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HomeMy WebLinkAboutOC1968-1419 - ESTATE OF ELLSWORTH~. ~'-7 -It)'~S1c. (Form where dec.dent died Inteatat.) In t4r OOrp4ans'aIourt of lIIas4tngtnn arnu~ty .uq ESTATE OF No.63-68 -1419 Term,19 ,A.A. In the audit oft-he First and Final _...~~.~~~~.~~~...~~.....~.~~?.~Q~~.~..~...:.9:.~.~.~.~.?.~.9:Account of ~:~;~~~~~S\'lOrth,Admin- Deceased Th . .f Betty EllsworthepetItIon0 ,. (Name of Petitioner) SUte (I)whether de- cedent was married or unmarried;(2)if mar- ried,whether a husband or wife survived and his or her name;(3) whether or not tbere was any marriage settle- ment;(4)whether or' not family relation was maintained until dec<;~­ ent's deat.h.;and (5) whether .ihe decedent left children or issue of deceased children. respectfully represents:_:_. (a)The decedent died Mar.ch.1.5.1:1.961 _ ,intestate and (Date) letters of administration on his.estate were granted .JYJ.~y.3...,1.9fi:L . (Date) as per record thereof appearing in Administration and Bond Book No 5..e . 247 " .at page . Decedent was survived by Betty Ellsworth,s.pouse ;Twila Ellsworth',daughter;Roderick R.Ells\Vorth,son;Thomas?Ellsworth,son.Family relationships were maintained and there was no marriage settlement..}" (b)At the time of death,the decedent's do.micile wa~~~.!he Com- monwealth of Pennsylvania,to-wit,at.....MQ.n.(}n~ahe.la."....P.a........'I.:..U.•.S~.A.•·.... (to'wn or Townsliip,State and 'Nation) and res idence was at ~.<?.~.~!?:.~~.~.~~.~.~~.~.~~.~;y~.y..~~~.~~~~.~.e.~.~.~.. (Town or Township,State and Nation) (c)The names of all persons having any interest as heirs or next of kin with the names of their deceased parents,to show relationship if they take by representation are as follows: NAMES '.'Relationship Interest Of age,sui- juris,or not,(write yes or 110). Name of Guardian,Trustee or Committee,if any.or beneficiary,manr.er and place of record of appointment and is bound suffi- cient to cover and protect share. Betty Ellsworth Twila Ellsworth Roderick R.Ellsworth Thomas P.Ellsworth Spouse Child Child Child 1/3 2/9 2/9 2/9 Yes I YesYes . Yes N/A N/A N/A. N/A State exceptions,if any, giving names and dates of death and the namea of their executors or administrators,or the names of their issue asthesamemaybemater- ial. All of said parties in interest are living,except No exception. Describe type of notice.(d)All p'arties having any interest have had.._notice of the filing of the account by personal communication.. ',.','.1 .(e)Balance'for distribution per Account (f)Additional debits,not shown by Account (Itemize). ..Subrogation Employers Liability Assurance Company (g)Additional credits,not shown by Account (Itemize)None $J§.2.3..2§.~.?9 $9..2.§.~.J..~.90 $ . $..8..~.5.1..7..!l.3..9 Insert word "not"where I (h)Claim for exemption has been made,and has been paid. necessary. (i)The estate is subject to the payment of inheritance tax to the State of Pennsylvania.Tax has been paid. If ta.able state w~eth-I (j)The estate is n.o.t subject to the payment 'of the county 4 mills er tax has been paId. tax. (k)The estate is n.Qt subject to the payment of Federal inheritance tax. 11 too many for the space,annex a list ther~. 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. (1)All cretHtors (and other persons who have complied with Rule II, Sec.9),of,whose claims the accountant...notice or knowledge,have ........:received actual notice of this audit;the amounts of their claims and whether or not.they are admitted to be correct are as follows: None (n)The balance for distribution consists of property in kind,form and character,as follows: ....~r ... Here insert a reference to all questions requir- ing adjudication,and a statement of any mater-ial facts not already given,If none insert thewordHnone:' If 'any share.has been assigned or attached that fact should also be stated here. State kind,form and character of property composing the balance for distribution,and if any part thereof is not cash,whether or not there has been any elec- tion to take Bum part in kind. \ (m)None .$8,517.39 ~ cash Are there any advance- menis by decedent to be considered on distribu- tion and has any distri- bution on account been made by accountant to any distributtee? (p)Distrib~tion has been made to and for the benefit of children periodically. (q)Give brief location of any real estate sold.N/A If prior accounts have heen iiled.list number and term. (f)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):- Child Child ~etty Ellsworth 1/3 Twila Ellsworth 2/9 30derick R.Ellsworth Thomas P.Ellsworth spouse child 2/9 2/9 County of Washington,ss: The above named petitioner being duly sworn doth depose and say that the facts set forth in the foregoing petition are true to the best of h.er knowledge an~belief.;1:'~:ya:tp:;::~_:e~or~1~:~ ~.•....(.._--_..- c.REID DOUGHERTY.NOTAItY PUBLIC·····-•-.MO·NON.CAH·EliCw"A"S"HiiiGT'ON-C·OUN'T'y..·. MY COMtI'ISStO~1 EXPIRES JULY 29.1988 Mem~.er.Penns~lh'ani3 Association of Notari~s ,'.. And your petitioner will,etc., ,.,; Vi FORM IN CASES OF INTESTACY 63-68 _.1419No,:Term.]9 ,A.A. IN THE ORPHANS'COURT WASHINGTON COUNTY.P2\.. Estate of •.....Ro.d.e.rick...R......E1.1.sw.Q.;rl·1;h Deeeased. Sur account of ~.~.t.ty El..l..Q.W'.Q.r.t.b.. Administratrix..............--:~--.-- -__:._---.--___. PETITION SUR AUDIT In Conformity with Court Rule III. 'Sec.5 (B) COUNSEL FOR THE ACCOUNTANT WILL SUBMIT HEREWITH 1.The letters of ·administration. 2.A coPY of the inventory and appraisement. 3.Proof of advertisement of the grant of letters, if not filed with accountant•. 4.An appearance for those represented. 5.Inheritance tax receipts.if any. 6.Certificate of liens in case any of the funds 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.P.J•.McArdle Esq. 301 B~gham St.#7 Pitt.sburgh.P:A.1~211 Attorney for A-ccountant. ~~ .~.t c ,'. ... . / FIRST AND FINAL ACCOUNT OF BETTY LOU ELLSWORTH,ADMINISTRATRI X OF "THE ESTA TE OF .-RDBERICK R.ELLSWORTH,DECEASED ~ ."April 14,1969 1968 October 21 RECEIPTS:--;..~. ••~...._J • ~~-"-'-.---',:'""~'.-. Inventory and app-raisement filed .' DISBURSEMEN TS ......-.......,.------- $22,748.01 1968 October 21 Family Exemption Betty Lou Ellsworth,widow $1,000.00 624.50 10.00 70.00 14.00 3.00 12.50 500.00 15.00 A ttorney fee Filing this acct. P.J.McArdle,Esq. Register of Wills Washington County Rep. Re giste r of Wills Daily Republican Administrative Expenses Register of Wills Letters of Adm. Morris Insurance Agency Bond premiums 5 /15/ 61 to 5/15 /68 @ $10:00 Adv.Letters F:iling inventory Adv.Letters 1961 May 3 May 15 I 1968 I I oc,t.10 Q~t.21 Oct.29II,1969 iApr.14 'Apr.14 I 1961 May 20 iMay 20 'May 20 May 21 Preferred Debts R.A.Hancock,M.D. C.W.Vate s,Jr.M.D. St.Clair Memorial Hosp. Frye Funeral Home Medical services Medical services Hospitalization Funeral 350.00 100.00 729.27 1100.00 2,279.27 r. 1968 Dec.19 I. Other Debts Rodgers &Roney, A ttorneys for George Wassel -Sa tisfaction of judgment at 30 May Term,1958 185.25 185.25 1969 Jan.21 Other Taxes Commonwealth of ,..._Pennsylvania Pa.Inh.&Est.tax .on $22,784.01 @ 2%- Interest from 7/1/68 $454.96 15.89 470.85 $4,559.87 ::," '-. THE D~~.AH~~~~LlCAN 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 }ss: State of Pennsylvania Personall~appeared before me,a Notary Public in and for said county and state, PSfTl.honpson .dul .s~le . th DOO'kkee;;;er'''·''wfhoT'hbeMmg YhSWIorpn,bdl~Ph~ses cand sayps,thaIL:~,,--..ISe..,~0 .e ononga e a u IS mg 0.,a ennsy vama corpora- tion,and its agent in this behalf:that the said company is the publisher of The Daily Republican.published daily except Saturday and Sunday,having its place of business at Monongahela,Washington County,Pennsylvania;that the said Daily Republican was established in the year of 1846;that the printed notice or advertisement,attached hereto is a copy of a notice or advertisement,exactly as printed or published,which appeared in the said newspaper in its regular issues on,the following dates: october 11,18,25,19(~ ~stnte of r~dorick R.El1s~orth v Public le ,ESEstateofWORTH·deegahela,WIISLetters'ofi ' the above estedto'the'Ulidherebyglventheretotomakement,.and ,td,thos~" ,or demands to present t ,.forsettlement.'.,'",':; BETTY LOU ELLSWOlt'l',H.Admrx.'-'c,111 Laken St. Monongahela,PennsylvanillP.J;McARDLE,Attorney1300AlleghenyBuildingPittsburgh,P-enna.1521li. Oct.11.Ill;2.1888 ..~ash~on Couftly Reports Washington,Pennsylvania (PUBLISHED BY WASHINGTON COUNTY BAR ASSOCIATION) Estat_tlces The Register of Wills has granted letters, testamentary or of administration,in the following estates.Notice is tereby given to all persons indebted thereto to make payment without delay and to those hav- ing claims or demands to present t'hem for settlement to the Executors or Admin- istrators or their Attorneys. • '••••••••G ••••••• 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 01'PBNNSYLVANIA (SS. ELLSWORTH,RODERICK R.,Dec'd. Late of Monongahela,WE.shingtonCounty,Penna. Administratrix:Betty LoUl Ellsworth 111 Laken St.,Monongahe:a,Pa.' Attorney:P.J.McArdle,1300 Alle-gheny Bldg.,429 Forbes.Ave..Pitts-burgh,Pa.15219 ' Personally appeared before me,a Notary Public in and for said County and Comrr.onwealth,CHARLES C.KELLER,who,being duly sworn,deposes and says:that he is the Editor of the WASHINGTON COUNTY REPORTS,the officia.legal per(odical for said Washington County,publis'hed weekly having its place .of business at Washington,Washington County,Pennsylvania,and is act- ing a;its agent in this behalf;that the said WASHINGTON COVNTY REPORTS was established on March 31,1920,and was designated as the official legal publication for Washington County,Pennsylvania,by order of the several courts of said County,dated November 11,1920;that the printed notice or adver- tisement attached hereto is a copy of a notice or adverti~ment,exactly as printed or published,which appeared in the said legal periodical in its regular issues on the following dates: ....Q.~t.9.!?~r.J.1."~~..3.J..J.9.9..a.. ,, -.~..;:...~..~;.;.;..~:'. KATHERINE C.YARD,ary Public Washington,Washington Co.,Pa. My Cummission Expir~s Novembel'1,1969 .....3~y.day of ;~,19.6 ~ ......~~.. that 1he affiant or the corporation in behalf of which he is acting is not interested in the subject matter of said notice or advertising and that all of the allegations of this affidavit as to~~e,place and charafr)f thecL.7tioo are true. t:noJr1td .r:::..'"&~tL_--=----;-.--__'.,."Editor Sworn to and sub 1 ed before me this . . .....} .r· .. l l ".,',", ' i."1 I',\ '.:.\ ',\ l· The Court is respectfu II y requested to determine proper distrib on \n his estate. 7-:-~.::'.._~::' STATE OF PENNSYLVANIA, COUNTY, /l/4yieA/'~ ~55: The within named Accountant being duly sworn according to law,depos€S cind so}€)that the above account as stated is true and correct as ~~.~verily believe. ,.'V/ltl Sworn and subscnbed before me this . day Of ..·,•.......:..!l:l2~:....1...L/19..9.~.~~i.yZ_r •............. LOIS G,,C0rJl.':V '·l:J~3ry PlI~licPifts;';"gii A,;,:,,',,'r-y;',,Pa. My COldmi,sica E)("ires February 5,1971 Washington County,ss: ~/'~~ .......~..~.·:a:e:ttY"Lou Ellsworth f .F I do certify that I have given legal notice to all persons concerned of the filing of the within account in the manner prescribed by Statute and Rule o~CoO'as evidence by proofs thereof filed to No."3:-::~.2-:::?).L .. ~)C~, Witness my hand and official seal this.a{~. day aLn~....t.:lili;..191o.t ...~~~l:2Jl(l(t&~A-Q . Register of Wills ..."".-.--'--,-._--/~~..> ___cs;.~_!:,~ oo M..... /'< ......·f -,.,.-.1:'""'-i !. Co ...., FILED PR 11 PM 12:24 RUSSELL MARINO EGISTER OF WILLS :1 ,.t.~ ...., M::l~\~~.:l :0...., Ui~:=:Q).gj •M~ i =...{1 g~8 :cd .J =.~:§ 2 .~ Q) ~..c:lo....,=~"d O':li,=CD!<11 C>.... :0 10 i'O O!,!ll,.MC:Q)~\6 :0:'(3 ~~\~,~ ,:fi<1 ,"d.~~~=Q)o ....,~~~'~S .Q) M :P::~8 : Q.4 ; ~~ Q0:: ~C) .;;E I-:l. Pi "- ....,~Cll~CD-;:;en ::l CD!~ 6 CD 'bi~~N ~ o III~*(. 111 ~ ~ " \ " .'y'. -.; ;~" In tlJe atnurt nf atnmmnn Jleas of lIas4ingtl1n atnunty, Jenn6ylnania ®rp4ans'Qtnurt iini!itnu ESTATE OF RODERICK R.ELLSWORTH, deceased I \ No.c3-68 -1419 In the matter of the Fj rst and Final_ Account of Betty E1J sworth , Administratrix ADJUDICATION AND DECREE BY THE COURT, And now July )'7 r 19..8..6-,this matter having came on for hearing,audit and distributtion an!ltestimony taken;L.pon due consideration thereof,the bal- ance for distribution in the hands of the Accountant is determined to be $Ru..5.Ll.L..L7.L-'3.L9::L.-_ and the account is accordingly confirmed;and it is ordere:l,adjudged and decreed that the said bal- ance be paid out by the Accountant in accordance with the schedule of distribution hereto attached and made a part hereof,unless exceptions hereto,be filed sec.reg.or an appeal taken herefrom sec. leg. Balance per account --..:.'...;,.'0 1 {,"-~-~-I $...18"J58.39 Additional Credits Post Audit Petition 9841.00 Ba lance $8,517.39 Attorney ---=P=-=-.---=-J..::.._M....:c_A...::.r....:d-=-l::..:e=--__~_-1 Betty Ellsworth Twila Ellsworth Roderick R.Ellsworth Thomas P.Ellsworth, .. Spouse. Child Child Child $2,839.14 $1,892.75 $1,892.75 $1,892.75 5,678.25 3,785.50 1,892.75 NO BALANCE No.63-68 -14-19 In the matter of the First and Final Account of Betty Ellsworth, Administratrix of Estate of RODERICK R.ELLSWORTH DECEASED Abjubitatinn aub iJetree ·v."00 N01~nIHS¥M Sll\f','":Cj~}] S8 11 hl8 L1 lOr 9P, OJYd'0 ...·\-;'C'"'\\\=q t22 ({;<.9 -"'",1-,,0 .2 1----------..------------------- ,-..'.............-..I) I I! , IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY,PENNAi ORPHANS'COURT DIVISION RODERICK R.ELLSWORTH, HEARING ON AUDIT • IN RE: ESTATE OF •~Deceased.•~~D--i:i.. ) ) ) ) ) ) ) No.1419 of 1968 ~BEFORE: ~ ii•~ t APPEARANCES: i:Iiii oJ~ ~TIME: ;:)... t t-OOl 1 THE HONORABLE P.VINCENT MARINO,PresideintiJudgeofthesaidCourt.iI McARDLE &STEGENGA,ESQS.,representing the Accountant. Thursday,September 11,1969,at 10:00 A.M., EDST. We will pass this audit to the foot of today's list. Number 1419 of 1968,the estate of Roderick R. and the attorneys are McArdle a:ld Stegenga. Ellsworth,deceased. Is Mr.Stegenga presei:lt? The Administratrix is Betty Lou Ellsworth I.~THE COURT: "toI:I)..u I:: toI: ;:)oo ...I<Ciii:Ii.o (At the close of the call of audits for the,da,y,the following occurred): THE COURT:In the estate of Roderick R."Ellsworth,which was earlier called this morning,counsel appears to be named as McArd e and Stegenga.Mr.Stegenga being of our local Bar and Mr.McArdle presumably of the Allegheny COl.:.nty Bar.On calling Mr.Stegenga's office this morning,we find that he states that his office is not 2"~----tl------_..--.--.".,-----'---------_--.------I--- .involved in this .estate,.and that :.t\s -being.handled .exclusively by.. ~ Mr.McArdle.So we will therefore continue this matter until contact is made with Mr.McArdle and a subsequent date will be set • !r:(.:>.I..j)zZ11/II. i 0l-I) Z:r -Dl~~ to:<.Iiii..!!!•a.....0(U Q ;) ""%t:; ,N AUDIT COKTINUED * ******** *~* * • IiIt:~a:oII.III.'0:..ll:;)oU ..I'0(g. l&.l&.o I hereby certlf7 that th~..pl-oceedings and evidence are contain d '. fullyand accurately in .t~e JIOtq talt,e"9W me on the hearlni of the above cause.and that this c~py,la.correct tranacript'of the .ame. .:. ..- The foregoiDi record of the 'Proc~lnp pan the heariDg of the ,..,. above cause is hereby approved aDd d1tected to be fUed. J - ,I 1,~,.~oPY OF INVENTORY ~ Roderick R~El18wo:rth Roderick R.Ellsworth xxxxxx October 68 xxxnxx .. 1JnUtntnry anb .Apprai.atmtut of the goods and chattels,rights and credits which were Roderick R.Ellsworth '..Mo'nongahela, of _ _.._ _ _-_late of _. Washington County,Pa.,taken and made in conformity u;ith fhe above affidavit. / Cash ..Proceeds r,")ceived·under the Survival Action in the case of BETTY LOU ELLS\"\O RTH,Administratrix of the Estate of ROderick R.Ellsworth,deceased,Plaintiff,vs. UNITE'D STATES OF AMERICA,et ale -fUed in the United S.tes District Court for the Western District ot DOLLARS CENTS Pennsylva.~a at Civil Action No.61-577 $22,748 01 ,J Form RCC-33 RESIDENT DECEDENT COMMONWEALTH OF PENNSYLVANIA .DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS COUNTY OF WASHINGTON .. ..........._RQ;;..;~.:.;~.:~O~.~~~.:;.~:~}=:OF (State full name of decedent) Late of Was.hJngtQn County ADMINISTRATOR and sayS This return mus";;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~.In1?erit!l-nce_!ln~.E.l;lt!l-te .T.ax l\ct of 1~!i1.) IMPORTANT: State of PE.N.NSYLVAN.IA } .ss: County of ALLE.GHE.N.Y.. ..................................~B.et.ty L.Q.u E.lls.wQr.th.. . Administrator ix .of the estate of the above-named decedent being duly sworn,depose S Decedent'dJed Ma.rc..b... (Month) Name and address of attorney or} other authorized representative to . whom ell correspondence should be. mailed.. .16.... (DllY) .......,196.l ~J·N~NXJX~H}i...IDUtXi!KMX~XKJm[~X1X~«»XlJf~} (Yl':Ilr)Lintestate That as such .......9.:g.mJQ!.~.t.r.9.Jr.t.~deponent is familiar with the affairs of said estate and the property con- (I';x"outor·Administrator) stituting the assets thereof and their fair market value. 'That at the time of death there was no safe deposit box registered in decedent's individual name,or jointly with,or as agent or deputy of another,or in decedent's individual name,with right of access by another as agent or deputy,with the exception of the following:- NAME AND ADDRESS OF BANK OR OTHER INSTITUTION :N WHICH DECEDENT RENTED A SAFE DEPOSIT BOX THIS SAFE DEPOSIT BOX RENTED IN NAME OR NAMES OF RELATIONSHIP OF JOINT HOLDERS TO.DEC~DENT None That the contents of said safe deposit box or boxes are itemized under Schedules of this re~urn,with the exception of the follOWing,for the reasons hereinafter set forth: That Schedule A attached h,ereto and made part hereof sets forth fullv 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 th~amount still due at death,name of mortgagee,date,rate of interest,and book and page of record th~reof.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 banks,trust companies,or other institutions,whether individually,or in trust for any other person or persons giving also separately the accrued interest thereon,if any,,down ~6 the last~.~interest day prior to decedent's death in t~e case of savings banks,and to the date of decedent's death,>'in all other cases;all bonds,postal savings,treasury certificates or notes and other evidence of in- debtedness of the United States 'to the decedent;all obligations,whether by statute ,or Jg~eement t~ey are designated as tax free,of the United States,or any state,or political SUbdivislonJth;reo~or of.,-llr:~any foreign country,which,are owned at the time of death;all wearing apparel,jewelry,silverware,pic-,ytures,books,works of art,household furniture,horses,carriages,automobiles,boats;.and any and all ,,#0;./"1ot.her personal chattels of whatsoever kind or nature,left by decedent,together with the fairly estimated --<J "market value thereof;all bonds and mortg8!!eS held by decedent and of all claims due and owing decedent at the time of death,and all promissory notes or other instruments in writing for the payment of money of which decedent died possessed,of whatsoever nature,wi th 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 8state from life insurance policles carried by decedent;all annuity and endowment contracts the proce8ds of which were payable upon the death of the decedent;and all the corporate stocks and dividends dne thereon and unpaid as of the date of death,bonds and accrued interest thereon to the date of dece- dent's death and other investment securities owned by the decedent at the time of death,with the market va1 ue thereof at such time. Subscribed and swo ... \. In the case of securities of close or family corporations,the values reported are as far as possible substantiated by financial st~tements of the corporations,showing the assets and liab~lities thereof as of the·date..of death.The .schedule also sets forth the interest of rlecedent at the time of death in any co-partnership or business,and in support of the value of such interest there is annexed to said schedule,financial statements"showing the assets and liabilities of said co-partnership or business. A copy of the co-partnership agreement,(if oral,a statement setting forth the nature of the agreement) together with a statement setting forth the character of the business,its location,and such other facts pertaining to the business as may be pertinent to a fair and just appraisal of the decedent's interest therein must be submitted.It should also set forth in itemized form,together with the fair market value thereof,any other property owned or bequeathed by'the decedent at the time of death. The Schedule C attached hereto and made part hereof sets forth a true answer to each inquiry contained therein and in the case of transfers ofproperty,real or personal,within two years of decedent's death,in contemplation of decedent's death,or intended to take effect in possession or enjoyment at or after death,said schedule sets forth the nature and value of such property,to whom transferred,'the relationship of the transferees to the decerlent,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 attacherl to the scherlule a copy of the deed,trust agreement or other instrument creating the trust.TherA is also set forth in said schedule a list of all property,real and personal,with its·value,which pa~ses at decedent's death ~y virtue of the exercise by decedent,either individually,or jointly with another,or any power of appoint- ment vested in decedent,either individually or jointly,by the Will,deed,or other instrument of another, with a copy of the instrument creating such power attached to the schedule. That Schedule D attached hereto and made part hereof sets forth the names and addresses of all persons beneficially interested in this estate at the time of decedent's death,th~nature of their res- pective interests,their relationship,if any,to the decedent,together with the ages at the time of decedent's death of all minors,annuitants and beneficiaries for life under decedent's Will.It also contains a statement showing which of the beneficiaries named in the decedent's Will,if any,died prior to decedent,the dates of their death,their issue,andthe relationship of such issue to the beneficiary. That SChedule E attached hereto .and made a part hereof sets forth all property,real and per- sonal,owned by the decedent jointly with another or others,including intangible,standing i~the name of the decedent and others,plus the date and place of record of instruments effecting t~e vestiture of real estate and the date of acquisition of personalty,plus the name,address and relationship,if any, of co-owners to the decedent. That Schedule F attached hereto and made a part hereof sets forth fully and in detail all debts and deductions claimed for and on behalf of this deced~nt's estate,including funeral expenses paid; family exemption,where applicable;costs of arlminist~ation 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 anrl Impaid at time of ~.death;taxes accrued charge.able for period prior to decedent's rleath (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 colunms in Schedules "A","B","en,"E",and "F"as directed therein,. have been carried forward and properly registered in the Summary. ....~~~ ....J..U Lg,k.~.n..s.t.r.g,.~.t ___.. (Street Number) .......Mo.nongah.ela Pe.nns.ylv.a.nia.. (City or Town and State) NOTE:Before signing affidavit make sure all blank spaces in the affidavit and schedules annexed are filled in with details or the word "None",and in case the assets include rare and unlisted securities, securities of close or family corporations or an interest in any co-partnership or business,that the data and statements requirerl under the paragraph above relating to Schedule "B"are attached.Also make certain that colunm #1 in the "Summary"has been properly completed as above-directed. _"tJ RCC-34 (1-64) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BbREAU OF COUNTY COLLECTIONST~ANSFER INHERITANCE TAX RESIDENT DECEDENT .....'"OJ-:..,~;••:'! SCHEDULE "A" /,REAL PROPERTY Real property in Pennsylvania,wit~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 "E".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 rl!al property located In the Commot'lwealth of Pe'nnsylvanla should be (1 )(2)(3),I described by lot and block number,street and street number,together wi th DE:PARTMENTageneraldescriptionoftheproperty,with a reference to the record of the ASSESSED VALUE VALUATION conveyance by which the decedent took title;If a farm state number of a-FOR YEAR OF ESTIMATED CAUTIONcres;also statement of mortgage encumbrances upon each parcel at death DECEDENT'S MARKET VALUE (Do not writeofdecedent.Toxes,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 /];V at.~ 't1 . •. Insert thi s total opposi te "real property",Schedule"A"in the X X X X X "As Reported"column on the last page of this return. None RCC-35 COMMONWEALTH OF PENNSYLVANIA '~RANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "B" PERSONAL PROPERTY INSTRUCTIONS:This Schedule must disclose all tangible and intangible personal property owned individually by the decedent,at the time of his death.Property owned by the decedent jointly with another or others must be listed under Schedule "E".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 rlividends,salaries or wages,insurance pay- able to the estate or firluciary in sairl 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.--..,...--..-.;...-----------------r----r------.,....------- Item No. ITEM List and describe fully UNIT VALUE ESTIMATED MARKEr VALUE DEPARTMENT VALUATION (Do not write in this space) 1 Cash -Proceeds lfeceived under the Survival Action in the case of BETTY LOU ELLSWOli TH 1 Administratrix of the Estate of Roderick R. Ellsworthl decaasedl Plaintiff vs.UNITED STATES OF AMERICA1 et al.-filed in the United States District Court for the Western District of Pennsylvania at Civil Action No. 61-577 $221 748.01 Insert this total opposite "Personal Property",Schedule "B"in the "As Reported"column on the last page of this return. x X $221 748.01 RCC-36 f.OmION 1I'EALTH OF PENNSYLVANIA ~T1L\NS1~=R INHERITANCE TAX ~~S[DENT DECEDENT SCHEDULE "c" TR...c\.NSFEIlS (1)Did decedent,within two years of death,make any transfer of any :naterial part of his estate,without receiving a valuable and adequate consideration therefor?(Answer yes or no)~~~OL-_ (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 wit~out 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)__A~~O~_ (a)Was there any possibility that the property transferred might return to transferer or his .estate or be subject to his power of disposition?(Answer yes or no)~~~OL-_ (b)What was the transferee's age at time of decedent's death?_N__o _ (5)Did decedent in his lifetime make any transfer without receiving a valuable and adequate consideration therefor under which transferor expressly or impliedly reserves for his life or any period which does not in fact end before his death: (a)The possession or enjoyment of or the right to income from the property transferred? (Answer yes or no)__~~~O~__ (b)The right to designate the persons who shall possess or enjoy the property transferred or income therefrom?(Answer yes or no)No (6)If the answer to (5)(b)above is in the affirmative,state wheth~r the right was reserved in decedent alone or 0 thers ..,-_ (7)Did decedent in his lifetime make a transfer,the consideration for which ....as 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 c01l1d revert to decedent under terms of transfer or by operation of law?(Answer yes or no)~rJ~ou-_ (9)If the answer to (8)above is in the affirmative,was the power to alter,amend,or revoke the inter- est of the beneficiary reserved in the decedent alone or the decedent and others? (Answer yes or no)-..IN.:u,o!.-.__ NOTE 1:The answers to these questions should be supporter!by affidavit by the attending physician as well as a copy of the death cer-tificate. NO'I.'E 2:If answer to any of the above questions is yes,set fortt below a description of the property transferred,it's fair market value at date of death,dates of transfers and to whom transferred,with reLationship of transferees to decedent,if any.Submit copy of any trust deed or instrument,if trans- fers are claimed to be non-taxable,also submit detailed statement of facts on which said claim is based. NOTE 3:List applicable property below in manner in which provided in Schedules A,B,or E. ITEM NONE DESCRIPTION MARKET VALUE (Estimated)DEPT.VALUATION (Dept.Only) lnsert this total opposite "Transfers·,Sehedule "e"in the rAs Reported"column on the last page of this return. NONE " RG-C-38 COMMONWEALTH OF PENNSYLVANIA THANSF12R INHEIUTANCE TAX. RESIDENT DECEDENT SCHEDULE "E" JOINTLY OWNED PROPERTY INSTRUCTIONS: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 tUlder Schedule "A",plus the date and place of record of instrument effecting vestiture,but do not include entireties or out of state real estate value in estate valuation column.Personal property should be listed as in Schedule "B",plus date of acquisition,and the name,address and relationship (if any)of co-owners to the decedent. Description of Property,Date of Acquisition,Name I unit percentage Estate DEPARTMENT VALUATION Address and Relationship of Co-Owners,and PIace I Value Share Valuation CAUTION-Do not Write of Record of Instrument,where Real Estate.I In This Space. Value of Value of Entire Decedent's Property Interest NONE • .c ...... II IIIII . "';4;..I!I.,I 1 • - Insert this total opposite "Jointly Owned Property",Schedule'"E"NONEinthe"As Reported"column on the last page of this return..- _ •".':,.r .~...,..,~,....,....:".'.. -~...• RCC-37 (12-63) COMllON',rEALTH OF PENNSYYLANIA TRA,NSFER INHERITANCE TAX RESIDEN'::'DECEDENT SCHEDULE "0" .. BENEFICIARIES BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED,(If step-children or DATE INTEREST OFStatefullnamesandaddressesofallwhoillegitimatechildrenDECEDENTOFBENEFICIARY ave an int€rest,vested.contingent or other-are involved,set STATE YES IN ESTATE wise.in estate)forth this fact.)OR NO BIRTH etty L::m Ellsworth wife yes 111 Laken St.,Monongahe.la Pa. wila E.llsworth -.daughter yes 6/8/51 same --"--- oderick Ellsworth son Vf"!=:P./1t1/~') !=:::ITnf" homas Ellsworth son Vf"!=:l?l7/flP. ..---,, 0' r ,, I <. R T T ( h Deponep.t further says that all the above-named beneficiaries are liVing at this time except below: NAME DATE OF DEATH RESIDENCE None OF THE ESTATE OF ~IATTER OF THE APPRAISEMENT (Executor·Administrator must complete "As Reported"column #1.) C1 >-j '"d ::0........(1)(1)0 ~....~'"::s '"-'"'"0 >+>::s '"d>-j (1):::..........~en 0:><'"d "d~(1) C'"........en 0 ~"d ~(1).... '"........'<~....(1) 4 enc: ~s::::>::0---~W en en()()II -,?"'?"'?"'q ~~------ -(ffl ~~~~~II J) ~I:\.:)::1\:) :1\:):N :>~:..~'":-J ::-J !:C~:~:~0 :00 :00 ~(1)_ 4 •'g- :0.0 ........:......::......(1)c..--- Year . CJ F 'I •~ - :; P.II THE t No, .', ;. :;1.'-r~'wen P.J.McAiRDLEwAttorneyatLaw 1300 Allegheny Building Pittsbyrgh,Penna.15219 261-6696 Late of ....Monong~b.~l~... ...RQP~.RIG.K ...R.•...~~LS.WQRTH .. Deceased CommonwealtA~of Penns~'lvaniai,.,;F.~-.j.."/) -·1 REPORT AND:APPIfXlSAL County of~~..Washington~4 .....•..........................•••. . WilXx Administration J ../ ~~..n~""",~ ',,' '-I;)..:'\:~-J:". ~.: ~i:,; ~. &1 '-.l:~. .")::~::"" :>:r. t:l(t~2'1'0:)3- ::Ir.c.. .~~,:,,'I - R CC-8I (2-64) . COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS INHERITANCE TAX DIVISION NOTICE OF FILING OF APPRAISEMENT BETTI LOU··ELLSWORTH (~~Administrator) IN YOUR REPLY PLEASE REFER TO 37-~56-9 In Re:Estate 0 f R~O>!.:D:!:ER~I~C~K~R.L..•~EL=:!'~l:S='~W~CR~·.:.:TH....~_ WASHINGTON 63 68 1419_______________County -File No.-- Dear Mrs.Ellsworth: You are hereby notified that the original appraisement in the estate of Roderick R.Ells~rth' has been filed in the office of the Register of Wills qf Washington County on October 30 ,19·~.Said appraisement reflects the following valuations:, Real Estate -.:..._ Personal Property ~2~2~,~7~4~8~.~O~1 _ Transfers ......,_ 'l'ota1 .__-'-----..,-_-=2::.=2"""•...J.,7.;;,4::.:.8.o..;.O~l=____ 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 (5%)percent per annum is charged. Any party in interest who is aggrieved by an appraisement may appeal therefrom as provided by law. Date ....;O:;.;c:;.;t:..::o:..::b:..::e.::..r-'3~O~,l.._.::1:...:9:..::6...:;;8 _sig~e~f~e~ Title W.R.CHANEY,CH '~APPRAIS - DATE OF DEATH:March 16,1961 Note:This is not a bill. RCC-39 (6-67) I- I I ,/COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT '0 ELlSWORTH,RODERICK R,. FILE #63-68-1419 Ivlar ch 16,1961 SUMMARY / I,the undersigned #63 Washington FILE #63-68-1419 the real and personal opposite each item in ftEPOHT OF INHERI1'ANCE TAX APPRAISER duly appointed Inheritance Tax Appraiser in and for the County of ,Pennsylvania,do respectfully report that I have appraised property as reported in the foregoing return at the values set forth the last column to the right in Schedules "A","B","C"and "E". D a ted:10-30-68 03-1.6-61 RRPORT OF THE REGISTER OF WILLS I,the undersigned duly elected Register of Wills in and for ... Coun ty ,Pennsylvania,dr.'sp"r:tfuily report t~at I have allowed deductions in the amounts claimed by deponent,exc'~l t itS to those items where a greater or lesser amount is set forth in the last column to the rig;ht in Schedule "F",which greater or lesser amount represents the sum allowed as a deduction. Dated: REGISTfR OF WILLS ======:= 22,748.01 22,748.01 ======.- 22,748.01._ 22,748.01._ =====::=.- VALUE AS REPORTED VALUE AS J\PPRAISED VALUE AS REAPPRAISED $$$-------- INVENTORY Real Property (Schedule A) Personal Property (Scherlule B) Transfers (Schedule C) J oint-Held Property (Schedule E) rOTAL GROSS ASSETS LESS Debts and Deductions (SCHEDULE F) CLEAR VALUE OF ESTATE Valuation of life estates or annuities ...•....$----_.- , ESTATE TAX ASSESSMENTS ~-----_.-.- CO~WUTATION OF TAX (:::)As evidenced by Charitable Exemption Certificates issued by the Secretary of Revenue.TOTAL TAX $_ "Less tax previously paid $~==========.__ BALANCE *_ Less 5%of tax if paid within 3>J!lonths after death $======1= FOR USE OF REGISTER ONLY T a:x on $f)'1o ~-------_.--,------Tax on $.__10%1:~__ Tax'on ~.~$_ T~*on $.1~%$ Exemptions .__(:::) T ot:al Es tate------- BALANCE OF INHERITANCE TAX DUE ~-------- Ad~interest at rate of 8%from to $_ AMOUNT OF ESTATE TAX ASSESSED $._ Estate tax paid $__ BALANCE DUE *_ Add interest at rate of 6%fromto $_ TOTAL TAX BALANCE $_ PAID $ ~JH USE QF REGISTER QNLY ADJUSTMENTS NOTE:Where subsequent adjustments are made to the above computation of tax by the ftegis tel'of Wills,for proper reason,same should be noted below,wi th short explanation.· ',;, Will lAdministration~No Year , IN THE MATTER OF THE APPRAISEMENT OF THE ESTATE OF ...,ltQ.l)MqQ.I\.A~~.L.s.}iJ.1i1'li ' . Deceased Late of MONONGAHill..A........................................................................ County of J"(A..$rI.I.NGT.ON . Commonwealth of Pennsylvania REPORT AND APPRAISAL f' .' .,. ",--- .I ~.' --------- Forin:RCC-2 -CP~MONWEALTH OF PENNSYLVANIA DATE ........................Q.c.t.Q.b.~r....J.Q..1.....19.9..$.......... 'bEPARTMENTOF REVENUE .,..RESIDENT INHERITANCE TAX COUNTY ...................,..............~~..::'.~~?~.?.~...................-,BUREAU OF COUNTY COLLECTIONS HARRISBURG.PENNA.17127 APPRAISEMENT FILE NO.................§?~.§?:.~.~.?....................................... Whereas,..........................~99:~F~.~.~...~.~.....~~~~~9t~.~.................................................late of ...............................~.?~.?~.~~.~:.~.~........................................ in the County of ................................W.a.:~h.~.D.g~9..~....................................................................Commonwealth of Pennsylvania,having died on the ..........................J.~....~h..................................................day of ..................M?:r..~h ..........................................19..9.~....,seized and possessed of an estate subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore,I,....................,....W.~.~.~.....9.h9.-.n.~.y.......................................................................,an appraiser duly appointed according to law, havbg 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 Purpo••s $ PERSONALTY:. Cash -Proceeds received under the Survival Action in the case of Betty Lou Ellsworth,Administratix of the H.'9tt.::lt.P nf'l"'>.('1<"R Ell Rworth deceased Plaintiff vs. United Stes of America.et ale -filed int ehe United States District Court for the ~Western District i of Pennsylvania at Civil Action No.61-577.22,748.01 22,748 01 Total 22,748.01 , J , , form~~':fhb~~::rhi:wl>1"Il:,m~o~~:~:;:~~~~~?:~;;el~~?, ..AppraIser ~_:..t~'~4~~~=.s:')•....•..•.•..•..•••••••.•.••••••••••....;::: (Poet OfBee),. I ".<. ~JASHINGT0N............................................................................................C'.'oUlIty RESIDENT INHERITANCE TAX APPRAISEMENT Estate of ................................RO'D.E.RJ.G..K R~J~;l!T8.y.~QRT:H .. Deceased. Late of .................................................l'iQNO'NQAI~,. Datc of Death,Har..ch l6.,l9.61..,;. Appraisemel!t Docket Vol.,.3.7 . Page,:1:5..9::.9.:No ~?~.f>?::~.~~,?... Filed in Register's 0 [fice,QGt.Qp..~.r.3..QJ .19..9.JL Amount of tax due,$_.. DEPARTMENT OF REVENUE Received, Examined and Approved,,.. Wrote abo.ut Appra.isement, Appeal f1'om Appraisement,~.. Entered and charged,. .... ~/ ~ ~