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OC1968-0366 - ESTATE OF SIVEY
' FOitM67 REV.l-50 REG. WILLS '- .Appliratinu for i4rttrrB of AilminiBtrattnu nu tbr Estate of ............. J1~X .... §J;.Y.:§:.¥. ..... ~/.J~/e .... ~.e .. :: .... ~x .... ~IY.:§¥. .................................................................................... . late of .................. f~.£J.± .... 1'.9.Yf.n.:?.h:i:.P. ......................................................................... , Deceased. Before the Register of Wills of Washington County personally appeared ...... ~e.:f..;i;..Q.Q .... :§.Sl:F-.!:9..1.±.:1 ........................................................................................................................................ . who, being duly sworn deposes and says that....M.9..:f.Y. .... §.;i;..Y..~.Y. ..... ~L~/..9.-.. J:1:F..§ .. ,. ..... M9.:f.Y ..... ~ .. :i..Y..€!.Y. ............ . age .... 9..J ........ , having ... h.§r. ..... last family or principal residence at... ......... M2-.t?.JJ?. ..... ~.t..:J;:~.~.t. ..................................... . (Street and Number) .............................................................. MU.S.~ ................................................... , Washington County, Pennsylvania, died intestate (City, Borough, Township) at .... ~F..QYill.§Y.i.J:.J:..~ .... G.~D..t ..... JJ.Q.§.J?..;h.t.g.J .. , on the ... ?:.4 ... day of ................ f.§J?.r..JJ.?.l:r..Y. ....................................... . A. D., 19 ... §~.~ ......... , at... ........................ ;?..:.}.9. ......... J?. .. ~.:M., possessed of personal estate to the estimated value $ ... J?.., .. 4..J.4 .. , .. J.I ..... , and of real estate in the Commonwealth of Pennsylvania to the estimated value of . \ $ ........ P..9.J:l§? ................. , situate in ................. :::::-.::.::::.::.:::::.::.:::::7.::.::: .............................................................................................................. . The names and addresses of the decedent's surviving spouse (if any) and other heirs including heirs by adoption) are as follows. RELATIONSHIP I I RESIDENCE ~.~E.~.9.~ .... !?.~.E:~9..~.~-~ ....................................................... 9.~~9.~!.~E.. ~~~.~.!.~.! ..... g.~.~ ............................................................ . That deponent is over 21 years of age, reside:s at... .. J?..Qf.i: .... J§J., ..... .N~.W.§ll" ..... P..£1:.,. .......... .1.2:4.!?..9. ........ . 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 ~revi<:msly issued thereon. Sworn and subscribed before me this ..... .J_.::. ) ~~---~~:-·······-·····--···- dayJ!?········M·~······-·····-::;_::;12 ..... ) ........................................................................................................... . .... a~ ......................... ~ ......................................................................................................................................................... .. REGISTER ~~::~::::~:.~;~;r.~~:~§.~~::rnes ..... !1~£~9.P._ ... ?-~£t.9..U.L ... -.. ·····················-··· who being duly sworn doth depose and say that... ..... !?.:h.~ .......... will well and truly administer the goods and chattels, rights and credits of ......... ~.~~.Y. .... §JY.§?.Y. .... e/~/.~ ..... ~:.§ .. ! ..... !1eE.Y. .... §J.Y.§?.Y ....................... , deceased, to the best of.h§?.f ... skill and judgment in strict compliance with the laws of this Commonwealth, mind- ful of the laws relating to inheritance taxes . . ~ Sworn and subscribed before me this .. ;!. ................ . ~:~#~-~~~~::.~=::::: REGISTER '· "· . .. ~· /701 i,;·;63-~ J-g ~ c, APPLICATION FOR Letters of Administration ESTATE OF MARY SIVEY a/k/a ........... M.B..S.A .... ~RY .... S.I.JlEY .................................... . Deceased R $ ................................ . ............ ~c.) Letters ......................................... · / C · p $ ................................ . Extra Alias ............. $ ....................... ~ ........ . ·Certificates ... / ......... $ .............. !... ... ~ .... ~ .. Renunciations ........... $ ................................ . ~·-·.·-~·.~·.·.·.·.~·.·.·.·.·.~·.·.·.·.·.·.·.·.·.·_· .. ··································· .!;;;;········ .. ········ ........ . ..................... t:-rc>< ;&-~P Toto!. ····-·-· ·······~~·· :::::::~::~::::::::::::::::::::::::::: ~-u-; • l (Tlf"tl ~ ;;u; -....] r--. !g:z: t --:r~ --;--. sr--.-4 -.:;::o ..• : t f j GEORciqy. MQDRA~ Attorney at·Law 22 N. Cent~l Ave. Canonsburg, Penna. Attorney ~ f1 11 ~2 N .... o ~-1,~ -----a -';). 3 7 ~ ~ I l~ ~ ' . 1Kunw l\11 !lru iy Wqr.ar Jrr.arut.a Estate of Ma.ry ... S.i.v.e.y. .. . late of . q~~~~---~P~ .. . . ... of 19 ........ . KNOW ALL MEN BY THESE PRESENTS, That we, Ivili.~. ~ ()_11 .13!3:~ .t. C?:JJ. ~-.. -~-~-.. -~~ ~!l~.~P.~ ~. ~:rl~ ... :lJll:~ ~~.~-.. -~ ~~ -~~-~ . F..~~~-~~ ~J ~. -~~-. Guaranty ~.?..~.--!j_~.l..~.~?.:r.~~. ... Jv1.~.~--··~\J:~f3.~.r. ...................... ················································································· ............. . all of Washington County, Pennsylvania, are held and firmly bound unto the Commonwealth of Pennsyl- vania:, for the use of those interested in the estate, in the sum of :F.J:V:~ ... 'r.J::lq.~-~-~t:'l~ ................. Dollars, to be paid to the said Commonwealth, to which payment, well and truly to be made, we do bind ourselves, jointly and s=_ve~ai_ly, 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 '!~h. • .. day of ............ Ma.r.ch ...................... A. D., one thousand nine hundred and ... Si~tY, ... ~!gP.t .... . THE CONDITION OF THIS OBLIGATION IS, That if the above bounden ............... . . . . . . . . . . . . . . . ........... ~r.i.on ... B.a..r..t.o.ll.1 .......................................................................................................... . 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 Sealed and delivered in the presence of: ~~iiiid(~&"~anty Co, Ba.lt.i.more...... . . •..... u..r.~ .. tY. .............. (SEAL) otherwise, it shall remain in force. ~ ~t~O~~ey i ct. ~ &tutrmrut nf t;urdy 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 a~d 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 P.O. &tutrmrut nf @lurtty 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 P.O. COMMONWEALTH OF PENNSYLVANIA, } SS· WASHINGTON COUNTY, ..., . 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 th1.t 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 _______ _ ----------------------------------------------------------------------------------------------- ~ tl 1· ,. 'v.' ~'~~-:'. . .;. l : l J. "' . 63 -68 -366 No. ___ j_7_a_J__ ______ _ A~miuintrntinu iBnu~ IN THE ESTATE OF MARY SIVEY aka ______________ l.ffiS._, ___ ~BX. .. ~~-~--------------------- And now _______ M@._~gb, .. J.~~-L ....... , 19 __ §_~--- Bond approved a·nd ;Letters issued to :::;::1 ___ •. ..,. ... -r,7.> .. : -( .. , _________ MARI.OJt1~RTO.LLI. ___ =_,_: ______________ _ ---1:-rJ ~c: ~·! -.J ,--' . .:--~-wbo--was .. fci-JP.y ... ~pa11:,ti_"e,d_. ________ __ ·--::;o -~:2 0 ro .p,. ____________________ Rus.s.e~l--,M.~u~i_nQ~--------------- 0 cv Register Bond Book ___________ 62,____________ Page '2..'~} __ _ BADZIK PRINTING ~9 DONORA ' ' -~ 1 ' I I I I l I i /, /. ell ,--~ .. ... .. C!rnmmnnwraltq of Jrnusyluanta.l s.a • 1ltlla.aqtugtnu C!lnuuty. I, 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, ·to Marion Bar tolli administratrix credits, which were of of all and singular the goods and chattels; rights, and Mary Sivey Mary Sivey1 A/K/A Mrs. late of Washington County, deceased, GREETING: . WHEREAS, the said Mary Sivey ,IA/K/A Mrs. Mary Sivey late of Cecil Twp. in the county aforesaid, lately died intes~ (as is affirmed), possessed of divers goods and chattels, rights and credits, within the said County, Russell Marino by reason whereof the power of granting administration thereof doth belong to me; I therefore, confiding in your fidelity, do by these presents grant unto you these LETTERS OF ADMINISTRATION, here- by committing unto you full power to administer the goods and chattels, rights and credits, which were of said deceased within this Commonwealth, you having taken and subscribed the oath of office pre- scribed by law; requiring you to well and truly administer the goods and chattels, rights and credits, which were of said deceased, and to exhibit a true and perfect inventory thereof into the Register's office, at Washington, within ninety days, and to render a just and true account of your administration at the expiration of six months from the date hereof, and to regard and comply with the provisions of the laws relating to inheritance taxes. IN TESTIMONY WHEREOF, I have hereunto set my hand and caused the seal of said Office to be affixed this 7th. day of in the year of our Lord one thousand nine hundred and Sixty Eight ., '• ~ ~ .... !5: 1f ~ '1 a to • i'1 ~ f j'< z b lea M ......... 'i i ..... r:Fl ~ t '< :<: t-3 i(!) > t:Y {/) l'< t-3 a ~ ...... j• M <" -· CD i:r> 0 = '< i' ~ -· l~ t:l .... ~~ ~ fa .... -· b = i\ffi~auit ®f fxrrutnr ®r i\bmiuistratnr ~tatr nf Jruunyluauia, t nn: C!tnuuty nf Banqiugtnu \ Personally before me, the undersigned authority, a. ..................... !'I9..~~Y. .... ~~J.J.9. ............... in and for said County and State, appeared .................................... M:eEJS?P: .... ~.~E.~Q..~.J:A ............................................... who, being duly sworn according to law, deposes and says that she is the~ administrator of the estate of ~X .... S.;J;.WX .. 3~:/~/~ .... ~.~ .. l\ •••• ~¥. .... §.~~ ............. deceased, that the foregoing schedules constitute a come,lete in,ventory and appraisement of the real and personal estate of .. ~.~;.Y. .. J?.JY..~Y. .. Jtt/!$/~ .... ~.~, .. , cJW.~t~d,S~FeT¥ 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 just appraisement of each item made by the above named R~ Admi~trator. ~·----. Sworn d subscribed before me this ... i/?..(=::::.... l ~~........, ( _......---·-. day of. .............. &.~~···· ...... ~· .. ~ .. 19 .... §6.. ..L/~ ........ ··············:··~· F!"l~ a Pu ·-. ~fiH.~Admm1strator G-··· . . ............................................................ . Canonsburg, washi to o., Pa. \ ADDITIONAL INSTRUCTIONS My CommiSSion Exp1res 14, 1972 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 lluueutnry auilJ\pprai.arm.rttt of the goods and chattels, rights and credits which SIVEY were of.~¥. .... S..I.'Y.n .... ~LJs.I.~ ... .MR.t?..~ ..... ~XI .. late of .................. g.~£~J .... ~9..w.n.~.'hJ.P. ................................. . Washington County, Pa., taken and made in conformity with the above affidavit. REAL ESTATE NONE PERSONAL PROPERTY Proceeds from redemption of u.s. Savings Bonds Series E (copy of itemized list of Bonds attached .to;·:Ret4rn) DOLLARS CENTS 6,698 48 ~ E-,t.-..3~ No. 2600 Inventory and Appraisement IN THE ESTATE OF MARY SIVEY a/k/a ................. .Ma.S .•.... ~x .... .s.I.Y.:e.x .............................. . Filed .................................................................. , 19 .......... . :-. ' ~., .. ; .· } ~ • f') •I ·-!'-. i ~ .... : . ., r-. -r-= "'u :--, w ·-:u ln ' . ' ~ !.-) '.J I ~ •. i I I ' c::, GEORGE J. MODRAK ATTORNEY AT LAW 112 NORTH CENTRAL AVENUE CANONSBURG, PA • .... 9 0~~ .: ,-, • '_.1 .---. J· i. '\ ~ .. r·. • . ,, tl ~-·~)f':' ~~ !··r-;P:J L.:t ::,.r.\ c/ ·--~~~-s li~ STATE OF PENNSLYVANIA, WASHINGTON COUNTY, } SS: The within named Accountant being duly sworn according to law, depose and say that the aborve acco,unt as stated is true and correct as ______________ ~h~---------------------------verily believe. . .cr Sworn and su'bscrihed before me this ------~~---=--- day of --ff----4?_~---------------------19 _____ §~--~~~---- Canonsburg, Washington Co., Pa. tAy Commi~on Expires May 14, 1972 -Washington County, ss: ';;;." ~ ~i ~I ~! ~i I ! ~~ ~: 0 z I ! ! ,..., ,. I . ~ .. ...:....c; :-:-' •J t-·,~~? ·-•'J L..:.' '-~ I '- -· --::;:;-·-·-- -------; . -71-----1' -' _/:2W~:~<~~t7k!/~----- I do certify that I have given legal notice to all persons concerned of the filing of the wi1hin account in the manner pre- scribed by Statute and Rule of Court, as evidenced by proofs thereof filed to No. --------------·----------·------·---------------· Witness my hand and official s~al this _______________________________ _ day of ____________ ·----------------.. ------·-------------·-------------------------19.§·~-----·- Registe·r of Wills ./ .. ;! .. . . .,~ ' ......,. .. ' . ·-... ----------,rr------------------------------r--------. • -e ... The First and Final Account of Marion Bartolli, Administra- trix of the Estate of Mary Sivey a/k/a Mrs. Mary Sivey, deceased, late of Cecil Township, Washington County, Pennsylvania. The Accountant is charged as follows: Inventory and Appraisment filed $ 6,698.48 Total Assets of Estate $ 6,698.48 Total amount of credits claimed by account $ 1,922.50 Balance for distribution $ 4,775.98 ~· -· The Accountant claims the following credits out of the assets of the estate, to-wit: Name of Payee Krawczyk Funeral Home Russell Marino George J. Modrak Marion Bartolli McCrory Funeral Home Daily Notes Washington Co. Reports F. J. Buckley Agency Russell Marino Russell Marino Remarks Funeral expenses Letters Attorney Fee Fiduciary commission Ambulance Legal Advt. II II Admr. Bond Filing Return & Inv. Filing Account TOTAL ----------------------------------------------- Amount $ 1,112.50 16.00 350.00 350.00 15.00 12.50 12.50 35.00 3.00 16.00 1,922.50 --------------~L_ _____________________________________________________________________ _ W asbington County Reports ~~~NX.51CJU!El: Washington, Pennsylvania (PUBLISHED BY 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} STATE 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 peri'odical for said Washington County, pu blis'hed 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 COL'NTY 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: April 25, 1968 May 2, 9, 1968 Sworn to and subsc .;:ed~b~e=f~or:_:e~m~e:_:th~i~s---~~---- 9th. May 8 ::::~~:sp Washli~gton, Washington _co., Pa. My Commission Exptres . __ -·-_ ---------------u----""'-----"'-"·oa.o_ --..--- 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 • • • • • • • • SIVEY, MARY, a/k/a MRS. MARY SIVEY, Pec'd. Late of Cecil Township, Washington County, Penna. Administratrix: Marion Bartolli, c/o 22 North Central Ave., Canonsburg, Penna. 15317 Attorney: George .J. Modrak, 22 N. Central Ave., Canonsburg, Pa. 15317 THE ·DAILY NOT-ES CANONSBURG, PA. PROOF OF PUBLICATION 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, Mabel ~. Day . ·-·----------------------------------------------------------------------------· who bemg duly sworn, deposes and says: that ·------~-~-~-----------is the 1::?.~-Q~-~-~-~-p_eJf the Notes Publishing & Printing Co., a Penn- sylvania corporation, and its agent in this behalf: tha,t the said company is the pub- lisher of The Daily Notes, published daily except Saturday and Sunday, having its place of business at Canonsburg, Washington County, Pennsylvania; that the said Daily Notes was es:tablished August 1, 1875; that the printed notice or advevtisement, 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: ____ !_p_ril _____ 2) _ _,__ ___ April _ __JQ __ ,_ ____ M_ay ____ z __ , _____ l9_6_8 ____________________________________________________ _ that the affiant or the corporation :in behalf of which ----~-~~---------is acting is not inter- ested in the subject matter of said notice or advertising and that all of the allegations of thiO affidavit •• to th:_:"_"_P~:_::~·:~~~~ Sworn to and subscribed before me this 7th { ,~ ---·-···----~c------day of -~------- ---:-~C----·:··--19..6.8_ ----------------------------------"-~~//~ &CU tZ...d AUDdEY J t-ALC'' ' NotarfftftrrtNotary Public W _shinnt CQunty . .'a. ~'li Con1mission Expires l\4arch 30, 1970 &3~ te !,;.0 &p . ~- April 23, 30, May 7,-1968 · :> ( f'orm where decedent died intestate) Jn tqr ®rp4ans' Qlnurt nf Dllas4ingtnn <t!nunty ESTATE OF No. {3 ~6 8v j lo'= Term, 19 ,A.A. In the audit of the First and Final MARY SIVEY a/k/a MRS. MARY SIVEY Account of Marion Bartolli ~--······································•······································-···-···········-···········-···-······· State (I) whether de- cedent was married or unmarried; (2) if mar- ried, whether a husband or wife survived and his or her name; (3) whether or not there was any marriage settle- ment; ( 4) whether or not family relation was maintained until deced- ent's death; and (5) whether the decedent left children or issue of deceased children. Deceased The petition of ...................... ~-~?;_:'::~.~----~-~?;-~<?..:!.~.t ............... -----····-··-···-···-····-·-···-----·-··---·--··-··--···-··- <Name of Petitioner) respectfully represents : ···············-------···--···-··-··---------------·····--··-···········-········--------------········-------------------·----------------- (a) The decedent died ......... ~-~!:?.;:~~;:_y_ ___ ?._?._( .... A~-~? ....................... , intestate and (Date) letters of administration on ...... h~_;: _______ estate were granted .. M.9.~_G.h ... .:Z., ...... l9.6..8. .......... . (Date) as per record thereof appeanng m Administration and Bond Book No ..................... . at page .................. ------------------------------------------· Decedent was survived by Marion Bartolli, daughter, Newell, Pennsylvania. within h (b) At the time of death, the decedent's domicile was ~iB8f:l}@:.Xt e Com- mon wealth of P ennsy 1 v ani a, to-wit, at ....... (:.~_q_:j,._J: ____ ~.QWTI.e.h_;!,p __________________________________________ _ (Town or Township, State and Nation) and residence was at ...... 9.~.!?.J.~-----~~~!?.~JPJ ..... ~~-!?.~:1-:-~9.~?~----~~-~~-~.¥.-~------~~-~~_§Y 1 van i a • (Town or Township, State and Nation) (c) The names of all persons having any interest as heirs or next of kin with the names of their deceased parents, to show relationship if they take by representation are as follows: NAMES Relationship Interest Of age, sui- juris, or not, (write yes or no). Name of Guardian, Trustee or Committee, if any, or beneficiary, manP..er and place of record of appointment and is bound suffi- cient to cover and protect share. Marion Bartolli Daughter 100% Yes State exceptions, if any, giving names and dates of death and the names of their executors or administrators, or the names of. their issue as the same may be mater- ial. Describe type of notice. All of said parties m interest are living, except No Exceptions. (d) All parties having any interest have had ... ?l-9..~~9-.l.:notice of the filing of the account.lij{ •-. ,#:.• (e) Balance for distribution per Account $ ... ~.! . .?..?..?. .. ~ .. ~.8 (f) Additional debits, not shown by Account (Itemize) • $ .................. 9. .. ~ . .Q.9 (g) Additional credits, not shown by Account (Itemize) $ .................. 9. .. ~.9..~ $ ... 4 . .~ . .7..7..$..!!.~J3 Insert word "not" where I (h) Claim for exemption has been made, and has ........................ been paid. necessary. (i) The estate is .................. subj..e)t to the payment of inheritanc~x to ;the State of Pennsylvania.Pavf-r~ ~--ct4 ~ ~ u taxable state w~eth-1 (j) The estate is ..... :g.9.t ............ subj ect to the payment of the county 4 mills er tax has been pa1d. 1f too many for the space, annex a list there- of; if no such claims, insert the word "none." If any creditor or other claimant has not re- ceived actual notice, that fact must be stated. Indicate such claims as may be secured or en- titled to a preference, and give detailed infor- mation concerning such security or preference. Here insert a reference to all questions requir- ing adjudication, and a ~tatement of any mater- ial facts not already given. If none insert the word "none," If any share has been assigned or attached that fact should also be stated here. State kind, form and character of property composing the balance for distribution, and if any part thereof is not cash, whether or not there has been any elec- tion to take such part in kind. tax. (k) The estate is ..... D9.t ............ subject to the payment of Federal inheritance tax. (1) All creditors (and other persons who have complied with Rule II, Sec. 9), of whose claims the accountant... ..... £tg_§ ........... notice or knowledge, have ........................ received actual notice of this audit; the amounts of their claims and whether or not they are admitted to be correct are as follows: N 0 N E (m) N 0 N E (n) The balance for distribution consists of property in kind, form and character, as follows: CASH --~, ......... ____ ... __ -----"'"·"'"-----·--··--·------~--~-~--~-'--····-~-____ ... ,..._.~ Are there any advance- ments by decedent to be considered on distribu- tion and has any distri- bution on account been made by accountant to any distributtee? (p) N 0 N E ( q) Give brief location of any real estate sold. N 0 N E ·If prior accounts have ( } heen filed, list number r and term. N 0 N E Wherefore your pet1t10ner asks that distribution of principal and income be awarded to· the persons thereunto entitled and suggests that the balance of principal and income should be awarded respectively as follows (shares being stated in proportions but not in amounts) :- Marion Bartolli, sole disbibutee County of Washington, ss. And your petitioner will, etc., The above named petitioner being duly sworn doth depose and say that the facts set forth in the foregoing petition are true to the best o~ h.er ............... knowledge and belief. --·-· --------zJ :-:::~.:.~.ti.~Qq~4~ ...................... . { d:; ~~y·~: s~~~~~;;Q;~::~ 1;:~~hi: (Signature of Petitioner) , FORM IN CASES OF INTESTACY No ..................... , ................................ Term, 19 ........ , A. A. IN THE ORPHANS' COURT WASHINGTON COUNTY, P A. MARY SIVEY a/k/a Es·tate of .... MB.S..l' ..... MAAX ... SJ.Y.e.Y ....................... .. De·ceased. Sur account of ... M.a.r.io.n .... B.a.r.to.l..l.i.., .............. .. Administratrix PETITION SUR AUDIT In Conformity with Court Rule III, Sec. 5 (B) COUNSEL FOR THE ACCOUNTANT WILL SUBMIT HEREWITH 1. The letters of administration. 2. A copy of the inventory and appraisement. 3. Proof of advertisement of the grant of letters, if not filed with accountant. 4. An appearance for those represented. 5. Inheritance tax receipts, if any. 6. Certificate of liens in case any of the funds for distribution are derived from the sale of real estate. 7. Copy of Federal Estate tax return, if estate is subject thereto. 8. Signe11ections to take in kind, if any. ················~~t~?!;~~~i~~i ~9 ") . .... ~~, 1.' --- ST. ''. :'.:WI. ::r: ~J C ....... : T.; • ..,~:·.j til ~7 . "l ... r:. ·~: ::· ~ -J (! . ~ I lJu tf1r (@rpf1aun' (llourt of -llan11ingtnu C!touuty In the matter of the Audit of Account in MARY SIVEY a/k/a MRS. Estate of ____________________________ ·---··--------------------------------------------------No, ________________ , --------------------------------------------· 19 ____________ , A.A. MARY SIVEY TO THE AUDITING JUDGE: Enter _______________ my_ _____________________________ appearance for ....... M.?!-.~.i.Q.D .... ~-~;r::_t:QJJ.~-'--,--~d~J-~}:._§.~-~-~-t-~-~~-------------------- 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 Counsel sugges-ting proper distribution shall file a separate concise statement in that regard. a -:r-(p r---~ to_&_ ________________ , 19 ____________ , A.A. No ................. , ---------------------- In re Audit of Account in Estate of ________________ J1N~X ... eJ.~.¥. .... ~/Js/.~-----------------------------· MRS. MARY SIVEY AUDIT Jrarrtpr fur i\ppraraurr FOR --------~-~-!:.!2.P. .... ~-~~t.2.!.!J_, _____ ~9.-~.!-~A-~-~E-~~r3x GEORGE J. MODRAK, ESQUIRE --~-----------------------------------------------------------------Attorney ~2 1Ju tqr ®rpqaus~ Qlnurt nf lllasbtngtnn Oinunty 63-68-366 ESTATE OF No ............... Of 19------------, A.A. Mary Sivey, a/k/a In the matter of the .. X~-~~~-~-t?:~ . .f.-~~~J_ ____ _ Mrs._ Mary Sivey, Marion Bartolli, Account of .. ----------------------------------------------------------------------------------------------------------------------------------- Deceased. Administratrix ADJUDICATION AND DECREE And now ________ p_~~~~~-~-~-----------------------/~-----, 19 .. ~.$ .. , this matter came on for hearing, audit and distribution at this session and testim6~yo taken; and thereupon, upon due consideration th4r~5h§3'alance for distribution in •the hands ~f the Ac_countant_ is determ_in_ed to be $ ... L .. -----~--------------------------------------·------and the accoun1t IS accord 1 ng I y conf1 rmed; and 1t IS orde,red, adjudged and decreed that the said balance be paid out by the Accountant in accordance with the schedule 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 pe-r account ..... --------------·------------------------------------·------------------------- Balance·------------------------------------------------------------------·-------·---·----------------------- Deduct Clerk's Costs & Receipts.------------------------·----------------------------------------17.00 Attorney .......... Q.~~:tg~ __ !: ... M.<?.9:~9:~------------------------------------------------------- Russell Marino, Agent, transfer inheritance tax, 127.65 Marion Bartolli, daughter, balance, 4631.33 No balance \ ~- 0 .,.._ ..-< -+. 0 .~\Jv ~ m n :I z In n ........... :_") .... 0 -+ ~ ~ "--' t:Y 0 c :T ,-=· ct :::::! (1) ' 0 ...... 3 t:Y -+. 0 0 "" -+. .... t ;:;· .... (1) ~ "'t 0 0 ...... -+. .... - "' = .... :T = (1) ~ = :-o t:Y s ' ~ ~ +-t ~ ~ ~ ~ \ ~--- , Fonn No. RCC-62 (12-66) THIS FORM REQUIRED IN ALL ESTATES WITH GROSS ASSETS UNDER $10,000, UNDER SECTION 701 OF ~CT OF JUNE 16, 1961,'-I .f·""'ANUARY 1.1902. (FILE IN DUPUCATE WITH COPY 0' WILL AlTACHEO) 0., /~ f r ., (,(!b • OFFICE OF THE, REGISTER OF WILLS C t f washinaton oun yo ............ ~. ~.t')1'. ·~· fl ......... ~0::1;"~~11. ~~;-~,q~).A.· ................... of .~~ ~~ ............ ~ ... ft.~ ... . (Name) (Address~ 1 being duly ----------~~<?..;'!-::I __________________ .according to law, deposes and says thatEhe is the __ }!gro_i.n_i_~c-X:.Sid __ t:t:~-----------------------MARY SI VEY <Exec., A m., Legatee, Ere.) of the estate of --~X. __ f?_±~X---~f]_<j_(! __ ~~-!j ____ whose last residence was--------------------~BJ.~ ___ $< __ t;r;,~-~!. _______________ _ (No.) Street ·' REAL PROPERTY v REAL PROPERTY IN PENNSYLVANIA, WITH STATEMENT OF MORTGAGE ENCUMBRAN<!:ES UPON EACH PARCEL AT DEA)~!ECEDENT, WHERE PROPERTY HELD AS JOINT TENANT OR TENANCY BY ENTIRETIES, GIVE NAMES, ADDRESmD :::.;T;S~ R OWNERS. Real Estate ~-Estimated NONE Value I Personal Property Proceeds from redemption of U.S. savings Bond Series E (copy of itemized list of Bonds attached hereto.) $ 6,698.48 ~ ~ . . ---• . I 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. I Jointly Held Property Estimate~ Value • ' NONE •t,.. . - . I . I . ' Transfers within TWO YEARS Prior to Death NONE 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 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 NONE - 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 BENEFICIARY an interest, vested, contingent or otherwise, in estate.) are involved, set OR NO AT DEATH OF IN ESTATE . I forth this fact.) DECEDENT Marion Bartolli daughter Yes -----Sole Distributee %;zPl/1.~~ /!n L. A ~r . ...,., / I .._______ ~. / r;..-~~-~~- '-J!i~a~ ~ ~~-~J.-en) ; h 3. ;;; r. , }'t t; 1v /, ~~ . 'JJ ~'t/.11'7 ·'>" .:l d 0 -,· 'YC ( ~(; oo) .;.;:;,:. ~Y, t2:u... t /;'.J} /, '.' :> .' :'9 :f ~.'\I £' (!>Oid) f/7. •7 :>~~a?/ lf.J7? /, ·'!?:.: ! '1~ 6'Sb C { 5bco) -r'p o1.l, ~ ",;( J/ ?J , _:J i, .<'r:.. I" J '1 s.s·> E (sO.oo j '~? <"~,_,, O;",:w.:/ ;?J_ /y j9 · -., ,-~ 'lfj-7 'lt;o on~ (soc,) I!; f .• 1 ;>..--r;_~ ; 1 1-ij , c ,j /. "'"' ~ "1 r 6-~t! t G •<'<') 1f-J. ;J-/ry.:.:y .t;. f jf ; C) < /, '!> 7 f>.';? t) 0 ~; 7 ( {;-, ·~) 1t ,;· ;• 'I' ./ •)'"-'' 3o/ --;4 .J(; ' ' .. ' ' . 1 !. • r · ,. ' ~ r r I~ I . l ~ , ,-f , r ·."' ~ -/-k;' ---<.t. ~# /:J/ /p ( Ci • j . /; /r. i ./ • I 'I I I ' ....._ . 'c. I (I I I l f (. ' ·,.. / ' ' n •I " '/ -~ J I j ..,,,__. ',- I _?f 0 "7 -.I' .'I ! . ..--:; ' --· -'. ( -· ,._ 7 , , I (,-~:. c !-'(• ~ / I I \ , ·.(.I l' ~/ ~ ' ' { ~'t't' (f:;:) (;, ~.I'•J) r '~'I'} 1 J ):"'i I I I ,., I , I I' " I I "I -· --, . r; I il v •', I r,_-,.1 L~r , -'.I -· ,,...· '~ 'I c./ c, r l .... •) . ~ l \.._J I· I , ... ...., I: '· /1 l..c· '/-; /l -· .'.- I -, . " /:'" 1/ ', I I~~~ ,.-; ') ,-- l ' ' I r. I_ ' , ... ( / I. , I .• lr, ) " I ' ! ,~_ ~-' ' I ' ~------••lllllll!ll•t••••••a•:•s••••• .!' • . R~SiifENT DECEDENT DEBTS AND DEDUCTIONS CLAIMED 'NOTE· List first five items in the spaces so provided, observe notations there::.:o:.:n2,_:a:::n:.:d:....::in=s~tr:...:u::;c:.:t:.:io~n:::s:...._ _______ ___, ______ _ DEBT 0 R CLAIM -~_:•__:.N:..:A.:..:T:..::V~R:.:.:E::__:O::..:F:........::S:.:.:A:.::M:=.:E=---------,---=-A.:..:M=.O.::....::.U-=..N:...:TT---1PTHIS COLUMN ~---~==~~~.:..::=.:~-----.----~EGISTERONLY Krawczyk Funeral Home Russell Marino George J. Modrak Marion Bartolli OTHER DEBTS AND CLAIMS McCrory FUneral Home Daily Notes Washington co. Reports F. J. Buckley,Agency Russell Marino Russell·Marino Funeral expenses paid Family exemption (will not be allowed unless decedent died residing with a spouse or children.) Administration Expenses • Letters Counsel fees • Fiduciary commission * (*) See Note below Ambulance Legal Advertisement II " Admr. Bond Filing Return & Inv. Filing Account $ lt_ll2.60 $ lG.bo 350.bo 350.00 1s.po 12.150 12.~0 35.po 3.po lG.po Total $ 1 ' 9 2 2 • pO Note: The estate agrees to advise the Register of Wills if the amount actually paid in settlement of any fee, commission oi· debt is greater or less than the estimated amount claimed and allowed. ~~ ~~ :!:! . ·/1 ~ .~0 /£-) --· Subscribed and sworn to before me this . . . . . . . . . . . . . . . . . . . . . . . . "'·/·. l,..l(.~ ... : . . . . ........ ~ ..... . (~-'Administrator) ........ ~ .. : ....... ~ .. ayot~~· ,t•f>S '?cJ.?~Y/0 rfif::!j4.r ..... ........... , ....... ~ .. ~C............ c~ . .. GEOrlGE J. 0 , Notary Public .... ~)!\/ .. ~~! ........................... . Canon>burg, . shington Co., Pa. (City or Town and State) MY Coil•m~ss!Oil bpu es 1v1ay 1-., 1912 Having been duly sworn according to law, I do ~y ce~f~?that the above apprais~ment is ade in conformity with law on this .................. o(?d~. day of ........... ~ .................. ~19 .. r /) ~ ~~ A ratser .... ~~.. ~z .. -~ .. 4. Jf? .. In the event that any future interest in this estate is transferred in possession or enjoyment to colla al 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·inheri- tance taxes at the lawful collatei'al rate on any such future interest. E~ISTER _9F WILLS I, the undersigned duly elected Register of Wills in and for.. . . .~."'. --~l-••.• County, Pennsylvania, do respectfully report that I have allowed debts and deductions in the amou claimed by depon~e cept as to those items where a greater or lesser amount is set forth in th; last ~~7 to the right in said schedule above, which greater o les e~nt represents th~lowed as a deduction. Dated: .... ?P.~ .. t?f.~ .. /f.&./..... . . .r..u~~£.: ..... :~~---······ Register of Wills ... > ·; ~y Fonn No. RCC-62 (12-66) Will • l Administration sNo. · · · ....... Year .. · .. . IN THE MATTER OF THE APPRAISEMENT OF THE ESTATE OF . . MARY SIVEY a/k/ a ...... ~S # •• $RX. P.l.Vf!X ............ . Deceased Late of .... C~.q~~-.'+9~~A;P .......... . ' County of · .. ~~11'l!'~:i.I;l9.ton .................. t-\ ' . Commonwealth of P~~nsylvaftia ...., .. \ . ' -i REPORT AND APPRAISAL· .. . . --- 1 :-1 ~ ;---. ; --I r ! .---i CJ <.o w .. r.., f..,t GEORGE J. MODRAK ATTORNEY AT LAW 82 NORTH CENTRAL AVENUE CANONSBURG, PA, ' ·' ~CC:·39 (6·67) .,. '20MMONWEAL TH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SIVEY, .HARY a/k/a SIVEY, NRS. MAin FIL,i:; # 63-68-366 February 22, 1968 t r SUMMARY FILE # 63-68-366 ftEPOnT OF INHERITANCE TAX APPRAISER I~ the undersigned tiuly appointed Inheritance Tax A.ppraiser in and for the County of # 63 Washington , Pennsylvania, do respectfully report that I have appraised the real and personal property as reported in the foregoing return at the values set forth opposite each item in the last column·to the right in Schedules "A", "B", "C'/)d "E". Dated: 10-22-68 ~ ~~ 02-22-68 APPRA~~ REPOR1' OF THE REGISTER OF WILLS I, the undersigned duly elected Register of Wills in and for Washington County, Pennsylvania, do rPspectfu1ly report that I have allowed deductions in the amounts claimed by deponent, except as to those i terns where a greater or lesser amount is set forth in the last column to the right in Schedule "F", which the sum allowed as a deduction. gr~;;;::n: Dated: 10-22-68 INVENTORY Real Property (Schedule A) Personal Property (Schetiule B) Transfers (Schedule C) Joint-Held Property (Schedule E) TOTAL GROSS ASSETS LESS Debts and Deductions (SCHEDULE F) CLEAR VALUE OF ESTATE Valuation of life estates or annuities ESTATE T.~~ ASSESSMENTS FOR USE OF REGISTER ONLY Tax on $ _________________ , ___ 5% Tax on $ .~6.<1' l~O,;;'.~·o T a;x: on ~-....:4:<..Z..., 7w7~5:...::'...£9..::8_---'~ Tax on $ , __ lfi% Exemptions := (':') Total Estate __________ __ TOTAL TAX Less tax previously paid BALANCE Liss 5% of tax if paid within REGISTtR OF WILLS VALUE AS REPORTED VALUE AS APPRAISED VALUE AS REAPPRAISED $ $ $ _____ _ 6,698.48 6.628.48 6,698.48 4.775. 98 ·-- $ -------- 6.678.48 ;;: J,,Q22.5Q,, 4.775.98 ======:= COMPUTATION OF TAX d> ·:·-----~ !f. ---....-,---.-- $ __ 2.;;..,;8;...:..6_;;_,. 5::...;c6_ $ _____ _ $ ____ _ $ =====·-$ ------ (':') As evidenced by Chari table Exemption Certificates issued by the Secretary of Revenue. 3 ~onths after death $ ======= 3ALANCE OF INHERITANCE TAX DUE Add interest at rate of H% from to AMOUNT OF ESTATE TAX ASSESSED $ _____ _ Estate tax paid BALANCE DUE Add interest at rate of 6% from to FOR USE OF REGISTER ONLY $ ~--~-- TOTAL TAX BALANCE PAID ADJUSTMENTS ~----------------- $ ______ _ $ ______________ _ $----~-~ $ ______ _ $ NOTE: Where subsel}uent adjustments are made to the above computation of tax by the rtegister of Wills, for proper reason, same should be noted below, with short explanation. Will Administration ~ No. IN THE Year ........... . MATTER OF THE APPRAISEMENT OF THE ESTATE OF 1:1A}tY S.l.VE.X". e./1</~ .. Deceased Late of_ . ~ ... C_E;Cl.l.. . ..TWl?L .............. . County of . WASHINGTON Commonwealth of Pennsylvania REPORT AND APPRAISAL .. .. ,~.' ) DATE ................. _9.~~-~?~:r:: ..... ?..?..?. ...... ~.~?.? .. COUNTY ................... ~~~-~~~~.?.? ............... . JY·· . DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS HARRISBURG, PENNA. 1 7 1 2 7 COMMONWEALTH OF PENNSYLVANIA RESIDENT INHERITANCE TAX APPRAISEMENT "" . . . FILE NO •.................... 2 . .2::.9..?::~.~.2 .................... ···················~ Whereas, ................................ M<?:.r.Y. ... R.i.Y..~Y. .... ?.:/}5/C?: ............................................................. late of ........................... 9.~.9-~;l. ... ~~-~---·············································· I in the County of .......................... ~~~-~-~-~~~~.?.!.!: ........................................................................ Commonwealth of Pennsylvania, having died on the ....... . ............... ?.? .... ~9: ................................................ day of ............ X.~?.~~.Y. ..................................... 19 .... ?..~ .. seized and possessed of an estate subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore, I, ........................................... w.~.~ .. ! ..... G.h?.:P..~x ...................................................... , 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: I 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. I Description of Unit Appraisement Asset Values Made for Inheritance Tax Purposes $ -PEH.SONALTY: Proceeds from redemption of u.s. Savings Bond Series E. 6,698 48 - Total 6.698 48 ' form~;·~hbl:~ ::~h:.w~~~~:· ~; :r~~~{~~~~f2~~;;v~~ ~? Appra1ser ~r:=·"=·' . ~::a (Post Oftlee) ................... WAP.JfL.NG.'l'.ON . ................................ Cou1tty RESIDENT INHERITANCE TAX APPRAISEMENT Estate of .. ~~~R! ... ?..~.Y.~~ .... a./.~/~ ................................. .. Deceased. Late of CECIL TWP. Date of Death, ...... .f..~RJ.1l.cq;:Y. .... ??.., .... J.9.?.$. ................. . Appraiseme11t Docket Vol., .............. ]? ............................... .. • Page, ..... 10.9~.4 ....................... No .... 63.-:::.6.e.:::3.6.6. ........... .. Filed in Register's Office}JO.qt.9P..~:r .... ?~., ... 19 .. 9..$ .. Amount of tax due, $ ...................... _ ................................... -.. DEPARTMENT OF REVENUE Received, Examined and Approved, Wrote abo.ut Appraisement, £1"1",\ :·;··-·"'·'-'':.! C...J ,:',; -1 •-'~~ .. J Appeal ft'om Appraisement, h t · +;o "j ' r r ·• ,,. -r v i r j. i.. ! \,.. w~ .... j. Entered and charged, .... 0 :1 -.. 1 I . , ·-.' I I - ;.~ - - Form RCC-10 OF AND OFFICE OF THE REGISTER OF WILLS Washington couNTY AGENT OF THE COMMONWEALTH FilE# 6.3_-68~66 ESTATE OF Mary Siyey DATE OF FILING APPRAISEMENT STATEMENT OF DEBTS AND DEDUCTIONS TlXABIE @ 6% LATE OF J.2-30-Q8 DATS: OF DEATH DATE NO. OF NAME OF PAYEE VOUCHEIII SUPPlEMENTAL ll11rl; t. t:n!'l!f. & ReceintR COMMONWEALTH OF PENNSYLVANIA }••: COUNTY OF lllfa:ili ington I, ,1\.:l;t;y: Gec:r:ge rl. MQdrak DEDUCTIONS ALLOWED IN THE SUM OF ............ $ ........ J, 939,5Q ~ Register of Wills, Agent ~ '-""' Cecil Twp, Februar~ 222 1268 REMARKS AMOUNT 1_1 00 Total li _QQ. HERESY CERTIFY. THAT. TO THE BEaT OF MY kNOWLEDGE AND BELIEF, THE FOREGOING IS A JUST AND TRUE STATEh'T OF DEBTS, FUNERAL EXPENSES AND EXPENSD OF ADMINISTRATION SUBMITTED TO THE ESTATE OF M::l"I"V ~; ~V '/' DECEASED, AS DEDUCTIONS FOR INHERITANCE TAX PURPOSES. ~~\y'/J~r CL. &.) ' /' -( SWORN AND SUBSCRIBED BEFORE ME THIS DAY 01' 18 __ - . . ~~~~~~~~~~~~~~~~~~~~~~~~/ Form RCC-4-RI-3-66 ~9 COMMONWEALTH OF PENNSYLVANIA JIESIDENT DECEDENTS No. 948831 OFFICIAL RECEIPT Transfer Inheritance and ·Estate Tax File No 63-68 ... 366 WASIJINGTON, Date Mn.y 21. 1968 Office REGISTER OF WILLS. a. HASHINGTON County, ss: Received from __ .!:}f~a~r:...:!i~o~n~-_:B!!:a!:!:!.!..rJ!t:.!.io~l!d.lb..i;L--------------- l~f~~r, Administrator ~r~Glfdf~ of the estate oLf ---------~~-if_tJf\J:iT:WYWS~JJ.::VE~·-;xY:__;_ ________________ _ who died Feb. 22 'f 19 68 I the sum of O~"E HUNDRED FIFTY and ru:~/1 on -... .. ... Dollars, being TRANSFER INHERITANCE TAX and/or ESTATE TAX due the Commonwealth as follows: Appraisements Made and Filed Real Estate Date Valuation $. _____ _ $. _____ _ Total $•------- Personal Property Date · ·--Valuation $. _____ _ $, ______ _ Total Total Gross Assets Less Debts and Expenses of Administration Clear Value of Estate Valuation of Life Estates or Annuities $ _____ _ $. $'--'------- $ INCOMPLETE 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 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. trOOD [JJ[LD ©£ tr[ 37-109-4 NOTE: This triplicate Receipt to be retained by the Register of Wills and filed in numerical sequence for audit purposes. Computation of Tax Tax on$----------- Tax on $ ~-:--------- 5% 10% ti.« m-t Taxon$ On Acct .. . -..- Tax on$-....,.----------IS% Exemptions * $ ============ Total Estate $ ----------- $ $ $ 157.89 $ Total Tax $ ----~----- Less Tax Previously Paid (if any) $ =========== Balance $ ----------- Less five per centum of tax if paid 7 89 within 3 months after date of death $ ====="======= Amount of Estate Tax Assessed under the Act of May 7, 1927. Add interest at the rate o %' from-----------------,-- to ---------------- Total $ ______________ _ $======== $ 150.00 * 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 =ended by Act No. 38?:€Jo~ed July ll,;;~~207, 1961, Section 30; II##~"'~&:, ~4 '~ .. ,;,:~~tt--, Register of Wills MOORE BUSINESS FORMS. INC., ELMIRA. N.Y • FORM RCC-4-Rl TRANSFER INHERITANCE and/or ESTATE TAX. RESIDENT DECEDENTS. RECEIPT Docket 37 Page 109 I ine: __ 4:___ l-1.1\.RY SIVEY Estate OL-____________ _ OmCE OF REGISTER OF WILLS tlASHIN'GTOt~. Date: ____ l_1a_:y_2l ____ l9~ 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 Register of Willa 1201 (g), Act of April 9, 1929. P. L. 343, as amended, viz:-"To receive from Registers of Wills all duplicate .-e-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 settlement of the estate. 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 by the Register of Wills." Fill in below name and address of person to whom tax receipt is delivered: I To __ ~A~T·rf~l~·~G=£0~R=G=E~J~·~)~ID~D~RAK ________ _ 22 N. CEl!TRAL AVBNUE L CANOK5BURC, PENNSYLVANIA 15317 _j v' Form RCC-4-RI-3-66 ~9 COMMONWEALTH OF PENNSYLVANIA RESIDENT DECEDENTS 979192 OFFICIAL RECEIPT No. Transfer Inheritance and Estate Tax File No. 63-68-:366 Date Dec~or 20a 19~ Office REGISTER OF WILLS. Ht!~' ~1l.:(;!l:M! Pa. H!\~Tl:t"f."J"(»J County, ss: Received from !k\r:C.on B-.rt,nlU tE;~&.®l'Qr;, Administrator '6i{Guardian): of the estate of N:\tlY ~Itr;?V who died Febl"Wf.ey . 22. 19 68 , the sum of OflE HUtiDRED 1l1F.f1Tf SRV~-;f': nnd ~'1/l 00 - - -""' • Dollars • I being TRANSFER INHERITANCE TAX and/or ESTATE TAX due the Commonwealth as follows: Appraisements Made and Filed Computation of Tax Real Estate ,l Tax on$ 5% $ Date Valuation $ Tax on$ 10% $ $ Tax on$ k,75S.9S $:2;'X, $ 2f?.'i.;4 Total $ Tax on$ 15% $ :Personal Property Exemptions * $ Date Valuation 1.0.22-68 $ 6.698 .. 48 Total Estate $ $ Total Tax $ Total $ 61 69A.Mt Less Tax Previously Paid (if any) $ ~S1.89 Total Gross Assets $ 61698!40 Balance $ Less Debts and Expenses of Less five per centum of tax if paid I 6.3-6f,..366 AA Administration $ 1,939 .. 50 within 3 months after date of death $ Clear Value of Estate $ 4~758.98 Amount of Estate Tax Assessed under Valuation of Life Estates or Annuities the Act of May 7, 1927. $ Date 19 __ $ Add interest at the rate of % 19 __ $ . from Estate Tax Assessments to $ Date 19 __ $ l27.-6S Total $ 19 __ $ * As evidenced by Charitable Exemption Certificates issued by the. Secretary of _NOTE: In accepting the transfer inheritance tax on future estates prior to the death of Revenue under Act of May 28, 1956, P. L. 1757, effective June I. 1957, as amended the hie tenant or tenant for years, as evidenced by this receipt, it is understood that the Com-by Act No. 381, approved July 11, 1957, and Act No. 207, 1961, Section 302. 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 SEAL") tax may be legally due and collectible for any reason whatsoever. 1JTffi0[p[L0©£lY[ 37·109-4 ;.( ;{1'·.? <l/ l''.~/ ,,#.r7. 4 ~ . / • I _'.": 0....-"( .. ..,~"'(,·-· NOTE: This triplicate Receipt to be retained by the Register ol Wiils and liled in numerical i! .. ,_ ;r ' · Register of Wills sequence lor audit purposes. MOORE BUSINESS FORMS, INC., ELMIRA, N. Y. FORM RCC-4-Rl TRANSFER INHERITANCE and/or ESTATE TAX. RESIDENT DECEDENTS. RECEIPT 'J7 p lQ9 I. 4 Docke+~--~ age.;__ ___ ._..Jne ___ _ u-ltl SIV.Gl Estate of..__ ____________ _ OFFICE OF REGISTER OF WILLS t';.\S: J:tD'l'OJ _______________ Fa. Date Deccdler 20, 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 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 lor taxes paid to them by executors or adminis- trators and to charge the Registers receiving the money with the amount receipted lor. 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 settlement of the estate. 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 by the Register of Wills." Fill in below name and address of person to whom tax receipt is delivered: I To a-nt. c~ o..1ro J. ~:crP..t'k't 22 n. c;.tnBAL AV"'clJtr..; L lSJl7 _j