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HomeMy WebLinkAboutOC1968-0271 - ESTATE OF WILSONTestate Form ./ PETITION SUR AUDIT IN THE ORPHANS'COURT OF WASHINGTON COUNTY Estate of ~.~~~.~~~~.~Q~..~!~!~___--'-- .....................H.~R.·WJ:.~S.QN _ . Deceased N 63-68-2710 . Fiduciary ~~:t::.~~.~..~:~.~.~~9-~L . Executrix..................................._---':~_ _ _. Date of Date of Decedent's death ~~.1?~~~E.¥.?~..}.~.?.~Grant of Letters ~~.1?~~~!.¥.?.'-~.~.~~. This is the ~.~.~~.~..~.~9:...~.~~~~account filed in this estate If there have been former accounts filed in this estate,list file number or number and term N.Q.n~. Election to take Under or Against ~ill.(cross out one) Date Election Place of; Filed _._Record . Name of surviving spouse ~.!?'!:~.~~..:~.~YY..~!:-.~~.l!:__ _ _ . List issue,where material: ~'.),....\:.~;.. Did decedent marry after execution of will?{indicate}¥:es.No.Any children born after execution of will?{indicate} ~.No.If answer yes,name them _ __ _ _.. Leg.atees Esther M.Wilson Relationship Wife Interest Entire Fiduciary,if deceased or not sui juris Not applicable List,if exceptions to above: None If partial intestacy,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.No. If any exception give cause:N"9.n~. Fi Ie copy of Notice and date of mailing ~~."Y.~~:;.~~.~.!~~.?~.. Is estate subject to the filing of a Federal Estate Tax Return?!'J.9.. Actual payment made on Pennsylvania Transfer Inheritance Tax.Amount $.~!..?Q9.:.9.9.. If the Will makes any portion of estate subject to a life-estate,give name and birth date of.life tenant ~~.~~. Give Names and addresses of all unpaid creditors who a re legally entitled to notice,tog-ether with the amounts of such claims;state whether they are admitted to be correct;and whether the claim is denied. None Give reference to such parts of the will as require interpretation by the Court;a reference to all questions re- quiring adjudication,and a statement of any other facts deemed necessary for the preparation of the adjudication: None Balance for distribution per account, Itemize any additional debits not shown by account:$~~.!.~.?~.~}*. Total additional debits (Add)$....................................34,489.31 Itemize any additional credits not shown by account: Russell Marino,Agent -part payment Pa.rnh.tax $1,500.00 Family exemption 1,000.00 Total additional credits (Subtract) Balance for distribution $..?!.~.9.Q.~.Q.Q . $.~.~.'..?~.?:..~.~. If balance for distribution is not in cash,list each item held in kind,giving appraised Value (or distribution Value)', Entire balance in kind at appraised value as per election attached hereto. Legatee has made contribution to preserve assets in kind. ------~- ,>- If Family Exemption claimed by Petition,give place of Record:. If Family Exemption is claimed at audit,give name,relationship and basis for Claim:. Esther Wilson,wife,resided together in family relationship at time of death. List any advancement or distribution on account that has been made,and nature and amount of same: 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: Esther M.Wilson -entire assets in kind. (stock transfers and automobile registration already made) COUNTY OF WASHINGTON,55: COMMONWEALTH OF PENNSYLVANIA. The above named Fiduciary or representative thereof, being duly......•4«~-::?1j doth depose and say that the facts set forth in the foregoing petition are true to the best of ~£..Y knowledge and belief. ............;J..~to and subscribed before me thiS....4~~.~ay of J.?.f!d.::~.....19..4..f S;gno'u,e of Offke,~_~_ Title of Officer :-:tt..K7:~.~. Office expires.......••.1JJ !..,..:.1.~..I... And your petitioner will ever pray,etc. ... u No.63-68-271 . Estate of.....?!!.~~...R.~...~.~LSON a/k/a........._____ . H.R.WILSON Deceased Fiduciary J;l~.t.h~.f:..M.~...wi-.J:§.9.D.t . ......................~~.9.'9t.f:j.~' . PETITION SUR AUDIT FROM WHERE DECEDENT LEFT A WILL Counsel of Fiduciary will submit herewith the following,in conformity with Court Rules adopted effective December 3,1951,being rule No.9:paragraph b-c;and divisions thereof:shown on pages 23-24. 1.Written praecipes 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. Attorney ~2 ,\ I ·-' ------------------~~ IN THE ORPHANS'COURT OF WASHINGTON COUNTY,PENNSYLVANIA IN RE: ESTATE OF: HUGH R.WILSON a/k/a H.R.WILSON, Deceased. ) ) ) )No.63-68-271 ) ) ) ) NOTICE OF AUDIT This is to advise you that the First and Final Account of Esther M.Wilson,Executrix of the Estate of HUGH R.WILSON a/k/a H.R.WILSON,deceased,hasiibeen filed in the Register's Office of Washington County,Pennsylvania,at No. 63-68-271 and that this account will be audited on the lOth day of December,1968 at 10:00 o'clock a.m.at which time and place you can be present if you so desire. BLOOM,BLOOM,ROSENBERG &BLOOM 200 Washington Trust Building Washington,Pennsylvania 15301 -.-~---------------------~-----~ Q!nwwnUtuta1t4 nf ,tUU.BYIUaUia,}lUI.D1htli~ington monntg, KNOW ALL MEN BY THESE PRESENTS:Whereas,at Washington,III the County aforesaid on the 7th day of February A.D.19 68,before me, Russell Marino ,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 HUGH R.WILSON aka H.R.WILSON late of Borough of Burgettstown in the County aforesaid,deceased, (a true copy whereof is to these presents annexed),was duly admitted to probate;and ESTHER M.WILSON the Executor III said Will and Testament named,having appeared before me and taken and subscribed I the oath of office prescribed by law; NOW,THEREFORE,I,Russell Marino ,Register as aforesaid,do grant these LETTERS TESTAMENTARY,unto the said ESTHER M.WILSON committing unto her the administration of all and singular the goods and chattels,rights and credits,which were of said deceased,and requiring her 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 WHEREOF,I have hereunto set my hand and the seal of said Office at Washington,this seventh day of February in the year of our Lord one thousand nine hundred and Register tII> • ,---.-, of 42 Highland Avenue,Burgettstown,Washington County, vania,being of sound mind and memory,do ~ake,publish WE,HUGH R.WILSON and ESTHER M.WILSON,husband and wife, Pennsyl-'JI and declar this Will to be jointly as well as severally,our Last Will and Testament,hereby revoking and making void all former Wills by us at any time heretofpre made. FIRST:All just debts and funeral expenses shall at all times be fully paid. SECOND:We desire that all 'property,real as well as personal,of which we -may be possessed at the time of the decease of either of us,shall be inherited by the survivor,with the exception that Esther M.Wilson's interest in Edwin McFarland Insurance Agency,Inc.,upon her death,go to her daughter,MARY E.WILSON. THIRD:Upon decease of the survivor,it is our desire that the property of both be treated as one and the same is hereby I given,devised and bequeathed to our daughter,MARY E.WILSON. without bond,and in the event of the death of both of us,we do hereby appoint our daughter,MARY E.WILSON,to act as Executrix, the decease of one of us,we agree upon ( , Iadministrationhereonat.I the survivor as the Executor I In case of the need ofFOURTH: to serve without bond. ,1967. IN WITNESS WHEREOF,we have hereunto set our hands and J.fsealsthis!1'-day of [1 l .(SEAL)'. J ~l. ,, ! f·l f•IJ f 1 "1, be of a sound and disposing mind and memory,have hereunto sub- 'f)J.4..),:-"day of Signed,sealed,published and declared by the above named, HUGH R.WILSON arid ESTHER M.WILSON,"to-be their Last Will and ! I !presence,and in the presence of each other,we believing them to 1 1967. Testament,in our presence,who at their request and in their scribed our names as witnesses,this .' II II II I I IIIIi /./Address Address -2- 63-68-271 63-68-271 Affi~auit (@f iExrrutnr ~r 1\~mini!itratnr ~tatt of 'tttttoyinattta.t ss: C!I.llUttty llf Dibt!i~t1tgtll1t ~ Personally before me,the undersigned authority,a ~~.~.~!'.y.~.e!.!£in and for saidEstherM.Wilson .County and State,appeared :who,beIng duly sworn according to law,deposes and says that S he is the executor or administrator of the estate ofHUGHR.WILSON a/k/a H.R.WILSON "...............................................................................................................................deceased,that the foregomg schedules constitute a complete inventory and appraisement of the real and personal estate of.~~~.~....~..~.....!..~.~.~~~.....~!.~!~....~W~is on deceased,except real estate outside the Commonwealth of Pennsylvania;that the figures opposite each item 1 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. day o~J:-~:~~:.~~.::;:~~thkJf.!b-...~1'-t.£~k...~_dl.Jil!>L ....._...._ 14 .~.Executor-AdministratortIwc.J....·......·..·rsrH'El'a:·W~U~Il·i ..·..·?JTJm'Y''Sue·......·........·........·......·..· My Commission Expir€s March 23,197ADDITIONAL INSTRUCTIONS 1.An J:ltesllingtmYFmust ~s{iJietd~~llMtl 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 3Jttuttttnry nUll .Apprni.atmtut of the goods and chattels,rights and credits which Hugh R.Wilson a/k/a H.R.Wi1sQn Burgettstown,were of :Jate 0t . Washington County,Pa.,taken and made in conformity with the above affidavit. PERSONALTY: 146 Shares Standard Oil Co.of Ohio Common 0 unit price $66.50 100 Shares -Standard Oil Co.of Indiana Common -unit price $52.50 33 Shares -St.Joseph Lead Co. Common -unit price $41.875 335 Shares -American Metal Climax Inc. Common _.unit price $48.375 68 Shares -American Telephone and Telegraph Common -unit price $51.875 1964 Dodge Automobile TOTAL DOLLARS 16,205 3,527 500 CENTS 00 00 87 64 50 00 01 63-68-271 //i/t5Z. Inventory and Appraisement IN THE ESTATE OF .................HUGH R W.ILS.ON Cl.ka,.. R.H.WILSON .February 20 68Fzled,19 . !-: t I1..,; /' -11r·,to n \..I ~ "-u ~. 1\,) .t:::. ~9 19-If --[- "-.Ii!o v.vO,....- ~yJL STATE OF PENNSYLVANIA, WASHINGTON COUNTY,~55: The within named Accountant being duly sworn according to law,depose and say that the above account as stated is true and correct as d~.verily believe. ,,;<7 cK.Sworn and subscnbed be'fore me this . ,/"-'rL~9 (tdaY~f_~__-__:ij~------:-- ROWENE EBELING NOTARY PUBLIC MY COMMISSION EXPIRES FEB.8.1969 WASHINGTON,WASHINGTON COUNTY Washington County,ss:I do certify that I have given legal notice to all persons concerned of the filing of the within account in the manner prescribed by Statute and Rule of Court,a;,evidence by proofs thereof filed to No.....I-~-.fll...':l_..I.y..~;r Witness my hand and official seal this..~£. day Of.~~-.---_..--.--19_4~(( .........~-~~. Register of Wills " ~...,...,....:: ~:::l «l...,:,0 ...,=0 =~;:l ;:l 0 Q;)0 t),Q t) t)I::I L ...,t) <ED 0 <~co ..., !-.""-'"0 ~~Q;):""'...,!:>.~...:: \!co z Q;).J...!~fi«., r-l 0 1"'''-'("-Q;):...N(\.0 ....!o.,I.,J ..')::]...: 0 ~i z co U)•'",0,...1 P;l -4 Po Qfril0CH....,,Eo<U)C'•..-1 H l:l<')};:lH04-l ~0~!Eo<r.'J~.c:r.!l ",~I"<)rn.H rn <)SIi:1 ~r-l ro .><:",..;...)«l\1 •..-1 c ~•..-1 'L -I"I"t .I'LC'l:l....·1 ...j~.J ...,:a ~.~co l-l .~..........~p::;0::'+J ...,.+J ~~0 .~~-"I ::r::o::rn (J ..., Q;) ,Q ~0 l-l 8 Q)~....,~~~•..-1 U)~o~_ Ii<Iil Iil l:l !~'"~0 =... <0Z..-i ""' \ / l- ". ,!. "- '" \ The Court is respectfully requested to determine proper distribution in this estate. /~13~1o>~' Counsel for Accountant FIRST AND FINAL ACCOUNT OF ESTHER M.WILSON,Executrix of the estate of HUGH R.WILSON a/k/a H.R.WILSON Deceased The Accountant is charged with the following: - - - - - - ---- As per Inventory and Appraisement-- - - - - - - --$36,574.01 Gain from stock dividends,first quarter 1968 (which stocks were later transferred to Esther M.Wilson at the inventory price)366.78 Total Assets of Estate - - - - - - - - - - - - - --$36,940.79 Total Credits claimed by accountant - - - - - - - -2,451.48 Balance for Distribution - - - - - - - - - - - - --$34,489.31 The Accountant claims credit for the following: Russell Marino,Reg. Russell Marino,Reg. Washington County Reports Burgettstown Enterprise Russell Marino Russell Marino Bloom,Bloom,Rosenberg & Bloom Angelo Spanogians,M.D. Rev.Jacob C.Ruble Rev.John P.Borter Washington Hospital Lee &Wilson Funeral Home McCoy Company Shaffer Pharmacy Ltrs.Testamentary and 5 s.c. 1 s.c. Advertising Advertising Inventory Final Account Attorneys'Fees Last Illness Funeral Service Funeral Service Last Illness Services Merchandise Medicine $23.50 1.00 12.50 8.00 3.00 16.00 1,828.00 35.00 25.00 25.00 67.78 355.00 49.27 2.43 Total $2,451.48 Washington County Reports EBCSlIlmECMSlmanllltU 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 t'hem for settlement to the Executors or Admin- istrators or their Attorneys. • • • •e •••••••••••• 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 WASRINGTON) STATF.0"PENNSYLVANIA (SS. WILSON,HUGH R,alkla H.R WIL-SON,Dec'd. Late of Burgettstown,WashingtonCounty,Penna.Executrix:Esther M.Wilson,42HighlandAvenue,Burgettstown, Penna.Attorneys:Bloom, Bloom,RosenbergandBloom,Washington,Penna. 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,publisbed 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 order of the several courts of.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: .......f..~Ju::M.~:n~J.s..•....2.2 .2.9 19.68 .. 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 <hi,,ffid,~i,,,ID'ti •pi".~_~:::~X~~ ~,~Editor Sworn to and sUb~e me this ~____ ..}~.day of....m ~~!.Y.,196 ~ ...../.~.~(!?~. N ry Public KArH~rNE C.YARD,Not Publict~a8hlRgton,Washington 0" r.1y Commission Expil'i!s November 1,1969 PROOF OF PUBLICATION ---01--- ss. ._..~l:~ /'Notary Public fDWAilD F.LaUNDER,NOTARY PIl811C My " .lhrr""tlstewn •L W L'comIDlSSlOD expll'es _..J'l~•••••••••••vlll1U9 .as..lIIg.loll..C9Inty 19 . NY COMMISSION EXPIRES fEBRUARY I,1m Taken,sworn to and subscribed before me this 8~of ~.~.~~.~_ State of Pennsylvania County of Washington I,_~.,.~.!y.Q~P..~.r.g.,~r..L ,publisher of THE BURGETTSTOWN ENTERPRISE,a weekly newspaper published in the Borough of Burgettstown, County of Washington,State of Pennsylvania,hereby certify that the annexed ad- vertisement !'J:..~.~9.~._~~~.~~~was published in said newspaper for ..............~_consecutive weeks,commencing on the 1.4.tb.. day of F..eb.r.u.ax::v._19 .6.8.and concluding on the 28th day of 6819 _ . ..........Ee~,19 9.8.. ...g·N./~O'\r..•~..<'!...c:~.I...~••••,Publisher EXECUTRIX·S ~OiIWi1_ .Estate of Hug wnson•ajkja H.R.son d late of Burgetts- I deceaseWa'shingtOn county,1town,, pennsylvaniaiestamentary \.Lette~e estate hav- upon the ov ted to the \ing bee n gdr a ~ll personsunderSig~~s against the having c requested to e state are .~"the Sli1He I.V-'make known at-' the undersigned or Mnss in-~ and all perso \~C:b~~~to the decedent ar~ requested to makel~~~~t Itotheundersigne\ delay.h M Wilson'Est er •42 Highland Ave.I Burgettstown,Fa.\ Bloom RosenburgBloom,, and Bloom \Attorney F:,4,21,28 \ L - 11u tQt (@rpl1n«5·<nourt of IIn5Qiugtou Q1:nuuty In the matter of the Audit of Account in Estate of:_.=.:HU~G:::=H~R~._W~I:..=L::.::S~O~N~a~/.::..:k:L/..:::a:--! H.R.WILSON TO THE AUDITING JUDGE: No.63-68-271,,19__,A.A. Enter__-=o'-'u:::;r=-appearance for·__....:E~s~t::.:h~e:..:'r=____.=:M~.--..!.W.!...l=:·-=l~s::::o~n:..,L--=E=.;x=e:,:,c::...u~t~r=-=i~x~_ Bloom,Bloom,Rosenberg &Bloom _-.;/,-O_day of._--=Dc...:e=--c=-=e~mb::.::=...~e.::r'___ 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. 19~ No.63-6,8-271 ,19__,A.A. In re Audit of Account in Estate of HUGH R.WILSON a/~ H.R.WILSON AUDIT Jrarripr fnr i\ppraraurr FOR "Esj:her M.Wi1so~xe~_utr ix Attorney ,~)',2 / 19_•••••••••••1 AA In the matter of the..X.~E.~.t..9:~9___~~.~9:.L . Account of .._.E.$.tJ1~r.__M.•..WjJp..Q.n~__.__. _____. . .._..E~_~~}.]._tr.~..Deceased. 3Ju tl1t (@rp4nn!i~(!laurt af lIus4ittgtatt maunty 63-68-271No.OfESTATEOF __~~9:~_~_~__Y!.g?~.~1 ...':l:!.~I..':l:._:...... R.H.Wilson, ADJUDICATION AND DECREE And now p.~~_E?_~1?_~~~~1 19__6..S __1 this matter came on ~r he>ari.ng, audit and distribution at this session and testimony taken;and thereuponl upon due conSideration th!3reof 8~e §alance for distribution in the hands of the Accountant is determined to be$L_B 1 and the account is accordingly confirmed;and it is orderedl adjudged and decreed that the said balance be paid out by the Accountant in accordance wi1th the schedule of distribution hereto attached and made a part hereofl unless exceptions hereto be filed sec.reg.or an appeal be taken herefrom sec.leg. SCHEDULE OF DISTRIBUTION Balance per account_._ Additional credit asked at audit 2500.00 Balance .._ Deduct Clerk/s Costs &Receipts _ Attorney ~JQQm_':s_tQ_9.m,__R..Q_$.§nb_~r._<J_&__BJQQ_ill _ Russell Marino,Agent,transfer inheritance tax, Contribution to maintain assets of estate in kind, 42.00 $31,947.31 ~.30,19(,f (961.'1d.(J-(j .ciJ. 405.88 Ry·~,J.L·~.tie: $31,541.43~_1()IfJ~g 5032.58 fJ.,Q.'1()S:.ff~I~'$~4.01 Esther M.Wilson,widow,residue,including a 1964 Dod(e automobile;146 shares Standard Oil Co.of Ohio common stock;100 shares Standard Oil of Indiana common stock; 33 shares St.Joseph Lead Co.common stock;335 sharep American Metal Climax Inc.common stock;68 shares American Telephone and Telegraph Company stock;held in kind and distributed as such at the appraised value, per election filed,36574.01 No balance .\' so ..('-•\,..,t"f...I.. Cn :J Zn0....9 c :r :J Cl>....3 0 c , .............Cl>.., 0 0.............. :rCl> IN THE ORPHANS'COURT OF WASHINGTON COUNTY,PENNSYLVANIA IN RE: ESTATE OF: HUGH R.WILSON a/k/a H.R.WILSON, Deceased. ELECTION TO TAKE IN KIND ¢ AND NOW to wit this ~~day of September,1968,I the undersigned,sole legatee under the will of the above de- cedent,do hereby elect to take in kind,at the inventory' value,the following items of personal property which are assets of the decedent's estate: 146 Shares Standard Oil Co.of Ohio $9,709.00 Common 0 unit price $66.50 100 Shares Standard Oil Co.of Indiana 5,250.00 Common -unit price $52.50 33 Shares -st.Joseph Lead Co.1,381.87 Common -unit price $41.875 335 Shares -American Metal Climax Inc.16,205.64 Common 0 unit price $48.375 68 Shares -American Telephone &Telegraph 3,527.50 Common -unit price $51.875 1964 Dodge Automobile 500.00 Total $36,574.01 Esther M.Wilson Form RCC-33 RESIDENT DECEDENT COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS COUNTY OF Waohington IMPORTANT:This return must be completed in detail and filed in duplicate,with will attached,with the Register of Wills of the County where decedent resided;Return is due within one year after date of death,unless an extension is granted hy the Secretary of Revenue.(Section 703 of the InhElritance__an!i E_st,ate Tax A,ct of 1961.) IN THE MATTER OF THE ESTATE OF }AFFiDAVIT OF-----~_l\!!!.~.~.n t;tI'lf/Q .R..~.Wi~~n..........EXECUTmt"rlx Eothor U.t1iloon (State full name of decedent) WOohlngt:on ADMINISTRATORLateof.............. .County Pennsylvaniastateof..-....-----:.}ss' County of -_______~~~~~~9.~~l..t _ __.. ._...g~~~~~!~f.~!~~!t _._..__....._._.._..Eecutor of the estate of the above-named decedent being duly sworn,depose and say ltGbDecedent-dJed _.__ __~~.__.__..__._ (Month) 0;)-----------,19-i"y~~~-,{~~~eaVing a last will,copy of which is hereto attached.} Name and address of attorney or} other authorized representative to_ whom all correspondence should be mailed. _B~~.J:l1.~,~Qt!:I~~~g ...§S ..~~tt\ 200 Washin~on Trust Buildingt:ash1ngt:on,-Pennoylveufil -----·-15:101-----------------------.-----..--- . That as such ~~~~.~!~deponent is familiar with the affairs of said estate and the property con- (EXt~C\ltor-Administrator) 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,or in decedent's individual name,with right of access by another as agent or deputy,with the exception of the following:- NAME AND ADDRESS OF BANK OR OTHER INSTITUTION THIS SAFE DEPOSIT BOX RENTED RELATIONSHIP OF JOINT IN WHICH DECEDENT RENTED A SAFE DEPOSIT BOX IN NAME OR NAMES OF HOLDERS TO DECEDENT That the contents of said 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 hereto and made part hereof sets forth full v and in'-detail all the real property in the Commonwealth of Pennsylvania of which decedent died having an interest therein.It also sets forth the mortgage encumbrances upon each parcel of real property at the date of death,giving the amount still due at death,name of mortgagee,date,rate of interest,and book and page of record thereof.It also sets forth in the columns provided therefore the assessed valuation of each of said parcels,the estimated market value thereof as of date of death of decedent. That Schedule B attached hereto and made part hereof sets forth fully and in detail all personal property wheresover situated owned by the decedent at the time of death;all 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 of in- debtedness of the United States to the decedent;all obligations,whether by statute or agreement they are designated as tax free,of the United States,or any state,or political subdivision thereof,or of any foreign country,which are owned at the time of death;all wearing apparel,jewelry,silverware,pic- tures,books,works of art,household furniture,horses,carriages,automobiles,boats,and any and all other personal chattels of whatsoever kind or nature,left bydecedent,together with the fairly estimated market value thereof;all bonds and mortga',tes 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 payable upon the death 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. In the case of securities of close or family corporations,the values reported are as far as possible substantiated by financial statements of the corporations,showing the assets and liabilities thereof as of the'date of death.The schedule also 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 forth 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 therein must be submitted.It should also set forth in itemized form,together with the fair market value thereof,any other property owned or bequeathed by the decedent at the time of death. The Schedule C attached hereto and made part hereof sets forth a true answer to each inquiry contained therein and in the case of transfers ofproperty,real or personal,within two years of decedent's death,in contemplation of decedent's death,or intended to take effect in possession or enjoyment at or after death,said schedule sets forth the nature and value of such property,to whom transferred,the relationship of the transferees to the decedent,the proportionate share received by each transfe~ee and all other facts of a pertinent nature regarding said transfers.In the case of transfers intended to take effect in possession or enjoyment at or after death,there is also attached to the schedule a copy of the deed,trust agreement or other instrument creating the trust.Ther,~is also set forth in said schedule a list of all property,real and personal,with its value,which passes at decedent's death by virtue of the exercise by decedent,either individually,or jointly with another,or any power of appoint- ment vested in decedent,either individually or jointly,by the will,deed,or other instrument of another, with a copy of the instrument creating such power attached to the schedule. That Schedule D attached hereto and made part hereof sets forth the names and addresses of all persons beneficially interested in this estate at the time of decedent's death,the nature of their res- pective interests,their relationship,if any,to the decedent,together with the ages at the time of decedent's death of all minors,annuitants and beneficiaries for life under decedent's Will.It also contains a statement showing which of the beneficiaries named in the decedent's will,if any,died prior to decedent,the dates of their death,their issue,andthe 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 the death of the decedent;debts and claims owing and unpaid at time of...death;taxes accrued chargeable for period prior to decedent's death (except .those allowed under Section 651 of the Inheritance and Estate Tax Act);together with a statement of collateral pledged for obliga- tions,if any.It is agreed that the fiduciary will present proof of said claimed obligations upon re- quest,that if the 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 . ......day of 19 . (Executor-Administrator) (Street Number) (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 assets include rare and unlisted securities, securities of close or family corporations or an interest in any co-partnership or business,that the data and statements required under the paragraph above relating to Schedule "B"are attached.Also make certain that column #1 in the "Summary"has been properly completed as above-directed. ~--~~~~~~~~~~~~~~----------------- RCC-34 (Hj4) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS' TRANSFER INHERITANCE TAX RESIDENT DECEpENT SCHEDULE uA" .REAL PROPERTY Real property in Pennsylvania,with statement of mortgage encumbrances upon each parcel at death of dece- dent.Where property heid as joint tenant or tenancy by entireties,report on Schedule "E".Property hf"ld by thede.cedent 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 Commor:'lwealth of Pennsylvania should be (1)(2)(3\/ described by lat and black number,street and street number,together with DI;PARTMENT a general description of the property,with a reference to the record of the ASSESSED VALUE VALUATION conveyance by which the decedent took title;if a farm state number of a·FOR YEAR OF ESTIMATED CAUTIONcres;also statement of mortgage encum~rancesupon each parcel at death DECEDENT'S MARKET VALUE (Do not writeofdecedent.Taxes,assessments,accrued Interest on mortgages,etc.,are DEATH In this space)to be listed on Schedule "F"and must not be deducted from thi·s schedule. Insert this total opposite ureal property",Schedule "A"in the X X X X X uAs Reported"column on the last page of this return. RCC'-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".Inta~gible personal property,titled in the name of the decedent,but payable at death to another or others,including but not limited to P.O.D.U.S.Savings Bonds and tenta- tive trust accounts,must be listed,despite the fact that they are not of the administered estate. Tangible personal property should be listed first (e.g.jewelry,wearing apparel,household goods,and furnishings,books,paintings,automobiles,boats,etc.) Intangible personal property,such as bonds,treasury certificates,cash on hand and in bank,•stocks,"mortgages,notes,together with accrued interest or dividends,salaries or wages,insurance pay- able to the estate or fiduciary in said capacity,partnership interests,interest in anyundistributed estate of or income from any property held in trust under the will or agreement of another,even though located outside of the State,at the time of death,should be listed in this schedule. Item No. 1 2 4 5 6 ITEM List and describe fully 146 shares Standard Oil co.of Ohio Common 0 unit price $66.50 100 shares -Standard Oil co.of Indiana -Common -unit price $52.50 33 shares -St.Joseph Lead Co. Common -unit price $41.875 335 shares -American Metal Cltmax Inc. Common 0 Unit price $48.375 68 shares -American Telephone and Telegraph -Common -unit price $51.875 1964 Dodqe Automobile UNIT VALUE ESTIMATED MARKET VALUE $9,709.00 5,250.00 1,381.87 16,205.64 3,527.50 500;00 DEPARTMENT VALUATION (Do not write in this space) /;3;/fl /{,/,J 65-t V 500-60 Insert this total opposite "Personal Property",Schedule "B"in the "As Reported"column on the last page of this return. x X Rcc-36 ('.OM~fONlmALTH OF PENNSYLVANIA Tfu~NSFER INHERITANCE TAX ~S~IDENT DECEDENT SCHEDULE "c" TRANSFERS (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)nn (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)nQ (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)__~r~>~./~n~._ (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)no (b)The right to designate the persons who shall possess or enjoy the property transferred or income therefrom?(Answer yes or no)"'1'\ (6)If the answer to (5)(b)above is in the affirmative,state whether the right was reserved in decedent alone or others n/::l (7)Did decedent in his lifetime make a transfer,the consideration for which was transferee's promise to pay income to or for the benefit of care of transferor?(Answer yes or no)__..;;....:.;....:...J-_ (8)Did decedent,at any time,transfer property,the beneficial enjoyment of which was subject to change, because of a reserved power to alter,amend,or revoke,or which cOllld revert to decedent under terms of transfer or by operation of law?(Answer yes or no)...'" (9)If the answer to (8)above is in the affirmative,was the power to alter,amend,or revoke the inter- est of the beneficiary reserved in the decedent alone or the decedent and others? (Answer yes or no)n/., NOTE 1:The answers to these questions should be supported by affidavit by the attending physician as well as a copy of the death certificate. NOTE 2:If answer to any of the above questions is yes,set forth below a description of the property transferred,it's fair market value at date of death,dates of transfers and to whom transferred,with relationship of transferees to decedent,if any.Submit copy of any trust deed or instrument,if trans- fers are claimed to be non-taxable,also submit detailed statement of facts on which said claim is based. NOTE 3:List applicable property below in manner in which provided in Schedules A,B,or E. ITEM DESCRIPTION MARKET VALUE (Estimated)DEPT.VALUATION (Dept.Only) Insert this total opposite "Transfers",Schedule "C"in the "As Reported"column on the last page of this return. CaM\h),\,WF:\LTH OF l'ENNSYLV:i.NIA f:,\:\::'l'FH rXHFlllTANCE TAX n.F:~IJ)EXT DECEDENT SCHEDULE "E" JOINTLY OWNED PROPERTY I~srRrCTIOSS:This schedule must disclose all property,real and personal,owned by the decedent 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 ,-mder Schedule "A",plus the date and place of record of instrument effecting vestiture,but elo not include entireties or out of state real estate value in estate valuation column.Personal property should be listed as in Schedule "B",plus date of acquisition,and the name,address and relationship (if any)of co-o-wners to the decedent. Description of Property,Date of Acquisit-ion,-Name!uni t Address anel Relationship of Co-Owners,and Place ,Value of Record of Instrument,where Real Estate.! percentage Share ..J__ Estate Valuation DEPART~lENT VALUATION CAUTION-Do not Write In This Space• Value of Value of Entire Decedent's Property Interest Insert this total opposite "Jointly Owned Property",Schedule"E" in the "As Reported"column on the last page of this return. ...~. RCC-37 (12-63) COI\1I\IONWEALTH OF PENNSYYLANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT •->f.'_~ SCHEDULE "D",J BENEFICIARIES BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED(If step-children or DATE INTEREST OFStatefullnamesandaddressesofallwhoillegitimatechildrenDECEDENTOFBENEFICIARY ave an interest,vested,conti~gent or other are involved,set STATE YES IN ESTATE wise,in estate)forth this fact.)OR NO BIRTH Esther M.Wilson Wife Yes Entire 42 Hic:rhlnnd Avenue Burc:rettstown,Pa. ( h Deponent further says that all the above-named beneficiaries are living at this time except below: NAME DATE OF DEATH RESIDENCE ~[ATTER OF THE APPRAISEMENT OF THE ESTATE OF Will Administration (No. DO THE Year . (Executor-Administrator must complete "As Reported"column #1.) Cl ...,'"t:1 ::0 '"''"'(l)(l) 0 ~'"'~til ::s til til til 0...,@"'::s '"t:1~'"'~....0;.:til '0~'"t:1 (l)er'........ ~0 ~'0 trl (l).... til ,.......'<~....(l) ".;,.,, HUGH...R.WILSoNalk./aH.R•..WILSON Deceased Late of..B.UJ::g~t:t:!J.t~. REPORT AND APPRAISAL Commonwealth of Pennsylvania !1 :l'l'J ( s.,....,"..",J C.,..·I,.•_~•..J enc::~~;.> ::0"-"""-"""'-""~W en ennn?"?"'?"'o tJ >::::::-........ ~-oo~-oo-oo-oo.0 1.» ~.:"f';.>,.Vi til ~.;..,J::O.:~.g:: .~.•0-••0 ~K ....~:.'''-C\o -,,: -oo-oo~-oo-oo-oo ~.~.;.>;r.~.of'•0 ~.'".~~ ~.(t t~'"'-'\l'3 ~.::s~(": O·c... "--~" W~shillg~f:)~ C1 ~I County of ~CC-3Q (e-a,,! ':OItIMONWEAL TH OF PENNSYLVANIA.. TRANSFER INHERITANCE TAX RESIDENT DECEDENT vJILSpN,HUGH h.a/k/a l;VlLSON,H.li. n1~#6.3-68-271 February 2,1968 SUMMARY J I.the unrlersignen #6.3 Washington FILE #6.3-68-271 the real ann personal opposite each item in rtEPOnT OF INHERITANCE TAX APPRAISER rtuly appointen Inheritance Tax ~ppraiser in ann 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". Da ted:10-02-68 02-02-68 REPORT OF THE REGISTER OF WILLS I,the undersigned duly elected Register of Wills in and for _ County,Pennsylvania,do r"spectfully report that I have allowed deductions in the amounts claimed b;y deponent,except as to those i terns where a greater OT 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: REGISTtR OF WILLS VALUE AS REPORTED VALUE AS APPRAISED VALUE AS REAPPRAISED $$$------36,574.01 36,274.01 INVENTORY Real Property (Schedule ~) Personal Property (Schedule B) Transfers (Schedule C) ,J oint-Heln Property (Schedule E) TOTAL GROSS ASSETS LESS Debts and Deductions (SCHEDULE F) CLEAR VALUE OF ESTATE Valuation of life estates or annuities . . . • . . . . ESTATE TAX ASSESSMENTS 36,574.01._ ====="-".- $--_. 36.574.01 ======:========l= COMPUTATION OF TAXFORUSEOFREGISTERONLY Tax on $f5~1a <l>.--.~) Tax on $101 ~ Tax on ~>~#%~$ Tax on $.__1Fl%$ Exemptions :=(:::) Total Estate TOTAL TAX Less tax previously paid BALANCE Less f5%of tax if paid within 3 months after death $----- *=====:=:\=$--~~-- $=====:-,-- (:::)As evidenced by Charitable Exemption Certificates issued by the Secretary of Revenue. 3ALANCE OF INHERITANCE TAX nUE $---------~--- 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 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 Year . IN THE MATTER OF THE APPRAISEMENT OF THE ESTATE OF HUGH R.WI~S.~~Cl:/~/{i Deceased Late of .........BUhG.J:!.TTSTJWN......--._.._-..-. County of ..1,rV-!iSIj,lNGWN. Commonwealth of Pennsylvania REPORT AND APPRAISAL COUNTY ~.~.~!J:~~.?!1 . FILE NO :??:.§.?.:.~~.~_. DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS HARRISBURG.PENNA.17 127 COMMONWEALTH (fF PENNSYLVANIA ...-.....,-- RESIDENT INHERITANCE TAX APPRAISEMENT DATE October 2,1968 Whereas,H1lB:.h ~.~.w.~J.,~.9.n.9:/"¥/.?::late of ,a.),p;g~t.t&t..9wn .. in the County of ~~.~.h.~.~.~gP.:Commonwealth of Pennsylvania,having died on the ?!!:~day of F.:.~1?~~:ry................................19..2~,seized and possessed of an estate subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore,I,~.~.~.~9.~l}.~.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 ItheexpirationofanyestateforUfeorforyears.the Commonwealth hereby expressly reserves the right to appraise and assess transfer inheritance taxes at the lawful collateral rate on any such future interest. Unit Appraisement Description of Asset Values Made for Inherllance Tax PurPOleS $ , P.ERSO.l~ALTY : 146 shares Standard Oil Co.of Ohio Comnon 0 Unit price $66.50 $9,709.00 100 shares -Standard Oil Co.of Indianna -Common - unit price $52.50 5,250.00 33 shares -St.Joseph Lead Co.Conmon -unit price $41.875 1.'381.e7 355 shares -American Metal Clims.x Inc.Common 0 Unit price $48.375 16,205.64 68 shares -American Telephone and Telegraph - Common -unit price $51.875 3,527.50 I 1964 Dodge Automobile 500.00II Total 36,574.01 36.574 01 Total 36~574 01• I form~;~fhh:::::h~.W~.~~~:~~o~~!~h>o~~~~fle~~~i~/ ;ZZZ;:d_~(N\J~8Dd Street) .............<::--;;;;r.(p;,;,~i·····Penna. r WASHINGTON Coullty ,. RESIDENT INHERITANCE TAX APPRAISEMENT Estate of HUGH...#\Ii.r.:L.§9.N.~I~!~~. Deceased. Late of ...................:I3,Y.~G}!;T1'$'l'OW.~. Date of Death,.f.~p.r.:.1,@.:r.i..?J j,.99..$. Appraisemcl!t Docket Vol.,3..7 :.. Page,83.~.5 No 6:3"".68".,27~·· Filed in Register's 0 fficeJ Q9..t9.P.f3,.:r.~.J.199..$.. Am.ount of tax due,$.. DEPARTMENT OF REVENUE Received, Examined and Approved,,:. Wrote abo.ut Appraisement, Appeal ft-om Appraisement,. Entered and charged,. .. RESIDENT DECEDENTSFormRCC-4-RI-3-66 924903No.,_ COMMONWEALTH OF PENNSYLVANIA OFFICIAL RECEIPT Transfer Inheritance and Estate Tax FileNo.63-68-271 Date,---'lVr!'i,u.-dbini1l:wn-u....r'"'y..-"'il2lflOI-,-19--6& ----...,-....UH't:;~Sle;~r:riI'F:~zeP-:Tql:4!lO~N~---County,ss: no/lOO Dollars,-- Appraisements Made and Filed Computation of Tax 1,518.95 5%$ lO'Yo $ ""itt $Op 15'Yo $ Exemptions *$===========:::; Tax on $_ Tax on $~__ Tax on $_ Tax on $--jGpt,n--I.il'""c,...,tllr.o""U......nni!t--~~ Valuation $,------- $,------- Total $,_ Personal Property Date Real Estate NOTE:This Triplicate Receipt to be retained by the Register of Wills and filed in numericalsequenceforauditpurposes. $======== MOORE BUSINESS FORMS,INC.,ELMIRA,H.Y. Balance $_ Register of Wills Total $1 500.00 *As evidenced by Charitable Exemption Certificates issued by'the Secretary of Revenue under Act of May 28,1956,P.1.1757,effective June I,1957,as amended by Act No.381,approved July 11,1957,and Act No.207,1961,Section 302. SEAL /,,-)r C;I-'II ",-IJ>G--, Amount of Estate Tax Assessed under the Act of May 7,1927.$_ Total Tax $_ Less Tax Previously Paid (if any)$=========== Add interest at the rate o....f % from _ Less five per centum of tax if paid within 3 months after date of death $=====:::::j7~S:;l::••~9~S):::== to ~_ Total Estate $_ $,------- $ $,------- $ $------- $,------- Total Date Valuation NOTE:In accepting the transfer inheritance tax on future estates prior to the death ofthelifetenantortenantforyears,as evidenced by this receipt,it is understood that the Com- monwealth shall not be precluded or prevented from hereafter assessing additional inheritance tax at the death of the life tenant or tenant for years whenever it appears that such additional tax may be legally due and collectible for any reason whatsoever. Total Gross Assets Less Debts and Expenses of Administration Clear Value of Estate Valuation of Life Estates or Annuities Date 19__$,_ ________:19__~$========== Estate Tax Assessments Date ~19__$_ ________19__~$====== FORM RCC-4-RI TRANSFER INHERITANCE and/or ESTATE TAX. RESIDENT DECEDENTS. RECEIPT Docket J 2 Page 1"3 Line S- HUGS R.UILSONEstateof'--_ OFFICE OF REGISTER OF WILLS t7ASfllt:GTON t ----------.lPa. Date Fcbi"OO17 2019 Ga 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 nussrw.tJAnINO 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 moneywiththeamountreceiptedfor.The original 01 each suchreceiptshallbesignedandsealedbytheRegister01Willsandtransmittedtotheexecutororadministrator.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 L Ants.BLOOUttlLOO~,nO~1JIL'l.O&aLdon 200 t1ASiJI};GiOU iftUSl BUILDII\.1} ------------------------- RESIDENT DECEDENTS --..-..Dollars, 63-68...271FileNo.~_ COMMONWEALTH OF PENNSYLVANIAFormRCC-4-Rl-3-66 979211 OFFICIAL RECEIPT No..Transfer Inheritance and Estate Tax Date Docomber 30 19 68 l1ASHINCrrON Office REGISTER OF WlLLS,·--.=----,,~"'.-ri--------------~Pa.t'lASHINCTON ED'ther ti.v loon--------------'County,ss:Received from _ (Executo~of the estate o'1-f HU_'_C_I_f_R_\__mo:-"_L-:-S-:-O_N__"'7""7::::--_--::::-:::-r-:-:::.-::::-_ who died Februa.ry 2:19 6a ,the sum of FOUR HUNDRJZD FIVE AN»8S/100 being TRANSFER INHERITANCE TAX and/or ESTATE TAX due the Commonwealth as follows: Appraisements Made and Filed Computation of Tax Date Valuation 1,984.83 $===i4~e~s~.S6J,;O~= $---------1,578.95 $=====:~;::::::;;m===405.88 $--------- $======= $--------- 5%$ 6~10%$ ~$ 15%$ j" Tax on $~__:_:;;_- 33,080..53Taxon$_ Total Tax Tax on $_ Balance Tax on $_ Exemptions *$=========== Less Tax Previously Paid (if any) Less five per centum of tax if paid within 3 months after date of death Amount of Estate Tax Assessed under the Act of May 7,1927. MOORE BUSINESS FORMS,INC.,ELMIRA.N.Y. Total Estate $_ .Total $_ *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 Tuly 11,1957,and Act No.207,1961,Section 302. S E A.L / " Add interest at the rate OJ-f % from _ to _ 37-33-5 $36.514.01------- $36,574.01 3,493.48$,--=--=~---..-:;,.....33,080.53$ 36,514.01 Valuation $,------ $,------ Total $,_ $ $,------ Total 10-2...68 Date Real Estate Personal Property NOTE:This Triplicate Receipt to be retained by the Register of Wills and filed in numericalsequenceforauditpurposes. Total Gross Assets Less Debts and Expenses of {}2711G81AA Administration Clear Value of Estate Valuation of Life Estates or Annuities Date,19__$,_ ________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 83 Line 5 Estate of ooon It..tIlLSON OFFICE OF REGISTER OF WILLS tJASHINGTOrJ Pa. Date »c~cmb'?r 30,19-68- 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 ~ nusmIJ:.rjffi1.Irn) 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 entilled to a credit in his account by theRegisterunlessthereceiptissosignedandsealedbytheRegisterofWills," Fill in below name and address of person to whom tax receipt is delivered: I To L I ATTYS..DLOOU,OLCOtt,nOSBNimRO f1 ilLO<r.l 200 UASnING10N 'mUST BUILDIr~ ." Regllter of Willi.Agent DATE STATEMENT OF DEBTS AND DEDUCTIONS OFFICE OF THE Form RCC·IO ESTATE OF Hugh R.Wilson a/k/a LATE OF Burgettstown,Pennsylvanla H.R.Wilson DATE OF FILING APPRAISEMENT /.2.-30 -&'f~ATIi:Oil'DEATH 2~/_2-,/_6_8 _ DATE NO.OF VOUCHI:It 2/7 68 2/16 68 2/8 68 2/14 68 2/20 68 NAME OF PAVEE Russell Marino.Req. Russell Marino,Req. Washington County Reports Burqettstown Enterprise Russell Marino REMARKS Letters T and 5 S.C. 1 Sh.Cert. Advertising Advertisinq Inventorv Russell Marino Final Account Bloom.Bloom Rosenberq &B Attornevs'Fees 2/20 68 2/R hR 2/8 68 3/30 68 3/4 68 3/4 68 3/4 68 Angelo Spanogians,M.D. Rev.Jacob C.Ruble Rev.John P.Borter Washington Hospital Lee &Wilson Funeral Home McCoV Company Shaffer Pharmacy Last Illness Funeral Service Funeral Service Last Illness Services Merchandise Medicine {/ --;--t----t-------------j----------+----t-c! TOTAL 3'A.D,DUCT,O.''OR it USd"h (L.5.) COMMONWEALTH OF PENNSYLVANIA } COUNTY OF _--,-,W:..:a::.:s::.;h=i;.:;n::.;;g;Lt::.o::..:.:n~80: ".--.......LE...s:l..tl-hu.s;;e;.j,r.......JM:.LL.~Wl.iL...l.w:iS.!oiou.nL_~_~HEREBY CERTIFY.THAT.TO THE BEaT OF MY kNOWLEDGE AND BELIEF.THE FOREGOING 18 A JUST AND TRUE STATEMENT OF DEBTS.FUNERAL EXPENSES AND EXPENSES O~ ADMINI8TRATION 8UBMITTED TO THE ESTATE OF Hugh R.Wilson INHERITANCE TAX PURPOSES.£/! :<7 tZ unw ~7b< IIUB8CRIBED BEFORE ME THIS DAY OP'•--;fF-I-----"~'9P~~'#~;=:::::....,..._18 ~ ROW!cNE E LING NOTARY PUBLIC MY COMMISSION EXPIRES FEB.8.1969 WASHINGTON.WASH-INGTON COlmTY ~'. '.-I 'n -, " r S7";1".')':-1.~'P'j,.C;;,::~:,:"·iJ::i:.:J lr J.IJ r __....r