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Home My WebLink AboutOC1968-0367 - ESTATE OF CLOKEYTR-2 REV. 9-62 t~-tY-:-dt:,7 IN rrHE ORPHANS 1 COURT OF VTASHINGTON COUNTY, PENNSYLVANIA ESTATE OF ELIZABETH ANNA CLOKEY, DECEASED FIRST AND FINAL ACCOUNT OF PITISBURGH NRTIONRL BANK ADMINISTRATOR ) NO. 80738-3 PITTSBURGH, PA. OCTOBER 14, 1968 - s U M M A RY -.. - SCBEDULE A PRINCIPAL_.., PEBSONAI/1,1; --- Receipts Page 3 $ 1,230.70 Amount transferred --. from Principal-Realty 26' 2g_lt. 63 $ 27' lt-55 33 Disbursements Pages 4 and 5 19~691 -52 Ba1anQe 1$ 7,763 81 " I SCHEDULE J3 INCOME ..., PERSONALTY I Receipts Page 6 $ 70 11 ,I \ Disbursements Page 6 3 50 Balance 66 61 I SCHEDULE c I PRINC:(PAL ..., REALTY I Receipts Page 7 $ 26,800 00 Disbursements Page 7 $ 575.37 Amount transferred, to c 4 6 I 26,8ooioo I Principal-Personalty 2o,22-. 3 ---r Balance I 0 00 ------1--- NET BALANCE $ 7,830 Ll-2 I I I I I I I -· 11. I i I !' I I I i I I ELIZABETH ANNA CLOKEY TR-2A REV. 9-62 THE BALANCE CONSISTS OF THE FOLLOvliNG: PRINCIPAL -PERSONALTY Cash $ 7,763 81 -INCOME -PERSONAL'lY Cash 66 61 $ 7,830 42 ··-- i I I \I ' -2- i ' ' ~-----~---------------------------------,_, ~ ELIZABETH ANNA CLOKEY -- TR·2A REV. 9-62 SCHEDULE A I PRINCIPAL -PERSONALTY RECEIPTS 1968 Aug. 23 Inventory filed $ 1,230 70 Assets Purchased 1968 Aug. 15 $10,000 United States Treasury Bills due I 10/10/68 . $ 9,929 89 Cash disbursed to purchase above assets 92929 89 0 00 ! Conversion of Assets without Gain or Loss 1 1968 Proceeds redemption $10~000 United States I Oct. 10 ~-- Treasury Bills due 10/10/68, at 100 (por- tion proceeds allocable to principal) $ 9, 929.89 Carrying value 9~929.89 0 00 Amount transferred from Principal-Realty for distribution 26,224 63 --$ 27,1+55 33 . . ! - I -3- I . I I l I ! ~---- TR·2A REV. 9-62 1968 Mar. Apr. June Aug. 1968 oct. I 14 14 18 15 7 26 14 14 14 1968 June 7 Aug. 16 27 27 27 27 Sept. 10 ELIZABETH ANNA CLOKEY DISBURSEMENTS Administrative Expenses Washington County Reports - Advertising letters of administration Russell Marino, Register - Letters of administration and renunciation 2 short certificates Observer Publishing Co. - $20.00 2.00 Advertising letters of administration Pittsburgh National Bank - Appraisal fee re property situate Route 136, South Strabane Tmmship, liTashington County, Pa. Richard H. Piatt - Appraisal fee re old paper and silver money Russell Marino, Register - Filing inventory Expenses re maintenance and preservation of property situate Route 136, between Washington and Eighty-four, South Stra- bane Tmmship, Washington County, Pa. - Liability insurance premium - 1/19/68 to 11/20/69 Less return premium insurance cancelled, property sold - 8/5/68 Greenlee, Richman, Derrico and Posa - Attorney's fee Russell Marino, Register - Filing this account Administrator's compensation Preferred Debts Piatt Funeral Home - 11.00 8.00 $ On account funeral expenses $ Piatt Funeral Home - Balance funeral expenses Commonw·eal th of Pennsylvania - Maintenance of decedent from 7/30/59 to date of death M. Elizabeth McBurney - Reimbursement for funds advanced for medical expenses Latrobe Area Hospital - Hospital expenses G. F. Nealon, M.D. and W. F. Berberich,M.D. Professional services Moreland Burial Vault Co. - Marker Amount forwarded -4- 12 50 22 00 12 50 35 00 8 00 4 00 3 00 1,400 00 20 00 1,400 00 $ 592 50 900 00 10,558 20 1,000 12 145 13 45 00 112 00 $ 2,917 00 13,352 _95 16,269 95 I I I '" ~ ' .- ELIZABETH ANNA CLOKEY TR·2A REV. 9-62 I Amount forwarded $ 16,269 95 Other Debts 1968 July 23 Delmer C. Larkin, Tax Collector - South Strabane To~mship road tax for 1968 $ 17 01 23 Malcolm L. Morgan, County Treasurer - Washington County real estate tax for 1968 28 73 Aug. 27 M. Elizabeth McBurney - Reimbursement for funds advanced for taxes and other expenses 1,093 33 Sept. 3 M. Elizabeth McBurney - Claim under judgment entered at No. 325, August Term 1954, as follows: $1,200.00 Principal of judgment Interest from 7/20/59 648.00 Costs advanced 7.00 1,855 00 2,994 07 -- Other Taxes 1968 Apr. 19 Russell Marino, Agent - On account transfer inheritance tax at 15% 450.-00 Less 5% discount 22.50 427 50 $ 19,691 52 I ' I -5- I . ' ELIZABETH ANNA CLOKEY TR-2A REV. 9-621 I . SCHEDULE B INCOME -PERSONALTY RECEIPTS Interest -Bonds United States Treasury Bills $10,000 -8/15/68 to 10/10/68 $ 70 11 DISBURSEMENTS Administrator's compensation $ 3 50 \ -6- . ! ---------------:------------------, . . ' ~- TR-2A REV. 9-62 1968 ELIZABETH P~NA CLOKEY SCHEDULE C PRINCIPAL -REALTY RECEIPTS Aug. 23 Inventory filed 1968 Aug. 2 DISBURSEMENTS Loss on Sale of Assets Proceeds sale vacant land, being 88.5 acres South Strabane To't'mship, vlashington County, Pa. - Cash $26,800.00 Less Pennsylvania transfer tax $268.00 South Strabane Town- ship tax 268.00 Pro-rata share of 1968 taxes __ 39.J7 575.37 --::::-~-:=--~1 Net proceeds 26,224.63 BFS:rw Carrying value 26,800.00 Amount transferred to Principal-Personalty for distrj~ution -7- I $ 26,800 00 $ 575 37 26,224 63 $ 26,800 00 • I . ! . ' Obsla;er -Reporter WASHINGTON, PENNSYLVANIA PROOF OF PUBLICATION • In compliance with the News.paper Advertising Act of 16 May, 1929, P. L. 1784, as amended. Commonwealth of Pennsylvania, County of Washington, SS: ........... . Pe·rsonally aprpeared before me, a Notary Public in and for said County and State, ....... Ric.b.a.r.~L-~.!! .... G.9W.3JL .............. , who beirug duly s•worn according to law, deposes and says that he is the .S.ec.~.y ...... & .... l'r.eas • of the Obsrerver Publishing Company, a PteniJJs~lvania corporation, and its agent in thrs behalf; that the said Company is the owner and publisher of the Observer-Reporter, succressor to The W.as·hington Obs·erver, established Sept-embe•r 18, 1871, and The Washington Reporter, established August 15, 1808, a daily newspaper of general circulation, printed and published and having its place of bus.ines•s at Washington, Washington County, Pennsyl- vania, where it or its predecessors have been established and published continuous•ly for more than six monthsr prior to the publication of the notice hereto atJtached; that the printed notice or advertisement hereto attached is a ·copy of an official advertisement, official notice, legal notice or legal advecrtisement, exactly as printed or published in the Obsterver-Reporter in its regular editions on the following date or dates; ........................................... . ........... : ........... Mar.c.h ... .14 .•.... 2.1 .... and .... 2.8., ..... l.9..6.S ....................................... . that neither thre affiant nor the Observer Publishing Company is interested in the subject matter of sraid notice or advertising and that all of the aHega- tions' of this affidavit as to the time, p~ and character "ublication are true. /[;_£.-w J L:,'?A .................................. ?.: ................... 'fl-.: ........ -::~---·-· Sworn to and subsc~A'~fore _me' this .... 2.~.day of ... ~.~~-~---J.9._(t8 .. /.#~z:,P.t.~Kt"r<t(~~ w. 28752 WASif!'l(,t!JN, y ·~4"'G'~:; :~~:n t'Y COI.w:~· G' f V?'r<<~ MA• • 1u, ,. • . ADMINISTRATOR'S NOTICE-I 'Estate . of ELIZABETH .ANN A !CLOKEY deceased, late of~pth I. Strabane Township, Waslimg!Jin! County, Penna. · · Letters of Administration upon th~ above estate having been granted to. ithe undersigned, notice is her.eby given to ' · ; i'ndebted there,to, l,(J_, make im te · ayment, and ~t~; those having 1 ~:.or demands '!9· present the'ID r l!'e'ttlement. · · · PITTSBURGH 'NATIONAL BANK' ! Admin,istrator ·. ''J· ' 6 South Main Streef,.\--· Washin~ton, Penmi'.' I5301 C;reenlt~e'•,,_Richman, De-rrico . and Pos Attorneys Washiifgt 'A Trust Buildlng Washington, :P•nna. 15~(!1 , · ·-"686~·Thurs.-3t WashingloD Co~ Reports ~~ Washington, Pennsylvania (PUBL.ISHED 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 periodical for said Washington County, publis'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 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: ---··--·-~~~~~~---?..!.r....?.?..? ..... ~.?..2.~---························ ........ April ... 4., ... 1.9.68-----------------·-------·-·--··--········ Sworn to and subshot'MWoeii::~J:e-.o:Le..t.h.is--------- 4th. April 8 ::::::::tttd::==::a:::::::::··-·:::: -~~~:-__ :::·· tary Public t<ATMIRIN! C. YARD, Nota ubllo Wa1hlngton, Washington Co., Pa. My Commission Expires November t, 1969 Estate_Mces --. • The 19er 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 ~hem for settlement to the Executors or Admin- istrators or their Attorneys . • • • • • • • • • • • • • • • • • CLOKEY, ELIZABETH ANNA D 'd Late of s ' ec · Washingtonoub~u~{yrabpanee Township, Ad · · t • nna Ba::k,nss S.a~~;n ~tittsWburgh . National 15301 · • ashmgton, Pa. .A,ttorneys: Greenlee Richman D rico & Posa 325 w' . , er-Bldg w h' ashmgton Trust ·' as mgton, Pa. 15301 -----~-··--. --------------------------------- Obs~ver -Reporter WASHINGTON, PENNSYLVANIA PROOF OF PUBLICATION In compliance with the News.paper Advertising Act of 16 May, 1929, P. L. 1784, a's amended. Commonwealth of Pennsylvania, County of Washington, SS: ........... . Personally appear·ed before me, a Notary Public in and for said County and State, ... .-J~.i.C.b.a..J:~L.$..J! ____ Q_QW.~J.L .... __ .. __ .... , who beirug duly s;worn according to law, deposes and says tha:t he is the .S.ec.~.y. ... ____ 8L.'l'r.eas • of the Obs,erver Publishing Company, a J?!ennsylvania ·corpo•ration, and its agent in thi-s behalf; that the said Company is the owner and publisher of the Observer-Reporter, succ'essor to The Washington ObSJerver, established Septembe•r 18, 1871, and The Washington Reporter, established August 15, 1808, a daily newspap'er o.f general circulation, printed and published and havin'g its place of busines•s at Washington, Washington County, Pennsyl- vania, where it or its prede<:essors have been established and publi-shed continuous•ly for more than six months• prior to the publica:tion of the notice hereto attached; thwt the printed notice or advertisement hereto attached is a <:opy of an official advertisement, official notice, legal notice or legal adve;rtis·ement, exactly a:s ·printed or published in the Obsterver-Reporter in its regular editions on the following d1ate or d·ates; ... ________________________________________ _ _______________________ Mar.c_h ___ l.4_, ____ 2l. __ .. and .... 2.8 __ , _____ l.9..6.S ______ .. _______________ .. ______ , ______ _ that neither thoe affiant nor the Observer Publishing Company is interestted in the subject matter of s1aid notice or advertising and that all of the aUega- tions of this affidavit as to the time, pla~ and chamcte~ubUcation are true. . ... .-..................... __ .!t:c.:/..~1::-.: .. / .... :.<.!:1:..<:-'T.<-:!-:.V.. ..... . Sworn to and subsc~ before me this ____ 2.3..day oL.M~.r~.h--.J.~-~8 ~£(~ill~~~~ \VASIW!GlON, VIIS'IINGTON COU:HY w. 26752 MY CO~H~I'.;.iOil tXI'Ii1!', 1~.\Y 191,/1 r.;·mwg:NisTR,.\ToR"'s'No~rc'E'~'C .,E~tale · oi · E~IZABETH 1A;t:f N A C.LOKEY ,deceased, late .•• of11So.\(th Strabane·.·.-Township," '·Washington qountYJ~e'ii~a.\ · L . '}o': . .:_-.•.r.,_,; .'~'!: , ,Letler,s.of _Adminislrali,on ._tlp()n .. the., above estate .havmg been granted. to\ thEi ·undersigned, 1\otice is hereby; given i t<;Htlllls.C iti.!J,debted there.t\J; to,' make · immedlate't·:payment, ':'n<\,; till those h'aviftg'; claims'./,C(i'.' ·qe~ae<J~ t~.i 'prcsent'.therh• fpr .settlement._-' _l.~,) : . ·i PIATdT~J3ni1TR1GHt.· N1-_ 'J;l!?lt>/~:,~~NKV~: · · . n11 , s -.ra 9r ·_.<..f ••. · • .·~·_, ., . •;M 6 ~outh·M_clin Stre~t..:f~· ·I• 11'\(),:;: .. 4~~-~; ·;: washit),it~n, Pent)a:" i530l ' ·,:-·~-:~: Greenlee,· ·~1.ch1nan~ ·-:p~;r:r;1co :-.H. -:-·,·, and Pqsa··~~tt.orneys >! ••. • .. ·, , 1: __ ~: •• _~~·~ Wasl)inglbn•TrustBtiild.ihJf ... ,... · :, Washipgt;on; J>~lina .. l~30l' ·, .. · ... , ,'·' ,:i:'~ \ ·· ' ·: .. :·~·· _ ·. \6863·Thtir"i;>31: Washington CoUbtY Reports Estate I'' -i:Jces ~M~~¥H~~~~~ Washington, Pennsylvania (PUBLISHED BY WASHINGTON COUNTY BAR ASSOCIATION) PROOF OF PUBLICATION In compliance with the Newspaper Adv(:!rtising Act of May 16, 1929, P. L. 1784 Sec. 3, paragraphs ( 3) and ( 25). CouNTY oF W ABHINGTON) SS STATE OF PENNSYLVANIA ( ' Personally appeared before me, a Notary Public in and for ~aid 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, publis'hed weekly having its place of business at Washington, \Vashington 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 Ior Washington County, Pennsylvania, by order of the several courts oJ: 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: ......... ~~~~~~~~ ... ?.J.:.? ..... ~§..L}.?.~.~ ......................... .. 4th. April 8 ........... :;-~ oL ........ : .................... ~2 ...... , 196= .. ........ 1Rca.L~ .. a ......... ~~-.... . tary Public KAfff~RiffE C. YARD, Notar ubllc Waahlngton, Waahington Co., My Cummlssion Expir·es November 1, 1969 The 1, ;er of Wills has granted letters, testamentary or of administration, in the following estates. Notice is hereby given to all persons indebted thereto to make payment without delay and to those hav- ing claims or demands to present them for settlement to the Executors or Admin- istrators or their Attorneys. aeeeeeooo•••••••• CLOKEY, ELIZABETH ANNA. Dec'd Late of Soutl St. · Washington C~unty1 abpanee Township, Ad · · t • nna Ba~l:,n~s ~-a~~; PStittsWburgh ·National 15301 · 11 · • ashmgton, Pa. Attorneys· Gr 1 . rico . een ee. Richman, Der- Bldg &WPosla, 325 Washington Trust ·• as lmgton, Pa. 15301 COMMONWEALTH OF PENNSYLVANIA ) COUNTY OF' WASHINGTON ) SS. : Chas. E. Enlow, Trust Officer for the within named accountant, being duly sworn"; according to law, deposes and says. truit the foregoing account as stat~d' rs true and correct as he verily believes. Sworn and sybscrib~e~~ me) this ~ day of ~ L9~ ~~1?;~~ Register WASHINGTON COUNTY, SS.: I ' r:£1 Cl) ~ Iii 0 ~ 0 :z; ~ r:£1 E-t <I; ~ z f:Q ~ :::> " 0 t--=1 ~ 0 <I; ~ lit lil 0 :z; 0'1 0 ~ <G 0 ~ 0 H ~il H ~ 8] IH E-t 0 c:x: ·~ 0 <I; z :z; E-t <I; H \ Cl) :z; Iii ::r:: ~ :z; d ~ <G ~ p:: z :::> ::r:: <G f:Q l~ E-l Cl) r:£1 8 E-t . ~ ga E-t 0 H :z; N H P-4 H Iii H ) PITTSBURGH NATIONAL BANK ··? .,:/ ), '\:\ /) BY ·-(~it:z4 .. ~-#~,-.-..:~~ Trust Officer 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, as evidence bb c/ proofs thereof filed to No. /tfe.FO er1 /z_/;d Witness my hand and officia; seal ehis day o~'-(_-Jrlt·~ :f)S , 19 68 f-~u7?1~ ~ R;gister bf Wills -------------------- "' c '00 CX)Q>-M \().J->-P .J-) ., 0'1 c m c ~ a>E till ~ w H c ' \ Q)·rl ·.-I p::~ HIH 'd ' / g o.c rlrl 0\0 0 ·rl 0 0\0 ~ .J-)t) :;j(Y) t)t'-c r:QU\ c:x: I { ' E-t j'~ :J H rl 1.1\ Cl) 0 0 .p HC\1 H ·rl OIH ·CJ fll . OC\1 z :s: t) ~ ·rl ~tf IH H m ~_, p:; . ·~ 0 H 8 >.o 8 .J-) c :J ::~·(c;~: " " Q):z"; <:l; ·rl 0 • a> m c c c "' .co ~~:~~; ~ Q)U) 0 0 H Q) :s: -P rl 0 .p .p 0 c 0 •rl Q) @@~ bOQD .J-) 0 c :s:.c:: ·. bQ·Q)I·:. c c .J->..C: .J..) (!}''~?3 0 Q) 'd ·rl •rl <I; p, '0 Q) p:: ~ HHC..C:..C: Q) c ,C:: 0 ~~ :>it'JcOU)rJl rl c:x: _p.J-) ~ rom Q) E-t --- . \ FORM 67 REG. WILLS REV. 1-50 .Application for 1Erttrrs of .Ailministratiou on thr Estate of .......................... E.liz.ab.e.th .. Aona .... ClQke.y. ................................................................................................................. . late of ....... .S.Q.l.l.t.b .... S..t:J;:~.Q.9.P..~ .... T..9.W..~.h.iP. ................................................... , Deceased. Before the Register of Wills of Washington County personally appeared .......... C;.J.~.C.~J.l: ..... E ........ EP..l.Q~ .•.... l':~.Y~.t .... Q.f.f;J,.c..~~., ..... ~.t.t.t.~.l?..~;rgh .. J~l9.t.l .. , .. J~.ank who, being duly sworn deposes and says that. ................. ~.l.i.?,:.~.Qg,t.h ... AP.:D.!?. .... QJ9.J5.§Y. ........................................... . age .... 8.5 ....... , having ... b.er .... last family or principal residence at. ........................................................................................... . (Street and Number) ............... Eigh.ty.::Eo.ur..,.: ..... : ............................ 't'.-.::···········t:.············n Washington County, Pennsylvania, died intestate (-City, Borough, Township) Latroue, reUUSYJ.Van~a at... ..... Lat.r~ib.~.~-.A~.f#.~•.Jl9.~.P..!.t.9.l.t ......... , on the .... l9 .. day of .......... J.anuar.y. ................................................ . A. D.;. 19 ... ~.6 ......... , at... .............. 7..: .. 10 ...................... A ... M., possessed of personal estate to the estimated value $ .. 8.0.0.-!'.0.0 ............. , and of :real estate in th~ Commonwealth of Pennsylvania to the estimated value of $ .. 15.,.00.0 .... 0.0 .. , situ ate in ....... S..QY.th .... S..t.~.9Q.~.P.:~ .... 1.9.ID.?:§.Q.~.R.t ..... W.!?.§.DJP.&.t9.P.: .... Q.Q~.!1.tY., ..... r..!?.. • •ooooouoooooooonooo~'oooooooooooooo.ooooooooooouooooooooooooooonoooooooooooooooooooooooooooooooooooooooooooooooooooooo•oooooououuouoooooooooooooooooooouooooooooooooooooouooooooooooonouoooooooooooooooooooooooooooooooooooooooooooooooo The names and addresses of the decedent's surviving spouse. (if any) and other heirs including heirs by adoption) are as follows. REI,ATIONSHIP RESIDENCE ............ w ....... E.li.z.ab.e.th ... .dt~!-1.~~-Y. ................... Niece .............. Z.1 .... Mo.rgan ... Av.en.ue~ .... W.a.s.hing.to.n, P a • ............ He.l~n .... C ....... A.§.b.c.:r.a.f.t ..................................... N.!~.9..~ ............. .!.9..§.4. .... f..Q~.;:.th .... ~.~ .. ~ .. , .... ~9.~9.~.8.§.9.~.!.a , P a · ............ M~.~t.b..9. .... e..A ..... C.JQ~~.Y. ........................................ N.!g.£.~ ............... 4.~.§ .... ~ .. ! ... J?..~.~.~ .... ?..~ .. ~ .. L.~~-~9.:~~g-~~~., P a • J ............. $..!?..~~.~J: .... J. .. ~ ..... C..l9.~~.Y. ........................................ N.~P..h.~~ .......... A .... ~~9.:Y.P..!: .... ~.Y.~.~ ..... ~.~-~-~-~ .. ~ .. ~-~~-~-~~-g ton , P a • .................................................. ..... ~-.................................................................................... ~ ................................................................................................... . That deponent is o~er 21 years of age, resides at... ........ W.ashing.ton., .... P.ennsylY..~ni.a .............. . ............................................................................................................................. = ...................................................................................................................... . is a citizen of the United States and a resident of Pennsylvania, and respectfully applies for Letters of Administration upon the Estate of said decedent, no letters having been previously issued thereon. '? 'Y// Sworn and subscribed before me this ... ~ .................. .. ... ~~~~~~ ........... .. L/rTr~st Officer day ~ .. E.eb.r.~a=.Y, ...................... , A. D., 19.9..~ ......... . /~ht \ ................................................. _ .................. ~ ...................... . .. ........................................................................................ u ................ . REGISTER COMMONWEALTH OF PENNSYLVANIA } SS: WASHINGTON COUNTY, . . And now ...... F.gl;u;:Y~.t:Y. ..... ~ .... ~, 19 ... §.§ ... , come s ..... Qh.'?:~.~-~ ..... ~ .. ~ ..... ~~.!.9.~-' ..... J..E~~-~ .... Q.~.~ic er who being duly sworn doth depose and say that... ....... it ............ will well and trui)riata_~~RrMfPb\e ~8Jal an~ank chattels, rights and credits of... ......... Eli".ab.e.th ... Anna .... C.lo.ke.Y, ............................................................. , deceased, to the best of... ... i.tS .. skill and judgment in strict compliance with the laws of this Commonwealth, mind- ful of the laws relating to inheritance taxes. J4{ Sworn and subscribed before me this.~~ ............. . ~:~:~::::~~~::::::~~::= ___ ji~.~:~~-· ........................... T.x:us.t .... O.ffi.c.e.r .................................. . REGISTER ·" .; =.! Y· \ M. & 8-& F -.3c. 7 I~ II APPLICATION FOR 1• Letters of Administration f: l I f I I' '.f. ESTATE OF .......... E.li.zab.eth ... .A.nna ... Cloke.y. ............... . Deceased R $ ............................. . Letters...................................................... 0 d P: $ ....... /..e... .......... Extra Alias . . . . . . . .. , ...... $ ............................. . Certificates · . ?.-:-1?. ~ .... $ ........... ~?.: .. ~.~ Renunciations ~. ~ .. $ ............ ~ .. ~ .. ~ ... ~ .......................................................... IX. -:;t.. :it: Q c) -.p ............................. . Total.................................. r-: .......... ;···-····························--············· ;::":! r.-:;::::J C)C:: . -'(/) (..t.:t./) ---lrrl f'•;-...-~'r 0··?' -n~ ~:-o r-z r-o ;.j C) ~ - •• ,-- ' IT! 0 \') <n . AA r1... 2.t P~:· :t./.. ~ ......... f!:§L. .. ..... -/-.. • • .< ..... : .................... ~ .... • Attorney GREENLEE, RICHMAN, DERRICO & POSA ATTORNEYS AT LAW WASHINGTON TRUST BUILDING WASHINGTON, PENNA. r j 'I r I l ., .. . . . • . _____ _.... ___ --~-~------.__. .... ~----~---4-1~:.:._..-· ~------.. ----------- ESTATI: OF ....................................... ~.~.!.~.~~J.:!! ... ~.~~ .... Q1Q1f:~X ............................................................................................................. DECEASED The undersigned .......................................................................................................... : ............................................................ ~ ...................... and heirs of ................ ~1I.~.~J.";.IH ... ~.~ ..... C..W.K;t<;.Y .............................. late of ..... E.i.ghtJ, ... Eo.ur. ...... F.ennsy.lv.a.ni.a ................ . deceased, hereby renounces ........................ right to administer on .. , .............................. h!at: .......................................... ~ ............... estate and respectfully asks that Letters of Administration be issued to .... F.it.t.s.bur.gh ... Na.ti.ona.l.. .. Bank. ............... . ............................................................................................................................ -............................................................................................................................ . ................................................................................................................... .................................................................................................................. . ............................................................................................................... .. .. .. ~ ......... -~No. 80738-3 INVENTORY of all real and personal estate of _____ ~~~-~~!?.~~~--~~~--g-~~~~l-------------------------------------------------------------------------deceased, late of·-----------------------------~----------------------------Street _______________________________________________________ City ______________________ -_______________________ Ward ----------------------------------------------------------------_______ Borough _______________ ~~~:t-.0.. .. ~~T-~P.9:~~------------------------Township, Pennsylvania. PERSONAL ESTATE SCHEDULE Mellon National Bank & Trust Company Washington Office Savings Account No. 7405 Jewelry Old Paper and Silver Money (As per appraisal on file with Administrator) DPB $ 995.70 130.00 105.00 $1,230.70 I REAL ESTATE SCHEDULE REAL ESTATE IN PENNSYLVANIA 88.5 Acres, vacant land, Route 136, between Washington and Eighty-four, South Strabane Township, Washington County, Pa. None l~ORANDUI-1 OF REAL ESTATE OUTSIDE THE COMMONWEALTH OF PENNSYLVANIA $26,800.00 ~ ~ ~ ... AJI'II'IDA VIT 01' EXECVTOR OR ADMINIITRA'I'OR STATE OF PENNSYLVANIA l SS.: COUNTY OF ALLEGHENY ~ Personally before me, the undersigned authority, a Notary Public in and for said County and State, appeared --~Cha~r~l~e~s~E~·~En~l~ow_.,~T~ru~s~t~O~f~f=ic~er~--------------------- Pittsburgh National Bank who, being duly sworn according to law, depose and say that PITTSBURGH NATIONAL BANK is the ~ Administrator of the estate of Elizabeth Anna Clokey deceased, that the foregoing schedules constitute a complete inventory and appraisement of the real and personal estate of Elizabeth Anna Clokey 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. Pittsburgh National Bank Sworn and subscribed before me ) th1s~:~68l By: ~ -~.4~) ~·~ ;. \~ 0 p;! ~ "' 1 ~D o· . 0 I o: b() i 11 J ·--·rl ~ : k. : ~ k"'! ~ '1 Q)! r-1 i-t ~·r-f 0 ~ ~~ 1' ''"\ Q) : ~ r<'\ ~ ~ r "" 1 !""" t:-• Q) ~ r:Q ).{\ Q)o I . .;) ~ ~: ( ':J _o...J HS:: i-i 0 0: :s::! +': 1""'4 aS l""'i: : Q) IT.! : • .... ll. ~ o: :Q) ~:ro "!''~-,I :l5 0. 0.. 0 ~ 0 ro; ~' " .. "'') : •r-f E-l : r r:z;l S:::: I, -l.., ,;_ j L. ~ ·-• .. t;..Ls : P'1 s:: :d z s::: !~ ~ o !o 0 ~ <: ' Ql~tD ~! ~ ..c:: :'0 Ql : :~~ s:: :s:: ~! ~ rn +I! :0 •r-f ~r-f Q)! ~ ~i :H Q), ..t:: :..t:: ~! > : ~Ql IT.! !IT.! t-:J! :l!J ~ ro :ro ~ ·r-f! : ~:;;:~ 0 N. z r-i! ' : : z r:r:~: ' : >. ~ G) ~ r::: f rd ""' _; G) ~ 0 ., .. ~ -.. ., ~ < < -... ,. 3Jn t~r ®rpqans· arnurt of llas~ingtnn Qiounty In the matter of the Audit of Account in Estate of:_....::EL::::.:I::..:Z=AB~E::..:T:..::H:..:......::A~NNA=-=--C::..:L::..:O::..:K:..::E::..:Y=-·L., --! No. 63-?...=..8___:-3:::..:6::.....:7 ____ ~~ deceased TO THE AUDITING JUDGE: Enter ___ o..;_u=r ____ appearance for PITTSBURGH NATIONAL BANK, Administrator and Accountant. 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. I , . /' _, No. 63-pS-367 , ~X!(;~. In re Audit of Account in Estate of ELIZABETH ANNA CLOKEY, deceased AUDIT Jrarripr fnr i\ppraraurr FOR PI~T~~URGI!_ NATIONAL B~~''- Administrator and Accountant GREENLEE, RICHMAN, DERRICO & POSA Attorney ~·2 M.· He Ma ·-~--~-~--~~----~~------... (Form where decedent died intestate·) 3Ju tqr ®rpqaus' QTnurt nf llaaqtugtnu QTnunty ESTATE OF No. 63-68-367 In the audit of the First and Final ····-~-~.!.~.§:~.~-~}:?: ... ~P:~!:I: .. _g .. ~9.!::~~--·················································· Deceased Account of Pittsburgh National Bank 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 ;arriage 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. The petition of ........... P.it.t.s.!;nu.:gl::t..N9.:.ti9n9.:.t .. ~9.:nk ..................... _ .............................................. . (Name of Petitioner) respectfully represents : ........................................................................................................................................... .. (a) The decedent died ..... J.9.:P.-~-~~Y ... J9. . .2 ••• J9..§JL ..................................... , intestate and (Date) letters of administration on ...... h~-~---······estate were granted ..... ~~E-~.b-.... ~-'----J~.§-~ .............. . (Date) as per record thereof appearing in Administration and Bond Book No ....... 9.Z ........ . . 219 at page ..................... ~ ...................................... . Decedent was survived by three nieces and one nephew. Decedent was unmarried. -, ,., .. " (b) At the time of death, the decedent's domicile was = the Com- mon wealth of P ennsy I v ani a, to-wit, a t...l; !ghJ;y::-J.9'\l.~.~ ... .W9.:s.h;hngt.Qn ... C.QJ.mt.Y..~ ... :renna. (Town or Township, State and Nation) and residence was a t...J;!_:!,gh.t.Y:::J.9.~.~.1...W.~.s.hJP.-Kt.9.P.-... Q.9.~.D:tYL .. f'.~.TITI!=!.L ............................ .. (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, rnanf!er and place of record of appointment and is bound suffi- cient to cover and protect share. Elizabeth McBurney Niece 1/4 yes len C. Ashcraft Niece 1/4 yes rtha E. Clokey Niece 1/4 yes J Sa muel J .-Clokey JNeph.ew 1/4 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.wxJ.t.tg.n_notice of .the filing of the account by letters dated October 21, 1968 (See copies attached) •,. ' ~-.. (e) Balance for distribution per Account $ .. ..?.., .. ?..J.9.~..4.?. .. (f) Additional debits, not shown by Account (Itemize) $ ...... ~.~?..: ........... . (g) Additional credits, not shown by Account (Itemize) $ ...... ~.'?.?..C: ........... . not $ . ..1..,.~3.Q .•. ?±Z ... Insert word "not" where necessary. (h) Claim for exemption has/ been made, and has ...... n9.t ......... been paid. . n9t applicqqle . . If taxable state wheth- er tax has been paid. (1) The estate Is .. :.::.::.: ..... subJect to the payment of mhentance tax to the State of Pennsylvania. (j) The estate is ......... ~~.!7 .......... subj ect to the payment of the county 4 mills tax. (k) The estate is ......... ~~.!7 .......... 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... ...... .h~~············ notice or knowledge, have ........................ received actual notice of this audit; the amounts of their claims and 11 too many .for the 1 whether or not they are admitted to be correct are as follows: space, annex a hst there- of; if no such claims, insert the word "none." If any creditor or other claimant has not re-I No e-ceived actual notice, that n ' 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 statement 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. (m) None State kind, form and (n) The balance for distribution consists of property in kind, form and character of propeny composing the balance h f 11 for distribution, and if c aracter, as 0 ows: any pan thereof is not cash, whether or not 1 there has been any elec-1 Balance for Distribution consists solely of cash tiOn to take such part • in kind. .• 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) None (q) Give brief location of any real estate sold. 88.5 Acres, vacant land, Route 136, between Washington and Eighty-four, Washington County, Penna. If prior accounts have heen filed, list number and term. (r) None filed Wherefore your petitioner 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) :- To M. El~zabeth McBurney ) ) Helen C. Ashcraft ) ) Each 1/4 of Residue Martha E. Clokey ) ) Samuel J. Clokey ) County of Washington, ss. The above named petitioner being duly sworn doth depose and say that the facts set forth in the foregoing petition are true And your petitioner will, etc., PITTSBURGH NATIONAL BANK to the best of h ... ~-~---··· ......... knowledge and belief. Sworn to and subscribed before me this :<,(o day of ........ N.Q.Y.emb.e.r ................ , 19 ..... 9..8 .... . ............ 7.1.2~ .... €~--~'-'-··········································· MABEL E. RUT,,N ·····-····-····-················N9.t.9:l;".Y ... ~gJ?.1.:!:~ ........................ ~QIABY .. J?.l!E!.IC WASHINGTON, WASHINGTON, COUNTY MY COMMISSION EXPIRES FEB. 1, 1969 . ••...•....••••••• ::r.-..• J .•••• ~---································ ···············-··-········ (Signature of Petitioner) Trust Officer I ~ •. ,..--,.. FORM IN CASES OF INTESTACY No ...... 9..~:::9.§.:-;~§_l.__ _______________________ 'UT~~~It~~~~:lW. IN THE ORPHANS' COURT WASHINGTON COUNTY, PA. Estate of ____ _)g_~-~-~:t?.~~-"b-_ __ ~P.!.l:9; ___ C 1 okey ----------------------------··· Deceased. Sur account of ____ f>_;i,_t_t._$_Q~rgh ___ N~_!;J.<?.~f1J .... ~-~~k Administrator 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 fo.r distribution are derived from the sale of real estate. 7. Copy of Federal Estate tax return, if estate is subject thereto. 8. Signed elections to take in kind, if any. Attorney for A·ccountant. ~2 t 1 ' ~ ' : i) . l n·• -, ' tl :J r·.---·~· '· ''\"·::-:J L .. ~i'~~~l~~·,.:~LS f) • (~ J. lin tqr ®rpqans~ Qinurt nf llushiugtnn Qinunty 63-68-3cl7 ESTATE OF ~~ No _______________ Of Fll.9r.s--t·--a--n---d-, AF.l~n-al --~-~~~~~-~~~-A~?.':l:_Q_~~~-~-Y.;_________________________ In the matter of the·--------------------------------------- Deceased. Account of ____ R_~~-~~P-~~gg_N§-_ttg_~_t~-~-~~-t--- --------------------------------------_h._gmto.i§_tr.a_tQr _________ _ ADJUDICATION AND DECREE And noW----------~-~E.'::~~.Y. ___________________ : ______ /tZ _____ , 19.~-~---, this matter came on for hearing, audit and distribution at this session and testimdny-taken; and thereupon, upon due consideration th,.ere§Sdhe ~a lance for distribution in •the hands of the Accountant is determined to be $.'/.,. ________ . _ _4 _________________________________________ and the account is a ceo rd in g I y confirmed; and it is ordered, adjudged and decreed that the said balance be paid out by the Accountant in accordance with the schedule of distribution hereto a'ttached and made a part hereof, unless exceptions hereto be filed sec. reg. or an appeal be taken herefrom sec. leg. /---~~ I - - --------v z------------------~ ------(/) scHEDULE oF o•sTRia~,~~~~-~~-~ ........ Q,rez?l I Balance pe'r account---------------------------------------------------------------------------------· Balance·------------------------------------------------------------------------------------------------------ Deduct Clerk's Costs & Receipts------------------------------------------------------------------ Green lee, Richman, Derrico & Po sa AttorneY-----------------------------------------------------------------------------------------------------· Russell Marino, Agent, transfer inheritance tax, NI;. Elizabeth McBurney, niece, 1/4 balance, Helen C. Ashcraft, niece, 1/4 balance, Martha E. Clokey, niece, 1/4 balance, Samuel J. Clokey, nephew, 1/4 balance, 23.00 $7,807.42 775.25 1758.05 1758.04 1758.04 1758.04 No balance J --- r No ............... Of 19 ............ , A.A. In the matter of the account of of Estate of i\!lju(Hration an!l 1llrrrrr 1{.; s·n·\:'}'~--~~:; ~J c~:·.·~·~j~l.,1_:; .. }~ .. J . (" . ..:. HJ ( .. . 0 ., GPr':'i .. · ) ~ ~·-~ )._,;~ r--~: ...... f I I _ ;. , • .. "-' . -~2 t) ~-1-/y~' l ) ) ORPHANS' COURT OF WASHINGTON COUNTY. PENNSYLVANIA In re Estate of ..... Elizabeth Anna Clokey Deceased ? ) RECEIPT KNow ALL MEN nv THESE PRESENTS That I, No •. 6}-:-.<?.?::·}<?Lof 19 ........... . Sanrud .. J .• C~okey .. .. .. 9 do hereby acknowledge to have received from PITTSBURGH NATIONAL BANK .Adm;i,n;i,~:t;ra:t;o;t;" ... . . . . . . . . . . . . . . . of the Estate of . .. El izab.eth .. Anna .. C.lokey . .................. , Deceased, the sum of .One. Tho\l~and. Seven.HJ..mdred F:Lf:ty~eight. and .. 04/.100 .. {$t,758 .• 04)dollars, in full payment of the amount awarded me under the decree of the Orphans' Court of Wash- ington County entered ~Cit1U(lry)Q. , 19 ()9 ... , at the above number and year; and I do hereby authorize and empower the Register of Wills in and for said county to enter and file this receipt. In witness .whereof, I_"ave hereunto set my hand and seal at .. 'll.~..,~~ ... £. . , thJS /~Zit day of ····~··············· A.D. 19. .. 1... ~~~~·~ .. c;:~~ s~e"l ~~~ ·•····· (sEAL) 17-934 REV. 3-63 J .· L) · .... ~ ' . ~ ·• • \.. .... : -• • I' •• i, • .J . -.. J !~ _, ' ~ m m ~ n m ... ~ m 0 'II 0 ~ s ~' ._ ' fll . ' (') ~I ~ r i o) I ORPHANS' COURT OF WASHINGTON COUNTY, PENNSYLVANIA In re Estate of El.iza,bet.h .. Anna. (;l()k~Y .. Deceased ~ ) RECEIPT KNOW ALL MEN BY THESE PRESENTS That I, No .. 6}-:.6.8.-:.~.9.7..of 19 ........... . . Mcir. t:ha, E. (; 1 okey . ..... ' do hereby acknowledge to have received from PITTSBURGH NATIONAL BANK .Acim.:i,n,:Lst:r.a,t:qr. . ............. of the Estate of . . . .. . . . E:Uz.a,b.E!t:h .A,n,n,a, .. G~()lcE!Y ................................. , Deceased, the sum of On,~ l'4qu,sa;nci .. Seyc;m llu,n,cir.E!cl E'Ut:Y:-:E!tg4t: .a,nci .. 04/L00 .. ($;I,.,.7:5~ .• 04) dollars, in full payment of the amount awarded me under the decree of the Orphans' Court of Wash- ington County entered .JanWI,ry.JQ , 19 09 .... , at the above number and year; and I do hereby authorize and empower the Register of Wills in and for said county to enter and file this receipt. In witness whereof, I have hereunto set my hand and seal at ............................................... . 17·934 REV. 3·63 .l • ... 1.. ;~: . ' ' \ ... r jiO m n m ! ' . f.! ; 14 , ·-· .J m E m 0 "II 0 PI n ~ il s oj I ----------------------------------------------- ORPHANS' COURT OF WASHINGTON COUNTY, PENNSYLVANIA In re Estate of Elizabeth. Al1naCloke:y Deceased ~ ) I RECEIPT KNow ALL MEN DY THESE PRESENTS That I, No ... f?J-:-9.a.-:-.39.7of 19 ........... . ..... ' do hereby acknowledge to have received from PITTSBURGH NATIONAL BANK .Adm.inist.rat.Qr .. .. . of the Estate of . . . . . . . . . Eliz.ab.~t.h _.Anna .. C lqk~y ................................. , Deceased, the sum of On.e Thou.sa,n.d_Se_yen.I-It111clr.~ci E'~~1:Y-:-.~~gl11:. B:l1cl .. 9[j:f~99 ... (n_,}S.~ .. q~) dollars, in full payment of the amount awarded me under the decree of the Orphans' Court of Wash- ington County entered .. J.a.nu.a,ry_J(). , 19 ~9 ..... , at the above number and year; and I do hereby authorize and empower the Register of Wills in and for said county to enter and file this receipt. In witness whereof, I have hereunto set my hand and seal at ............................................... . ................ ,this j/t/t:_dayo£ ~ ............. · ........... A.D. 19?1'. ~ (/, ~ .. (sEAL) ~~:~··7-···~,Helen.C •. Ashcraft 17-934 REV. 3-~3 ' \ ,. -' r , ••. .--' ,_, -·:,; .'>-..' ' . '· J( :Ill rn rn ~ n rn ... :; rn ... 0 "II 0 v-. ·, ... '< 111 (') 111 ~ > f/1 r 111 r ol ORPHANS' COURT OF WASHINGTON COUNTY, PENNSYLVANIA In re Estate of ..... El.iza})eth A!lna C~ok:~Y . Deceased ~ l I RECEIPT KNow ALL MEN BY THESE PRESENTS That I, No.9.3::·.9.~.~.3.9L.of 19 ........... . M.. Eliz.ab~th McBurn~y . ..... 9 do hereby acknowledge to have received from PITTSBURGH NATIONAL BANK• .1\cirn~!l~l:lt::r<lt:C>:r .. ............ of the Estate of . . .. . ~g2:C11J~th. .. .I\I111C1 G.l.e>J:<.ey_ ............................... , Deceased, the sum of OP.~ .. ~h<>t1~C1I).cl .. ~~Y~I1 .. llt1I1cl:r~ci .. Fift:Y-:-~igh..t .. Cin...d .. 0?/JO.o ... ($.1.~ ?.5.8.~ .o.~) dollars, in full payment of the amount awarded me under the decree of the Orphans' Court of Wash- ington County entered Ji'!.P.t1C1:t;y.l0 , 19 .. 6.9 .... , at the above number and year; and I do hereby authorize and empower the Register of Wills in and for said county to enter and file this receipt. In witness whereof, I have hereunto set my hand and seal at ... ttJ~~·········· ~ , this U. day of ~ .. A. D. 19/4 ... IJ!Xl~r?a~ (sEAL) ~~.c. ... ??.1.~ ........ . 17-934 REV. 3·63 ..• "' ......... t .. ~ \ .... ,f ..... -•• . . ( .... ·~· ~ . ' ... '·. ;.··· jiO m m ~ n m ~ ... m 0 "II 0 ·. \. Ill n Ill ~ )> r f': i 0 I .. ,• No. 80738-3 Form RCC-33 COMMONWEALTH OF PENNSYLVANIA .DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS I RESIDENT DECEDENT COUNTY OF ..... W.~.~h;J.pgt.qn .................................................. . 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 by the Secretary of Revenue. (Section 703 of _ t_h!_!_In11.erit!lnce_ an!I_Estate Tax A,ct of 19!)1.) IN THE MATTER OF THE·ESTATE OF AFFIDAVIT OF .. . .. Eli z.a.b.e.t..h ..... An.n..a ..... C..J...qk~Y ..... (State full name of decedent) . ........................... ~~~ ADMINISTRATOR Late of ............. W~H?..h;ingt.on. ........ . .. .... . ............. . County State of .......... J:'~rJ.:t}l3.Y~Y?~:i,?. ............................................. } ss: County of .... W.?:fih:i,~g~(?t1 ......................... .. ...... :r, ..... Gh.~:r-~~f3.. --~-~----~~()!.'., ... 'I'.D.l..~~---··Q:t;f.~.9.~.r.., ..... l:':i.::tt.f:>l?p,r.&t ... N.~t..:bc:>n?.:L ...... :E?<mk ..... . Administrator of the estate of the above-named decedent being duly sworn, depose Decedent ·died Name and address of attorney or} other authorized representative to whom all correspondence should be mailed. Pitt::>l?,'ll:rgh National. :89-nk Washington, Pa. 15301 and say ................... ~ That as such .~9:~9.J!-.~§~.:r.~~.Q.r. .......... deponent is familiar with the affairs of said estate and the property con- QGQ(i]6K.AdminiRtrator) 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 Ok 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 Sc.hedu!e 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 pr~vided therefore the assessed valuation of each of said parcels, the estimated market value thereof as of date of death of decedent. That Schedule 8 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, whfch 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 JHlrsonal chattels of whatsoever kind or nature, left by decedent, together with the fairly estimated market valne thereof; all bonds and mortgae:es held by decedent and of all claims due and owing decedent at the time of death, and all promissory notes or other instruments in writing for the payment of money of whlch 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. DPB 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, '0 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 transferee 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 cony 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 sche?-ule, 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 instrt~ents effecting the vestiture of real estate and the date of acquisition of personalty, plus the name, address and relations~ip, if any, of co-owners to the decedent. That Scf>edule 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 ann unpaid at time of ~ . death; taxes accrued charge.able for period prior to decedent's death (except. those allowed under Section 651 of the Inheritance and Estate Tax Act); together with a statement of collateral pledged for obliga- tions, if any. It is agreed that the fiduciary will present proof of said claimed obligations upon re- quest, that if the amount actually paid in settlement of any fee, commission or debt is less than the estimated amount claiming and allowed, that the same will be reported to the Register of Wills, and that the amount of tax assessed can be reassessed in accordance therewith. That the totals of the appropriate columns in Schedules "A", "B", "C", "E", and "F" as directed therein,. have been carried forward and properly registered in the Summary. Pittsburgh National Bank Subscribed and sworn to before me this .... r..--,? ............. . ················'······················dday of .... G.?.C:t-...~9 .. ~?. ..... . ---~(:!t;:s~ By;·~-'r~~·onrcer ....... 9.~~ .... ~.9.~.~h .... ~.~n ... ~~.r..~~·~····································-········--·· (Street Number) ...... ~~~.!3.h:i.ng~q.n., ..... P.9.-.. ~ .... J.5.3..9.+. .................................................. . (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 (i-64) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "A" . -RfAL PROPERTY Real property in Pennsylvania, with statement of mortgage encumbrances upon each parcel at death of dece- dent. Where property held as joint tenant or tenancy by entireties, report on Schedule ''E". Property hdd by the de.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 Commortwealth of Pennsylvania should be described by lot and block number, street and street number, together with a general description of the property, with o reference to the record of the conveyance by which the decedent took title; If a farm state number of a· cres; also statement of mortgage encumbrances upon each parcel at death of decedent. Taxes, assessments, accrued Interest on mortgages, etc.,are to be listed on Schedule "F" and must not be deducted from this schedule. 88.5 Acres, vacant land, Route 136, between Washington and Eighty-four, South Strabane Township, Washington County, Pa., (1) ASSESSED VALUE FOR YEAR OF DECEDENT'S DEATH 'l~f8, (2) (3) DEPARTMENT VALUATION ESTIMATED CAUTION MARKET VALUE (Do not write In this spoce) $26,800,00 ~ I ~~ <lf),~4--f ~f-M2-~Y ~~ cfc, 1 fO o · oO ~~~........-.~ • Insert this total opposite "real property", Schedule "A" in the X X X X X $26,800.00 "As Reported" column on the last page of this return. ·. RCC-35 COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "B" 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", Intangible 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 e~tate. 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. ITEM List and describe fully Mellon National Bank & Trust Company Washington Office Savings Account No. 7405 Jewelry Old Paper and Silver Money (As per appraisal on file with Administrator) I UNIT VALUE ESTIMATED MARKET VALUE $ 995.70 130.00 ,. 105.00 '· DEPARTMENT VALUATION (Do not write in th:is space) ... ..; . ( ff5JO:~ 1 ;J o oo Insert this total opposite "Personal Property", Schedule "B" in the "As Reported" column on the last page of this return. X X $1,230.70 RCC-,36 COmt0:\'\1': \LTH OF PENN SYLVAN I A. TlL\.i\SFER INHERITANCE TAX SCHEDULE "C" TIUNSFEllS 1\ESIDEXT DECEDENT ( 1) (2) ( 3) 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) _N_o __ _ 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) __ N_o __ _ 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)~N~o~---- (a) Was there any possibility that the property transferred might return to transferer or his estate or be subject to his power of disposition? (Answer yes or no) ____ __ (b) What was the transferee's age at time of decedent's death? (5) Did decedent i~ his lifetime make any transfer without receiving a val_u_a_b_l_e_a_n_d--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) ~N~o _______ _ (b) The right to designate the persons who shall possess or enjoy the property transferred or income therefrom? (Answer yes or no)~N~o~------ (6) If the answer to (5) (b) above is in the affirmative, state whether the right was reserved in decedent alone or others __________________________________________ ~------- (7) Did decedent in his 1 ifetime 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) __ N_o ___ _ (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 could revert to decedent under terms of transfer or by operation of law? (Answer yes or no) __ N_o ____ _ (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) ______ _ 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 Insert this total opposite "Transfers", Schedule "C" in the "As Reported" column on the last page of this return. MARKET VALUE (Estimated) DEPT. VALUATION (Dept. Only) RCC-38 CCMMONWEt\LTH OF PENNSYLVANIA THANSITR INHERITANCE TAX RESIDENT DECEDENT SCHEDULE II E" JOINTLY OWNED PROPERTY HiSTRl'CTIOKS: This schedule must disclose all property, real and personal, owned by the decedent jointly with 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 under Schedule "A", plus the date and place of record of instrument effecting vestiture, but do not include entireties or out of state real-estate value in estate valuation column. Personal property should be listed as in Schedule "B", plus date of acquisition, and the name, address and relationship (if any) of co-owners to the decedent. Description of Property, Date of Acquisiti~m, Name l Unit Address and Relationship of Co-Owners, and Place 1 Value of Record of Instrument, where Real Estate. ! Percentage Estate Share Valuation None I I I I I I I I I Insert this total opposite "Jointly Owned Property", Schedule "E" in the "As Reported" column on the last page of this return. I I I I DEPARTMENT VALUATION CAUTION-Do not Write In This Space. Value of Entire Property - I I I I i I I I ! Value of Decedent's Interest ( h .fWC-37 (12-63) COMMONWEALTH OF PENNSYYLANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT BENEFICIARIES AND ADDRESSES State full names and addresses of all who ave an interest, vested, contingent or other- wise, in estate) 1-1. Elizabeth McBurney . 77 Mor~an Avenue \t.Jashington~. Pa. 15301-~-' ~ SCHEDULE "D" BENEFICIARIES RELATIONSHIP SURVIVED (If step-children or illegitimate children DECEDENT are involved, set STATE YES forth this fact_) OR NO Niece yes -... Helen C. Ashcraft ~~lNiece :ves 16B4 Fourth Avenue Monongahela, Pa. ~Brtha E. Clokey Niece yes 34B East Beau Street Washington. Pa. 1530! Samuel J. Clokey Nephew yes 4 LeMoyne Avenue Extension Washington, Pa. 15301 .., ' I .- DATE INTEREST OF OF BENEFICIARY IN ESTATE BIRTH Deponent fUrther says that all the above-named beneficiaries are living at this time except below: NAME DATE OF DEATH RESIDENCE - Will Administration ~ No. Year D< THE :\lATTER OF THE APPRAISEMENT OF THE ESTATE OF Elizabeth Anna ~lokey . Deceased Late of So11th .StratJ<:ii1E3 ·:ro."\IIJI"lsil.iP County of Was}1:l,.pgt,on. Commonwealth of Pennsylvania REPORT AND APPRAISAL Sll:!.\ :10 :1]!SID1'J O!Ji:J\il J "J l~.:S!~J ss: r t:J f ~~ C•n,J , f"' .... ...,,. ..... , i I' (.--' 0 3l I .--l I (Executor-Administrator must complete "As Reported" column #1.) 0 ......:.! 'i::l ::0 .... .... ~ ~ 0 $l.l .... E.. Vl :::! Vl Vl Vl 0 ......:.! (t' ::l 'i::l .... e. .... $l.l "' 0 ;..: 'i::l '0 $l.l ~ 0"' .... .... ~ 0 ~ '0 tr1 ~ .... Vl ...... ..... '< $l.l ..... ~ en c: ~ ~ > ::0 .......... -.....:! w c:n en (") (") ?" ?" ::r' 0 ~ > :: :: :: --- -{1) -{1) ~ -{1) -{1) -{1) 'l'V :I\) :~ +-' :a---.. .,. .,. > :o 1\) -~ . . "' "-'> \;.) : :o :o 0 ::0.--... :• :. :. .g """"" :-..J '""'-J :0 o~ :o :o 0 .... .... ~ c.. --~-{1)--{1) -~: ".~: ·10. \.~ ~ "'-:!" C) : : > . ~"' "" ~~-. '~!'() ·~·~~-~ t\1 : ().g <::),.~ ~ 0 . • _C.. 0. Form RC C·lO .. -;,. \. -! t 7/ {, F 0<000.>0" ACCOW<O " • J OFFICE OF THE REGISTER OF WILLS STATEMENT OF DEBTS THE SUM OF ............ $if; ft~r.;Ji OF __ W_a_s_h_i_ng...=..t_o_n ___ COUNTY AND DEDUCTIONS DATE APPROVED ........ ·'.=f ~ 7 ~ ' AND AGENT OF THE COMMONW5ALTH ESTATE OF __ E_l_i_z....ca_b_e_t...;;..h;;...._A_n_n--'a-'--C_l_o_k_e~y..__ __ DATE OF FILING APPRAISEMENT October 15, 1968 DAn: oF DEATH ---=J-=a=n:.::u:..:a::.::r:..~Y'--'1:..:9:....,:~.-.;1::.;9~6=-8:::....... ____ _ DATE NO. OF NAM& OF PAYEE REMARKS AMOUNT VOUCHE" 1 9 I> 8 Letters of Administration, Renun- Mar. 14 Russell Marino, Register ciation and 2 Short Certificates j; 22 00 14 Washington County Re£orts Advertising Letters 12 50 1R Observer Publishing Company Do 12 50 Apr. 15 Pittsburgh National Bank Appraising Real Estate 35 00 Aplraising old paper and June 7 Richard H. Piatt s~ ver money 8 00 Aug. 26 Russell Marino, Register Filing Inventory 4 00 26 Pittsburgh National Bank Public Liability Insurance 3 00 Oct. 14 Greenlee, Richman, Derrico and Posa Attorneys' Fee 1,400 00 14 Russell Marino, Register Filing Account 20 00 14 Pittsburgh National Bank Administrator's Compensation 1,400 00 June /Aug. 16 Piatt Funeral Home Funeral Expenses 1.492 50 Maintenance of Decedent at Aug. 27 Commonwealth of Pennsylvania Torrance State Hospital 10.558 20 Reimbursement for funds advanced 27 M. Elizabeth McBurney for Medical Expenses 1.000 12 27 Latrobe Area Hospital Hospital Expenses 145 13 Drs. G. F. Nealon and 27 W. F. Berberick Professional Services 45 00 Sept. 10 Moreland Burial Vault Co. Grave Marker ll2 00 July 23 Delmer C. Larkin, Tax Collector South Strabane Twp. Road Tax for y_ear 1968 17 01 23 Malcolm L. Morgan, County Treas. Washington CountS Real Estate Tax for vear 196 28 73 Reimbursement for funds advanced Aug. 27 M. Elizabeth McBurney for taxes and other exoenses 1 093 133 Sept. 3 M. Elizabeth McBurney Claim under Judgment e.nt,er.ed·~ at No. 325, August Term, 1954 ' Principal I $1,200.00 ' Interest from 7 20/59 648.00 Costs advanced 7.00 1,855 00 Exp nses [of Sal e of 88.5 Acres, South Strabane Tw J., Washington County Pennsylvania Realty Tr nsfer Tax 268 00 South Strabane Twp. Tr nsfer Tax 268 00 Pro-rata share 1968 Re :tl Estate Taxes 39 37 COMMONWEALTH OF PENNSYLVANIA COUNTY OF -=:----::W:-a-:s:-h-~_ng....::.,t=-o_n __ -=-=-,;-:---} ~~.~-J~JC. ~I Jl., :;il9,tl39.39 H: p ..<_..-.,3. d'TJ 1 Chas. E. Enlow, Trust Officer of Pittsburgh National Bank /:OI-£2,27 HEREBY CERTIFY, THAT. TO THE/BEaT OF JloiY KNOWLI!:CGE AND BELIEF, THE FOREGOING IS A JUST AND TRUE STATEMENT OF DEBTS, FUNERAL EXPENSES AND EXPENSES OF ADMINISTRATION SUBMITTED TO THE ESTATE OF Elizabeth Anna Clokey DECEASED, AS DEDUCTIONS FOR INHERITANCE TAX PURPOSES. -- SWORN AND suascRIBED BEFoRE ME THis J.-.; ~cAY OP' Trust Officer for Pittsburgh National B~~k·1 fl,ovember ~ ,., ~ L~ '/1;V~ Reg~ster --~-Fonn.RCC-2 ~ DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS HARRISBURG, PENNA. 1 7 1 2 7 COMMONWEALTH OF PENNSYLVANIA RESIDENT INHERITANCF} TAX . APPRAISEMENT· DATE ......................... 0.Ct..QP~.r. .... J.5..1 ....... J::99.$.j 1 COUNTY ........................... ~.c.t..~.~-~§~.?.~ ........................... . FILE NO. .. ...................... 9.?..::.9.§-:::..?._§7. ................................ . Whereas, .............................. §J.o~.~9.-.'!?..~.t..h ... Ar.U19.-.... CJ.9.~.~Y ............................................. late of ................................ $. ........ $..t.:r.~P..9..;m:~ .... T~.P..~ ..................... .. in the County of ............................ ~~~.!.1.~.1?:~9.~ ....................................................................... Commonwealth of Pennsylvania, having died on the ........................................ J.:.9 ... t.h ..................................... day of ............ ~@.W3.-.cr .......................................... 19 .. 9JL, seized and possessed of an estate subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore, I, ..................................... W.~.R.~ ..... C.h?.Jl~Y. ........................................................... , an appraiser duly appointed according to law, having been designated to make a fair and conscionable appraisement of the said estate, and to assess and fix the cash value of all annuities and life estates growing out of said estate, hereby file the following appraisement: In the event that any future interest in this estate is transferred in possession or enjoyment to collateral heirs of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer inheritance taxes at the lawful collateral rate on any such future interest. Description of Asset REALTY: Unit Values $ Appraisement Made for I nherltance Tax Purposes ----------------------------------------------------------------------------+-------~----------T----- 88.5 Acres, vacant land, Route 136, between Washington and Ei~hty-four, South Strabane Two •• Washin~ton County 26,800.00 26,800 00 l --------~~~~~~~~~~~~~=====-~~~~==~~~~~~~--~~~~~+-------~----~~~~~-1 --------------------------------------------------------------------+-----~~--------+----J PEH.SvNALTY$ Mellon National Bank & Trust Co •• Washin~ton Office Savings Acct. No. 7405 995.70 Jewelry 130.00 Old Paoer and Silver Monev 105.00 Total l.230. 70 1.230 70 Total 28,030 70 --------------------------------------------------------------------------T-----'------tt---------+----' ----------------------------------------------------------------------------4--------n---------~---· --------------------------------·--------------------------------t--------Ilt---------+----- --------------------------------------------------------------------+-------~----------~---- WAt:>HINGTON Cout1ty RESIDENT INHERITANCE TAX APPRAISEMENT Estate of ELlZAB~TH ANNA CLOK~Y Deceased. Late of S • S TRABAN.l!. TWP • Date of Death, ........... ~~V,?.XY. .. Jo.9, .... J.9~.~ ............. .. Appraisemel!t Docket Vol., .......... -...... 3.7 .......................... . Page, .......... 9.$.::-:.9 ....................... No .. ~:?..:::.~$:::-.?..~! .............. . Filed in Register's Office, .O.c.to.b.e.r. .... 15 .. ,.J9 .... 68. Amount of tax due, $ .................................................................. .. DEPARTMENT OF REVENUE Received, Exa.mined and Approved, Wrote abo.ut Appra.isement, Appeal j1'o-m Appraisement, Entered and charged, .... s·1-· ·~ .'"\ \ · ·, L,,.u ,·, J "! ,_ J r? E "J ( .. G ., -"' "··· ~,. f' •.• ll .:· ' ... l 'lCC-39 (6-67) COrAMOI'IWEAL TH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT FILE # 63-68-367 CLOK.E.Y, ELIZABETH ANNA FIL.c; # 63-68-367 January 19, 1968 SUMMARY TtEPOHT OF INHERITANCE TAX APPRAISER I. the undersigned # 63 Washington duly appointed Inheritance Tax Appraiser 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 real and personal opposite each item in the last column to the right in Schedules "A", "B", Dated: 10-15-68 01-19-68 REPORT OF THE REGISTER OF WILLS I, the undersigned duly elected Register of Wills in and for------------ County, Pennsylvania, do r·espectfully 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 greater or lesser amount represents the sum allowed as a deduction. Dated: REGISTER OF WILLS INVENTORY VALUE AS REPORTED VALUE AS APPRAI SEDV.!... A~L:!U~E~< ....;;A;.!.:S:::._~RE~AP~P'-"RA~I'""S~E=D Real Property (Schedule A) Personal Property (Schedule B) Transfers (Schedule C) ,Joint-Held Property (Schedule E) $ 26,800.0Q_ $ 26,800.00,_ $ ______ _ 1!230. 7Q_ 1,230. 70 ·- TOTAL GROSS ASSETS LESS Debts and Deductions (SCHEDULE F) CL~AR VALUE OF ESTATE Valuation of life estates or annuities . . . • • . . • $ 28,030.7Q_ =====:::::.·~--- ---- ESTATE TAX ASSESSMENTS ~----------- 28,030.70 := ======·-==============~ FOR USE OF REGISTER ONLY C01viPUTATION OF TAX Tax on $-----------------•--~ ~% $~---------- Tax on$ , ____ 10% ~------------ Tax on~ ~$ Tax on$ :_~$============ Exemptions :--'-(':') Total Estate ________ ~-- TOTAL TAX Less tax previously paid BALANCE Less 5% of tax if paid within 3 months after death $ ____ _ $ =======--$-~-~-- $ ======:= As evidenced by Charitable Exemption Certificates issued by the Secretary of Revenue, JALANCE OF INHERITANCE TAX DUE ~--------------- Add interest at rate of 6% from to $----~------~- AMOUNT OF ESTATE TAX ASSESSED *--~--- Estate tax paid $~---------- BALANCE DUE $ ______________ _ Add interest at rate of 6% from to FOH USE OF REGISTER ONLY TOTAL TAX BALANCE PAID ADJUSTMENTS $ ______________ _ $ $ ~OTE: Where subsel]_uent 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 t No. IN THE Year ........... . MATTER OF THE APPRAISEMENT OF THE ESTATE OF ELIZABETH ANNA CLOKcY Deceased Late of. S. ~TRABAN.l:!. TWP. . .. ~ . . . . ... ~ . . . . . ......... . County of , .. WA?hl.~G.'I'()N. Commonwealth of Pennsylvania REPORT AND APPRAISAL I)' Form RCC-4-Rl-3-66 ~9 COMMONWEALTH OF PENNSYLVANIA BESIDENT DECEDENTS 948714 OFFICIAL RECEIPT File No 63-68 ... 361 No-Transfer Inheritance and Estate Tax April 19 61 Date 19 __ WA.SHINOTON 1 WASHINGTON Office REGISTrJt<i~-. . . . Pa. ·. u Ill National t.JtUm, washington Office County, ss: Received from ~~Adm .. X~E ELIZABETH A. CLOKBY or, m1strator or · uar · 1an) of the estate o who died January 19 68 FOUR HUNDRED TWBNfi,.SIVBN and 50/100 ... -'!It Dollars, 19 __ , the sum of being TRANSFER INHERITANCE TAX and/or ESTATE TAX due the Commonwealth as follows: Appraisements Made and Filed Computation of Tax Real Estate Tax on$ 5% $ Date Valuation $ Tax on$ 10% $ $ Tax on$ Ott' Account 2% $ 450.00 Total $ Tax on$ 15% $ Personal Property Exemptions *, $ Date Valuation $ Total Estate $ $ Total Tax $ Total $ Less Tax Previously Paid (if any) $ Total Gross Assets $ Balance $ 22.50 Less Debts and Expenses of .Less five per centum of tax if paid Administration $ within 3 months after date of death $ tNcoMPittrB Clear Value of Estate $ 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 __ $ 4~7.50 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 1, 1957, as amended the life tenant or tenant for years, as evidenced by this receipt, it is understood that the Com-by Act No. 381, approved July ll, 1957, and Act No. 207, 1961, Section 302. monweal!h shall not be :precluded or prevented from hereafter assessing additional inheritance tax at the death of the hfe tenant or tenant for years whenever it appears that such additional /'"")SEAL ·, tax may be legally due and collectible for any reason whatsoever. lJOOD [JJLLD @~ lJ[E 31·98-9 ~/ ~~r--~, .· ~ tJ/' I . . . . ~--~·": ... -•.. ., .. --::;,-.,l<t. •. ~ /' , //?C/ v·?·:t:-··£./r;/ NOTE: This Triplicate Beceipt to be retained by the Begister of Wills and filed in numerical "' .. Register of Wills sequence for audit purposes. MOORE BUSINESS FORMS, INC., ELMIRA, H. Y, FORM RCC-4-Rl TRANSFER INHERITANCE and/or ESTATE TAX. RESIDENT DECEDENTS. RECEIPT 37 Docket._ __ --"Page '98 I jne'--_9 __ ELIZABETH A .. CLOKEl' Estate of _____ -'-------- omCE OF REGISTER OF WILLS WASHINGTON --------------------------------~0. Date, __ =AP~R=IL~-=1=8 ___ 19_§!! SIGNED AND SEALED AS PROVIDED BY SECTION 1201. ACT APRIL 9. 1929. P. L. 343 AS AMENDED BY ACT MAY 15. 1945. P. L. 528 RUSSELL UAlUtiO Register of Willa 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 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 PiftSBURGH NA'f:mNAL BAl\I'"K I To ------------------------------------------\IASIIINGTON ,OFFICE,· VASBDiOTON, PA. 15301 e/ o UR. ClllUlJ,ES ENLOW,: TRUST OFFICER L _j ,~,-,_~---~-----.----------_,_----,_.----------~--~-------~ ~~ -,-~ -----:---- RCC-4 (8-68) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE No.A033076 OFFICIAL RECEIPT • PENNSYLVANIA INHERITAN~E AND ESTATE TAX SEVEN HUNDRED SEVENTY-FIVE and 25/100 RECEIVED _______________________________________ dollars ........... PITTSBURGH NATIONAL BANK, WASHINGTON representing Pennsylvania Inheritance or Estate Tax due from the following estate: From:--------------------.-------------------------1~1 OFFICE, WASHINGTON, PA. 153 Address __________________ ~ Charles Enlow, Trust Officer 63-68·367 File No. Date of '"'"'"'"'--------i January 21, 1969 Date of Payment ----------------l ELIZABETH ANN CLOKEY Name of Decedent ---------------1 WASHINGTON County __________________ ~ Remarks: S E A L NOTE: This Triplicate Receipt to be retained lor audit purposes. 2% Tax on $ _________ $ _________ ~ 6% Tax on $ _________ "'----------111 8;168.31 1;225.25 15% Tax on $-_________ $ _________ _ %Tax on $ _________ $ _________ ll'lll Estate Tax, Act of May 7t~'if· Prev. Pay. TOTAL TAX CREDIT Less five percentum of tax if paid within three months after date of death Plus interest at the rote of __ %from--------- to ___________ _ TOTAL AMOUNT PAID $ ___ _.4~so-e-.~. e"'el-- 775.25 $ ______________ __ $ _________ u $ ________________ "1 775.25 $===============~!