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Home My WebLink AboutOC1968-1378 - ESTATE OF ROTHKOPFQInmmnnmraltl1 of Jrritt.6yluania.~!i!i. lIa!i4ittgtott <!LOUttty,) ,J 1 II,Jasephine M.Douglas ,Register for the Probate'of Wills and Granting Letters of Administration in,and for the County of Washington,in the Commp6wealth of Pennsylvania, // to Jerome ·Rothkopf administr ator ./ of all and singular the goods and chattels,rights,.and credits,which were of Lois PesiA Rothkopf late of Washington County,deceased, GREETING: in the county aforesaid,lately died intestate WHEREAS,the said Washington,Penna. Lois POI3i.n Rothkopf late of (as is affirmed),possessed of divers goods and chattels,rights and credits,within the ~aid County, JOSEPHINE M.DOUGLAS by reason whereof the power of granting administratipn thereof doth belong to me;I therefore,confiding in your fidelity,do by these presents grant unto you these LETTERS OF ADMINISTRATION,here- by committing unto you full power to administer the goods and chattels,rights and credits,.which were of said deceased within this Commonwealth,you having taken and subscribed the oath of office pre- scribed by law;requiring you to well and truly administer the goods and chattels,rights and credits, which were of said deceased,and to exhibit a true and perfect inventory thereof.into the Register's office,at Washington,within.ninety days,and to render a just and true account of your administration at the expiration of six months'from the date hereof,and to regard and comply with the provisions of the laws relating to inheritance taxes. IN TESTIMONY WHEREOF,I have'hereunto set my hand and caused the seal of said Office to be affixed this 11th _.day of 'OctC;;ber''-....-'in 'the year'on{ur L'ord one thousand' nine hundred and Sixty-six. ~-C·-~••"..-~_.,'"If'''~••~-,- ',.~.. .,., ;.".. ·1 STATE OF PENNSYLVANIA, W,ASHINGTON COUNTY, The within named Accountant being duly sworn acco.rding to law,depose and say that the above account as stated is true and correct as _~~__.....verily believe. .Sworn and.subscribed before me this .....??.-._~_.. ,.~~.errdayof...__..__'__..19 ___ .-~d~...........:,,:_-_-----------.. _0 ROWE~E EBELING NOTARY PUBLIC . MY COMMISSION EXPIRES FEB.,8 1969"..:.', .WASHINGTON,W~.SHINGTON COUNTY IWSC;r.UI'l 'RnFr;ls~T">n '!i "INO..J.C,n Of WILLS .:-~ I do certify that I have given legal notice to all persons concerned of the filing of the w.ithin account in the manner prescribe~by Statute an~Rule of (ourh~?idence by proofs thereof ~lIed to No.--/L'ldd..rg-.lz.,...-..--....... Witness my hand and official seal thiS~C ,__...... dayOf.~~----.---.:-_l~· ...~'-~."...' Re:ster Of Wills ~::::J rn L,~~~.(,iJ i;~~.~ o -':..11 0 :.,,.._~=-o r<;--().=;;;:;r'~o'II.=<l)':0~~:;d '1~ar.~:r~ B ~~~.~~~:\~~'t:S ..-.'Q):_01 Q)r-c-,0:):c.-.d U),:.>.I ~.i.·il:lo':.~!j.}l9:>;:.<1:i :~.::l ;Ii:1;i '~41 i~~ !\,. Washington County,ss: J. II ~,., .'."'~ .,..".. / .~~~\ .-.~_~~_~~......_..c::-..~."'-.---=~~~-~~"""--- \/1 ' ..."., ...~t>. THE WASHINGTON REPORTER WASHINGTON,PENNSYLVANIA PROOF OF PUBLICATION In compliance with the Newspaper Advertising Act of 16 May,1929,P.L.1784,Paragraph 3,Sub-paragraph 25,as amended. Commonwealth of Pennsylvania,County of Washington,SS:. Personally appeared before me,a Notary Public in and for said County and State,gi~h~!.4.~..!~.~~.~P.-,who being duly sworn according to law,deposes and says that he is the...Se.~..~.y'.•....~....rr.~.~.#i. of the Observer Publishing Company,a Pennsylvania corporation,and itB agent in this behalf;that the Baid Company is the owner and publisher of the Washington Reporter,established August 15,1808,a daily newspaper of general ciruclation,printed and pUblished and having its place of businesB at WaBhington,Washington County,Pennsylvania,where it has been established and publiBhed continuously for more than Bix montb,B prior to the publication of the notice hereto attached;that the printed notice or advertiBement hereto attached iB a copy of an official advertisement,official notice,legal notice or legal advertisement..exactly as printed or publiBhed in the Washington Reporter in its regular iBsue 9r iBsueB on the following date or dates;De.c.embe.r 16.,2.3..:..~.n9 3..Q.,.J.9.Q.9.. ............................................................................................................................. -that neither the affiant nor the Observer Publishing Company iB intereBted ...,<..'in the Bubject matter of said notice or advertising and that all of the allega. ....."tionB of this affidavit aB to the time,place and character 0Cfpublication ......are true./,fJ \/_11.;4 {;I.'-./vk~~'·0--:. Sworn to and Bubscri~~d);'reme this..30....day of..P.e.~.~m..p.~.~...J..966MZ1~~~;~~ WASHINGTON,WASHINGTON COUNTY \MY COMMISSION EXPIRES MAY 6,1968 ADMINISTRATOR'S NOTICE Estate of LOIS POSIN ROTH·,KOPF,deceased,late of Washing· ton Washington 'County,Pa.Letters .of Administration upon '" the above estate having been grant·,ed the undersigned,notice is hereby , given to those indebted thereto to ..-make immediate payment and to '.(.Jthosehavingclaimsordemandsto present them for settlement.JEROME ROTHKOPF 63 Acre DriveWashington,Pa..Bloom,Bloom,Rosenberg and Bloom,Attorneys200WashingtonTrust Bldg., Washington,Penna.27992·Fri·3t -- ------------------------------~----------------------------------...... Washington County Reports:: WashingtoD,Pennsylvania (PUBLISHED BY WASHINGTON COUNTY BAR ASSOCIATION) .c.. Estate Notices The Register of Wills has granted letters, testamentary or of administra'tion,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. • • • • • • • • • • • • 0 •••• PROOF.OF PUBLICATION In compliance with the Newspaper Advertising Act of May 16,1929,P.L. 1784 Sec.3,paragraphs (3)and (25). COUNTY OF WASHINGTON) STATE OF PENNSYLVANIA (SS. Personally appeared before me,a Notary Public in and for said County and Commonwealth,CHARLES C.KELLER,who,being duly sworn,deposes and says:that he is the Editor of the WASHINGTON COUNTY REPORTS,the official legal periodical for said Washington County,publis'hed weekly having its place of business at Washington,Washington County,Pennsylvania,and is act- ing as its agent in t'his behalf;that the said WASHINGTON COL'NTY i 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 oi 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: ROTHKOPF,LOIS'POSrn;l!-Dec'd. Late of Washington,WashingtonCounty,Penna.Administrator:Jerome Rothkopf,·63AcreDrive,Washington,Pa.Attorneys:Bloom, Bloom,RosenbergandBloom,200 Washington TrustBldg.,Washi~gton,Penna. ...;:;:q~.~.~~~.~.~._..~.~..L.~~.t.}.~~~. .......Janu.a.ry S.~l.9.9.1... ..................:·::·;:::·,····::·:·~"···Edi~~; Sworn to and su~;g!;~~:!£!~~~!!L --~'-,'\ that the affiant or the corporation in behalf of which he is acting is not interested in the subject mat of id notice or adv~~and that all of the allegations of this affidavit as 'me,plac and cha~.of t lca . e true. ........Sth day oL.January.,196..].. ......~~A~_!..rZ G.~~_ /N ary Public KATHERINE C.YARD,Notary ubllc ...Washington,Washington..,Pa. .My Commission ExpIres ttQ'(llffiUllf ",~~ FIRST and FI'NAL ACCOUNT of JEROME ROTHKOPF,Administrator of the Estate of LOIS POSIN ROTHKOPF, Deceased. Balance per Invenbory s:nd Appraisement \ - - - --$63,321.30 August 27,1967 August 27,1968 Annual installments due under said Agreement and secured by Judgment Note (Installment) dated 8/2/67 and paid during administration. Installment Installment 4,718.25 4,718.00 Balance due under terms of said Agreement and secured by Installment &udgment Note i.e.eight equal annual installments of $4,7l8.00·each.37,744.00 Gain on·sale of conversion of stock Total.assets of Estate - - 62,907.00 148.19 '63,469.49 Total cr~dits claimed by accountant-- - - - - - - - - -11,026.63 t- Balance for Distribution Advance Distribution: Mellon:National Bank -Guardian for Shauna Rothkopf Dr.Jerome Rothkopf -$52,442.86 ~ 7,000.00 7,000.00 ·~......~ The Accountant claims credit for the following: - --- -- -- - - - - --- --- - - - - --- --- --- Josephine M.Douglas. Observer Publishing Co. washington Co.Reports Triangle Oetho.Assoc. Allegheny General Hosp. Joseph P.Concannon,M.D. Vernon B.Callomon,M.D. Kepner Funeral Home Jewish Memorial Park Jerome Rothkopf Ltrs.of Administration Advertising Advertising Professional Services 'Confinement Professional Service Professional Service Professional Service Rest 'and Marker Administrator's fees' 9.00 12.50 ,12.50 50.00 424.63 150.00 475.00 1,248.00 290.00 3,500.00 Bloom,Bloom,Rosenberg &B.Attorneys'fees 4,000.00 Russell Marino,Agent Russell Marino Russell Marino Russell Marino Jerome Rothkopf Part Prot.Inh.Tax Account Bal.on Ltrs.&Inventory 1 Short Certificate Reimbursement Med.Exp. 750.00 16.00 13.00 1.00 75.00 TOTAL ---- - - - - - -$11,206.63IX· ,/II D~"~ .....COPY OF INVENTORY Notar,P\\blic Jerome Rothkopf Lois Posin Rothkopf,. ,. t Lois Posln Rothkopf 'I December 67 I' 3Junrutnrg anb !\ppraisrmrttt of the goods and chattels,rights and credits which were .Lo1s Pos1n Rothkopf Washington,of :..late of ~. Washington County,Pa.,taken and made in conformity with the aboveaDidavit. DOLLARS CENTS REALTY: NONE PERSONALTY: 10 Sbares GENERAL DYNAMICS CONDtATION Common -Unit Value 41.43 134 Shares 01 CLASS A Stock 1n POSIN'S JBWlLBIl8.INC.Value established by agreement dated July of 1966 ." 414 30 aDd '} 166 Shares of CLASS B Stock 10POSIN'S J'BWBLBRS,INC.SUbject to an lDStall-. ment payment OV8~a 'periOd of lO~years Tal'AL " 62,907 00 $63,321 30 ,.r.~....- -,:. Estate of._-=L::...;O::...;I::...;S::....-.:;,.P-=O-=S-=I:.:;Nc:......;R:...;.O.:;,.T=H;.::,.K-=O-=P...;;FO'---..,.-1 In the .matter of the Audit of Account in J No.1378'~~____-,--__,19-.!e..lL;A.A. I TO THE ,AUDITING JUDGE: our Jerome Rothkop·f.,AdministratorEnter----:appearance for·__~~::...::::..::.:=__~:::....:::..:.:=::._J::::;:...L~~=::..:..:c=..::::....::~:=....:::=.:=--_ ~~~~. Bloom,Bloom,Rosenberg &Bloom /0 day Of D_e_c_e-'-mb__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. o L\, L__,-)""'-~ .......1..~ ~-._~ Ci\ ..->.. r..,<-1 ~~ o,--.-~ Cj t<Jt;.. m{~'-'jt",",--I :I'lO-!~::;--~ ~;:;:;,",.Zci =';-';~,5'l·.I.:::- u;(.,>(n--;-~~~-c:: No.1378 ,,19__,A.A. In re Audit of Account in Estate of LOIS POSIN ROTHKOPF AUDIT Jrarripr fnr i\ppruranrr FOR Jerome Rothkopf,Admi~istrator Attorney ~~2 I;, I' (Form where decedent died intestate) lIu t4r (@rp4au!l~.aIonrt of lIa54tugtnu;aIonuty j ESTATE OF No.1378 Term,19 ,A.A. LOIS POSIN ROTHKOPF In the audit of the first and final Account of Jerome Rothkopf,Admin. Deceased The petition of.:~~E.?~~~.?.~h.~gp~. (Name of Petitioner) respectfully represents:,. (a).The decedent died }\~g~.:?.t.~.§.f J.~.§§,intestate and (Date) letters of administration'on h.~.£estate were granted g.c:.~.~?~E ~.~.!}.~66 (Date) State (l)whether de- cedent was:married or unmarried;(2)if mar· ried,whether a husband or wife survived and his or her name;(3) whether or not there was any marriage settle- ment;(4)whether or not family ;elatioQ was maintained until deced- ent's death;and (5) whether the decedent left children or issue of deceased children. as per record thereof appeanng III Administration and Bond Book No .. at page . Decedent was survived by 'Jerome Rothkopf -Husban~ Shauna Rothkopf -Daughter (b)At the time of death,the decedent's domicile was :.:the Com- monwealth of Pennsylvania,to-wit,at~§}....A~.F..~....P..~.~.Y..~.!.....~~.~~.~.~9.:~.~~..~.....?a (Town or Township.State and Nation) and res idence was at......§}....~~E.~....P.E.~.Y.~.!.....~.~~?~~.9.!-.?.~.~......~~.f.l.~~.Y..~.y..~!2-.~.~.. (Town or Township.State and Nation) (c)The names of all persons having any interest as heirs or next of kin with the names of their deceased parents,to show relationship if they take by representation are as follows: NAMES Jerome Rothkopf Shauna R0thkopf Relationship Husband Daughter Interest Of age,sui- juris,or not, (write yes or no). Yes No Name of Guardian,Trustee or Committee,if any.or beneficiary,manner and place of rccord of appointment and is bound suffi- cient to cover and protect share. Mellon National Bank State exceptions.if any. giving names and dates of death and the names of their executors or administrators,or the names of-their issue as the same may be mater- ial. All of said parties III interest are living,'except No exception Describe type of notice.(d)All parties having any interest have had :notice of the filing of the account by letter. (e)Balance for distribution per Account (f)Additional debits,not shown by Account (Itemize) See attached sheet. (g)Additional credits,not shown by Account (Itemize) None $..5..?..c••4.~.~.~..~6 $..;h.!..~.?A·..~.§} $ . $..:?4.l..~§.?...~A-9 Insert word "not"where I (h)Claim for exemption has been made,and has E~9.:t;.been paid. necessary.. (i)The estate is subject to the payment of inheritance tax to the State of Pennsylvania. If taxable state w~eth-I .(j)The estate is ~g.:t;.subj ect to the payment of the county 4 millsertaxhasbeenpaId. tax. (k)The estate is ~?.~subject to the payment of Federal inheritance tax. If too many for the space,annex a list there- of;if no such claims, insert the word "none." .If any creditor or other claimant has not re- ceived actual notice,that fact must be stated. Indicate such claims as may be secured or en- titled to a preference, and give detailed infor- mation concerning such security or preference. Here insert a reference to all questions requir- ing adjudication,and a ~tatement of any mater- ial facts not already given.If none insert thewordIInone.tI If any share has been assigned or attached that fact should also be stated here. (1)All creditors (and other persons'who have complied with Rule II, Sec.9),of whose claims the accountant :notice or knowledge,have .....·.·:·..recei~ed actual notice'of this"~udit;the amount's of their claims and whether or not.they are admitted to be correct are as follows: (m) (n)The balance for distribution consists of property in kind,form and character,as follows: State kind,form and character of property composing the balance for distribution,and ifanypartthereofisnot cash,whether or Dottherehasbeen:any'elec- tion to take such part in kind. t\ r~:;.~:.:,.,...;-;;:,;-~~~-_~~-;=-_._~_..::._._..~.._ ~;"'." ~.:.!"-:;--~-;::;~- C' ITEMS ORIGINALLY TAKEN.AS CREDITS IN ACCOUNT (ASSUMED BY·HUSBAND AND NOW. CARRIED AS DEBITS Triangle Oetho~·A.ssoc. Allegheny General Hospital Joseph P.Concannon,M.D~ Vernon B~Callomon,M.D: Jerome Rothkopf Professional Services Confinement Professional Service Professional Service Reimbursement Med.Exp. 50.00 424.63 150..00 475.00 75.00 ·Jerome Rothkopf Partial repaYment on fees 750.00 TOTAL $1,924.63 .-,..~.., ; Are there any'advance- ments by decedent to be considererl on distribu- tion and has any distri- bution on account been "made by accountant to any distributtee? (p)Mellon National Bank,Guardian for,'Shauna Rothkopf ·$7,000.00 Je~ome Rothkopf -$7,000.00 (q)Give brief location of any real estate sold. None ,,, If prior accounts have heen filed.list number and term. (r)None Wherefore your petitioner asks that distribution of principal and income be awarded to"the persons thereunto entitled and suggests that the balance of principal and income should be awarded respectively as follows (shares being stated in proportions but not in amounts):- Mellon National Bank,Guardian of the Estate of Shauna Rothkopf,a minor,1/2 interest in balance due on judg- ment note plus 1/2 ~esidue Dr ..Jerome Rothkopf,1/2 interest in balance due on judgment ~ote plus 1/2 residue County of.Washington,ss. 'the above named petitioner being duly .~doth depose and say that the facts s~t forth in tge foregoing petition are true .to the best.of h..~....:....·knowledge and belief./!~6 and sub/~ribed before me this.~r~'/b~dayof...:: ,19..0.X . ./r"'-......y~!!:.!..::...:~..~. -._~..ROWENE ;~~~~~~~UBU~ M{COMMISSION EXPIRES FEB.81 1969 ·····.-··········_·················WASfiiNGTOK·WfiSHiTiGTfJli··{;g~i'l',l'·····················. And your petitioner will,etc., ...~7:.....•,9·~/..~..:.2.~.,"J'(Sign'atureof Petitioner) r~- '\~ .' ~, .'(FORM IN CASES OF INTESTACY 1378No ,Term,19 ,A.A.;'! IN THE ,,-" ORPHANS'COURT WASHINGTON COUNTY,PA. ~... I'; " i i: •/r Estate of LOIS POSIN ROTHKOPF Dlilceased. Sur ac~ount qf '!-~!.g~.~R.9.thJ59..P.~.,. ..........A.qm.i-.nl~.t.:r.g,..t.Q.;r;::. •<. PETITION SUR AUDIT '- In Conformity with Court Rule III, Sec.5 (B) COUNSEL FOR THE ACCOUNTANT WILL .: SUBMIT HEREWITH S~1"':~~·:'.:~J ~.'.~.~~~-~."J O:'::U\;~:,j OJ i;_';j~lj'j •I c:.\. , f -',0>. t .. ~[. ,"f.. ,", (I'\..~'.~':.'~ <il r-· 1II .~_G1 ~9 1.The letters of administration. 2.A copy of the inventory and appraisement. 3.Proof of advertisement of the grant of letters,. if not filed with accountant. 4.An appearance for those represented.. 5.Inheritance tax receipts,if any. 6.Certificate of liens in case any of the funds for distribution are derived from the sale of real estate. 7.Copy of Federal Estate tax return,if estate is subject thereto. 8.Signed elections to take in kind,if any. ...<?~.?~..4.~.!."!...!4~.~.....~.~~ .::,......Attorney for Accountant. l![1 f fjI, i', L;--~'. I ~n t4r (@rpqans'Olnurt of lIusl1ington <trnunty In the matter of the.~.:.E1r.§L~mLF.t.r)JM . Account of ~§x.9.m~..E.QthkQ1ii.l.. Administrator ESTATE OF ...:..~~.~~..~~~~~..~.~~.I::~~P.~!. .Deceased. No..1.:?7.§....Of 19...9.8.....,A.A. $.52.,.442.~.8BBcildnceperaccount,",. SCHEDULE OF DISTRIBUTION ADJUDICATIO~NDDECREE And now !.~.1?~~~~y.,19..9..~..,this matter .came on for hearing, audit and distribution at this session and testimon taken;and thereupon,upon due consideration the~.ff tg7b.f9ance for distribution in the hands of the Accountant is determined to be $..l.$!and the account is accordingly confirmed;and it is ordered, adjudged and decreed that the said balance be paid out by the Accountant in a~cordance wi1th .the schedule of distribution hereto attached and made a part hereof,unless exceptions hereto be flied sec.reg.or an appeal be taken herefrom sec.leg.., - Additional debit -asked at audit ·1924.63 Balance . Deduct Clerk's Costs &Receipts ,. Attorney J?t99.~.J..J?JQQ.:rr!.1~BQ.9.~DR.~:r.g ..&..:s.l9.Qill . Russell Marino"Agent,transfer inheritance tax,$309.83 Interest from 11-26-67 to 2-16-69 22.70 ~Mellon National Bank and Trust Company,Guardian of th estate of Shauna Rothkopf,a daughter,a minor,1/2 balance,including cash and an undivided 1/2 interest in agreement dated July 1,1966 providing a'formula in-stoc value and secured by an installment judgment note dated 8-2-67;held in kind and distributed as such at the value of $37744.00 (full interest),credit to be taken by the accountant for funds advanced in the amount of $7000.00 advanced prior to distribution by the Court,26990.98 Jerome Rothkopf,husband,1/2 balance,including cash and an undivided 1/2 interest in agreement dated 7 -1-66 providing a formula in stock valuation and secured by an· installment judgment note dated 8-2-67;held in kind and distributed as such at the value of $37744.00 (full interest, credit to be taken by the accountant for funds in the amou t of $7000.00,advanced prior to distribution by-the Court,26990.98 No balapce ,~~" ,~'~,,' \ ,.:'\-'.~.". en...... --/.: k:'·-:': ....4... .1 J \ \1 J ..J J .) .W .\ o-W6....IIIo- j J l, I\J _,.) 0n :J Z n0 ....9 c :::r :J III -+30-0....nr.., 0 0-....-:::r III J .'J l j .::.,,....../ \ j >_..--- .'., Form RCc-33 RESIDENT DECEDENT COMMONWEALTH OF''PENNSYLVANIA' DEPART~ENT OF REVENUE BUREAU OF COUNTY COLLECTIONS COUNTY OF w.~.E3,~~~g.~~.~. IMPORTANT:This return mus t 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~.Inl)eritllnce..lln!i .E.~t!lte .T8JC A,ct of 1~91.) IN THE MATTER OF THE'ESTATE OF } LOIS POSIN ROTHKOPF ..,AFFiDAVIT OF ..........................··································i·s:t;;t~··f~ii··~;;;~···~i ·d·;~~~t·)·..·..· : · · ·EXECUTOR Washins:rton .ADMINISTRATORLateof0County-----....;;.... State of p.e.n.ns;.Ylv.ani.a ·,} .,..ss: County of Was.hi.ng.ton . Jerome Rothkopf Eucutor of the estate of the above-named decedent being duly sworn,depose Decedent'dJed :A.~g.~l.?~?§..J . (Month) and say ......................................19....9.9.........rtestat'e 'leaving a last'will,copy of which is hereto attached.} (Ilay)•(Y~ar)L~e . L othe:aamuet:::i::;r:::r:fse:ttt::~::::}··..·~rici?~~..h~·~C!·C?mt ~.~.~.~.I.:1.~.~.!.~~~~.~.~m .. whom all correspondence should be...Wa 1ngt0I:l Trus~J3.~.~.~.fi:i.i.l.lg .. mailed.Washington,Pennsylvania That as such @.9.m.~~j,...§.tJ.:a:t.9J(leponent'is famiIiarwith th~affairs of said estate and the property con- ,(I·;x""uwr·'Admini.lmwr)..~ Rtituting 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 indecedent'·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 That the ~onten~s 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 Schedu/~A attached h,ereto and made part hereof.sets forth fullv and in"detail 8,11 the real property in the Commonweal th of Pennsylvania of which decedent ~ed haVing an interest therein.It also sets forth the mor.tgage 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 deafh of decedent•. That Schedu~e 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 .banks,trust companies,or other ins.tituttons,whether individually,or in truiSt for any other person or persons giving also separately the accrued interest thereon,if any,do~to the last -4."...,.•~interest day prior ~~decedent's death in the case of savings banks,and to the date ~r ~ecedent's death in all other cases;all bonds,postal saVings,treasury certificates or notes and .other evidence of in- debtedness of the United States to the decedent;all obligations,whether by st~tute or agreement they are designated as tax free,of the Uni ted States,or any state,or political subqivision thereof,or of nny rorei~country,which are owned at the time of death;all wearing apparel,jewe!ry;.silverware,pic- tures,lJooks,works of art,household furniture,horses,carriages,automobiles,b9ats,and~any and all other personal chattels of Whatsoever kind or nature,left by decedent,together with'·t!te fairly 'estimated market value thereof';all bondS and mortga~es held by decedent and of all claims due 'and"o.w.ing decedent' dt the time of death,and all promissory notes or other instruments in writing for the payment of money of wlli.ch decedent flied possessed,of whatsoever nature,With interest thereon,if any,giving the face value tJ.nrt 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 ",oneys payable to the estate from 'life insurance polici'es carried by decedent;all annuity and endowment contracts the proceeds of which were payabl~upon the death of the decedent;and all the corporate stocks and dividends. due thereon and unpaio 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 substantlated by financial statements of the corporations,showing the assets and liabilities thereof as of the'date of death.The schedule also sets forth the interest of decedent at the time of death in any co-partnership or business,and in support of the value of such interest there is annexed to said schedule,financial statements showing the assets and liabilities of said co-partnership or business. A copy of the .co-partnership agreement,(if oral,a statement setting forth the nature of the agreement) together with a statement setting forth the character of the business,its location,and such other facts pertaining to the business as may be pertinent to a fair and just appraisal of the decedent's interest therein must be submitted.·It should also set forth in itemized form,together with the .fair market~valjJ,e.,'. thereof,any other property owned or bequeathed by the decedent at the time of death. The Schedule C attached hereto'arin made part hereof sets forth a true answer '~J;ea'cfi 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 o~enjoyment at or after death,said schedule sets forth the nature and value of such property,to whom,transferred,the relationship of the transferees to the decedent,the proportionate share received by.'each transfe~ee and all other facts of a pertinent nature regarding said transfers.In the case~of transfers intended to take effect in possession or enjoyment at or after death,there is also attached ~o the schedule a~~~y.- of the deed,trust agreement or other instrument creating the trust.Ther,~is also set forth -fn--~faIa~ schedule a list of all property,real and personal,with its value,which pa$.'ses at decedent's death by virtue of the exercise by decedent,either individufrrly,orjointly with another,or any power of appoint- ment vested in decedent,eithe·r individually 'or-':joi~tly),!"b'ythEt :w;i;J;.l,deed,or other instrument of another, with a copy of the instrument t?:,~~.t:~!1g.s.uc.!t~~)\,:er ~~!-~che.~.t~;the"~c~edule. ....;-..~t '..0""\That Schedule 0 attached her'et~~and'm'ade'pa'r't'h'ereof sets 'forth the names and addresses of all persons beneficially interested in this estate at the time of decedent's,.death,.the.nature .of their res- pective interests,their relationship,if any,to the decedent,together with the ages at the time of decedent's death of all minors,annuitants and beneficiaries for life under decedent's Will.It also contains a statement shoWing which of the beneficiaries named in the decedent's will,if any,died prior to decedent,the dates of their death,their issue,andthe relationship of such issue to the beneficiary. That Schedule E attached hereto .and made a part hereof sets forth all prop~rty,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 r.ecord of instruments effecting the vestiture of real estate and the d~te 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 ann unpain at time (If death;taxes accru~d charge.able for period prior to decedent's neath.(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","~","C","E",and "F"as directed therein,. have been carried forward and properly registered in the Summary. (Street Number) (City or Town and State) ~.~'~3~.~.~~.........._...··..r7E~~~tor-Admin·ator)......................................................19··..~1.. I Subscribed and sworn to before me this ~..t!::..................f ·.'dayof""'r'"'oil.j .. ~.......................................................... ESTHER E.WAUGH,NOTARY PUBLI My Commission Expires March 23,1970 Wasllington,Pa,W~shinAton ()Q\I~t)'/,",,.".,'~~ NOTE:Before signing affidavit make sure all blank spaces in the affidavit and schedules annexed are filled in with details or the word "None",ann in case the assets include rare and unlisten 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 Schenule "B"are attached.Also make certain'that column #1 in the "Summary"has been properly completed as above-directed. RCC-34 (1-64)COM¥O~EALTH OF PENNSYLVANIA D.EPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "A" ·REAL PROPERTY .'~~ Real property in Pehrisy.lvania,with statement of mortgage encumbrances upon each parcel at death of dece- dent.Where property heid as joint tenant or tenancy by entireties,report on Schedule liE".Property held by the .de.cedent·as tenant in common with another or others,should .be identified as to quantum of interest and the estimated value should be that of the decedent's interest only. The real property located In the Cammo!"wealth af Pennsylvania shauld be (1)(2)(3)/described by lot and block number,street and street number,together with DEPARTMENTageneraldescriptionoftheproperty,with a reference to the record of the ASSESSED VALUE VALUATION conveyance by which the decedent took title;If a farm state number of 0-FOR YEAR OF ESTIMA TED CAUTIONcres;also statement of mortgage encum~rances upon each parcel .at death DECEDENT'S MARKET VALUE (Do not writeofdecedent.Taxes,assessments,accrued·interest on mortgages,etc.,are DEATH In this space)to be listed on Schedule "F"and must not be deducted from this schedule. NONE .,. .. ~.-, '. , Insert this total opposi te.lIreal property",Schedule"A"in the X X X X X liAs Reported"column on the last page of this return. RCC-35 ~O~ONWEALTH 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 ~enta tive trust accounts,..must be listed,despite the fact that they are not of the administered estate. Tangible ,personal property should be listed fir~t (e.g.jewelry,wearing apparel,household goods,and furnishings,books,paintings,automobil'es,boats,etc.)I Intangible personal property,such as bonds,treasury certificates,cash on hand and in bank,'I.'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..... ITEM List and describe fully UNIT VALUE ESTIMATED ,DEPARTMENT VALUATION MARkET VALUE (Do not write in this space) and t(t,Shares GENERAL DYNAMICS CORPORATION Common -Unit Value 41.43 134 Shares of Class A.Stock in PQsin's Jewelers,Inc.Value established by .D '" agreement dated July of 1966 IO~f~)O~~ 166 Shares of Class B.Stock in Posin's Jewelers;Inc.Subkect to aninstall~ ment payment over a period of 10 years 414.30 0/< 62,907.00 Insert this total opposite "Personal Property",Schedule "B"in the "As Reported"column on the last page of this return. x X $63,321.30 RCC-36 • .1. .CO\!\lO\T?\LTII OF PF:-INSYL\i.~NIA. Tll\N~FEH INHEl\ITANCE TAX 11I<:SIDE:\T DECEDENT SCHEDULE "c" TRA~SFEnS (1)Diet etecedent,within two years ofeteath,make any transfer of any material part of his estate,without receiving a valuable and adequate consideration therefor?(Answer yes or no)DO (2)Did decedent,within two years'of death,transfer property from himself to himself and another or others (inclueting a spouse)in joint ownership?(Answer yes or no)DO (3)If the answer to (1).or (2)above is in the affirmative state: (a)Age '01'decedent at time of transfer _ (b)State of decedent's heal th 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 i.n possession or enjoyment at or after his death?' (Answer yes or no)DO . \ (a)Was there any possibility that the property transferred might return to transferer o'r his estate or be subject to his power of disposition?(Answer yes or no)DO (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 uneter 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 etesignate the persons who shall possess or enjoy the property.transferred or income therefrom?(Answer yes or no)DO (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 rlecedent in his lifetime make a transfer,the consideration for which was transferee's prolnise 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 c01l1d revert to etecedent under terms of transfer or by operation of law?(Answer yes or no)__~D~O~_ (9)If the answer to (8)above is in the affirmative,was the power to alter,amend,or revoke the j,ilter- est of the beneficiary .reserved·in th~,decedent alone or the decedent and others? (Answer yes gr no)DO NOTE 1:The ans'wers to these questions should be supporteil by affidavit by the attending physician as well as a copy of the death certificate. NOTE 2:If answer to any of the above qu~stions 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 transferred,with relationship of transferees to ilecedent,if any.Submit copy of any trust deed or instrument,if trans- fers are claimeet 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 iI!,,,, ~IiIIIi I DESCRIPTION MARKET VALUE (EsUmated)DEPT.VALUATION (Dept.'(lnly) ":: Insert thls tnt,:t.l 0i'flt)slte "Transfers",Schedule "C"in the "As Reported"column on the last page of this return. .;...•-,'.~.'~•:.·....1' COMMONWEALTH OF PENNSYLVAt~IA rHI\NSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "E" JOINTLY OWNED 'PROPERTY .' IiiSTRFCTIOr;s:This schedule must d.isclose all property,real and personal,owned by the decedent jointly with another or others,including intangibles,standing in the name of the decedent and others.L~st real estate first,as entireties,or joint tenants,giving brief description,as indicated under S~hedule "A",plus the date and place of record of instrument effecting vestiture,but do not include entireties or out of state real estate value in estate valuation column.Personal property should be listed'as in Schedule "B",plus date of acquisition,and the name,address and relationship (if any)of co-owners to the decedent. Description of Property,Date of Acquisition,Name Iunit' Address and Relationship of Co-Owners,and Place Value of Record of Instrument,where Real Estate.I NONE percentage Share Estate Valuation DEPARTMENT VALUATION CAUTION-Do not Write In This Space. Value of Value of Entire Decedent's Property Interest ., --------------_..._-------:-----'------'----_.........--,.----+------+------ Insert this total opposite "Jointly Owned Property",Schedule ,"E" in the "As Reported"column on the last page of this·return. .,.-~ ~: RCC-37 (12-63) nnnll):,\WEAI.T11 OF PE:,\:,\SYYl.:\NIA TRANSFER I~IIERITA~CE TAX RESIDENT DEL'EDENT SCHEDULE "D" BENEFICIARIES ,,~"'..--~-.....~..I RELATIONSHIPBENEFICIARIESANDADDRESSES(If step-children or SURVIVED 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 .Jerome,-R~thkopf husband ves one half....-'-f ._'to ...\A\Shauna Rothkopf daughter yes one half ,... ... -"','j .) " •, (-.,-- ~\1..~"...-,"f- iiJ ~.......-..........,, I'~ \ -h Deponent further says that all the above-named beneficiaries are liVing at this time except below: NAME DATE OF DEATH RESIDENCE J ~IATTER OF THE APPRAISEMENT OF THE ESTATE OF (Executor-Administrator must complete "As Reported"column #1.) ..,l''''tl ::0 ....(l)(l)~....~::l VI _ VI 0-..o::l "'tl(l)~........- 0 '"'t:l"'tl (l).........g ~ (l).......'<~: a(3VI~VI·,'-;...." ~x·~0-ro: .'trlVI...~...(l) Year . Dl THE (No .Will Administration LOlS POSIN ROTHKOPF Deceased Washington Late of ..fe County of .Wasb1ngtQQ.... Commonwealth of Pennsylvania REPORT AND APPRAISAL " V)c:~~»-::0Vlv)Vl~ ()()() ?"'?'"?'"n c5 ;;:::: ."»- · I "'.·I:~:J;.g::: :'1 o~I.::+ ·..-(1:c.. ~ (n ~ !io t.) l".....-. ~ ~-fh~ ~: ~t :t: ~-~ 0') t.)..~~•(.,)e I.~: "'1.' ....j:.." c ~-.~~-.~.~~~~., :.~.;"'.'" '-~: :::\~ >-:~.....~.,:~~~~ ~.~ .~ c: ""---.-- :C'..:»-:~'.:~~~:I tJ:~:1 ~____: : 1 ~Iv:·1 ...~o.1 3:~:::.:ci.:r..""\J'c- :~: ~. .. ~' 'f) /.", .'COMMONWEAL.TH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OP COUNTY COLLECTIONS INHERITANCE TAX DIVISION NOTICE OF FILING OF APPRA!SEMENT JEROME ROTHKOPK (~Administrator)' IN YOUR R!P~Y P~IA'I IU"1I1'l 'to 36-239-6 j In Re:Estate of L=-o:...:I:...:s~,P...:..O.:..S=IN:.:.....:R.::O:..:T;.:.:H::.:K~O::..;PF:...·",--_ ____---:W~AS=H.:IN~G:::.:T~O~N:..._..County -File No.9))8-75 De ar Mr.Rothkopf: You are hereby notified that the original appraisement in ,the estate of Lois Posin RotbkQ~f has been filed in the office of the Register of Wills qf Washington County on December 12 ,19-62.Said appraisement reflects the following valuations: Real Estate'..,...-_ Personal Property ~6~3~,~3~2=1~.3~O~__ Transfers -------"7"='"~~__:_--- Total __~....,......~6~3~'..L3~21=-'i!.....3L.::O~'__ As to such tax that is paid within ~hree death,a five (5%)percent discount is allowable. remains unpaid after one year from date of death, of six (6%)percent per annum is charged. months ,from date of As to any tax that interest at the rate Any party in interest who is aggrieved by an appraisement may appeal therefrom as provided,by law. Dat e __..JDwe"'-l·c.-.se;amw.h.ue;ur.:........JJJ,2:..,,----l.J...:jI9u:;:64-7----Signed -t::/£a:1 £.o/-P Title .W.R.CHANEY,EF APPRAISER DATE OF DEATH:August 26,1966 Note:This is not a bill. .... COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT ~CC-39 (6-67) .~._.-....~ f.----r" ROTHKOPF,LOIS ROSIN FILE #9338-75 August 26;1966 SUMMARY Ij'lI/~co ,~'.'..' .'-..•.,,' .~.~.• I~the undersigned #63 Washington FILE #9338-75 the real and personal opposite each item in It.EPOH'1'OF INHERITANCE TAX APPRAISER duly appointed Inheritance Tax AppFaiser in and for the County of ,Pennsylvania,do respectfully r~port that t~have ~ppraised 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". Dated:12-12-67 08-26-66 REPoaT OF THE REGISTER OF WILLS I,the ,undersigned duly elected Register of Wills in and for _, CountJ',Pennsylvania,do respectfUlly report that I have allowed deductions in the amounts claimed bJI deponent,except as to those items where a greater o'r lesser amount is set'forth '~'Ioiin the last column to the right in Schedule "F",which greater or lesser amount represents the sum allowed as a deduction. Da ted: REGISTeR OF WILLS VALUE AS REPORTED VALUE AS APPRAISED V~A=L=U""E~'-",A""S_~RE"",'AP~P~RA=I"",S,,=,E~D 5;$._*_ 63,,3ll.30_63,321.30_"-'--_ 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..~VALUE OF ESTATE 63,321.30_ ======.- 63,321.30_'_ =====.-======:= ,'\ Valuation of life estates or annui ties . . . . • . . .$_ ESTATE T.~X ASSESS~mNTS $_ COMPUTATION OF TAX TOTAL TAX BALANCE PAID ~-------- $---'------- *-------- *--------$-------$ (,:,)As evidenced by Charitable'Exemption Certificates issued by the Secretary of Revenue. $=====1= *"'------ ~)------- $-----'".~======..=$------ 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 0%from to AMOUNT OF ESTATE TAX ASSESSED Estate tax paid BALANCE DUE Add interest at rate of 6%from to FOR USE OF REGISTER ONLY Tax on $•5~%$_ T,ax on ~10%~~·.-~o "'.,------T ax on ~________s.-..::.:Y;l) T ax on $.lFi%$_ Exemptions :=(,:,) Total Estate __ FOR USE OF REGISTER ONLY ,ADJUST~mNTS 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 Administration (No Year D<THE ':1 ~IATTER OF THE APPRAISEMENT OF THE ESTATE OF LOIS POSIN ROTHKOPF Deceased Late of ..Wi\.$H:J;NG.'l'ON . County of .....WAS.BlWG'r.ON \f' l~(£ Commonwealth of Pennsylvania REPORT AND APPRAISAL .........-.---- ,. , DEPARTMENT 'OF REVENUE.. BUREAU OF COUNTY COLLECTIONS HARRISBURG.PENNA.17127 Fo"!,.f1cC-2'·., COMMONWEALTH OF PENNSYLVANIA RESIDENT INHERITANCE TAX APPRAISEMENT DATE D.e.~emb.e.r.~..l2.,.l9.6.7 . COUmy :~W~.§.h~ngt...9.P..l FILE NO...9.3..3..?::.7.5._. Washington1tfRtbkpipLWhereas,..........................................Q1.s......o.sJ.n.....0..O..............................................a eo........................................................................................................... in the C~unty of .........................................W.~.~h.:4?:g:~9..11 ...................·.........:...............................Commonwealth of Pennsylvania,having died on the ................................26....th.............................................day of ......................A.ugus.t...................................19......6.q seized and possessed of an estate subject to Inheritance Tax under the la",s of the Commonwealth of Pennsylvania; Therefore,I,........................................W.~.R.~.....C.haney.......................................................,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 I 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. 1 Appraisement , UnitDescriptionofAssetValues Made for Inheritance ITaxPurpoles I $ REALTY: NONE NONE IE RSONALTY : As oer 50bedlh1ed!B~.!,filed 61.121 10 - TRANSFERS: '... NONE NONE JT.HELD:, NONE .'NONE. 1 I '.. -. ," Total ;::'~3,32l 30 -. ", I ,.-, ;,I " ",;", I-.'! 0'r l'~ f Having been duly sworn according law,I do hereby ce)t~that th above appraisement is made in co.'",-~ ,.._..WA.$H.IN.G.l.'QN..,..Coutliy . .:-\(~.~F'~- "w T INHERITANCE TAX APPRAISEMENT .Estate of ......................LO.IS P.OS.IN RO.THKOPF . Deceased. Late of ........................................WAS.HIIDT.ON . Date of Death,.A:ug:U:;lt Z6."~96.6 . Appraisenle/!t Docket Vol.,3.6 .. Page,Z3.9~.6 No 93.3.8"'7.5 ·· Filed in Register's OfJi.ce,P~G..~..:..J,,~.~J9 6.7. Amount of tax due,$.. DEPARTMENT OF REVENUE Received, Exa.mined and Approved,.. Wrote abo.l/t A ppra.isement,. Appeal f,.om Appraisement,. Entered and charged,.. 'j ~.. '....>') r.~ I;j ~ !,'~!"'1-......_;, ,"..i 19 t ~,.' -':'J~'.' ,• :,.... .. .1 ROWEN EBELING NOTARY PUBLIG MY COMMISSION EXPIRES FEB.8,UlGO WASHINGTON,WASHINGTON COLJ.NTY Form RC C·10 DEDUCTIONS ALLOWED IN /~i.t....-1rtJ .. THE SUM OF ".."""".$/~rQc?,.f:~~:,1 OFFICE OF THE STATEMENT OFr"DEBTS" .I'I.EGISTER OF WILLS ."....r~ ,Washington AND DEDUCTIONS D~~~~P~:;~,~~.. l-)'-'rqFCOUNTY....~......................................... ~E,NIr°f;~C~~M;;:-LTH qJ~J4-J:z%I , Rec)r'/1~'}.J~II"Age"'---pennsybYaniaESTATEOF':Lois Posin Rothkopf LATE OF Washington, DATE OF FILING APPRAISEMENT c:2 -11-6f OATS OF DEATH August 26,19.66 DATE NO,'OF .NAMIi OF PAYEE REMARKS AMOUNT VOUCH"" ,/ 913 66 Josephine M.Douq1as Ltrs.of Administration 9 00 12/2 66 Observer Pub1ishinq Co.Advertisinq 12~~BO 12/2'66 Washinqton County Reports Advertisinq /12 50 8/9 67 Trianqle Oetho.Assoc.Professional Services tI 50 00 8/9 67 Allegheny General Hospital Confinement ."424.63 8/9 67 Joseph P.Concannon,M.D.Professional Service 1':150 00 8/9 67 Vernon B.Ca11omon,M.D.Professional Service (475 00 9/3 66 Kenner Funeral Horne Professional Service 1 248 00 9/3 66 Jewish Memorial Park Rest and Marker 290 00 R/q 67 Jerome Rothkopf Administrator's 1--'1')1)1 -3,-1;,1"\1"\r.~_fees 8/9 67 Bloom. Bloom.Rosenberq &I Attorneys'fees 4.000 00 .......-........1lII , '-,Ru"S's-e"l-r-Marino,Aqenf:Part Prot.~rtl'i.Tax 7"5"0 00 I 10/22 68 Russell Marino Account 16 00 12fr:;67 Russell Marino Bal.on Ltrs.&Inventory 13 00 8/9 67 Russell Marino 1 short certificate 1 00 1/10 6R Jerome Rothkonf Reimbursement Med.Rxn..(7S 00 ~A~J~~vcA..n ~J .$3 rrd-in va1uationU 7Netreduction of Installment Judgment 7}7'0 /6.of.:l.j ~..? Note inventoried at face . value in accordance with - statutory 3~/o tables ...a110winq discount of anticipated payments q~94-2""'"1-3.(1-"< TOTAL ......-9.3. COMMONWEALTH OF PENNSYLVANIA }ss:COUNTY OF Washington I,Jerome Rothkopf H&REBY CERTIFY.THAT,TO THE BEaT OF ....y KNOWL!:OGE AND BELIEF,TH!:FOREGOING IS A JUST ~ND TRU E .srATEMENT OF DEBTS,FUNERAL EXPENSES AND EXPENSd OF ADMINISTRATION SUBMlnED TO THE ESTATE OF L01S POSln Rothkopf DECEAtlED,AS DEDUCTION»FOR INHERITANCE TA;PURPOSES,__~Wk#(L.S.l SWORN ANDAUBSjf!BED BEFORE ME THIS 1-1-"'-40AY OP'f1 P -;;"'J.'"~, f(~-D..A ~~.J)j JA-= .J ~,-- RESIDENT DECEDENTS File No~._-J.9.L3L.3=8--J7,-",Se- ltiASHINGTONOfficeRfGrSTEROFWILLS.__...:.."~Pa. Jerome RothkoffReceivedfrom _ COMMONWEALTH OF PENNSYLVANIA OFFICIAL RECEIPT Transfer Inheritance and Estate Tax F"'lll P:G·4.Hi·j·6€ WASHINGTON------------,County,ss: (~Administrator ~I the estate of -'W~IS~...:!P6S~!:!IN:£!.....!!R~O.:.TH!.!;K~O!:!!FF~_ ~~~~t~19__6~~~cl----~-'-~--H_~__~--F-I-F-n---a-n-d---n-o-l-l-OO__-_-_-_-_-_-_~~ being TRANSFER INHERITANCE TAX and/or ESTATE TAX due the Commonwealth as follows: N 92lt5850.,__'-_ Date r;ovember 2tl 27 19~ ------ Appraisements Made and Filed Computation of Tax ,. 750.00 ------------'J";'..''0'!.!..""'1t.------------~. $========== $--------- 750.00 .$------~--*As evidenced by Charitable Exemption Certificates issued by the Secrelary 01 Revenue under Act 01 May 28,1956,P.L 1757,effective Tune 1,1957,as amended by Act No.381,approved July 11.1%7,end Act No,207,1961.SecIbn 302. Total Amount 01 Estate Tax Assessed under the Act 01 May 7,1927. Add interest at the rate 01....-------"10 lrom _ to _ Tax on $5"/0 $ Tax on $10"/0 $ ,Tax on $On Account 2"/0 $ Tax on $15"10 $ Exemptions *$ Total Estate $ Total Tax $ ,Less Tax Previously Paid (if any)$ Balance $ Less live per centum 01,tax if paid within 3 months after date 01 death $ 36r2.39-6I; .J $------- $ $ $ $INCONPLETE 19__$ 19_·_$ 19__$ 19__$ Valuation Valuation $------- $,------- $,------- $------- Total Total 'Total Gross Assets Less Debts and Expenses of Administration Personal Property -Oate NOTE:In accepling the transfer inheritance tax on future estates prior to the death 01theIiietenantOr:enant for years,as evidenced by this receiJ01,it is understood that the Com· mon·..ealth shall not be precluded or prevented from hereafter assessinq addilional inheritance tax at the death 01 the Hie tenant or tenont lor years ....henever.it appears that such additionaltaxmaybelegallydueandcollectibleloranyreasonwhatsoever. NOTE:To be deUvered to taxpayer by Register of Will. Real Estate -iSate Clear Value of Estate Valuation of Life 'Estates or Annuities 'tt'it ."..:r.'Date,'~j'-':~,------------ .~~~",'./;~ ,'tstate Tax AssessmenJs ·t, ...:,~.~':~~:..q~'Date '-":'~";\(....,'-----r.;-~li