HomeMy WebLinkAboutOC1968-0583 - ESTATE OF PERUNKO~3·(,T...OY3
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CltUUl1ty uf Busl1il1gtUl1 \
Personally before me,the undersigned authority,a N:Q.tg.r.y.P.~b.l.iQ in .and for said
County and State,'appeared f..g.yJ N..~.•J~9.In9.who,being duly
sworn according to law,deposes and says that he is the executor *~lUiKof the estate of
...........,Anna P..e.I.unkQ deceased,that the foregoing schedules constitute a
complete inventory and appraisement of the real and personal estate of...Anna P..er.unka ,
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 deathybed upon a just appraisement of each
item made by the above named Executor Administrator./::.~a~o;=l!Ji!IE.:~...b;;:;;;;iS.:..d.J..~..~~f~
...................·~~~:.~A~~:;~S~~·~~JiW~;~~..·INSTRUCTIONS
1.A.n iriventl91nyGm1'9i1~f1iieifte~ifultht@lPmonths 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
r;
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l1nnentl1rg anll1\pprai.aement of the goods and chattels,rights and credits which
were of ·Anna .P.e.J::.unk.O late of c.9..r.J;'.Q.ll TQW}.~.h.;hP :..
Washington County,Pa.,taken and made in conformity with the above affidavit.
DOLLARS CENTS
REAL ESTATE:
Meadow Avenue,Victory Hill,Carroll Township,Pennsylvania;'
Lot No.37 in the J.E.Nutt Plan of Lots,Carroll Township~
50'x 200',being the same parcel as conveyed to Louis
Perunko and Anna Perunko,his wife,by deed in Deed Book
Volume 685,page 56.The said LOl1is Perunko died on
December 5,1955;upon which is constructed a two-story
frame dwelling house (parcel sold to Jack R.Taylor et ux.,
recorded in Deed Book Volume 1279,page 253 at inventory
price)4,000 00
PERSONAL PROPERTY:
Blue Shield refund check
Blue Cross refund check
U.S.Treasury Dept.,Social Security for March,1968
Blue Shield refund check
48.70
9 70
100 90
12 17
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KNOW ALL MEN BY THESE PRESENTS:Whereas,at Washington,in the County aforesaid
on the 15th.day of April A.D.19 68 ,before me,
Russell Marino ,Register for the Probate of Wills and Granting
Letters of Administration in and for the County of Washington,.in the Commonwealth of Pennsylvania,
the last Will and Testament of
Anna Perunko
late of Carroll Township in the County aforesaid,deceased,
(a true copy whereof is to these presents annexed),was duly admitted to probate;and
Paul N.Barna
the Executor III said Will and Testament named,having appeared before me and taken and subscribed
the oath of office prescribed by law;
/
NOW,THEREFORE,I,RU8se11 Mar ino
grant these LETTERS TESTAMENTARY,unto the said
Paul N.Barna
,Register as aforesaid,do
committing unto Him the administration of all and singuhr the goods and
chattels,rights and credits,which were of said deceased,and requiring Him
to exhibit a true and perfect inventory thereof into the Register's Office,at Washington,within ninety
days from the date hereof,and to render a just and true account of said administration at the expiration
of six months from the date hereof,and to regard and comply with the provisions of the laws of this
Commonwealth relating to inheritance taxes.
IN TESTIMONY WHEREOF,I have hereunto set my hand and the seal
of said Office at Washington,this 15th.
day of April
nine hundred and Sixty.Eight
III the year of our Lord one thousand
..................-~.
Register
-...-,-~~-
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LAST WILL AND TESTAMENT
I,ANNA PERUNKO,of Car.rollToVlnship,Washington County,
Pennsylvania,do hereby make my Last Will and Testament and
revoke all Wills be me at any time heretofore made.
FIRST:I direct the payment out of my estate of the
expenses of my illness and funeral.
SECOND:All the rest,residue and remainder of my estate,
real anClpersonal,I give,devise and bequeath to my sister,
MARY RUSNAK of East Fultonham,Ohio,her heirs and assigns.
THIRD:I nominate,constitUte and appoint Paul N.Barna,
Executor of this my Last Will·and Testament.
IN WITNESS WHEREOF,-I have set my hand and seal to this
my Last Will and Testament this 30th day of January,A~D.19560
Signed,sealed,pUblished and declared by Anna P.erunko,
the above named testatrix,as and for he r Last Will and Testa..ment,
in the presence of us,Viho at her request,in her presence,and
in the presence'of each other,all being present at the same time,
have hereunto subscribed our names as vrltnesses.
\
.,
I
I.
III
STATE OF PENNSYLVANIA,
WASHINGTON COUNTY,~55:
The within named Accountan't being duly sworn according to law,depose 5 and s~s that the above account
as stated is true and correct a'---I)."-••...••...verily be~
Sworn and subscribed before me this }.2.11,I..-/~4 .
1970
ublic
I do certify that I have given leg'al notice to all persons
concerned of the filing of the within account in the manner
prescribed by Statute and Rule of Court,as evidenced by proofs
thereof filed to No..../tf..tf.~_?...!.1.-~r..-..
Witness~ial seal thiS.~""ti7
day of ~,___19 ~..
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IN THE ORPHANS I COURT OF WASHINGTON COUNTY,PENNSYLVANIA
."--v..
IN RE:
ESTATE OF ANNA PERUNKO,
Deceased.
)
)
)
)
)
FIRST AND FINAL ACCOUNT OF PAUL N.BARNA,
EXECUTOR OF THE ESTATE OF ANNA PERUNKO
SUMMARY:
Principal:
Receipts $4,171.47
Disbursements 2,245.35
$1,926.12
Income:
Receipts
Disbursements
$3.00
0.00
3.00
AMOUNT FOR DISTRIBUTION $1,929.12
,.
P R INC I PAL
INCOME
Inventory and Appraisement Filed
DISBURSEMENTS
Administration Expenses:
Russe1l,Marino,Letters of Administration
Washington Co.Reports,Advertising Letters
Daily Republican,Advertising Letters
Russell Marino,Filing Inventory
Russell Marino,Filing Account
Paul N.Barna,Executor's Commission
Paul N.Barna,Jr.,Attorney's Fee
Notary Public Fees
Guy Rodgers,Deputy Register of
Wills,Travel Expenses'
Preferred Debts:
Paul Macik,Funeral
Quinet Monuments,Gravemarker
Other Debts:
$13.00
12.50
12.50
3.00
16.00
210.00
100.00
3.50
10.00
$1,715.00
120.00
..,....~...
$4,171.47
380.50
1,835.00
Peter J.Gallick,Ringgold School
District Taxes
West Penn Power,Final Electric Bill
Columbia Gas Company,Final Gas Bill
Monongahela Water Company,Final Water Bill
Bell Telephone Company,Final Bill·
Malcolm L.Morgan,County Real Estate Taxes
Peter J.Gallick,Carroll Twp.Road Tax
Peter J.Gallick,Carroll Twp.Fire Hydrant
and Street L~ght Tax •
Assets Converted at a Loss:'...
$47.04
6.79
2.45
12.42
6.23
14.59
6.59
10.24
106.35
'"fir.".
Proceeds of Sale of 'Real Estate to Jack
Taylor et ux.,DBV 1279,p.253
~..11;,
$4,000.00
Less Expenses:
Prepar~tion of Mortgage
Satisfaction
Recording Mortgage Satis.
Preparation of Deed
Local Stamps
Notary Public
Inventoried @
$15.00
5.00
15.00
40.00
1.50 75.75
$3,924.25
4,000.00
L -76.50
$2,245.35
Garage Rent for May,1968
None
INC 0 ME
RECEIPTS
DISBURSEMENTS
$3.00
$0.00
'-
'1
THE DAILY REPUBLICAN
MONONGAHELA,PA.
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 Iss:
State of Pennsylvania r
Personally appeared before me,a Notary Public in and for said county and state,
______R~~~l __11:l_Q!IlPs.Q,tt,who,being duly sworn,deposes and says:thaL She is
the J~Q_~~~~~~of The Monongahela Publishing Co.,a Pennsylvania corpora-
tion,and its agent in this behalf:that the said company is the publisher of The Daily
Republican,published daily except Saturday and Sunday,having its place of business at
Monongahela,Washington County,Pennsylvania;that the said Daily Republican was
established in the year of 1846;that the printed notice or advertisement,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~_;.~J/h ~_~1 ~~__}_~J9§_~__________________,,_
Estate ot Anna Perunko
1
·_-~r~TlCE ",-
j Estate of ANNAPERVNKO de-
"
ceased,late of .',carr,OIl,T,,0,Wn,-,~hipWashmgtonCountyPenna.>'
,Letters ~~estal1)entary tipon the
'above estate having been.''.~''ranted,t~th!!undersigned.notiCe:is eieby
]gIven ~o thos.e -indebtedtheri!to.:to
I make ImJ,lU!dlat«;payment,and tothosehavmgclaIms,or demands topresentthemforsettlement.
Paul N.Barna
Seventh &McKean Ave.Donora,Pa.15033PaulN.Barna.Jr.,Attorney
'i Seventh &McKean AvenueDonora,Pa.15033AprilIll,26;May 3,1968
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 t~t all of the allegations of
this affidavit as to.the time,place and~cter If th .cation are true.
.,'.:·_>:~,----------------Sdkad---------------------~----------------
Sworn to:and subscribed before .me this
rld«t.i~~Le&_4~........•........,oo%'~;:'::::~se:';-~··~"';:;P;;bi;'
,Washington Counly Reports'
asc:sm.xDHC~!5'XRIEIEl:
WashingtOD,Pennsylvania
(PUBLISHED BY WASHINGTON COUNTY BAR ASSOCIATION)
Estate Notices
The Register of Wills has granted letters,
testamentary or of administration,in the
following estates.Notice is hereby given
to all persons indebted thereto to make
payment without delay and to those hav-
ing claims or demands to present them
for settlement to the Executors or Admin-
istrators or their Attorneys.
• • • • •e •••••••••••
PROOF OF PUBLICATION
In compliance with the New~aper Advertising Act of May 16,1929,P.L.
1784-Sec.3,paragraphs (3)and (25).
COUNTY OF WASHINGTON l
STATE 01;PENNSYLVANIA (SS.
PERUNKO,ANNA,Dec'd.
Late of Carroll Township,Washing-
ton County,Penna.Executor:Paul N.Barna,Seventh &McKean Avenue,Donora,Penna.
Attorney:Paul N.Barna,Jr.,Seventh
&McKean Ave.,Donora,Pa.15033
Personally appeared before me,a Notary Public in and for said County and
Commonwealth,CHARLES C.KELLER,who,being duly sworn,deposes and
says:that he is the Editor of the WASHINGTON COUNTY REPORTS,the
official legal periodical for said Washington County,publiShed weekly having its
place of business at Washington,Washington County,Pennsylvania,and is act-
ing as its agent in this behalf;that the said WASHINGTON COVNTY
REPORTS was established on March 31,1920,and was designated as the official
legal publication for Washington County,Pennsylvania,by 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:
..............~.p..r..~}~.~.!...J~~~.
.............M.~y f..s ~.s JJ~§.~.
,
Sworn to and subscrib
that the affiant or;the corporation in behalf of which he is acting is not interested
in.the ~ubj:ct matter o~s'd n 'ce or advertising a~hat a;1l.~f the allegations of
tlus affIdaVIt as to the ce and 7~aracter of';,th~)PUbl~S-q«ilr~ru,
-7 ~(,I -I -I -'.
(...{"..<...\.c'--y --,--',.-/-.=_/...--1 itor
.....~.~Of...~~Y...~~~,196 ~
......................U~&.t:;.
N'tary Public
I<ATHiRINE C.YARD,Notary P 10
WAlhlnoton,Washington Co.,Pa..'
My Cummission Expires .".r-
November 1,1008 /
PETITION SUR AUDIT
IN THE ORPHANS'COURT OF WASHINGTON COUNTY
Testate Form v?
Estate of .8N..NA..P..ERJJ.NKQ _.___.._..
Deceased
No 9)::.9.§:~.?.~.~A.A.
Fiduciary _..l'.~JJ1..N BgX'.TI.Q .
......__ ___--___--
Date of Date of
Decedent's death Ap.x.il..2.,19.6.8.Grant of Leitters ,APJ:i.l..J...5..,..J..9.6B .
This is the F.ir.s.t and..Einal account filed in this estate
If there have been former accounts filed in this estate,list file number or number and term..None .
Election to take ~.
Under ~will.(cross out one)
Date Election Place of;
Filed _..................Record .
Name of surviving spouse JSI.aue _ _ .
List issue,where material:
Did decedent marry after execution of will?(indicate)Yes.~.Any children born after execution of will?(indicate)
If:lI!t~.If answer yes,name them __._.._.
Leg,atees
Mary Rusnak
Relationship
Sister
Interest
Total estate
Fiduciary,if deceased or not sui juris
List,if exceptions to above:
None
If partial intestacy,give facts:
N/A
Adeemed:Revoked:Lapsed:Abated:Give Cause:
Notice to interested parties.Have all parties,having either vested or contingent interests and all crediors entitled
to notice (Court Rule No.9 paragraph C:Section 6:Subdivision c)received written notice of the filing of the account
and of call of audit?Yes.~.
If any e~ception give cause:.
File copy of Notice
and date of mailing NQ:vJ~mh~.+...2.Q.,l-.9.Q.8 "",.,......•.,,
Is estate subject to the filing of a Federal Estate Tax Return?N'?...
Actual payment made on Pennsylvania Transfer Inheritance Tax.Amount $.
If the Will makes any portion of estate subject to a life-estate,give name and birth date of life tenant N/A .
Give Names and addresses of all unpaid creditors who are legally entitled to notice,together with the amounts
of such claims;state whether they are admitted to be correct;and whether the claim is denied.
None
Give reference to such parts of the will as require interpretation by the Court;a reference to all questions re-
quiring adjudication,and a statement of any other facts deemed necessary for the preparation of the adjudication:
None
Balance for distribution per account,
Itemize any additional debits not shown by account:
Proration of Real Estate Taxes at Sale
which were previously paid $34.25
Total additional debits (Add)
Itemize any additional credits not shown by account:
1 short certificate $1.00
Total additional credits (Subtract)
Balance for distribution
$.l~9..29..:J.f..
34.25$.
$1.~.9.Q .
$1.,.9.o6.1~.3.1..
If balance for distribution is not in cash,list each item held in kind,giving appraised Value (or distribution Value);
.-
If Family Exemption claimed by Petition,give place of Record:~f.~,..
If Family Exemption is claimed at audit,give name,relationship and basis for Claim:N/A .
List any advancement or distribution on account that has been made,and nature and amount of same:
None
Suggested distribution of balance shown,both as to principal and income,attaching signed and itemized elections
to take in kind if balance is not in cosh:residuary shares being stated in proportions:
Mary Rusnak,balance of residue
COUNTY OF WASHINGTON,SS:
COMMONWEALTH OF PENNSYLVANIA.
The above named Fiduciary or representative thereof,
being duly SY.lQrn doth depose and say
that the facts set forth in the foregoing petition are true
to the best of hi§~.knowledge and belief.
....".::.~.::,.~yy.2;J;'.TI _to and subscribed before
~'~"~:h~""../&«-d'f December 19 68_~':;~~t;:~~~~;;;;crO~dL;::::::
~."Title'ckOfficer.lfQ.t.g.+-y P.Q..bliQ .
•...._.-","'CONSTANCE l.RISJ<EY,Notary Public
Office expires~...r;>.~~.~~cl..WCl~bjD.BtQD..C.o...P-a•.•....••••••••...........•••
My Commission Expires April 13,1970
And your petitioner will ever pray,etc.
,..~.
".,....
No..Q.~::.9.~.:.~~.~A.A.
Estate of ANNA..P.ERUNKO .
Deceased
Fiduciary .P.AUL...N.•...BARNA .
...
PETITION SUR AUDIT
FROM WHERE DECEDENT LEFT A WILL
Counsel of Fiduciary wi II submit herewith the
following,in conformity with Court Rules
adopted effective December 3,1951,being
rule No.9:paragraph b-c;and divisions
thereof:shown on pages 23-24.
1.Written praecipes of all Counsel in the
case.
2.Copy of order appointing Guardian ad
litem,if pertinent.
3.Copy of Order appointing Trustee ad
Iitem,if pertinent.
4.Proof of service of above,
5.Letters Testamentary or Administration
C.T.A.or an attest copy of Will.
6.Copy of inventory and appraisement.
7.Proof of advertisement of grant of letters
if not filed with account.
8.Certificate of liens in case any of the
funds for distribution are from judicial
sale of real estate.'
9.Signed and itemized elections if any
distribution in kind.
10.Copy of Federal Estate Tax return if es-
tate is subject thereto.
......5.{:n:::D.~{3.ng a.{3J~DJL ____
Attorney
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10~Cl :...':"J pq .,,).9":l.'''JJ L.'';I '-,ilL.•c.:...)
RUSSELL i1J.\RI,':O/;£GISTER or \'i!LLS
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1Jn tltt (@rpltuns 'l Ctraurt af.lIusltingtan O!aunty
In the matter of the Audit of Account in
Estate of__A_NN_A_P_E_R_UNK__O--,-t
TO THE AUDITING JUDGE:
63-68-583No.••19__•A.A.
Enter__m---"-y --eappearance for Paul N.Barna,Executor of above estate
12th day of._--=D:..,:e:...:c:..,:e=ffi:::.::b::....:e:...:r::....-"19_6_8_
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.
No.63-6,8-583 ,19__,A.A.
In re Audit of Account in Estate of
ANNA PERUNKO
AUDIT
Jrarripr for Appruraurr
FOR
PAUL N.BARNA.EXECUTOR
Paul N.Barna,Jr.
Attorney
~.2
lin 1111'(@rp4ans'OInurt Df lIus4tngtnn (tlnunty
ESTATE OF
Anna Perunko•.•....•..••..........••.••.••••.••J.•••••••••••••.••••.•...•••••.....••
Deceased.
No..~?:~.??~~.??Of ,19 ,AA
In the matter of the :f.J!..~t.9:~9:.;f~~9:~.
Account of.)?qj.J;llJ:J:!..~.~r.D.~.1 .
Executor
,
ADJUDICATION AND DECREE
And now .J.'?::rW~r.y !~,19.?~,this matter came on for hearing,
audit and distribution at this session and testiml~~'taken;and thereupon,upon due consideration
thereof the balance ·for·distribution in the hands of the Accountant is determined to be
$1 962.37 ..,:..d h .d'I f'd'd"d d...J :an t e account IS accor Ing y con Irme I an It IS or ere,
adjudged and decreed that the said balance be paid out by the Accountant in accordance with the
schedule of distribution hereto'attached and make a part hereof,unless except'ereto be filed
sec,'eg,0'on oppeol be to?en'herehom sec,leg,/().",_cJ
,".:..........<'..........··r···········.0<J-<f~---
SCHEDULE OF DISTRIBUTION
Balance per account :.............................................I $1J..~?~.~J.?..
Additional debit asked at audit 34.25 I
Additional credit asked at audit
Balance ~.'.
Deduct Clerk's Costs &Receipts ,.,.
At~omey ~.~rP.-0..~..:J;?'?:r.~.~~,.
1.00
12.50
$1,963.37
Russell Marino,Agent,transfer inheritance tax,
estate liability only,280.56
Mary Rusnak,sister,residue,1669.31
No balance
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Form RCC-33-RI
RESIDENT DECEDENT
COMMONWEALTH OF PENNSYLVANI,A
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTION.S
COUNTY OF ..WASHING.TON..
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
..th~.Inh.eritancean!iE.st.ateTaxAct of 19~1.)
.(State full name of decedent)A A;r-
Late of _Wasbing~Qn ..---...-eo.....~I r~./
State of PENNSYLVANIA } .~~f
""uuty.'WASHINGTON....____._._".~~~
............................................................P.AUL N.B.A.RNA,, .
of the estate of the above-named decedent being duly sworn.depose S ;.,and saY S
Executor
Decedent died ............A~~~h~............(~yj ...•19(~~~)..{~aVing a last will,coPy "f which is hereto attached.}
Name and address of attorney or}
other authorized representative to ...
whom all correspondence should be
mailed,
--'PauLN.B.arna,..Jr........
7th&McKean~~Avenue,DQnQra,P.a •........l5Q33 ..
That as such E~g~JJ.tQX deponent is familiar with the affairs of said estate and the property con-
(Ex"c\Itor·Administrator)
stituting the assets thereof and their fair market value.
That at the time of death there was no safe deposit box registered in decedent's individual name,or jointly
with,or as agent or deputy of another,or in decedent's individual name,with right of access by another as agent
or deputy,with the exception of the following:-
NAME AND ADDRESS OF BANK OR OTHER INSTITUTION THIS SAFE DEPOSIT BOX RENTED RELATIONSHIP OF JOINT
IN WHICH DECEDENT RENTED A SAFE DEPOSIT BOX IN NAME OR NAMES OF HOLDERS TO DECEDENT
Mpllon National "R.qnk &.Trust C:o.Mrs.Anna Perunko and
Donora,Pennsylvania 15033 Miss Marv Rusnak .Sister
That the contents of said safe deposit box or boxes are itemized under Schedules of this---return,with the exception of the following,for the reasons hereinafter set forth:
That Schedule A attached hereto and made part hereof sets forth full v and in'detail all the
real property in the Commonwealth of Pennsylvania of which decedent died having an interest therein.It
also sets forth the mortgage encumbrances upon each parcel of real property at the date of death,giVing
the amount still due at death,name of mortgagee,date,rate of interest,and book and page of record
thereof.It also sets forth in the columns provided therefore the assessed valuation of each of said
parcels,the estimated market value thereof as of date of death of decedent.
That Schedule B attached hereto and made part hereof sets forth fully and in detail all personal
property wheresover situated owned by the decedent at the time of death;all moneys left by th~•.deeede~~
,,....,.L \"'='no "at the time of death,whether in decedent s immediate possession,standing to decedent s credi~in'banks'~
~.~••,.'01 j,...C r ......~~
of deposit,saVings banks,trust companies,or other institutions,whether individually,-6t-..i'n·,ti·i.fstr'fol":/-._...-,..,"......"I ,.,.-
any other person or persons giving also separately the accrued interest thereon,'if any,tdown'.;t~(the lest ."_
.;0-,'-,"V,",)-interest day prior to decedent's death in the case of savings banks,and to the date of~dec'eajmt'"s(death'.-".-,"'-'.,Jinallothercases;all bonds,postal savings,treasury certificates or notes and other,ev\4ence'of in~".•fit'.".,.......debtedness of the United States to the decedent;all obligations,whether by statute 6~rag~ement they -
........"~"4rl.l'I?~•are designated as tax free,of the Uni ted States,or any state,or political subdivision,(nere.o.I:,,or'of".~...v~r"·,,,·~,...·~tanyforeigncountry,which are owned at the time of death;all wearing apparel,jewelry,silNeTw~re"pic~'"~rll;:1 .~~I··tures,books,works of art,household furniture,horses,carriages,automobiles,boats,and anyland all
other personal chattels of whatsoever kind or nature,left by decedent,together with the fairly estimated
market value 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 which decedent died possessed,of whatsoever nature,with interest thereon,if any,giVing the face
value and estimated fair market value thereof,and if such estimated fair market value be less than the
face value,it sets forth briefly the reasons for such depreciation'as to each item;all moneys payable
to the estate from life insurance policies carried by decedent;all annuity and endowment contracts the
proceeds of which were payable upon the death of the decedent;and all the corporate stocks and dividends
due thereon and unpaid as of the date of death,bonds and accrued interest thereon to the date of dece-
dent's death and other investment securities owned by the decedent at the time of death,with the market
value thereof at such time.
,.,,
In the case of securities of close or family corporations,the values reported are as far as
possible substantiated'by financial statements of the corporations,showing the assets and Habilities
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-pat;tnership agreement,(if oral,a statement setting forth the nature of the agreement)
together with a statement setting forth the character of the business,its location,and such other facts
pertaining to the business as may be pertinent to a fair and just appraisal of the decedent's interest
therein must be submitted.It should also set forth in itemized form,together with the fair market value
thereof,any other property owned or bequeathed by the decedent at the time of death.
The Schedule C attached hereto and made part hereof sets forth a true answer to each inquiry
contained therein and in the case of transfers ofproperty,real or personal,within two years of decedent's
death,in contemplation of decedent's death,or intended to take effect in possession or enjoyment at or
after death,said schedule sets forth the nature and value of such property,to whom t-ransferred,the
relationship of the transferees to the decedent,the proportionate share received by each transferee and
all other facts of a per~tinent 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 cOllY
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 join,tly,by the w~ll,deed,or other instrument of another,
with a copy of the instrument creating such power attached to the ~chedule.,
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,Ule nature of their res-
pective interests,their relationship,if any,to the decedent,together with the ages at the time of
decedent's death of all minors,annuitants and beneficiaries for life under decedent's Will.It also
contains a statement showing which of the beneficiaries named in the decedent's will,if any,died prior
to decedent,the dates of their death,their issue,andthe relationship of such issue to the beneficiary.
That Schedule E attached hereto and made a part hereof sets forth all property,real and per-
sonal,owned by the decedent jointly with another or others,including intangible,standing in the name
of the decedent and others,plus the date and place of record of instruments effecting the vestiture of
rea3.estate and the date of acquisition of 'personalty,plus,the name,address and relationship,if any,
of co-owners to the decedent~
That Schedule F attached hereto and made a part hereof sets forth fully and in detail all debts
and deductions claimed for and on behalf of this decedent's estate,including funeral expenses paid;
family exemption,where applicable;costs of administration of this estate;counsel fees and fudiciary's
commissions paid or to be paid;cost expended for burial trusts,tombstones or gravemarkers,and reli-
gious services,in consequence of the death of the decedent;debts and claims OWing and unpaid at time of,'death;taxes accrued 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•
..::_~::'::=:dS::~ftob~.~~~k("'E--/f-;;;~t..o,,:_k).......~.:...._::1~~~~.&_]~:i~;~~~_---------
-.'Donora,Washington Co.,Pa..DQ.uQ.r.a..,Pe.nns.yl:v..an.iaa ".
My Commission Expires April 13,1970 '(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 "Sununary"has been properly completed as above-directed.
,,_,.J .,
!:f,!.,...~~;.~D._1{1
('\!,'~'[I)N:W:\L'1'H OF PENNSYLVANIA
T':\~~:li'I;;lt INHl~IU'l'.\.NCE TAX
!U':~IPFNT DEC~DENT
SCRF.DULE "{l."
REAL PllOPEIlTY ...
'\.plll property in Pennsylvania,with statement of mortgage encumbrances upon Hach parcel at
denth of decedent.Where property held as joint tenant orte:q.ancy by entireties,report on
Scheclule "E".Property held by the decedent as tenant in common with another or others,
should be identified as to quantum of interest and the estimated value should be that of
the decedent's interest only.
The real property located in the Commonwealth of Pennsylvania should
he described by lot and block number.street and street number.
together with a general description of the property.with a refer-ence to the record of the conveyance by which the decedent took
title;if a farm state number of acres;also statement of mortgage
encumbrances upon each parcel at death of decedent.Taxes.assess-
ments.accrued interest on mortgages,etc.•are to be ~isted on
Schedule up"and must not be deducted from this schedule.
(1)
ASSESSED VALUE
FOR YEAR OF
DECEDENT'S
DEATH
ESTIMATED
MARKET VALUE
(3)
DEPARTMENT
VALUATION
CAUTION
(Do not write
in this space)
Meadow A~enue,Victory Hill,Carroll
Township,Pennsylvania;Lot No.37 in the
J.E.Nutt Plan of Lots,Carroll Township;
50'x 200',being the same parcel as conveyej
to Louis Perunko and Anna Perunko,his wife,
by deed in Deed Book Volume 685,page 56;
the said Louis Perunko died on December 5,
1955;upon whCh is constructed a two-story
frame dwelling house (parcel sold to Jack
R.Taylor et ux.,recorded in Deed Book
Volume 1279,page 253 at inven.t0;.l price)
fov'{-~
Insert this total opposite "real property",Schedule
"A",in the "As Reported"column on the last page of
$960.00
x X X X X
$4,000.00 OI{____-/[f;J\.
.J;:660.00
RCC73'3b-RI
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 :flOt limited to P.O.D.U.S.Savings Bonds and tenta-
tive trust accounts"must be listed,despite the fact that they are not of,the administered estate.
Tangible personal property should be l1stlld 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 any undistributed
estate of or income from any property held in trust under the will or agreement of another,even though
located outside of the State,at the time of death,should be listed in this schedule.
Item
No.
1.
2.
3.
4.
ITEM.
List and describe fully
Blue Shield refund check
Blue Cross refund check
U.S.Treasury Department;
Security for March,1968
Blue Shield refund check
Social
UNIT
VALUE
ESTIMATED
MARKEl'VALUE
$48.70
9.70
100.90
12.17
DEPARTMENT VALUATION
(Do not write in
this space)
Insert this total opposite "Personal Property",Schedule "B"in
the "As Reported"column on the last page of this return.
x X 11117 /ll t/l
,I .............
nCC-:13c-RI
COM:~roNlI'EALTH OF PENNSYLVANIA
Tlli\NSl~R INHERITANCE TAX
~~SIDENT DECEDENT
SCHEDULE "c"
TRANSFERS
(1)Did decedent,within two years of death,make any transfer of any material part of his estate,without
receiving a valuable and adequate consideration therefor?(Answer yes or no)~N~O _
(2)Did decedent,within two years of death,transfer property from himself to himself and another or
others (including a spouse)in joint ownership?(Answer yes or no)_N~o~__
(3)If the answer to (1)or (2)above is in the affirmative state:
(a)Age ·of decedent at time of transfer _
(b)State of decedent's health at time of making the transfer.(Note 1).
(c)Cause of decedent's death.(Note 1).
(4)Did decedent,in his lifetime,make any transfer of property without receiving a valuable or adequate
consideration therefor which was to take effect in possession or enjoyment at or after his death?
(Answer yes or no)'No
(a)Was there any possibility that the property transferred might return to transferer or his
estate or be subject to his power of disposition?(Answer yes or no)_
(b)What was the transferee's age at time of decedent's death?__
(5)Did decedent in his lifetime make any transfer without receiving a valuable and adequate consideration
therefor under which transferor expressly or impliedly reserves for his life or any period which does
not in fact end before his death:
(a)The possession or enjoyment of or the right to income from the property transferred?
(Answer yes or no)_~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 lifetime make a transfer,the consideration for which was transferee's promise to
pay income to or for the benefit of care of transferor?(Answer yes or no)_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 ~ffirmative,was the power to alter,amend,or revoke the inter-
est of the beneficiary reserved in the decedent alone or the decedent and others?
(Answer yes or no)No
~OTE1: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
None
DESCRIPTION MARKET VALUE
(Estimated)DEPT.VALUATION
(Dept.·Only)
Insert this total opposite "Transfers",Schedule "C"in the
"As Reported"column on the last page of this return.None
SCHEDULE "E"
JOINTLY OWNED PROPERTY
He c'-:JG e-it I
CQM~1L)\WF.\1.TH l):·
'rln.:,{~.FFH IKHmlll.\HE '1.
HF.~IDENT DECEDENT
"..'.
n;STRt'CTIOKS:This schedule must disclose all property,real and personal,owned by the decedent jointly
wi th another or others,including intangibles,standing in the name of the decedent and others.List
real estate first,as entireties,or joint tenants,giving brief description,as indicated tmder Schedule
"A",plus the date and place of record of instrument effecting vestiture,but do not include entireties
or out of state real estate value in estate valuation column.Personal property should be listed as in·
Schedule "B",plus date of acquisition,and the name,address and relationship (if any)of co-o-wners to
the decedent.
Description of Property,Date of-Acquisition,N~me-I··unit·perc;~t~ge-'-
Address and Relationship of Co-Owners,and Place I Value Share
of Record of Instrument,where Real Estate.!
Estate
Valuation
DEPARTMENT VALUATION
CAUTION-Do not Write
In This Space.
Value of Value of
Entire Decedent's
property Interest
1.Mellon National Bank and Trust I,ICompanySavingsAccountNo.
65-17229 held in the names of I
Mrs.Anna Perunko or Miss Mary
Rusnak,the balance on date of ~~~~~
death being $7,639.76 ~I~~
2.Six shares of United States
Steel stock in the name of Anna I
Perunko and Mary Rusnak held as
joint tenancy with the right of
survivorship,value on date of
death 38 1/~
J.(Jiv/hvJ J~hf,~£/tJ /1'//
#o1tM.//£ALl oJ'II.fJ1f1ej
'io..r j).t1/:,~.)Ot4 (j 'J11>tJ /II '0 AJ I
-.HL /!,f//;t../t/J ~/j;-,J1i</5 6 I
115.50
Insert this total opposite "Jointly Owned Property",Schedule"E"
in the "As Reported"column on the last page of this return.
RCC -37'.C12,:63)
C'OMl\t0N\rEALTH OF PENNSYYLANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "D"
BENEFICIARIES
BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED(If step-children or DATE INTEREST OFStatefullnamesandaddressesofallwhoillegitimatechildrenDECEDENTOFBENEFICIARY
ave an interest,vested,contingent or other-are involved,set STATE YES IN ESTATE
wise,in estate)forth this fact.)OR NO BIRTH
Marv Rusnak
Monnt Perrv .Ohio Sister Yes Over 21 'M.'.;'1"10'
J ......
.
--
(
h
Deponent further says that all the above-named beneficiaries are living at this time except below:
NAME DATE OF DEATH RESIDENCE
..''flO
SUMMARY
Real Property (Sch."A")
Personal Property...........................................(Sch."B").~s&St~..::::.::.:::..::.:.:::(SCh."C").(Sel.Z I
)
Gross Taxable Estate
(1)
(As Reported)
$4,OQO~OO ..
$1.71 47 ..
$ .
$
$.....
$..4,17.1.47..
,.
(2 )
(As Determined)
$.y/OQQCJO
$/1/5/7
$"'/N/"C)"$./.
~f:.59f,/O$.,L .
[-.:'0Z~...W CIlC1l~"$..;l(1)~><CJ <W :~
(fJ .c::l rIJ--<-(....-l ,,~..
~....-l ~=:~'2 ,,
~.0 a 1::.~,
~~~w -(w 0
l-i 0 2:<::t:::t:W l-i .j.J :.>,i 11:-J
(-<W (-<r-o ~ttl 0.0 Vl Q r:.-:
~0 c:."...--I
0 ~::to.I'<I::c:Z (,,{'l -;
0 r-o ".{Q.)z r-o (fJ ~.~..J::~~I ":',
--....-..~W ~.ll!I C/).....!-.'-r-~<
0 Pot.~co 0 CIl:r ......._......
~...c:0,:-"ic:~<.....0 .'7'I !
0 CllC ~.,-:c W <-:
Cl:r-o ~~Q.)~r'O '-..-J.....;..CIl:t-ubr-o 0 ".....
~c:(0
Vl -('2 ......c,0-0 EE""c:1..'1Q.),..
~"0 .....(5 c:rv~0<...J U U
RCC.~9.(6:i!l'7)
r:C1~MONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
PERUNKO,ANNA
FILE #63-68-583
Apri12,1968
SUMMARY
,.
I,the undersigned
#63 Washington
FILE #63-68-583
the real and personal
opposite each item in
rmrOHT OF INHERITANCE TAX APPRAISER
rtuly 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 last column to the right in Schedules "A"~"B","c"and "E".
/....LL:::...:..~~~A-4---.
pR
i?~~04-02-68
11-22-68Dated:
REPORT OF THE REGISTER OF WILLS
I,the undersigned duly elec ted Regis ter of Wills in and for ...
County,Pennsylvania,do r"svectfully report that I have allowed deductions in the amounts
claimed by deponent,excc,pt as to those i terns where a greater or lesser amount is set forth
in the last column to the r 19h t in Schedule "F",which greater or lesser amount represents
the sum allowed as a deduction.
Dated:
REGISTER OF WILLS
.Vl\TJn)_-~5'REPORTED VALUE AS APPRAISED
$4;f)()e~eO $4,000.00
171.47 171.47
INVENTORY
Real Property (Schedule A)
Personal Property (Schedule B)
Transfers (Schedule C)
J oint-Held Property (Schedule E)
TOTAL GROSS ASSETS
LESS Debts and Deductions
(SCHEDULE F)
CLEAR VALUE OF ESTATE
8,599.10
=====:.-...--'
8,599.10
=====:-'-
VALUE AS REAPPRAISED
$--------
======:~
Valuation of life estates or
annui ties . . . . . . . .*_
ESTATE TAX ASSESSMENTS ~_
.(:::)As evidenced by Charitable Exemption
Certificates issued by the Secretary
of Revenue.
COMPUTATION OF TAX
*------d>c,_
FOR USE OF REGISTER ONLY
T ax on *________5)~$_
Tax on $'_'_'_10%~_
Tax on ~~~~%
T ax on $:1:/0 $
Exemptions :~
Total Estate __
TOTAL TAX $_
Less tax previously paid $~==~~~==~~
BALANCE $_
Less 5%of tax if paid within
3 months after death $======:
3~~NCE OF INHERITANCE TAX DUE
Add interest at rate of 6%from
to
AMOUNT OF ESTATE TAX ASSESSED
Estate tax paid
BALANCE DUE
Add interest at rate of 6%from
to
TOTAL TAX BALANCE
PAID
$--------
$~-------
$~------
$~----~--
$-------$
FOrt USE OF REGISTER ONLY ADJUSTMENTS
NOTE:Where subsequent adjustments are made to the above computation of tax by the
Register of Wills,for proper reason,same should be noted below,with short
explanation.
Will (...No.Admlmstration
IN THE
..year ..
MATTER OF THE APPRAISEMENT
OF THE
ESTATE OF·
ANNA PERUNKO ...... .
Deceased
Late of .CARROLL TWP.
County of ...WASH.I.lIJG':rOl'J........
Commonwealth of Pennsylvania
REPORT AND APPRAISAL
.f
Fonn'RCC-2
~,.~COMMONWEALTH OF PENNSYLVANIA DATE """,,,,,,.......N9..Y..Ell.J:l9..~~.....??~......~~§?."...
~DEPARTMENT OF REVENUE
BUR'EAU OF COUNTY COLLECTIONS
RESIDENT INHERITANCE TAX;COUNTY ".".".""."".w.a.§.mn~"9.n............,,............
HARRISBURG,PENNA.17127 APPRAISEMENT FILE NO.................??=§.?:.?.~?......................................
Whereas,...................................An.n9....P.~;r.~.Q........................................................................late of .............................q.~~:r..~~~....~.........................................
in the County of ...................................W~;?@.:ggt.9.P,.............................................................Commonwealth of Pennsylvania,having died on
the .....................................Z....nd............................................day of .......................Ap.r.~+......................................19<>.~.....,seized and possessed of an estate
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore,I,....................,.............W.•.R.......Cba.ne.y.............................................................,an appraiser duly appointed according to law,
having been designated to make a fair and conscionable appraisement of the said estate,and to assess and fix
the cash value of all annuities and life estates growing out of said estate,hereby file the following appraisement:
In the event that any future interest in this estate is transferred in possession or enjoyment to collateral heirs of the decedent after
the expiration of any estate for life or for years,the Commonwealth hereby expressly reserves the right to appraise and assess transfer
inheritance taxes at the lawful collateral rate on any such future interest.
Unit Appraisement
Description of Asset Values Made for Inheritance
Tax Purposes
$
REALTY:
Meadow Ave.,Victory Hill,Carroll Twp.,Pat ,Lot No.37
in the J .E.Nutt Plan of Lots,Carrol Twp.DB.1279,page 253.4,000.01 4,000 00
PERSONALTY:
Blue Shield refund chick 48.7
Blue Cross refund check 9.7 ~
II.S.Trllasurv Denartment:Social Security for March,1968.100.90
Blue Shield refund check 12.1
Total 171.4 171 47
JT.HELD:
Mellon National :sAnk and Trust Co.Savings Acct.No.
65-17229 held in the names of Mrs.Anna Perunko or
...",r.,..."MiSs Mary tl.USnaK oJ ,"".7 .....v
Six shares of United states Steel s~ock in the name of
Anna Perunko and l~ry Rusnak held as Joint tenancy with
the right of surviwrship 115.50 i
U.S.Series liE"Bonds MaryyRusnak Anna Perunko liSJ2.25 Ior
Total 4,427.63 4,427 63
Total 8,599 10
fonn~V:~hbl:~::IiJ,;.w~a~~~~~:~~o~e~~~s~?~~
praIser;&2·········..7······,···········....··..··......·..············...............................................................(~r (I Str.et)
..,.................q~.~-.....;~....-...................................................,Penna.;;1 (PO"Ofllce)
,f'(
WASHINGTON County
RESIDENT INHERITANCE TAX APPRAISEMENT
Estate of
ANNA PERUNKO
Deceased..
Late of
CARROLL TWP •..........................
Date of Death,April...1Z.,1.96J3...,..
Appraise/Hellt Docket Vol.,.3.7 .
Page,ll.~l No 63~.6.$~.5$3 ,.
Filed in Register's Office,W.9y~p..~;r.g4.J19.Q$.
Amount of tax due,$.
DEPARTMENT OF REVENUE
Received,
Examined and Approved,.
Wrote abo.ut Appra.isement,
Appeal f,.om Appraisement,;.
Entered and charged,.
;
,,
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'J
AND AGENT OF THE COMMONWEALTH
Form RCC·IO
OFFICE OF THE
REGISTER OF WILLS
OF WASHINGTON COUNTY
STATEME~T,OF DEBTS
AND DEDUCTIONS
ESTATE OF ANNA PERJINKO LATE OF Carroll Towoship
DATE OF FILING APPRAISEMENT DAU OF DEATH __'i-'-_---:.z,_-_'--J9'~_
AMOUNT
13 00
12 11)0
12 50
3 00
11;no
210 PO
100 00
3 50
10 00
1 71 I)100
120 00
47 04
6 179
2 45
12 42
6 23
14 59
6 59
I
10 24 I
)3 SO -
•tI1
Countv Real Estate Taxes
and Street Light Tax
Carroll Twn.Fire Hvdrant
REMARKS
Carroll Twp.Road Tax
School Taxes
Final Telenhone Bill
Final Water Bill
Gravemarker
Attornev's Fees
Executor's Commission
Advertising Letters
Filing Inventorv
Letters of Administration
Advertisin2'Tetter!=:
1-
l'Final nas Rill
IFinal Electric Bill
'T'r.qve1 F.~menses
r.o
Peter J.Gallick
Monongahela Water Company
NAME OF PAYEE
Peter J.Gallick
Notarv Public Fees
Russell Marino
Paul N.Barna.Jr.
Paul N.Barna
Russell Marino
Mtl1 ('()1m T,.Morgan
Peter.T n.qllick
Ouinet Monuments
n.qi~Renublican
TATtlc:lhi no-ton r.ountv Renorts
'Ptell Telenhone Comnanv
NO.OF
VOUCHEJtDATE
rv
{\
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.....11 I ;]
COMMONWEALTH OF PENNSYLVANIA }
~~_8.:COUNTY OF _WASHINGTON
Pal IN.BarnaI.----~==-::~:]..:,..~~~~------HEREBY CERTIFY.THAT.TO THE BEaT OF
MY KNOWL.EDGE AND BELIEF.THE FOREGOING IS A .JUST AND TRU E srATENENT OF DEBTS.FUNERAl.EXPENSES AND EXPENSES OF
ADMINISTRATION SUBM,ITYED TO THE ESTATE OF A~nna,pet::,~ED'AS DEDUCTIONS FORI"'HIl!RITANCET~FU~E8.,"~??
•-..=.~r--U-~----Ix::~-=----~!>......-(L.8.)
SWORN AND 8UitsCRIBED BEFORE ME THI.22nd D 01"
/1 r ./l~~nR.~~f/\-trAhA ,c;{g/l'~
CONSTANCE L.RISKEY,!'fotary Public
Donora.Washington Co.,\fa.
My eblnmission Expires April 13,1970
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