HomeMy WebLinkAboutOC1968-0302 - ESTATE OF LITTLE~tatr of 'rnnagluania.t ss:
Cltounty of Baa4ington \
Personally before me,the undersigned authority,a :NQ:£~.*-.Y.f.!J.Q.!.~.£in and for said
GEORGE J.LITTLE .County and State,appeared who,beIng duly
sworn according to law,deposes and says that·he is theJlnlllllQKJOt administrator of the estate of
............................~.~~XN~~J'r'!:~deceased,that the foregoing schedules constitute a
complete inventory and appraisement of the real and personal estate of..~..~~~.~~J1'.'!:g ,
deceased,except real estate outside the Commonwealth of Pennsylvania;that the figures opposite each item
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 jULt-praisement of~a£h
item made by the above namediiHeQlKr Administrator.k~
Sworn and subscribed before me this ~.Q.~.t ;February 68.~
day Of.~;z;{~~9............,E'Li~i·;..;;.;...iiiAd;i~i~t;~t~;..· ·..N·0,'Ccfr·f~~1fh:c ..;....V1ct'~~H'r~'Wa·s·h·t'tlg on
County2,Pen'osylvanta.",~nJ:TIO.NAL INSTRUCTIONSMt;0£Qlll1.ssion ex ~r .';e\,.'i!';'19'l1y.l.An mventor~niuJf ~e'fiPe'~lt .t8ree months after appointment of personal representative.
2.A supplc:rp.ental inventory must be filed within thirty days of discovery of additional assets._
S.1 Original ""nd 2 Copies and 2 RCRI-34,Under $10,000;1 Original and 2 Copies and 2 RCRI-33,
Over $10~OOO,including Copy of Will;1 Original and 3 Copies and 2 RCRI-33,Over $50,000,in-
dudingCopy 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
were
lIuueutnrg nUll i\pprnispmput of the goods and chattels,rights and credits which
of ~.:~~.~~.!.TI.~!f late of ~~.~.E ~.!~.~~.!?9.~.~.J g..~J?.~..1t.J".
Washington County,Pa.,taken and made in conformity with the above affidavit.
DOLLARS CENTS
ALL that cer~ain tract of land si~ua~ed in West
Finley Township,Washington Coun~y,Pennsylvania,bounded
and described as follows:
BEGINNING at a corner (southeast)on the public
road;~hence 1.n a westerly direction along the line of
said publiC road 150 feet to a stake;thence in a north-
erly direction with ~he line of Harry Win~ers (formerly
M.J.Wht~eman)220 feet ~o a s~ake;thence inan easterl~
direction with-the line of W.A.Ritchie (formerly Swan
Ritchie)102 feet to a stake;thence in a·southerly
direction with the ltne of said Ritchie,201 feet to the
place of begtnning.
SUBJECT to right of way 1n rear of lot for use of
adjoining property as used at present by owner of said
adjointng proper~y.
UPON which ts erected a seven-room frame dwelling
va lued a~~he a ssessed va luation of,S,000 00
'"
63-68-302
"..
l~/J..
",
I!lv.flntory and Appraisement
IN THE ESTATE OF
"
."E.-,LYNN LITTLE
...........:..i'":~..
"l\..
F:iled FEBRUARY 26..................................................................,19 68 ............
..
r-;
~~
::0 -.,,.,,::0 r"me:U-I./)t j~•.I)"1 :;]r.'~-:::""r-L;r--
0..".J-,,-~-~_:t>~,
•f-:~;:=:::;0r-~.-(1)0 ..........-,,
f\).,
D.M.CUMMINS
Attomey at Law
VVashington,Pennsylvania
~2
7 f-:<~
OFFICE OF THE REGISTER OF WILLS
FOll11 ","0.RCC-62 (12-66)THIS FORM REQUIRED IN ALL ESTATES WITH GROSS ASSETS UNDER $10,000.UNDER SECT~O~FJUN~I.
"EFFEC3!VE JANUARY I,1982.(F~LE IN Dl.jPLICATE WITH COPY OF WILL ATTACHED).--f rJ..
vJ9-~
County of Wasbitlgton '..,. , .
.....C?~.~~~~.~:..I;~~t.l.e ,.,..' ,of ~9 .~~~~lf~r.\yp.qq .:YP:11~,Wh..ng.W•.v.a..~..
(Name)(Addreaa)..
being duly__u.s_W_QrUuu u n u.according to law,deposes and says that he is the--~~.p.~O{J1/~iftJY':n -....-7A.~-t~t.:"m.,Legatee,E .)
of the estate of E..LY-mLLittle whose last residence was _R.__D..._ttl#-W~J?_LAl~xang._e_r..~--p.a,---I
.(No.)(Street)W_e_~LE~Ill~.Y.-T-Q.wXH:~h~R .deceased,and that the whole of the estate of said decedent,who died __;r_~r.!:y!?--_r;Y..__~Jn.__.1-'1 ~
(CitY,Borough or Township)(Date)
consisted of:a house and lot located in the Village of Beham.
REAL PROPERTY
REAL PROPERTY IN PENNSYLVANIA.WITH STATEMENT OF MORTGAGE ENCUMBRANCES UPON EACH PARCEL AT DEATH OF DECEDENT.
WHERE PROPERTY HELD AS JOINT TENANT OR TENANCY BY ENTIRETIES.GIVE NAMES.ADDRESSES Aim RELATIONSHIP OF OTHER OWNERS,
Real Estate Estimated
ALL that certain tract of land situated in West Finley Value
'l'ownstl1p"Waslllngton County"Pennsylvania"bounded and described as
follows:
BEGINNING at a corner (southeast)on the public road;
mence m a westerLy direction along the lme ot"said public road 150 feetto
a stake;thence in a northerly direction with the line of Harry Winters
(formerly M.J.Whiteman)220 feet to a stake;thence in an easterly
direction with the line of W~A.Ritchie (formerlv Swan Ritchie)102 feet
to a stake;thence in a southerly direction with the line of said Ritchie"-.-......--,,-.~u J.reet to tne pLace or oeglnnlng._LU-•-
SUBJECT to right of way in rear of lot for use of adjoining
p.L VpC.L Y a8 usea at present oy owner or sala aaJOlnlng property.
UPON which is erected a seven-room frame dwelling.
~a
V r2~-'J ('1ft ..A..~::>"UUU.uu...L_~72..~
oJ -d J)~:"~_.-1/~~~~~~~.Aj ~~(J_~dJ7t%;.,~.rJ2 .i
I~r
~-~~p.erPersonalProperty
NONE
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.
-~~-~----~~~~--~-~-~-----------------------~----
Jointly Held Property
NONE
EstimatedValue-..
1 '
q.
~.\..\
f'
,
,r
'j ,
,.
:[
.J':,
Transfers within TWO YEARS Prior to Death
, f
r .'j
,J
,r
J
J
'J ,
, J r
• r i
J1
,J
j
, J
'J
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,,.-:'J):}1:
That at the time of death there was no safe deposit box registered ih decedent's individual name,or jointly with,or as agent or deputy of
another,or in decedent's individual name,with ri~ht of acc.ess by an'oUier'as agent or deputy,with the exception of the following:-'.J'..
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
NONE t '.i• J J
-
BENEFICIARIES
BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED AGE OF LIFE
(If step-children or DECEDENT TENANTS OR INTEREST OF
(State full names of all and their addresses who have illegitimate children STATE YES ANNUITANTS BENEFICIARYaninterest,vested,contingent or otherwise,in estate.)are involved,set OR NO AT DEATH OF IN ESTATEforththisfact.)DECEDENT
George J.Little son yes ----entire
.'
-
......
".
""
.
""-----------------------------------------------------------
.--
none
/
/
/
co mission *
~
*
(*)See Note below
/
I
Fiduciary
Fa ilyexemption (will not be allowed un~s
dece nt died residing with a spouse or children.)
/
DEBTS AND DEDUCTIONS CLAIMED
($250.00)
$2"097.81
OTHER DEBTS ANd CLAIMS
ncludin Two Hundred Fift
NOTE:List first five items in the spaces s provided,observe notations thereon,and instructions.
RESIDENT DECEDENT
.---'D=-E=B.c::..T_O=-R::..:.......cC:..::L:.:.A.:.:I=-M=------\-.c::..N:..::A=-T=-U=-R:.:.E=-O=-F:........:.:S:.::.A:.:.M=-E=-----:~-:..::A.::..:M=-=-O...=.U=-N:..::TT______inTHIS COLUMNEGISTERONLY
97 $
Total
Wheeling"West Virginia.............(City '~r'To'~~'~~iSt~t'ei'"....,.'".
Note:The est<lte agrees to advise the Register of Wills if the amount actually paid in settlement of any
or less than the estimated amount claimed and allowed.
Subsc!'ihed and sworn to before me this.. . . . . . . . . . . . . . . . . . . . .____
~r-1"I ___....4f~:..~.daYOf ...fV0.1<\-~"9GY.....~~.:z~.
;lof<lry Public,Washington,Washington Co.'"
iily Commission EXpires ]unQ 28.19z:t
Having been dUI;:7~accOrding to law~~y that the above appraisement is2'in conformity with law on this
............~dayof ··~··7..j':dJ ~,)!!..·../7 /p
..//f.~~;;:z~~..~t?._.A~~~r
In the event that any future interest in this estate is transfened in possession 01'enjoyment to ral heirs of the decedent after the
expiration of any estate for life 01'for years,the Commonwealth hereby expressly reserves the right to appraise and assess transfer'inheri-
tance taxes at the lawful collateral rate on any such future interest.
l
REPORT OF TH jYGISTF;R OF WI LS
I,the undersigned duly elected Register of Wills in and for.. .~~~--e-;.•.'County,Pennsylvania,do respectfully
report that I have allowed debts and deductions in the amou ts claimed by depone except as to those items where a greater or lesser amount
:::d~o~=:;(t:fi~::;;;;d~.l~.above,which greater 0 ~s.s~~.e.~~.~c.t~~~.....
Register of Wills
<.;.Fonn Xo.RCC-62 (12-66)
It/I
.:-,';;~~(!r'IJ I"~J
l .,.r-///~.I...
•..~~.~:,;J ';.
"
Will
Administration !NO .year ......~,...-l...Of...'.(,.',
.,h,···.
IN THE
"MATTER OF THE APPRAISEMENT
OF THE
ESTATE OF
..."0 r"~~,$~~/'.~.-:->.:...._..«,./~
..........,I j':'".(~::-:.,..C"./.\...'
#'J'4'~....~I c:.\..~,,"\'
'"1"f ,Il I 1I ~\• \
Deceased
Late of ..
County of .
Commonwealth of Pennsylvania
--..
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.J
.....
,,.
.
(..
REPORT AND APPRAISAL...,i!i3:!!.-•
-('7)~C/),..,.,,.,..,_r--
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R C coal (2-64)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
INHERITANCE TAX DIVISION
NOTICE OF FILING OF APPRAISEMENT
G.b;URG~J.l.IT'l'L.c.
(~Administrator)C.T.A.
IN YOUR REPLY PLEAOE
REFER TO 37-84-7
In Re:Esta te of -'E:::.i·~.-,L:::.Y~NN=-,L:::.I::::.T.:!:..T~LE~'_
____---,O<W:::.:AS::::'H:.:..:IN=G~T..=;O.:..:N County -File No.63-68-302
Dear Mr.Little;
You are hereby notified that the original
appraisement in the estate of E.Lynn Little
has been filed_in the office of the Register of Wills qf Washington
County on March 27 ,1968.Said appraisement reflects the
following valuations:
Re alEst ate --'5,1-.0.:::,0.:::,0.:::..:.,.0;::.0:::.-__
Personal Property __
Transfers _
Tota1 5J.,'uQQ~QLA.u.Q~Q'___
As to such tax that is paid within three
death,a five (5%)percent discount is allowable.
remains unpaid after one year from date of death,
of six (5%)percent per annum is charged.
months from date of
As to any tax that
interest at the rate
Any party in interest who is aggrieved by an appraisement may
appeal therefrom as provided by law.
Date ~Ma...r~lt31,__~..~,{4;9;:;;:8::.--_~~~~~'--~~
Title \'i.R.CHANhY,APPliAlbE,H
DATE OF DEATH:January 5,1968
Note:This is not a bi".
RCC-39 (6-67)
COM~ONWEALTH OF PENNSYLVANIA
TRANSF ER INH ERITANCE TAX
RESIDENT DECEDENT
LI'rTLE"E.LYN11J
FILE #63-68-302
Januar;'S,1968
SUMMARY
rmponT OF INHERITANC1~TAX APPRAISER
duly appointed 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 S hedules "A","B",nd "E".
01-05-68
03-27-68
FI.LE #63-68-302
I.the undersigned
#63 Wash:i.~tQn
the real and personal
opposite each item in
Dated:
03-27-68Dated:
REPORT OF THE REGISTER OF WILLS
I,the undersigned duly elected Register of Wills in and for Washington
County,Pennsylvania,do respectfully report that I have allowed deductions in the amounts
claimed by deponent,except as to those items where a greater or lesser amount is set forth
in the last column to the right in Schedule "F",which greater or lesser amount represents
the sum allowed as a deduction.
REGISTtR OF WILLS
VALUE AS REPORTED VALUE AS APPRAISED VALUE AS RE,~PRAISED
$5.000.00._*_5,000.00 $_
INVENTORY
Real Property (Schedule A)
Personal Property (Schedule B)
Transfers (Schedule C)
J oint-Held Property (Schedule E)
TOTAL GROSS ASSETS
LESS Debts and Deductions
(SCHEDULE F)
CLEAR VALUE OF ESTATE
_----5.,000.00._
2 2099.3J.:=
2.900.63.__
5,000.00
==2..099a1
2,900.69
:=======:=
Valuation of life estates or
annuities ..•.....*-----
ESTATE TAX ASSESSMENTS
TOTAL TAX BALANCE
PAID
St _
$--------
g;-------*--------$
As evidenced by Charitable Exemption
Certificates issued by the Secretary
of Revenue.
*--------
C01UPUTATION OF TAX
$======1=
*d>-------c:'_
$-----'):$======~=
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%fromto__
FOR USE OF REGISTER ONLY
T ax on $•__!'5%*_
T ax on $_!9~!P.__---,...,
Tax on $2,900.69 :=~$__t/J.tl03(.Tax on $.__lfl%$_
Exemptions=======:=(':,)(.,:')
Total 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 t NAdministration\o.
IS THE
Year .
~IATTER OF THE APPRAISEMENT
OF THE
EST.\TE OF
l!;..LYNN LITTLE
Deceased
Late of ...W.~.4WN.P:E;E...
County of .W1\.SHINTON .
".,.;..,
Commonwealth of Pennsvlvania.~
REPORT AND APPRAISAL
f
_"'1~:.~···"""''''
_R_~~-:roI'_"""~;"~'-=O---'-"_~...~-i---
Dollars,....-
·BESIDENT DECEDENTS
File No.63-6S-302
COMMONWEALTH OF PENNSYLVANIA
OFFICIAL RECEIPT
Transfer Inheritance and Estate Tax
19681,
Form RCC-4-RI-3-66
Date Ap'QU
No.948627
Office REGISTER OF WILLS.,t;;....:IA;;....:S::..;:f=II=N:..;;;.G...=.T..:;..ON.:.:..---.lPa.
HASllIrroToN County,ss:Received from_G_O=-O:..:r~I1::!.C=-·:.:...:J~.:.:...:L:.:...:l:;:..t:;:..'t.:..::l:;:..o=-----'--_
~or.~1ristrat~~)of the estate o'.l-f ~G.....<---.IIt.u,fnu..iLrrJ:L.....lILIot.IIL.oTL..TLJLwE~1 ~-------
who died January S 1@~,the sum of Olm liUNDnED SIXTY.FIW tUtcl 3~/100
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.
174.04
$--------
$---------
$=======
$--------
$===G~',=7:==0===
Tax on $_
MOORE BUSINESS FORMS,INC.,ELMIRA,R.Y.
Register of Wills
5%$_
Tax on $10%$_
2,~OO.69 Gr:5l2%$_--"'1~7....;..~..:....;.04~__
Tax on $15%$_
Exemptions *$===========
Less five per centum of tax ifpaid
within 3 months after date of death
Total Tax
Tax on $
Balance
Less Tax Previously Paid (if any)
$=::::::::::=====
Total $__1_6_5_.3_4 _
*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.207,1961,Section 302.
S E"'AL/"1/.,.,,:...'...-,/.I'l":"":./.....",tC-•//-4 "'l (.-I--t.-.t/
Total Estate $_
Amount of Estate Tax Assessed under
the Act of May 7,1927.
Add interest at the rate o,!-.f------~"/d
from _
to _
$5.000.00
2.099,31$-------
$2.900,69
$,-------
$5,000.00
$-------
$
ValuationDate
Valuation
$5.000.00
$------
Total
Personal Property
$,------
$-------
Total
Total Gross Assets
Less Debts and Expenses of
Administration
Clear Vp:lue of Estate
Valuation of Life Estates or Annuities
Date,---:-19__
_________19__
Real Estate
Estate Tax Assessments
Date,19__$_
________19__!::$============
NOTE:In accepting the transfer inherltance tax on future estates prior to the death ofthelifetenantortenantforyears,as evidenced by this receipt,it is understood that the Com-
monwealth shall not be precluded or prevented from hereafter assessing additional inheritancetaxatthedeathofthehfetenantortenantforyearswheneveritappearsthatsuchadditionaltaxmaybelegallydueandcollectibleforanyreasonwhatsoever.
FORM RCC-4-RI
TRANSFER INHERITANCE and/or ESTATE TAX.
RESIDENT DECEDENTS.
RECEIPT
1S431DocketPageIjne'_
Estate of E.tnm LIfiLE
OFFICE OF REGISTER OF WILLS
tJASHIf:GTON,____________-IPa.
Date april 1 19~
SIGNED AND SEALED AS PROVIDED BY
SECTION 1201.ACT APRIL 9.1929.P.L.343
AS AMENDED BY ACT MAY 15.1945.P.L.528
RUSSIaL rmnn:o
Register of Wills
1201 (g).Act of April 9.1929.P.L.343.as amended.viz:-""To receive from Registers of Wills all dupliccrte re-ceipts for taxes paid to them by executors or adminis-Ircrtors and to-charge the Registers receiving the moneywiththeamountreceiptedfor.The original of each suchreceiptshallbesignedandsealedbytheRegisterofWillsandtransmittedtotheexecutororadministrator.whereupon it shall be a proper voucher in the settlementofthesstcrte.In no event shall the executor or adminis-trator be entitled to a credit in his account by theRegisterunlessthereceiptissosignedandsealedby
the Register of WUls:'
;
Fill in below name and address of person to whom
tax receipt is delivered:
I
To ATTY.D.~1.CUl>21fiNS
220 SASMIKo1oN TaUST BUILDING
I
L
UASHD:GTON,PENNSYLVAlnA 15301
--1
I
~
Fonn'RCC-2·
,.
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
HARRISBURG,PENNA.17127
COMMONWEALTH OF PENNSYLVANIA
RESIDENT INHERITANCE TAX
APPRAISEMENT
DAlTE Mar ch 27."1.9.68 .
COUNTY J(~~~l9.~..
FILE NO...§J..::??:.?.9..?.
Whereas,~.~I,.Y:O:n ~it.t.l~late of W.Al~xande.r..
in the County of W~.~h~gt..on.Commonwealth of Pennsylvania,having died on
the 5.~.h day of v.:@.~.r.y 19 6.$..,seized and possessed of an estate
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore,I,W.~.-R..~Cha.ne.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 expiratlon of any estate for Ufe 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 AppraisementDescriptionofAlletValuesMadeforInheritance
rax Purpoaes
$
.ri.EALTY:
As per appraisement filed 5,000 00
PliliSWAl..TY :
NONE NONE
..
..THANSFERS:
NONE NuNE
JT.HELD:
NONE NONE
.
Total 5,000 00
~----
o
.........................~W.N>.J:i.J.J:J9:r.9.N .Coulley
......- -~--....-~-,....----,
RESIDENT INHERITANCE TAX APPRAISEMENT
Estate of
.............E .~....r..XN:N..~f',l'1',l,$
Deceased.
Late of
.w.~A~¥X.ANPER .
Date of Death,January -:5.,l-96.8 .
Appraisemel!t Docket Vol.,.3..7 .
Page,$4.~7 No 63.~.6.8:~~·a.02 .
........................................................................................................................
Filed in Register's Office,Mar.ch 27.,1968 .
Amount of tax due,$.
DEPARTMENT OF REVENUE
Received,
Examined and Approved,.
Wrote abo.ut Appra.isement,
Appeal f1'011l Appraisement,.
Entered and chnrged,,..
~:--.....-,~~~~.;-:::;-::-...-'-,...~~...;.,.-...-~-.~--:..:::--:---_.----~,.~::-=--~,-:;:._.~
,<
V
Form RCC·lt .•DEDUCTIONS ALLOWED IN
OFFICE OF THE STATEMENT OF DEBTS THE SUM OF •..•.......•$......ei:...c1Y£:#
REGISTER OF WILLS
OF COUNTY
~D DEDUCTIONS DATE APPROVED ..........~..=.c!!?...?=.~;-
~~T ~~;~~7-&J;j IZA~~Q 01%Register of Wills.Agul
"
ESTATE OF E.Lynn Little LATIi OF R.D.#1,West Alexander,Pa.
~.:2t~P January 5th~1968DATEOFFILINGAPPRAISEMENT•2 lr DATE 01"DEATH
DATI!:NO.OF NAME OF PAYEE REMARIUI AMOUNTVOUCHIOIiI
Russell Marino~Reg.Letters of Adm.C.T.A.12 PO
Observer Publishing Co,Proof of publication 12 50
Washington County Reports ""12 ~O
Florence Dasta Witness to will 5 PO
Edward y.~1~~~"'M.D.Medical service 25 (0
'.J ,~,rA~'
Ohio Valley Hospital Hospitalization 54 81
Kepner Funeral Horne Ambulance to hospital 38 11
Kepner Funeral Horne Cost of burial 1"285 ~7 I
Clergyman Funeral Services(2)30 00
Power of Attorney 25 00
Mae Herceg Affidavit to Inv.&App.1 50
I
George J.J3 Ii'Hit Z>r~k Executors fees 250 00
D.M.Cummins Attorneys fees 250 00
Alva King~bar)Utilities 31 41
Gas Gas bill 47 03
I
Telephone 6 69
Electric bill 8 79
Mae Herceg Aftidavit to debts &ded.1 50
Mae Herceg AUidavit to Form -RCt:n~.titi)1 ou
.-f-$%;-B9-9-3-1_.
-
-Z:;,4L .,:J Of'/'J/
COMMONWEALTH OF PENNSYLVANIA }
COUNTY OF __W~a_s_h~in....li2g_t_on_____so:
I.--.,;G~e~o~r;...lg=-e~J~.!.._:L~i~tt~l~e:...._HEREBY CERTIFY.THA!>-TO THE SUIT OF
MY kNOWLEDGE AND SELIE'F.T""~FOREGOING IS A .lUST AND TRUII!:DrAT FUNERAL EXPI!:NSE D EXPENSD 0 ..
ADMINISTRATION SUBMITTED TO 'fH.It ·..STATE OF _-.&-=:L::,,<..::n:.::n=-:L=it.::.;t:.:l:.::e77'~~"""::::::::":+-D..UCTIONli "OR
INHERITANCE TAX PURPOflE1I.
_-"'7D fl.,-~L..-=~=s-...:;.~~:z;;~~~¥::::::=~::::;;e.--CL.S.)
SWORN AND 5UDS:CRIS&D BEFORE Mil:THUS c;:;>r L DAY OF
Februa=%.HI ~2?i~.-=-?;Z!:..~.-~~.;.:::::~~~_
$2"099.3 1·MAt:HERCEG U __
Notary Public,Washington,_WashIngton CO.
My Ccmmission ExpIres Junl!28.1971
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