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HomeMy WebLinkAboutOC1969-0949 - ESTATE OF ZIELINSKI',\,,',"."..63'-&1 ?iJ1J .. : L,....__..~, f'. .i •'.~..,>'• ..,. . i ,J I ! . I i II ·1II I I II, I I! (SEAL), ii I I I II\I /~_(.,9 -C;4-7· ~;;4 q if 11.'1 ) ( ,) (NO. ORPHANS'COURT DIVISION RECEIPT OF LEGACY . WITNESS our hands and seals this .Sealed and delivered in the presence of:- KNOW ALL MEN BY THESE PRESENTS,that we,THOMAS PHILLIP ZIELINSKI,ROBERT ZIELINSKI and DONALD WAYNE ZIELlNSK'I,have this day received of JUDITH EILEEN McCULLOUGH the sum of FJVE HUN ffiED and no/lOa ($~OO.OO)DOLLARS each,being the full amount of a legacy and the interest due thereon,bequeathed to us by our mother,ROSE ZIELINSKI,late of Houston, Washington County,Pennsylvania,deceased,in and by her Last Will and Testament, dated the 3rd day of July,1968,and since her decease,to wit,on the 22nd day of June,1969,duly proved and now remaining of record in the office of the Register of Wills of said Washington County,and which legacy was by the said Will charged upon a certain tract of la~d situate in the Borough of Houston,Washington County,Pennsylvania,therein and thereby devised unto tihe said JUD ITH EILEEN McCULLOUGH AND in consideration of said payment,we do hereby release and forever discharge as well the said JUDITH EILEEN McCULLOUGH as also the said 'lands so as aforesaid devised to her of and from all liability,claim or demand,charge or lien on account or by reason of the said legacy./'!..///I>'/15/tt/day of ~"'~~~~'.r.:..:/1~r_·__,1969 . (/ IN RE: ESTATE OF ROSE ZIELINSK I IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY,PENNSYLVANIA IId II IIIi IIjJIIIIII II II j t.· /.P!~fi 'UI,~_696 [av tIeqtlIe~<resJ°kJp --'p"""oX=£"""c-s!~l a::>!II °P!OS a~t 10 ,oas pu:)c;~.::)~ku Japun uaA!9 ;5"f?/a6od~~~oog~trrf.\--Ui /r:n01 P!OS JOt p'UD uf ):I spo~a 6ulpJo,,~JOI »,!io ·'rl UI p.pJO"~ .'S'S J 'oJ uOlOU!4S0 MlO!UOAIAsuuad ;..·.;'.1 •..' RUSSEll MMUNO REGISTER OF WfLL.S WA.SHLHGTON co..PA. '69 SEP'23 FilEf), w ~« ,,I- 0 I- Z 0 I- U W -JW JJHU o.r i,' I"\<:'I ,.;,_,VI ,·....1 j J I '" -J-JnC'r '..-3:.,.,'l·.\:~l :0 0.:::wS~FZ3 11'!?~,.r:1'~;"1 J,:::::> ~ V') Z -Jw N w V') 0 0.::: u.. 0 00 w w I- 0.:::« Z l- V')w u..o V')«w-Jc... ) .... MICHAEL E o KUSTURISS ATTORNEY AT LAW 12 NORTH JEFFERSON'•CA AVENUE NONSBURG.PENNSYt ~VANIA 15317 " J ~:. ..--"-' .'.) ~-_.-.-...#,_.----..t,,;".,,;,.... NO. ELECTION1 TO TAKE UNDER WILL -..-~..--'"-~-~~-. I,Vincent T.Zielinski ,surviving husband of Rose Ziel inski Deceased,having read the will of my said deceased wife in its entirety,and clearly understanding that my said wife by her Will disposes of all of her property,real, personal and mixed,including the share thereof '.which I am entitled to take and receive by law upon her death,knowing that said will makes no provision for my interest in her said estate,being fully convinced in my own mind of the reasonableness and equity of said Will and the wisdo'lTJ of its provisions,I hereby elect to and do accept,acquiesce in,and consent to said Will and all of its provisions,and hereby waive any and all claims, rights,interests,and estates which I may have in the said estate of my deceased wife, Rose Zielinski " IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY.PENNSYLVANIA ORPHANS'COURT DIVISION 19 th day of '..Jt?ki~:M-(SEAL) (usba 1 -idower>~"~~_._.-..-~.-._----".--.-.----.....~....---- .SS: In Witness Whereof,I have hereunto set my hand and seal this 1969. CbM1vibNWEALT~OF P'ENNSY1.:VANIlX COUNTY OF WASHINGTON f . On this,the 19th day of Sept .}\,1969,before me,the undersigned officer,personally appeared Vincent T.Ziel insJ<f.surviving husband of Rose Zielinski Deceased,known to me (or satisfactorily proven)to be the person whose name is subscribec to the within Election To Take Under Will,and acknowledged th,at he executed the same for the purposes therein contained., EVELYN C.TELES::~.Ned-" Canonsbul'9.W.:..l'l .on r ~.1531~j My Commiss1on ex.-..c:.....,10,19Th .. '.. r • • -.) ..~~.In Witness Whereof,I hereunto set my hand and official seal../:~.~~~·<C~~~·,:,·_·~_"..~~-·, . J ,'. / ... -~----------: '. ve should b~filed in the office of the~~g'ister;~9%'j:Wills,.and recorded in the Office e Recorder of Deeds if real estateisinvolved,;;)t'-,.~t:' '<~l?f:;~;., -,-.._...-....- i\ffi~auit (@f l:3-tor-cr.tli iExrtutnr ®r 1\~mini!ltratnr J ~hdt of Jtuusylttuuht } arouuty of 1IIIIus4iugtou ss: Personally before me,the undersigned authority,a NQt~Uy..P.yJ~Li.~in'and for said Judith Eileen McCullough .County and State,appeared --.-..-f4 who,bemg duly sworn according to law,deposes and says that he is the>elOO~~~m~of the es- tate of Rose.ZleLinski..._deceased,that the foregoing schedules constitute a complete inventory and appraisement of the real and personal estate of .....R9~~..Z.i.~.uD~.~L......_...., 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 namedxEx~xx~~mi~lf:1l~?<Informant. day O Sfworn a.~d.SUb.SC:ibed be~f"9"me tim .l(r;{·····}.....~...fJJwrv ..~..(}<~!~~/I~/' . .·"7/.······J'········XEU~Mmililf:1l~m~v EVELYN C.TELE3Ko;";'"j{__~u,;'e.U.~. Cillnonsburg,Wlls~·;~....on Co.,PII.,5317 ADDITIONAL INSTRUCTIONS My Commission Expires March 10.1973 1.An inventory 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 Oopies and 2 RCRI-33, .,Over $10,000,including Copy of Will;1 Original and 3 Copies and 2 RCRI-33,Over $50,000,in- 'I eluding 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 JUtttutory UM i\ppruistmtutof the goods and chattels,rights and credits which were of R.os.e ..Zi.eJ.imki .late of t!~~.~.~~.~!... Washington County,Pa.,taken and made in conformity with the ab01Je affidavit. PERSONALTY NON E REALTY / DOLLARS CENTS ALL that certain lot of ground situate in the Borough of Houston,Washington County,Pennsylvania,bounded and described as follows: BEING part of Lot No.121 and par~of Lot No.122 of a Plan of Lots laid out for Cummins Realty Company and later surveyed for William W.Donaldson by H.M.Day,C.E.,establishing the line of the lot hereby conveyed as follows: I BEGINNING at a point of intersection of southern boundary line of Crawford Street and the Western line of the same St~et (said Crawford Street forming the right angle);thence along first said Iine of Crawford Street North 64°5'West, 42 feet to a point;thence South 25°55 1 West,86.5 feet to a point;thence South 320 51 East 49.7 feet to a point;thence along second said line of Crawford Street,North 25°55'East 112.9 feet to said first line of Crawford Street,the place of begin,ning. BEING the same lot of ground as was conveyed to Rose Zielinski by Deed of Ralph A.Hamilton et ux.dated June 21,1967 and recorded in the office of the Recorder of Qeeds of Washington County,Pennsylvania,in Deed Book Vol.' 1262 page 1.8,000 00 ,I 'Vd '·00 NOl.~NIHSVM S111t\30 H3lSW3lJ ONHJVti 113SStUi l£JJUti £2 :J3S 69. #Q 31 JJ "lj t ~;;:o ~o:Vl:m ~N:n; j!:: Z:VljA ... 'D Form No.RCC·62 (2·64)THIS FORM REQUIRED IN ALL ESTATES WITH GROSS ASSETS UNDER $10,000,UNDER SECTION 701 OF ACT OF JUNE 16,1961,J EFFECTIVE JANUARY 1,1962.(FILE IN DUPUCATE WITH COPY OF WILL ATTACHED)..;'":\..... OFFICE OF THE REGISTER OF WILLS· County of ,..Wq~~i.n.gt?n . . ... ... ......... .Judit.h fiJeel'l.McCIJ.lJovgh '"of HQlJstPJl,..P.e.nl1s.y.IYMip.. (Name)(Address) being duly .sw_o.rn According to law,deposes and says that he is the JrlfQrm9DL _ .*O(;X~~oeM~X of the estate of R~~~._~J.~JL~~_~.L ------._whose last residence was 205__CrLLwford__.st.reeL _ (No.)(Stteet) _!j.Q.JJ~.tQn .deceased,and that the whole of the estate of said decedent,who died __)~n!L~_~JJ.2.9_~_ (City,Borough or Township)(Date) consisted of: REAL PROPERTY REAL PROPERTY It-rPENNSYLVANIA,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 AND RELATIONSHIP OF OTHER OWNERS. Real Estate ALL that certain Iqt of groul1d situate in the Borough of Houston,Washington County,PaboundedanddescribedasfOllows:_ BEING part of Lot No.121~art of Lot No.122 UMI"C Tlen ot Lots laid out for Cummir s RF!altv r,and la~rveved for William -~naldson by H.M.Day.C.E. establishing the line of the lot hereby conveyed as follows: BEGINNINGat a.point of intersectjon of...south.ern boundqry line ~f Cr.awford Str:eet and Estimated Value rne vvesrern line Or rne some ~neer \:'011.1 \",I .......v'·...~IICCI IUIIIIIII!j I IC 11!j11l UII!jIC/, thence along first said Iine of Crawford Street North 64°51 West,42 feet to a point; thence South 25"55'West,86.5 feet to a POint;thence South 32e 51 cast ~tl'-:lr~e;;:;e:1:'""'1=rr"'o:-+-----­ a point;thence along second ~aid line of Crawford Street,North 25°551 East 112.9 feet to said first line of Crawford Street,the place of beginn,ing."i11t1..5t::J BEING the same lot of ground as was conveyed to Rose Zielinski by Deed of Ralph A. Hamilton et ux.dated June 21,1967 and recorded in the office of the Recorder of Deeds "~\AI,..~h~n",+,,n rn,.nh,n .••in f)""""r1 Rnn~Vnl I?f..?nnnF!1 a,ooot ...,I , /_. .-I -v--vr/ Personal Property NON E NOTE:You may expedite the processing of this return by filing with it,and as a part of the return, letters from financial institutions or mortgage holders,certifying to amounts on deposit or owed by the decedent as of the date of death.Such letters must be signed by a responsible officer of the financial institution or mortgage holder and indicate clearly amounts of principal and interest in the decedent's account at the date of death and the type of account,account number and the exact name or names in .~~ which the account is registered. --------------------------------------------~ Jointly Held Property Estimated Valu~-- N 0 N E .-..- -. - Transfers within TWO YEARS Prior to Death N 0 N E " 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,contingentor otherwise,in estate.)are involved,set OR NO AT DEATH OF IN ESTATE forth this fact.)DECEDENT Thomas Zielinski Son Yes $500.00 Legacy I1nnnlrl 7i",linck'Son Yes $500.00 Legacy Robert Zielinski Son Yes $500.00 Legacy -hJdith Eileen Mc..CuJlolJnh Dauahter Yes Entire estate ---.;--" ---_.-----~-~---------------------------------------, RESI~T DECEDENT DEBTS AND DEDUCTIONS CLAIMED IO'OT~'List first five items in the spaces so ~rovided:observe notations thereon,and instruetions.• DEBT OR CLAIM NATURE OF SAME AMOUNT THIS COLUMN iKEGISTER ONLY William E.Sp'3:1kmcm Funeral HoI"~eFuneral expenses paid $1,700 PO $ Judith Eileen McCullough Family exemption (will not be allowed unless 1,000 00 decedent died residing with a spouse or children.) Administration Expenses * M.E.Kusturiss Counsel fees *200 PO Fiduciary commission * .,OTHER DEBTS AND CLAIMS (*)See Note below Russell Manno,Register of Wills Probating of Y.'i11 17 IOU Pittsburgh Anesthesia Associates Medical treatment 12f 00 NeuoslJrgical Associates of Pgh Medical services 49~00 Mercy Hospital Hospital care as 00 Anthony C.Ripepi,M.D.Medical services 4C 00 Mary M.Cavasina,M.D.Medical services 2~50 Gaydos Monument Co.Headstone 36':001 St.Patrick's R.C.Cemetery Burial lot 22~00\ J.Kenneth Hootman,M.D.Medical services 15 00 Evelyn C.Telesko Notary Fee 3 50 1 Russell Marino,Register of Wills Filing Inventory and Appraisement 3 00 St.Patrick's R.C.Church Priest services 25 00 ,. Total 4,32.5 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 01'less than the estimated amount claimed and allowed. Subscribed and sworn to before me thiS .....;/..ttt........'~'~~~ant . ........ ..'0·day of ~,19.W ~Q?~~9!'!f"!~..~t.~~!. .......".'/u~~..e..?/if~.......Houston(St;::~u~:~~ia 15342~EVELYN ,'1 ( .c C.T ESKO,Notary Publ'(City or Town and State) Manonsb,,"?."/2 'i"",~""'".,i"a,,1;317 REPORT OF THE~EGITER F WIL I,the undersigned duly elected Register of Wills in and for....... . ....County,Pennsylvania,do respectfully report that I haveallowed debts and deductions in the amounts clai ed by deponent,ept as to those items wher a greater or lesser amount :::d~o~t.h~.h.e.~~~:(f;.S;~~~.I~.above,which greater or I~S..~.~~~~.~t.g .....l~~~~~.~~.d.e~.u.c.t:~~..... Register of Wills ~ /' ~ ,.,1/1'Form No.RCC-62 (2,641 .......:......~ Will .I'"I •_ Administration S~o.~..:-',:.':,'. .Year ..... 'J -i:::~I...."'" 1 ..,.::IIN'T!JE .. II'"'l' MATTER 'OF ~THE APPRAISEMENT.",-~-....-"-.~ ., j .... "1 , •I \OF..THE.:• , ES1ATE OF: JI II r t I I ." -ROSE ZIELINSKl Deceased ...'H:f"'""\t .'Late of .~.o ••";.:••:P!J;~t~D;.:.,. :..I l ,- County oi ..':..~~~rJ':lgt9~.{'(.:-...,-.-, Commonwealth of Pe.ilnsylvania,.' 0=;..."E ~t.CREPOR~~~A~P~IS~ •.,.-~;..r-n r={,.,M -c:~~M'·l"'-J n,(;)m ....'~:J.1 r-:tAJ 0 ~Q~,......-"'f'j~~~:I:S ;po.::xc:>..:::tl~r=ii "'0'-0><n'~•c:;:, ..J' 0', M.E.kUSTURISS ATTORN'Y AT lAW '2 N.JIiiFFIi:RSON AVE. CANONSBURG,PA. / Form RC C·lO &3 'G,7-'9/9 DEDUCTIONS JALLOWEDIN...- .OFFICE OF THE STATEMENT OF DEBTS THE SUM OF ............$...................."......... REGISTER OF WILLS·tt AND DEDUCTIONSWgstjlngton DATF.:APPROVED ........OF )COUNTY .............. AND AGENT OF THE COMMONWEALTH Regill..of Wills,Agent ESTATE OF Rose Zielinski LATE OF Houston DATE OF FILING APPRAISEMENT DATE OF DEATH June 22,1969 DATE NO.OF NAME OF PAYEE REMARKS AMOUNTVOUCHEJIt ~-.8/21/~9 1 Russell Marino.Reaister of Wills Probating of Wi II 17 00 , "2 Pittsburgh Anesthesia Assoc iates Medical treatment 126 00 !..I "3 Neuosurqical Associates of Pgh Medical services 495 00 "14 Mercy Hospital Hospital care 88 00 "5 Anthony C.Ripepi,M.D.Medical services 40 00 "6 Mary M.Cavasina,M.D.Medical services 22 50 "t7 Gaydos Monument Co.Headstone 365 00 "I~I St.Patri ck IS R.C.CemeterY Burial Lot 225 00 "9 J Kenneth Hootman.M.D.Medical services 15 00 "lin !Willinm F C:::neakman Funeral Home uneral exoenses I 700 00 "11 Judith Eileen McCu Ilouqh r-amilyexemption 1,000 00 "12 Evelyn C.Telesko Notary Fee 3 50 "13 M.E.Kusturiss ~ttorneyIS Fee 200 00 "14 Russell Marino,Register of Wills Filing Inventory and Appraisement 3 00 "15 St.Patrick IS R.C.Church Priest services 25 00 - 4,325 00 COMMONWEALTH OF PENNSYLVANIA }ss:COUNTY OF Washing)On I,Il'dith Fileen McCullough HEREBY CERTIFY,THAT.TO THE BEaT OF MY KNOWLEDGE AND BELIEF,THE FOREGOING IS A JUST AND TRUE STATEMENT OF DEBTS,FUNERAL EXPENSES AND EXPENsa 01" ADMINISTRATION SUBMITTED TO THE ESTATE OF Rose Ziel inski DECEASED.AS DEDUCTIONli FOR INHERITANCE TAX PURPOSES.~tld'l:k ~m~.~~~y~(L.5.) Juaith Eileen McCuloug EVELYN C.TELESKO,Notary Public Canonsburg,Washington Co.,Pa.15317 My Commission Expires March 10,1973 R Cc-el (2-64) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS INHERITANCE TAX DIVISION NOTICE OF FILING OF APPRAISEMENT JUDITH EILEEN McCULLOUGH (Executor~~~· IN YOUR REPLY PLEA8E REFER TO 37-249-3 J In Re:Estate of R_CB--,;-E_Z_IEL_·,_I_N_S_KI _ _______W_A_Sill-..:.N...:,G...:,T...:,.ON County -File No.63-69-949 Dear Mrs.McCullough: You are hereby notified that the original appraisement in the estate of Rose Zielinski has been filed in the office of the Register of Wills qf Washington County on December 5 ,19J22.Said appraisement reflects the following valuations: Real Est ate _--,;-__....:8:::.:.L:O::.:O::.:O~.wOO::.:::----_ Personal Property __ Transfers ...,.....~...................._---- Total 8-~,-O-O-O..:..-OO----- 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 (8%)percent per annum is charged. Any party in interest who is aggrieved by an appraisement may appeal therefrom as provided by law. Dat e _--=D::..:e:.::c:.::em:::.:::b~e.:::..r-<!..5L'....:1:::.9t.:.6~9'---_Signed Title DATE OF DEATH:June 22,1969 Note:This is not a bill. COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SUMMARY Estate of ZIELINSKI,ROSE (Last Name)(First Name)(Initial) DATE OF DEATH 6-22-69 FILE NO.63-69-949 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 ill the last column to the right in Schedules "A","B","C",and "E". Dated:12_-_o....::;5-_6..:-9 _ 06-22-69 REPORT OF THE REGISTER OF WILLS I,the undersigned duly elected Register of Wills in and for Washingtcn 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 ..a deduction.Q •I n/lA __ Dated:12-05-69 ~'JLI'~ REGISTER OF WILLS 8.000 00 8,000 00 4,325 00 3.675 00 8 000 00 8,000 00 4,325 00 3.675 00 VALUE AS REPORTED VALUE AS APPRAISED VALUE AS REAPPRAISED $$$-------+--- 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 F) CLEAR VALUE OF ESTATE Valuation of life estates or FOR USE OF REGISTER ONLY Taxon $~~Tax on $3,675 00 ~ Tax on $5% Taxon $~10%nxoo$1~ Exemptions '" Total Estate . TOTAL TAX COMPUTATION OF TAX $---------+-- $-.!:::2~?r...J.'5I~0- $--------+--- $-------~­ $--------+--- $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 $L Add interest at rate of 6%from_____to $--------' AMOUNT OF ESTATE TAX ASSESSED $--------:1- Estate tax paid $L- BALANCE DUE $---__L- Add interest at rate of 6%from -------lto-----$------1t=TOTAL TAX BALANCE $------1' PAID $....1 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 !Ad ..tr ti No...,mlms a on IN THE Year . MATTER OF THE APPRAISEMENT OF THE ESTATE OF ROSE ZIELINSKI Deceased Late of . County of ...H()US'l'()N .. WASHINGTON Commonwealth of Pennsylvania REPORT AND APPRAISAL I• fonmty Wlth law on thl8 ~day Of 7Ji)...:::e..r:s-J<:.<r.-Ff?1'14.L~..-:\--:·:.·:.·.····.:·.·.:Q=:"S;..llf~~ Fonn RCC-2.COMMONWEALTH OF PENNSYLVANIA DATE ...............P.~.~.<:l.~.~~.....?'........~.?§.?.............. DEPA:£TMENT OF REVENUE ~.RESIDENT INHERITANCE TAX '".....................t.'!.~.~.£1.~.~~.~.............BuAEAU OF COUNTY COLLECTIONS •COUNTY ................... HARRISBURG.PENNA.J 7127 APPRAISEMENT FILE NO................................?~=.??:.?~.?............................. Whereas,..............................~.?~.~....~.~~.~~.~.~.~......................................................................late of ..............................................~9.~~~.~........................................ in the County of ................................................w.~.~.~.!.)g.~.~......................................................Commonwealth of Pennsylvania,having died on the ..........................................?~?.~........................................day of ................................~.:l.lt.l.~................................19..~.9....,seized and possessed of an estate subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore,I,.........................w..•.R.......Cbane.y.......................................................................,an appraiser duly appointed according to law, having been designated to make a fair and"conscionable appraisement of the said estate,and to assess and fix the cash value of all annuities and life estates growing out of said estate,hereby file the following appraisement: In the event that any future interest in this estate is transferred in possession or enjoyment to collateral heirs of the decedent after the expiration of any estate for life or for years,the Commonwealth hereby expressly reserves the right to appraise and assess transfer inheritance taxes at the lawful collateral rate on any such future interest. Unit AppraisementDescriptionofAssetValuesMadeforInheritance Tax Purpoles $ REALTY: All that certain lot of ground situate in the Borougtl of Houston,Washi.ngton County,PEl.,Being part of Lot No. 121 and part of Lot No.122 of a Plan of Lots laid out for Cummins Realty Company and later surveyed for .. William W.Donaldson hv H.M.Day.C.E.8,000 00 ." Total 8,000 00 Having been duly sworn accordin to law,I do hereby certif hat the ajove appraisement is made in..',,__/} ..............W.1.\$I{IJ~Q'l:'~.County RESIDENT INHERITANCE TAX APPRAISEMENT Estate of ........................................ROS.E Z.IEL.INS.KI .. Deceased. Late of HOUSTON Date of Death,~.W].~??-'),9.9.9 .. Appraiselneilt Docket Vol.,.3.7.'~:':2.4.9~3 . Page,No 9.r..9.9-:94.9 .. Filed in Register's Office,p.~.~~!1l1:>.~:r.P..'.J9.9.9... Amount of tax due,$. DEPARTMENT OF REVENUE Received, Examined and Approved,.. Wrote abo.ut Appra-isement,.. Appeal f"om Appraisement,.. Entered and charged,. !' 1