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HomeMy WebLinkAboutOC1970-0921 - ESTATE OF GEORGE,.. R CC-B\(2-64) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS INHERITANCE TAX DIVISION NOTICE OF FILING OF APPRAISEMENT .. HENRY W.GEORGE Ird'onnant IN YOUR REPLY PLEAGE REFER TO J In Re:Estate of MARGARET R.GEORGE WASHINGTON County -File No.63.70.921 De ar 11.-•George: You are hereby notified that the orisinal appraisement in the estate of Mal'garOt R.GOarse has been filed in the office of the Register of Wills qf WatJhin6ton County on SeptGmber 2$,19.7.0.Said appraisement reflects'the follOWing valuations: Real Estate Jt.Hold..=~.~6,413.75 Transfers . Total __-_-_-_--'-_-...:.-_-_-_-_-....,;-----...:....6;.L.-4;1;;:31S"·;.~7;S:.....-_-= As to such tax that is paid wi thin three months·.from date of death,a five (5%)percent discount is allowable.As to any tax that· remains unpaid after one year from date of death,interest at the rate of six.(6%)percent per annum is charged• .Any party in interest who is aggrieved by an appraisement may appeal therefrom as provided by law. Date _--=S~es.p..:.to=mh=.··=o=r...:...::2=5~,-=1!!!.!9L.l7i...l!!O~·_ DATE OF DBATR: Note:This is not a bill. June 20,1970 \>'..ct R'cC-39 (5-68)- COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SUMMARY Estate of GEORGE, (Last Name) MARGARET R. (Firs t Name)(Initial) DATE OF DEATH--..:6=---=2::....:0:.....---=7c...::0=--FILE NO.63-70-921 REPORT OF INHERITANCE TAX APPRAISER I,the undersigned duly appointed Inheritance Tax Appraiser in and for the County of Washington Pennsylvania,do respectfully report that I have appraised the real and personal property as reported in the foregoing return at the values set forth opposite each itern in the last column to the right in Schedules "A","B","C",and "E". Dated:__-=.9_--=2~5_--=-7...=O:....-_ \ REPORT OF THE REGISTER OF WILLS I,the undersigned duly elected Register of Wills in and for lV'ashington County,Pennsylvania,do respect- fully report that I have allowed deductions in the amounts claimed by deponent,except as to those items where a greater or lesser amount is set forth in the last column to the right in Schedule "F",which greater or lesser amount represents the sum allowed.,a dedoellon.?' Dated:9-25-70 ~~ REGISTER OF WILLS 6.413 75 6,413 75 1 517 20 4.896 Iss h A1 ~71:\ 6,413 75 1 517 20 4,896 55 VALUE AS REPORTED VALUE AS APPRAISED VALUE AS REAPPRAISED $$$-------+-- INVENTORY Real Property (Schedule A) Personal Property (Schedule B) Transfers (Schedule C) Joint-Held Property (Schedule E) TOTAL GROSS ASSETS Less Debts and Deductions (SCHEDULE F) CLEAR VALUE OF ESTATE Valuation of life estates or FOR USE OF REGISTER ONLY Tax on $........---=-:~__=;_:::_ Tax on $---'-4~·•..".8,-,=9~IE~5::.;5~ Tax on $---------4-- Tax on $---------4-- Tax on $---------4-- Exemptions========I==Total Estate --'-__ TOTAL TAX 2% 60h 5% 10% 15% * COMPUTATION OF TAX $--------,:-----4--$..6!.?:..z.Q,.>L...j..~17J..."qoz___ $--------4--- $-------l--- $-------l--- $----l.__ (*)As evidenced by Charitable Exemption Certificates issued by the Secretary of Revenue. Less tax previously paid BALANCE Less 5%of tax if paid within 3 months after death ::::::::::::::t=== BALANCE OF INHERITANCE TAX DUE $L Add interest at rate of 6%from_____to $--.J AMOUNT OF ESTATE TAX ASSESSED $-------.11- Estate tax paid $--JL-. BALANCE DUE $-----~~ Add interest at rate of 6%from t= ------I:to-----$-----~. TOTAL TAX BALANCE $-------<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 (...No.Admlmstration IN THE Year . --------------- MATTER OF THE APPRAISEMENT OF THE ..... ESTATE OF I MARGARET R.GEORGE..~. Deceased Late of ..McDONALD County of \"ASHINGTON Commonwealth of Pennsylvania REPORT AND APPRAISAL ,,~. ...... Fonn RCC-2 •~EP~TM~T OF REVENUE.• BUBE.4.U OF"COUNTY COLLECTIONS HARRISBURG.PENNA.17 127 COMMONWEALTH OF PENNSYLVANIA RESIDENT INHERITANCE TAX APPRAISEMENT ~~ DATE $..~p..t~~p..~.r...,?~..,J..~!.9.. .....1 '"• COUNTY \v.ashingt.o.n . FILE NO §..~.:..7..Q.:.~..?.!. Whereas,Ma.rgar.e.t R G.e.o..r.ge late of M.9.P..9.n.~.l.4 . in the County of Jv.a$..b.i.,P.,g..t.Q.n Commonwealth of Pennsylvania,having died on the ~.O t..h.day of ~.~.~~19 7.9,seized and possessed of an estate subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore,I,W.•.R.Cha.n.e.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 fi.."{ 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. De.cr/ptlon of Allet JT.HELD: See conv of Schedule "E"attached to appraisement Total Unit Value. $ Apprai.ement Made for Inheritance Tax Purpole. 6,413 75 6.413 75 ..WASHINGTON ..County ...... RESIDENT INHERITANCE TAX APPRAISEMENT Estate of MARGARET A.GEORGE Deceased. Late of McDONALD Date of Death,~.1:J:J.l:.~~~..'~.~.70 Appraisemel!t Docket Vol.~r""""""""""'" Page,./9.-!-:{~~·.···.::::~~:;:?:Q;:;:i.i:· Filed in Register's Office,~~.P~..~~.?.L.J9 ..?..9 Amount of tax due,$. DEPARTMENT OF REVENUE Received, Examined and Approved,. Wrote abo.!It Appra.isement, Appeal ft'Om Appraisement,. Entered and charged,. ---., '4l . • --... Form RCC-33 RESIDENT DECEDENT C:OMMONWEAlTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS COUNTY OF J ..WASHTIiGT.ON . 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 Inheritance and Estate Tax Act of 1961.) ......................}~::;;::~.~;::;:~~~~.~.O~};:::u:v~:OF (State full name of decedent)• Late of WASHINGTON . .County ADMINISTRATOR ..................................................................................Exeeutor Administrator state of PENUSYLVANIA } ss: County of WASHING.TON . .................HENRY.i'L GEORGE , of the estate of the above-named decedent being duly sworn,depose and say HENRYW.GEORGE .12 PROSPECT AVE INDIANHEAD,MD;;'20640 Decedent dJed ..............20 ...JUNE. (Month) Name and address of attorney or} other authorized representative to whom all correspondence should be mailed. ..........•19.70..1 testate leaving a last will,copy of which is hereto attached.} (Uay)(Y~ar)Lintestate That as such ~.x.~.QV..'r..QR deponent is familiar with the affairs of said estate and the property con- (Ex"cutor·Administrator) 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 or deputy of another,or in decedent's individual name,with right of access by another as agent or deputy,with the exception of the following:- NAME AND ADDRESS OF BANK OR OTHER INSTITUTION THIS SAFE DEPOSIT BOX RENTED RELATIONSHIP OF JOIN~ IN WHICH DECEDENT RENTED A SAFE DEPOSIT BOX IN NAME OR NAMES OF HOLDERS TO DECEDENT NO'N"R 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 attached hereto and made part hereof sets forth fully and ~n detail all the real property in the Commonweal th of Pennsylvania of which decedent died having an inte'rest therein.It also sets forth the mortgage encumbrances 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 made part hereof sets forth fully and in detail allpersonal 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 other institutions,whether indiVidually,or in 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 d&te of decedent's death in all other cases;all bonds,postal savings,treasury certificates or notes and other evidence of in- debtedness of the United States to the decedent;all obligations,whether by statute or agreement they are designated as tax free,of the United States,or any state,or political subdivision thereof,or of any foreign country,which are owned at the time of death;all wearing apparel,jewelry,silverware,pic- tures,books,works of art,household furniture,horses,carriages,automobiles,boats,and any and all other personal chattels of whatsoever kind or nature,leftbydecedent,together with the fairly estimated market value thereof;all bonds and mortgages 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 polici"es 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,bo~ds 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 ca!;ie 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 ousiness 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 COllY of the deed,trust agreement or other instrument creating the trust.Ther.~is also set forth in said schedule a list of all property,real and personal,with its value,which pa~ses at decedent's death by virtue of the exercise by decedent,either individually,orjoint~y 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 D 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,and the 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 Impaid 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","en,"E",and "F"as directed therein, have been carried forward and properly registered in the Summary. Subscribed and sworn to before me this .. .~/..q .)!r:J..k~_. (Executor-Administrator) ........./..2··./?;.7.l(:.:;T{/~;b';;.T·········..·..···..··..···. ...........YJ>..d.-f..i;;q.<~t:i~e.:l2z.qf.2r:'.c;..Y.Q .. (City or 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 completed as above-directed. RCC-H 11-(14) COMMPNWeAl...TH OF PENNSYL;VANIA DePARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE uA" 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 hf'ld by the de.cedent 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 Commo!,wealth of Pennsylvania should be (1)(2)(3) described by lot and block number,str"i!et and street number,together with DI;PARTMENT a general description of the property,with a reference to the record of the ASSESSED VALUE VALUATION conveyance by which the decedent took title;If a farm state number of a-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 IOF"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. RCC-35 COMMONWEALTH OF PENNSYLVANL'~ TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "n" 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".Intangible 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 propl~rtY1 such as bonds,treasury certificates,cash on hand and in bank, stocks,mortgages,notes,together with 8.ccrued interest or dividends,salaries or wages,insurance pay- able to the estate or firluciary 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 tjmn of death,should be listed in this schedule.- Item ITEM UNIT ESTIMATED DEPARTMENT VALUATION No.List and describe f'1I1.l:'VALUE MARKITI'VALUE (Do not write in this space) NONE Insert this total opposite "Personal Property",Schedule "B"in X X the "As Reported"column on the last page of this return. RCC-38 COMMONWEALTH OF l'ENNSYLVANr'A TRANSFER INHERITANCE TAX... RESIDENT DECEDENT SCHEDULE "E" JOINTLY OWNED PROPERTY I NSTRl'CTIOJliS:This schedule must disclose all property,real and personal,owned by the decedent jointly with 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 under 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 ariy)of co-owners 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.I percentage Estate Share Valuation DEPARTMENT VALUATION CAUTION-Do not Write In This Space. Value of Value of Entire Decedent's Property Interest STOCK CERTIFICATES HELD IN JOINT ACCOUNT . MARGARET R.GEORGE HENRY W.GEORGE (SON) ·12 PROSPECT AVE INDIAN HEAD,MD.20640 UNION NATIONAL BANK OF PGH. 38 SHARES COMr>lON dated 11 Feb 1970 MESTA 11ACHINE COMPANY 100 SHARES C0M110N dated 23 Jan 1966 DIAMOND SHAMROCK CORP. 346 SHARES COI1MON dated IlFeb 1968 231 srL~ES PFD.1.20 t6 tJ ~~ 28!50%f!!1~~;.~,.,., 24 50%~t2~00.OC ~'~~'l oo.ot ~ 141 50%111501e.0.(/~~ ~.250 .5C 14\50%ft?244.5C~,'1622.2; , Insert this total opposite "Jointly Owned Property",Schedule"E"rJJ.2.:;S in the "As Reported"column on the last page of this return. Rcc-36 COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "c" TRA.N SFEIlS (1)Did decedent,within two years ofdeath,make any transfer of any material part of his estate,without receiving a valuable and adequate consideration therefor?(Answer yes or no)_N........O"--__ (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 hea.l 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 tha.t the property transferred might return to transferer or his estate or be subject to his power of disposition?(Answer yes or no)NO (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)NO (b)The right to designate the persons who shall possess or enjoy the property transferred or income therefrom?(Answer yes or no)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).....IlN~O'oJ---- (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 the 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 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) t I Insert this total opposite "Transfers",Schedule "C"in the "As Reported"column on the last page of this return. • t ~• RCC-37 (12-63) COMMONWEALTH OF PENNSYYLANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "D" BENEFICIARIES BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED(If step-children or DATE INTEREST OFStatefullnamesandaddressesofallwhoillegitimatechildrenDECEDENTOFBENEFICIARYaveaninterest,vested,contingent or other-are involved,set STATE YES IN ESTATE wise,in estate)forth this fact.)OR NO BIRTH HENRY W.GEORGE SON YES 20 JAN 1 L TOTAL ( h Deponent further says that all the above-named beneficiaries are living at this time except below: NAMENONE DATE OF DEATH RESIDENCE ·~. . (1) SUMMARY (As Reported) Real Property (Sch."A")$NONE.. Personal Property (Sch."B")$NON.E. Transfers (SCh."C")$NONE . c1l'iIn2..{t::r..:,J..??OP"~,]Zt·..·..·{.sc.!1 ..!l)$$•.812025· ..a;;t~l.'lt;.r.m op..')m?':",.'/~;:~:;1.:r":?1Jtr.O?.!O;;:9......................$,.(1..).,11020). Gross Taxable Estate ,........................................$.i.j;i'35~O$ (2) (Ali Determined) $,. $ . $d:·9/3~······ $,/2., $. $,6;~/3.7~ !• '0 .G. I;::::oU Form RCC·IO OFFICE OF TME REGISTER OF WILLS OF COUNTY COMMONWEALTH .. STATEMENT OF DEBTS AND DEDUCTIONS DEDUCTIONS ALLOWED IN J THE SUM OF ...:........$t?S/Z~9. om~.~~...~ Regi.ter of Wills,Age.t ESTATE OF MARGARET R.GEORGE LATE O~3jl~3 RAILROAD ST.MCDONAW,p!'.., DATE OF FILING APPRAISEMENT 12 SEPT 1(170 OATIi OF DEATH 20 .row 1910 DATE NO.OF NAM&:OF PAYEE REMARKS AMOUNTVOUCH"-" 6/2ll.r70 RALPH L.JOm~SO!i IT Hm lE l'oliTRTAT"(h"f 1,1:'':)"'n~".... f.../?h r70 ;:'?H!lT ~ii'f:rn:rrmq.;:t'C'mrT"',.."'1'\1l'\1'\1'1.'".N l.;ot'H',..I"... 7 /1./~0 \'1ESTERN pzm AUESTHFlSl'A ASSC C-t:tEDI CAr."'J(,J,on . " , - .'. TOTAL $1,511.20 COMMONWEALTH OF PENNSYLVANIA }sa:COUNTY OF ~lASHINGTmt I,HENRY W.Gri:QRG't!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 OP' ADMINISTRATION SUBMITTED TO THE EST",TE OF M~it.GEORGlS DECEASED,AS DEDUCTIONli FOR~BgAFtElT INHERITANCE TAX PURPOSES. ':MuClldd-y fL.5.1~ORN AbUBSCRIBED IlEFORE ME THIS \..,n DAY 01'~---;;;:C\.."".111 ~,.~'o..o-C.D...",C!_..J /'~...., Rcc-n (9-68) ,COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS APPLICATION FOR AND CONSENT TO TRANSFER SECURITIES REGISTERED IN THE NAME OF A RESIDENT DECEDENT )~ DATE 12 SO?1J:1910APPLICATION(MUST BE FILED IN TRIPLICATE) TO THE PENNSYLVANIA DEPARTMENT OF REVENUE: Application is hereby made for consent to the transfer of the following securities of a Pennsylvania Corporation or a National Banking Associalion located in Pennsylvania: (a}1OO snl\Rr:~(b)n~?i\r:gOHIrmCO.PGR.P1\..(c)co··~mr g700R (NOTE:In describing securities e'nter in (a),ab Ole,either the number of shares of stock or the face amount of registered bonds,in (b),the name of the issuing company and in (c)the class of stock or the stated interest rate and maturity date of registered bonds.) ISSUED ON 23 Jiln 1956 ,and having a TOTAL MARKET VAILUE OF $~2~J'&Q~...·~O~.t..:!!OO~··c--_ (Date) as of the date of death of the decedent,t1ARG:am ft..GOORGB (Name of Decedent) ,on-.:20==--.....::J=Ui=17=d~~=9~1~O~_ (Date of death) (County)(Street and Number) who was late of_1_L_:a.':-.M_·_I_L_:t_O_,"_')_Wl_~..:...._r~·!e~oo_·.·--=B~A....::.:L=-n ----.:·~-=I!l:::.:SR="::=X~tta::.::U'~·'RO..:::·=::.l1__~p~.l'.l:=trr=J=AW!:"t _ (State)(Post Office) ttl\F.G.'\Re1'n.G£Orl-GU The securities are registered as follows:~~~~·~~·~·~~_~~"_~_~~~_~~·~_~~J ~ (Name or names in which certificates are registered) A\it'Qf~~5 BPJ1fiY u.anoRa-au PRCS~fAVE.%1iDIJW 11&1.1),tID.206hO EXECUTOR}(Name)NAME OF APPLICANT HEttlli Ait;es6EOftGB COUNTY FILE NUMBER 63-70-921 ADDRESS OF APPLICANT ImIJilltm:J>,.t·::».20640 BUREAU FILE NUMBER Same SIGNATURE OF APPLICANT WahY;')~e2rf NOTICE:IF YOU FAIL TO PROPERLY FILL IN ANY PORTION OF THIS APPLICATION,IT WILL NOT BE CONSIDERED COMPLETE AND WILL BE RETURNED TO YOU FOR COMPLETION. COMMONWEALTH OF PENNSYLVANIA -DEPARTMENT OF REVENUE CONSENT TO TRANSFER SECURITIES _<:t tDAT~ep •12th.1970 I hereby consent to the transfer of the above securities now registered in the name of the aforesaid Decedent and waive the filing of a certificate certifying to the payment of the transfer inheritance tax to which the property of said Decedent is made subject pursuant to the provisions of the Act of June 20,1919,P.L.521, as amended and the Act of June 15,1961,P.L.373,as amended.This is also in accordance with the provisions of the Act of April 9,1929,P.L.343. This Consenf to Transfer the herein described property operates only in reference to the estate of the above-named Decedent. Washington or t e Secretary of RevenueBY-JJ-L~~~~~~~~::::'-''=''':"~ Regiat~Fa~T)Wills (Title)(County) Rcc-n (9-68) COMMONWEALTH OF PENNSYLVANIA DEPARTt,(ENT OF REVENUE BUREA,1.1.0F COUNTY COLLECTIONS APPLICATION FOR AND CONSENT TO TRANSFER SECURITIES REGISTERED IN THE NAME OF A RESIDENT DECEDENT DATE 12 SW:PT 1970APPLICATION(MUST BE FILED IN TRIPLICATE) TO THE PENNSYLVANIA DEPARTMENT OF REVENUE: Application is hereby made for consent to the transfer of the following securities of a Pennsylvania Corporation or a National Banking Associalion located in Pennsylvania: (a)38 SHARES (b)UNION UATIOllAL BANK OF PITTSBURGU (c}----v-OO...,.lffi4?''±\;!OffitTf------ (NOTE:In describing securities enter in (a),ab O/e,either the number of shares of stock or the face amount of registered bonds,in (b),the name of the issuing company and in (c)the class of stock or the stated interest rate and maturity date of registered bonds.) ISSUED ON 11 FEB 1970 ,and having a TOTAL MARKET VAILUE OF $......J~.,~O~B,;3-ftJ.O\,LlOoJ------- (Date) as of the date of death of the decedent,KARGARET R.GEORGE (Name of Decedent) ,on 20 JmlB 1970 (Date of death) PEtmA. (State) who was late of 143 RAILROAD sr..f.teDOllALD tfASHImTON (Street and Number)(Post Office)(County) )1ARGARE'r R.GEORGE The securities are registered as follows:~~~~~~~~'.~~~~~~~~~~~~~~~~~~~~~~~~~ (Name or names in which certificates are registered) HiX·iRtmAm)HSIlRY U.GEORGE 12 PROSPECT AVE.InDIAn READ,MD.206',0 EXECUTOR)(Name)(Address) 6~70 NAME OF APPLICANT HENRY H.GEORGE j--921 COUNTY FILE NUMBER t1~XJ{)FX«?JjI?ADDRESS OF APPLICANT INDIAN HEAD.MD.206!~Q BUREAU FILE NUMBER A~SIGNATURE OF APPLICANT 'ttO=CfZ'.')t/L$;L!/~ NOTICE:IF YOU FAIL TO PROPERLY FILL IN ANY PORTION OF THIS APPLICATION,IT WILL NOT BE CONSIDERED COMPLETE AND WILL BE RETURNED TO YOU FOR COMPLETION. COMMONWEALTH OF PENNSYLVANIA -DEPARTMENT OF REVEN CONSENT TO TRANSFER SECURITIES DAT~ept.12th.1970 I hereby consent to the transfer of the above securities now registered in the'name of the aforesaid., Decedent and waive the filing of a certificate ce;'tifying to the payment of the transfer inheritance tax to which the property of said Decedent is made subject plHsuant to the provisions of the Act of June 20,1919,P.L.521, \ as amended and the Act of June 15,1961,P.L.373,as amended.This is also in accordance with the provisions of the Act of April 9,1929,P.L.343. This Consent to Transfer the herein described property operates only in reference to the estate of the above·named Decedent. Signad foy a acratary of Ra~a By "-_?7~ (Signature) Register of Wills Whshington (Title)(County) HENRY \01.GEORGE 12 PROSPECT AVE. INDIAN HEAD,MD 20640 MR.G.ROGERS REGISTER OF \fILLS OFFICE COURTHOUSE WASHINGTON,PA.15301 DEAR SIR: ENCLOSED ARE THE FORMS SUPPLIED FOR CLOSING OUT THE ESTATE OF MY MOTHER MRS.MARGARET R;GEORGE,AND APPLICATIONS FOR TRANSFER OF SECURITIES.SHOULD THE NEED ARISE FOR MORE INFO~~TION,MRS.E.MAX~mLL OF MCDONALD MAY SUPPLY IT OR CONTACT ME BY }1AIL. THANK YOU FOR YOUR HELP IN THIS MATTER. /' 1#J1/1/1&i.,Jed>'< HENRY'll.GEORGE WARNING:It is ille~al to duplicate this copy by photostat or photo~raph. JUt 3 1970 I I 3 e>C>.....'S Date No. Ellsworth R.Browneller,M.D. S~cretary of Health Harrisburg,Pennsylvania This is to certify that this isa true copy oC the record which is on file in the Pennsylvania Department oC Health,in accordance with Act 66,P.L.304,approved by the General Assembly, 1une 29,1953.. I (Fee for this certificate,·$1.00) Hl01l.143 RKV.9.a9 J.f77tJ LCH:AL REG.NO.~_ COMMONWEALTH O'PENNmVANIA DEPARTMENT OP HEAltH VITAL STATISTICS~~~~~6.Jt~Q_QJ__________CERTIFICATE OF DEATH. I.DEATH a.County b.Oly or borough 2.DECEASED'S •.Street .ddr....R.D••or Box Numbor ,?;'CURRED mLcr,;...l1-rrsBdRGII 4 ~~~/¥.3 Jl,l1I/.Ro,q£)~S"r:' 4.NAME OF 0.(Rm)b.(MIddlo)c.(&,ed) DfCEASED'GEO,oGE(l'ype or print)MARGARET R ~ ••Which Wer b.SorIal No.-' 1 5.DATE (Month)(Dey)(Yoer) D~~JUNE,20 1970 T• 21.WAS AUTOPSV PERFORMED V••Iii!No 0 Month D.y Vo.r 6.WHERE DID P£;c.Did deco.sod live In •townahlp?DfCEASED II.St.to___),//I9..:..'0 Voe.deCleasod lived 1R....townoh/p. ACTUAUV .nJ,/..IE J A;/~I\LIVE?b.Coun _.LI.!G_:.__________l.2I No.deCleasod lived within 1Ictu.1 IImlta o'-l!l:...Jd~1I1J.~ 7.SEX 18.RACE 19 MARRIED 0 NEVER MARRIED 0\10.DATE OF BIRTH 1".AGE (In y.arsllf und.r I y.ar If und.r 24 hours~f:M8LE:W,J./III WIDOWED lit'DIVORCED 0 SEPT:7.//1121 ~rthday)Month.Day.Hour.~'n. 12.U AL OC~PATION (.v.n If retired)I~SOCIAL SECURITY NO.114.BIRTHP0CE (Stat.for.1 n country)liS.CIlI EN OF':'HATCOUNTRV? 16.FULL NAME OF SPOUSE 111.MOTHER'S MAIDEN NAME£t...D 1/iiI81..IFF.4A~TH~E~R~.S~N~AM~r_.-...J~..:..-~~~:..a:...J;:::lr:...c;;:,.------_t1';i119~.iiIN~F~O~RM~~NTi}.'n~"~M~E~,~A~D~DRijE~SSfA:iii5liji(~!El~~~~~~~ 22.•.ACCIDENT 122•.b.DESCRIBE HOW ACCIDENT OCCURRED Hour m. Yes 0 No 0 ESTi2~2.-:--:7::-=~==-===::-;'-:7--::-:-=::~:-:-::==::7--:----;--==--:-=:-:-::=~:-::-:-:"""7:-:-:-~:.::==-=:;..:..--.::::·C::..:·0~·U-N....:TY=----S-TA-TE-- I (It.ms through 23 mu.t be completed by phy.ld only) 20.CAUSE OF DEATH:Enter only one alUM per line for Ca).(b)&Cd.".j PART I.Death w••alusod by:~.~1R'-G---.);::1!2 :,o.~~( .~~"'-"""- C••If;';•••:".,,,,.Wh;':::"EDlATE CAUSE lol --;~-----'"--:=ti=-~,'{:'-~----------I .:gave rise to ebov.ceus.DUE TO (b).--------------~---------------.-,----'7 ------------- :(e)sIeling Ihe underlying •)r~-v-?\CIIuse luI.DUE TO (c)----.:.--------..__i PART II.OTHER SIGNIFICANT CONDITIONS:contributing to d.th but not r.lated to tho Immedlat.aulO given In P.rt I C.) .\ l!llrtY .!•O:30RGTI 12 PHOSP ~~CT AVB. rill)Il·.l~W-:",D 1 :10 2061,.0 :-111.G•ROOr:~8 RTiGI:)~"~H 0:·'.,'!T#LS OP'?ICB COUilTHOUSB .:ASIIlllG"?Oll,rs.1~301 I~ST'~TE OF FlY :-OTIII:a U~3.Hf\RGfI.R'ET n.GEOHOO,M7D f~ppr#IC1\'.rl0'RS FOR TRl\~TS}?~OF Sr:CURI'i.'Ir.S.SHOULD 'i:'UE r:T~'~D ARISE Fon ~;ORE InFO}f-1ATI01~,l·UtS.11.rUOC.fELL OF HODOlll:.LD jl..\y SUPPLY IT Ort COi;rAC~fIR BY J;'I\IL. 'i'H.'\IJt YOU FOH you:-t ~F'.L~!It '£1118 HAT'lIl:R.