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HomeMy WebLinkAboutOC1969-0227 - ESTATE OF ROBERTSaai"-:::, -..'".........', (Form where decedent died intestate) llu t4r (@rp4ans'Olnnrt of lIa54tngtou Olnunty j ,A.A.Term,19 D.Bruce Roberts, Administrator No.63-69-227 Account of In the audit of the first and final Deceased The petition of .P..~~~.~.s:~g9..e.~.F..!:.~. (Narne of Petitioner) ESTATE OF. MRS.ETHEL J.ROBERTS a/k/a ETHEL JONES ROBERTS a/k/a ETHELM.JONES ROBERTS respectfully represents:. (a)The decedent died P.~.~.~~.~E .?'-J.~.§.?..,intestate and (Date) letters of administration on h.E?~estate were granted ?.!E?.!§.~. (Date) State (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 there was any marriage settle- ment;(4)whether or not family relation was maintained until deced- ent's death;and (5) whether the decedent left children or issue of deceased children. as per record thereof appearing in Administration and Bond Book No . at page . Decedent was survived by D.Shanor Roberts -Husband -Now deceased D.-Bruce Roberts,Adminls- D.Bruce Roberts -Son trator Frances M.Worthington -Daughter (b)At the time of death,the decedent's domicile was ~=the Com- monwealth of PennsyIvania,to-wit,at.....~..~tght.y.':':'.¥..9.~.F..!......~.~.D.-.!?:.§y.;hy.~P.:.~.~.. (Town or Township.State and Nation) and residence was at...R •.D..•.....#.G..,E..i,gh..t.y:::'.F.Q~.J;::.I.~~.nJ?:ey):Y.~p.J.~. (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,ewrite yes or no). Name of Guardian,Trustee or Committee,jf any,or beneficiary,manI!er and place of record of appointment and is bound suffi- cient to cover and protect share. D.Bruce Roberts Son 1/3 Yes Frances M.Worthington Daughter 1/3 Yes D.Shanor Roberts -now deceased Husband 1/3 D.Bruce Roberts, Administrator of the Estate of D.Shanor Roberts,deceased State exceptions,if any, giving names and dates of death arid the names of their executors or administrators,or the names of their issue as the same may be mater· ial. All of said parties m interest are living,except D.Shanor Roberts died September 6,1968. D.Bruce Roberts is Administrator of his estate. Describe type of notice.(d)All parties having any interest have had notice of the filing of the account by (e)Balance for diftribution per Account (f)Additional debits,not shown by Account (Itemize) (g)Additional cre~its,not shown by Account (Itemize) $..~..f..~.7..~..~..7..9 $~9..~.~. $~?!:.~. $?~..~..?..~.~..?.Q.not Insert word "not"where I (h)Claim for extption has/been made,and has P.:Q.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....ln9.t..subj ect to the payment of the county 4 mills er tax bas been paId. tax. (k)The estate is j n.Q.t subject to the payment of Federal inheritance tax. fi 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 statement of any mater- ial facts not already given.If none insert theword"none."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 clai s the accountant notice or knowledge,have ........................received actu 1 notice of this audit;the amounts of their claims and whether or not they ar admitted to be correct are as follows: None (m) None State kind,form and I (n)The balance Wor distribution consists of property in kind,form and character of property composing the balance h f 11fordistribution,and if C aracter,as 0 ows: any part thereof is not cash,whether or not there has been any elec- tion to take such part in kind.I All prowerty for d,istribution consists of cash. --"~...".......-- .. 1 Obsert?er .Repor~er' WASHINGTON,PENNSYLVANIA PROOF OF PUBLICATION In compliance with the News,paper Advertising Act of 16 May,1929, P.L.1784,rus amended. Commonwealth of Pennsylvania,County of Washington,SS:. Personally ap,pear,ed before me,a Notary Public in and for said County and State,Ri.c.b.a.:r.d S..•.....C.owan ,who being duly SiWorn ",1.,1.•1.Secretaryaccordmgtolaw,deposes and says h..at ue IS tue . of the Obs'erver Publishing Company,a J'lennsylvania corporation,and its agent in this behalf;that the said Company is the owner and publisher of the Observer·Reporter,succ1essor to The Wiashington Observer,established Seprtembe,r 18,1871,and The Washington Reporter,established August 15, 1808,a daily newspap1er of general circulation,printed and published and having its place of businesis at Washington,Washington County,Pennsyl- vania,where it or its predecessors have been established and published continuously for more than six months,prior to the publication of the notice hereto abtached;thrut the printed notice or advertisement hereto attached is a 'copy of an official advertisement,official notice,legal notice or legal adve,rtis,ement,exactly a;s printed or published in the Obs1erver-Reporter in its regular editions on the following date or dates;_ _. ........................................f..~J?~.~~.~.y...JJ..!.....HL.~.n.g ?5..,J.9..9.9._ . that neither tb!e affiant nor the Observer Publishing Company is interesrted in the subject matter of said notice or advertising and that all of the aUega- tions'of this affidavit as to the time,place and character of publication are tme.f1ilf/j (? ..._..._...__.....:L.<.<_:~i'~g~_..tJ.!_..._.i:!__;~~.__ i"""DMINI TR:ATORiSNOTICE ,,'",•Estateir.'Of·Mrs.Ethel J.Rober,ts ,ka,Ethebi.Jones,Rob"'erts aka EthelI'I Jones Rob'ertS!"-deceased;'late I.f'North Bethlehem Township..Letters of,Adii'finistration upon he above estate irving been,grant'",d to the ',imd'ed,all,pers()ns I\aving claims n,st the,estate!)re reques'eknown the ,'iame to it .ned or his at-'. ,torney',a .ns ind,ebted ,to ( the":dece uested to make ipayment"dfrsignedwith. lout.delay.,,",'.UCE ROBERTS •~~R~i'D.#2,'~,jElghty FoRI',Pa.' BLOOM.:BLoOM"ROSENBERG 1&BLOOM\'WAtt9r c'>.',~.,y,.• 200,Washington ~!1"",',.>;l',Washington,'Pa.j'i''}~~';"35·TlIes·3t ...;."'- Sworn to and W.26792 subscrib~efore me this.?.5......dayA1f..e.p..:r.JJ.a.ry---J.969 ······&~~;!'~~;~;c WASHINGiON,WASHINGTON COUNTY MY COMMISSION EXPIRES MAY 6,1972 -,...-.-ll'ORM 67 REV.1-50 REG.WILLS Application for 11jrUrrn of Allminintration on thr j Estate of...~g§..~~.m~.~g,.::~.Q~.~~r.~~!.~.!..~~.!~~.~!..9.~~.~~.9.~.~~r.~~!.~/.~. ............f';:.T.H.f';:.!!M::.;r..QJ~u?§EQ~.~R1'.§. late of ~9.E.!.~~~.~~.~.~~~~1::!.J2..~:,Deceased. Before the Register of Wills of Washington County personally appeared p...~~.EY.:S.~E2P..!?Et..!?.~.. who,being duly sworn deposes and says that..f';:.:th.~J !l..~B.QQ§.f.:t.§.. age §.§,having !:.~.E last family or principal residence at...R..~P..::#.?.. (Street and Number) ...................§.~.CJ.b-.!:Y.:::.f.?.~.E ,Washington County,Pennsylvania,died intestate (City.Borough,Township) at.)~9..f:.t.h ~§:.t.hJ.~.b.!?~~J?.::,on the ?day of....P.~.~~.~~E ::.....- A.D.,19..§.?,at..§..:..?.Q ~.:M.,possessed of personal estate to the estimated value $~...r~~~~(J~nd of real estate in the Commonwealth of Pennsylvania to the estim~ted value of $.(:!..g.':;!..I3.,situate in .. The names and addresses of the decedent's surviving spouse (if any)and other heirs .including heirs by adoption)are as follows. REI.ATIONSHIP RESIDENCE ....p...,S.h~n.Q~RQ.l:?.~~.t..$.H.~.§Q9.-.ng ::N9.:w.9.~9.§.9:§.~g . ,D.Bruce Roberts -Administrator.........................................................................................................................................-.. ....p..~~.E.~~.!?~gp.!?..;:.t-.:?.§9..~~.~.P..~#.?.!.~.~9.".b.!:¥..:::.~~.~E ..!g~.~.. ....f.E.~P.:~.~.$.w:Q.Et.hJ?-g.t.9..r.!.P..9:~.9:ht..~E I ~??~:h.~:?..!?.§.~.~~~g!:.~.~9.".~!:.~.!.~.'Pa • .........................................................................................................................................,. ....................................................................................................··1 ···.. That deponent is over 21 years of age,resides at...~.~p..~J~?!.~.~9.:~.!:¥.:.~?..~:..~~~..~.. .,..................................................................................................................................................................................................................................................' is a citizen of the United States and a resident of Pennsylvania,and respectfully applies for Letters of Administration upon the Estate of·said decedent,no letters having been previously issued thereon. Sworn and subscribed before me this.......§.t.h.~.......... day ofB..~.~E..~.~.~::.X ,4.D.,19 6..9.................v.~~4:..!:.~~. REGISTER J .J)~f2~.. ( )(. 1 _.. COMMONWEALTH OF PENNSYLVANIA WASHINGTON COUNTY,}SS: And now F..eb 6.th ,19':3.9..,come1ii>.4?.r.JJ.~.~R.QQ.{l.r.Ji.S... who being duly sworn doth depose and say that...~~will well and truly administer the goods and chattels,rights and credits of ~t.h-.~1 ~g.n.~..~~Q'!?.~.r.t~,deceased, to the best of..~!.~.....skill and judgment in strict ~ompliance with the laws of this Commonwealth,mind- ful of the laws relating to inheritance taxes. Sworn and subscribed before me this Q.th.!. day of...4~~.Q;r...9.~~Y.'27 ~~D.,19..§.~.. ...............f...~~~Lzrf.~.. REGISTER j)~~£Jb;t;.... • • I, . \ -If ?~7 'Ito ~~8-&tf---Z £7 APPLICATION FOR Letters of Administration ESTATE OF MRS.ETHEL J.ROBERTS a/~ ETHEL JONES ROBERTS a/k/a....................................................................................................... ETHEL M.J~a&soo ROBERTS R $. Letters ._p(;,l P $(,.~. "'I;" \ .' Extra Alias $.............................................. Certificates ..I A.~$L ..~~. Renunciations f $l....J!....Q ..................................................................$. ~~::~~~~..·.·.·.·.~·.·.·.·.·.~· ·..·;o..};..·~7 ;·;......·:..·,V:'e.....· : ·..·..·.. (,'" -.j :.- -j r .::;'-u Ul -''1, L) -, . L) ,-I ;1 U ,~ " ,j ..E).Q.9..P.?-..t.....~J.9..Qm.A....B.~.~~np..~.~.~....~D:9.om o Attorney ~2 ~Mt:3 ?~?'7" ESTATE OF The undersigned f.E.~.!}.s:~,~g..~~.9.E.!.-h.~.!}.9:~.9..!}and heirs of.....E;.t:h.~.l g,.~~?.e.~E.!.-.~.late of...~9..E."!:-.h ~~.t:~.~.~~.~~~J2..~.. deceased,hereby renounces h~.E......right to administer on E;.t:~.~.~!..~~?.e.~E.!.-.~estate and respectfully asks that Letters of Administration be issued to P...~!?E~S.~gge.~E.~.~.. ...............................................................................................................................................................................................................................................................' Signed in the presence ~~~R .. ..........................................................·····..···..·····....·······:·l·..···.~·······..··....···.. ..............................................................................................!.. ......................................................................................'.·;f :~. ","~l'.~;......................................................................................~..j".l ~........................................................................................~~;.. ), f ::u ITI Z C Zn-» -I-oz Qlommonmraltl1 of 'rnnB!Jluantu.~ss. IIas~ttt!1tott (fiounty.. j I,Russ:ell Marino ,Register for the Probate of Wills and Granting Letters of Administration in and for the County of Washington,in the Commonwealth of Pennsylvania, ~D.Bruce Roberts administra t or of all and singular the goods and chattels,-rights,and credits,which were of Mrs.Ethel J.Roberts,Etc.late of Washington County,deceased, GREETING:Ethel M.Jones Roberts WHEREAS,th~said Mrs .Ethel J-.Roberts ,A/K/A Ethel Jones Roberts/late of North B~thlehemTwp~in the county aforesaid,lately died intestate •i (as is affirmed i,possessed of divers goods and chattels,rights and credits,within the said County, flu ss'ell Marino by reason whereof the~power'of granting administration 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 6th. day of February in the year of our Lord one thousand nine hundred and Sixty Nine _....._..~£.L_.~~._.._ RUSSELL MARINO,Register. iLrttrrn nf A~miuintrattnu IN ESTATE OF Mrs.Ethel J.Roberts..........................................................;. A/K/A Ethel Jones Roberts,...,~- A/K/A Ethel M.Jones Roberts........................................................................................................ ~2 j il(unw 1\11 :LItu iy W~tst Jrtstuts KNOW ALL MEN BY THESE PRESENTS, That we,P..~~~~.~.~~?.e..~E.~.~~..~fr.J.P.:g.~p~).~.n.q gD.J..t.!?g §..t.@.,.t..§..~:E..~9.Jl..1J..t.y g..n.g . ..................g.~~..~.~.~.~..y.q..Q..~~.~..~.~..~.~9.!...~..I.~9...~§.~r..~.ty... all of Washington County,Pennsylvania,are held and firmly bound unto the Commonwealth of Pennsylvania,for the use of those interested in the estate,in the sum of..T..!?.n 1'.h.Q.g..~~.D.g D..Q.ll.~.r...~.. Dollars,to be paid to the said Commonwealth,to which payment,well and truly to be made,we do bind"ourselves, jointly and severally,for and in the whole,our heirs,executors,administrators,successors and assigns,and each and every of them,firmly by these presents.Sealed with our seals and dated the ,g.t.P.L.........day of ¥..!?.p...r..!J~.r..y .. A.D.,one thousand nine hundred and ~.~~.~.y ~.tP.:~.. THE CONDITION OF THIS OBLIGATION IS,That if the above bounden . ....................................................................p...!~.~.~.~.~~.Q9..~.r..~.~:. Administrator..................................................................................................................or any of them,shall well and truly administer .the estate according to law,this obligation shall be void as to those who shall so administer the estate;but otherwise,it sh'all remain in force.n ~-,.~,v.--'_:. Sealed and delivered in the presence of:Uri~·e~..s.JPIcfe'Ir't'y....a·nd....·G\ia~:~~j CO. ............................................................................................................................B!lI.H~!I!.g..,§]11"..:t ..............•.............(SEAL)f?.y.~:A)Attorney 1 a JI' ..............................................................................................................................(SE L) §tatrmrnt of §urrtg I,,surety in the sum of $on the administration bond in the estate of...:,say that I reside at ..................................................................................................................,Washington County,Pennsylvania;that I am the owner of real estate,the title to which is in my own name and duly recorded,situated in .. Washington County,Pennsylvania,worth above all encumbrances $;and that I am worth the amount expressed in said bond,over and,above my just debts and liabilities. Street ~tatrmrnt of j,;urrtll P.O. I,:,surety in the sum of $on the administration bond in the estate of...,say that I reside at ..................................................................................................................,Washington County,Pennsylvania;that I am the owner of real estate,the title to which is in my own name and duly recorded,situated in .. Washington County,Pennsylvania,worth above all encumbrances $;and that I am worth the amount expressed in said bond,over and above my just debts and liabilities. COMMONWEALTH OF PENNSYLVANIA,} SS: WASHINGTON COUNTY, Street P.O. And now................................................19 ,comes . who being duly sworn,says that he is acquainted with the financial standing of the securities to the within bond;that the said obligors have each executed the said bond and that the sureties thereto are the owners of real estate in their own right of value more than the penal sum of said bond over and above all incumbrances and exemptions. Sworn and subscribed before me this . day of A.D.19 . #847 No...~3.~6.9.~221........ Allmtntstratinu iSnull IN THE ESTATE OF MRS.ETHEL J.ROBERTSa/k/a ETHEL JONES ROBERTS a/k/a ..E.THEL M J.ONES ROBERTS . /fa> ---- - - -------- '..And now F.ehr.U&r.Y.6 ,,19 9.9 .. Bond approved and ~tters issued to ~"l ',1 D.Bruce :Roberts........................................................................................................ ·"1 ........~~~;..~~~~~1.:9.1.~,!.1:!.;.~4.~..,... Gj;;,~ ..................R~~~!~~~.:r.iP.9.::.. \.~Register o Bond Book.......63..............................Page......4M:...... ~2 \I, I I I II ~ .. !~,',.'.' ATTORNEY:Bloom,lUoom,Rosenberg &Bloom, I •• P.ffibnuit ®f1£xrrutnr (@r 1\bministrntnr ~tatr of 'rttttayluattta,t 55: moUttty of lIIlfaa4tttgtott \ Personally before me,the undersigned authority,a nQt.s.~y..P.1l.QJJ.c..in and for said County and State,appeared p..~~E.~~.~~?!?~E.!:.?.who,being duly sworn·according'to law,deposes and says that he is the &l8(jQ~or administrator of the estate of M!::.§..,.....E.t.h~J ....J..~.....E.9.p..~f.t..§....9.-.~~....;;t..h.~t ..~9..P..~&ceased,that the foregoing schedules constitute aR~5'Jpl~~in~~~or~t~!;pp~aise~~tileof tl~;?r~:I~~cr personal estate of....Mf.§.::.....~t.J:!.~1....J..~.....B.9..Q.~.f..t.~ deceased,except real estate outside the Commonwealth of Pennsylvania;that the figures opposite each item of real and personal estate in the foregoing schedules are determined and stated by the undersigned to be the fair value of said items as of the date of the decedent's death,based upon a just appraisement of each item made by the above named Executor Administrator. Sworn and subscribed before me thiS....?J.!?t...:...?01 12..DM day..~:.::Jc:::~~.~~..J~:~::~~~;:Ad;;;i~i;i;~I~;···_··.. 1.An in~entory must be filed within three months after appointment of personal representative. 2.A supplemental inventory must be filed within thirty days of discovery of additional assets. 3.1 Original and 2 Copies and 2 RCRI-34,Under $10,000;1 Original and 2 Copies and 2 RCRI-33, Over $10,000,including Copy of Will;1 Original and 3 Copies and 2 RCRI-33,Over $50,000,in- cluding Copy of Will and copy of Federal Estate Tax Return. REFERENCE FOR ADDITIONAL COPY Act of 1947 P.L.513 Sec.5.2,72 P.S.4844.2 lIuututnry au~""ppraisrmtut of the goods and chattels,rights and credits which weher··~~·§·~s·~~g·5~r·i·~..··~~~~·~·~lie·IJs~·:·..·~~hg~··R~~·~~~·s~·§·t.hJ.~.h.~m 'r.Q~n.§h!.P.. Washington 2iounty,Pa.,taken and made in conformity with the above affidavit. I PERSONALTY Mellon National BanK,Savings Account #919 Mellon National Bank,Checking Account #584-8810 Pennsylvania Public School Retirement payment REALTY None DOLLARS 8,753 28 920 54 165 09 CENTS TOTAL -~9,838 91 J3d? (p3-iP f-~;;;?7 Inventory and Appraisement IN THE ESTATE OF MRS.ETHEL J.ROBERTS a/k/a ETHEL JONES ROBERTS a/k/a ETHEL M.JONES ROBERTS Filed ,19 . 0 0 ••C'J (/) 0 ..... 0 -,z ..... ~~~~ uJ 4u-'Z-Q --',o:;t -'0:-'w-.N ~;-(l,)~ li-0::::;>t::l ~0:::u.J0::: $ $ ~9 '... FIRST AND FINAL ACCOUNT OF D.BRUCE ROBERTS,Administrator of the Estate of MRS.ETHEL J.ROBERTS aka ETHEL JONES ROBERTS aka ETHEL 'M.JONES ROBERTS, Deceased. Balance per Inventory and Appraisement .•...........$9,838.91 Mellon National Bank -Interest -$352.16 .10,191.07 Total Assets of Estate ...........•............•...$10,191.07 Total Credits claimed by Accountant.....•...•.....•1,815.37 Balance for Distribution $8,375.70 ...~,• r'.,- The Accountant claims credit for the following: ................................................................. Russell Marino Washington Co.Reports Observer PUblishing Co. Russell Marino Mellon National Bank F.J.Buckley Ins.Agency Greenlee Funeral Home Richard Harkcom,M.D. Russell Marino Dean Hughes Russell Marino Bloom,Bloom,Rosenberg &Bloom Ltrs.of Admin.,SC,Renun.17.00 Advertising 14.00 Advertising 14.00 1 Short Certificate 1.00 Check charge on transfer .10 Administrator's Bond 60.00 Funeral 1,182.00 Last illness 3.27 Filing Inventory 3.00 Minister 10.00 Filing Account 16.00 Attorneys'Fees 495.00 TOTAL $1,815 .37 / Washington County Reilofts 63 SOUTH MAIN STREET Washington,Pennsylvania (PUBLISHED BY WASHINGTON COUNTY BAR ASSOCIATION) 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 0'"P£NNSYLVANIA (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 this behalf;that the said WASHINGTON COVNTY REPORTS was established on March 31,1920,and was designated as the official legal publication for Washington County,Pennsylvania,by order of the several courts of said County,dated November 11,1920;that the printed notice or adver- tisement attached hereto is a copy of a notice or advertisement,exactly as printed .(1 or published,which appeared in the said legal periodical in its regular issues on the It following dates: .......Ee.br.ua:r::y.13.,....2·O',....2.7.t·..~9.6.9 .. that the 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 'h;.,IH&V;',,~d.:@~_K~ ~?~S';~ tot"ry Public KATHERINE C.YARD,Notary Public:~ Washington,Washington Co"Pa. My Commission Expl.... November 1,1869 Estate Notices The Register of Wills has granted letters, testamentary or of administration,in the following estates.Notice is hereby given to all persons indebted thereto to make payment without delay and to those hav- ing claims or demands to present them for settlement to the Executors or Admin- istrators or their Attorneys. • ••• • • ••• • • • • • • •• ROBERTS,MRS.ETHEL J.a/k/aETHELJONESROBERTS,a/k/aETHELM.JONES ROBERTS,Dec'd. Late of North Bethlehem Twp.,Wash-ington County,Penna._~dministra!or,_D._!3ruce Roberts,R.. D.#2,Eighty-Four,Pa.---.. Attorneys:Bloom, Bloom,Rosenberg .&Bloom,200 Washington Trust Bldg-Washington,Pa.., STATE OF PENNSYLVANIA, WASHINGTON COUNTY,~55: The within named Accountan't being duly sworn according to law,depose and say that the above account as stated is true and correC'tas __..h~___verily believe, Sworn and subscribed before me this ~_~~~.. d 1 September 69 ay _Of_~::::::~:::__::: ,ROWENE EBELING.Notary Public My Commission Expires February 8.1973 Washington,Washington County.Penna. Wa1shington County,ss: :J)~12 .()ll "...._.D~.._.8.._\..(___..____.. D.Bruce Roberts I do certify that I have given leg'ol notice to all persons concerned of the firing of the within account in the manner prescribed by Statute and Rule of Court,as evidenced by proofs thereof filed to No.~-3.:::.b.r--:.3.2:L--,Wit~my hand nnd official 'seal 'his..__tfl'!:l!:m _ dayOf------7.-~-----.---~------19//1.~------_.-._-----------------._-- egister of Wills ~1 J i \}j ~l,I «j 1oz RUSS 0 REGiSTER ()f WillS WASHiNCaaU C0'P'A'~•','~"Ji '-, ,I, .tl~ ~.,,-.=.---- !a ~b9-~~7..... o o...o ~....:Q)U o'8iEo~r;il;1 -~"'''d=cO 5l...., rtl.~ P:: ".~ ,"-... ,r " '\' / /,-" " The Court is respectfu lIy requested to de'termine proper distribution in this estate. L~~a--. Counsel for Accounta t -.......:. .'.' / '. No.63 "':6 9-;...-...:2~2~7~'----,.19--=--..A.A. 'In the matter or the Audit or Account in .. ,\ Estate or ,MRS.ETHEL J.RO'BEE,TS .aka· "ETH~LJONES ROBERTS'ak~ETHEL M. ·:JONES ROBERTS ;. ,"',.,".TO THE AUDHIXG JUDGE: -.. '.•..i '.'Enter__--:o;;..u;::r::......R·ppearance ror__~D~:----=B~r;..u~·cl::c~e~R~·ob~e~r..l.t...s;w...._·..Au.dJ.lID.!.l·...iJ,.DUiL..;·s;u..t...r..l;aa..;tL.:·Qu'...r _ '.,-------=--------_.:.-_---..;-,;..-----------=------ .1/ 12th day or December •19~ .',.BIloo.H,BLOOM,ROSENBERG &~LO.DM.I~!3~~~ly I2Lr-.-- .; ..... N.B.-...:Cou~set shall.bj"separate IJ1!Jer.present a concise state:;::~nt or each claim,with SUI1;lorti,,;c:I!cul::.non o{:In}interest cb..i:ne'i,Obj,;ctions to an account as tfled.sh:lli b'3 concisely st:lted in a se:;:,:!.r:lte p:l;Jer. Coundl sU;;-=5~iL;:;pr0tler di3triblltion sbll tile a sep:lrate concise st:l.te· meut in th:lt re;ard. ..~ Are there any advance- ments by decedent to be considered on distribu- tion and has any distri- bution on account been made by accountant to any distributtee? (p) No (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):- D.Bruce Roberts -1/3 Frances M.Worthington -1/3 D.Shanor Roberts,deceased -1/3 (D.Bruce Roberts is Administrator of his estate.) 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...i..l?__knowledge and belief. Sworn to and subscribed before me this If ~day of ~,19§.~. ~)£t/._>~ ...........................................................~.~.~. ROWENE EBELING,Notary PubliC!. .....___My...Cnmmlssion..hp.ires..fehruaqt..8,..1973. Washington,Washington County.Penna. And your petitioner will,etc., J.l ~{(kt . (Signature of Petitioner) , \ '"''\\ FORM IN CASES OF INTESTACY 63-69-227N,o., . ...._~Term,]9 _.,A.A. IN THE ORPHANS'COURT WASHINGTON COUNTY,PA. Mrs.Ethel J.Roberts aka Ethel Jones Roberts aka Ethel Es,tate of M_~;r.9.~_~_~.~9.p._~:I_t:§....__. Deceased. Sur account of .P._!J3.~_~~_~.R.9.p._~.Et.~.L ..._... Administrator.._---__----__-__-------__--_.._--__--._---_.._------------------_-.. PETITION SUR AUDIT In Conformity with Court Rule III, Sec.5 (B) COUNSEL FOR THE ACCOUNTANT WILL SUBM IT 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 fo,r 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. ", S11i,',1 .n ~c!TtS!8ju ONliJVi·l TIJSSnH . .~ LQ :Z IJ,.l.....OZo 0:0 SSGI Attorney ~9 for A'ccuuntant.o.3 _..",=1 j In t1Jt Qtnurt of <1rnUtmnn 'lrali of lJali4ingtnn Qtuunty. Jrnn5ylnnuin.®rpqnns'Qtaun ltittisinn ESTATE OF Mrs.Ethel J.Roberts a!k!a N 63-69-227o.~_~.L_..::...!:::.=..L _ In the matter of the First and Final Ethel Jones Roberts a /1,r/a Ethe~, M...Tones,Deceased. Account of D.Bruce Roberts Administrator ADJUDICATION AND DECREE And now December 3D ,19~,this motter come on for hearing, audit and distribution at this session and testimony taken;and thereupon,upon due consideration thereof the bal:nce for distribution in :the hands of the Accountant is determined to be $Ji,37.2.70 and the account is accordingly confirmed;and it is ordered, adjudged and decreed that the said balance 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 be taken herefrom sec.leg. SCHEDULE OF DISTRIBUTION Balance per account _$8,375.70 $8.375.70 24.00 A 8,351.70 :;idl.,t1<tJ(J~1-1'-70~n /1 ci;]..'''',,#7J(~~.I,(J.e... Balanct:..e _ Deduct Clerk's Costs &Receipts:a-_ Attorney Bloom,Bloom.Rosenberi &Bloom Russell Marino,Agent,tran~'fer inheritance tax, $159.99 Interest from 3-7-69'to 1-5-70 7.95 D.Bruce Roberts,son,1/3 balance, Frances M.Worthington,daughter,1!3 balance, D.Bruce Roberts,Administrator of the estate of D.Shanor ROberts,husband,now deceased,1!3 balance,2727.92 No balance E 0 ~~ ....::s Z (B (-+p;rcCD ltJ?i a 3a0~ ~. .... ~ CD.. a 0 t ........-+ t:f ;r =CD "~~ ~~~ '-._, _..,.,,....•.r . \ \0a.. C'\J .,~_~__~~~~"""""M-~_~'""""''''-_''''''__'' Form Xo.nCC-62 (12-66)THID FORM REQUIRED IN ALL ESTATES WITH GROSS ASSETS UNDER $10,000.UNDER SECTION 701 OF ACT OF JUNE 16,1961,/ EFFECTIVE .JANUARY I,1962.(FILE IN DUPLICATE WITH COPY OF WILL ATTACHED) OFFICE OF THE REGISTER OF WILLS .. Coqntyof W?t.~J:1~ng~~J:?. ...l?~..~~~'?~..~?~.~~:t.~'of .~•..~!F.2.~.~~9'~~¥:-.~~?:t:~..~~:'_. (Name)(Address) being duly SW.Qrn .accordingto law,deposes and says that he is the 1\~inis_trg._tQX:_MRS.ETHEL J.ROBERTS aKa (Exec.,Adm,.Legatee.Ecc.) of the estate of ~~~!!.__q_Q~}~;.e ~9_l?_~~?;§~~?:_whose last residence was ~!.l.?_~.__#_?.-----ETHEL M.JONES ROBERTS (No.)(Street) ___~j.glxty_:-_f_Q.:g,f'.deceased,and that the whole of the estate of said decedent,who died __R§!_~_~I,1~§_7. (CilY.Borough or Township),(Date) consisted of: REAL PROPERTY REAL PROPERTY IN PENNSYLVANIA,WITH STATEMENT OF MORTGAGE ENCUMBRANGES UPON EACH PARCEL AT DEATH OF DECEDENT, WHERE PROPERTY HELD AS JOINT TENANT OR TENANCY BY ENTIRETIES.GIVE NAMES.ADDRESSES AIim RELATIONSHIP OF OTHER OWNERS. Real Estate Estimated Value - NONE Personal Property Savinqs Account #919 O~,j IMellonNationalBank 8 7S~2R-O+\/::rjMellonNationalBank,Checkinq Account #584-8810 920.54 Pennsylvania Public School Retirement payment ().,{J1-':J 165.09 I ~.. - ".--. ~ -.'--9.838.91.TOTAL NOTE:You may expedite the processing of this return by filing With it,'-and as a part of the return, letters from financial institutions or mortgage holcfers,certifying to amounts on deposit or owed by-tne decedent as of the date of death.Such letters must he signed by a responsible officer of the financial institution or mortgage holder and indicate clearly amounts of principal and interest in the decedent's account at the-date of death and the type of account,account number and the exact name or names in which the account is registered. .lit,...~ Jointly Held Property Estimated Value ,._._--.. None - ~-... ( - Transfers within TWO YEARS Prior to Death None That at the time of death there was no safe deposit box registered ih decedent's i dividual 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 eputy,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 NA ~E OR NAMES OF HOLDERS TO DECEDENT - BENEFICIARIES BENEFICIARIES AND ADDRESSES RELATIONSHIP SURV VED AGE OF LIFE (If step-children or DECE )ENT TENANTS OR INTEREST OF (State full names of all and their addresses who have illegitimate children STATI N6 ES ANNUITANTS BENEFICIARY an interest,vested,contingent or otherwise,in estate,)are involved,set AT DEATH OF IN ESTATE forth this fact.)OR DECEDENT D.Rruce Roberts Son Yes 1/3 R.D.#2,Eiqhty-Four,Pa. -Frances Worthington Dauqhter Yes 1/1 ~427 Chess St. MononQahela,Pa., D.Shanor Roberts Husband No 1/3 Now deceased ~. . - -. r I ~RESIDENT DECEDENT DEBTS AND DEDUCTIONS CLAIMED L:::NOT~'List first five items in the spaces so provided,observe notations thereon,and instructions. DEBT OR CLAIM NATURE OF SAME AMOUNT THIS COLUMN~__--=-:..:..::..:::....::...::=----=....::=-----..:.:.c==-=-_.-----.--:..:..::..:=..::..=-=r----1iKlo.EGISTER ONLY • . ,J Funeral expenses paid $$ Family exemption (will not be allowed unless decedent died residing with a spouse or children.) Administration Expenses * Counsel fees * Fiduciary commission * OTHER DEBTS AND CLAIMS (*)See Note below Total f?~~..;[).:~..;(~'.. (~~-Administrator ) Subscribed and sworn to before me this ?+~1;.. Note:The estate agrees to advise the Register of Wills if the amount actually paid in settlement of any fee,commission oi'debt is greater or less than the estimated amount claimed and allowed. ...............~:.day of !).p~~~\'19.6.9 ...........,..tI.~....I.",..,aIjI.P.ublic My Commission Expire February 8.191-1 Washington,Washington County.PennI.. ...~~..P.·#;2.. (Street Number) ...~.:igl:l:t;y":'~Q:q+.~..:P.~n.l).?',. (City or Town and State) Having been duly swor~~c~'ding to law,I do ~y certify that the above appraisement is made in conformity with law on this ·.··········eP.?:·~···..day of ~.<-~.£,!9.~..r-?~ ..~/G ~"~....~.£•••~••«:..J..Ap Iser In the event that any future interest in this estate is transferred in possession 01'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'inheri- tance taxes at the lawful collateral rate on any such future interest. REPORT OF THE REGISTER OF WILLS I,the undersigned duly elected Register of Wills in and for County,Pennsylvania,do respectfully report that I have allowed debts and deductions in the amounts claimed by deponent,except as to those items where a greater or lesser amount is set forth in the last column to the right in said schedule above,which greater or lesser amount represents the sum allowed as a deduction. Dated:. Register of Wills ~I I Fonn No,RCC-62 (12-66) WillAdministration }No Year ..' . IN THE MATTER OF THE APPRAISEMENT OF THE ESTATE OF MRS.ETHEL J.ROBERTS a/k/a ETHEL JONES ROBERTS a/k/a ETHEL M.JONES ROBERTS....................................... Deceased Eighty-Four Late of ...~?:r::~J:..~7:t?~~?7~..~?~... County of ..l:'1~~l).i.~g:ton..................'"", Commonwealth of Pennsylvania ." rmo ~3 1\)~ -- :::0",:::0me::-(f) (f)(f).-i,.."., Mr-~r- 03:"Tl;p. =E::v;=z '-0U> REPORT AND A~RAISAL CJ)o;D ~::0 In~ RCC-B I (2-64) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTI0J-tS INHERITANCE TAX DIVISION NOTICE OF FILING OF APPRAISEMENT D.BRUCE ROBERTS (~Administrator) IN YOUR REPLY PLEA.E REFER TO 37-188-5 In Re:Estate 0 f ..::.;MRS=..;...-.:E::.:T:.:.;HE:.:.;'.=L:....J=-.:...-::.R;..=O=.BER~':.:.;T::.::S;....;:;a;L./=k/t...:.a=-- _____W_A:..:..S__H_IN--..;..GT_O_N County -File No.63-69-227 Dear Mr.Roberts: You are hereby notified that the original appraisement in the estate of Mrs.Ethel J.Roberts al~a has been filed in the office of the Register of Wills qf Washington County on April 29 ,19QSL.Said appraisement reflects the following valuations: Re al Est ate _--'---."._...,-.......,....~-- Personal Property ~9~.sa~··_8~.u931~__ TransfersTota1 ---------------9-,,8;:;:·~;;::a':;-.-::9~1--- As to such tax that is paid within three months from date of death,a five (5%)percent discount is allowable.As to any tax that remains unpaid after one year from date of death,interest at the rate of six (6%)percent per annum is charged. Any party in interest who is aggrieved by an appraisement may appeal therefrom as provided by law. Dat e ---:A:=Jp==r-=il=-:2::...9u .L.....:!!:1.L;9$:t:;.,9t...-__Sign.~::::z:;-1* Title W.R.~EY '-,S DATE OF DEATH:December 7,1967 Note:This is not a bill. RCC<.39 (ll-88) COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SUMMARY Estate of ROBERTS (Last Name) ETHEL (First Name) J. (Initial) DATE OF DEATH__12_-_7:.--_6..:...7_FILE NO.63-69-227 REPORT OF INHERITANCE TAX APPRAISER I,the undersigned duly appointed Inheritance Tax Appraiser in and for the County of Washington Pennsylvania,do respectfully report that I have appraised the real and personal property as reported in the foregoing return at the values set forth opposite each item in the last column to the right in Schedules "A","8","C",and "E". 04-29-69 12-07-67 Dated:-----'::::=-=-~~----- REPORT OF THE REGISTER OF WILLS I,the undersigned duly elected Register of Wills in and for County,Pennsylvania,do respect- fully report that I have allowed deductions in the amounts claimed by deponent,except as to those items where a greater or lesser amount is set forth in the last column to the right in Schedule "F",which greater or lesser amount represents the sum allowed as a deduction. Dated:_ REGISTER OF WILLS VALUE AS REAPPRAISED $-------+--9,838 91 9.838 91 $ 9.8'38 91 '1.8':\8 91 VALUE AS REPORTED VALUE AS APPRAISED $ INVENTORY Real Property (Schedule A) Personal Property (Schedule B) Transfers (Schedule C) Joint-Held Property (Schedule E) TOTAL GROSS ASSETS Less Debts and Deductions (SCHEDULE Fl CLEAR VALUE OF ESTATE Valuation of life estates or FOR USE OF REGISTER ONLY Tax on $--------+--(2%)0 Tax on $---------t--~ Tax on $5% Tuoo$lK Tax oil $15% fu~ptioos * Total Estate -1-__ TOTAL TAX COMPUTATION OF TAX $-------4--- $-------+.-- $-------4-- $--------4-- $---------+-- $---1.-- (*)As evidenced by Charitable Exemption Certificates issued by the Secretary of Revenue. Less tax previously paid BALANCE Less 5%of tax if paid within 3 months after death :::::::::::::::t==== BALANCE OF INHERITANCE TAX DUE $t= Add interest at rate of 6%fro~_____to $-.J AMOUNT OF ESTATE TAX ASSESSED $~L- Estate tax paid $---IL- BALANCE DUE $---Il- Add interest at rate of 6%from t= ------\to-----$-------1 TOTAL TAX BALANCE $------1PAID$...J FOR USE OF REGISTER ONLY ADJUSTMENTS NOTE:Where subsequent adjustments are made to the above computation of tax by the Register of Wills,for proper reason, same should be noted below,with short explanation. Will Administration !No. IN THE Year --------------------- -------------------------------, MATTER OF THE APPRAISEMENT OF THE ESTATE OF --Ml:1P._:wrI;:iE.~.J._@~:ER'I'P _a/}{,/~__ Deceased Late of _ County of N.IETHLEHEM TWP. WASHINGTON Commonwealth of Pennsylvania 1 _ " Fonn RCC-2 ;.,DI!:P4RTMENTOF REVENUE BUREAU OF COUNTY COLLECTIONS HARRISBURG.PENNA.17127 COMMONWEALTH OF PENNSYLVANIA RESIDENT INHERITANCE TAX APPRAISEMENT '"• J .. DATE ..Ap:r.~.J:?9..#.!.?.§.9 COUNTY J.~~§b...mg.t~..9P.,. FILE NO...§'J..=.§..9.:.??.7.....(,. Whereas,&.~.~~.~h.~+.~..~~~~.~!.~.~~I~.I~late of ~..~~.:~~~~~.~~~~.~. in the County of W~~.h~gt.9..~Commonwealth of Pennsylvania,having died on the 7 t.b day of P..~~~~~.~19..§7...,seized and possessed of an estate subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore,I,W.~R..L ..C.b@~y.,an appraiser duly appointed according to law, having been designated to make a fair and conscionable appraisement of the said estate,and to assess and fix the cash value of all annuities and life estates growing out of said estate,hereby file the following appraisement: In the event that any future interest in this estate is transferred in possession or enjoyment to collateral heirs of the decedent after the expiration of any estate for life or for years the Commonwealth hereby expressly reserves the right to appraise and assess transfer. Iinheritancetaxesatthelawfulcollateralrateonanysuchfutureinterest. Unit AppraisementDescriptionofAssetValuesMadeforInheritance I Tax Purpolel $ PEESONALTY:I I Account 8,753.28 IMellonNationalBank,Savings Mellon National Bank,Checking Account 920.54 Penns:vlvamd.a Public School Retirement payment 165.09 9.838.91 9.838 91 I , I , I Total 9,838 91 form~:~bl::::~h~~·~1~:·~.~:rere~~~~s~=~~=;:i:F /IJ2:;;~?;"••..••••••••••••••••••••••••••••••....~::. (Post Offiee) I r-----___,_____,__~___,_____,__,,___,__~~~~~~~_co_~~___,_____,__~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~___,_____,__~~~~---,--~~~~~~~~~---_._-- ...............w.~:tQ:N.<:T'JPN....County RESIDENT INHERITANCE TAX APPRAISEMENT Estate of ........~~.~~~~f.'9.~':l'~~ll~/~. Deceased. Late of N.BEI'HLEHEM TWP.................................................................................................... Date of Death,P..~9..~J!:IP..~.:r..7-'J,.,9.9.7... Appraisemcl!t Docket Vol.,?7 . Page,:I,.~~.5.No .f/J.:~~:.~.~??7 .. Filed in Register's Office,April 2..9."J96.9 . Amount of tax due,$.. DEPARTMENT OF REVENUE Received, Examined and Approved,. Wrote abo,ut Appra-isement, Appeal j"om Appraisement,. Entered and charged,.. #- ~ " Form RC ColO it:,. TI)37-I %Y-S- DEDUCTIONS ALLOWED IN J QFFICE OF THE REGISTER OF WILLS OF _w_a...;.·_s_h_i_n.....9....t_o_n_.__COUNTY AND AGENT OF THE COMMONWEALTH STATEMENT OF DEBTS.. AND DEDUCTIONS THE SUM OF .__..._.....$... DATE APPROVED . Regi.ter of Wills,Agent ESTATE OF MRS ..E'l'HEL J.ROBERTS L....TE OF Eighty-FOUr,Pennsylvania aka ETHEL JONES ROBERTS aka E'l'HEL M.JONES ROBERTS DATE OF FIL.ING APPRAISEMENT DATE OF DE"'TH _...!De=!l·=.:lCII:.:El~mb!!l~~e:-",!r~7w,~1=.:!9~6...L7 _ D"'TE NO.OF VOUCH""NAME OF PAYEE REM"'RKS AMOUNT 2/6 69 2/6 69 Rus.ell Marino Washinaton Co.Renorts Ltrs.of Admin ...se..Renun.17 00 Advertisina 14 00 2/21 fi9 .....Advertisin(t 1400 2/19 69 Russell Marino 1 Short Certificate 1 CO (!heel<:charae on transf~r 10 2/25 69 F.J.Bucklev Xns..A~eney Administrator •s Bond 60 00 ~reenlee FUneral Home FUneral 1.182 00 4/24 69 __-+_-----j,....-_--t-=R~i:.:lc~h~a~r~d~H=a.:::.:rk:..::;c:::.:o~m:lI.,L.....:M.:..:..:..:D:....:.+..:L::;a::..:s::..;t=..·;..:1::.:1:..:1:.,::n:..:e:,:8.:::9 -+-_---=3:..+=2:..,:7:...-..I Russell Marino Filin'l Inventory 3 00 Dean Huahes Minister 10 00 Russell Marino FilinQ'Account 16 00 Bloom..~loom.Rosenbercr &A't:totnevs'Fees _;:.1. TOTAL 495 GO 1~1.5 I.::u-- COMMONWEALTH OF PENNSYLVANIA } COUNTY OF washinqton se:D.Bruce RobertsI,-------~---:..:.-:...-:....:.=.-----------_HEREBYCERTIFY,THAT.TO THE BEaT OF MY KNOWLEDGE AND BELIEF,THE FOREGOING IS ...jiB!"'NDiIYl~lr"'U:MEtlTpF DIiElTS,FUNERAL.EXPENSES "'ND EXPENSES OF ADMINISTR...TlON SUBMITTED TO THE ESTATE OF rs..u..t:<.ODerl:S DECEASED.AS DEDUCTIONli FOR INHERITANCE T"'X PURPOSES.#j.,~~(L.5.1 SWORN "'ND.S~BSCRIB,ED!lEFORE ME THIS :<.r~D"'Y 01'D.Druce Roberts ,~A/'J.f11 .//.."I 69t18_ /6/l#..A!.I L/.AU ..yillf J •~/J (J $_--=-'1.......9~9=_=9_=_.5=-4.=-·_$_~1$""_'9"'_"._""_99""_____,r..l,2%Tax onAddress RECEIVED _~O~NE~R!!:mm~·~R~B~D!..-...!!!!s~I1~n~~.=:!8E~V!..!!irs!!:!NL·_____!a~n!l1!dl!....·,_...JIM!:!!Itf-a....O!l£O!IiL-----:!-~-~..~-----!.~.~·....!!!-!........:!!!!-c......!!!!.-_dollars Ih 8rute RobertI f Admr.representing Pennsylvania Inheritance or From:C'!!!L:.O!!.---!A~T~~n~'.!!!S!..!._..!!B~L~OO~.!...!:M!..t·~B~L!!.::!O!!..:lO~)l!:.!..Jlft~O~SE~NB~E~R!!.!O:!!:"Tff:!!!."---!o!B~~O~O~ML.'_Es_ta_te_Ta_x_d_u_e_fr_om_th_e_f_o_lIo_w_in_g_e_st_a_te_:1 200 WASHINOTON TRUST BUILDING WASHDOTON ,mmVANIA 15301 File No.63-69-227 Date of Death 12-1-61 6%Tax on $$---------.11'11 15%Tax on $$111 Date of Payment J_a_D_Ual'Y__c_·__"-'-,__1_9_7_0 --1 $-'---------IfliNameofDecedent %Tax on $$---------ml Estate Tax,Act ofBfJIBLJ.R08lRTS,aka etC.May 7,1927 County ¥_l_S_H_tNO_·_.,_'_05_·----1 TOTAL TAX CREDIT $_--=1::..=5-=-9..::...;.9:::...::9=-----__UI $--------IHI 7.95$'--'-'---111 II{ !I Less five percentum of tax if paid within three months after date of death 61 us interest at the.;~~pf __%from 3 Of 09 to Da__t_e_.--- ;. 'urn ~[P[t~@ill u~SEA L "TOTAL AMOUNT PAID $16'.94 .. NOTE:This Triplicate Receipt to be-retained I~r ~udit RI~~8e~5 (....-_._)J//,''JJ1'' : '. ',~.'",".Received by".X.{A~~/!J2.--"""-/'c.-o NOTE:In accepting the transfer inheritance tax on futU're estates,prior to the death of the life/"""')'.(Signature)<:daJ tenant or tenant for years,as evidenced by this receipt,it is understood that the Commonwealth shalle ~..I ,!'~.}</ not be precluded or prevented from hereafter assessing odditional inheritance tax at the death of the"~:/.t.4..v.,§;U ~~. life tenant or tenant for years whenever it appears that such additional tax may be legally due and ' \(Tip e) collectible for any reason whatsoever.-. Remarks: ___.1