....~tz::l:0 <!C)l>iC'IJ co ~. ~ ••(/)-O....J 0 Z....J ::;::o:~ UJ c..<e.....~o -lex:.....J --lw,<.\1 WI--,~~ LL.0::=:>C) Sf c::;Wc::; ~ ..--(.. 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 l ~ ~ { ~ ~ ( ~ ~ciZ / .~.'.' ". .-. .... "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 IIII ,I 0 ~:J Z... ~~s .....p ~:rcCD :J 3coyo+.CIl ..... /.39 "'Q'~S-o ~....._... (/)~0.....O...J a ...Z_l ..... iE c::~_.:r ,•I ~l'.~CD t .....0 ::: .-J ...J.......-1 ....Jw "(\j w,__~(/)cn S.If)-L 0::::::;,c;::l 9J:o:::w 0::: ffi ~ Q:'~.....a~ ,\T j (~J j ,)" 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' -r T I J '.r f t , I I l Ifi f J il 1,I, t 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 $. ..................................................................$/./~.................................zf:.~. .(\1 g / Total ~:~~!.;~:.~. .r-.f1'1,- I .!..- !_...'').". -j r-,,) l.-... Attorney ~2 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 . ~(tj .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 "-:,::0-; -j r"lI, I ,.-. Bond Book ~~.............Page.Q.7/. ~2 ~ i-- I" .. t.; 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. ...-:~a'::<-0 ~.,(.;')~ <r"t"l ""Lo -.J~-.•I (y -. .'-:> t ):,-.J -1 ......G-?~~r -I ..........1 ,,? ;,..:"T}-0 ",-:u ~~;.i:--'-m ,).'--+="0r- -".r-;.~(J)-~~1'1)<:::) ~0~(:) PETITION FOR DISTRIBUTION CHRIS VLACHOS ATTORNEY AT LAW LAW &FINANCE BUILDING CANONSBURG,PA.15317 »() -l J:Cl ::0 ::0 -Z Ul ~<r»»-l () r J:»0::E Ul \ o»...z >o ::E~l!'~~:!!"""z;0 > COl z• 0 '"'!'m~~..c ...-cU1_ Ul Z -Gl'-l 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 '." .,' 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. II j 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 -.- i, .... Feb.14,21,28,1968 ~~~---....---.-.--.----._~.....~... .------_._.---_.. 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" "" ,"•• 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 !' .. .. 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" I; "I'!~l' I I' '. REAL ESTATE TO BE CERTIFIED TO THE RECORDER OF DEEDS BY THE CLERK OF ORPHANS'COURT DIVISION I II, III ,. I'I'II , 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 -I 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. IIi I I II I, .'.',. 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 • .' 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 \ - 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\.)"'-~~,....... ,..:........:::.,I ....."\/.-;: ~-, .:.-....."'-:-i /""r.-1:::-~ :..._~~;/."\."'J.:.f·i: ••••J ',"•..;'•.:.' '"~:\./.,1''''"\\.\.\\\\' 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 \:.,.~2n 'U~l?B3J6L~ 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·