The URL can be used to link to this page

Home My WebLink AboutOC1968-0714 - ESTATE OF WOLOSZYN,---------------------------------------------------- :,cc-~q'(6 -64).--_. CG.W~GN~ALTH OF PFNN~YLVANI:\ T~\AN~FEn.INHERITANCE TAX RRSIDENT DECEDSNT WOLOSZYN,~~LLIE FILE #63-68-714 March 5,1968 SUMMARY FILE #63-68-714 rmpOHT OF INHEH.ITANCE TAX APPRAISER I,the unriersigned duly appointed Inheritance Tax ~ppraiser in and for the County of #63 Washington ,Pennsylvania,do respec tfully report that I have appraised the real and personal property as reported in the foregoing return at the values set forth opposite each item in the last column to the right in Schedules "A","B","c"and "E". Dated:65/22/68 _----::==::z:"!..:-LI.~~~~~ ~.' REPORT OF THE REGISTER OF WILLS ~'" I,the undersigned duly elected Register of Wills in and for ,, \County,Pennsylvania,do respectfully report that I have allowed deductions in the amounts cli!-imed by deponent,E;xcept 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: REGISTfR OF WILLS VALUE AS REPORTED VALUE AS APPRAISED VALUE AS REAPPRAISED $15,000..00 $15,000..00 $_ INVENTORY Real Property (Schedule A) Personal Property (Schedule B) Transfers (Schedule C) J oint-Held Property (Schedule E) TOTAL GROSS ASSETS LESS Debts and Deductions (SCHEDULE F) CLEA...q VALUE OF ESTATE Valuation of life estates or annuities .••.•..• ESTATE TAX ASSESS~mNTS IS,OOO:.-mr =====:-- $----- ~------ 15,000..00 =====.-======:= (,:,)As evidenced by Charitable Exemption Certificates issued by the Secretary of Revenue. COMPUTATION OF TAXFORUSEOFREGISTERONLY Tax on $•__5%$__~__~ T ax on $..~1~1,~:,"Tax on $~:1>_ Tax on $.__11'1%$_ Exemptions,?,,======:=(':')Total Es tate _ TOTAL TAX $___ Less tax previously paid *===========~___ BALANCE $------Less 5%of tax if paid within 3 months after death $======:= BALANCE OF INHERITANCE TAX DUE Add interest at rate of 6%from to AMOUNT OF ESTATE TAX ASSESSED *_ Estate tax paid $_ BALANCE DUE Add interest at rate of 6%from to _ TOTAL TAX BALANCE PAID St _ $------ *------- *------- $--------- $ '\" t-;. FOR USE OF REGISTER ONLY ADJUSTMENTS NOTE:Where subsequent adjustments are made to the above computation of tax by the Register of Wills,for proper reason,same should be noted below,with short explanation. Will lAdministrationf.No.Year . I:S THE :\IATTER OF THE APPRAISEMENT OF THE EST.-\TE OF NELLIE \"OLOSZYN Deceased WASHINGTON Late of ... County of.WASHINGTON Commonwealth of Pennsylvania REPORT AND APPRAISAL ~ " ~. Fonn RCC-2· .-COMMONWEALTH OF PENNSYLVANIA DATE ..~......?.?..~.......!..~.§..~....:..........................:......... DEPARTMENT OF REVENUE .. ,RESIDENT INHERITANCE TAX COUNTY #63 WASHINGTON 1suREAU OF COUNTY COLLECTIONS .................................................................................................. HARRISBURG.PENNA.17127 APPRAISEMENT FILE NO.....................§J.::.Q..e..:::..7..1.4.............................. Whereas,...............................~.~~.!.~.....~~r9..~.9..~.~X.~.......................................................late of ...........................~A.~.~~.Ng.~.9.N ........................................ in the County of .........................w.A~.HINQ.T.QN..................................................................Commonwealth of Pennsylvania,having died on the .......................................$..1:.4.............................................day of ................M~.:r..~.4..........................................19.....§.§,seized and possessed of an estate subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore,I,W.R.CHANEY 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 transferinheritancetaxesatthelawfulcollateralrateonanysuchfutureinterest. Unit AppraisementDescriptionofAssetValueSMadeforInheritance Tax Purpoles $ REALTY: As per Schedihle "A"attached 15,00C 00 PERSONALTY: NONE NONE TRANSFER: NONE NONE JT.HELD PERS .. NONE I NONE ! TOTAL 15,OO(00 I torm~';,':fhbl:~.:rh~W~~.£~:~:~;~~~~~~~~;;~~£ Appraller ---·....~··..2·············..··..··....··....·..··········..··..··..··.....................................................(lil\Imber ~Strtet).J.....................................·....·,"',:.:·"..·r"Oiii;,'i".."'···········,..,,·,·..·.............,Penna. - \VASH.l..N.GTQN...CoUtlty RESIDENT INHERITANCE TAX APPRAISEMENT Estate of NELLIE WOLOSZYN Deceased. Late of WASHINGTON . March 5.1968DateojDeath, Appraisemei!t Docket Vol., Page,!J:.?~.?No. 37 63-::.§.§::::.7..J.A. I Filed in Register's Office,Ng,y 2..2..,.19 6..8 Amount of tax due,$.. DEPARTMENT OF REVENUE Received, Examined and Approved,.. Wrote abo.ut Appra.isement, Appeal j1'om Appraisement,.. Entered and charged,.. ( ./o 1< FOR INHERITANCE TAX PURPCSES COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS COUNTY OF IMPORTANT:This return must be completed in detail and filed in duplicate,with will attached,with the Register of Wills of the County where decedent resided;Return is due within one year after date of death,unless an extension is granted by the Secretary of Revenue.(Section 703 of _th~~Jnl1eritance_.~n~.El;;tate'Xax A:ct of 19.B1.) Form RCC-33 RESIDENT DECEDENT Ne.lli.e.....:o::s::.=:~:=~~::~______}.~VIT O;o~~.:~;nAn~a:~t~~:t~:d M~.~~e (State full name of decedent).•d ' d .fma1nermenan1n ormers • ....of :_Ci.±jL..af....Was.hing:ton.Wash •._....._.....'"--~~==.e,:;;?S-...~:::;:;::state of P.ennsylvam..a ~}_ ss: County of Was.hi.ngton . remaindermen...I.r..ene Ann W.ol.oszYtl and.L.ot.t.i..e Mari.e WQ.l.9..$.?y.~."..g~~.gh1=.~!'.~?:.~g..X1OfJ9MfAf ~of the estate of the above-named decedent being duly sworn,depose and say Decedent'dJed Mar.ch.. (Month) Name and address of attorney or} other authorized representative to. whom all correspondence should be mailed. .AdamL..Sanders . 61LWashingtonTrustBldg.•, Washington,Penna.15301 That as such daught.e.r deponent is familiar with the affairs of said estate and the property con- ~ 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:- .. N/\ME AND ADDRESS OF BANK OR OTHER INSTITUTION IN WHICH DECEDENT RENTED A SAFE DEPOSIT BOX THIS SAF.E DEPOSIT BOX RENTED IN NAME OR NAMES OF RELATIONSHIP OF JOINT HOLDERS TO DECEDENT That the contents of said safe deposit box or boxes are itemized under Schedules 1\of this-.:.::..- return,With the exception of the following,for the reasons hereinafter set forth: That Schedule A attached hereto and made part hereof sets forth full v and in'detail all the real property in the Commonwealth of Pennsylvania of which decedent died having an interest therein.It also sets forth the mortgage encumbrances upon each parcel of real property at the date of death,giving the amount still due at death,name of mortgagee,date,rate of interest,and book and page of record thereof.It also sets forth in the columns prOVided therefore the assessed valuation of each of said parcels,the estimated market value thereof as of date of death of decedent. That Schedule B attached hereto and made part hereof sets forth fully and in detail all personal property wheresover situated owned by the decedent at the time of death;all moneys left by the decedent at the time of death,whether in decedent's immediate possession,standing to decedent's credit in banks of deposit,_savings ~anks,trust c9mpanies,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,pos-tal savings,treasury certificates or notes and other evidence of in- debtedness of tile Uni ted Sfates to the decedent;all obligations,'whether by statute or agreement they are designated as tax free,of the United States,'or any state,or political subdivision thereof,or of any foreign country,which are-owned at the time of death;all wearing 'appare~,jewerry,sil"verwar:e,pic- tures,books,wdrksof art,h~usehold furniture,horsesJ carriage,S,:'automobiles,boats,an~'any a~d all other personal chattels of whatsoever kind or nature,leftbydecedent,together with the fairly ~stimated market value thereof;all bonds and mortgages 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 ~t the time of death,with the market value thereof at such time. In the case of securities of close or family corporations,the values reported are as far as possible substantiated by financial statements of the corporations,showing the assets and liabilities thereof as of the'date of death.The schedule also sets forth the interest of decedent at the time of death in any co-partnership or business,and in support of the value of such interest there is annexed to said schedUle,financial statements shOWing the assets and liabilities of said co-partnership or business. A copy of the co-partnership agreement,(if oral,a statement setting forth the nature of the agreement) together with a statement setting forth the character of the business,its location,and such other facts pertaining:t?the business as may.be pertinent to a fair and just appraisal of the decedent's interest t~erein 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 -wh~m'transferred,the re'lationship of the transferees to the decedent,the 'proportionate share received by each transferee and all other facts~of a pertinent.na'ture 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 co~y 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 p~sses 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 wpl,deed,or other instrument of another, with a copy of the instrument creating such power ,attacl!,ed to the sc"!edule. ~. That Schedule 0 attached hereto and made part lfereof setsf~rth 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,and the relationship of such issue to the beneficiary. That SChedule E attached hereto ,and made a part hereof sets forth all property,real and per- sonal,owned by the decedent jointly with another or others,including intangible,standing in the name of the decedent and others,plus the date and place of record of instruments effecting the vestiture of real estate and the date of acquIsi~ion of personalty,plus tlle name,·address.and relatioQship,if"any, of co-owners to the decedent. That Schedule F attached hereto 'and ~ade 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 uponre- quest,that if the amount actually paid in settlement of any fee,commission or debt is less than the estimated amount claiming and allowed,that the same will be reported to the Register of WillS,and that the amount of tax assessed can be reassessed in accordance thereWith. That the totals of the appropriate columns in Schedules "A","B", "C","E",and "F"as directed therein,· have been carried forward and properly registered in the Summary. Subscribed and sworn to before me this . .................;J..~..ff!day of ~,,:;~J;;<._l9.?iL.'.----?"~,.~t~~~..L~~t~iiC My Com.Exp:March 26,1971 Washington,Washington County,Penna. NOTE:Before signing affidavit make sure all blank spaces in the affidavit and schedules annexed are filled in with details or the word."N.one",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 (1-6.4) COMMONWEALTH OF PENNSY.LVANIA DEFARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS TRANSFER INHERITANCE TAX RESIDENT DECEDENT .: SCHEDULE "A" -ttEAL 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 hl'ld 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 Commo!"wealth of Pennsylvania should be described by lot and block number,~treet and street number,together wi th a general description of the property,with a 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 "FlO and must not be deducted from this schedule. Lots 36 and 37 in Hess Plan (Plan Book 2, (1)(2)(3)/ DEPARTMENT ASSESSED VALUE VALUATION FOR YEAR OF ESTIMATED CAUTIONDECEDENT'S MARKET VALUE (Do not write DEATH In this space) pages 38 and 39)in the 7th Ward,Washingtcn Pa.(corner Allison and Woaftawn)60 x 100 feet),fronting on Allison Ave.,with two story frame house thereon.See Deed Book 1116,page 536,Washington County,Pa., records for source of utle.House has three finished apartments in it,daughters live in one and other two are rented for $90.00 per month for the two.A fourth apartment is unfinished and empty.Heat is coal and gas. Assessed valuation for 1968 of lots and house is $4200.00.~.... Whole valued at---------------------$4200.00 $15,000.00 Insert this total opposite "real property",Schedule "A"in the X X X X X "As Reported"co Iurnn on the last page of thi s return.$15,000.00 RCC.-35 COMMONWEALTH OF PENNSYLVANIA -TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "n" PERSONAL PROPERTY INSTRUCTIONS:This Schedule must disclose all tangible and intangible personal property owned individually by the decedent,at the time of his death.Property owned by the decedent jointly with another or others must be listed under Schedule "E".Inta~gible personal property,titled in the name of the decedent,but payable at death to another or others,including but not limited to P.O.D.U.S.Savings Bonds and tenta- tive trust accounts,must be listed,despite .the fact that they are not of the administered estate. Tangible personal property should be listed first (e.g.jewelry,wearing apparel,household goods,and fUrnishings,books,paintings,automobiles,boats,etc.) Intangible personal property,such as bonds,treasury certificates,cash on hand and in bank,.. stocks,'mortgages,notes,together with accrued interest or dividends,salaries or wages,insurance pay- able to the estate or fiduciary in said capacity,partnership interests,interest in anyundistributed estate of or income from any property held in trust under the will or agreement of another,even though located outside of the State,at the time of death,should be listed in this schedule. Item ITEM UNIT ESTIMATED DEPARTMENT VALUATION No.List and describe fUlly VALUE MARKET VALUE (Do not write in this space) None , , Insert this total opposite "Personal Property",Schedule "B"in X X the "As Reported"column on the last page of this return. ·rU\!\I(J:,\T:?\LTIl UF PF~N~YLVAN I A Tll\\~FFll Ii\HElUTANCE TAX n.EsrnE~T DECEDENT SCHEDULE "c" TIl:\NSFEllS (1)Did decedent,within two years of death,make any transfer of any material part of his estate,without receiving a valuable and adequate consideration therefor?(Answer yes or no)no (2)Did decedent,within two years of death,transfer property from himself to himself and another or others (including a spouse)in joint ownership?(Answer yes or no)no (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-except deed reported (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)no (b)What was the transferee's age at time of decedent's death?past 21 (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:no,except as reported (a)The possession or enjoyment of or the right to income from the property transferred? (Answer yes or no)__ (b)The right to designate the persons who shall possess or enjoy the property transferred or income therefrom?(Answer yes or no)_ (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)_ NOTE 1:The answers to these questions should be supporten by affidavit by the attenriing 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 prcperty transferred,it's fair market value at date of death,dates of transfers and to whom tr(1.nsferred,with relationship of transferees to necedent,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 / V MARKET VALUE (Estimated)DFPT.VALUATION (Dept.Only) __-J-~_""_..... Insert this totrtl 0II[JOS j te "Transfers",Schedule "C"in the "As Reporterl"column on the last page 'of this return. ReG-sa COMMONWEALTH OF PENNSYLVANIA rnAN~}l~H INHERITANCE TAX RF.SIDENT DECEDENT SCHEDULE "E" JOINTLY OWNED PROPERTY INSTRFCTIONS: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,Name I unit percentage Estate Address and Relationship of Co-Owners,and Place I Value Share Valuation of Record of Instrument,where Real Estate.I None,except real estate reported on I I Insert this total opposite "Jointly Owned Property",Schedule"E" in the "As Reported"column on the last page of this return. DEPARTMENT VALUATION CAUTION-Do not Write In This Space. Value of Value of Entire Decedent's Property Interest ~OOe37 na.63)r , Clnl~W:'\\\'E:\\'Tll OF PE:,\:,\!'YYl.ANIA TRANSFER 1:'\IlEHITA1\'l'E TAX RESIDENT DcX'EDE:'\T .'~...... SCHEDULE "0" BENEFICIARIES .. \ h .- 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 Lni:i:;p M;:\Tip Wnln~7.vn d;mnh'tiPr v~s lO/7/1Q1Q 1/2 TPsidup "01:;A";~nn Auo -( W::l c::hi '0"........ T,..ono Ann Wnl rt ..voc::1011 0/1 02:P-1 /2 ,.oc:i nn 0 11Q5 Al1ic:nn Ave. Washinaton.Penna. Deponent further says that all the above-named beneficiaries are liVing at this time except below: NAME DATE OF DEATH RESIDENCE OF THE ESTATE OF REPORT AND APPRAISAL ~IATTER OF THE APPRAISEMENT ---, (Executor-Administrator must complete "As Reported"column #1.) CJ ,...;j 'i:i ::t'...',....('l)('l) 0 Il:>...e.tiltil::l 0tiltil.....,::l 'i:i,...;j ('l)e.......Il:>til 0~'i:i "0Il:>('l)C"'...... ~0 ~"0 trl ('l)... til t'+II 'f t'+'<Il:>t'+('l) II "1 ./ ~ :. II • I • II , II en'.c:: ~~>~ en en en >-<: (')()()?"'?"'?"' c5 ~~-II •-. -00 ''00 -00 -00 -00 -00:)-1 )-I VI \Jl.....>:0 (:)til :0 8 ~~0•.''~>- •o~g'0 ... 0 -+('l),'c.. :\ f/"'~~-00 -00 -00 ~..>:r. 0~-~_~II . ---:t ...rI (:'-3 <,~-1 ::lr.";c.. Year DO THE (No. ,Wasll-ingtQIl Inheritance Tax Purposes Only B.e~~raprS/','h~J I t --,. Adam L.Sanders,Attorneys for ,NellieWol,C:;>$~yn, ' Deceased S1111~:JJ &JLSJfj:;~ ONlUtt:-J 'ri';Ssn~ e£":Z Wd J r ".1':,,'!"":"l't 1-".r'\t I tj 4..•t.$. Late of CityofWasb::i.ngton, Commonwealth of Pennsylvania County of Will Administration .,, I DEDUCTIONS ALLOWED IN OFFICE OF THE REGISTER OF WILLS OF Wash;ngton COUNTY AND AGENT OF THE COMMONWEALTH STATE~EN;OF DEBTS AND DEDUCTIONS THE SUM OF $.1...l~..b.!'~.. ~lR 29 137fRUSSELL MARI~ A PROVED -==. ESTATE OF Mel lie Woloszyn LATE OF City of Washington,Penna. DATE OF FILING APPRAISEMENT _,!;,M!liai&,;YL-..o!l:..!7:..",--=1:.::9~6=8~_DAT5OF DEATH __-cMl.ca:s.Tl.J,,;c;.LhL.-S,J.·-t,_1...9;;u,6~8~_ ~Inn 1 Inn l~Inn lAo 100 ._....- ~REMARKS ..p E:./AMOUNT . ~- __...__••J!!!_- • ~------h;"noF no....d -....,"oF no....n 1 c::n?101::: Y''',..'h':11 ",oF no,...'n An Inn 10A.Q ,..;+..+~'V_Y'0~'1'7n i1 n 01 ..,..'h';11 ,,~N ....,...N ')0 ~,C::A ........'h';11 "oF No,..'A ,..,.,I,, r"....yo1.-"""Y'oF"'Y'nOl""n 1An Inn I ....,,+...you oFo....,11'\1'\ ~.:.,.:--.:_......__.:""",,_..-~Ion-.. .'h';1 1 "oF ,.:r....,...N,,&..In&.. , ,n.::.o ,1 -'-.::.'2'OA 1-1:':.,.:...._- • DATE NO.OF NAME OF PAYEE VOUCH"" ...1Q68- 1\,,__??,lA7~~h _1=1'tAl~~h .1n;nt Anth_... -~ AnY'I:::?T...3_--tAl;10n 1t ~on~ A....._1C::'2 -4 -',1 U"".o-..- M.....A Ll J{;,.kC!-.·+"Y'o 11"_••A c::~y ("",,1.-(".;+..T,.o~C! '?• M_"•I:.A.I'J........+D_.......-r'n.~ 11"_•.,...'7 (""1 ••_'h':..r-......,,~'0_.......... "'7 .;.' M_••,.::Q ............1';'M -·OC!A ____..., M.....1'7 a U010n -·N"".... u_••,,.,1n ....•"M __';..."D...........,7 ... M_••')'7 11 (".;+.;................(",," T~.'..,..0 1')M_.,__,_••ro,,'- ""..'7 ,n.::.n............... 'I:'....'h '2 1'2 'AN"''''T -4 ~_......,...u .....,_....""-•..3_.... ..w -. '1:'_.....,c::....."'"f__':.......D;;"~-7 .... T .7 ---1---4..----!------------.+-----------__f-------lf---- COMMONWEALTH OF PENNSYLVANIA COUNTY OF WasbiZlgto:c. We:mc Lotti Q ~ari e~Wol oSZJrn and Irene Ann Woloszyn HEREBY CERTIFY.THAT.TO THE BEST OF MY KNOWLEDGE AND BELIEF,THE,FOREGOING IS A JUST.ANO TRUE srATEMENT OF'DEBTS,FUNERAL EXPENSES AND EXPENSES OF ADMINISTRATION SUBMITTED TO THE ESTATE OF NQlliQ Woloszyn °ECEASED,AS DEDUCTIONS FOR INHERITANCE TAX PURPOSES.\..._''!~ ·4 i(~';I';'r:TT-LJ?./4;'-,U~,~/(L"5.) SWORN AND 8U~SCRIBEDB~=:£_"')L/#~:""_'__DAY OF WM:~7#' ~::~~liC i.~~$~·(L.S.) Washington,~t~County,Penna. (., j, ,, .,'," f:.'~.'1 }.I 1.. .\r ;I,·.".t)11)'....'J,'[i.,I,'. (,(', .0 I, f''ij:, I'::-" ,.If(I ••,~'.J,~,,...'(I 1~("I, ,)'1 ~,t. ..","\ I ,)J J · ,,)'k/ -'· r r ()·)~ ()r (i ) (r·',' f'·' ",J ,.\...' I;,.~ 'r I ,:J\.r I t.I') ,,'J,, {'I ,. 'J. "If' 11 :'!I;~,...~ (' "'()' (, j' ,.,. " ., "..,.. ~i.:~;, '1,.'j ,,.J I,r j •':;..L...'-.J r \r\,', " ~,.f' '.-) r " , ,),;.'. I,, ),,,. .' ..., I 'r '.I .-, I [ t (I, !',. t_ p;::';t i ~".J 1 .'),.r(1 (I,,',: I;r 1 :' i,l/ r .',,)\. ,,,r:){. \. ,, T'.'' ~ "\...~...'..."1;-.:.......':,"':.""'.~..~~~"'i.~ r r',,",I I ;1 J:f,,j