HomeMy WebLinkAboutOC1970-0612 - ESTATE OF SMITH......----------------_.-- - -----------------;-----------,---,--------to-7o-!c/~
Affillautt (@f iExrrutnr (@r Abmtntstratnr
t!'tatt nf 'tnnsylnania.~55:
<naunty af lIasQingtan \
Personally before me,the undersigned authority,a ~~.~~:.r.~.~~.~.~~..in and for said
County and State,appeared .Me.r.le F.S1n.i:th who,being duly
sworn according to law,deposes and says that he is the executor or administrator of the estate of
....~~~.Y.:'!...~~~!.~~deceased,that the foregoing schedules constitute a
l ·T d .f hid I t f Lucv V.SmithcompeteInventor)an appraIsement 0 t e rea an persona es ate 0 \';,
deceased,except real estate outside the Commonwealth of Pennsylvania;that the figures opposite each item
of real and personal estate in the foregoing schedules are determined and stated by the undersigned to
be the fair value of said items as of the date of the decedent's death,based upon a just appraisement of each
item made by the above named Executor Administrator.
Sworn and subscribed before me this....J..~l (k j),1 J
day of a ;-lg.7~....p')1~~..~.............~..L :..~J..~¥...C!I~Executor-~X
LOUISE L.CARSON,NOT~RY PUBLIC ADDITIONAL INSTRUCTIONS
WASHINGTO:N..WG\)\{I1ilt\tWitlo~·nfJst be filed within three months after appointment ofpersonal representative.
MY COMMISSI2N E~lRfiSpr.ij1i~ll\~Ult~ntory must be filed within thirty days of discovery of additional assets.
3.1 Original and 2 Copies and 2 RCRI-34,Under $10,000;1 Original and 2 Copies and 2 RCRI-33,
Over $10,000,including Copy of Will;1 Original and 3 Copies and 2 RCRI-33,Over $50,000,in-
cluding Copy of Will and copy of Federal Estate Tax Return.
REFERENCE FOR ADDITIONAL COpy
Act of 1947 P.L.513 Sec.5.2,72 P.S.4844.2
lIuututnry aUll i\ppraistmtttt of the goods and chattels,rights and credits which
were of ~~~.Y.:Y...~~~.!~.~Jate of ..!.~~.~~.~.~.~.!~.~~.~!!?~.~~!P..L ..
Washington County,Pa.,taken and made in conformity with the above affidavit.
j
DOLLARS CENTS
Savings Account No.S-2253,First Federal Savings and
Loan Association of Washington
Savings Account No.61-64,Mellon National Bank and
Trust Company
13,055 48
3,571 05
16,626 53
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Inventory and Appraisement
IN THE ESTATE OF
LUCY V.SMITH
Filed ,19 J.J).
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KNOW ALL MEN BY THESE PRESENTS:Whereas,at Washington,in the County aforesaid
J
on the 17th day of June A.D.1970 ,before me,
Russell Marino ,Register for the Probate of Wills and Granting
Letters of Administration in and for the County of Washington,in the Commonwealth of Pennsylvania,
the last Will and Testament of
L U C Y v.S MIT H
late of West Bethlehem Township,in the County aforesaid,deceased,
(a true copy whereof is to these presents annexed),was duly admitted to probate;and
MERLE F.S MIT H
the Executor in said Will and Testament named,having appeared before me and taken and subscribed
the oath of office pr,escribed by law;
NOW,THEREFORE,I,Russell Marino,,Register as aforesaid,do
grant these LETTERS TESTAMENTARY,unto the said
MERLE F.S MIT H
committing unto him the administration of all and singular the goods and
chattels,rights and credits,which were of said deceased,and requiring him
to exhibit a true and perfect inventory thereof into the Register's Office,at Washington,within ninety
days from the date hereof,and to r,ender a just and true account of said administration at the expiration
of six months from the date hereof,and to regard and comply with the provisions of the laws of this
Commonwealth relating to inheritanoe taxes.
IN TESTIMONY WHEREOF,I have hereunto set my hand and the seal of said
Office at Washingto.n,this se V e n tee nth
day of J u n e in ,the year of our Lord one thousand
nine hundred and s eve n t y.
vJ _/7\/n.~....~~~I ..~.
Register
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Pennsylvania,being of souhd and disposing mind,memory
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ATTOFlNEY AT L./l,W
LAST WILl..AND TESTAMENT
SAMUEL Gr:.)LDFAF?B
I give and oequeath the sum of Three Hundred
I direct that my 'funeral and burial expenses be
5.
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I,LUCY V.SMITH,of West Bethlehem
spective parents for them.
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II and understanding '.do h~reby m,ake,publish and.declare this my
1,1 Last,Wlll and Testament,hereby revoking and ~aking void any and
I all other Wills by me heretofore made.'.'I,
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I paid as soon as convenient after my·death,and that there be ex-II.pended for the same not more than $1,500.00.
ill 2 • I give and bequeath the sum of 'R'wo Thousand
I'($2,000.00)DolIars to my husband,SAMUEL H.SMITH,and the sum I
I of One Thousand ($1,000.00)Dollars to my daughter-in-law,NELLIE,II:
IIII MAE SMITH.'..I
II'.'3.I give and bequeath the sum of Six Hundred"($600.00)I
II Dollars to each of my three grandchildren,na~ely,MERLE FLOYD I
Ii SMITH ,JR.;DONNA MAE MERCANTE,and DONALD lIitWNE SMITH.I
I 4.I give 'a:i.1d bequeath the sum of "Fi veHundred ($500000)
I Dollars to be divided eqnally between my grea t grandchildren,and I
!said bequests may be paid during their minorities to their re-I
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1
'1 ($300.00)DolIars to HIGHLAND BRETHREN CHURCH,R.D.1,Marianna,IIPennsylvania.i
I]6 • I give and bequeath the sum of Three Hundred I
II ($300000)Dollars to Nor·~h Ten Mile Cemetery to be used for the j
Ilil IIupkeepofthegravesofmyhusbandandme,and to help in the up-
II11 keep of the cemetery.;1
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Il'l 7.All the rest,residue and remai'l1der of my estate,'tIIreal,personal and mixed,~of whatsoever nature and wheresoever·
il situate,which I may own or have i:he right to dispose of at the
II ILtimeofmydeath,I give,devise and bequeath to my son,MERLE F 0 I
II ,IISMITH,absolutely.
II 8 1 direct that all inheritance taxes be paid out of !II .i
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Signed,sealed,published and declared by the said
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I herebyappoin.t my son,MERLE F.SMITH,as Executor9.
IIII my general estate as expenses ofadniiilistration.
III
lofthis ~y Last Will ~nd Testament.I
II .IN WITNESS V;THEREOF,I have hereunto set my hand and
Iseal this
11
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Ii LUCY V.SMITH,to be her Last Will and Testa.m:ent in our presence,
IWhO at her request and in her presence and in the presence of each
III other,we believing her to be of sound and disposing mind,memory
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rl and understanding,have h::eunto sU!j/~scribei.d our names as
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~OlJRT OF COMMON PLEAS ORPHANS'
POURT DIVISION FOR THE COUNTY
OF WASHINGTON,PENNSYLVANIA
NO.63-70-612
IN THE ESTATE OF
LUCY V.SMITH,DECEASED
ELECTION TO TAKE UNDER WILL
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SAMUEL GOLDFARB
ATTORNEY AT LAW
WASHINGTON TRUST BUILDING
WASHINGTON.PA.
1?.3-t37f
STATE OF PENNSYLVANIA,
WASHINGTON COUNTY,~55:
The within named Accountant being duly sworn according to law,depose s and says that the above account
as started is true and correct as 1.J:~verily believJl
Sworn and subscribed be'fore me this ~9J~.
day of JanuarY-19 1.1 .
~~;~~~>J
WASHINGTON,WJ\SHi~lGTOI!CO.,PA,
MY'COMMISSION EXPIRES SEPT.15,1973
Washington County,ss:
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I do certify that I have given legal notice to all persons
concerned of the filing of the within account in the manner
prescribed by Statute 9nd Rule of Court,as evidence by proofs
thereof filed to No ..b3-:-::7-/..~.J .
Witness my h~nd and official seal thiS.tF!_ .
-aL14 />•-[),7/
day of I..I..~-.Ci)ii.~-;19 .LX~:.rr~.
Register of Wills
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COURT OF COMMON PLEAS ORPHANS'COURT DIVISION FOR THE COUNTY OF
WASHINGTON,PENNSYLVANIA
IN THE ESTATE OF
LUCY V.SMITH,DECEASED
)
)NO.63-70-612
)
ELECTION TO TAKE UNDER WILL
TO MERLE F.SMITH,EXECUTOR OF THE ABOVE ESTATE:
I,SAMUEL H.SMITH,widower of the above decedent,who
died en the 17th day of May,1970,haVing first made,published
and declared her Last Will and Testament dated August 3,1966,
duly probated in the office of the Register of Wills of Washington
County,Pennsylvania,on June 17,1970,and recorded in Will
Book 110,page 271,hereby elect to take under theterms of the
said Will.
IN WITNESS WHEREOF,I have hereunto set my hand and seal
this3rd day of __~J~u=l~y ,1970.
1.~fI~(SEAL)
....,....
COMMONWEALTH OF PENNSYLVANIA )
)SS~
COUNTY OF WASHINGTON )
On this the 3rd day of July ,.1970,before me,---=----
a Notary Public,the undersigned officer,personally appeared
SAMUELH.SMITH,known to me (or satisfactorily proven)to be the
person whose name is subscribed to the within instrument and ac-
knowledged that he executed the same for the purposes therein
contained.
IN WITNESS WHEREOF,I hereunto set my hand and official seal •
LOUISE l.CARSON,NOTARY PUBLIC
WASHINGTON,WASHINGTON CO PA
MY COMMISSION EXPIRES SEPT.Ii 1973
COURT OF COMMON PLEAS ORPHANS'COURT DIVISION FOR THE COUNTY OF
WASHINGTON,PENNSYLVANIA
IN THE ESTATE OF
LUCY V.SMITH,DECEASED
)
)
)
NO.63-70-612
The FIRST and FINAL ACCOUNT of Merle F.Smith,Executor
of the Estate of Lucy V.Smith,late of West Bethlehem Township,
Washington County,Pennsylvania.
The Accountant is charged as follows:
Inventory
The Accountant claims credits out of the
assets of said estate as follows:
Register of Wills,Letters Testamentary and
Short Certificate
Washington County Reports,advertisement Letters
Observer Publishing Company,advertisement Letters
Register of Wills,filing Inventory
Register of Wills,filing Election Under Will
Register of Wills,Short Certificate
John H.Shrontz,Funeral
Quinet Monument Company,stone lettering
Robert C.Gordon,ambulance
Washington Hospital,account
Washington Orthopedic Associates,services
Doctor C.J.Tripoli,services
Doctor M.W.Graham,services
Samuel H.Smith,Family Exemption
Register of Wills,on account inheritance tax
Notary
Samuel Goldfarb,Attorney for estate
Register of Wills,filing Account
R E CAP I T U L A T ION
TOTAL ASSETS
TOTAL CREDITS
BALANCE
$16,626.53
20.50
14.00
14.00
3.00
2.50
1.00
1,316.00
20.00
15.00
13.50
85.00
24.00
38.20
1,500.00
600.00
6.00
830.00
15.00
$4,51".70
$16,626.53
4,517.70
$12,108.83
-~------~-------,="",-~------~
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A
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Observer .Reporter
WASHINGTON,PENNSYLVANIA
PROOF OF PUBLICATION
In compliance with the Newspaper Advertising Act of 16 May.1929.
P.L.1784,a:s amended.
Commonwealth of Pennsylvania,County of Washington,SS:.
Personally appear,ed before file,a Notary Public in and for said County
and State•........Richa.r.d S Cowan who being duly s,worn
according to law,deposes and says that he is the ..S.ec.r.e.tary..
of the Observer PUblishing Company.a P,ennsylvania corpo,ration.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 busines's at Washington.Washington County.Pennsyl-
vania,where it or its predecessors have been established and published
continuous'1y for more than six months'prior to the publica;tion of the notice
hereto aHached;th3lt the printed notice or advertisement hereto attached
is a ,copy of an official advertisement.official notice.legal notice or legal
advertis,ement,exactly a:s printed or pUblished in the Ob:;:lerver-Reporter in
its regular editions on the follOWing dlate or dates;.
............................J:~.rr~J,9..,?9.~~g J~J,.Y...)..,!.9..7..Q ..
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-
~~~n~r~~.this affidavit as to the time,Pla~d"chara)~.
..............................~:..
fl'EXECdTOR'SNOTIC?',.,
ESTATE OF'LUCY,V.SMIT.W.,·.de·:ceased lateo~":'!~West'Bethlehem
Township,.Washington );,eounty.j
Penna.'<',."'.,:z\;;~.Jf~Letters Testaqientary"'~i1poI'1,.~thaboveestatehavmg·.,;,been ,gHinte,'I to the underSign,"<t,d!riO,tic,,',.e,}is ,.,.h,ere]),given t.o thos~,i,~',Cle"!It,d".',:·ther,eto'~!;tomakeI'mmedlatsfflrlj,'yment and,,\t
those having.cl~1m 'ort,aemands,t"present.them fo settlemllnt.:,,£,:
MERLE F',MITH.,'ExecutalR.:rD.1 'J<~;,_<I.,.'-;:-;;~:l;'
Marianna·5:i~5:"",SAMUEL GOLD,flf-(\ttorney".!514 ~ashingtoni.'llig.:'",<
Washmgton,Pa.,,',.".:('~
>70144'Frt,3,•
'~--..)\.
Sworn to and ..b·'7#~~~~:~AB~
WASHINGTON,WASHING10N COUNTY
MY COMMISSION EXPIRES MAY 6.1972
Washington County Reports
Washington,Pennsylvania
(PUBLISHED BY WASHINGTON COUNTY BAR ASSOCIATION)
PROOF OF PUBLICATION
In compliance with the Newspaper Advertising Act of May 16,1929,P.L.
1784 Sec.3,paragraphs (3)and (25).
COUNTY OF WASHINGTON )
STATE OF PENNSYLVANIA (SS.
Personally appeared before me,a Notary Public in and for said County and
Commonwealth,CHARLES C.KELLER,who,being duly sworn,deposes and
says:that he is the Editor of the WASHINGTON COUNTY REPORTS,the
official legal periodical for said Washington County,published weekly having its
place of business at Washington.Washington County,Pennsylvania,and is act-
ing as its agent in this behalf;that the said WASHINGTON COL'NTY
REPORTS was established on March 31,1920,and was designated as the official
legal publication for Washington County,Pennsylvania,by order of the several
courts of said County,dated November 11,1920;that the printed notice or adver-
tisement attached hereto is a copy of a notice or advertisement,exactly as printed
or published,which appeared in the said legal periodical in its regular issues on the
following dates:
................~.~~!:??L..~.~.?..g __ __..__ __.
Estate NotIces
-.The Register of Wills has granted letters,
testamentary or of administration,in the
following estates.Notice is hereby given
to all persons indebted thereto to make
payment without delay and to those hav-
ing claims or demands to present them
for settlement to the Executors or Admin-
istrators or their Attorneys.
• • 0 ••••••••••••••
SMITH,·LUCY.·V.,Dec'd.
'Late .of West Bethlehem Township,
i.Washmgton County,Penna.i·Executor:Merle F.Smith,R.D.1,,.Marlanna.Pa.15345
HAttorney:Samuel Goldfarb,514 Wash-nngton Trust Bldg.,Washington Pa;;15301 ' .
·J.u.1.¥2.,.9.,..l9.7.-0 .
that the affiant or the corporation in behalf of which he is acting is not interested
in the subject matter of said notice ~~.ert'ing and that all ~~allegations of
this affidavit as to the time,place a~:ter of ~1ublica~.e t~
Sworn to and subscribed before me tC.....···......··.........~
.......~~y of ~.~J..Y.,19d.1.Q·......~..e Lt.u~~
Notary Public
KATHERINE C.NICHOLAS,Notary Public
Washington,Washington Co.,Pa.
My Commiss.ion Expires
November 1,1973
3Jn tQP (@rpl1'1n9"aInurt of 1I'19Qington mounty
In the matter of the Audit of Account in
j
Estate ol!:.-f_~LU:..::C:..::Y:....-V:....!-.~S~M~I~T~H~.~D~e:::::.c=e~a:!::s~e~d~_/
TO THE AUDITING JUDGE:
No.63-70-612
Enter m.....y'--appearance for·....:..~A~c~c:!.:o~u~n~tC!<al<.!n~·..!ot'--__'--_
=1M:j7~J--/b~ay of ~Ch ,19_71_
N.B.-Counsel shall,by separate paper,present a concise statement of each
claim,with supporting calculation of any interest claimed.Objections
to an account as filed,shall be concisely stated in a separate paper.
Council suggesting proper distribution shall file a separate concise state-
ment in that regard.
No.63_-,7..:0~---=6.:::.1-=2 XXKxxx*~X
In re Audit of Account in Estate of
LUCY V.SMITH,
DECEASE_D~__
AUDIT
Jrarripr for Appraraurr
FOR
Merle F.Smith,
Executor
Accountant
SAMUEL GOLDFARB
Attorney
_..==============JJJll@~·2
PETITION SUR AUDIT .Testate FormJ
'~IN THE ORPHANS'COURT OF WASHINGTON COUNTY
Estate of r:..~~y y.~~~J.~g.,No ~~~.'!.~:::~.~.?~~
.............................................................................................Fiduciary M~'f.~~¥..!§~~J!!..l .
Executor
Deceased
~~~~~~
Decedenes death M~.Y...J'J..,..J·.~'J..Q Grant of Letters ~:':1:~~~.?-J.~~.?~.
This is the :f.:-t~§.1..~.~~¥.J.m~J account filed in this estate
If there have been former accounts filed in this estate,list file number or number and term .
None
Electio:~X Date Election Place of;
Under •xittn (cross out one)Filed ..J~!y...~.,...J~I9.....Record .~~.g~.l?:t:~~...~~...Wills
Name of surviving spouse s.~m~~J...a.~~~~:t.~.
List issue,where material:
Not material.Accountant-Executor-Residuary beneficiary-son,is only issue.
Did decedent marry after execution of will?(indicate)~.No.Any children born after execution of will?(indicate)
~No.If answer yes,name them .
Legatees Relationship Interest Fiduciary,if not sui juris
Samuel H.Smith
Nellie Mae Smith
Merle Floyd Smith,Jr.
Donna Mae Mercante
Donald Wayne::Smith
Sherry Jo Mercante -Born
Anthony Wayne Mercante-Born
Connie Jo Smith -Born
Samuel David Smith -Born
Wayne Allen Smith -Born
Merle F.Smith
Highland Brethren Church
North Ten Mile Cemetery
Husband Bequest
Daughter-in-law 'Bequest
Grandchild Bequest
Grandchild Bequest
Grandchild Bequest
4/26/63 Great Grandchild Bequest
9/4/65 Great Grandchild Bequest
12/22/64Great Grandchild Bequest
6/3/67 Great Grandchild Bequest
IO/23/67Great Grandchild Bequest
Son Residue
None Bequest
None B~quest
None
None
None
None
None
List any exceptions to above legacies:
None
If any partial intestacy,give facts:
None
Adeemed:Revoked:Lapsed:Abated:Give Causes:
Notic~to interested parties.Have all parties,having either vested or contingent interests and all creditors entitled
to notice (Court Rule No.9 paragraph C:Section 6:Subdivision c)received written notice of the filing of the account
and of call of audit?Yes.bttx .
If any exception give cause:.
Attach copy of form used and
r;Jive date of mailing such notice Cop.y...,q;f Np-t~,c.e,..~:t:!:;~.c.h~.g J;J,~.:r.~.~Q.!M~.:iJ~.(L¥.~p.~~..t..J~.71 •...-..."'.
Is estate or any portion subject to Federal Estate Tax?~Q _ ·_ _ ___..___._.
Itt t'b't t PIP t T ;>,·~N8 ..---s es a e or any par Ion su lec a ersona roper y ax ____
Has Pennsylvania Transfer Tax been paid?y.e.~(P.a;r;.~i_~~.~.yJ _Amount $60.0.00
t~r631~-5g··c·redl"t)"
If any portion of estate subject to life-estate,give name and birth date _ ___. _ _ .
...._:N9.J;:\~.._ __ _ .
Give Names and addresses of all unpaid creditors who a re legally entitled to notice,together with the amounts
of such claims and whether or not they are admitted to be correct:
None
Give reference to such parts of the will as require interpretation by the Court;a reference to all questions re-
quiring adjudication,and a statement of any other facts deemed necessary for the preparation of the adjudication:
Inheritance tax charitable exemptions for two $300.00 bequests are on file
with Register of Wills.
Will paragraph 4 bequeaths $500.00 to be divided equally between the great
grandchildren,said bequests to be paid during minority to the respective parents.
There are five great grandchildren,all minors as above set forth,whose parents
are as follows:
Sherry Jo Mercante &Anthony Wayne Mercante:Parents Anthony &Donna Mae Mercante.
Connie Jo Smith &Samuel David Smith:Parents Merle Floyd &Carolyn Smith.
Wayne Allen Smith:Parents Donald Wayne &Marjorie Smith.
List any advancement or distribution on account that has been made,and nature and amount of same:
Receipts attached her.eto for bequests paid as follows:
Samuel H.Smith,par.2 of Will $2,000.00 Highland Brethren Church,$300.00
Nellie Mae Smith,par.2 of Will $1,000.00 par.5 of Will
Merle Floyd Smith,par.3 of Will $600.00
Donna Mae Mercante,par.3 of Will $600.00 North Ten Mile Cemetery,$300.00
Donald Wayne Smith,par.3 of Will $600.00 par.6 of Will
Balance for distribution per account,
Itemize any additional debits not shown by account:$..12.,.lOaJl~.a .
Total additional debits
Itemize any additional credits not shown by account:
Total additional credits
$~.
$-::.
Balance for distribution $..!~.1.~.9.~.!.~~.
If balance for distribution is not in cash,list each item held in kind,giving appraised Value:
Cash.
,I'
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p-..'~._~~~.__._U"_
Family allowance claimed?'..------.----~~~-----.----.....------.,Paid?..r~~~ii~i.~Y...i~·~-~I~t--:i-~a-g~~-~i~~·~etg-.
Suggested distribution of balance shown,both as to principal and income,attaching signed and itemized elections
to take in kind if balance is not in cash:residuary shares being stated in proportions:
(a)Confirm payment of bequests as above.
(b)$100.00 to each of five great grandchildren,through respective
parents,per paragraph 4 of the Will.
(c)Residue to Merle F.Smith,per paragraph 7 of the Will.
"
COUNTY OF WASHINGTON,SS:
COMMONWEALTH OF PENNSYLVANIA.
The above named Fiduciary or representative thereof,
being duly .._§~QJ".:n.__._doth depose and say
that the facts set forth in the foregoing petition are true
to the best of _._bJ~L____knowledge and belief.
--..~~~!~..._------to and subscribed before
~e th;sJ.3.~daYa~..19.n..
Signature of Offlcer__~.e~...A..J.•••~
.Title of Officer...---.~Q-VJ~~--L~~~.~Q~:.-~9-~~~_~.r~~~~~~7'i~.--__...~WASHINGTON,Wf\SHiNGTO~!"':J.,r'·.
Office expires ._MY__CDMMlS_SlO_N_.~_~P.l~I??_~~T:__~?!__!~?~..
Arid your petitioner will ever pray,etc.
...~.7-~.
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No.__..~~_~'!..Q-::_E?_~~... ..~
Estate of ...__...__._.__. ._..
LUCY V.SMITH
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Fiduciary ~!!_~~_~~~~TH,---~-----~---..--------..
EXECUTOR
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PETITION SUR AUDIT
FROM WHERE DECEDENT LEFT A WILL
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Counsel of Fiduciary will submit herewith the
following,in conformity with Court Rules
adop,ted effective December 3,1951,being
rule No.9:paragraph b-c;and divisions
thereof:shown on pages 23-24.
1.Written praecipes of all Counsel in the
case.
2.Copy of Order appointing Guardian ad
litem,if pertinent.
3.Copy of Order appointing Trustee ad
litem,if pertinent.
4.Proof of service of above.
5.Letters Testamentary or Administration
c.T.A.or an attest copy of Will.
6.Copy of inventory and appraisement.
7.Proof of advertisement of grant of letters
if not filed with account.
8.Certificate of liens in case any of the
funds for distribution are from judicial
sale of real estate.
9.Signed and itemized elections if any
distribution in kind.
lO.Copy of Federal Estate Tax return if es-
tate is subject thereto.
'\
_________SAMUEL GOLDFARB .
Attorney
~2
.•
-'~-.,
ESTATE
of
LUCY V.SMITH,
DECEASED
IN THE
ORPHANS'COURT OF WASHINGTON COUNTY,
PENNSYLVANIA
NOO'XXXXXX~~
NO.63-70-612
NOTICE OF ACCOUNT AND AUDIT
You are hereby notified that the fiduciary,whose name appears below,has filed an account as such in the
Office of the Clerk of the Orphans'Court and Register of Wills for Washington·County,Pennsylvania,at the above
number and term,and that the same will be called and presented for audit before said Court in the Court House,
Washington,Pennsylvania,during the week beginning March 15 ,19 71.
SAMUEL GOLDFARB
ATTORNEY FOR ESTATE
514 WASHINGTON TRUST BUILDING
WASHINGTON,PENNSYLVANIA t 5301
Merle F.Smith
U~X
Executor
"
.-
\
nEGIS1EL Of WILLS
VI ASII iN (.:TO r4 CO"PA.
.-........
...
.,,;.~
IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY,PENNA!.
ORPHANSI COURT DIVISICN
.~
{).
e
IN RE:
ESTATE OF
L DCY V.SMITH,
~Deceased.
<>oJ>-OJZZ11/Do
)
),
)
)No.612 of 1970
)
)
)
HEARING ON AUDIT
deceased.The Executor is Merle F.Sm ith and the attorney is
Petition,together with the necessary attached papers or instruments.
Samuel Goldfarb.Mr.Goldfarb?
MR.GOLDFARB:
'"
May it please the Court,I have here the Audit
SAMUEL GOLDFARB,ESQ.,of Washington,P~.,
representing the Accountant .
THE HONORABLE P.VINCENT MARINO,Judg
of the s aid Court.
'N~mber 612 of 1970,'the estate of Lucy V.Smit
-'Tuesday,March 16,1971,at 10:00 o'clock A.M~.,
ESU:.
i.g BEFORE:
ClzxOJ<~
t APPEARANCES:
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jj TIME:
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uiII:~II:o~THE COURT:
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There are no claims and no particular complications.I might
mention just for the information of the Court generally---of cour~e,
the balance for distribution is cash---there have been,there areltwo
charitable bequests,both of which have been paid and receipts
are attached hereto.We filed with the Register the Applicat ion
for Exemption,which should be among the papers in the file at
2
"
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the present time.There are a number of specific bequests to
adults,all of which have been paid in full and receipts attached
hereto.Actually,the only thing remaining to be distributed
are bequests of $100.00 each to five great grandchildren,a total
of $500.,00.•The balance,of course,goes to the son who is the,
Executor.
:The Will requests,suggests or directs that the
bequests of the 1$100.00 E<al.each of the great grandchildren be paid
to their respective parents and I have recited their parents here.
Their parents are als?specific beneficiaries who have received
their bequests.'We have no obj ection that these beques ts of
$100.00 each be paid to some bank,but it is'suih a small amount
that we thought that perhaps it might be proper for them to be
paid to their res pective parents who are good people who lWlnl
•
com ply with it.
iiiII:
'IIII-0:oa.III,
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Uii:THE COURT:
II.o
MR.GOLDFARB:
THE COURT:
We hnderstand.There are no outstanding claim~?
No.
Is there anyone else in Court interested in this
decedent's estate?
(NO RESPONSE)
THE COURT:
the Court.
The audit of this account is ordered closed by
(A UDIT CLOSED)
I hereby certify that the proceedings and evidence are
The foregoing record of the proceedings upon the bearing
:$contained fully and accurately in the notes taken by me on the hearing of.~,
,~the,above cause~and that this copy is a COrrect transcript of the same.
zz,'IIID.
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and directed to be filed.
/
,-By-the Cout-~,.'AI
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ffi of the above cause is hereby approved
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Jltuusylunuiu,(@rp4uus'Qtoun 13inillinU
ESTATE OF
Lucy V.Smith
deceased
No.63 ...70.612
In the matter of thc..e__F_i_r_s_t_&__F_1_·n_a_1__
Account of_....:M.::.:e:;.:r:..:l:.;;:e~F...:.._Sm....:;;.i~th~_
Executor
ADJUDICATION AND DECREE
And now April .1S ,19~,this matter came on for hearing,
audit and distribution at this session and testimony taken;and thereupon,upon due consideration
thereof the iaLaI'\C~for distribution in the hands of the Accountant is determined to be
$12,ms .lj and the account is ace0 rd in9Iy confi rmed;and it is ordered,
adjudged and decreed that the said balance be paid .out by the Accountant in accordance with the
schedule of distribution hereto attached and made a part hereof,unless exceptions hereto be filed
sec.reg.or onappealb~taken herefrom sec.leg.
SCHEDULE OF DISTRIBUTION
Balance per account ~_
Bolance'_
Deduct Clerk's Costs &Receipts _
$12,108.83
33.£)0
AM:omey'.-.;.::S:.::8~m~u~e~1I....o::::G:.:::o;o::l;,,;;:d=.f..:;::.a.=_r.::.b _
Russell Marino,Agent,transfer inheritance
tax,
Samuel H.Smith,husband,legacy,credit to be
taken by the accountant for funds in the
amount of $2000.00 advanced prior to distribu-
tion by the Court,
92.91.1
2000.00
Nellie Mae Smith,daughter-in-law,legacy,
credit to be taken by the accountant for funds
in -tt;te.aITlount of $1000.00 advanced prior to
distribution by the Court,11000.00
$8,982.39
Merle Floyd Smith,Jr.,grandson,legacy,
credit to be taken by the accountant for funds
in the amount of $600.00 advanced prior to
distribution by the Court,
Donna Mae Mercante,granddaughter,legacy,
credit to be taken by the accountant for funds
in the amount of $600.00 advanced prior to
distributfon by the Court,
Donald Wayne Smith,grandson,legacy,credit
to be taken by the accountant for funds in the
amount of $600.00 advanced prior to distribu-
tion by the Court,
600.00
$8,382.39
600.00 $87,7 2.39
600.00
$7,182.39
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Anthony B.nd Donna Mae Mercante,Parents end
natural guardians of Sherry Jo Mercante,a
great grandchild,a minor,legacy,
Anthony end Donna Mae Mercante,Parents and
natural guardian of Anthony Wayne Mercm te,
a great grandchild,a minor,legacy,
Merle Floyd &:Carolyn Smith,Parents and natura
guardian of Connie Jo Smith,a great grandchild,
a minor,legacy,
Merle Floyd &:Carolyn Sm1 th,Pa,rents and natura
guardian of Samuel David Smith,a great grand-
child,.a minor,legacy,
Donald Wayne and Marjorie Smith,'Parents and
natural gua.rdian of Wayne Allen Sm1 th,a great
grandchild,a minor,legacy,'
Highland Brethren Church,1egac~credit to be
taken by the accountant for funds in the amount
of $300.00 advanced prior to .distribution by
the Court,.
"
North Ten Mile Cemetery"legacy,as set forth
in the Will,credit to be taken by the accoun-
tant for funds in the amount of $300.00
a.dvanced prior to dis tribution by the Court,
Merle F.Smith,son,residue,cash,
100.00
100.00
100.00
100.00
100.00
lOO.OO
300.00
6082.32
---_._-~
...
$7,08.2.39
$6,882.39
$6,782.39
,:
$6.382.39
$6,082.39
No balance
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COURT OF COMMON PLEAS ORPHANS'COURT DIVISION FOR THE COUNTY OF
WASHINGTON,PENNSYLVANIA
IN THE ESTATE OF
LUCY V.SMITH,DECEASED
)
)
)
NO.63-70-612
RECEIPT FOR LEGACY
of $300.00
AND NOW,this /35!t day of ~~~~~~..::::.."1971,the
undersigned hereby
in full payment and r~lease of the legacy bequeathed to the under-
signed in paragraph 6 of the Will of the above decedent,to be
used as provided in said Will for the upkeep of the graves of the
above decedent and her husband,Samuel H.Smith (after his death),
and to help in the upkeep of the cemetery.
NORTH TEN MILE CEMETERY
I,
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IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY,PENNSYLVANIA,
ORPHANS'COURT DIVISION
J
ESTATE OF
LUCY V.SMITH,DECEASED
)
)NO.63-70-612
)I
R E C E I P T
'"r~........
ltJ
KNOW ALL MEN BY THESE PRESENTS,that we do hereby ac-
knowledge to have received from Merle F.Smith,Executor of the
estate of Lucy V.Smith,deceased,the sum of $100.00 in full of
the amount awarded the undersigned under the Decree of the Orphans'
Court of Washington County,Pennsylvania in the above estate dated
April 23,1971.
...
"
t~;
C·,__.l1'
BburAft OJ'
LUOf V.SIll.,HCBAJiIII»,
RICUIPT4.a•.$IJ..1.,At 1)1
BIfOW ALL II.'BY 'ftmSI PURI'lS,ilia"_dO unity ...,-
knowled.e to have J:ece14fed b:omlel"le J'.Sm1th,SJWCUliott 01 the
estateof L\t;Q,V.S1*itb,deceMe4,tbe __of $l00.oetu '.11 0'
~jl jJ '<-!~~!~.~(SIAIo)
~.,~~&'..,~~......(SIAL)'arB f--'--".
Parents and natural guardians of
Connie Jo Smith,a great grandchild,
a minor.
,,,
IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY,PENNSYLVANIA,
ORPHANS'COURT DIVISION
ESTATE OF
LUCY V.SMITH,DECEASED
)
)
)
NO.63-70-612
our hands and seals this ~ay of ~,
R E C E I P T
KNOW ALL MEN BY THESE PRESENTS,that we do hereby ac-
knowledge to have received from Merle F.Smith,Executor of the
estate of Lucy V.Smith,deceased,the sum of $100.00 in full of
the amount awarded the undersigned under the Decree of the Orphan '
Ln
rv;•
Cggrt ~~~~ington County,Pennsylvania in the above estate date
A:@'il ~E@7l .
....-'C~~
ec::..-.J'f'l'·?
(',<I,;';..:..'!ITNESS
0:::(I)V)::::0-.(/)_
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Witnessed:
-r.-'--~...;..:'~~CL'~)~~P~:LJ=(SEAL)
MarJo e smit~
Paren s and natural guard1ans of
Wayne Allen Smith,a great
grandchild,a minor.
".
lit TBB eOtmT OF ~OMJION PLEAS OF WASHINGTOtf COUNTY 1 PENNSYLVAlIA,
ORPHANS'COURT DIVISION'
ESTATE OF
"
LUCY V.SMITS,DECEASED
)
)NO.63-70-612
)
.'.
RBCEIPT
'I(N'OW ALL MEN BY Tm!:SE PRESENTS ,that we do hereby ac"",
.,knowledge to have received from Merle F.Smith,Executor of the
estate of Lucy V.Smith,deceased,the sum of $100.00 in full of
the amount awa~ded the undersigned under the Decree of the Orphans'
Court of Washington County,Pennsylvania in the above estate dated
and seaU this }&\1:-da:v of 4J:.4-.
~.~~<SW<)Anthonyrcante
iJ/~k4)~eJki4kfi~(SIAL)Donna Mae Mercante .
Parents and natural guardians of
Anthony Wayne Mercante,a great
grandchild~a minor.
·,~....
IS"'..
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II
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..1.......__I.,"Ii'"J til,of ..
___oj la.,"'.S1d_,••,.,the.of flOO.OO ttl.lUll of
.............'._..-...........-.-..tu.-__-...,./Ii .lI._0IDba •.~__..,_',....,..~1"~.....,'.~.,.
~.of ··.·~8 .....,1..............'"Jo._...~_.--..VV'.lMr1li _~.~."T',.··.'y-_IIIIAI''''!Ua.~
A_till.1911.
"~.~~(1iW.tMerleFloydSmi
~~.....,,""....",C8lIAlo)
Parents and natural guardians of
Samuel David Smith,a great
grandchild,a minor.
..
IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY,PENNSYLVANIA,
ORPHANS'COURT DIVISION
ESTATE OF
LUCY V.SMITH,DECEASED
)
)NO.63-70-612
)
R E C E I P T
KNOW ALL MEN BY THESE PRESENTS,that I do hereby ac-
knowledge to have received from Merle F.Smith,Executor of the
estate of Lucy V.Smith,deceased,the sum of $6,082.39 in full
of the amount awarded the undersigned under the Decree of the
Orphans'Court of Washington County,Pennsylvania in the above
estate dated April 23,1971.
WITNESS our hands and seals this :;l.:t.{i3.day of A4..J..r..LrI_-
1971.
--.-.L~...L:;:~f-*W~.£-::;..-!--:?-,.n-,6~g~,/:ti-o::::.!\=.::::..(SEA )
Merle F.SIii'th
lJi
Cf)<;("0""')C)-J Q.....,..
-J"'-"-:Q ~a-£.::':~.......~Cl...-""-LL ;;!:~--c·..
C,T ..
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.------.....------------------------
COURT OF COMMON PLEAS ORPHANS'COURT DIVISION FOR THE COUNTY OF
WASHINGTON,PENNSYLVANIA
J
IN THE ESTATE OF
LUCY V.SMITH,DECEASED
)
)NO.63-70-612
)
RECEIPT FOR FAMILY EXEMPTION
AND NOW,this 3rd day of J_u_l_y ,1970,I hereby
acknowledge receipt of the sum of $1,500.00 in full payment of my
Family Exemption.
COURT OF COMMON PLEAS ORPHANS'COURT DIVISION FOR THE COUNTY OF
WASHINGTON,PENNSYLVANIA
IN THE ESTATE OF
LUCY V.SMITH,DECEASED
)
)
)
NO.63-70-612
I
paymen
AND NOW,this -13-day of ---7i~,.,LI,C.~r..:::.t.4
hereby acknowledge receipt of the sum
and release of the legacy bequeathed to me in paragraph 2 of the
Will of the above decedent.
-"
COURT OF COMMON PLEAS ORPHANS'COURT DIVISION FOR THE COUNTY OF
WASHINGTON,PENNSYLVANIA
IN THE ESTATE OF
LUCY V.SMITH,DECEASED
)
)NO.63-70-612
)
RECEIPT FOR LEGACY
hereby acknowledge receipt of the sum
AND NOW,this /1 day of ~~14.4.Ll.Z.~:""--_'19'71,I
full payment
and release of the legacy bequeathed to me in paragraph 2 of the
Will of the above decedent.
ellie Mae Smith
COURT OF COMMON PLEAS ORPHANS'COURT DIVISION FOR THE COUNTY OF
WASHINGTON,PENNSYLVANIA
IN THE ESTATE OF
LUCY V.SMITH,DECEASED
)
)
)
NO.63-70-612
RECEIPT FOR LEGACY
AND NOW,this /');-day of ~"7 ,1971,I
hereby acknowledge receipt of the sum of $600.00 in full payment
and release of the legacy bequeathed to me in paragraph 3 of the
Will of the above decedent.
COURT OF COMMON PLEAS ORPHANS'COURT DIVISION FOR THE COUNTY OF
WASHINGTON,PENNSYLVANIA
IN THE ESTATE OF
LUCY V.SMITH,DECEASED
)
)
)
NO.63-70-612
hereby acknowledge receipt of the s
RECEIPT FOR LEGACY
AND NOW,this Iv day of ,1971,I,.4-'~~~~;;L---
full payment
and release of the legacy bequeathed to me in paragraph 3 of the
Will of the above decedent.
COURT OF COMMON PLEAS ORPHANS'COURT DIVISION FOR THE COUNTY OF
WASHINGTON,PENNSYLVANIA
IN THE ESTATE OF
UCY V.SMITH,DECEASED
)
)
)
NO.63-70-612
RECEIPT FOR LEGACY
ill of the above decedent.
nd release of the legacy bequeathed to me in paragraph 3 of the
$600~OO in full payment
-}~.:I4A..L,.J;.~~,1971,IANDNOW,this /V day
ereby acknowledge receipt of the
·''.
COURT OF COMMON PLEAS ORPHANS'COURT DIVISION FOR THE COUNTY OF
WASHINGTON,PENNSYLVANIA
IN THE ESTATE OF
LUCY V.SMITH,DECEASED
)
)
)
NO.63-70-612
AND NOW,
undersigned hereby
RECEIPT FOR LEGACY
\.Ll -\\-.&~this:J.-;day of <;51o.'pll a ~.,1971,the
acknowledges receipt of the sum of $300.00
in full payment and release of the legacy bequeathed to Highland
Brethren Church in paragraph 5 of the Will of the above decedent.
HIGHLAND BRETHREN CHURCH
..
"
Form RCC-33
RESIDENT DECEDENT
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
COUNTY OF
3f-?a'..;7
""".WASHINGTON·..·..···....·..··..···..··..·..······......
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
the.In1leri tance..an~:E.f!t;ll.te .Tax A.c tof 1~61.)
-----I-~~:~~:e.i~~i:~~;;~:~~---------}==:
Late of .Washington ,,................................................................County ,
::t:.~-::~:::I~:_-::-=:=},,'
MERLE F..SMITH.".,.,,,........",,.,".,,.,,.......................,.,,".,..
~of the estate of the a.bove-named decedent being duly sworn,depose S and say S
Executor
Decedent'dJed May.17 ,.
(Month)
............19,7.0...,......r testate leaving a last will,copy of which is hereto attached.,}
(lIay)(Year)L~
'That as such ..~~~~.~~.~.!',,deponent is familiar with the affairs of said estate and the property con-
.,'.n:x"cutor.~,
stituting the assets thereof and their fair market value.
That at the time of death there was no safe deposit bux registered in decedent's individual name,or jointly
with,or as agent or deputy of another,or in decedent's individual name,with right of access by another as agent
or deputy,with the exception of the following:-
NAME AND ADDRESS OF BANK OR OTHER HfS'I'I TUTION THIS SAFE DEPosiT BOX RENTED RELATIONSHIP OF JOINT
IN WHICH DECEDENT RENTED A SAFE DF;pOSIT BOX IN NAME OR NAMES OF HOLDERS TO"DECEDENT
None ...
,'.
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 Schedule A attacqed Qereto and made part hereof sets forth full v and in'detail all the
real property in the CommonwealtQof Pennsylvania of which decedent died having an interest therein.It
also sets forth the mortgage encWllbrances upon each parcel of real property at the date of death,giving
the amount still 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 mad,e 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 immed,iate possession,standing to decedent's credit in banks".-...r"--'.....of deposit,saVings banks,trust companies,or other institutions,whether individually,,~~~n trust for"..~.any other person or persons giving also separately the accrued interest thereon,if any,:'down to the last
.interest day prior to decedent's death in the caSe of savings banks,and to the date dt dec~~:nt's death
in all other cases;all bonds,postal saVings,treasury certificates or notes and other ~{dence of in-
debtedness of the United States LO th~decedent;all obligations,whether by statute or agr/ement they
*'are designated as tax free,of the United States,Qr any state,or political subdivision thereo~,or of
any foreign country,which are owned at the time of death;all wearing apparel,jewelry,si!v;~~are,pic-
tures,books,works of art,household furniture,horses,carriages,automobiles,boats,and any and all
other personal chattels of whatsoever kind or nature,left by decedent,together with the fairly estimated
market value thereof;all bond$and mortga~es held by decedent and of all claims due and owing decedent
at the time of death,and all promissory notes or other instruments in writing for the payment of money
of which decedent died possessed,of whatsoever nature,with interest thereon,if any,giving the face
value and estimated fair market value thereof,and if such estimated fair market value be less than the
face value,it sets forth briefly the reasons for such depreciation'as to each item;all moneys payable
to the estate from life insurance policies carried by decedent;all annuity and endowment contracts the
proceeds of which were payable 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 accrued interest thereon to the date of dece-
dent's death and other investment securities owned by the decedent at the time of death,with the market
value thereof at such time.
.....
In the case of securities of close or family corporations,the values reported are as far as
possible substantiated by financial statements of the corporations,showing the assets and liabilities
thereof as of the'date of death.The schedule also sets forth the interest of decedent at the time of
death in any co-partnership or business,and in support of the value of such interest there is annexed to
said schedule,financial statements showing the assets and liabilities of said co-partnership or business.
A copy of the co-partnership agreement,(if oral,a statement setting forth the nature of the agreement)
together with a statement setting forth the character of the business,its location,and such other facts
pertaining to the business as may be pertinent to a fair and just appraisal of the decedent's interest
therein must be submitted.·It should also set forth in itemized form,together with the fair market value
thereof,any other property owned or bequeathed by the decedent at the time of death.
The Schedule C attached hereto and made part hereof sets forth a true answer to each inquiry
contained therein and in the case of transfers ofproperty,real or personal,within two years of decedent's
death,in contemplation of decedent's death,or intended to take effect in possession or enjoyment at or
after death,said schedule sets forth the nature and value of such property,to whom transferred,the
relationship of the transferees to the decedent,the proportionate share received by each transferee and
all other facts of a pertinent nature regarding said transfers•.In the case of transfers intended to
take effect in possession or enjoyment at or after death,there is also attached to the schedule a co~y
of the deed,trust agreement or other instrument creating the trust.Therl~is also set forth in said
schedule a list of all property,real and personal,with its value,which passes at decedent's death by
virtue of the exercise by decedent,either individually,orjointly with another,or any power of appoint-
ment vested in decedent,either individually or jointly,by the Will,deed,or other instrument of another,
with a copy of the instrument creating such power attached to the schedule.
That Schedule 0 attached hereto and made part hereof sets forth the names and addresses of all
persons beneficially interested in this estate at the time of decedent's death,the nature of their res-
pective interests,their relationship,if any,to the decedent,together with the ages at the time of
decedent's death of all minors,annuitants and beneficiaries for life under decedent's Will.It also
contains a statement shoWing which of the beneficiaries named in the decedent's will,if any,died prior
to decedent,the dates of their death,their issue,andthe relationship of such issue to the beneficiary.
That Schedule E attached hereto and made a part hereof sets forth all property,real and per-
sonal,owned by the decedent jointly with another or others,including intangible,standing in the name
of the decedent and others,plus the date and place of record of instruments effecting the vestiture of
real estate and the date of acquisition of personalty,plus the name,address and relationship,if any,
of co-owners to the decedent.
That Schedule F attached hereto and made a part hereof sets forth fully and in detail all debts
and deductions claimed for and on behalf of this 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 be paid;cost expended for burial trusts,tombstones or gravemarkers,and reli-
gious services,in consequence of the death of the decedent;debts and claims owing and Ilnpaid 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);together with a statement of collateral pledged for obliga-
tions,if any.It is agreed that the fiduciary will present proof of said claimed obligations upon re-
quest,that if the amount actually paid in settlement of any fee,commission or debt is less than the
estimated amount claiming and allowed,that the same will be reported to the Register of WillS,and that
the amount of tax assessed can be reassessed in accordance thereWith.
That the totals of the appropriate columns in Schedules "A","B","e","E",and "F"as directed therein,·
have been carried forward and properly registered in the Summary.
Subscribed and sworn to before me this .........~-::.=day of .~19 7..9...
0~·~~~..t!I~..~lOUISE L CARSON,NOTARY PUBLIC
WASHINGTON,WASHINGTON CO.,PA.
MY COMMISSION EXPIRES SEPT.15,1973
.~"~-~-__---(ExeCt£tor-"~tmk
...R..p.•••••P...P.••••••J:..
(Street Number)
Marianna Pa.15345..~..
(City (Yf'Town and State)
NOTE:Before signing affidavit make sure all blank spaces in the affidavit and schedules annexed are
filled in with details or the word "None",and in case the assets include rare and unlisted securities,
securities of close or family corporations or an interest in any co-partnership or business,that the
data and statements required under the paragraph above relating to Schedule "B"are attached..Also make
certain that column #1 in the "Summary"has been properly con~leted as above-directed.
'-•u
,.
RCC-34'(1-64)"
COMMONWEALTH OF PENNSYLVANIA
DEPARTME~,TOF REVENUE
BUREAU OF COUNTY COLLECTIONS
TRANSFER INHERITANCE TAX
RESIDENT DECEpENT
SCHEDULE "A"
REAL PROPERTY
Real property in Pennsylvania,with statement of mortgage encumbrances upon each parcel at death of dece-
dent.Where property held as joint tenant or tenancy by entireties,report on Schedule "E".Property held by
the decedent 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 (1 )(2)(3)
described by lot and block number,street and street number,together wi th DEPARTMENTageneraldescriptionoftheproperty,with a reference to the record of the ASSESSED VALUE VALUATION
conveyance by which the decedent took title;If a farm state number of 0-FOR YEAR OF ESTIMATED CAUTIONcres;also statement of mortgage encumbrances upon each parcel at death DECEDENT'S MARKET VALUE (Do not writeofdecedent.Taxes,assessments,accrued Interest on mortgages,etc.,are DEATH In this space)to be listed on Schedule "F"and must not be deducted from this schedule.
None
..
Insert this total opposite "real property",Schedule "A"in the X X X X X
"As Reported"column on the last page of this return.
None
RCC"35·
COMMONWEALTH OF PENNSYLVANIA
T·RANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "B"
PERSONAL PROPERTY
INSTRUCTIONS:This Schedule must disclose all tangible and intangible personal property owned individually
by the decedent,at the time of his death.Property owned by the decedent jointly with another or others
must be listed under Schedule "E".Inta~gible personal property,titled in the name of the decedent,but
payable at death to another or others,including but not limited to P.O.D.U.S.Savings Bonds and tenta-
tive trust accounts,must be listed,despite the fact that they are not of the administered estate.
Tangible personal property should be listed first (e.g.jewelry,wearing apparel,household
goods,and furnishings,books,paintings,automobiles,boats,etc.)
Intangible personal property,such as bonds,treasury certificates,cash on hand and in bank,..
stocks,'mortgages,notes,together with accrued interest or dividends,salaries or wages,insurance pay-
able to the estate or fiduciary in said capacity,partnership interests,interest in anyundistributed
estate or 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
UNIT
VALUE
ESTIMATED
MARKET VALUE
DEPARTMENT VALUATION
(Do not write in
this space)
Savings Account No.S-2253,First
Federal Savings and Loan Associatmon of
Washington
Savings Account No.61-64,Mellon National
Bank and Trust Company
$13,055.48 ....I 3J O~.6~,i-Ji~»0~~Ws-3,571.05 ~
Insert this total opposite "Personal Property",Schedule "B"in
the "As Reported"column on the last page of this return.
x X ~16,626.53
".rcc-%
comfbNl\TIALTH OF PENNSYLVANIA
T~\NSFER INHERITANCE TAX
~~SIDENT DECEDENT
SCHEDULE "c"
TRA.NSFERS
(1)Did decedent,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)~
(2)Did decedent,within two years of death,transfer property from himself to himself and another or
others (including a spouse)in joint ownership?(Answer yes or no)No
(3)If the answer to (1)or (2)above is in the affirmative state:
(a)Age of decedent at time of transfer _
(b)State of decedent's health at time of making the transfer.(Note 1).
(c)Cause of decedent's death.(Note 1).
(4)Did decedent,in his lifetime,make any transfer of property 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 or his
estate or be subject to his power of disposition?(Answer yes·or no)~Nun~·_
(b)What was the transferee's age at time 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?
(Answer yes or no)~N~o~_
(b)The right to designate the persons who s~possess or enjoy the property transferred or
income therefrom?(Answer yes or no)_
(6)If the answer 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)-AN~Q~._
(8)Did decedent,at any time,transfer property,the beneficial enjoyment of which was subject to change,
because of a reserved power to alter,amend,or revoke,or which cOllld revert to decedent under terms
of transfer or by operation of law?(Answer yes or no)-..::N;.:..o=--_
(9)If the answer to (8)above is in the affirmative,was the power to alter,amend,or revoke the inter-
est of the beneficiary reserved in th~decedent alone or the decedent and others?
(Answer yes or no)~
NOTE 1:The answers to these questions should be supported 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 forth below a description of the property
transferred,it's fair market value at date of death,dates of transfers and to whom transferred,with
relationship of transferees to decedent,if any. Submit copy of any trust deed or instrument,if trans-
fers are claimed to.~e 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
I'
:\
t.
DESCRIPTION MARKET VALUE
(Estimated)DEPT.VALUATION
(Dept.Only)
Insert this total opposite "Transfers",Schedule "C"in the
"As Reported"colunm on the last page of this return.
--------------_._-----------------
"I •
ReG-38
..
C'CMMONWEALTH OF PENNSYLVANIA
Tl1ANSFEH INHERITANCE TAX
PillSIDENT DECEDENT
SCHEDULE "E"
JOINTLY OWNED PROPERTY
INSTRrCTIONS:This schedule must disclose all property,real and personal,owned by the decedent jointly
wi th another or others,including intangibles,standing in the name of the decedent and others.List
real estate first,as entireties,or joint tenants,giving brief description,as indicated 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-awners to
the decedent.
Description of Property,Date of Acquisiti~n,Name I unit
Address and Relationship of Co-Owners,and Place I Value
of Record of Instrument,where Real Estate.!
None
percentage
Share
Estate
Valuation
DEPARTMENT VALUATION
CAUTION-Do not Write
In This Space.
Value of Value of
Entire Decedent's
Property Interest
Insert this total opposite "Jointly Owned Property",Schedule"E"
in the "As Reported"column on the last page of this return.None
--r':..,
.....••v.
~ec~37 <(i2~63)
nnDt~)~\\'EAl<Tll OF Pl'::"::,\SVYl.ANIA
TR ..\NSFER 1"'l\EHITA~l'E TAX
RESIDENT DEL'EDENT
SCHEDULE "D"
BENEFICIARIES
.......
\
h
-
BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED(If step-children or DATE INTEREST OFStatefullnamesandaddressesofallwhoillegitimatechildrenDECEDENTOFBENEFICIARY
ave an interest,vested,contingent or other-are involved,set STATE YES IN ESTATE
wise,in estate)forth this fact)OR NO BIRTH
Samuel H.Smith Husband Yes See Will
Nellie Mae Smith ~aughter-in-l~w Yes ~<:><:>Will
Merle Floyd Smith,Jr.Grandchild Yes See Will
Donna Mae Mercante Grandchild VA~See Will
Donald Wayne Smith Grandchild Yes See Will
....Jo ••Lnt:e real
1..."'-I1A Yes See Will._"'.....:l
Anthonv Wavne Mercante reat
.L "lA Yes See Will....'"
Connie .Tn Rmi 1:h rea .h-l1A Yes RAA Will
,1 n",...i A ~....;+h
rea .••1 rl VA~See Will........'"
Wayne Allen Smith 'rea Yes.•.•.i 1rl See Will
MerlA 1i'Rmi't.h Son Yes ~<:><:>Will
RiO'h1"'nA on ......_~C'.NnnA ~<:><:>W.;11
North Ten Mile Cemetery None CI~~tIT·"----
-
.
-
-
,~_....
Deponent further says that all the above-named beneficiaries are living at this time except below:None
NAME DATE OF DEATH RESIDENCE
OF THE
ESTATE OF
~IATTER OF THE APPRAISEMENT
Late of .West:ElE:!1;ll::I.~1:l~11l 'I'~\'Il1s;I:li:-l'
(...
~~~~o ~..,~....~~--;:s ....,:l
rt-~~~
•C/')-0a-a '0'<"'d Cl>·..,..,
i .g ~
·Cl>..,
1:1 ....~'<
~
~a~mH
rl~
>-l~x~c:r'~
Cl..,o'"'"
t%j
'"....~....Cl>
(Executor-Administrator
must complete "As
Reported"column #1.)
1
Year
..I,.UCY Y •...SMl'nl
Deceased
~THE
Will (N
Administration ~o.
,
\\'I
~
'.\,
.'
County of Washi,l1gt(>n
Commonwealth of Pennsylvania
REPORT AND APPRAISAL
'Yd ··~O NOIQNIHSVA'~l?l,h~,.::IO l-3:31 SI~3U
ONid·,'}t;'-;,ron~.SAMUEL GOLDFARB Ii:',.)~I!tl
ATTORNEY AT LAW
514 Washin.!o'Jl~ust B~9~.
Washington,Pa.1fJ30Jl/IJ OL4
~'>&;1 '.:J .'J i I\iJ ...I f:!W;.l• •.~~l
rJ'lc:~,...~
:rJ)>
:(').~'=-'~~c:;;to<..(';)()()·?"?"?"
:~~~~-'"......·v'-
-~~~--~i-'Q').1 1 d)--I I..1 >d).en I'"
l\)l\:)~-----en m.g.-
~•0--
C1l (11::4-
tI)(,IJ B..
~~~---
~~:~.~~._'(1 'Ji
II •..,tJ&-~~-SO ..9J r::tv
...,~
lS':fi'~...~0,t,r::....c..U,\
RCC-81 (2-64)
COMMONWEALTH OF PENNSYL VANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
INHERITANCE TAX DIVISION
NOTICE OF FILING OF APPRAISEMENT
:Merle F.Smith
(Executor~.·
IN YOUR REPLY PLEAIE
REFER TO
38-80-7
...J
In Re:Estate 0 f __.==L~U>l=:c.1-Y_V~,.......,.JS~IIlJ.!!!=!o..·tl.!.!hl.L-_
_____W~a::..:s:.:h=ing=.::.t.::.:on:.:_County - FHe No.63-70-612
Dear Mr.Smith::
You are hereby notified that the~~_o_r-i~g~in--a-l-----------------
appraisement in the estate of L_u_c~y__V_.__S_IIlJ._·_t_h _
has been filed in the office of the Register of Wills qf ¥~8hingtQR
County on October 27 ,19~.Said appraisement reflects the
following valuations:
Re alEstate _--'--..,.-..,.-..,._
Personal Property ~1~6~,~6~2~6~.~5~3~__
Transfers -::'""O....-.,~..__.:=_----
Tota1 --.,..----=1::.:6:..z,-=6::.26=..:.::...::5~3~--
As to such tax that is paid within three
death,a five (5%)percent discount is allowable.
remains unpaid after one year from date of death,
of six (8%)percent per annum is charged.
months from date of
As to any tax that
interest at the rate
Any party in interest who is aggrieved by an appraisement may
appeal therefrom as provided by law.
Dat e .>.<Q....c""t.....o...b...e....r---""2o-1-7..,.,--.]....97~0:..--------
DATE OF DEATH:May 17,1970
Note:This is not a bill.
Signed tel'(!'e£.au4f ,AU1/L-4.
Title W.R.Chaney,Chief Appraiser
"1CC-39 (!5-68)
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERiTANCE TAX
RESIDENT DECEDENT
.SUMMARY
Estate of Sudth
(Last Name)
I,llCy
(First Name)
V.
(Initial)
DATE OF DEATH.5-1~7--!..7-=-O__FILE NO.63-70-612·
REPORT OF INHERITANCE TAX APPRAISER
I,the undersigned duly appointed Inheritance Tax Appraiser in and for the County of__W_a_s_h_i_ng-=-.t_o_n _
Pennsylvania,do respectfully report that I have appraised the real and personal property as reported in the foregoing return at
the values set forth opposite each item in the last column to the right in Schedules "A","B","C",and "E".
Dated:_--==O~c~t~ob~e~r~2~7~,-::!=.1.L97L:O~-_
REPORT OF THE REGISTER OF WILLS
I,the undersigned duly elected Register of Wills in and for County,Pennsylvania,do respect-
fully report that I have allowed deductions in the amounts claimed by deponent,except as to those items where a greater or
lesser amount is set forth in the last column to the right in Schedule "F",which greater or lesser amount represents the sum
allowed as a deduction.
Dated:_
REGISTER OF WILLS
VALUE AS REAPPRAISED
$-------+--16 626 .~
16.626 53
$
16&626 £)1
16.626 53
VALUE AS REPORTED VALUE AS APPRAISED
$
JNVENTORY
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 $-1__2%
Tax on $-1__@;)
Tax on $5%
Thxoo$lK
Tax on $15%
Exemptions *
Total Estate -+-__
TOTAL TAX
COMPUTATION OF TAX
$-------4--
$--------l--
$--------l--
$-------4--
$--------1--
$---1.__
(*)As evidenced by Charitable
Exemption Certificates issued
by the Secretary of Revenue.
Less tax previously paid
BALANCE
Less 5%of tax if paid within
3 months after death ::::::::::::::t===
BALANCE OF INHERITANCE TAX DUE $t=
Add interest at rate of 6%fro~
_____to $---------1
AMOUNT OF ESTATE TAX ASSESSED $----~L-
Estate tax paid $--Il-
BALANCE DUE $---JI_
Add interest at rate of 6%from
------Ito-----$--------It=TOTAL TAX BALANCE $-------i.
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
Administration f No.
IN THE
Year .
t
J
MATTER OF THE APPRAISEMENT
OF THE
.ESTATE OF
.I.llC:Y.Y.8mith
Deceased
Late of ...WestB¢:tl1:L~l1~J1l.1'()VoJ!1:3.h.~p........
County of ,vfa.sl1:4J.g'fj()l1.
Commonwealth of Pennsylvania
REPORT AND APPRAISAL
."
.fI;'.....,
Fonn RCC-2
..D8PAR'FMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
HARRISBURG.PENNA.17 127
COMMONWEALTH OF PENNSYLVANIAP··._.__,......__..
RESIDENT INHERITANCE TAX
APPRAISEMENT
DATE .9.<::~g?~~?.7.?.~?.?..9..
COUNTY Wa.shingt.on..
FILE NO•..........?;3,.:.?g:.?~.".
Whereas,~':l.~.y..Y.~ell.9.:~.h late of .Y{~.f?t.F3.~.t.h.J"E?b.~m r..9.w.n.~b.ip .
in the County of ~!~.~~.~.~.?~Commonwealth of Pennsylvania,having died on
the 1.7t.h day of IV'lay UnO ,seized and possessed of an estate
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore,I,!.~~.~..~.~.~.~.~,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.
Personal Property:
Description of Asset Unit
Values
$
Appraisement
Made for Inheritance
Tax Purposes
_____--'='S.>.<e....e.....;s""'c......b""'e""'d.....u....l,.,.e'--lI""'B.....;lI.....;a....t~t,...a"'"'c"""h...,e""'d>....._"t:..:::o,-=a,p:.pJ;<:.pr:..:a=J.S=·:..::e~~m=e=n=t -+---fl__16,626 53
Total 16,626 3
~avi~g been duly ~worn according to law,I do hereby cert~_:ha.!-the abo~e appraisement is made in ~on-
forrnlty WIth law on thIS O?.'}~day of ~~_" ":;i9ZO'.
.........t.(j"..e e~U(y....~,,{~~~~,.
2()~~:'.;::.
................WC3.-Elh:i,p,gt.9.l:l:......County
RESIDENT INHERITANCE TAX APPRAISEMENT
Estate of
.....:L.1,lCly y ~.~~.l1:.
Deceased.
Late of
.......................\'l.e.$.t ;e ~t..hJ...~h~r.n.'I.'.9.~.s..f.1.:i::P .
Date of Death,5..~~7~7.9..
Appraisemel!t Docket Vol.,.3.8..
Page,.J~.~7 No .63~.7~.6J2 .
Filed in Register's Office,Q.Qt..•....27.:.19...7Q.
Amount of tax due,$.
DEPARTMENT OF REVENUE
Received,
Examined and Approved,.
Wrote abo.ut Appraisement,
Appeal f1'om Appraisement,.
Entered and charged,.
~
,,~~
AND AGENT OF THE COMMONWEALTH
DEDUCTIONS ALLOWED INFormRCC',let ..
OFFICE OF THE
REGISTER OF WILLS.
OF WASHINGTON COUNTY
".&J -70-&Iv
STATEMENT OF DEBTS
AND DEDUCTIONS
J
,7Cj~'f~~d
THE SUM OF $..
D.,.Q~~;_:~?l
Regist.r of Wills,Agen~,
ESTATE OF LUCY V.SMITH LATE OF West Bethlehem Township /I
i
DATE OF FILING APPRAISEMENT _J_u_l~y_6--',!..-_1_9_7_0__DATs:OF DEATH __M..;",a;.!!,y_1_7~,_1.:....9_7_0 _
DATE NO.OF NAME OF PAYEE REMARKS AMOUNTVOUCH';"
Letters Testamentary and
Register of Wills Short Certificate 20 50
Washington County Reports Advertisement Letters 14 00
Observer Publishing CO.Advertisement Letters 14 00
Register of Wills Filing Inventory 3 00
Re~ister of Wills Filing Election Under Will 2 50
Register of Wills Short Certificate 1 00
John H.Shrontz Funeral 1,316 00
Quinet Monument Company Stone lettering 20 00
Robert C.Gordon Ambulance 15 00
Washington Hospital Account 13 50
Washington OrthopedicAssociates Services 85 00
Doctor C.J.Tripoli Services 24 00
Doctor M.W.Graham Services 38 20
Samuel H.Smith Family Exemption 1,500 00
Notary 6 00
Samuel Goldfarb Attorney for estate 830.00
Re~ister of Wills Filing Account 15 00a.A ...[£'111 .A ~/;:J~~",..J~A<77 s~-
I
r---;---t---+----------------+----------------4-----+---
COMMONWEALTH OF PENNSYLVANIA }
COUNTY OF _..:.:.W.:.:A:..:;:S;;;;H:.::I:.::N:..:..G:::.T=O.=.:N~____S8:
I,MerJe F.Smith,Executor-HEREBY CERTIFY.THAT.TO THE BEaT OF
MY KNOWLEDGE AND BELIEF,THE FOREGOING IS A JUST AND TRU E srATEMENT OF DEBTS,FUNERAL EXPENSES AND EXPENSES OF
ADMINISTRATION SUBMITTED TO THE ESTATE OF Lucy V.Smj th .DECEASED.AS DEDUCTIONS FOR
INHERITANCE TAX PURPOSES.Cht;...~,..~
SWORN AND SUBSCRIBED BEFORE ME THIS 20th DAY OP'M jp 7>A-4oC (L.S.)
~_'JaC2~,e Z!-
_'<-&-1'R l -----.:...~~
LOUISE L.CARSON,NOTARY PUBLIC
WASHiNGTON,WAShi;:GTOI·J CO.,PA.
MY COMMISSiON EXPIRES SEPT.15,1973
'"01"......_..-....:•~.;::,-»f77".:t::;0:l C)c:c.....~.:Z:0,.::1':::10 ,t.(,I)Co'):t="Z -I !'T!r-o,,)t;-')~.....,),,t'..
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RCC-3 (1-69)
"
COMMONWEALTH OF PENNSYLVANIA..,,,,.
DEPlIRTMENT OF REVENUE
BU~EAU OF COUNTY CO!-LECTIONS ,
APPLICATION FOR CHARITABL E EXEMPTION
FROM PENNSYLVANIA TRANSFER INHERITANCE TAX
(Act of M~28,1~56,P.L.1757,and Ac~of June.l5,1961,
.:;p,.L.37.3,,a,s,al11el'ldep)0,._•
j
Application is hereby filed for the approval
01 an exemption from Pennsylvania Transfer
Inheritance Tax on the transfer of'theproperty
described below:
1.Bureau File #6_3_-_7_0_-_6_1_2 _
2.Date of Death --M.l!Y.17 /-1970
'-
3.Dateo,f AI'pro'o!!;I1 ---;-:-.:-F'7'C'e,.....b_r:-uTa_r_y__1_1_t:-h~•...,.-1_9_7-;-,1_
4.Name of Decedent 'Lucy V.'Smith
5.The Commonwealth's appraised value of the property for which an exemption is claimed is $_3_0_0__._0_0 _
(Note:Where the property is othenhanaspecified amount of cash;the exemption carinot be approved until the value of
the property has been established by appraisal by the Commonwealth,except in those cases where the amount of the gift
or b'equest represents a stated fractional or percentage portion of the entire est~t~or the ~~ti~e ;esidue.In those 'case~
enter such fractional or percenta~amount above).
6.Check the manner in which the transfer was effected and submit a copy of the document authorizing the transfer,unles~
such material has~;~e.~~~~e~-io~sl),fi,led.'_.':''''(":,"I ••i
WILL Xl;DEED 0;TRUST INDENTURE 0;SURV'IVORSHIP 0;OTHER 0;
(If other,explain)----'-_
7.Correct Business Name and Address of Choritable Organization receiving property:
NAME _~_~N_o_r_t_h_T_e_u_M_1._·1_e_C_e_m_e_t_e_r.:_y __'___
ADDRESS __...-:R:..:....:....._D----=-,_1~,_A_m_l._·t--.:y~,_P_a_.~1_5_3_11 _
8.I certify that the information contained herein is,to the best of my knowledge and belief,true and correct.
Executor of the Estate of
Official Title Lucy V,Smith,deceased Date J_a_u_u_a_r_y_1_4_,_1_9_'1_1__
This form must be completed in tripiicote ond 011 three copies delivered to the Register of Wills for the County in which the decedent
resided,or in which letters were issued for a non-resident decedent's estate.If the decedent was a non-resident of Pennsylvania and
letters were not issued by a Pennsylvania Register of Wills,deliver all three copies to the Director,Bureau of County Collections,
Penna.Department of Revenue,26 S.4th Street,Harrisburg,Po.
Do not write below this line·For Official Use OnlyAP"'2 Fo'the Smete,y of Reve••e Referred to Bureau Headquarters Approved 0
~~For Secretary of Revenue
1/J "AI Denied*0
I
(Signature of Register of Wills)(Initials of Register of Wills)(Authorized Signature)
Washington
(County)(County)(Title)
February 11th.1971
(Date of Approval)(Date of Referral)(Date of Action)
*See reverse side for reasons
MUST BE FILED IN TRIPLICATE
,
This section will be compl eted by Bureau Headguartersonly when the application for exemption has been denied.
Date:__~_
r r.r . .
The application for exemption contained on the face of this form has been denied because _
Note:Any party in interest,including the Commonwealth,aggrieved by this action may within sixty (60)days after
the date of this notice exercise their rights of Protest,Notice,or Appeal in accordance with the provisions of applicable
Pennsylvania Inheritance and Estate Tax Acts.
I
l
APPLICATION FOR CHARITABLE EXEMPTION
FROM PENNSYLVANIA TRANSFER INHERITANCE TAX
(Act of May 28,1956,P.L.1757,and Act of Jun~15,1961,
...P,.L.;3T3,as amended),
RCC-3 (1-69)
COMMONWEALTH OF PENNSYLVANIAD~f"A1rTMENTOF REVENUE
BU~'EAU OF COUNTY COLLECTIONS,
Application is hereby filed for the approval
of an exemption from Pennsylvania Transfer
Inheritance Tax on·thetransfer-of the property
described below:
1.Bureau Fi Ie #---'lYcA.p..'_J__...:!7_=U_-__U__I_.2-_
2.Date of Death .,17#--l9fuO'-------~~-
.3.,Date of Approval February 11th.1971
4.Name of Decedent
5.The Commonwealth's appraised value of the property for which an exemption is claimed is $8Q(hOO ....
(Note:Where the property is other thana specified amount of cash,the exemption cannot be approved unti I the value of
the property has been established by appraisal by the Commonwealth,except in those cases where 'the amount of the gift
orbequesf represents a stated fractional or percentage portion of the entire estat~or the entire residue.In those cases
enter such fractional or percentage amount above).
6.Check .the manner in which the transfer was effected and submit a copyofthr d.ocument authorizing the transfer,unless
such inateriafhas be~n'p~~viously'filed""..'.....,...."':......\'......'...,.,.....','.'
/:.I.:..~,.-."<.;.j,'~v,',''<~i?
DEED 0;TRUST INDENTURE 0;
..
OTHER 0;
(If other,explain)_._
7.Correct Business Name and Address of Charitable Organization receivin!tl property:
NAME __H-'.l-",S:-.b_la_1'l_d_B_I"_o_th_"_·_u_Ch_·Ul"C_,_·_11 _
ADDRESS__B_i_D_.·_.,_1_,_·_Ma_._r_laD__Da__,,_,_Pa__._l_S_a_4_6 ~_
8.I certify that the information contained herein is,to the best of my knowledge and belief,true and correct.
Address of Applicant B.Di 1.Marlaana,Pa.
hecutor of 'the Estate of
Official Title LucY V•smith,deceased
15345
This form must be completed in triplicate ond all three copies delivered to the Register of Wills for the Couhty in which the decedent
resided,or in which letters were issued for 0 non-resident decedent's estote.If the decedent was a non-resident of Pennsylvania and
letters were not issued by a Pennsylvania Register of Wills,deliver all three copies to the Director,Bureau of County Collections,
Penna.Department of Revenue,26 S.4th Street,Harrisburg,Po.
Do not write below this line -For Offrcial Use Only
~;;;~e""e Referred to Bureau Headquarters Approved 0
For Secretary of Revenue
Denied*0
•
(Signature of Register of Wills)(Initials of Register of Wills)(Authorized Si gnature)
Washington
(County)(County)(Title)
February 11th.1971
(Date of Approval)(Date of Referral)(Date of Action)
*See reverse side for reasons
MUST BE FILED IN TRIPLICATE
.-
This section will be compl eted by Bureau Headquarters only when the application for exemption has been denied.
Date:_
r -,-
The application for exemption contained on the face of this form has been denied because ...;..;._
Note:Any party in interest,including the CC)mmonwealth,aggrieved by this action may within sixty (60)days after
the date of this notice exercise their rights of Protest,Notice,or Appeal in accordance with the provisions of applicable
Pennsylvania Inheritance and Estate Tax Acts.