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Home My WebLink AboutOC1968-0734 - ESTATE OF DUBARTCOUNTY W.~§lh~.~~.2~. FILE NO ~J7::.~.?=7).4 _. Fonn RCC-2· ;:>EP'ARTMENTOF REVENUE BUREAU OF COUNTY COLLECTIONS HARRISBURG.PENNA.17127 ·COMMONWEALTH OF PENNSYLVANIA RESIDENT INHERITANCE TAX·, APPRAISEMENT DATE June 25,1968 Whereas,p.~y;t.Q,A.~;p~p.~late of ~.~~~.~y.~~.~. in the County of ~~~~~~?.~Commonwealth of Pennsylvania,having died on the e.t.b day of ~.~P:t'.E:lJ.n.l?~~19..§7.,seized and possessed of an estate subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore,I,W.•.R~C.h.ane.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 AppraisementDescriptionofAssetValuesMadeforInheritance Tax Purposes $ REALTY: I , NONE NONE B'EliSONALTY : As ner aDDI'aisement filed 1,495 80 TRANSFERS: NONE NONE JT.HELD:I NONE NONE I Total 1,495 80 I Estate Insolvent I I I I Having been duly sworn aCCOrdi~W,I do hereby ,~that the above appraisement is made in can-.'-~formity wIth law on'this "."."""".,,~~G .."""...day of ........".....................<-~.n?k;""".""....""".~".....,,.:""".1 ,,_...£; """",.~~""""...~~."".~-{c-~6"""".~.......d..'~"""'"r~ppral••r ""...".....,""',..,"""""""""'".,"~"''';.......,.."""""",,,.,,,,,,,,,,.,.,,,,,,,,,,,,,.,,,,,,,,,,,,,,,,"",.",,,,,,,,,,..,,,,,~~7;:···~·~·~································'Penna..ron 0lIl001 ., WASHINGTON........................................................................................COU1Jty RESIDENT INHERITANCE TAX APPRAISEMENT Estate of DAVID A.DUBART Deceased. Late of .....................:e.lJ:,N+.;\,$XVI.~. Date of Death,S.ept..ember 8,19.67 .. Appraisemel!t Docket Vol.,3..7 . Page}+.:l,.9~7.................No...§.~.~~7..?4... Filed in Register-}s Office}Jun~~5."......19.6.e.... Amount of tax due,$_.._ DEPARTMENT OF REVENUE Received,__•••__••••••••••••••••••••._•••••••_•••_•••••__u •••••__••••••_t J Examined and Approved,. Wrote abo.ut Appra.isement, Appeal j"om Appraisement}.. Entered and charged,.. I ,r -•• RCC-81 (2-64) 'COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS INHERITANCE TAX DIVISION NOTICE OF FILING OF APPRAISEMENT ELIZABETH A.DUBART (~Administrator). IN YOUR REPLY PLEA8E RE"ER .TO 37-ll9~7 In Re:Esta te of ---:D:;..:A:.:..:V:..=I==D~A.:....--=DU::.=.::BAR=:.:T _ ______---=.W~A:::.S=HI=N::.:G:.::T.=.ON=__County -File No.63-68-734 De ar Mrs.Duhart: You are hereby notified that the original appraisement in the estate of David A.DUbart has been filed in the office of the Register of Wills qf Washin~Qn County on June 25 ,19~.Said appraisement reflects the following valuations: Real Estate ~..,...",.~.."...".-- Personal Property ~1~,~4~9~5~.~8~O__ Transfers -,-__ Total -..,..._~.:!:l:.l..::t.4.L95.L;.L::8~O'___ As to such tax that is paid within three months from date of death,a five (5%)percent discount is allowable.As to any tax that remains unpaid after one year from date of death,interest at the rate of six (6%)percent per annum is charged. Any party in interest who is aggrieved by an appraisement may appeal therefrom as provided by law. Date JSLumll!til'e~2....5l..4,~1..:29:lo!6.l..l8 _ Ti'tle ::J..----E:::~~~.::....G~...J.ijlP APPRAISER DATE OF DEATH:September 8,1967 ESTATE INSOL'iENT Note:This is not a bill. ..r FORM 67 REV.1-50 REG.WILLS Application for.1Lrttrrs of Allminintration on thr ) Estate of D.a.y.id A D.uBa.r..t ~~.. -. late of..B.ent.le.y.:v:l.11e."f..e.nn~.y..l.y.anl.a ,Deceased. Before the Register of Wills of Washington County personally appeared E.l1.~g..'b.e.t.h A..,p.~.:r..t .. who,being duly sworn deposes and says that:....P.~.y..~.g ~..,f?~.;r..~.. age 15L..,having..biS last family or prinCipal residence at...l.Q3.H~.l.e.D ~.t.r.~.~.tJ,. (Street and Number) ...B~n.t.l.e.y.Y:.1.ll.~,Washington County,Pennsylvania,died intestate (City.Borough.Township) at...F..~.~J.Qw.f..1.~J~L ..T.9..w..mth.1.P.,on the..§J;~P.day of §.~.P..~.~~!:?~£.:~~.. A.D.,19.6.1 ,at....6.:.15 l?;M.,possessed of personal estate to the estimated value $0.0 ,and of real estate in the Commonwealth of Pennsylvania to the estimated value of $9.9 ,situ ate in (.f.D.:t'p.u.r.p.a,S.e o.f....f.iling ac.t.1.on u.nde.r.the w.~.o.ng.f.JJ1 d.ea.th and .s.tl.:t'!:II.;l,.va·l s.ta.tut.e ~. The names and addresses of the decedent's surviving spouse (if any)and other heirs including heirs by adoption)are as follows. REJ,ATJONSHIP RJ<JSIDENCE ..AJ~.~;A..,P..~~.r..t F..~.t.h.~.r..;J9.3.~.~.*.~.n.§.tr.~.~.~..t J?.~!il~J~.Y..'!.~J 1e ,Pa • ...~.;J,,~.?g,p..~.t.h A..,J?~~.;r..t.m:Q.t.h.~.r.J.Q3.~.~J~.~§..tr.~~.~..t J?.~.g.~l~y.y.JJ 1e ,Pa • .....••••~~.o ,••••••••'0'.. ...................................................••••;~•••••••••••••••••••••••••0••••••••••••••0 ~••••••••••••••••••••0•••••••••••••••••••••••••••••• ..........................................................................,~. ...................."'~. That deponent is over 21 years of age,resides at .l.Q3 He.le.n S.tr.e.et.".B.ent.l.e.y..v.il.l~, p..enn.s.y..lyan1a . is a citizen of the United States and a resident of Pennsylvania,and respectfully applies for Letters of Administration upon t~e Estate of said decedent,no letters having been previously issued thereon. Sworn ;;'UbSCribed before me tbis....6....f.:..~..-i(-.t.""'7J:u.J....t.~;:jjA ..d.,d;.~.A:t- day IZ-:::t:=:~A.D.,19 ~..:'......._ . REGISTER COMMONWEALTH OF PENNSYLVANIA}SS: WASHINGTON COUNTY, And now ~:..~?:..:.::,19 9.~1.,comes ~.l~.?~.p..~.th !.\..,D.l.1Ea.r..t... who being duly sworn doth depose and say that..She will well and truly administer the goods and chattels,rights and credits of..Da.v.l.d A..D.uB~.r..t ,,deceased, to the best of...h.~:r.....skill and judgment in strict compliance with the laws of this Commonwealth,mind- ful of the laws relating to inheritance taxes. :d Sworn an~bscribed before me thiS....?::.?"Z..F~. day ~...,..=:1!l ~;;£;.~!:;o 19 . ............[~.. REGISTER r • !' y I I 1- I I I I j ~.<J1l./ .;k~c;g -t,p.-73~' APPLICATION FOR .I Letters of Administration ,ESTATE OF De.vld A.DuBart·:··..\·····························..···D~~~·~~~·d·····. . \R $ ;.. L .-------etters:.:...................................................d t: P $1-. Extra Alias·$...........'. Certificates /....J <2...$ /0 2>........................................... Renunciations $.. I ..................................................................$.. ............./pL................................................f,r.../?:..I 0 (;;u...........................::..... Total .. :-...·10,.!~~ enc~... ;0 ~: rr,;:o ..~~l.GJc:-<I .-e/)c.:>C:r)_.....n-,f\)_ frl:--;:...__::0;-~..'"J J o Begi.-:;".~..Her~~.S2'.!::-'Z rAttorney ..................~;.o ....,.,r--.................F=z:'I 'J r-r-., v'"j v '1 ~2.~~.&:L. ~.'-;,<(P I }~-.. / Estate o£Dav.1d ",.,..DuBa.r.t .. late of .I:3~.~~.1..El.y!~~.le.,",Deceased }No........of 19..."" KNOW ALL MEN BY THESE PRESENTS, Blizabeth A.DuBart as Principal and United States Fidelity andThatwe," "" " , " " ".. .........'l.t1.~.1'.~.~.~1....~.<>.•..,:f3~.1..~.1.D.1c>,r..~.'.~.~~~.~.~.~!..., , , ,". all of Washington County,Pennsylvania,are held and firmly bound unto the Commonwealth of Pennsyl- vania,for the use of those interested in the estate,in the sum of ..Jr1v.e li.~nqr.~4.Dollars,to, be paid to the said Commonwealth,to which payment,well and truly to he made,we do bind ourselves, jointly and severally,Jor and in the whole,our.heirs,ex;ecutors,.administrators,successors.and assigns,-and each and every of them,firmly by these presents.Sealed with our seals and dated the~~~,h~..day of .,~.ay A.D.,one thousand mne hundred and ..$.~~:ty"'~~gl:l,~,. THE CONDITION OF THIS OBLIGATION IS,That if the above bounden , , , , . .....~J~.~P~.t.l:l ~.~~.~r.~.,·....·..··..rIx.. AdministratciX or any of them,shall well.and truly administer the estate according to law,this obllgation shall be void as to those who shall so administer the estate;but Sealed and delivered in the presence of: otherwise,it shall remain in force.t!~rd~~~~JQnty Co•.~~1.t1mor.e.~....M.d.•...s.ur.e.t:y..(SEAL) ~y.·~'Att·ornej..ln..·Fiic·t·~·..·..·..· ,(SEAL) ,, ,..,..,,.",.,.,.," , ,..(SEAL) ~tuttutrtlt of ~urrtt! I.. -- --------_...surety in the sum of $_.....................on the administration bond in the estate of ---.---..--..-__ _ ,say that I reside at -..-.---------.-.-------....-..,Washington County.Pennsylvania;that I am the owner of real estate.the title to which is in my own name and duly recorded.situated in ,, Washington County,Pennsylvania.worth above all encumbrances $;and that I am worth the amount:.expressed in said bond,over and above my just debts and liabilities. ._--------------------------------------------------------_.._--------------------------------_._--_.~ •••.•----••-••-•••--••--••--.--.-.--•••--.----••-•••_.~_•••_.4__•.•_ Street &tuttutttlt of ~urrttl P.O. I...--.-----..--... ,surety in the sum of $................................on the administration bond in the estate of ---,say that I reside at ............-.--Washington County,Pennsylvania;that I am the owner of real estate,the title to which is in my own name and duly recorded.situated in , Washington County.Pennsylvania.worth above all encumbrances $;and that I am worth the amount expressed in said bond.over and above my just debts and liabilities._._.~. ...................................................................................-. P.O. COMMONWEALTH OF PENNSYLVANIA.}55:WASHINGTON COUNTY. And now........................................19.............comes . who being duly sworn.says that he is acquainted with the financial standing of the securities to the within bond;that the said obligors have each executed the said bond and that the sureties thereto are the owners of real estate in their own right of value more than the penal sum of said bond over and above all incumbrances and exemptions. Sworn and subscribed before me this _.. day of .......................................................A.D.19 .._.....--_.------._-_._--..--....._...__._~-------.-----~_.._----------..-._------------------- ! J ~:..--: ~.2 'Gl ~!~1~=~"i : :r:n "'<: t+.::;)F/Lito Q) fa 'ell Cl:ell0..-0 « :ell 0...II: ~0=....z ~u.i 0<1:Q).,0 ~~~='.0 ~I-1::,:...·,·,1 _,: ~'Q)......:~~a !~';Il ':'2L?m,\'<b ~~H3 ~~I ..'j PN 1'2 :23 t\'--~j ~~1...wt:t :RU:"SEJ:~i REGrs'"rfhl1:rARINO 'f C) I 0 ...I-z ~Z =,>:./or WILLS ;: z :0 z...'..ita•'Q.~'j :Q... '"~'0 ~N I ~"'O g 0 ~-<«~o C a:l In C 0 0 "'Oa:l "'0 C C«0a:l • SURETY DEPARTMENT UNITED STATES FIDELITY AND GUARANTY COMPANY SALTIMORE.MARYLAND .A Sloct Compang REPORTING FORM FOR ALL FIDUCIARY BONDS (SUCH AS ADMINiSTRATOR.EXECUTOR.GUARDIAN.COMMITTEE.TRUSTEE.RECEIVER.ETC.) I BOND EXECUTED I RENEWALPROCEDURENAMEANDADDRESSOFAGENT F:ranels tJ.B,ue.Jl;~e,"li A.gency Canonsburg,Pa.DCYES D NO I PREMIUM FROM TO I BOND NUMBER I LOC. I P.F.I CLASS $10.00 15/24/68 16/24/69 -16·- NAME AND FULL ADDRESS OF APPLICANT OCCUPATION OR POSITION I AGE Elizabeth A.DuBart H.w.44 103 Helen St.Bentleyville,Fa.ESTIMATED NET WORTH I CHARACTER OF BOND $Adm. PENALTY OF BOND I COURT IN WHICH FILED COUNTY STATE $500.00 Orphans'washington Penna. ADMINISTRATORS.EXECUTORS OR TRUSTEE u/w GIVE Letters taken out for the purpose of suiteNAMEOFDECEDENT&DATE OF DEATH GUARDIANS OR COMMITTEES GIVE David A.DuBartNAME(S)OFWARD(S)&DATE(S)OF BIRTH September 8th.1967 RECEIVERSHIPS OR FORECLOSURES GIVE TITLE OF CASE DOCKET # NAME AND ADDRESS OF ATTORNEY , Herman J.Begi 323 Fallowfie1d Ave.Charleroi,na •, ESTIMATED }:ERSONALTY REALTY ESTIMATED ESTATE DEBTS ESTATE ASSETS $$ IDOESHEREPLACEYESD \ IFYES STATE WHY I DOES THIS BOND YES DJIF YES STATE WHY I A PRIOR FIDtJCIARY?NO IX REPLACE A PRIOR ON'E?NO D IS TH15 A VETERANS CASE?YES D NO COt 115 THIS AN ADDITIONAL BOND?YES D NO IX WILLJOINT CONTROL BE EXERCISED?YES D NO~ IIF YES BY WHOM? IIRECOMMENDTHISRISK AGENT IF BOND PENALTY IS MORE THAN $25,000.COMPLETE THE FOLLOWING NAME OF HEIR (5)OR BENEFICIARY(IES)AGE(S)ADDRESS (ES)RELATION TO DECEDENT I IS APPLICANT RELATED YES D IIF YES HOW? I WHAT IS HIS SHARE I 15 A TRUST YES D CREATED TO DECEDENT OR WARD(S)?NO D OF ESTATE?BY WILL?NO D 15 APPLICANT INDEBTED YES D IIF YES STATE AMOUNT I HOW SECURED? TO THE ESTATE?NO D $ 15 THERE A YES D IIFYES_STATE NATURE AND PROPOSED DISPOSITION OF IT GOING BUSINESS?NO D IF APPLICANT IS A RECEIVER OR TRUSTEE OF AN INSOLVENTWILL HE REORGANIZE OR LIQUIDATE? Judicial 892 6-63 ':~:o <USE OTHER SIDE FOR REMARKS OR ADDITIONAL INFORMATION) • send receipt to Me Guy ------_._--_........---~---------~----------._------"------- HERMAN J.BIGI ATTORNEY AT LAW ESCROW ACCOUNT 901 /P 60.75219_~_433 $/O.ti- ESCROW ACCOUNT --jc9")(JCC ~'-/I 116 eAJ C '-/T'I ------------------:----------¥\t)OLLARS 323 F"ALLOWF"IELD'AVENUE CHARLEROI,PENNSYLVAN IA 15022 CHARLEROI OFFiCE MELLON NATIONAL BANK ANDTRUST COMPANY PENNSYLVANIA ,,, --------------------~-~ •Form No,RCC·62 (2·64)THIS FORM REQUIRED IN ALL ESTATES WITH GROSS ASSETS UNDER $10.000.UNDER SECTION 701 OF ACT OF JUNE 18.1981./ ..EFFEC'l'IVE JANUARY 1.1982.(FILE IN DUPUCATE WITH COPY OF WILL ATTACHED)___~r '<:' OFFICE OF THE REGISTER OF WIL.LS, County of ..Washingto.n . ..El;i.2;~P.~t:h .1).,..Q\l~q.}:".~'of ~~~.~~~~~.~.~~~.t:~,.'~~~~~~~~'~~~'".~.8:~. /".(Name)(Address) being/duly SlIlO.01..according to law,deposes and says that!IJe is the __.A~?:_~!~_!:~~~!J~._ ""(Exec.,Adm.•Legatee.Etc,) of the estate of Da'\lid__A .._.DuBBt_t ..whose last residence was lQJ Rgl~!L~J~~_~~_~_ (No.!(Street) Bent.le~i.li~-~-.f~n.g~-~----..deceased,and that the whole of the estate of said decedent,who diedS_ep,t..embex:-Ji.-.196 7 (City,Borough or Township)(Date) consisted of: REAL PROPERTY REAL PROPERTY IN PENNSYLVANIA.WITH STATEMENT OF MORTGAGE ENCUMBRAN~ES UPON EACH PARCEL AT DEATH OF DECEDENT. WHERE PROPERTY HELD AS JOINT TENANT OR TENANCY BY ENTIRETIES.GIVE NAMES.ADDRESSES AND RELATIONSHIP OF OTHER OWNERS. \ Real Estate \\}Y Estimated Value ~~ 00 .I \~I\'~ ~~ \.... Personal Property II-ffT l?J?e r?1 v';;1)1/ftI~"WI2tft.II!~I.l J)~A'T7I ~1.495 8L ~LJ »-\lH).·fJ-t1.it. v -n~A-~lIA,J '<--.~~r . NOTE:You may expedite the processing of this return by filing with it,and as a part of-the return, letters from financial institutions or mortgage holders,certifying to amounts on deposit or owed by the decedent as of the date of death.Such letters must be signed by a responsible officer of the financial institution or mortgage holder and indicate clearly amounts of principal and interest in the decedent's account at the date of death and the type of account,account number and the exact name or names in which the account is registered. ~----_.._..~._------------------------------------., Jointly Held Property Estimated I,.ValuE\''---......., None , - -. ..-.-.,._..._.~-""",,....._~..•,.'. Transfers within TWO YEARS Prior to Death None That at the time of death there was no safe deposit box registered ih decedent's individual name,or jointly with,or as agent or deputy of another,or in decedent's individual name,with right of access by another as agent or deputy,with the exception of the following:- NAME AND ADDRESS OF BANK OR OTHER INSTITUTION THIS SAFE DEPOSIT BOX RENTED RELATIONSHIP OF JOINT IN WHICH DECEDENT RENTED A SAFE DEPOSIT BOX IN NAME OR NAMES OF HOLDERS TO DECEDENT Not applicable BENEFICIARIES BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED AGE OF LIFE (If step-children or DECEDENT TENANTS OR INTEREST OF (State full names of all and their addresses who have illegitimate children STATE YES ANNUITANTS BENEFICIARY an interest,vested,contingent orotherwise,in estate.)are involved,set OR NO AT DEATH OF IN ESTATE forth this fact.)DECEDENT Alex A.DuBart Father Yes Vested 101 lit:>lt:>n c --",- R~nr1p.vvi11~....o. - Eli zabeth A.nllR::lrr M,..+-'J...""...Yes l7........+-.....A 0103 Helen Street Bent1ey-yi11e,Penna. r • REstDENT DECEDENT DEBTS AND DEDUCTIONS CLAIMED ,,-'------------------------------------'."--'--~~---------------- NOTE:List first five items in the spaces so provided,observe notations thereon,and instructions. DEBT OR CLAIM NATURE OF SAME AMOUNT THIS COLUMN ltEGISTER ONLY Kenneth v.....,n Funeral expenses paid $1_495.60 $ Family exemption (will not be allowed unless decedent died residing with a spouse or children.) Administration Expenses * Counsel fees * Fiduciary commission * OTHER DEBTS AND CLAIMS (*)See Note below Russell Marino Taking out letters of administration (for purposes 10 .OC Administrator's Bond under Wrongful Death and .OCSurvivalActions)10 , I . I --- ~ Total 1,515.~O ·103··Helen·Stree·t···········;······..·..(Street Number) .~~~~~.~~~~.~~~..~.~~~~~. (City or Town am!State) Note:The estate agrees to advise the Register of Wills if the amount actually paid in settlement of any fee,commission or debt is greater or less than the estimated amount claimed and allowed. "~/~ Subscribed and sworn to before me this {':t:. . .::~..day of .~:une ,19.6.8...~~~m~~ ,CHARlEROI BOROUGH,WJ.SHINGTON COUNTY ""M(cOMM/SSloN E~E;BEdny19 1969.....":.,l '.. "H~~ing been duly ~~olil according to law,I do he~ertifY that the above a.ppraise.m,nt i,mad,in "nfm·~:ty With.law on.this ....................;..~-f...~ayOf ~~;:P ..'4P9~C;;r .//7 7...¥t:7'/~~d~,,;-;~<-'~.~~~'~~r"'" In the event that any future interest in this estate is transfened in possession 01'enjoyment c ateral heirs of the decedent after the expiration of any estate for life or for years,the Commonwealth hereby expressly reserves the right to appraise and assess transfer'inheri- tance taxes at the lawful collateral rate on any such future interest. REPORT OF THY~OF WILLS I,the undersigned duly elected Register of W.ills in and for./~q.......~~... .~.Q:-"''-'--....County,Pennsylvania,do respectfully report that I have allowed debts and.deductions in the amounts claimed by deponent xcept as to those items where a greater or lesser amount is set for#hinth,la "Iumn to th,doht in ,.id "h,~nl'ahov~whi,h great"06 ~,am~,~n"th,sum a:wed as a deduction. Dated:~..-./~..~C.,//(/..... .1.'~('~-;;};:9reL£.:9?:?F!f.~i.:~f::-:~.. ./Register of Wills ",! •~ Form No,RCC-62 (2-64) WillAdministration INo Year . IN THE \ MATTER OF THE APPRAISEMENT " OF THE ESTATE OF It-~-.........."'.....,:-.. ..P.a.Y;i..~.~.•..l;)~~?F.~. Deceased ..._.......'l ..~ Late of ..Bentl~)lVill~.).f.ct.,. .--..r--'" County of ....W~~.~ington..................... r--f -~I .!o ~: ......- o~"'1~:t.~=<':0r-z'0v; ~Commonwealth of Pennsylvania '--' ~.c..8~:~ -U)-•' REPQiRT AND AI*RAISALtTl_~- -..I ~r-..;~'--~ .;;.. LSi Hennan J.Bigi,Esq • .323 Fallowfield Ave. Charleroi,Penna." 1,5022 ..:C('j;~q~(6-64) COWONWEALTH OF PFNN~YLV,\NI:\. TRAN~FER INHERITANCE TAX ~~SIDENT DECEDENT DUBART,DAVID A. FILE #63-68-734 September 8,1967 SUMMARY ~&ApPRAIS R FILE #63-68-734 ImpORT OF INHERITANCE TAX L\PPRAISEH I.the undersigned duly appointed Inheritance Tax Appraiser in and for the County of #63 Washington ,Pennsylvania,do respectfully report that I haVe appraised the real and personal property as reported in the foregoing return at the values set forth opposite each item in the last column to the right in Schedules "A"~"B"',"c"and "E". Dated:06-25-68 ;{/;.4/d-<:/~ 0~-08-67 REPORT OF THE REGISTER OF WILLS I,the undersigned duly elected Register of Wills in and for Washington County,Pennsylvania,do respectfully report that I have allowed deductions in the amounts claimed b;y deponent,~xcept as to those items where a greater or lesser amount is set forth in the last column to the right in Schedule "F",which greater or lesser amount represents the sum allowed as a deduction./J../iL ~1/.7~~\ Dated:06-25-68 /kt/.'k2.//Y ~~~·t"1'-1r:(:;;. REGISTER OF WILLS VALUE AS REPORTED VALUE AS APPRAISED VALUE AS RE"L\PPRAISED $.-$$------ 1~495.80 1.495..80 1; ESTATE INSOLVENT----- 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 (SCHEDUL E F) CLEA....J:l VALUE OF ESTATE 1.495.80 1~5l5.80==::tf.~~~=.~._ ___-=1::L,4:::::..!95-.80 =====1~~5s1?.80 ======:= Valuation of life estates or annuities .•.•....$----- ESTATE TAX ASSESSAffiNTS $------ COMPUTATION OF TAXFORUSEOFREGISTERONLY Tax on $•__5%$_ Tax on !l:10'%~ y '.-~.'"'."m,.-------Tax on *________~;l) Tax on $.__lFl%$_ 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. 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 $ FOR USE OF REGISTER QNLY 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. i --- Will { Administration \No..... DJ THE Year :\IATTER OF THE APPRAISEl\1ENT OF THE ESTATE OF DAVID A.DUBART Deceased Late of ....)3E:N.I'J:.JgVILLE ~ County of WASHINGTON Commonwealth of Pennsylvania REPORT AND APPRAISAL f :.. ,