HomeMy WebLinkAboutOC1970-0070 - ESTATE OF PETERSON..:d)
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COMMONWEALTH OF P'ENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
INHERITANCE TAX DIVISION
NOTICE OF FILING OF APPRAISEMENT
MILDRED L.PErERSON
(Executor ~~~~)
IN YOUR REPLY PLEA••
REnA TO 38-39-2
j
In Re:Estate of ....;C~H~ARLES~=....:A~.:....:.P=E~TE::::F:.::tS;,;;O~N:..__
______\~vA~S~H~I::.:N.:=:.GT.=.;O:;:,:N~County -File No.63-70-70
.Dear V.!r:i:.Peterson:.
You are hereby notified that the or~inal
appraisement in the estate of Charles A.P~erson
has been filed in the office of the Register of Wills Qf.Wash~ngton
County o~April 24 .,19~.Said appraisement reflects the
followin~valuations:
Real Estate _.....,;,.-......--.."..,..............-
Personal property ~1l~,~8~6"4~.~1~4~
n Hel~m----~~4.000.00VIV.~~~~~~~_
Total --.....1....5u..~8~64;;1;.:·.=.=l::ot4;...
As to such ~ax that is paid within three months from date of
death,a five (5$)percent discount is allowable.As to any tax that
remains unpaid after one year from date of deatn,interest at the rate
of six (6$)percent per annum is charged.
Any party in interest who is aggrieved by an appraisement may
~ppeal therefrom as provided by law.
Dat e __---ot;Al>,lp""r.i..,1._2:=4,a......1=-9"-7~0~_Signed .~~
Title W.R.CHANEY,CHIEF IPPRAISER .
.DATE OF DEATH:January 8,1970
Note:This is not a bill.
--,
,.,.,:.-
>nCC'39 (&-88)
COMMONWEAL.TH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SUMMARY
Es ta te of PETERSON:
(Last Name)
CHARLES
(First Name)
A.
(Initial)
DATE OF DEATH 1-8-70 FILE NO.63-70-70
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 o-;lposite each item in the last column to the right in Schedules "A","B","C",and "E".
Dated:...;O=:4t...-..:=.24;:r.--l7...::0:.....-_
01-08-70
REPORT OF THE REGISTER OF WILLS
I,the undersigr.ed 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
les,ser amount is set :orth 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
11.86ie 11
L..OOO ·0U-
15.864 14
11 86LL lie
ie.OOO 00
-1s.864 14
VALUE AS REPORTED VALUE AS APPRAISED VALUE AS REAPPRAISED
$$$------4--
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
Tax on '$-+__
Tax on $---------t---{
Tax on $---------+---Tax on $-+-__
Tax on $---------t---
Exemptions========t:==Total Estate ~___
TOTAL TAX
10%
15%
*
COMPUTATION OF TAX
$------~--
-$-------+--
$_--------4--
$-------~$-------~-
$1...-_
(*)As evidenced by Charitable
Exemption Certificates issued
by the Secretary of Revenue.
Less tax previously paid
BALANCE
Less 5%of tax if paid within
3 months after death ::::::::::-:::!::t==-=-=
BALANCE OF INHERITANCE TAX DUE -$t=
Add interest at rate of 6%from
to ---c=$---AMOUNT OF ESTATE TAX ASSESSED $-
Estate tax paid $I
BALANCE DUE $~L-
Add interest at rate of 6%from
to $-------It=TOTAL TAX BALANCE $------I-
PAID $...J
FOR USE OF REGISTER ONLY .ADJUSTMENTS
NOTE:Where subsequent adjustments are made to the above computation of tax by the Register of Wills,for proper reason,
same should be noted below,with short explanation.
Will lAdministration~No...Year : .
IN THE
MATTER OF THE APPRAISf.:MENT
OF THE
ESTATE OF
.......GI1AR):~F$..A.~P~'I'~~qN..
Deceased
Late of ,WASHING.TCN .
County of ..WASHJ.NGl.'ON .
Commonwealth of Pennsylvania
REPORT AND APPRAISAL
,
~
...~.,
Fonn RCC-2'
D~RTMENTOF REVENt1E',.•.
BWEAU OF COUNTY COLLECTIONS
HARRISBURG,PENNA.17 1Z7
COMMONWEALTH OF PENNSYLVANIA
RESIDENT INHERITANCE TAX
APPRAISEMENT
DATE ,."""""".."Aptil""2.4""".19.7.Q"",,
CO~NTY'".~"""""""""W.~~h.:!::!).gt..9.I.l."""".
FILE NO."."."."??.:.?..9=.7.9.""""""""""""""..".."....""""...,,..
Whereas,........................"..........G.D.~.l.~.g ....A.~.,,"p.~.t..~.r..~.Qn .......................................".....late of "...".........".........."J.fa.,~.h~ngt.Qn ................."..........."..........".
in the County of .....""".."...........""""".w.9:~.hi..ngt.QO ...."........"............".."",,..................,,....Commonwealth of Pennsylvania,having died on
the ......................"................,,$.....t'.D........................................day of .................J.anuar.y............"..............."......19.70."..,seized and possessed of an estate
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore,I,.........."...................".W~.R..!.....G.h9:n~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 Appraisement
Description of Asset Values Made for Inheritance
Tax Purposes
I $!
;HERSONALTY:i
;,11,864 14SeeCODVofScheduleliBattachedtoaDDraisement-
JT.HELD:
See conv of Schedule "E"attahhed to annrais ement 4.000 00
I
..
Total 15.86L.lL.
form~;V~fhb~':::~h~W~~;?~~~'~a~o~"':~~~~ea~o.~;~r~i":e~~..tii~3~
~g;Appra)•.."··"..··,,·,,····,,..,,···..Z·~····..···....········..··········............"..."......."..............................~Cc,,·.(J .......::;;~~i·~l....................................Penna.
!
............................WASH.ING1Q.N.....County
F
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RESIDENT INHERITANCE TAX APPRAISEMENT
Estate of
CHARLES A.PETERSON
Deceased.
Late of
........................................v.lASH.I.NG.1QN...
Date of Death,J.@1l,~y $.J +..9..79..
Appraisemel!t Docket Vol.,.??..
Page,...3.9~2 N o 93..~7Q~.7Q ..
Filed in Register's OfJice,Apr..i;J,.,?4..L ..19 7.9.
Amount of t.ax.due,$.
DEPARTMENT OF REVENUE
Received,
Examined and Approved,..
Wrote abo.ut Appra.isement,
Appeal f,.om Appraisement,..
Entered and charged,..
-
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3 -781S:-7'DFormRCC·10 t DEDUCTIONS ALLOWED IN j..•"TO.,ag -39-:;J...
THE SUM OF ............$g.~~£.y/..Z~~..
,".STATEMENT OF DEBTSOFFICEOFTHE
REGISTER OF WILLS AND DEDUCTIONS .AT£~....q~1(lJ:]ll,WASHINGTON -.
OF COUNTY
AND AGENT OF THE COMMONWEALTH ~~
Reglater of Wills.Ag""!
ESTATE OF Charles A.Peterson LATE OF City of Washington,Wash.CountY,Pa.
DATE OF FILING APPRAISEMENT Mar".2 0 ,1970 DATE;OF DEATH January 8,1970
DATE NO.OF NAMII:OF PAYEE REMARKS AMOUNTVOUCH~~
1970-'Rpn iT ,s of ."nm;n;~-t-r;:\+i,..,n ?l ,nnT""n''0 ,-.,,M;:\r;no
.1;:\n·19 2 1\T__'""-II Homp ".11 or dec'n ,,?O 00
.1~n'19 3 Rev Dozer ",;n;°"',°t"'oe;:,?n nn
.T~n··?-o 4-W;:\~h Co.Reports adver.arant of Ie 14-100
T .."",'".:tn r;R"t"''k-~011 Inc::lr A nrpm on .h,..,nn '7n Inn
I<'oh A ~r,.."r.",e;:,of ponn::a l;:\~-t-n~~h;ll of npc'rl r;~l".:t".:t
I<'oh'0 7 Woc:+Ppnn ....r.o l;:\~T.pIpe,hi"of not""n 0 lo?
H"oh'17 A Wash'Hosoita1 bill of dee'd r;I?n
~_l-.',,".:t 0 r;+;..,.one;:,•.•r.,..,,.,,~+hi "".,:rf,.._'rf ",
IQO
~,..l-.'"'2 ,n 12,.."'1'.....,r'~''""e;:,++0",hi"".,:A __t...:l ,r;11'\"7
M..:...·"n "l-fo'on ~on""".4:____;0_....1 Ie::.n
M::a,"?n ,?t>.·....-.,11 M",,.i n"~O,.,·I T';1 inn i °PC:'2 Inn
I
M~r\?~l~W;:\sh'.-E'.Wash.J'.A'.last sewaae bill of dec'd Q I,,
An,."?iJ.1iJ..1nc:··N Mt"M::ahan 1\1 D'medir.;:\l for dpc'd 1~nn
June /Y 1"~imnn Wh;T.pc:c::."ne;:,,on"c:+nno ,'7'()f'\
,Tuno /f 1ft M;ldred T PR:PTsOn fpp ~lA nn
T.....,..If ''7 An",m T"C'.:J oF....""r;()f'\nn
.1nnp //18 ()he;:,Pnhl'r.o ~d"pr ~of Ie 'iJ.Inn
T"no /1 10 Hplon -°nnp 1 ..._._-••fpp.!=:_~f'f'·+R.n Jl.):;',Ir;()
Tn'••???f'I n._."M"",.';no 00"IT';1.;.......11=..In",-;;iT 'J
Total---------------------IS2 r;".:tA Ir;?~-<'~l AA1f~~v d--r:'J~11 HJ
Q d .J l'rOAAJ'i.A L/:r "(.,~~JI ~dQ'.c):?3l),/'
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COMMONWEALTH OF PENNSYLVANIA }
COUNTY OF -_~w..&...I...U'~""'~____SG:Washington
__---'--'M.....,.L.°.l.l.J.Jdu.r..l:e:ad""--Iw..~.---I.P...se::;..t"'"e.......r.i:ls~oUnL_HEREBY CERTIFY.THAT.TO THE BEeT OF
(L.5.)
.DECEASEO.AS DEOUCTION~FOR
INHERITANCE TAX PURPOSES.
MY I<NOWLe:OGE AND BELIEF.THe:FOREGOING IS A JUST AND TRU E srATEMENT OF DEBTS.FUNERAL EXPENSES AND EXPENSe:s 01"
ADMINISTRATION SUB~ITTED TO THE ESTATE OF Charles A'.Peterson
,~-Yu(/~~/~8-~
SWORN ND SUBS~~,JED_BEFORE ME THIS /DAY Ol"~-.18~
,-
My Com.Exp:Mar'.2 ,1971---Not y Public
Washington,Washington County,Penna.
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'.,:,";,,:;,;.'"~EPART¥ENT OF REVENUE "''('",.,;.t.~-;
~?AO8'4-8 46.?Ff'C'AL RE~~IPT •PENN~~~~~NIA.IN~ERJTA~CE-AND.~S!~TE !~:
2%Tax on $$~,.)I
6 %Tax on $__O_n_A_c_c_o_u_n_t_$2_4_0_._0_0
1111
and
Ind.
RECEIVED TWO HUNDRED TWENTY-EIGHT
Mildred L.Peterson,Paying on
From:C 0 ATTY.ADAM L.SANDERS
611
Address »ti WASHINGTON TRUST BUILDING
WASHINGTON,PENNSYLVANIA 15301
no/IOO - - - - - - - -
Liab-epresenting Pennsylvania Inheritance or
Estate Tax due from the following estate:
-dollars
County _----"-__W_A_S_H_I_N_G_T_O_N ----l
i'~ame.'of pecedent __C_HA_R_L_E_S_A_._P_E_T_E_R_S_O_N_----I
March 20 1970....Date of ~a yment __---'::.::.::;:..::....;::.=_-'--L..-::::...:.-'-----!
15%Tax on $$
_•._"'t_____
%Ta~on $$
Estate Tax,Act of
May 7,1927 -;$
TOTAL TAX CREDIT $240.00
Less five percentum of tax if
paid within three months after 12.00dateofdeath$
Plus interest at the rate of
__%from
to $
TOTAL AMOUNT PAID 228.00$SEA L
Date of Death_l=--...;:.8_-_7_0_----J
Remarks:
File No.63-70-70
NOTE:To be delivered to taxpayer 38-39- 2 t:::Z '
.'Received by //7~
NOTE:In accepting the transfer inheritance-iax an future estates,prior to the death of the life (Signature)~',
tenant or tenant for .years,as evidenced by this receipt,it is understood that the Commonwealth shall ~;",,'./q ~/1
nat be 'precluded or prevented from hereafter assessing additional inheritance lax at the death of the ~-~P"~~
life teflant-or tenant ,fa.years whenever it appears that such additional tax may be legally due and-=--';~---~M'T~i-;-tle-;)---'~"""""-'="":::::";""-----lnl
collectible for any reasan,whatsoever..Y \
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I;,~::-~---'-,~~---.'.,.COMMON~EALTHOF P.~NNSYLVANI~0
DEPARTMENT OF REVENUE '.' .
NO.A0"84'e4':T0FrICIALRECEIPT •PENNSYLVA~IA INHERITANCE'A~D ESTATE ,T:4x.
2%Tax on $$---------.1fOl
510.00
$--------·1111
RECEIVED'FOUR HUNDRED EIGHTY-FOUR
Mildred L.Peterson,Admr.
From:C/o.ATTY.ADAM L.SANDERS
I Address 611 WASHINGTON TRUST BUILDING
\'lASHINGTON,PENNSYLVANIA 1530"
AND
6%Tax on
50/100
representing Pennsylvania Inheritance or
Estate Tax due from the following estate:
$"On Account
dollars
File No,63-70-70 Date of Death_.....::1__-_8=_-_7__o_---l 15%Tax on $$~
$---------
_,Date,of.paym.ent~,-:--....:M=a::::..r....;.c,...:::ch~,_2_0.:.,..L._..:.,.1_9_7_0_----'=:..:..-:::-:.:..,-'.:...'~-'----i
Name of Decedent _----=C:..=.HA=-=R:.::L=-E_S~A_•..,--P_E_T_E_R_S_O_N_-l
--,%Tax'off-$_"_-._-_-_-.,$---------llill
Estate Tax,Act of
May 7,1927
County.'_W~A:.=S:..=.H:.=I:.=.N__G__=T__O_N ___j
Remarks:
TOTAL TAX CREDIT
Less five percentum of tax if
paid within three months after
date of death
Plus interest at the rate of
__%from _
to _,.
510.00$---------
25.50$---------IUI
$---------1111
@rn ~@~[KJ ill [L SEA L TOTAL AMOUNT PAID $===4=8=4=.5=0:::::::;=:==1~
NOTE:To be delivered to taxpoyer .'38-39-2 ,/:7 , '\j
'.Received by ~.L..e!..e--~~
NOTE:In acCepting the ~ransfer inheritance tax on future estates,prior to the death of the life (Signature)
tenant or tenant for years,as evidenced by this receipt,it is understood thai the Commonwealth sholl ./J I
,not be.precluded or prevented from hereafter assessing additional inheritance tax at the death of the /~-"'JJ~~~~
life tenant or tenant:for.years whenever it appears that such additional tax may be legally due and ~'"~)..
collectible for any reason whatsoever.
.~•.''n
..------------------------_.------------_._-_...._----------
V70 SEP?5 M1 9 55'
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RUSSE l I ,(.,"'~IOL_~":·i i'\!1"
REGISTER OF WILLS
WASHIN(~TON CO .•PA .
.,.'
._.f·
FORM 67 REG.WILLS
REV.1-50
application for i4rttrrs of "~lttinistratton on thr
Estate·of...Q1.9!'.l~§....A.tl p'~.~g,!:§"9..n.,?:/~~,,"¢.!.t~~~.t~;:.§Q~."e/~/~"9.h.?:;.!.~§.
.......A;r.:~.D.~J p.g.:1:.~!'J?.Q!t "~:".
late of........._..9.;,.~y.....~.:f.....~e.~.~.~.~2.~~.~.1.~.?:~.~.~.9?~~.~.~~~~~.!..,Deceased.
Before the Register of Wills of Washington County
personally .appeared }~~;,.!9.;:.~9 ~.~~~.~~.;:.~.~.~:..,
who,being'duly sworn deposes and says that...Q}.9.:!'.;tg,§A~P.~.t~;:.§9..~..:,..
age 67.,having ht,.§..last family or principal residence at...;t9.4.:?S)J.!.§Q~Ay..~.l!~..
,(Street and Number)
......~~§.h~.!}.9..~Q.~"~~.~P.:?:.~~,Washington County,Pennsylvania,died intestate
_(City,Borough,Township)..-..:::-',.-._- - -'
at.....~~~.RiBgtgR,.~~R~~~.!,'on the..§,~hiay of J..?:P.:H.?:~.Y...
A.D.~__l9._..7.,at.....:.~.;..Q.9.~.;::.:E-~;..M~j'possesseq of:'ptttsonal estate to the estimated:value
$..II}..:z~e:~..~:#and .of real ;~tate in'j:heJ:oni~on~ealth of.Pe~nsylvania to the estimatcid v~lue of
-$~Q~.~;_,':~itu ~~e in ·..·:~..· ·,:;·;·..:·:;~..· :..7·;·:..• ·;~'f ;.
..................:~;._~;:~:~;......................................................................•.............
.;.Tli~\na~es,and,a<;ldresses 9f the d~ced~nt's ~surviving:spouse (if any)and other heir~in~luding
heirs by adoption)are as·follows~,.,:':.'<~:'i :'".,~EJ.A~IONSHIP . ,R}~SIDENCE ~::
. .".I I I .,.Mild d L P +on"'.'d'h·,nAc:.:A'l"A..h'P....................x.e J~..~.e.;r..$.aY.g t.eX'."".':r.:1;•.,/,n ..""..;t.§.Q.n -o.v.~,W~~G ~..
. -"',•,:I
Mar"n Eveln,"Wilhetm '.:"·d '.ht':'P"t·+.....h P .'-:..................~_~.~.~'!ap.g .,eX'Jr..,1t.s.w.YX:.g..,..:enn.a :.
.'"• •~<-"<.•
.......p.Qx.Q:t.uy.g:,,:.:..GQ9.h!':?:!l :Q.~~:ghj:;.!?~.J~J:p.~§.Q"..:r.!?~~§~..
.....J~~.:t~l.lg ..Jl~i.!iu~i..~:~:.da~:ght:er p.QP,Q;r..~.,P.~.OO~.II :.:,...,,..;...,
Charles Arthur Peterson Jr !son Columbus'Ohio ..........................._",,..
.......~r..1 :§:p..e.t.e.x:.$.Qn $..QD.: :.R.~};i'A..~)..".GJ:.?:y.§y.!JJg."p..?:.f!..
.........................•.............................................................................
)::~.~.
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Sworn and subscribed before me this.......L?::::::::::...:.
........................._~_::··:: 1 ·:·..·..· · ·,..
Th d ·,,'··r-:·2'1 f"d lOA5 Allison Ave WashingtonateponentISover_years 0 age,reSl es at..::f.f.1t lt."·.......1 ...','
Pa 15301:';'..........................................................................................................................................................................................................................:.
,).",~\\:I
is a citizen of the United States and a resident of Pennsylvania,and respectfully applies for:Letters of
Administration uppp the Estate of said dec.e~ent,no letters having been previously issued thereon.
)}f2t.g~~L.d~
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r'•REGISTER
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COMMON'NEALTH OF PENNSYLVANIA }SS:
WASHINGTON COUNTY,
d-.
And nnw J.anuar.y,..!...!..-=.,19 7.0..,comes Mi.~dr.e.d L P..e:t.er.s.on .
who being duly sworn doth depose and say that..S.b~L.........will well and truly administer the goods and
chattels,riglhts and credits of Char.l.es A P..e:t.er.s.on ,deceased,
to the best (.f..D.!?!......skill and judgment in strict compliance 'with the laws of this Commonwealth,mind-
ful of the larws relating to inheritance taxes.
.~
Sworn ar.d subscribed before ~e this......~..?==......
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REGISTER ._-
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APPLICATION FOR
Letters of Administration
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Ag.gm :k.lIl.S.ang.er.s~~.B A.."Er.anks ..
.Attorney s
ESTATE OF .
Charles A.Petersdn,.a/k/a,.,.
v C.A",Peterson,a/kla,.
.Q}.~.!.~§g.t.hy.:r;P'g1;.gl;".§.Q!L .
Deceased
•R $.
.Lette ,.....rs .....................""0
P $/..v.~~.
Extra Alias'$..Ger~ficates .~4 ~::::$:::::~:::?:.:.~;;:~
.''.Ren~~nciatiO.'./$4:~..:?
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ESTATE OF
................................_~!t.A 8 I::::..€$!i.:..:E.~.!.~.~~..?/.y :DECEASED
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rfhe undersigned ~..tt.!...~.J?...~;..J5:.().J and heirs
of 9:.I.td.~b::§;.~!J ~f5:c€.~.~..~~.late of c;.,/T:..!:::.~..~~~.~.~!.:~~T~..~~P4
d· d h +.,d'·1'"jfE'i.o .h d'.'H-/",s .ecease,erC::Jy renouncy,:.:l.rIg t to a mInIster on estate
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arO~mnn1UrnltQ of Jrnnsyluaniuf tss.
llIlfas~tl!gton mountg,'\
I,.Russ'ell Marino ,,Register for the Probate of Wills and Granting
Letters of .Administration in and for the County of.Washington,in the Commonwealth of Pennsylvania,
~Mildred L.Weterson
administr a trix
credits,which were of'
~,of,all and singular the goods and ;chatte!s,rights,and
C.Ae Pe'terson,A/K!A Charle s~:1,Arthur Weter.son
C~arles lA.Peterson/A/K/lA/late of Washington County,deceased,
in the county aforesaid,lately died intestate_
GREETING:
Charles Arthur Peterson
C.A.Peterson;A/K/A/late of
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WHEREAS,.th~-said Chatl~s A.Peter'son,A/K/A
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-:o,Cit.y of Washington,
,;-~(f ~"--~;.
(as is affirnaedL possess~wof divers goods and chattels,rights and credits,within the said County,',
to..
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~.:Rus~ell Marino
.-,
by reason whereof th~;power.of granting administration thereof doth belong to me;I therefore,confiding
-/'i .;':"
in your fidelity,¢l.o by these presents,grant unto you these LETTERS OF ADMINISTRATION,here-
-by committing unto you full power to administer the goods and chattels,rights and credits,which were
of said deceased within this Commonwealth,you having iakenand subscribed the oath of office pre-
scribed by'law;requiring you to well and truly administ.er 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 expintion 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 19th.
day of ---Ja nuaroy in the-year~of our Lord one thousand·
nine hundred and
r,
Seventy
~'"........................................................................~
RUSSELL MARINO,Register.
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1J.jettrra of i\llmtntatrntion
IN ESTATE OF
...........9..~.~.~.!:..~....f}..~.....!.!:..~.~!..~.?."9:.~....!!..~!..fi
9...~.!.~.~.~.~.!-:.!..~.g,~.J.;~!..~L~....g.~.r..!~..~....:._
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Arthur Peterson
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lKuuwAll m~u iy IDq~!i~'r~!i~ut!i
Charles A.Peter~on,alkla,.
E",..of~~Kf:t1S~~~¥~B6k/;>,'c:h""~"'~}No of 19 .
la~of ..City...of..,WashingtoTl".......,Deceased
KNOW ALL MEN BY THESE PRESENTS,
That we,.Mildr.e.d..L.•...P.eter.s.o.n.\.ariO'1:.b.~Q~i.~g.d..:.$1=~~~~F.1.q.~.l:;:t.y.:..~.q ~~anty .
.....GQmp~:p.y',~~J 1:.;i..mQ+'.~.,M¥.Y.~.~~.~..
all qf Washington County,Pennsylvania,are held and firmly bound unto !pe Commonwealth of Pennsy1-
...f h f h'd'h . h f·~f!..ti,o~\uf),AJ'-~11vama;or t e use 0 t ose Intereste In t e estate,In t e,sum 0 ~':':'..~Do ars,.to
be paid to the said Commonwealth,to which payment,well and truly to be made,we do bind ourselves,
jointly a!1d .severaIly,~for -and in·the-wholej-our-heirs;-executors,--administrators,-successors ·~h.d~ass~gns,-and'--...-...o.--
'0«each and ~very of them,firmly by these presents.Sealed with our seals and dated the .../.{.~...day of
........J.am~ary,A.D.,one th9usand nine hundred and ..§.t?".C?i1,~.Y...t~~7ql..........'.
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THE CONDITION OF THIS OBLIGATION'IS,That if the above bounden .
......................................................Mildr.ed L P..e.t.e.r$.on .'.
AdministraMf rix 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:
8'tntrmrttt of ~urdt!
I,-------:-":":-----------.::--~-::----=---------_._;---.........._,surety'in the ·sUm of $on the
administration bond in the estate of .--.--------------:._..._......__..__...,say that I reside at
---.------..-..--,~ashington County,Pennsylvania;that I am the owner of real estate,the
title to which is in my own name and duly recorded,'situated in ,
Washington County,Pennsylvania,wOlth above all encumbrances.$..-..___.'.:__~_~.._..__..:;and that I am worth the
amount expressed in said bond,over and above my just debts and liabilities~•
•i"-~,.":..,.r 'J
.__._---._--------------..-----------------------------------------------------------------
,.
P.O.Street
...._---_.._-----------------------------------_..------------------------
&tntrmrut.of ~urrtt!"
I,..----..-------..--..---------.------___..,sur~ty in the sum of $_____:_,__on the
administration bond in the estate of ..----....-......-------..-----..-_........__......:.........__..........,say that I reside at
............-------..--.--------,Washington County,Pennsylvania;that r 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 th~t I am worth the,
a.moun~~xpress~d in said,bond,over ~nd above my.just debts and liabilities.
.........................................................................................................................
._------_...._--_...._-_....__.._._~-
Street P.O.
COMMONWEALTH OF PENNSYLVANIA,};S:
WASHINGTON COUNTY,
And now ;_19 ,comes _:..
who being duly sworn,says that he is acquainted with the financial standing of the securities to the within bond;that
the said obligors have each executed the said bond and th.3t 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 ~ubscribed before me this ....__.._........_
day of ...._...._.._..__..........__.._.._......_...._...._..._........_......_........A.D.19__....._-..---._---------------------------------..._-----------._--------
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1\bmiuintrutinu ~nu.b
IN THE ESTATE.OF
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BAOZIK PRINTING ~9 CONORA
Adam L.Sanders-BeAeFranks
Attorneys at Law'
Charles A.Peterson,a/k/a,
C.A.Peterson,.a/kia,.
......Cha.r.J.e.s...!.\h.1:.bM~P.~.~~.;:~.9.~..
AndBOnno;a-~-~~~~~--L~;~-·i~~~-t~·o.···
_c:>c:""",-.. . .......-"'"c:.....,.-en "',::l::>o ~'..2:',.en <=i '·MJ.ldre:a;tl,"l1 Petersolil.--:.....................;;;.':tj..,!::.:;1'Tj"".
·~~-~..:~.~~.iJ;~-q~~.~~.~=:;_..-...."I."r--'--',,'"0 r-<:e..v I,Rus~lCf ~B[''inA t'.--_..-_---.-----_._---:~__-------.
..~........"Register
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Bond Book 63..............--_.._-__.Page ...?:~.7..
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...--~Date of Death:Janl~.8,1970
-",.".~~"
0 1<--J
~tatt of Jtttusylunuin }
C!Iouuty of IIns~iugtou ss:'.
Personally'before me,the undersigned authority,a .not.ar.y...pub~i.c ....in and for said
County and State,apPeared .._.Mil~e.d...L~...P..et.er.son __.who,'Qeing duly
sworn according to law,deposes and says that s he 'is the ~administrati?'aY the es-
tate of .Char.les_~~Peterson.deceased,that the foregoing schedule;'constitute a
complete inventory and appraisement of the real and personal estate of ....Char~.es __.~..Pe.t.e-fson
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 a:praiseme~t ~f each item m~de by the ~ve ~amed~Administratocc rix ",'\'
.Sworn an~s1t~scrtbed before me thzs ....../.j(....:;}.....'---J ~_./'./~L'.~
day '!J,;~g --"~"eE.~:Ad;;;i;;r:~
My com;~~{~6h·;·:z~9·,r~~....·Ntaiy ..·"lic \\~,\
Wash;~,'Wash·~CO~ty,·Penna\~'ADDITIONAL INSTRUCTIONS
1:An jnventory must be filed within three months after appointment of personal representative.
2.,A supple1Jlentai inventory must be filed within thirty days of discovery of additional assets.
3.1 Qriginal and 2 Copies and 2 RCRI-34,Under $10,000;1 Original and 2 Oopiesand 2 RCRI-33,
-:Over$J.O,OOO,including Copy of Will;1 Original and 3 Copies and 2 RCRI-33,Over $50,000,in-
cluding Copy of Will and copy of Federal Estate Tax Return...
.'..'REFERENCE FOR ADDITIONAL COPY ,.,
-.~'t·:,Act of 1947-'P.L.513 Sec.5.2,72-P.S.4844.2
";
CENTS~;:DOLLARS
....t;'
(i~4"..•~..
'...;.:.;n '(;3JUUttttory nub 1\pprnist~utof the,goods and .chattels, rights and credit~-Which
w~~e of·,":.~~les..A\~Peterson late of City o.f Washington :.
~{",-.',f1 ".~..j.
Washington"County,Pd.,taken 'and made.in conformity with the above affidavit:
.""':~~.;"..
Personalty
,~.
Total~------------------.------,.
-\
CheCking account in Pitts~urgh National ~~nk,
was~ngton"Penna.~-----~~---~~~-----~~---------.247'47
Savings ,Acct'.No"~25545 in Pittsburgh National Bank
Wasl1ington,
~,..i......-'.
&Loan Association,of Washington----------------10,00000
Household goods and small.tools-see attached itemiza-I,tiotl--:-II!--III!II'-----~~-------~.._-~-~.._--~--~---------II 292'·100.'.I
II$11,864"14
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Realty
,.......->
None
Tata1 Estate
Personalty $11,864':14
O'·~OO
Tota1----------$11,864"~14
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b3-70-70
Inventory and Appraisement
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:.'IN THE ESTATE OFCharlesA.Peterson,a/k./a,
,~-C.A.Peterson,a/kIa,
:..:.Cb.~;le.$AJ;.1;.~~..J~~~t.e.J;'.$.Q.:n ."'-'~~
Filed ,:'19 .
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Adam L.Sanders-B.A~Franks
Attorneys at Law
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Hall tree
double bed
dressing table
dresser
cedar chest
4 porch chairs @l'.SO
1 porch rocker
1 power lawn_mower
garden tools
spade
vise
small hand tools
i ...i tt electric drill
i-3/s"electric drill
crow bar
tool cabinets (small)
wheel barrow
8 ft'.~t~p ladder,
6 ft';,step-"ladqer,.\'washtubs,1 ~
2 cots.;@1'.50
mrrQr'.
gate leg table
Hoover kitchen Cabinet
2 bridge 'chairs @.50 ,
silverware "
kitcben-table
suitcase
toaster
G~E~"refrigerator
stool
iadder (straight).
Conlon mangel
Singer sewing machine-.w.Washer
G'~E.'hand sweeper
2 i.V.chairs ·@l.SO
2 section bookcase
~esk
swivel chair
wardrobe
chest drawers
double bed
iocker
corner chair
coffee table
:2 small tables @2'.OO
desk lamp
10 PC'.dining suite
,1/2 int'.in piano
6 glasses
dishes
Total----~--~--------~----.-~-·
i'.oo,
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5'.00
5'.00
1~00
6'.00
2"~00
lS'~OO
4'~OO
'.50
5.00
20.00
6.00
6'.00
'.50
'.50
1'.00
1.00
1'.00
i.50
3~00
1';'00
7'.50
3.00
1.00
10.00
".50
'.50
1'.00
10'.00
~~SO
2'.50
5~.OO
1()'.OO
l5~.00
5'.00
,3'.00
4\.00
7'.50
.~i~oo
10,.00
10.00
15.00
3'.00
5.00
2'~OO
4".00
1'.00
35.00
5'.00
1'.00
12'.50
$292'.00
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ESTATE OF
Charles A.Peterson,.a/k/a,C.·I ~'
..A.......P..e.t.e.r..s.Qn,......a/kla,.....Chax.l.e.s.._~Arthur Peterson t
.............F.i..~.$..t.....an.g....E.i..o.al..........Account of 1
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..9.f.....:t.hg....~.:t~:tg....9..f.C..h~.~Jt~....A......i
._P..e.t.er.$.Q.n.,.....a/~/a.,C.......A....p..g.1;.g~.~on ;
/I .'...fl ..~..~.,.....Gh-~~.J..g§.....g.:t.h~J'.....p'g.~.g.~.~on,r
dec'd _._";";1..........· ·..· ·..~--·~·- ·..·cS····..·.----.
And now to wit.~V
19.10 'the within accou'st/presented to the Court
au;Jt~~-.
Register and Ex-Officio Clerk of O.C.
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..Ad.am..L.....Sande.rs.~!f ...A..F..raJ'Jks..
AttorneYSfor Accountantrp~
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The Court is respectfully requested
to determine proper distribution in
thi.e.tate~cI'b"1 .£.J7"'"'-t4.
Counsel 'for Accountant
......)...
THE FIRST AND FINAL ACCOUNT of Mildred L.Peterson,Administratrix
of the Estate of Charles A.Peterson,alkla,C.A.Peterson,a/k/a
-..
Charles Arthur Peterson,'late of ,the City ,of Washington,Washingtol
County,Pennsylvania'
The Accountant is charged as follows:
I .!21.2
Feb.16
Feb.24
Principal-Personalty
To Anniuty check rec'd for Jan.1970_
To Social ~ecurity-contributionon
funeral bill (non-taxable)
$8.56
255.00
Mar.20
1970-
To amount of inventory and appraise-
m~nt filed
Total--~------~-------
Income-Personalty
To interest received on First
Federal Savings &Loan Inv.Acct.-
death to'account----
Principal-Realty
None
Income-Realty
None
TOTAL ESTATE
11,864.14
$12,127.70
$250.00
Principal-Personalty
Income-Personalty
Principal-Realty
~.:..
Income-Realty
Total Estate----------
Total credits claimed----------
Balance due-----------
$12,127.70
250.00
0.00
0.00
$12,377.70
$3,023.02
$9,354.68
·..
,..1:aiml::
Voucher
No ...
1970
Jan.19
Jan.19
1
2
Russell Marino,Reg.
Neale Funeral Home
Letters of Admin.
funeral of dec'd
2l·rO
1,120.bo
Jan.19
20
3
4
Rev.Dozer
Wash.Co.Reports
ministerial services
adver.grant of letters
20.100
14.00
Jan.30 5
i
Buckley Insur.Agency prem.on Admnx.Bond 70,00
Feb.8 6 Col.Gas of Penna.last gas bill of dec'd 56.~3
Feb.9 7 West Penn Power Co.last elec.bill of dec'd 9.~2
Feb'.17 8 Was~.Hospital last bill of dec'd 5.~0
Feb.23 I 9 Citizens Water Co.last water bill of dec'd~l 89
Feb.23 10 Bell Tel.Co.last tel.bill of dec'd 15.07
Mar:20 11 Helen Beveridge notary :fees-lnv.
Mar.20
Mar.20
12
13
Russell Marino,Reg.
Russell Marino,Agent
filing J.nv.
acct.of inher.tax
3.00
484.50
Mar.25 9.i1
l5.PO
l7.PO
6l8.bo
500.00
14~PO
lettering stone
adver.grant of letters
accountants fee
medical for dec'd
Attorneys :fee
last sewage bill
notary fees-acct.&
0.&E.
filing account
Adam L.Sanders
Observer Publ.Co.
Russell Marino,Reg.
Mildred L.Peterson
Helen Beveridge
Simon Whites Sons
Jos.N.McMahan,M.D.
19
16
15
14
20
21
17
18
22
Apr.24
June /.J
June
June
July
June
June
Total credits claimed------------$3,023.P2
}Vashington County Reports >
Washington,Pe~nsylvania
(PUBLISHED BY WASHINGTON ::OUNTY BAR ASSOCIATION)
PROOF OF PUBLICATION
In compliance with the Newspaper Advertising Act of May 16,1929,
P.L.1784 Sec.3,paragraphs (3)and (25).
COUNTY OF WASHINGTON}SS
STATE OF PENNSYLVANIA •
Personally appeared before me,a :t~otary Public in and for said County
and Commonwealth,CHARLES C.KELLER,who,being duly sworn,deposes
and says:that he is the Editor of the W.\SHINGTON COUNTY REPORTS,
the officilcl legal periodical for said Washington County,published weekly
hav.ing its place of business at WashingtCll,Washington County,Pennsylvania,
and is acting as its agent in this be~:J.alf;that the said WASHINGTON
COUNTY REPORTS was established OIl March 31,1920,and was designated
as the official legal publication for Wash:ngton County,Pennsylvania,by order
of the several courts of said County,datec.November 11,1920;that the printed
notice or advertisement attached hereto is a copy of a notice or advertisement,
exactly ·as printed or published,which a:Jpeared in the said legal periodical in
its regular issues on the following dates:
Estate Notices
The Register'of Widls has granted
letters,testamentary or of administratioI!,
in the following estates.Notice is hereby
given to all persons indebted thereto to
make payment without delay andt.o those
having claims or demands to present
them for settlement to the Executors or
Administrators or their Attorneys.
•• •••• ••• ••••••••
RETERSON,CHARLES A.,a/k/a C.A..PETERSON,.a/k/a CHARLESARTHURPETERSON,Dec'd.-
Late of Washington,-WashingtonCounty,Penna..Adminis~ratrix:Mildred L:Peterson,1045 Allison Ave..Washington Pa15301',.
Attorneys:Adam L.Sanders and B.
A.Franks,GIl-Washington TrustBldg.,Washington,Penna.15301
f.~.
\~~'
W
•
............~~!~~~.;Y.:??l ??.!~.?.?..~..
..~.~.~.~~.~.~y.?..~;?..?.2 .
that the affiant or the corporation in behalf of which he is acting is not
interested in the subject matter of said mtice or advertising and that all of the
~g~~'Of~~id.rn·~~~:_B::~
~SJ:iL~~
Sworn to and subscribed {~e me this _....__~~;;;...:.~_.-~,
...5..~b7.day Of :.~.Q.~~.~.Y.~19..?2.!::..:i,-
......~~...(£..~-!._~,
Notc.ry Public
ocATHERi~1E C.NICHOLAS,\l!Qt&ryPublc
Washington,Washington Co.,Fa.
My Commission :Expires
fJOY9ff:1lJar 1,'lSn
I
Observer .Reporte,:;,
WASHINGTON,PENNSYLVANIA
PROOF OF PUBLICATION
".!
"
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ADMINISTRATRIX NOTICE."
I ESTATE OF Charles A.Peterson"
a/k/a.C.A.l'eterson,a/kIa,Char~e~Arthur.Peterson deceased lB:te 0CityofWashingto~,Washmgtpll;r
County,Penna.'thLettersofadmi~!stration upon't ~~above estate havmg,been gran e .'I'to the'undersigned.all ,persons hav"'lng claims,against the_estate are.:
requested to'make ~ow~the salTle~.:to the,undersigned·or hIS attorney.,
and all persons,',indebted to the d~!.'>.••
cedent are req\lested to makeit~ay~ment to the undersigned w 0\1.
delay..f ~l JJ ••
Adam L.Sanders .'.",".'IB.A.F,ranks 't',
611 Washington Trust Bldg.I _.tWashington.Penna.,15301
I Mildred L.Peterson
1045 Allison Ave.15301 tWashington,Penna.
Administratrix''3t"'i.7018,.'Thurs'.'j
In compliance with the News,paper Advertising Act of 16 May.1929.P.L.1784,as amended.
Commonwealth of Pennsylvania,County of Washington,55:.
Personally appear,ed before file.a Notary Public in anil for said County
and State Richar.g S...L ..G.9W.~who being duly sworn
according to law,deposes and says that he is the Se.cr.e.ta.t.y ..
of the Observer Publishing Company.a I'renI1sylvania corporation.and its
agent in this behalf;that the said Com.pany is,the owner and publisher of
the Observer-Reporter,succ'essor to The Washington Observer.established
September 18.1871,and The Washington Reporter,'established August 15,
1808,a daily news,paper of general circulation.printed and publis,hed and
having its place of business at Washington,Washington County.Pennsyl-
vania.where it or its predecessors have been established and publish'll:d
continuous'1y for more than six months prior to the publication of the notice
h-ereto attached;that the printed notice or,advertisement hereto attached
is a -copy of'an official advertisement.official notice.legal notice or legal
advertis,ement.exactly as printed or pUblished iiI the Ob£'erver·Reporter in
its regula.r e~~~~~the221;2i9g :~d0F~¥>erhai'y "5'~l970 ...............................................y ..
that neither the affiant nor the Observer Publishing Company is interested
in the subject matter of said notice or advertising and that all of the allega.~~~~,~(hI,affl'a'it ..toth't;~'.~Z?a'lLZ::
..5 February 1970SworntoandsubSCfbe~}~fOre me ~thIS:day~..
.7Y~~.r~;;?!r;R;;;;;:·~;;;R;~
WASHINGTON,WASHINGTON COUNTY
I)1Y COMMISSION EXPIRES MAY 6,1971
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®rp4~u!l:.Qrnurt minintnu
Qrnurt
Estate of 'Charles A.petersonia/k/a,
C.A.Peterson,a/k a,:,
Charles Arthur Peters'on
In the matter of the Audit of Account in
.,".J
1 f'l.....~,~,
Enter__---=O:...:u=r=-~appearance for_---=A~C:=:..:::c:...:o:;;..·U=n:..;t:..;·an=..::..;t:..;S=_____'_-_'_~-I------_
TO THE AUDITING JUDGE:
,.l .."...
~daY O~-+..~f,I£.~~~=~=-=-==:-~
N.B.-Cornsel shall,by separate paper,present a concise statement of each
claim,wUh supporting calculation of any interest claimed.Objections
to ;a,n account as filed,shall be concisely stated in a separate pa·per.
COl.llcil suggesting proper distribution shall file -a separate concise state-
ment in that regard.
No.63 -70 -70
In re Audit of Account in Estliite of
Charles A•.Peters~n~a/k/a~
C.A.Peterson,a/k/a,'Charles Arthur Peterson
A'UDIT
Jrarripr fnr'i\ppraraUtr
FOR
•'of..
Mil~red L.Peterson,Adminis-
tratrix or'the Estate'of'Charles
A.P~terso~.a"lk/a,C:A.
peterson'~~~~~a:~ri~Arthur
~Ie:>C::;;,C-r.l':-...",.
Peterson;-~c£!'d ~.r-:--.:...
~~-:-v'-'.~t1:f.G~'M-o rrr "oJ~'l'"-I"'-;;-1 0:,'i=';:2;).,~_.,'-.,..,
'--J<:C'
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Adam L.Sand~rs·-B.A.Franks'
Attorney S
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F
(Form where decedent died intestate))
lln t4r (@rpquns'illnurtnf lIuslftngtnn illnunty
ESTATE OF No.63 -70 -70
Account of Mildred L.Peterson,'
Administratrix
First and FinalIntheauditoftheCharlesA.Peterson,a/l~a,
C.A.Peterson,a/k/a,
Cbar..l.e..~A.+..:t.hy:~p..~.t.~.~$..9..~.
Deceased
The petition of .Mildr.ed L•...P.et.er.s.an .
(Name of Petitioner)
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,.hot 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.
respectfully·represents :~.
(a)The decedent di~d J.@g~yj~.,J.9Z.Q ,intestate and
(Date)
letters of administration on his estate we;e granted Januar.y 19.,1970
(Date)".-.~,...
as per record thereof appearing 'in Administration and Bond .Book No : ....~....
at page .
Decedent was survived by no spouse but left issue,six
children listed below.
within(b)At the time of death,the decedent's domicile was ~the Com-
monwealth of Pennsylvania,to-wit,at...Washingt.an,.....P.enna•.~U•.s.oA.........
(Town or Township,State and Nation)
and residence was'at....l045...A1.lis.on..Av..e.•..,.....Was.hing.ton,....Pa•........u.S..A.
(T.own or Towrishipr 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 relation'ship if they~take ~y....~~
representation are as follows:
.'i .,r'\'
NAMES Relationship Interest
Of age,sui-
juris.or not,
(write yes or
no).
Name of Guardian,Trustee or Committee,if
any,or beneficiary,manr~er and place of
record of appointment and is bound suffi-
cient to cover and protect share.
M:i.ldred L.Pe.terson daughter.......1/6 I es .yes
All Sui Juris
No Guardians
Mary Evelyn Wilhelm
r-...\~::
daughter 1/6 I es.yes
Charles Arthur Peterson,Jr.·son
Dorothy E.Cochran
Estelle V.Lewis
daughter
daughter
~/6_:r:es.yes -."--1 .--...
1/6 I
.-.--\,es.yes ..
1/6 1
--es.yes
Earl B.Peterson son
":,..
J"•
State exceptions,if any,
giving names and dates
of death and the names
of their executors or
administrators,or the
names of~their issue as
the'same may be mater·
ial.
All 6f said parties m'interest are living,except
No exceptions
Describe type of notice.
I
(d)All parties having any interest have hadac.tual..notice of the filing
of the account by receiving a copy of the account and written
notice of the time and place of audit.
"•!
.,.
.,
(e)Balance for distribution per Account
(f)Additional debits,not .shown by Account
(Itemize)','.'"
None
(g)Additional credits,not sho'wn by Account
(Itemize)
Notary fee-audit petition••••••••••75
Add't1 cge.fi1ingaccount 1.00
Mildred L.Peterson-money adv.17.48
•'_~..'•.1 l.......,
$.,.354...6.8.
$0.•.0.0..
$~9 23..
~..,..33.5.•.45..,",.:- - .not·
(h)Claim for exemption has/be'en made;and has not been paid.
.,(i)The estate is ::._:.subject,to th~payment of inheritance tax to the
..Estate paid $484.50---3/30/70,
State of Pennsylvama.Mildred L.Peterson pd.$228.-indiv.aJiab.-3/20/70
0)(The estate is....n~.t..~...:....jubj~ct to'the"payment o{the county 4 mills-''
'Insert word IInot"where
necessary.
,,
If taxable state wheth-
er tax has been paid.
."tax.\'J:
(k~)The estate:is........no±........subject to the payment of Federal inheritance...
11 too many for the
space,annex a list there-
of;if no such claims,
insert the word "none."
If any creditor or other
claimant has not re-
ceived actual notice,that
fact must be stated.
Indicate such claims as
may be secured or en-
titled to a preference,
and give detailed infor-
mation concerning such
security or preference.
Here insert a reference
to all questions requir-
ing adjudicatioo,and a
statement of any mater-
ial facts not already
given.If none insert thewordt'none."
If any share bas been
assigned or attached
that fact should also be
stated here.
State kind,form and
character of property
composing the balance
lor distribution,and if
any part thereof is not
cash,whether or not
there has been any elec-
tion to take 8uch part
in kind.
tax.-<.\',.j
(1)Ai-I creditors (and other persons who have compli~d with Rule II,
Sec.9)~6f ~hose claims :the a·ccountant.....:,had notice or knowledge;'have
................,;....~~eceived a£tual,~otice of this audit;the amounts of their claims and
whether or not they are admitted to be correct are as follows:
'':
.·<ju'i~known claIms except audit costs and balance of
inheritance tax have been paid.
.......~
None
(m)Mildred L.Peterson,administratrix and one of the six
residuary legatees,through "her execution of this Petition,
elects to take all the household goods in kind,appraised at
$292 •.,as set forth'on the attached copy of inventory,as a
paft of the residuary estate due her,and requests the Court
to award same to her'.
,"
(n)The balance for distribution consists of property in kind,form and...),-"
character,as follows:
Cash and household goods appraised at $292.00,which
have been elected in kind•
.,,
..".'!",,
.'
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·------_~=cJ
Are "there any advance-
ments by decedent to be
consideretl on distribu-
tion and has any distri-
bution on account been
made by accountant to
any distributtee?
(p)None
If prior accounts have
heen iiled,list number
and term.
.',
f •
(q)Giv~brief location of any real estate sold.
None
(r)No prior accounts
"~~.,,,,
.>..~.~-(;....
'-
-!~-.
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"
.'Whefe[ore your petitioner asks that distribution of principal and income
~~be awfrded 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):-TO:'
~~~.
"'•.'f'"1•.r~ldred'L:Peterson
2.Mary Evelyn Wilhelm .
3.Dorothy E.Cochran
4.Estelle V.L~wis
1/6 of residue including household
goods'appraised at $29?OO
1/6 of resid~e"(·.·1
1/6 of residue
1/6 of residue
5.Charles ~thur ~eterson,Jr.-l/6 of residue
6.Earl B.Peterson
.V'"-/IL.~.~4dL~.L,f6:..~.......:&:.~...
(Signature of Petitioner)
County of Washington,ss.And your petitioner will,etc.,
The above nam=d petitioner being duly
sworn doth depose and say that the
facts set forth in the foregoing petition are true
to the best of h.e.r..:knowledge and belief.
Sworn to and sllbscribed before me this".,.
/~~-day ?L.,..se~.t~~,19 70 .
-/'.')1'--/?..'
------7//j.~y'/~--:~._"'/_n ,Lkl.?::::c.".c:.e.._,;:C ~7~..2§..,;~~-d.~.~~~
.....-;.Notary Pul'Ylic
;---'..'~".\. ..My:.~~Com~.Exp.:Mar.ch 2.6:,~~9.7~~.~
Washington,Washington County,Penna e
~,
;.
.~
FORM IN CASES OfJNTESTACY
No 63 ,70 ,.".70 ~
IN THE
ORPHANS'COURT
WASHINGTON COUNTY,PA.
CharlesA.Peters'on,a/k/a
C.'·A•.Peterson,a/k/a,'
Es-tate of Char~es...Ar.ihur...Pe:ter.son...-Deceased.
Sur account of .....Mi.l.dred-..L.....:Pe:ter.son.,
..............................................................Admini.s:tra trix
PETITION SUR AUDIT
In Conformity with Court Rule III,
Sec.5 (B)
COUNSEL FOR THE ACCOUNTANT WILL
SUBMIT HEREWITH
1.The letters of administration.
2.A copy of the inventory and appraisement.
3.Proof of advertisement of the grant of letters,
if not filed with accountant.
4.An appearance for those represented.
5.Inheritance tax receipts,if any.
6.Certificate of liens in case any.of the funds for
distributi.on are derived from the sale of real estate.
7.Copy of Federal Estate tax return,if estate is
subject thereto.. .
8.Signed elections to take in kind,if any.
....Adam-..L •...Sand.ers....B.A.Franks
Attorneys for Accountant.
~9
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'Vd "'00 N01~)NIH SV,\!\
S11J f.1 j 0 H31 SI~:3 U
ONlcVW Ti3SSnC/
5S 0 Uti ~J{;d3S OL
!I ."'~-1,1;I II.""WijlJ...J . ...~,
....
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Estate of:')··Charles-A.Peterson,a/kia,)
.C.A.Peterson,a/kia,
Charles Arthur Peterson,
Deceased
)No.63 -70 -70··)
)
You are hereby notified that the undersigned has filed a
First and Final Account in the Office of the Regi~ter of Wills of
Washington County,Pennsylvania,in the above captioned estate at
-the above mentioneQ number and that the same will be presented fOl
confirmation at the August Term,1970,of the said Orphans'Court,
and that it will be confirmed on the 3ls~day of August,1~70,
unless exceptions are fi~ed theretq;and that the Audit of said
Account will thereafter be held by the said Court the week of
September 14,1970.
Attorney for the Estate of Charles A.
Peterson,a/k/a,C.A.Peterson,a/k/a,
Charles Arthur Peterson,dec'd
Adam L.Sanders-a.A.Franks
-Attorneys at·Law .!.-
611 Washington Trust Bldg'.
Washington,Penna.15301
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~n t4e Qtnurt nf OInmntnn 'leus nf lIus4ingmn OInunty.
Jennsylttunin.(@rp4nns'OInurt ititrlsinn
ESTATE OF
Charles A•.Peterson a/k/a
Charles Arthur PetersonJ~ax~t
C.A.Peterson,deceased.
No.__......6'-"3_-7.a...:0"--........7......0 _
First .end FinalInthemotterofth....e _
Account of_---=M:.=.l.;:.:·l=d=r:...;:e;..:d:::-=L=•.....;;...P...;;;.e-=-te"'-r:;...s"-o;;.;;n...;;;.·'0-
Execntri x
ADJUDICATION AND DECREE
And now September a2/jU,19 70,this matter came on for hearing,
audit and distribution at this session and testimony taken;and thereupon,upon due consideration
thereof the balance for distribution in the hands of the Accountant is determined to be
$~33j.45 .,.and the-account is accordingly confirmed;and it is ordered,
odjudgecf an decreed that the said balance be paid out by the Accountant in accordance with the.
schedule ,of distribution hereto attached and made a part hereof,unless exceptions hereto be filed
sec.reg,or an'appeal be taken herefrom sec.leg',I ..J
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SCHEDULE OF DISTRIBUTION
Balance per account _$9,.35'1.68
Additional credit aske'd at audit
Balanc....e
1
Deduct Clerk's Costs &Receipts 1
Attorn-ey__SloLQJsnwd.;,r.;'elOl..r&.;.laOl...-ll&~Fr~8io11n""kw;!IJ'____
27.00
46.76
1543.62
1543.62
l543~62
1543.61
$9,335.45
$9,308.45
ti?eI"-7 ()()0r~~~;;"7 . \
(~?/i.~t-"'"
o ~kpe-
$9,261.69
~'i.6--7 v
p&l,.:{~¥~..~~
g~~,~vo
~r;-
Chsrles Arthur Peterson,Jr.,son,1/6 balance,
inclUding e~sh,~_1543.61
(;
"
Earl B.Peterson,son,IrS balance,inclUding,cash,1543.61
"No balance
_r ,:
"
)-;g 0 >j z....
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IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY,PENNA.
ORPHANS'COURT DIVD3LOO
,:1
attorneys are Sanders &Franks..]VIr.Sanders ?
Peterson,deceased.The Executrix is Mildred L.PetetrS0n and the
No.70 of 1970
Num her 70 of 1970,the estate of Charles A.
HEARING ON AUDIT
If the Court pleas~,I have all the necessary paper s
THE HONORABLE P.VINCENT MARINO,Judge
of the said Court.
Friday,September 18,1970,at 10:00 o'clock
A.MOl EDST.
SANDERS &FRANKS,ESQS.,of Washington,Pa ,
representing the Accountant.
MR.SANDERS:
)
)
)
)
CHARLES A.PETERSON,a/k/a )
CHARLES ARTHUR PETERSON,a/k/a)
C.A.PETERSON,)
)
)
ESTATE OF
IN RE:
:!:z«>oJ~Deceased.zz
IIIII.
ieCIzi
Ul BEFORE:~
ti~Ul
ii APPEARANCES:
oJ«Q
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:z:5 TIME:
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in this estate.Thereare no complications.All known claims are pai~.
T,here is $292.00 in value of household goods that the Administratrix
has elected to take in kind and asked the Court to award to her at apI raisal.
The balance in the estate is cash.And the people entitled thereto arE
set forth in the Audit Petition.
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THE COURT:
decedent's estate?
f •
THE COURT:..
Court.
Is there anyone.else in Court,inferested in this,
(NO RESPONSE)
The audit of thi~aC:Count is ordered closed'by the
'"i
(AUDIT CLOSED)
~----:------:----;/-....--.......----:------------:--------1-1
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IN mE,C<XJRT OF COMMON PLEAS
OF WASHING1'9NGOUNTY,PENNA.
"..C>RPHAN~~COURT.DIV.•
No.-63 -70 -70··
Estate of:
Charles A.Peterson,a/k(a,
Charles Arthur,Peterson,a/~a
C.A.Peterson,
Deceased
.;'
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PAY TRANSCRIPTS
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ADAM L.SANDERS.
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IN mE COURT OF COMMON PLEAS OF WASHINGtoN COONTY',PBNNSYLVANIA
Estate of:)ORPJi,ANS'COORT DIVISICW
••
Charles A.Peterson,a/k/a,)
Charles Arthur Peterson,a/k/a,:
C.A.Peterson,)
••
Deceased )No.63 -70 -70
PAY TRANSCRIPT
I,Charles Ar~hur Peterson,Jr.,de hereby on the date set
I ,forth below,acknowledge to have received from Mildred L.Peterson
Executrix of the Estate of Charles A.Peterson,a/k/a,Charles
Arthur Peterson,a/kIa,C.A.Peterson,deceased,late ef City of
Washington,Washington County,PelUlsylvania,the SWI set fort~
below,being the balance in distribution due me in said estate,
awarded by the Orphans'Court of Washington County,Pennsylvania,
by Decree of Distribution dated September 24,1970.
In Wi tness Whereof,I have hereunto set our hands and seals
Charle~:Arthu~,Peterson,Jr.,SOB,
1/6 balance,including cash
,,,,
.''.
IN 1'HB CXXJRT OF ~ON PLEAS OF WASHINGtoN CXXJNTY ,PENNSYLVANIA
f •.~t-
Estate of:)
•·
ORPHANS'COURT DIVISION.."~,
Charles A.Peterson,a/k/a,)
Charles Arthur Peterson,a/k!a,:
C.A.Peterson,)··Deceased )No.63 -70 -70
PAY TRANSCRIPT
,We,t~e undersigned,do hereby on the date set forth below,
acknowledge to have received from ,Mildred L.Petersen,Executrix
of the Estate of Charles A.Peterson,a/kia,Charles Arthur
Peterson,a/k/a,C.A.Peterson,deceased,late of City of
Washington,WashingtoD County,Pennsylvam.a,the sums set forth
below,being the balance in distribution due us in said estate,
awarded by the Orphans'Court of Washington County,Pennsylvania,
by Decree of Di$t~ibution dated September 24,1970.
In Wi tness Whereof,we have hereunto set our hands and seals
this '9 day t1J8..~,1970~
Mildred L.Peterson,daughter,1/6
balanee,including cash and house-
hold goods valued at $292.00,held
in kind and distributed as such at
the appraised value,per election
filed
$1,S43.62~,/L&~(Seal)
Mary Evelyn Wilhelm,daughter,1/6
balaitce,includi'ng cash
$1,543.62 ~7 try--orJ~(Seal1
."....
Estelle V.Lewis,.daughter,1/6
balance,including cash
$1,543.61'tat.-ad 11~
'Earl B.Peterson,son,1/6
,balance,including'cash "..'
...$1.~3.61 &a.e:rh f~
l
•f '.
(Seal)
(Seal)
I'.".,.,.
>•..
,Deceased
",..1._,
IN niB COURT OF COMMON PLEAS OF WASHINGTOO OOlJNTY ,PENNSYLVANIA
ORPHANS'COURT DIVISION
,..
<EState of:)
I Olarles A.PetersOR.a/kIa.;
Charles Arthur Peterson,a/k/a,:
C.A.Peterson,)
••
),No.63 -70 -70,-'
f·.f"tJ ..
PAY TRANSCRIPT
I,DorothY'E.Coehran,do hereBY OD the Gate set forth below,.;~'
1
acknowledge tehave,received from Mildred L.Peterson,Executrix
......"+,,.....~f"';''..,~I ..
of the Estate of Charles A.Peterson,&/kIa,Charles Arthur
Peterson,a/k/a,C.A.,PetersoR,deceased,late of City of
Washington,Wasbillgton County,Penasylvania,the SWI set forth
below,being the balance in distribution due me in said estate,
awarded by the Orpnans"Court of Washington County,Pennsylvania,
by Decree of Distribution dated September 24,,1970.
In,Witness Whereof,I have hereunto set my band and seal this
rJ.I~/.j·7'-day of @OU/H)-UT/.,1970.,.'
Dorothy E.Cochran,daughter,1/6
balance,including cash
-,-
......-
Form RCC-33-RI
RESIDENT DECEDENT
j
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
COUNTY OF WAS.HINGTON .
IMPORTANT:This return must be completed in detail and filed in duplicate,with will attached,with the
Register of Wills of the·County where decedent 'resided;Return is due within one year after
date of death,unless an extension is granted by the Secretary of Revenue.(Section 703 of
.._th~.Jntwritl:lnce.l:ln!i .E.~t!iteTax Act of 19.61.)
..IN ,THE MATTDt OF THEj.,ES;rATEOF .}Charles A'.Petersen atKfa'C.A.AFFIDAVIT OF
Pe.tez.SQn".8.lk/a,.,Cbarles......Ar:t.hur......,Pe.t,er.s.o ~.
.(State full name of de<:edent)
•.'",,'.ADMINISTRAUIX rixLateof....C1.t,y......of,..,.,Washi..ng,t,on.."......Was,~·"',.........County
State of penns-Y..lvania..":.}s!i:
County of '".Was.hingtGn..,.,.." ,, , _.
..._,Mildred.L.:.,."Pete.r.S:0D,, , ,,.,, ,.., , ,
Administratac rix 01 the estate of the above-named decedent being duly sworn,depose S and say S
.......,......~
Decedent:died , , _J.anuar.y...
(Month)
N~me and address of attorney,or}AdaDl_L:$anders,~Attorne.y at Law .., ,..other authorized representative to
whom all correspondence should be..611·Washing·ton··Trus·t·8,lag'•...,..
mailed.Washington,Penna.15301
That as such Administr.atr.ixdeponent is familiar with the affairs of said estate and the property con-
(ExI!cutor·Adminislrator)
stituting the assets thereof and their fair market value.
That at the time of death there was no safe deposit box registered in decedent's individual name,or jointly
with,or as agent.o:i deputy of another,or in decedent's individual name,with right of access by anot.her as agent
9r deputy,with.the exception of the following:-
NAi-IE AND ADDRESS OF BANK OR OTHER INS'TITUTION
IN WHICH DECEDENT RENTED A SAFE DEPOSIT BOX
None
THIS SAFE DEPosiT BOX RENTED
IN NAME OR NAMES OF
RELATIONSHIP OF JOINT
HOLDERS TO DECEDENT
.That the 'contents of said safe deposit box or boxes are itemized under Schedules of this
return,with the exception of the following,for the reasons hereinafter set forth:
That Sc.hedule A attached hereto and made part hereof sets forth full v and in"detail all ifR1e
real property in the Commonwealth of Pennsylvania of which decedent died having an interest therein.It
also sets ~orth the mortgage encumbrances upon each parcel of real property at the date of death,giving
the amdUnt sqll due at death,name of mortgagee,date,.rate of interest,and book and page of record
thereof.It also sets forth in the columns provided therefore the assessed valuation of each of said
parcels,the estimated market value thereof as of date of death of decedent•.
;That Schedule B attached hereto and 'made part hereof sets forth fully and in detail all personal
property wheresover situated owned by the decedent at the time of death;all moneys left by the decedent
at the time of death,whether in decedent's immediate possession,standing to decedent's credit in banks
of deposit,savings banks,trust companies,or o~her institutions,whether indiVidually,or in trust for
any ot!(er person or persons giving also separately the accrued interest thereon,if any,down to the last
interes,t day prior to decedent's death in the case of savings bank~,._~I').d .to the date of decedent's death
in alf·other cases;all bonds,pos tal saVings,treasury certificates or notes and other evidence of 'in-
debtedn~ss of the United State~to"the decedent;all obligations,whether by s~atute ~r agreement th~y.','\
are designated as tax free,of the United States,or a~y.s~~te,?~,p~litical subd~v~sion xhereo~or of
any for~i;gn.c(;mntry,which are owned at the time of death;-all we.aring-apparel,jewelry,,silyerware,pic-
tures,to'oks,wor'ks'of art,c'hmi-sehold furniture,horses,carriages,~~tom~bi<les,b"oa-ts,'an:.!any"and'all
other per~.?nal chattels of whatsoever kind or nature,leq bydece<\.e'nt,together :WithCithe-fa~rly:~sti~ated
market val'ue thereof;all bonds and mortgaltes held by decedent and of all claims due and owing decedent
at the time·of death,and all promiss()ry notes or other instruments in writing for the payment of money
of which de~edent died possessed,of whatsoever nature,with interest thereon,if any,giving ~he face
value and estimated fair market value thereof,and if such estimated fair market value be less than the
face value,it sets forth briefly the reasons for such depreciation-as to each item;all moneys payable
to the estate from life insurance polictes carried by decedent;all annuity and endowment contracts the
proceeds of which were payabl~upon the death of the decedent;and all the corporate stocks and dividends
due thereon and unpaid as of the date of death,bonds and a'ccrued interest thereon to the date of dece-
dent's death and other investment securities owned by the decedent at the time of death,with the market
value thereof at such time.
\.
,',...'::.,'".:.'-...
';:;-,
..
.'.'
In the case of securities o'f cloc>e (lr fam.p,y corporations,the values reportee!are as far as
possible substantiated by fin~nclal statements of~~e,~orp~rati9o.s,showing the assets and liabilities
thereof as of the'date of death.The schedule ~l~Q'sets.forth 'the interest of decedent at the time of
death in any co-partnership or business,and In s"~port '?f the value of such int~rest there is annexed to
said schedule,financial statements s~owing tM assets and liabilities of said co:-partnership or business.
A copy of the co-partnership agreement,(tforaJ,'a ,$tatement setting,forth the nature of the agreement)
together with a stat~ment setting forth the chara~t~r,of the business,,it~location,and such other facts
pertaining to the business as milS,be pertinent to ·a.~air an~Just 'appraislll of the'd~Qeden1:.'s int~j.est'
therein must be submitted.,It should also 'se.t fortn~1,n 'itemizecl f~r.m,:t'ogetJ1el.'~ith'the fair market"vai'ue
thereof,any other property owned .or bequeathed l>y.'t:h~'decedent at the time of death.."~"...'~
c
The Schedule C attache4 hereto 'an~I!1ll4e'~art hereof se~s forth a tru~answer to each inquiry
contained therein and in the,case of transfers ofpr.Qper~y,real ,or personal,within two years of decedent's
death,in contemplation of decedent's de~th,or !nteQded to t~ke effect in possession or.enjoyment at or
after death,said schedule sets forth the nature a~dval~e of sqcb property,to w~om transferred,the
o..Irelationshipofthetransfereestothedecedent,t~~propOrtion~teShare received by each transferee and
all other facts of a pertinent'nature regl,l,l'<Ung-;S~id,transfers.'10 the Cl;lSe of t~ansfers.intended to
take effect in possession or enjoyment 'Ilt o~'af~r..~4e~tb,there 1-8 also attaChed to the schenule a cOllY
of the deed,trust,agreement or other lnstrUllleri~.'Q,ree.ting'the'trWit.TherH is also set forth in said
schedule a list of ~ll property,,real and perso1ial,wHo its :value,which passes at decedent's death by
virtue of the exercise by decedent,either'i"ndiv!~lY,,or'joilltly with {mother,or any power of appoint-
ment vested,in decedent,either"in:dtv2.duali.y 6r:'joltiU'Y,bY,'the'will,deed,or ofher instrwnent of another,
with a copy of the instrument creatlpg such PQwer'a~,t~~h:ed to":the ~~hedule..
That Schedule 0 attached hereto and m8,d~_pirt h~reof .sets"forth the names and addresses of all
persons beneficially interested In th'ls est'ate a:t.t;l1e time of'd~~d..;mt'"~death,the nature of their res-
pective interests,their relatiQnship,if at)Y,,to ·tt'!e decedellt,,tog;ether with the ages at the time of
decedent's death of all minors,annuitant.!?~J)d be~e.flc1.ar.tEl:$?;Ol'"life under decedent's Will.It also
contains a statement shoWing which of the,benericia~ie§,n~~dIn the decedent's Will,if any,died prior.,.......
to decedent,the dates of their death,theit issue,,,~d,the:relQ.t1~nsb1p'of such issue to the beneficiary.
That Schedule £attaChed hereto ,and ma.de:a part hereof sets forth all property,real and per-
sonal,owned by the decedent jointly with ~ot~er or others,ipc!uglng intangible,standing in the name
of the decedent and others,plus the date and place of r.ecord of instrwnents effecting the vestiture of
real estate and the date of acquisition of personalty,plus the n~e,address and relationship,if any,
of co-owners to the decedent.
That Schedule F attached hereto and made a part hereof sets forth fully and in detail all debts
and deductions claimed for and on behalf of this decedent's estate,including funeral expenses paid;
family exemption,where applicable;,costs of administration of this estate;counsel fees and fudiciary's
commissions paid or to Qe paid;cost expended for burial trusts,tombstones or gravemarkers,and reli-
gious services,in consequence of the death of the decedent;debts and claims owing ann Impain at time of,'death;taxes accrued chargeable for period prior to decedent's death,(except ,those allowed under Section
,651 of the Inheritance and Estate Tax ,Act),;'toge.tller with a statement of collateral pledged for obliga-
tions,if any.It is agreed that the fiduciary w~11 present proof of said claimed obligations upon re-
quest,that if the amount actually paid in settl~ment of any fee,commission or debt is less than the
estimated amount claiming and allo~ed,that the $ame will be reported to the Register of WillS,and that
the amount of tax assessed can be reassessed in a.ccQrdance therewith.
That the totals of the appropriate colU!llJ1s in Schedules "A","a","en,"E",and "F"as directed therein"
have been carried fo~ward and properly registered ~~the Summary,
Subscribed and sworn to before me this ..:..,.._~,...."......':~..":"
---i,f..-~d.Y ~~--19;z:o.~~dC::-·~~······",t·····················~ie:':::ll!4S.A~f~~N~,;;t;r-------.----.
My Com'.Exp:March 26,1971 ,W,~~"~,;~9.,~,Q~,,",~~A~,,~,?,~9.,~,..
Washington,Washington County,Penna.(City 01'Town and State)
NOTE:Before signing affidavit make s~re all blank spaces i~tpe affidavit and schedules annexed are
filled in with details or the word "None",and in case the assets include rare and unlisted securities,
securities of close or family corporations or an.l0t~r~$t in any co-partnership or business,that the
data and statements requiren under the parag~apli.'fJ,'b9ve relating ,to Schedule "B"are attached.Also make
certain that column #1 in the "Summaryq has been properly co~le~~d as above-directed.
,'.
,.
1;r.r.-~:1a-r.U
CO~""1!ONWEAL'rH OF PENNSYLVANIA
T:!\N~:FY;;H INHF.lUTANCE 'l'AX
RESIflENT DECEDENT
SCHBDULE "A"
REAL PROPERTY
~leal property in Pennsylvania,with statement of mortgage encumbrances upon Hach parcc:l a.t
death of decedent.Where property held as jointte~ant or·te~ancy by entireties,report on
Schedule "E".Property held by the deced~nt as tenant in common with another or others,
should be identified as to quantum of interest and the estimated value should be that of
the decedent's interest only.
The real.property located in the Commonwealth of Pennsylvania should
'be described by lot and block number,street and street number,together with a general description of·the property.with a refer-
ence to the record of the conveyance by which the decedent tooktitle;if a farm state number of acres;also statement of mortgage
encumbrances upon each parcel at death of decedent.Taxes.assess-ments,accrued interest 6n mortgages.etc.,are to be listed onSchedulelip"and must not be deducted from this schedule.
Nene
Insert this total opposite "real property",Schedule
"A",in the "As Reported"column on the ·last page of
(1)(2)(3)
DEPARTMENT
ASSESSED VALUE VALUATION
FOR YEAR OF ESTIMATED CAUTIONDECEDENT'S MARKET VALUE (Do not writeDEATHinthisspace).
0'.,.
x X X X X
COMMONWEALTH OF PEN~SYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
,..~
SCHEDULE "B"
PERSONAL PROPERTY
INSTRUCTIONS:This Schedule must disclose all tangible and intangible personal property owned individually
by the decedent,at the time of his death.Property owned by the decedent jointly with another or others
must be listed under Schedule "E".Intari'gible persond property,titled in the name of the decedent,but
payable at death to another or others,including but not limited to P.O.D.U.S.Savings Bonds and tenta-
tive trust accounts,.must be listed,despite the fact that they are not of.the administered estate.
Tangible .personal property should be listed first (e.g.jewelry,wearing apparel,household
goods,and furnishings,books,paintings,automobiles,.boats,etc.)
Intangible personal property,such as bonds,treasury certificates,cash on hand and in bank,..
stocks,'mortgages,notes,together with accrued interest or dividends,salaries or wages,insurance pay-
able to the estate or fiduciary in said capacity,partnership interests,interest in any undistributed
,estate of or income from any property held in trust under the will or agreement of another,even though
located outside of the State,at the time of death,should be listed in this schedule.
Item
No.
ITEM
List and describe fully
Checking Account in Pittsburgh Natianal
Bank,Washington,Penna.--------------
Savings Account No.25545 in Pittsburgh
National Bank,Washington,.pa.~--------
UNIT
VALUE
ESTIMATED
MARKET VALUE
.DEPARTMENT VALUATION
(Do not write in
this space)
Investment Aect\~NQ\~1-939 in First
Federal Savings &Lean Association,
fO ~•
Wash.Pa.---------~-------------------~
Household goods and small tGOls-see
attached itemiza~ion-------------------
Insert this total opposite "Personal Property",Schedule "B"in
the "As Reported"column on the last page of this return.
x x
·.';:
('uml0\T:':\L1'1I OF PF.~NSYLVANIA
1'1L\.NSFER INHElU1'ANCE TAX
lillSIDEX1'DECEDENT
","~.
SCHEDULE "e"
TRANSJ:i""'EIlS ,.
(1)Dirt rtecedent,within two years of death,make any transfer of any material part of his estate,without
receiving a valuable and adequate consideration therefor?(Answer yes or no)no
(2)Did rtecedent,wi thin two years of death,transfer property from himself to himself and another or
others (inclurting a spouse)in joint ovmership?(Answer yes or no)no
(3)If the answer to (1)or (2)above is in.the Fdfirmative state:
(a)Age'of de~edent at time of transfer
(b)State of decedent's heal th at time of making the transfer.(Note 1).
(c)Cause of decedent's death.(Note 1)."
(4)Did decedent,in his lifetime,make any transfer of property without receiving a,valuable or adequate
consideration therefor which was to take effect in possession or enjoyment at or after his death?
(Answer yes or no)no',,
,(a)Was there any possibility that the property transferred might return to transferer o'r his
estate or be subject to his ,power'of disposition?(Answer yes or no)DQ
(b)What was the transferee's age at t'ime of decedent's death?_
(5)Did decedent in his lifetime make any transfer without receiving a valuable and adequate consideration
therefor under which transferor expressly or impliedly reserves for his life or any period which does
not in fact end before his death:
(a)The'possession or enjoyment of or the right to income from the property transferred?
(An1wer yes or no)no
(b)The right to rtesignate the persons who shall possess or enjoy the property transferred or
income therefrom?(Answer yes or no)-~nuQ~'__
(6)If the a~swer to (5)(b)above is in the affirmative,state whether the right was ,reserved in decedent
alone or'others ~~----'-------
(7)Did decedent in his lifetime make a transfer,the consideration for which was transferee's promise to
pay'income to or'for the benefit of care of transferor?(Answer yes or no)nO
(8)Did decedent,at any time,transfer property,the beneficial enjoyment of which was subject to change,
because of a reservert,power to al ter,amend,or revoke,or which cOllld revert to....decedent under terms
of transfer or by operation of law?(Answer yes or no)no
'(9)If the answer to (8)above is in the ';iffirmative,was the power to al ter,amend,"or revoke the inter-
est of the beneficiary reserved in the decedent alone or the decedent anrt others?
(Answer yes or no)no
NOTE 1:The answers to these questions should be supportert by affidavit by the attending physician as
well as a copy of the death certificate.
NOTE 2:If'answer to any of'the above questions is yes,set f'orth below a description of'the property
transferred,it's fair market value at rtate of death,dates of transfers and to wh9m transferred,with
relationship of transferees to rtecedent,if any.Submit copy of any trust deed or instrument,if trans-
fers are claimed to be non-taxable,also submit detailed statement of facts on which said'claim is based.
NOTE 3:List applicable property below in manner in which provided in Schedules A,B,or E.
ITEM
None
DESCRIPTION MARKET VALUE
(Estimated)
..~.
DEPT.VALUATION
(Dept.Only)
Insert this total opposite "Transfers",Schedule "C"in the
"As Reported"column on the last page of this return.
H.CS-J:.3e-H1
'J CCMML1XWE.\LTH (IF PENNSYLVANIA
rlL\~;~n~n TNHEH..lTANCE TAX
RFSrDENT DECEDENT
SCHEDULE "E"
JOINTLY OWNED PROPERTY
HlST!ll'CTIOl\S:This schedule must disclose all property,real and personal,owned by the decedent jointly
wit.h another or others,including intangibles,standing in the name of the decedent and others.List
real estate first,as entireties,or joint tenants,giving brief description,as indicated tmder Schedule
"A",plus the date and place of record of instrument effecting vestiture,but do not include entireties
or out of state real estate value in estate valuation column.Personal property should be listed as in
Schedule "B",plus date of acquisition,and the name,address and relationship (if any)of CO-01Vners to
the decedent.
Description of Property,.Date of Acquisition,Name I unit·
Address and Relationship of Co-Owners,and Place I Value
of Record of Instrument,where Real Estate.:
In names of 'Charles'A~PetersoD and
Mildred L~~·P$1:ersoD,daughter,as .
Joint .Tenants\~
Lot 'Number 56 (SO x 150 feet)in
Clark Plaee Plan (Plan Book 2,pages
6 and.7,in City of Wasmngt0n,Pa~,
with house therean kn~wn''as lG45
Al1isen AVf!i~'See Deed dated August
18,1965,and recorded in Deed Beak
1214,page 438,Washington .CQun1:y,
Pa.,records'.H0use and Lot assessed
at $2,085"~()(),fer 1969 CGunty Tax
purpases·'.Valued,as a whole at ----
percentage Estate
Share Valuation
,DEPARTMENT VALUATION
CAUTION-Do not Write
In This Space.
Value of Value of
Entire Decedent's
Property Interest
1/2 taxab1e-----------
I
I
II
Insert this total OllPosite "Jointly Owned Property",Schedule ,"E"
in the "As Reported"colUITDl.on the last page of this return.
I
I
$4,000'.00
.II'..)/-,;n\('r.-3~d.-RI
/"'C',DMMONWEALTH OF PENNSYYLANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "0"
BENEFICIARIES
•,c
INTEREST OF
BENEFICIARY
IN ESTATE
1/6 .;vas...
•r RELATIONSHIPBENEFICIARIESANDADDRESSES((If step-children or SURVIVED DATE
;tate full names and address1es o~all who illegitimate children DECEDENT OF
Lye an interest,vested,contingtfnt or other are involved.set STATE YES ,BIRTH_~-,w;..:i~se~,--=.;in::-..:;e=.;st;;:a;.;;.t",",e):.........'__~_-+-_fo_r_th_th__i_s_fa_c_t._>---jl--_O_R_N_P_-+----.:....._.",--,-,~l_-t----'-~_-'-~_
Mi 1dT'Dd L1
•-
1045 A11is0n Ave·..·.~.
Marv RuDl.vn W';lh""1,,,
Washinaton.Penna:15301
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NAME DATE OF DEATH RESIDENCE
Deponent further says that all the above-named beneficiaries are living at this 'time except below:
(Executor-Administrator
must complet~"As
~l...t No Year II Reported"column #1.)
:\c mlmstration ~
","".t.'.".0 ,.:c.....,"tl .~,-a 0 j;1 ~~P.ilTHE .III :)o'.:;j ~.....
-."III ::S~:;j "tl..,:c+(l)ll>...~IATTER OF THE APPRAISEMENT ".".<"'.<"',".~"1-I;;l "'-.g
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OF THE II ~.(,.g-?:'C>..•••(l)•./'".,.....,t%1:.........EST:\.TE OF .--'./~~~-:"§~,.~ll>:'m
(i)Q,
<!:harles A•.Pe'tersen,a/kla,'t'c.A.Pe'terson,a/k/a,:'..i
Cb~~l~s.~.tb.~J;....:r..ete:r.so.n .......... ..t·..~
Deceased j ~
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Late of City Q£Washing.t.en....'.
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~.~"00'"County of Washington:..~;'
3::.
Commonwealth of Pennsylvania II ::':.:~11.1
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REPORT AND APPRAISAL;".(,t'·i':y.M~.->
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Adam L..sanq8rs-..B.A;r·Ft'.anks I ""."~~'l -:'.:~_~.'".JiT "_1 .J "':1 ,:.:()::'"().0A1:to:rr)eys...J.at!~"J.;,.~.:,,',,:~_:~,::v ~~
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