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HomeMy WebLinkAboutOC1969-0392 - ESTATE OF DOMEN-~---~-------~-----------------------------------~--, Form No. RCC·62 (2-641 THIS FORM REQUIRED IN ALL ESTATES WITH GROSS ASSETS UNDER $10,000, UNDER S~CTION 701 OF ACT OF JUNE 16, 1961, ,:~,V,BIAliuARY>,P ... (PILE ON ~UPUCATE WITH COPY OF W<LLATIACm~l ~ *~ OFFICE OF THE REGISTER OF WILLS County of ... W~~:tl.j,!J.g:t.Q:t;J. .......... . . . . . ~.~?~~? .. ~I;I~~~~ .. J?~~~~.· ................... of ?.1.~. ~~ ~.~. ~~~~·'··. ~.1:~~.~!?-~~ ~. ?.~J?.!l.~Y~X~~ia (Name) (Address) being duly -----------~~-?-~-----------------.according to law, deposes and says that he is the ____ ,AQ.m;i..n.;i...s_t..rat.o.r _______________________ _ -(Exec., Adm., Legatee, Etc.) of the estate ~f ____ Jt~.:t!~.N.J~~! ___ P..m1.:FJ!L __________________ whose last residence was _____ ]_QX __ 8_4._,_ __ _Fr_ed.ari.ck.t.o:wn ______ _ (No.) (Street) ----"-~-~---~-~-~E:!~_P:~¥_1---~-:~i!?.~-----·deceased, and that the whole of the estate of said decedent, who died __ .!!_~~-! ____ ?_,l. __ J_2_9..2 (Cicy, Borough or Township) (Date) consisted ·of: REAL PROPERTY REAL PROPERTY IN PENNSYLVANIA, WITH STATEMENT OF MORTGAGE ENCUMBRAN<i:ES UPON EACH PARCEL AT DEATH OF DECEDENT, WHERE PROPERTY HELD AS JOINT TENANT OR TENANCY BY ENTIRETIES, GIVE NAMES, ADDRESSES AND RELATIONSHIP OF OTHER OWNERS. Real Estate None I "' Proceeds from sale of real estate pursuant to Order of Court dated November 12, 1969, and filed at No. 392 of 1969~ in the Court of C.ommon Pleas of Washington County, Penns__yl vania__,_ Orphans' Court Division Proceeds as beneficiary from two life insurance __12_olicie...s. .Ji.ith the Franklin Life Insurance CompanY. Sprino:fie£d Illinois Estimated Value ( I NOTE: You may expedite the processing of this return by filing with it, and as a part of the return, letters from financial institutions or mortgage holders, certifying to amounts on deposit or owed by the decedent as of the date of death. Such letters must be signed by a responsible officer of the financial institution or mortgage holder and indicate clearly amounts of principal and interest in the depedent's account at the date of death and the type of account, account number and the exact name or nanies in which the account is registered. J Jointly Held Property .. Estimated ' Value -:.. --__, . ' . -.. - -~fone .--· - Transfers within TWO YEARS Prior to Death None ·< _, ' . . . .. l . ' ' That at the time of death there was no safe deposit box registered ih decedent's individual name, or jointly with, or as agent or deputy of another, or in decedent's individual name, with right of access by another as agent or deputy, with the exception of the following:- NAME AND ADDRESS OF BANK OR OTHER INSTITUTION THIS SAFE DEPOSIT BOX RENTED RELATIONSHIP OF JOINT IN WHICH DECEDENT RENTED A. SAFE DEPOSIT BOX IN NAME OR NAMES OF HOLDERS TO DECEDENT None . BENEFICIARIES BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED AGE OF LIFE (If step-children or DECEDENT TENANTS OR INTEREST OF (State full names of all and their addresses who have illegitimate children STATE YES ANNUITANTS BENEFICIARY an interest, vested, contingent or otherwise, in estate.) are involved, set OR NO AT DEATH OF IN ESTATE forth this fact.) DECEDENT Joseph Thomas Domen Son Yes 1/3 Patricia Striker Daughter Yes 1/3 JoAnn Metallic Daughter Yes 1/3 -I I ~ ~ -~----~----~------------------~---------------, R:gffiDENT DECEDENT DEBTS AND DEDUCTIONS CLAIMED NOTE: 'List fir!)t five items in the spac~s so provided, observe notations thereon, and instructions. DEBT OR CLAIM NATURE OF SAME 'Greenlee Funeral Home ~1oschetta Gross Furniture Lazoviks Velia Bigi Greenlee Funeral Lang Monument Co., Joseph Thomas Reimbursemen Torre ce State Hospital Funeral expenses paid Family exemption (will not be allowed unless decedent died residing with a spouse or children.) Administration Expenses * Counsel fees * commission * (*) See Note below Furniture.. Clothing payment own Real state Co. Oak Grove .~ill ance on Ho e Washington County Tax Claim Bureau, 1969 taxes Washington County Tax Claim Bureau, 196$ liened taxes of E .• Bethlehem Twp. 1969 taxes Hospital Care Total • AMOUNT $ ., 500 77 2 18 2 490 1 '500 0 150 20 175 10 615 2 23 00 138 00 Note: The estate agrees to advise the Register of Wills if the amount actually paid in settlement of any fee, commission or debt is greater or le~s tha~. t~e es~i~ated amount .claimed and allowed. . ~J. ~·S· ~ .e _ ~· 1 .·h ~. 1 .. ~'ffi .. V:l(5~. ffl~.t~r·if· .. ·~·~··~· .·e·t~W .. t.o.r~) ............. . Subscnbed and swom to. before me th1s...................... ~~~ ......... .2 f.~ ... · .. d:~f ...... .!"larch ........ , 19.-70 .. ~~.~ .. ~~.~;v:. ~?.~~ ........................ . ....... dir.w.~.)?(~.~~······ ,1\'( C::)'',";::· 'I ~:f:·• .:~ .'.\.'.:':::-J 2t 1?72 CliY CF V/A~;;:~,_;::i, WA:~::NGTON C::OUN'I'Y M. (Street Number) Glenshaw, Pennsylvania (City or To'lfn and State) In the event that any future interest in this estate is transferred in possession or enjoyment tU"Cvrrltt' expiration of any estate for life or for yea1·s, the Commonwealth hereby expressly reserves the right 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 ) :;' / ,-,_,.. -: v' I Form No. RCC-62 (2-64) Will 1 c3 -g '1 Administration s ~ o. · · . /. -?1. . . • Year .Ia .f IN THE MATTER OF THE APPRAISEMENT OF THE ESTATE OF HELEN K. DOMEN Deceased Late of . -~~. ~~~?;lehem Twp • . . . . . . . . . . . . . . . . . . . . . County of .1~ashington ............................ Commonwealth of Pennsylvania Or$---:1" ... "3" J f t REPOR!I! AND APPifAISAL' > fTl ::0 -~ (J) 0 c :=1: :::c -cn :00 r -(._!") .-,.., :::::0 z -t !""~: 0 1'11 ,.-- ---1 ::0 i··-~0 ...c::_ ......... !i ~:a:... 0 ~ ;::; ... ~ 0 •'1::: :x:> ; r= z -or-o . '!:--(f) L. •. •..J -o :::1: r-..1 C) (J.,} rn 0 ... ., ' . . . I ~ ; ' j .. ' .. "':..._~ : ~ . ' c> ~ '-..;. '.. ~ ~ ? \, .,. ,: .• · .:. -~ r:f' -4·..... "c •• •,. oo ........ _.;J •• '\ , • ·~·~ C :-~ I .. ~· '' ~. ,, ," 't ,l' ... r''ltt '''If~ nf\ .. J :· ·" ~I I I . ' Form RC C ·le?-1\ I DEDUCTIONS ALLOWED IN ., ~1·~tJ~-t THE SUM OF ............ $10 rt!tF:] I ~ OFFICE OF THE STATEMENT OF EBTS j REGISTER OF WILLS AND DEDUCTIONS s---~ 1-70 OF Washington COUNTY OA'E A"ROV~························· A,;IO AGENT OF THE COMMONWEALTH ~ul ' ,)-] ' Register of Wills, Agent H:ELEN K. DO MEN East Bithlehem Township ES1.ATE OF LATIS OF \.""-, ~j DATE OF FILING APPRAISEMENT Marc:h 21 ! 1 sao OATS OF DEATH sl:anlJ.ar;}!: 2, 1969 DATE NO. OF {t ,(1 JNAMf'fF PA~ .... _1 ..a ..~":.i_ REMARKS AI•!.§' U N:. ... ) VOUCHii"'i: 1(969 ~ ~ "'""1"'\J Vl,... rvc.-rvvJ 77 p·u Jan Register of Wills Letters of Administ.T"l=l+.i n,., 11 00 Feb 1969 ·lvashington County Reports Advertising Estate 14 00 Feb 1969 Observer & Renorter Ad vertisin.o-ERt.:::l t.F~ 1h. i ()() Feb. 1969 F. J. Buckley Insurance Co. Bond 10 00 Feb. 1965 Notary Fees Letters of Admini stra t; n,., ? Inn Nov. 1969 Register of Wills Pet. for Sale of Real Est. 8 00 Nov. 969 Notary Fees Pet. for Sale of Real Est h. ()() Feb. 970 Gene Amanati Annraisal of RP-:::~.1 R~t.!:!+.o 10 00 Apr. 1969 Greenlee Funeral Home Funeral Bill 1. soo 00 Moschetta & Moschetta Attornev's fP.P.s )Jf)c:: I r1r1 .... Joseph Thomas Domen, Adm. Fiduciarv Commission 4?t:; Inn Feb. 1970 Gross Furniture Store Furnitu,..A "Rill 77 25 Feb. 1970 Lazoviks, Clothing 18 124 Feb. 1970 Velia Bigi Groceries. etc. 490 00 Apr. 1969 Lang I>1onument Co., Inc. Monument, partial payment 1 t:;O 20 Apr. 1969 Oak Grove Cemetery CemeterY Plot. Gr::~.ve OnA,.,;,.,! 175. 10 Apr. 196 g Greenlee Funeral Home Fn,., A'Y'a 1 "R; 11 r1&>,.. hlll:!"'"'"'rl 1: '500 00 Mar. 1969 First National Bank ~-~ortl!!:l.o-A T.nl=!,., ~1C:: 10 "Z ..... ..... Dec. 1q6q JoseDh 'f'hnm:::l!=! nnmAl1 Adm IR&>imhn'Y'~"'""'"'"'+ "h~ 11 <:! 000 1-z c:: ·- rp '..... .... <:! +..., + ,... u"' """"' ~ +..., 1 Hosnital Bill h.0'7 hrl •;: 1q7o !Recorder of' deen!=l 'T''T'""l1C!T'o..-. +a .... ,,.. 120 bo - F. J. Buckley Insurance Co. Bond 45 )0 Register of Wills IH1;1;,.,o-{l f'\1'> f'II1YI + 1t: "\('\ -.... ""' •v Register of Wills Filing Inv. & Annr. 7; hn Washington Co. Rpts. Adv. Audit c:; hn Notary Fees Inv. & Appr., etc. 10 po COMMONWEALTH OF PENNSYLVANIA }sa: COUNTY_ OF Washington I, \ JoseJ2l1 Thomas Domen HEREBY CERTIFY, THAT. TO THE BEfiT OF ' M"t KNOWLf:DGE AI~D· BELIEF, THf: FOREGOING IS A JUST AND TRUE STATEMENT OF DEBTS, FUNERAL EXPENSES AND EXPENSU OF A-DMINISTRATION SUi1JWlrr:'rED TO THE ESTATE OF Helen K. Domen DE]ED, AS DEDUCTIONs; FOR INHERITANCE TAX PU:RPO.$E9. bll~DAY..;~ ~ ~ (L.S.) .-· : ' . --- SWORN AND SUBSCRIBED BEFORE ME THIS I ~~·~a.lj_~ ___2Q MY CO'''~'""~·~ -x · • "'""~~· ~. -· ' .. ~:_, 1.\.\~::H 24, 1972 CITY OF VI/. ~ .. ,':\~T ~.:> .... ..; CN, WASHINGTON COUNTY, i'A, ... •. ~· RCC·Bt (2·64) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS INHERITANCE TAX DIVISION NOTICE OF FILING OF APPRAISEMENT JOSEPH THO~IAS DJ}.ffiN (~~Administrator). IN YOUR RIPLY PLEA8E RIP'IR TO 37-202-4 In Re: Est ate of ___ --:.;HEL:::::'=EN=• :.:..'....;K:.:;.:.. • ...::D~O:::.M.:;:;fE~'N:..,_ ______ _ _____ l"l_AS_H_I_N_G .... To_·iN _____ County_ FUe No. 63-69-392 Dear 1-:ir. Domen: You are hereby notified that the original appraiseD"•ent in the estate of Helen K. Domen has been filed in the office of the Register of Wills Qf Washington County on April 13 , 19~0. Said appraisement reflects the following valuations: Real Estate __ ~---~~~~------Personal Property __ ...;8;.;!,..:;;5...;0...;0..;.•.;..00.;..._ __ _ Transfers---------------Total _______ .l;OS:.a,. ""50~0"--.~0~0;...... __ _ As to such tax that is paid!. within three death, a five (5~) percent discount i.s allowable. remains unpaid after one year from date of deatn, 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 aggri·eved by an appraisement may appeal therefrom as provided by law. Date ____ ~A~p~r~il~l~3~·-=1~97~0~---Signed ~::::..:..!.~~~~~4-~.L4-~ /- Title R CHANEY DATE OF DEATH: January 2, 1969 Note: This is not a bill. ~ ' . FQRM 67 R:illV. 1-50 REG. WILLS 1\ppliratiou fnr 1Jjrttrr!i of 1\ilmini!itrntiou nu thr Estate of ............................... ~ .......... HE.L~.N .... K ...... JlQM~N ......................................................................................................................... .. late of.F.t:~Jl.~X:.i.c.l5.t..9.W..P. . .~. .... :W.a.§ .. 4.!.ngJ~.9P. ..... QQ.~g:t..Y.., ..... ?.~.!}gf.J; ·Deceased. Before the Register of Wills of Washington County personally appeared ..................... J..Q§~.P.tl .... 1'.HQMA~ .... P.Q~.~ ........................................................................................................ .. who, being duly sworn deposes and says that.. ...... H~l~.!} .... K.~ ..... P..Qill~.!} .............................................................................. .. age ...... RJ?. ...... , having .. J?&*. ... last family or principal residence at .. B.Qx .... a:4., ..... F.r.~.ct.e.x:.i.C.~.:t..9.W..il . .~. .... E.~s t (Street and Number) :e.~.:t.hJ.§h§.m .... T.Q:W.il.?..b.iP.., ............................................................. , Washington County, Pennsylvania, died intestate (City, Borough, Township) at ................ T.QX:.r..~.QC.§l .................................................... , on the.?..g9-.day of ........... ~.~.:'}."Y..~.?:..Y. ............................................... . A. D., 196.9. ........... , at.. ........ 9..~ .. !.§ .............................. f.b.M.,, possessed of personal estate to the estimated value $ ...... 3..QQ ..... QQ ......... , and of real estate in the Commonwealth of Pennsylvania to the estimated value of $ ... 4.,.D.O.Q .... O.Q .... , situate in ........ f..:r.§.9.§.r.J~.Kt.9..w..n., ..... ~.!i\.§ .. t .... ~~.t.h!.~.h.~m .... :+..9.W..m?.hJ.P. .. t ..... : ................... .. .......... W.as.b.:i.P.g.t.Qil ..... C.QY.n.t.Y..J ..... P..~.n.n§.Y..!.Y.!i\.n.!.!il: ....................................................................................................................... . The names and addresses of the d~cedent's :surviving spouse (if any) and other heirs including heirs by adoption) are .as follows. , REJ,AT.IONSHIP RESIDENCE ...... J.QS.~P.H.. .. THQMAS .... DQMEN. ........ ;.: .......... : ......... : ....... §.9..n .................. &i~.n.~hi.~~ .... ~~.~~!?..Y.J:v..~g!.~ ....... J§J 16 ..... .P.ATR.IC.IA ... S.TE.IKER ..................... ~ ................ Q..!;l.~gh.t.§.:r. ........... 1.\..r.JJ.ng:t.Q.P.., ..... Y.!.r.gJ.n!.~ ............................ . ...... J..QAnn ... .M~.:t.a.l.l.i~ ......................... : .................... Q..!;l.~gh.t.§.r. ........... ~.!;l.rmi.c.b.~§.l§ .. , ..... P.§.P..P.e.Y..!.Y..~P.J.~ ....... . ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::;:::::.·:::::::::::::::::::::::::::::::::r::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: ......................................................................................................................................... i ...................................................................................................... . ......................................................................................................................................... r .................................................................................................... .. That deponent is over 21 years of age, resides at... ...... 2.l.8 .... Am.i.:t.¥ .... R.Q.~9:.J ..... GJ.§.P.§A.!;l:W .. , .............. .. .................................................................... P..~ .. rrnP..Y..lY.:a.n.i.!;l ............ l.9.l.l9. ..... , .. : ............................................................................................ .. 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. and subscribed before me this...I.'J. ... ~.... -~---~ ... 'ii.~ --?~ day of ............... ¥-............. , A. D., 19 .. ;:.:yr. ....... .. /h~ REGISTER ,• COMMONWEALTH OF PENNSYLVANIA } SS: WASHINGTO UNTY, _#" And now .............. ~ ...... (Z.. ........................... , 19.~ comes ........... ~~~~P.~ ... !~~~.~ .... ~.~~.~ ............................... .. who being d 1 sworn doth depose and say that.. ... he. .................. will well and truly administer the goods and chattels, rights and credits of .............. HE . .I.l!N .... K. ..... D.OMEN ............................................................................................. , deceased, to the best of... ... h!.~ ... skil1 and judgment in strict compliance with the laws of this Commonwealth, mind- ful of the laws relating to inheritance taxes. ~ Sworn~ aubscribed before me this ... ./.Z. ............... . day of .................. ~-~·· 19.~~?'.. .. . ...................................................................................... ~ .... .. REGISTER j •' ''·41-· .. ' ' -~ .. , 1. ( .. -iF Z19 t ;'j --c:: f-c3f7,'( APPLICATION FOR L~tters of Administration ESTATE OF ~/ .............. !!.~1-:.~~ ... ~.~ .... P..Q.M.~.~.~~ .......................... . Deceased --; ,_, R $ ............................ .. L ' ) etters ..................................... ~:]............. /A.i:'J I ,,~ .... """ ~-., ("_ p $ .............. : .............. . ~:. , ~ :..: t J Extra Alias (n(,; $-. . . ·; :~ "t] •.. ; ,.~; 0 ..... ~······~·········· .. ••••••••• <:;ertificates .. ~(; ... ~-~ .... $;; ... ; .... (.. .... ~ ... ;;·· '"'TJ I I I Renunciations ::-::'2 =-..; $-j !.:. ·. ~ . . . . . . . . . • ............................ . • L.) UJ ([) ..................................................... ~_~ ........ $ .. : .......................... . l.J ;~~:;.·.·.·.·.·.·.·.·.·.·.·.·.·.·.·:·.·.·.·.·.·.·.·.·.·.·.·.·.·.·.·.·.·.·.·.·.·.·.·.·.·.·.·.·.·.·.·.12...""'7/"""jf'~ .. ...................... _4"'"'"" MOSCHETTA & MOSCHETTA ~~.~~··Att·~;~~Y······ ...,.2 i I (\ { It .I \ I £(/~£(3 ?0) (., ,_ STATE OF PENNSYLVANIA, WASHINGTON COUNTY, ~ SS: The within named Accountant being duly sworn according to laW1 depos~ and says that the above account as stated is true and correct as ________ h5? ______________________________ verily believe. 1 I • .-4 Sworn and subscribed~efore me this __ _.;?../' _ _::-::-:-____ _ day of __________________ M;ari.h ...................... 19 ..... 7Q __ _ -~{.</J?i../W.t!.~YJ ....... . MY COW.\IS!:!,~l CXr·:~:S MARCH 24. 1972 Cll'i OF WAS:·:lt{GTON, WASHINGTON COUNTY, fA, Warshington County1 ss: -.~ ~ --·---- ~--~/!~ 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 Staturte and Rule of Court1 as evidenced by proofs thereof filed to No ... k3. .. ~ ... 1D-:::.J.O..{;, _______ __ Witness_my hand and official seal thris ..... l:/A ........... . , . ~ day of.. ........... LL~: _____ i\·i\·---~------------~-19 ......... . -LJ\~ __ I.l.l~--- Register of Wills ·-··- ..., ... ::s 0 . <t : ~ I : ~ ~l 0 . Q) ,j ..<:1 ;, t~ . ' +' \1Jl r:~r~ ~=" i\ 0 A · 8 i i +' M .. "' : : Cf) •. <11 : : . B• ._ t}_, ~[ ~ l ~ ! 170 rfrtR ~ r PH Z a Ill <N ~ i ~~ i •· j( ... t ~! r:.. A : O' : 0 z ! A! i I i iJ:1 ti·l) f1· c~ ~~· R!:~iO [ ~ E-< <11 M ~: roi ~: I\\ \.,l-,)1..\.., ~ E-< ~ : ~: o: REG;ilC"~I:'"i. ~'iF \¥TlLS: rJl o zi .a.! +'i • 1•0 l ~ h v' t I j r;i1 A H: o: m: WASH.IHGTON CO., PA .. p:. j ::qj ~: ~l • : E-1! +': 0 Q) ol:l' ' rn· +' ..<:1 ~ +' 4 ~ ' i ::qi .r-fi . z E-ll ~j s:( r_., Cf) ! J:'il; .r-f! ~-ro: s H Oj 'd ~ II tii ! p:. 1-;,j <II : ! (. 1. Lc\ A· " . ~ _,. -, -~·. ,. " ., .. _._ ~ ~ t -A- \S) -~ ~ a ...., -.. I / (~ .. ,.· ~-"""--. .. I' .•. (. - .. . ~ .. l. ' . ! ; ~ ~ I...,J :. .'<.;> /'>v ./,,tt. ......... ·,.. .. ., . 'I \I·~ •.. -~ ~ , . The Court is respectfully requested to determine proper distribution in this estate. ~rA~ / --.. ""\ ~-- Qlommnnwraltq nf Jrnnsyluanta, lllllas~ingtnu <!Inuutg, I, Russell Marino , Register for the Probate of Wills and Granting Letters of Administration in and for the County of Washington, in the Commonwealth of Pennsylvania, to Joseph Thomas Domen administrator credits, whid1 were of WHEREAS, the said Fredericktown ' ··\ of all and singular the goods and chattels, rights, ·arid Helen K. Domen late of Washington County, deceased, GREETING: Helen K. Domen late of in the county aforesaid, la~ely died intestate (as is affirmed)·, possessed of divers goods and chattels, rights and credits, within the said County, Russell Marino by reason whereof the ;powe~ of gr11nting administration thereof doth belong to me; I therefore, confiding in your fidelity, do by these presents grant unto you these LETTERS OF ADMINIST~ATION, 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- l)cribed 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 20th. day of January i,n the year of our Lord one thousand nine hundred and Sixty Nine ··--.. ~-~····-RUSSELL MARINO, Register . •.. - ~ ~ ~ ... ...... ~ f-1 ~ CD ~ ::s 1-4 :;>;:· z Q M t-1-t • t en > 0 ~ ~ 0' ~ a .. CD M ::s ..... ~ = ..... = ... ~ S2: ...... ..... Q = ! .; . ) 1Kttnnt i\ll flrtt iy IDijrsr Jlrrsruta Estate of F .... IJ:~~.~n ...... Kk ... t.~ ... .D..()rn~:tl ............................. } No .... . late of ........ l".~.ci.~r.l:~. ..PVVIl, . . , Deceased .. .... . .. of 19 ......... KNOW ALL MEN BY THESE PRESENTS, That we, ..... J..O.f::l~PA .. r,l:'hom~.~ ... P.o.m~.P. ... ~.~ ... F.'r.i.n~:i.P~ ... J .. ~:rl<:1 .. Vn:i.~.~9 ... ~.~!:l.J~.~ .. f1.<:1~JJ, ty and Guaranty Co. Baltimore, Md. Surety ... '. ". '' .................................. •.• ~· .... ' ......... ' ..... ' '. ' ..... ' . ' ' ..... ' . ' .. ' .. ' ......................... ' ' ' ....... ' .......... ' ... . all of Washington County, Pennsylvania, are held and firmly bound unto the Commonwealth of Pennsyl- vania, for the use of those interested in the estate, in the sum of DlJ:l~ .. 'J:'P~~.S.~.l?:Cl ..................... Dollars, to be paid to the said Commonwealth, to which payment, well and truly to be c inade, we do bind ourselves, jointly and seYerafi}', 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 .l.?:tP.~ day of ... J.a.nua.ry ....................... A. D., one thousand nine hundred and Si.xt.y ... Nine .. .. THE CONDITION OF THIS OBLIGATION IS, That if the above bounden .................. .J. C>.~.E!Ph ... rh.:c:?.~.~ ... P..9m~.~ .................................................................................................. . 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 shall remain in force. Sealed and delivered in the presence of: ~ ... $.-;.~(SEAL) gnited States ~idelity'and Guaranty Co. S:).J~~?~~ ... I\1(1 .. • .... ~~:V.'-~ .. Y ........... (SEAL) ~ -'-_'-"., _.. ~Y! ................ ~~ .. pf. . ........ . Attormey iV. · ············································· ..... . ~tntrmrttt nf ~urdy 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 P.O. &tntrmrut nf ~urrty 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_ OO•OoOOooooooooooHo.oooooOooooOOOooooOOOOoOooooooooooo•OooooooooooooooooOooooOOOoOoOOOoooooooOOoooooooooooooooooooooooooo ·----------------------------------------------------.---------------------------------------------------- Street P.O. COMMONWEAL'fH OF PENNSYLVANIA, } ss-WASHINGTON COUNTY, "' . And now ·------· .. --···--····· .. ········-.. -... -19 ............ , comes ____ ..... -.............. ------·-··· .. ·---·--··-··· ........... -------..... --..................... -..... ---.--.. -.................. -.... --.. who being duly sworn, says that he is acquainted with lihe 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 ......... -. .. -------------------------------------------------------------------------------------------------- l' .!· " I f, ,. .. # 879 No .. ~J:~:f?2:-:-J_9g __ _ A~miuistrntinu iGn~ IN THE ESTATE OF ----------------~~---~~---P.Q~--------------------------- And now _____ .J_anJJ.ar.Y-,-~Q _____________ , 19 ___ (f]_ ___ Bond approved_and Letters issued to • I . :·.:: J ose_ph Thomas Domen ~----------------------':'----------------------------------------.------- . -vj . . ' • ·j . I ·-----------------~----~h.C?. .. ~~~---~~y ___ q~~~) __ ~f~~~-!- ·. .... \ ' ----------------------------------!--~~~~~~~~--~~-~---Register ~ Bond Book -----~) __________________ _ Page ---~~----- Atty: MOSCHEI'TA & MOSCHEn'TA BADZIK PRINTING ~9 DONORA !" ~ I ) I \ ·b'l• ... '\ ~ •' •-,. / 1Knnm i\11 :alrn iy Wqrar Jrrarnta Estate of ..... !f.~J:~.P: .... ~.:~~ .... P9.P.?:~.P.:............................................. } N. 3 92 . f 19 c. 9. 0 ............................... 0 .. u ... .. late of.. ............ F.r.~.d.e.r..ic.kt.o:w.n .................. , Deceased KNOW ALL MEN BY THESE PRESENTS, That we, .... :!..9.~~.P.E. .... ?L~9.~~ .. ~ ... J?.9.~~P.: .... ~.§. .... P..:r.~~P.:9.JP.~J .... ~.P.-9 ..... Y.n~.t.~.Q .... §.t..~.t.f.l .. s ..... fl.'l9..e.l.1.t.y.. and ........ ~.~~.!.~.~.~.Y. .... 9.g .. ~ .... ~.~.!.~.~~.9..!.:.~ ......... ~9.~ ..... §.P.:!:.~ .. ~.Y. ............................................................................................................ .. all of Washington County, Pennsylvania, are held and firmly bound unto the Commonwealth of Pennsyl- vania, for the use of those interested in the estate, in the sum of.. ... ~~J.Y..~ ..... J:.b.o.!J.a~.nd ..................... 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 .. a~signs, and each and every of them, firmly by these presents. Sealed with our seals and dated the ...... l,4.th ......... day of ................... ~9..Y.~.!!f~ .. ~E ................... A. D., .one thousand nine hundred and ..... ~J~.t.Y. ... J~JD..~ .......................... . THE CONDITION OF THIS OBLIGATllON IS, That if the above bounden .............................................. .. ......................................... ~.9..~ .. ~.l?..~ .... 'F.E.9.:P.~ .. ~ .... P..9.~~.~ ................................................................................................................................... .. the estate according to law, this obligation shall be void a otherwise, it shall remain in force. Sealed and delivered in the presence of: S'tatemeut nf S'urrty 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 1 the amount expressed in said bond, over-and above my just debts and liabilities . .................................................................................................................. '*····· Street P.O. ~tatemeut nf ~urety I, ....... , ......................................................................................................... : ..................... , surety in the sum of $ .............................. on the administration bond in the estate of.. .......................................................................................................... , say that I reside at .............................................................................. , Washington County, Pennsylvan'ia; that I am the owner of real estate, the title to which is in my own name and duly recorded, situated in .......................................................................................... , Washjngton County, Pennsylvania, worth above all encumb_rances $ .................................... ; and that I am worth the amount expressed in said bond, over and above my just debts and liabilities. COMMONWEA.L Tl! OF PENNSYLVANIA, WASHINGTON COUNTY, } SS: Street P.O. And now .......................................... l 9 ............. cornes ................................................................................................................................... . 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 incum- brances and exemptions. . · Sworn and subscribed before me this ............................. .. day of ........................................................................ A.D. 1 9 ............ . J Co. No. 392 of 1969 Ailministruttnn i'Gnnil IN THE ESTATE OF Helen K. Domen And now Nov. 14th_. ____ , 19_6_9_ Bond approved· ~ftX~«..Jb ~~ Clerk of Orphans' Di v.isio-n FILED Register November 14th. 1969 RUSSELL MARINO Bond ~STER Of Wllt.S Pag.e, __ _ ~2 o. c. Docket No! 123-25 . ~.r~ t "· ~ ·:'J ... f ' I ..... B ' 1.~ .. --' '70 MAY 22 PN 4 12 HUSSELL MAHINO REGISTER OF WILLS WASHINGTON CO .• PA. I 1\ffi~auit ®f 1fxrrutnr ®r 1\~ministratnr @lta:tr nf Jruusylua:uia:. t ss: <nnuuty nf 1lllla:s~iugtnu \ P all b f h d · d h · Notarv Public · d f aid erson y e ore me, t .e un ers1gne aut or1ty, a ............................ >l ...................................................... ln an or s County and State, appeared ........ ~9.§.~~!i .. :!.~9.M.~§ .. .P..9.M.~.~ ................................................. who, being duly sworn according· to law, deposes and says that he is the ~!IDt!XIXo.r administrator of the estate of ................................... H.~J~P.: .. ~.! .... P..9.'P..~g ........................................... deceased, that the foregoing schedules constitute a I · d · f h I d I f Helen K Do men comp ete mventory an appraisement o t e rea an persona estate o ..................................... ~ ........................................ , 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 jtem made by·the above named ltXOCHWX: Ad~trator. day ;z.i!/lf.&~-~.:.~:··b;.z.t~ thi...e?. .... --.... ~ .~ ... t?."~ ... !il~ ............... ~ .. ]2J&J...l:f:~ ....................... ) Joseph Thoma~E=:-dmimstrator MY CO'''\''-·-, •. , l~~,, ... _ ,1 .... ~. • ADDITIONAL INSTRUCTIONS "'" •~vo -·' '" ,.,,.,) f'i .\,h·.;J 24, J 97? OTY OF VI ~lJ: :!~iAu~j,nwi.!Jlt.qJf~rtm~~b~t9.t\il<;,d within three months after appointment of personal representative. 2. A supplemental inventoty1hust he filed within thirty days of discovery of additional assets. 3. l 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; l Original and 3 Copies and 2 RCRI-33, Over $50,0.00, in- cluding Copy of Will and copy of Federal Estate Tax Return. were REFERENCE FOR ADDITIONAL COPY Act of 1947 P. L. 513 Sec. 5.2, 72 P. S. 4844.2 lfuu.rutnry aub l\ppraistmrut of the goods and chattels, rights and credits which HELEN K. DOMEN EAST BETHLEHEM TOWNSHIP of ..................................................................................................... late of ....................................... ,. ............................................................. . Washington County, Pa., taken and made in conformity with the above affidavit. Proceeds from sale of real estate pursuant to Order of Court dated November 12, 1969, and filed at No. 392 of 1969, in th.e Court of Common Pleas of Washington County, Pennsylvania, Orphans' Court Division Proceeds as beneficiary from two life insurance policies with the Franklin Life Insurance Company Springfiled, Illinois DOLLARS CENTS 6,000 :oo -··:. 2, 500 00 / ·~d ··oQ NOl~:NIHS'VM Slllh\ JO B3lS\~3ti ON~'tl\1~~~ ll3SS!lB [0 l Ud \ t H~~ UL , . 'G3~l\:.! . ,I "l:j -~ r l j MOSCHETTA & MOSCHETTA ATTORNEYS AT LAW WASHINGTON, PA. 4) IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION ESTATE OF HELEN K. DOMEN, Deceased. Date of Death: Letters Granted: Letters of FIRST AND FINAL ACCOUNT 01!' JOSEPH THOMAS DOMEN, ADMINISTRATOR January 2, 1969. January 20, 1969. Administration Advertised: February 1 0' 17 and 'February 13, 20 PRINCIPAL --PERSONALTY RECEIPTS and 24, 1969. 27, 1969. The accountant charges himself with the Personal Estate of decede t in accordance with the Inventory filed with the Registe of vlills of Washington County, on M:arch 31 , 1970. ~: Proceeds as beneficiary from two Life Insurance Policies Proceeds from sale of real est~te Tang_ible Personal Property: None Real Estate: None TOTAL ASSETS OF ESTATE: $2,500.00 6,000.00 $8,500.00 r MOSCHETTA & MOSCHETTA ATTORNEYS AT LAW WASHINGTON, PA. DISB URSE-iENT S The Accountant claims credit for the following: Register of Wills, Letters of Administration Washington County Reports, Advertising Estate Observer & Reporter, Advertising Estate F. J. Buckley Insurance Company, Bond Notary, Letters of Administration Register of Wills, Petition for Sale of Real Estate Notary, Petition for Sale of Real Estate Gene Amanati, Appraisal of real estate Greenlee Funeral Home, Funeral bill :r-1oschetta & r-ioschetta' attorneys r fees Joseph Thomas Domen, Fiduciary commission Gross Furniture Store, furniture bill Lazoviks, clothing Velia Bigi, groceries, etc. Lang Monument Co., Inc, monument Oak Grove Cemetery; Cemetery plot, grave opening Greenlee Funeral Home, .funeral bill of decedent's husband First National Bank, mortgage loan Joseph Thomas Domen, Administrator, reimbursement bills Fredericktown Real Estate Co., Fire Insurance Lang Monument Company, balance of bill Oak Grove Cemetery,balance of bill Washington County Tax Claim Bureau, 1969 taxes Washington County Tax Claim Bureau, 1968 liened taxes East Bethlehem Township, 1969 taxes Torrence State Hospital, hospital bill Recorder of Deeds, 1% state transfer tax RE: Sale of Real Estate Recorder of Deeds, 1% Township transfer tax RE: Sale of Real Estate F. J. Buckley Insurance Co., Bond Register of vfills, Filing account Register of Vlills, filing inventory & Appraisement \•Iashington County Reports, Advertising Audi:t Notary Fees, Inventory & Appraisement, etc. 11.00 14.00 14.00 10.00 2.00 8.00 4.00 10.00 1,500.00 425.00 425.00 77.25 18.24 490.00 150.20 175. 10 1 '500 .oo 615.23 23.00 250.00 166.00 '138.00 192.68 1 52.67 497.00 60.00 60.00 45.00 16.00 3.00 s.oo 10., 00 The balance for distribution is subject to the payment of Inherita ce Tax. 63 SOUTH MAIN STREET Washington, Pennsylvania (PUBLISHED BY WASHINGTON COUNTY BAR ASSOCIATION) ,, __ _ ·~., I 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 Edit.or of the WASHINGTON COUNTY REPORTS, the official legal periodical for said Washington County, publisbed 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 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 or published, which appeared in the said legal periodical in its regular issues on the following dates: · ........ Eebi:uai::y. ... l3..,. ... 20 ....... 2.7.~ ... J.9..9.9 ....... 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 this affidavit as~e, place and ch~ of the ub · a 'on are true. :·~ .................................................... .. ...... 2·9·!2-jrY oL .. F.eb~-ua;;~--------·:• 196.9 .... .......... t~~-~-----····:--:·~4-----' 'ZJ'y Publtc KATHERINE C. YARD, Notary Public Washington, Washington Co., Pa. My Commission Expires November 1, 1969 • Estate Notices The Register of Wills has granted letters, testamentary or of administration, in the following estates. Notice is hereby given to aiJ persons indebted thereto to make payment without delay and to those hav- ing claims or demands to present !!hem for settlement to the Executors or Admin- istrators or their Attorneys. ••••••••••••••••• DOMEN, HELEN K., Dec'd. Late of East Bethlehem Township, Washington County, Penna. Administrator: Joseph Thomas Do-men, 218 Amity Rd., Glenshaw, Pa. 15116 · Attorneys: Moschetta & Moschetta, 78 E. Beau St., Washington, Pa. 15301 '"" - . \ • . .J !server -Repo~~r · WASHINGTON, PENNSYLVANIA PROOF OF PUBLICATION In compliance with the News.paper Advertising Act of 16 May, 1929, P. L. 1784, a,s amended. Commonwealth of Pennsylvania, County of Washington, SS: .........•.. Personally appeal"ed before m<e, a Notary Public in and for said County R. h d S C · ~ and State, ......... .l.C. .a.r. ........ A •••••••• ow.an .................. , who bel!lJg duly sworn according to law, deposes and says tha;t he is the ....... ~~-~_r-~_:t~XY. .......... . of the Obs•erver Publishing Company, a BenllJsrylvania corporation, and its agent in thrs behalf; that the said Company is• the owner and publislfer of the Observer-Reporter, sucC'essor to The Washington Obs·erver, established September 18, 1871, and The Washington Reporter, established AuguSJt 15, 1808, a daily newspap•er of general circulation, printed and published and having its place of bus.ines•s at Washington, Washington County, Pennsyl- vania, where it or its predecessors have been established and published -~ continuous'ly for more than six months• prior to the publication of the notice hereto attached; thrut the printed notice or advertisement hereto attached is a •copy of an official advertisement, official notice, legal notice or legal advertisement, exactly a:s primted or published in the Obslerver-Reporter in its regula;r editions on the following date or dates; ........................................... . ........................................ P~P..nu~.r.Y-.... l.Q ....... l.'Z. ... an.d .... 2f.L .... J.9..6.9. ............. . that neither tll!e affiant nor the Observer Publishing Company is interesrted in the subject matter of said notice or advertising and that all of the allega- tions of this affidavit as to the time, place and character of publication are true. Sworn to and w. 26732. ···························-~-t--~---···-- subscribed before me this ... ~A ... day oL .. f.~.Q.Pl.~J'.Y 19 6 9 ...... a?'~~!:~~.~~ WASHINGTON, WA:)HINGTON COUNTY MY COMMISSION EXPIRES MAY 6, 1972 f - 7355 CLERK OF ORPHANS6 COURT DIVISION State, etc. · • • $===== Total •• · -• -$ ~tt tqr <nnurt nf Qlnmmnu ·JUras nf lfasqiugtnu QJ:nuuty ®rpqaus' QJ:nurt ilinisinu . .,; In the matter of the Audit of Account in HELEN K. DOMEN Estate of. __________________ 1 No. _________________ _ TO THE AUDITING JUDGE: ·my the estate above named. Enter ___ ~ _____ ,appearance for ________________________ _ 20th day of ___ M_a-"y ______ , 19_7_0_ N. B.-Counsel shall, by separate pape.r, 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 dist.ribu·tion shall file a separate conctse state- ment in that regard. No. _______________ = In re Audit of Account in EstaJte of HELEN K. DOMEN AUDIT Jrarript fnr 1\ppraraur.r FOR '=E ':'0 __j -'t1 c::> ...... ....._,.,,.,. ... . )>-fTl ::o ::;: r·~-WG?c: :::;::.. , ,... -(/) _.,- CP-(.i) ~ Z--Ir-n r-....J i-'J r.~ !.:: ' ,......, _ . ...:.~ ~--"" r \:::;1 0,_..., Z~JJ:;.: ~- ~--- o::<JE:;:; ~ -o __ r-...,.. -a r-o --;-> (/) ------------------------~------------- ~-vt:Ti~ OSEPH P. JOSC'iiETTA, ESQ. Attorney ~2 (Form where decedent died intestate) / Jn t~r ®rp~ans' (11nurt nf llas~tngtnn (11nunty ESTATE OF No. Term, 19 , A. A. In the audit of the First and Final HELEN K. DOMEN Account of Joseph Thomas Domen, Administratol 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 relation was maintained until deced- ent's death; and (5) whether the decedent left children or issue of deceased children. Deceased The petition of. .................................. ~?.~ .. ~P.~ .. T~?~~~~ .. .P?.~~~?. ................................................ . (Name of Petitioner) respectfully represents: ........................................................................................................................................... . (a) The decedent died ............ <I§l:P:"Y.~.~Y ... ~.'--··J..~.~--~---···························--·, intestate and (Date) letters of administration on .......... ?.~E ... estate were granted .......... ~~!!:"Y.~E.Y. .. ~.Q.L.).~§.-~ · ·· ·. .-. '· (Date) : · as per record thereo1 appearirl:g iti" Administration and Bond Book-No .. ::.:?.~ ...... : ... : at page ............. ?..~ ......................................... . Decedent was survived by Joseph Thomas Domen, Son Patricia Striker. Daughter JoAnn Metallic. ·Daughter within (b) At the time of death, the decedent's domicile was widm:a~ the Com- mon wealth of P ennsy 1 v ania, to-wit, at~.~ ... J?..~!hJ~h ~:~ .. T~P..~.L. .. :P..?.-.~.L .. Y..~.:~-~ .. A · (Town or Township, State and Nation) and residence was at ... ~-~----~-~~~-~~~-~!? ... ::r'Y.:.P..~.L .. ?~.~--~·-··Y.--~.~-~--A~ ........................................ .. (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 r~lationship if they take by representation are as follows: NAMES Relationship Interest Of age, sui- juris, or not, (write yes or no). Name of Guardian, Trustee or Committee, if any, or beneficiary, mant'!er and place of record of appointment and is bound suffi- cient to cover and protect share. Joseph Thomas Domen Son 1/3 Yes Patricia Striker JoAnn Metallic State exceptions, if any, giving names and dates of death and the names of their executors or ad'ministrators, or the names of• their issue as the same may be mater- ial. Describe type of notice. Daughter 1/3 Yes Daughter ·1 / 3 Yes All of said ;parties m interest are living, except No Exceptions (d) All parties having any interest have had ........................ notice of the filing of the account by letter from the administrator's counsel, a copy attached. (e) Balance for distribution per Account $ ....... :~.~--~-9..~ .. : .. ? 3 (f) Additional d~bits~ not shown by Account (Itemize) None $ ............................. . (g) Additional credits, not shown by Account (Itemize) Inheritance Tax $ ............................. . not $ ............................. . Insert word "'not" where I (h) Claim for exemption has /been made, and has .. P:2~ ............. been paid. n-ecessary. (i) The estate is .................. subject to the payment of inheritance tax to the State of Pennsylvania. 11 taxable state w~eth-1 (j) The estate is ........ ~-~-~ .......... subj ect to the payment of the county 4 mills er ta'!' .has been paul •. ·tax. (~) .The estate is .... TIQL ........... subject to the Rayment of Federal inheritance tax. (1) All creditors (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 H too many _for the I whether or not they are admitted to be correct are as follows: space, annex a hst there- of; if no such claims. insert the word unone." If any creditor or other claimant has not re- ceived actual notice, that fact must be stated. I NONE Indicate such claims as I ~ 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 the word "none." If any share has been assigned or attached1 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 such part in kind. (m) \ !'. .c, ~ ... : r~ n .. NONE (n) The balance for distribution consists of property in kind, form and character, as follows: Cash $1,432.63 This balance for distribution is subject to the payment of Inheritance Tax. · ·:.-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) NONE ( q) Give brief location of any real estate sold. Lots Nos. 57 and 58 in Mrs. M. L. Bingler's Plan of Lots, as shown of record in Plan Book Vol. 1, page, 160, in the Recorder's Office of Washington County, Penna. If (!)rior accounts have ( ) heen iiled, iist number r and term. 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) :-· Joseph Thomas Domen 1/3 1 Patricia Striker 1/3 JoAnn Metallic 1/3 County of Washington, ss. And your petitioner will, etc., The above named petitioner being duly sworn doth depose and say that the ;~c:~:~e~~:~ ~;~e f~r~~:!fe~~:i~:~r~~~;. l(_ b~AliS~;fr~ ,_ to and sqpp_kribed before me this (/.v...:::·:::-::r-r..-'( ~ U.. day of ........ ::ll.~ ............. , 19 .. l--~·-· Joseph Thomas Domen, Administrator ~/ J1_~ ···········-··············-~t,·w!ttttQ'i'\'il:··r;Q"OWT·eu~lrQ·····-.. ·-··········· WASHINGTON. WASiiiNSTQ~ COUNTY MY COMMISSIO:"-J EXPIRES /if~IL 1. 1974 ·····-··········-············MEtrnbef;P€nns·yivaniqf."ill~i-at+~-QH/9Witl~---··· ........... . " I ~. \ FORM IN CASES OF INTESTACY NQ .... ·----------------• ------·---------------------·---Term, 19 --·-·---• A. A. IN THE ORPHANS' COURT WASHINGTON COUNTY, PA. Es-tate of HELEN K. DOMEN De-ceased. Sur account o f Joseph Thomas Do·men, Adm. 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 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 tiilke in kind, if any. MOSCHETTA & MOSCHETTA BY·~ ;,~...-.-. /:::? ~ ···-············-..-----····=·-····-··-l .... f*:":."t::J'.~--- :Attorney for Accountant . .... 9 'Vd ··oo NOl::lN I H SVM SlliN1 .:10 tE!.LSI~3U ONIH'i}'l Tl3SSn{1 J I !1 Wd 2 2 AV~J OL "03'"~11.:1 .. ~ \ ...... "' .. '"'•' ... . .t·• •. : "· -:.-· /:~· .. -.. -. / / <: ..... -LAW OFFICES MOSCHETTA & MOSCHETTA 76 EAST SEAU STREE"r WASHINGTON, PENNSYLVANIA 15S01 JOHN J. MOSCHE:TTA JOSEPH P. MOSCHE~TTA JOHN J. MOSCHETTA, JR. AREA COCE 412 TELEPHONE 226-:3060 April 30, 1970 TO: HEIRS OF THE ESTATE OF HELEN K. DOMEN, DECEASED. Joseph Thomas Domen Patricia Striker JoAnn .Metallic This is to advise you that the First and Final Account of Joseph Thomas Domen, Administrator of the Estate of Helen K. Domen, has been filed and same is scheduled for Audit before the ,Judge of the Court of Common Pleas of Washington County, Pennsyl- vania, Orphans' Court Division, in the Washington County Court House, Washington, Pennsylvania, on Wednesday, May 20, 1970, at 10:00 a.m. o'clock, at which time you may appear if you so desire. JPM:lkh Yours very truly, JOSEPH P. MOSCHETT A Attorney for the Estate of Helen K. Domen, Deceased ~n tift C!tnurt nf C!tnmmnn Jltas nf mus{Jingtnn C!tnunty, Jltnnsylunntn, ®rp4nns' <ttnurt lltntsinn ESTATE OF Helen K. Domen, deceased. No. 63-69-392 In the matter of the First and Final Account of Joseph Thomas Domen Administrator ADJUDICATION AND DECREE And now May £.,£.., 19--211-, this matter come on for hearing, audit and distribution at this session and testimony token; and thereupon, upon due consideration thereof the balance for distribution in the hands of the Accountant is determined to be $. · 1 ,ltJ2,·63 · and~the occou'nt is accordingly confirmed; and it is ordered, adjudged and decreed that the said balance be paid out by the Accountant in accordance with the- schedule· of distribution hereto attached arid mode :a port hereof, unless exceptions hereto be filed sec. reg~. or on· appeal be tok~n herefrom sec. leg. SCHEDULE OF DISTRIBUTION -_'' f 'i Balance per occount _______ __._~,...-__;;,------ ., ~ T' ' Balance ____________________ _ Deduct Clerk's Costs & Receip+c'~------------- Attorney __ :.:M~o.::.s..:::c.:.:h:=.e..:::t..:::t.!::ac....:::::&::.......:.:M:!:::o::!.s·~c~h;!!:!e~t~t~a---'-------- Russell M$rino, Agent, transfer inheritance tax, , $85.1[ Interest from 4-2-70 to 6-1-70 .8 . . -J Joseph Thomas Domen, son, 1/3 balance, Patricia Striker, daughter, 1/3 balance, JoAnn M"tallic, daughter, 1/3 balance, .I . . -. J . ,.. -· > •' '·· ·. ., l' ;J o· > z ~- -+1 ::s !I' 0' ~ ~n. :;. ~ 0 .~ 0 c (1) i· iti ·::S 3 -+ 0 0 0 -+1 -too =+ ~· (1) .., ~ ~ 0 ..... -+ ::r (1) t = N ' " " ~ .: ... !' :*···.., • i . ·~ +-t ~ ~ • ,t ... . ' ., .. ' '· . ....,. 0 .~/) <i . ,. ~ 2: .:....J.a... ~-• -( ---J • ' .. , .. .. . 0::::-. 4:::: ~~0 ... a... "'l.-U.. <:..) C.::l --0 fC:!: "'' -.,1 0 -.: ·' lU ~ -J r:c 1-- t;• tJ.J (.f ... I ,_:· ...:;;:. . ;:.... (/) ..,._ ... --..J c:::x:: <.f) -:c.: (J)-.::x:: ·-~ 0'' <::;:) 0::: I.U ' if,) f <: ,• . LL. c.::;: .... ~ __._ ,...._ ... -- I II, 3: 0 (/) )> () =I ~ 0 -f :p -f 1! l> M -< R> Ill :..·3: I) 0 r Ul )> () ~ J: '" JTI -f -f )> ·\_ ... ,. . ·l\ • I. ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF WASHINGTON COUNTY, PENNA. No. 63-69-392 IN RE: ESTATE OF HELEN K. DOMEN, DECEASED. DISTRIBUTION RECEIPTS ,, --.1 ; • f~ :.o c::;::. '> fl"1 ::7J --- (/) C) c:: c__ . ··-~ ;r ~ (..> s i .-(.0 r .7 -·"··-_,.. ' . .., ~._.., ;;::; nl :~~ ~--: i ; ~ ;-~.:; ~--, ... -.. :o._ .. _! e c:: '-..... .., ~ -.1 .: ~ ·--~f.., ... 0 -:--::::~ 0 ~!.;AI • -·-· :,..,,J r--_,. -or-e; l> r:-0 ,,......,_ 1:'.1• MOSCHETTA 8c MOSCHETTA ATTORNEYS AT L.AW 76 EAST BEAU STREET WASHINGTON, PA. 15301 ( MOSCHETTA Be MOSCHETTA ATTORNEYS AT LAW WASHINGTON, PA. ,I ..t' ., IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY, PENNA. IN RE: ORPHANS' COURT DIVISION ESTATE OF HELEN K. DOMEN, DECEASED. § § § No. 63-69-392 § § RECEIPT AND NOW, this / day of June, 1970, I, the undersigned, JOSEPH THOMAS DOMEN, one of the distributees in the above captioned estate, hereby acknowledge to have received from Joseph Thomas Domen, . Administrator of.said,Estate, the following item in accord with the Adjudicati n · .. and Decree filed ·at the above-number. BALANCE IN CASH ----------------------"" $444.38 TOTAL RECEIVED PER ADJUDICATION AND DECREE $444.38 IN WITNESS WHEREOF, I have hereunto set my hand and seal the day and year first above written. WITNESS: 4 . y (" ~-1-t.fc,>· p_ ~ -;;/~a.~ I ~ .. w~~(SEAL) t8oseph Thomas Domen MOSCHETTA & MOSCHETTA ATTORNEYS AT LAW WASHINGTON, PA. . ' n ... ·, •' ,-,' IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY, PENNA. IN RE: ORPHANS1 COURT DIVISION .... ·--._ ..... ·~·'--.... ~-···-... ESTATE OF HELEN K. DOMEN, DECEASED. § § § § § RECEIPT No. 63-69-392 I .Jd AND NOW, this_\:?_ day of June, 1970, I, the undersigned, JoANN METALLIC, one of the distributees in the above captioned estate, hereby acknowledge to have received from Joseph Thomas Domen, Administr - tor of said Estate, the following item in accord with the . .A.djudication and Deer e . filed at the above number. BALANCE IN CASH .. ------~---------------$444. 38 TOTAL RECEIVED PER ADJUDICATION AND DECREE $444.38 IN WITNESS WHEREOF, I have hereunto set my hand and seal the day and year first above written. WITNESS: _c./---=;J~~~-~~· ~--~:,______&-€._~-=-""--__ (SEAL) o JoAnn Metallic MOSCHETTA & MOSCHETTA ATTORNEYS AT LAW WASHINGTON, PA. IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY, PENNA. IN RE: ORPHAN$' COUR! DIVISION -EST ATE OF HELEN K. DOMEN,_ DECEASED. § § § No. 63-69-392 § § RECEIPT AND NOW, this .;z 1 day of June, 1970, I, the undersigned, PATRICIA STRIKER, one of the distributees in the above captioned estate, hereby acknowledge to have received from Joseph Thomas Domen, Administr - ' tor of said Estate, the following item in accord with the Adjudication and Decree filed at the above number. BALANCE IN CASH -.. ------------------$444. 38 TOTAL RECEIVED PER ADJUDICATION AND DECREE $444.38 IN WITNESS WHEREOF, I have hereunto set my hand and seal the day and year first above written. WITNESS: _'--+-~.,c:;_;,~~--~ ..... ~-.-i!S~~~~-:lo<:..I.Z...,.L-.) _(SEAL) Patricia Striker .. ~ 3: 0 CJ) )> n -1 I: ~ ~ ;u -1 ~ l> ~ ~ l> 3: / -1 0 I ' r CJl l> n ::l: I: I '4 Ill -1 -1 l> ~f?. ,! "'--- ,, I IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY, PENNSYLVANIA IN RE: ESTATE OF HELEN K. OOMEN, Deceased. PETITION TO FIX AMOUNT OF BOND i '• 05 "' ~· ffl ~· in ~ t:,;; ;:c ~ {f) rr# {,n (.l'i ~ ~ rrt ,...,ffll'""" '!.1-J ~ ~ =t ···-r ~ ~ -~ 1.~.; n ,.., eiE~ r-r :a; "'QF'g ~ C.ll • ... c:n 1..0 ::e: 1:> w.::: -.I -n :::r: ....... t.rt .: .. - c.rt~ .; .: .. , .. ._;-; .. MOSCHETTA & MOSCHETTA ATTORNEYS AT LAW 76 EAST BEAU STREET WASHINGTON, PA. 15301 ~ ~ I ., .,,- !;"_~ ·,: -~' ··:::=-..._.,. ~I ( MOSCHETTA & MOSCHETTA ATTORNEYS AT LAW WASHINGTON, PA. IN RE: IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY, PENNSYLVANIA ORPHANSt COURT DIVISION ESTATE OF No. ;3 tf~· of 1969 HELEN K. DOMEN, Deceased. ) ) ) ) ) PETITION TO FIX AMOUNT OF BOND IN RE SALE OF REAL ESTATE UNDER SECTION 541 AS AMENDEDr OF THE FIDUCIARIES ACT OF 1949 The Petition of JOSEPH THOMAS DOMEN, Administrator of the Estate of Helen K. Domen, deceased, respectfully represents: 1. Helen K. Domen~ late of Fredericktown, East Bethlehem Township, Washington County, Pennsylvania, died intestate on January 2, 1969. 2. The Register of Wills of Washington County, Pennsylvania, did on the 20th day of January, 1969, grant Letters of Administration upon her estate to your petitioner, Joseph Thomas Domen. 3. That at the time of her death, the said Helen K. Domen, was seised in fee of a certain lot of land, situate in East Bethlehem Township, Washington County, Pennsylvania, upon which is erected two frame dwellings, which said land is more particularly bounded and described as follows: , . ALL those two certain lots or pieces of ground situate ip,East Bethlehem Township, Washington County, Pennsylvania, ·.·~" mSJ,rked and numbered fifty-seven (57) and fifty-eight (58) ''' 1 ' .~~!)'Mrs. M~ L. Bingler' s Plan of Lots, as shown of record i~'the Recorder's Office of Washington County in Plan Book Vol. 1, Page 160; the said lots being bounded and described as follows: BEGINNING on the Westerly side of Second Street in said Bingler Plan, at the dividing line between Lots Nos. fifty-six (56) and fifty-seven (57), running thence Southwardly along Second Street Fifty (50) feet to the dividing line between Lots Nos. Fifty-eight (58) and Fifty-nine (59); thence extending back Westardly, preserving an even width of Fifty (50) feet throughout MOSCHETTA & MOSCHETTA ATTORNEYS AT LAW WASHINGTON, PA. and between line common to Lots Nos. fifty-six (56) .and fifty-seven (:57) and fifty-eight (58) and fifty- nine (59) aforesaid, a distance of one hundred (100) feet to an Alley ten (10) feet wide. SUBJECT to the exceptions and reservations as are set forth or referred to in prior deeds in the chain of title. HAVING erected thereon two frame dwellings. BEING the same lots or pieces of ground as were conveyed by Ernesto Battistoli and Maria Battistoli, his wife, to Andrew Domen and Helen Domenj his wife~ by deed dated July 5, 1958; and recorded in the Recorder's Office in Deed Book 1023, Page 279. 4. Attached hereto and made a part hereof are two affidavits con- cerning the fair and reasonable market value of the property to be sold, the valuation being placed at Six Thousand ($6,000.00) Dollars. 5. That the decedent left personal property in the amount of Two Thousand Five Hundred ($2,500.00) Dollars, being proceeds as beneficiary from two life insurance policies with the Franklin Life Insurance Company, Springfield, Illinois. 6. Except for the above noted, the decedent possessed no personal estate. 7. That the Letters of Administration were issued in this estate to your petitioner upon the filing of bond in the sum of One Thousand ($1,00 ) Dollars with the United States -Fidelity and Guaranty Company as surety. 8. The Administrator has entered into an agreement for the private sale of said real estate with Leonard A. Corazzi and Joan L. Corazzi, his wif~, dated June 10, 1969, for the full consideratio of Six Thousand $6,000.00) Dollars, which payment is to be made by the purchaser to the Administrator upon approval by the Courtof the bond mentioned herein. WHEREFORE, your petitioner requests your Honorable Court to fix th amount of additional bond to be given by him, or to excuse him from giving additional bond under the provisions of Section 541 of the Fiduciaries Act of 1949. rJosepn Thomas Domen, Petitione MOSCHETTA & MOSCHETTA ATTORNEYS AT LAW WASHINGTON, PA. STATE OF PENNSYLVANIA COUNTY OF WASHINGTON ) ) ) i'· I SS: Personally appeared befor-e me, the undersigned authority, JOSEPH THOMAS OOMEN, who, being duly sworn according to law, deposes and says that the facts set forth in the foregoing Petition are true and correct upon his knowledge, information and beli·ef. ~I.a....-»-~ 'SEPH THOMAS OOMEN Sworn to and subscribed before me this w£0 day ' 1969 • .. · Notary Public ESTHER E. WAUGH, NOTARY PUBLIC My Commission Expires: My Commission Expires March 23, 1970 Washington, Pa.. Washington County MOSCHETTA & MOSCHETTA ATTORNEYS AT LAW WASHINGTON.-PA. .I AFFIDAVIT OF VALUE STATE OF PENNSYLVANIA ) ) SS: COUNTY OF WASHINGTON ) Personally appeared before me, the undersigned authority, GENE P. AMANATI, of 292 East Maiden Street, Washington, Washington County, Pennsylvania, being duly swoi)h according to law, deposes and says that he is familiar with the premises situate in East Bethlehem Township, Washington County, Pennsylvania, being Lots No. fifty-seven (57) and fifty-eight (58) in the Mrs. M. L. Bingler's Plan of Lots, as shown of record in the Recorder's Office of Washington County in Plan Book Vol. 1, Page 160, owned by the late Helen K. Domen, appearing of record in the Office of the Recorder of Deeds of Washington County, Pennsylvania, in Deed Book 102~, Page 27.9; and havi:ng erected thereon two frame dwellings; that he ts familiar with the value of real estate generally in the same locality; that in his opinion a reasonable and fair market value of said property is Six Thousand ($6,000.00) Dollars; and that under all the circumstances a price of Six Thousand ($6,000.00) Dollars is probably the best price which can be obtained at public sale. ~~ GENE P. AMANA II Sworn to and subscribed before me this Notary Public My Commission Expires: ESTMER E. WAUGH; NOTARY PUBLIC My Commission Expires March 23, 1970 Washington, Pa. Washington County MOSCHETTA & MOSCHETTA ATTORNEYS AT LAW WASHINGTON, PA. .r AFFIDAVIT OF VALUE STATE OF PENNSYLVANIA ) ) SS: COUNTY OF WASHINGTON ) Personally appeared before me, the undersigned authority, AMEL L. TUCCI, of 292 East Maiden Street, Washington, Washington County, Pennsylvani~ being duly sworn according to law, deposes and says that he is familiar with the premises situate in East Bethlehem Township, Washington County, Pennsylvania, being Lots No. fifty-seven (57) and fifty-eight (58) in the Mrs. M. L. Bingler 1 ~ Plan of Lots, as shown of record in the Recorder's Office of Washington County in Plan Book Vol. 1, Page 160, owned by the late Helen K. Domen, .appearing of record in the Office of the Recorder of Deeds of Washington County, Pennsylvania, in Deed Book 10.23;; Page 279, and having erected thereon two frame dwellings; that he is familiar with the value of real estate generally in the same locality; that in his opinion a reasonable and fair market value of said property is Six Thousand ($6,000.00) Dollars; and that under all the circumstances a price of Six Thousand ($6,000.00) Dollars is probably the best price which can be obtained at public sale. Sworn to and subscribed before me this /7'& day of 9; t-·p·&:r,_vtu.-v ' 1969. Notary Public My Commission Expires: ESTHER E. WAUGH, NOTARY PUBLIC My Commission Expires March 23, 1970 W~~~pj~~t~111. Pa. Washington County AMEL L. TUCCI MOSCHETTA & MOSCHETTA ATTORNEYS AT LAW WASHINGTON, PA. IN RE: ' ':> IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION ESTATE OF HELEN K. OOMEN, Deceased, ) ) ) ) ) No. of 1969 ORDER /z -iff AND 1\DW, this a day of ____ · --------the within Petition being presented to the Court, upon consideration thereof, .., it appearing that the petitioner, as Administrator of the above estate, has filed bond in the amount of $1,000.00, and proposes to sell the within referred to real estate belonging to the estate of Helen K. Domen, Deceased, for the sum of Six Thousand and no/100 Dollars ($6,000.00), IT IS ORDERED . AND DECREED that the Petitioner, JOSEPH THOMAS OOMEN, Administrator of the ~ ~-----:-r--o ..... ~­above estate, file additional bond in the amount of __ _.::;;:~:;;-~y:__.:..._~V':...:=~=---- prior to receiving the proceeds of the sale of the said real estate. -.. ' ...... -; ~ n:cc-39;15-68) COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SUMMARY Estate of DOiviEN, HELEN (First Name) K. (Initial) DATE OF DEATH 1-2-69 FILE NO. 63-69-392 (Last Name) REPORT OF INHERITANCE TAX APPRAISER I, the undersigned duly appointed Inheritance Tax Appraiser in and for the County of \"J'ash:ington Pennsylvania, do respectfully report that I have appraised the real and personal pro~;>erty as reported in the foregoing return at the values set forth opposite each item in the last column to the right in Schedules "A", "B", "C", and "E". Dated: 04-1.3-70 -----0~1--0~2--~69 ________ _ 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 INVENTORY VALUE AS REPORTED VALUE AS APPRAISED " Real Property (Schedule A) Personal Property (Schedule B) Transfers (Schedule C) Joint-Held Property (Schedule E) TOTAL GROSS ASSETS Less Debts and Deductions (SCHEDULE F) CLEAR VALUE OF ESTATE Valuation of life estates or $ annuities .. a •• 0 0 Cl' •••••••• <t ,, • $ EST ATE TAX ASSESSMENTS $ $ 8.500 00 8,500 00 8,500 00 8,500 00 FOR USE OF REGISTER ONLY COMPUTATION OF TAX Tax on$ cy Tax on $------------1-- Tax on$ o $ _________ ~-- $ ___________ ~--- $-------------4--- Tax on$ 10% $ ___________ ~--- Tax on$ 15% $ ____________ -4---- VALUE AS REAPPRAISED $ __________ ~ __ Exemptions * Total Estate _______ -+--- TOTAL TAX $-------------J---- (*) As evidenced by Charitable Exemption Certificates issued by the Secretary of Revenue. Less tax previously paid $======1== BALANCE $-----+--- Less 5% of tax if paid within 3 months after death $=====::::::!==== Add interest at rate of 6% from -------to ------- AMOUNT OF ESTATE TAX ASSESSED $-----+--- Estate tax paid $ _______ _...!J __ __ BALANCE DUE $ ______ _J __ Add interest at rate of 6% from ---------~·0-------$---------4--- TOTAL TAX BALANCE $ --------+---- PAID $ --------l--- 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 HElEN K. DQ}:!EN Deceased Late of FREDERICKTO\Vl'J .............. ········· County of . WASHINGTON Commonwealth of Pennsylvania REPORT AND APPRAISAL /i Fonn RCC-2· ' DEPARTMENT OF REVENUE BUREA~" OF COUNTY COLLECTIONS ~ HARRISBURG, PENNA. 1 7 1 2 7 COMMONWEALTH OF PENNSYLVANIA , , , RESIDENT RNHERITANCE TAX APPRAISEMENT 4 ' DATE COUNTY .................. Was..bin.gt.on .............. . FILE NO ................... ?.2..::?..9.::2.9.?. .................. .. Whereas, ............................ f.I.~l..~n. ... K. ...... P..o~.n. ....................................................................... late of ............................. W.r.ede.ri.c.ktow.n ................................. . in the County of ..................... W9.-.:?.h:i,pgt.9.D ....................................................................... Commonwealth of Pennsylvania, having died on the ...................................... ..2 .... nd ........................................ day of ................. J.a.mw. .. zy ............................. 19 .. 6..9 .. , seized and possessed of an estate subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore, I, ..................................... W.~.f.l..~ ..... Ghi?.-.P.~Y........................... .. ......................... , an appraiser duly appointed according to law, having been designated to make a fair and conscionable appraisement of the said estate, and to assess and fix the cash value of all annuities and life estates growing out of said estate, hereby file the following appraisement: In the event that any future Interest In this estate is transferred In possession or enjoyment to collateral heirs of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer inheritance taxes at the lawful collateral rate on any such future interest. Description of Asset Unit Values Appraisement Made for I nherltance Tax 'Purpose• $ PERSONALTY: Proceeds from sale of r e!l estate pursuant to ~--------------------------------------------------~~--------------------1--------H----------~----- Order of Court dated N(w. 1~ 196q and filed at No. 3°2 of 1960. in the Court of Common Pleas 11Jashington County. Pennsylvania, Oroahn's Court. 6,000.00 Proceeds as beneficiary from t"\ . ..ro life insJ.U'ance policises with the Franklin Life Insurance Co •• ~--------------~~~~~~~~~~~====~~-=~~~~~~--------~-------n---------+----- Sprin.diled, Illinois. 2 500.0C 8,500.CO 8.500 00 Total 00 Having been duly sworn accordin~Jp law, I do hereby cert~'f hat ~h above appraisement is made in con- formity with law on this ...... /..;:1. ~ .. . . day of ... -T-)··r· ......... ~..... .. . .. . .... ... ... .... . .. 19 2. c? ~ -.. .. . .. ~ .. ~~?<'. ~i-~~~--, . . ~· •· .... ber ~·"street). .... .. ......... .. 0· .... I~ A . ... . . .. .. . ... , Penna. (Post Oftlee) ........ .. .... WJ\SH:P~G'J:'QN County RESIDENT INHERITANCE TAX APPRAISEMENT Estate of HELEN K •.. PO HEN. Deceased. Late of FH.EDERICKTO\rm Date of Death, .......... .J.@.l.§..PY .. ?, .. J.9.9.9 .................. . Appraisemellt Docket Vol., ........... .'];.{ ................................. . Page, ..... ..2.02.~4. ....................... No ..... 6.3.-:::.69:::-3.~ ........... . Filed in Register's Office, ... J\p:r.;i,l ... lJ., .... J9 ... 7.9 Amount of tax due, $ ................................................................ . DEPARTMENT OF REVENUE Received, Examined and Approved, Wrote abo.ut Appra.isement, Appeal f1'om Appraisement, Entered and charged, .. ~ . ...,. '(