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Home My WebLink AboutOC1971-0034 - ESTATE OF DAVIS SR'./), atnmmnuwtttlt4 nf 'tutl,SYluttUitt.!liS:1ItIItts4iugtnu atnuuty• KNOW ALL MEN BY THESE PRESENTS:Whereas,at Washington,in the County aforesaid J on the 12th.day of January A.D.1971 ,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 William H.Davis,Sr. late of City of Washington in the County aforesaid,deceased, (a true copy whereof is to these presents annexed),was duly admitted to probate;and WilliamH.Da.vis,Jr. 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 Ma.rino grant these LETTERS TESTAMENTARY,unto the said William H.Davis,Jr. ,Register as aforesaid,do 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 inheritance taxes. IN TESTIMONY WHEREOF,I have hereunto set my hand and the seal of said Office at Washington,this 12th. day of January nine hundred and Seventy One in the year of our Lord one thousand (2 /J/l ~~ .I I •••••I I•••••I.~•••I ••••••••I . Register , --~-------->--'-~--'-'-'-~--'-~-------------------_..,.------.-'-_.,~~ ---....~-_...-....-~----_....-.....-....----.--._-.....-_._~~---~....--------~--...-.--" ....~ti ~---.l~~;;::J J":;:>-III :::::J (I)0 C t::::l-,--(n rr1 (j)'.-r-, Z -1 r·....·r~I::l~i r-n r'.)J l --1 -~-t:-.~j ~"'..1)0 0-cw- .,~~c. (""):i~.._,."!.~ 0 ::"-r--z<J I 0l::-Cn ..~ .J'" ,I if LAST WIT...L ANDmSTAMENT,l,'.: ,. I,WILLIAM H.DAVIS,SR.,of the City of Washington, Testaments by me at any time heretofore made. and memory,do make,publish and declare this my LastW1ll and -, Testament,hereby revoking and making voi~'all other Wills and being of sound an~disposing mind IIj iI I I direct my Executor hereinafter named to payFIRST:I Washington County,Pennsylvania, all of my just'debts and funeral expenses as soon as may convenient. I 1y'be done following my death.I !SECONn:I give,devise and bequeath unto my grandson,; Will1am Ivan Forgie,my automobile. THIF~:.All of the rest,residue and remainder ot my and bequeath un+;o my rour (4)children,share and share alike. \children should pre.decease ma,I th~n giva,devise and ,bequeath In .the evantthat any ODa or mora of mysalf!IPOU'RTH:- estat,e of whatsoever natu,.e and wher-ssoever found,I giva,devise, "II, II ,the share of said decease~child to his or her children. FIFTH:I nominate,constitute and appoint my son, WILLIAM H.DAVIS,JR••as the Exeoutor or this my Last,Will and Testament. IN WITNESS WH3REOF,I have hsreunto set my hand and seal this 2:::V-:day of February.1968. SIGNRn.sealed.published and declared by the above WIT..LIAM H.nAVIS,SR.,'to be his Las+:Will and Testament.in our presence,who at bis request and in his presenoe and in the pre- senca of each other,webal1eving him to be of sound an~disposing mind.and mel1l0l"Y',have hereunto subscribed Our names as witnesses., ~3-7/-.fY 1\ffi~autt (JDf £xrrutnr ®r A~mtut1itratnr '-J.'-. Stutt of 'tuu.ayluuutu '} <nonuty of 1llIIu.a~tu!ltnu..a.a: Personally before me,the undersigned authority,a _N9_~_~.Y.__J>_~l>_J:Jg __.__.in and for said County and State,appeared _.m~I,.J~..R~.D..Av:l._S.~--..J.R!--------------..-__who,being duly sworn according to law,deposes and says that he is the executor~fthe es- tate of Wl.~L.I..AM_..H.L_D.AYIS......-SR~--.deceased,that the foregoing schedules constitute a complete inventory and appraisement of the real and personal estate of __W~U:~~~_M'1_.~~P.AY'+'S"SR. 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 xAotllab;~~ d ·aSfworn.andJunsubsecribed belf90re7ml·e this .....l...4..t.P........~......~...g~~~;......., ay './7J;:"·i"j'........Executo~mr;:::::Z=;:a::.~~~~~~~INSTRUCTIONS . 1.AHYiitf~l9PFflliM..,~llfM!d within three months after appointment of personal r,epresentative. 2.A supplemental inventory must be filed within thirty days of discovery of additional assets. 3.1 Original and 2 Copies and 2 RCRI-34,Under $10,000;1 Original and 2 Oopies and 2 RCRI-33, Over $10,000,including Copy of Will;1 Original and 3 Copies and 2 RCRI-33,Over $50,000,in- 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 ~UUtutory nub !\.pprut.atuttut .of the goods and chattels,rights and credits which were of W~}~:J;,J.~:ij.~p.AVJs."S~.~late of 9.t.~y..g.f.W.~.?p.t.ng~9.p.L . Washington County,Pa.,taken -and made in conformity with the above affidavit. REAL ESTATE: Lot No.56 in Montgomery Plan Plan Addition No.4, Seventh ward,City of Washington,Washington County, Pennsylvania,haVing erected thereon 1-1/2 story frame 6 room and bath dwelling and garage. SEE DEED BOOK 569,Page 399 SOLD FOR PERSONAL PROPERTY: Checking Account No.0433-0751,Mellon National Bank & Trust Company,Canonsburg,Pennsylvania Office Savings Account No.6261,First National Bank of Washington,Pennsylvania 1963 Dodge Tudor Sedan DOLLARS 16,.000 00 5,234·76 1,022 50 425 00 CENTS u.S.Savings Bonds,Series E,issued to William Davis or Mrs.Helen E.Davis (wife ...Deceased): 1 ...25.00 ...issued July,1959'29 051...25.00 ...issued August,1959'29 051...25.00 ...issued September,1959 29 15 1....25.00 ...issued Oc tober,1959'29 15 1 ...25.00 ...issued December,1958'29 931...25.00 ...issued November,1958'29 60 1 ...25.00 ...issued October,1958·29 60 1 ...25.00 -issued September,1958 29 60 1 ...25·00 ....issued August,1958'30 31 1 ...$25.00 ...issued June,1958 .30 21 1 ...$25.00 ...issued January,1961 27 49 1 ...$25.00 ...issued January,1957-30 64 1 ....$25.00 ...issued July,1958 .30 31 1 W f5.00 W issued January,195,8 30 83 1 ...25.00 ...issued April,1958_30 08 1 - 25.00 ...issued March,1958 30 08 1 ...$25.00 ...issued February,1958 30 83 (CONTINUED ON PAGE 2) ,, ,~'-... ," .~. ~, \'.' ,, t - ..., ,/ , I t-- ~, i,_"'--') t' t - t.. t ' ,j ....J. ;, r'.\... :) '-J I l ,. " ..' ~, ~"- ~~"-\~ ~ '" .(\. " INVENTORY AND APPRAISEMENT PAGE 2 IN RE: ESTATE OF WILLIAM H.DAVIS,SR. PERSONAL PROPERTY:(Continued) "'. 1 ~25.00"issued May,1958 1 ~25.00 ~issued November,1959 1,..25.00 ~issued December,1959 1 M 25.00 issued January,1959 1 M 25.00 issued February,1959 1...25.00 issued December,1957 1~·25.00 issued March,1959 1...25.00 issued April,1959' 1...25.00 issued May,1959 1 ...25.00 issued June,1959· 1...25.00 issued October,1960 1 ...25.00 issued September,1960 1...25.00 issued November,1960' 1 ...25.00 issued Julyg 1960' 1...25.00 issued June,1990' 1...25.00 issued May,1960' 1...25.00 ~issued October,1957 1...25.00 issued April,1960 1...25.00 issued March,1960' 1...25.00 issued February,1960- 1...25.00 issued January,1960 1 ...25.00 issued August,1960' 1...5.00 issued December,1960 1...25.00 issued May,1961' 1...25.00 issued April,1961 1...25.00 issued March,1961 1 ...25.00 issued February,1961 30.08 28·4628.51) 29.83 29.83 30.71 29.12 29.12 29.12 29.0528.08 28.08 27.4127.98 27.98 27.92 30.57 28.60 28.60 28.51 28.51~- 27.98 27.4726.91 27.56 27.56 27.47 One lot of household furniture 100.00 TOTAL PERSONAL PROPERTY -------------------$8,059.19 IVI;vv yo tU:.. STATE OF PENNSYLYA.I~ EI<.~WASllnf ON COUNTY,~55: The within named Accountant being duly sworn according to law,depose s and say sthat the above account as stated is true and correct as h~L .._verily believe. ..t:/~Sworn and subscribed be'fore me this ~=_. day of __o.~6.~.f.er::-..-.-..19..7.1 . ......P-~. GILBERT J.DENTON Notary PUblic.State of New York Qualified in Erie County My Commission exp,r2;i Mar.30.191~ Washington County,ss:I do certify that I have given legal notice to all persons concerned of the filing of the within account in the manner prescribed by Stotute and Rule of Court,as evidence by proofs thereof filed to No..b.3~'1l.-::835 . Witness my hand and official seal thiS_.d.9.~.__.__.__._. day Of ~tIN.~19'1L~~.lJ~.-. Register of Wills .----....-~'..."~,.,-~..--..-..........-~-.-...:......---'--..---..,..----.-_...._--~~....'- R'Li ,~"'-..., ,....J '..J'l!.I I I J ~I -P':'c - - .-.'"',1111\U I t Gk.red 0F t'!!LLC'V'A (""..I \),0t1INCTON CO ..PA, I '- ~1\'8:e- :<:)" :C)!<:;..: 0:....!>.:Q):1::1:....: 0,........'< ........::loQ Q)..c:l.... o.... P~l.-,3 28 '!'I'-'.:"1·1•~-,'I --oO )1-, >'7I DC'·;;I ....0....l'l~::l ~9 0~~~-< ci.oj, ~.t:I.l1 cd.H H r;:.:>i :>!~!o::t:!40Airil~I~Eo<-<., Eo<~i ~!Ul :a:iril ~!,i ~:Hi«)1 ...:Ii Hi...:I:...:I: "'I Hi ...:11~i ,0Z -.. ...., .L"" :3.-7J-3!-J " ,>'CL,; ....~ 'f JiJ• ~-•.# ":""'" ".., .-....~., ;*' r , -, ,. L .. po'''..~ ...~fo \,~ ...t... •j".1 ~.").J",'.'''-.. The Court is respectfu II y requested to determine proper distribution'"is estate.~ ~~~dlJd.tC~ for Accounta t The First and Final Account of WILLIAM H.DAVIS,JR., Executor of the Estate of WILLIAM H.DAVIS,SR.,late of the City of Washington,washington County,Pennsylvania. The Accountant is charged as follows: PERSONAL PROPERTY: ·. To Amount of Inventory and Appraisement Refund check received from Columbia Gas Company REAL ESTATE: $8,0.59.19 6.3.5 $8,06.5·.54 As Per Inventory and Appraisement 16,000.00 TOTAL ASSETS OF ESTATE -----------------------------$24,06.5 ..54 Amount of Credits claimed by Accountant 4,126.01 Household furniture appraised at $100.00 but sold at Auction Sale for $94•.50 .5 •.50 TOTAL AMOUNT OF CREDITS CLAIMED BY ACCOUNTANT ------- BALANCE ---------------------------------------------$19,934.03 .. The Accountant claims credits of the assets of said estate;to wit: DATE-NAME OF PAYEE REMARKS AMOUNT West Penn Power Co.Account Brownlee Funeral Home Funeral Expenses S.Charles Badiali,M.D.Medical Services Columbia Gas Company Account 55.36 7.66 84·00 8·42 51.00 22.50 14·00 14·00 9.59 5.97 18.00 7.00 867.50 7.66 34·90 11.56 100.00 Monument Inscription Account Harry R.Cook,City Treas.1971 City Taxes Citizens Water Company Mitzi Chambers Insurance Homeowners Premium AgBncy Columbia Gas Company Account West Penn Power Company Account Citizens Water Company Account Washington Co.Reports Advertise Letters Observer~Reporter Advertise Letters West Penn Power Company Account S.White's Sons Bell Telephone Co.Account Russell Marino,Reg.Probate Will & Short Certificate Pirris,Ruben &Underwood Medical Services 1971 1/11 1/12 2/12 2/12 2/12 2/12 2/12 2/16 3/2/ 4/23 4/23 4/23 4/23 4/23 5/4 6/21 6/21 6/29 William H.Davis,Jr.Haul Garbage-Reimburse- ment 18.00 6/29 Malcolm L.Morgan,Co. Treasurer 1971 County Taxes I64·98 7/7 7/28 7/28 7/28 7/28 Russell J.l1arino,Reg.Short Certificate West Penn Power Company Account Washington-East Washington Joint Authority Account Columbiaffis Company Account Harry R.Cook,City 1971 School Taxes Treasurer 1.00 2.19 8.82 39.13 193.65 Russell Marino,Reg. A.S.Frazee WashingtonTEast Washington Joint Authority West Penn Power Co. Citizens Water Co. Observer-Reporter Russell Marino,Reg. Mae Herceg William H.Davis,Jr. James C.Bane,Esq. File Inventory & Appraisement 6.00 Commission on Sale of Personal Property 28.35 Account 4.80 Account 1.27 Account 8.40 Advertise Sale 2.34 File Account 17.00 Notary Fees 8.00 Executor's Commission 1202.96 Attorney's Fees 1200.00 TOTAL ......------------$4126.01 ...." \ Observer .~eporter WASHINGTON,PENNSYLVANIA PROOF OF PUBLICATION In compliance with the Newspaper Advertising Act of 16 May,1929, P.L.1784,as amended. Commonwealth of Pennsylvania,County of Washington,55:....•....... Personally appeared before me,a Notary Public in and for said County and State,RiJ:;.JJcl.1::~L.$...~C.Qw.~p.,who being duly s,worn according to law,deposes and says that he is the ..Y.i.ce.~.P..r.e..s.id.e.p..t of the Observer Publishing Company,a f'1ennsylvania corporation,and its agent in this behalf;that the said Com.pany is the owner and publisher of the Observer-Reporter,succ'essor to The Washington Observer,established Septembe'r 18,1871,and The Washington Reporter,established August 15, 1808,a daily newspap'er of general circulation,printed and published and having its place of business at Washington,Washington County,Pennsyl· vania,where it or its predecessors have been established and published cO'll,tinuous'1y for more than six months prior to the publication of the notice hereto attached;that the printed notice or advertisement hereto attached is a ,copy of an official advertisement,official notice,legal notice or legal adve,rtis·ement,exactly as printed or published in the ObE:1erver·Reporter in its regular editions on the follOWing date or dates;. ...................................J.~n.!J.~.r;.y 1.4.,.2.l.~p..d.2.8.,.1.9.1.1.. that neithe,r the affiant nor the Observer Publishing Company is interested in the subject matter of said notice or advertising and that all of the alle,ga· tions of this affidavit as to the time,place and character of publication are true./tf:0 ,,/a...............al..j..lt.JJ.!uk '?0-r~. .. ,EXECUTO!l'5 NOTICEESTATEOFWIL'':'\:,1 H.DAVIS, SR.deceased lat."i City of Wash·ington,Washlngk.County,Penn·sylvania Letters Testam.entary lipon the above estate having been grantedtotheundersigned,all persons hav· ing claims against the estate are reoquestedtomakeknownthesame; to the undersigned or his attorneyandallpersonsindebtedtothede- cedent are requested to make pay·ment to the undersigned without delay.WIUJAM H.DAVIS,JR. 307 Washington Trust Bldg.Washington,Penna.15301 IJAMES C.BANE,Attorney 1~~_~7.!:.11-Thurs-3t Sworn to and ~..., 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.5,paragraphs (5)and (25). COUNTY OF WASHINGTON}S8. STATE OF PENNSYLVANIA 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 officiaJl legal periodical for said Washington County,published weekly having its place of business at Washington,Washington County,Pennsylvania, and is acting as its agent in this behalf;that the said WASHINGTON COUNTY REPORTS was established on March 51,1920,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 advertisement 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: January 14 21,28 1971.............................................1.,... Estate Notices The Register of WiHs has granted letters,testamentary or of administration, in the following estates.Notice 5,'1 hereby given to all persons indebted thereto to make payment without delay and to those having claims or demands to present them for settlement to the Executors or Administrators or their Attorneys. ••••• ••••••• ••••• DAVIS.WILLIAM H.,SR.,Dec'd. Late of Washington,WashingtonCounty,Penna.Exec~tor:William H.Davis.Jr.,307WashmgtonTrustBldg.WashingtonPenna15301', Attorney:James C.Bane that the affiant or the corporation in behalf of which he is acting is not interested in the subject matter of said notice or advertising and that all of the allegations of this affidavit as to the t~e,,ce and character of the publication =_.J.21:J)L~:~L_l!1_i{u~,~ ____________..:.(Editor (...--~~~Sworn to and subscribed before m~this _.._.-.:..-.------"~. .........?§.!.h.day of ~~E.~:E.Y.,19 .?.~. ~--",L------N~;;;;y-~-.;,- My Commission Expires July 1.1974 ~lt tij~QIuurt uf Q!ummuu Jltn.a uf Ilnsijiugtuu Q!uuuty ®rpijnu.a'Q!uurt iini.aiuu In the matter of the Audit of Account in J Estate of WILLIAJIII H.DAVIS,SR. TO THE AUDITING JUDGE: NO.L3.::t4:...-=of=--=l=--9!.....!7l....::1~_ Enter .....:ID::..::u.y ,appearance for A_c_c_o_un__t_an__t _ ___--=D:.....:e:.....:c:.....:e=-ID...c.b::......:..e.=.r...c..__,19_7_1_ N.B.-Counsel shall,by separate pape,esent 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 conctse state- ment in that regard. 34 of 1971 In re Audit of Account in Esta.te ofn1Ji(~('.,,,•.J ....",,~,I 1.'--l.,!(l~0nEGISTP"o:~,.:,'I WILLIAM H.DAVIS,SR.'I ,·.1,I ,IiLL.S----------------.::.-----~\;~SrllN;;TOr\!CO.,Pt\.,----_ ,~'l P ;:'-r~, j ;~~.-1..,.'":~==~==~====~=:==--_No.'71 DEC ?~l Ali II f 1 AUDIT 'rarripr fnr !\ppraraurr FOR Accountant JAMES C.BANE Attorney ~2 Testate Form PETITION SU R AU DIT IN THE ORPHANS'COURT OF WASHINGTON COUNTY J Estate of..Ji.~J:~JM1..H!P.AY.J§.L.§B.~. Deceased No )~..~f ~.~I~. Fiduciary ~f:IJJ.~J.@ ~.~P.:~YJ§.L.~~. Date of Date of Decedent's death eI~.~~.ry 9..J..J:.9.7.;!'Grant of Letters ;r.~!:l:t?:~.y...Jg.#..):~nJ . This is the f.J~.~.~~.2 :r..~p.~;!.account filed in this estat~ If there ,have been form.er accounts fi led,in this estate,li§t file .number or number and term :. None Election to take Under or Against will.(cross out one) Date Election Place of; Filed Record ,""-.....•.: . Name of surviving spouse :Ng~~:.?~_ . List issue,where material:None . .~.. • I .)".Did decedent marry after executio~of will?{indicate}~No.Any children born after execution of will?(indicate) ~o:If answer yes,'name them -::. ...............................................................................................................................................................:~:::. Legatees Relationship Interest Fiduciary,if deceased or not sui juris William Ivan Forgie Grandson Legatee William H.Davis,Jr.Son 1/4 Joyce Forgie Daughter 1/4 Helen Dickman Daughter 1/4 Glenna Pettit Daughter 1/4 List,if exceptions to above: If partial intestacy,give facts: Adeemed:Revoked:Lapsed:Abated:Give Cause: Notice to interested parties.Have all parties,having either vested or contingent interests and all crediors 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.JDti:x If any exception give cause:. ,,. File copy of Notice . and date of mailing ~.9.~.~~J?~~;!..9.'-~.9.7.~;. Is estate subject to the filing of a Federal Esta.te Tax ~eturn?:Ng :,~.-:-. Actual payment made on Pennsylvania Transfer Inheritance Tax.Amount $N.g.n~_. If the Will makes any portion of estate subject to a life-estate,give name and birth date of life tenant . None Give Names and addresses of all unpaid creditors who are legally entitled to notice,together with the amounts of such claims;state whether they are admitted to be correct;and whether the claim is denied. 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: None /....,... 1':1 l' Balance for distribution per account, Itemize any additional debits not shown by account: Insurance premium{refund...Mitzi.Chambers Insur ance Agency~ Interest First National Bank of Washington,Pa.IRefundw~~t Penn Power CompanyRefundl~(l Taxes Total additional debits (Add) Itemize any additional credits not shown by account: Real Estate Brokers Commission Transfer stamps on Deed Total additional credits (Subtract) Balance for distribution ;--- / $'1.9.,..9.J.1-b!.9.3.. 35.00 23.~£ •51 127.185.!.7.?.......$. 960.00 320.00 $1,280.00..._-. $J§.J.§3..9.!..7.5.. If balance for distribution is not in cash,list each item held in kind,giving appraised Valu,~(or distribution Value); Cash to be distributed.However,value of 1963 Dodge Tudor Sedan appraised ~t $42~~00,s~all be deducted from the balance shown. ~ "" ---_. If Family Exemption claimed by Petition,give place of Record:N~.~~:_. If Family Exemption is claimed at audit,give name,relationship and basis for Claim:N9XHL . List any advancement or distribution on account that has been made,and nature and amount of same: None Suggested distribution of balance shown,both as to principal and income,attaching signed and itemized elections to take in kind if balance is not in cosh:residuary shares being stated in proportions: William H.Davis,Jr. Joyce Forgie HELEN Di ckman Glenna Pettit COUNTY OF WASHINGTON,SS: COMMONWEALTH OF PENNSYLVANIA. The above named Fiduciary or representative thereof, being duly ~YY:~rp-doth depose and say that the facts set forth in the foregoing petition are true to the best of J~.~.~_._knowledge and belief. ...........~~.~~!.l:to and subscribed before me thiS.....I.Z.jay of ~19...7.~. Signature of Officer ~.:2 . r'O:Title of Officer L MA£..I:l.ERCEG :..ftil!ary Public,Washington,Weshlqtoa Ct. Office expires ~~!..~?'!1.~!~~~~..~~!~!~.!.~r!..!~!..~~~~. 1/4 1/4 1/4 1/.4 And your petitioner will ever pray,etc. /,~ea-#L),··Willf~··H;···f)av:t·~f;····3T'·;··················,·(··-:·. .~~.. RUSSE L L Li ;~,C{IN0 REGISTEH OF WILLS WAS JilN.GTON QO..PA.- ':-...."......~..... .......'r '._.. ~~0':.~ E :.0 l ._.., ---.t.\=....:-1;.n ,,_~....~....-:..".\.-:.{//-.'~f)"......-,"..+..._......~',.'.-:.·c··. ;"",.,'.."t.,,-'"""......;•.'/~')l.~i""- ,) , , \ No..3!±of 1971.. ..- --__-__--.-. Estate of....Y!.:P:~~.IAM..I3;~....l!.AY.~§.L ..~B.!.... ..................._-__---_--_.._-_Oo -_O'. Deceased Fiducjary WJ~1JA~..I3;!P.AV.J.$.,.J.B.O PETITION SUR AUDIT FROM WHERE DECEDEN'r LEFT A WILL Counsel of Fiduciary will submit herewith the following,in conformity with Court Rules adopted effective'December 3,1951,being rule No.9:po rag raph b-c;and divisions thereof:shown on pages 23-24. 1.Written praecipes of all Counsel in the case. 2.Copy of ord~r 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 WiII. 6.Copy of inveritoryand 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. 10.Copy of Federal Estate Tax return if es- tate is subject thereto. JAMES C.BANE Attorney ~2 "'""- ...... '-- -~ ...-- ,.- . " ~ r':/i Fn Ii j '....._,;l.-:I •~7I DEC 21.;AHII- -II -- / "... I I ,,-'-"'., j ~u t4t Qrnurt nf Qrnmmnu 'lens nf lIasl1iugmu Qrnuut!}, Jeuusylnauia.(@rp4aus·Qrn1U1 IJinininu ESTATE OF N 63-71-34O.__.....;::",.=::.-...!~~_I:--_ William H.Davis,Sr.In the matter of the__F_i_r_s_t_a_n_d_F_i_n_a_l_ deceased Account of William H.Davis,Jr. Executor No balance $19.934 $20,119.75 185.72 120.02 I ti?S.oo ~314.80 14314.81 I 4314.81 Balance per account 1 Additional debit asked at audit SCHEDULE OF DISTRIBUTION I Addit1,_'o_n_a_l_c_r_e_d_i_t_a_sk_e_d_a_t_a_U_d_i_t 11280000 Balance__ Deduct Clerk's Costs &Receipt:l..s 1 3$.50 At'torney J_9_m_e_S_C..;..'_B_a_n_e _ Russell Marino,Agent,transfer inheritance tax, WilliaM H.Davis,Jr.,Bon,1/4 residue, Joyce Forgie,daughter,1/4 residue, Helen Dickman,daughter,1/4 residue, Glenna Pettit,daughter,1/4 residue, William Ivan Forgie,grandson,bequest in kind of automobile,being a 1963 Dodge Tudor Sedan, held in kind and distributed as such at the appraised value, ADJUDICATION AND DECREE And now December J./,19 71 ,this matter came on for hearing, 'audit and distribution at this session and testimony taken;and thereupon,upon due consideration ther~t~e..ba1.aslce for distribution in 'the hands of the Accountant is determined to be $,)9,.1'J and the account is accordingly confirmed;and it is ordered, adjudged and decreed that the said balance be paid out by the Accountant in accordance with the schedule of distribution hereto attached and made a part hereof,unless exceptions hereto be filed sec.reg.or an appeal be taken herefrom sec.leg.' ,) r ", 0 »:J z.... ~.~~R -+!J 0 ::r ~c CD <it :J 3~..... ~0 0 0-+........~CD_.... ~0~.........-+_.::r b CD t ::: ..~,~ S+'Q.t:i r ~~ ,r .'-- t ~;:7rr:t>I"T1 :::0 if)(;)c: :::t:--u, (f)(fl .r_--,,' ~r r,-i "'-..--r,-0 (~..,±:-'-IC)r_~0::::;..; ..~---.l .i -r -t::::l 0'r.-,,I"I"->;-'-1.1 -t="l:J ;::p:,r-_.... ")r I r ,\ ,\ \ I ...,..,r z u r 0 l>(f) law.,.,"".6"".-'4!1.?VI...""'~.~4",1'!'.If'"''''''''....~!''.'I!"'€......."....,1""".....",.....,....,.,'.-...'..,.......•Of".....~ 1600000 1600000s 5 2 :3 4 7 6 102250 4 2 5 0 0 2 9 0 5 2 9 0 5 2 9 :L 5 2 9 :L 5 2 9 9 :3 2 9 6 0 2 9 6 0 2 9 6 0 :3 0 :3 1 3 0 2 1 2 749 :3 0 6 4 :3 0 3 1 :3 0 8 :3 :3 0 0 8 3 0 0 8 :3 0 8 3 :3 0 0 8 2 8 4 6 2 8 ')1 2 9 8 :3 2 9 8 :3 3 0 7 1 2 9 :L 2 2 9 1 2 2 9 1 2 2 9 0 5 2 8 0 8 2 8 0 8 2 7 4 1 279 8 2 7 9 8 2 7 9 2 :3 0 5 7 2 8 6 0 2 8 6 0 2 8 5 1 285 1 2 7 9 8 2 7 4 7 2 6 9 1 2 7 S 6 2 7 5 6 2 7 4 7 1 0 0 0 0 2405919s 2405919~:~...',' _.•__~.c ..r _''Y,e''Jid't'''Jth.a1'btIIiltttz •at ~ ---L-~_/_-#~II--~-/_J_' IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY,PENNP.. ORPHANS'COURT DIVISION INRE: Estate of WILLIAM H.DAVIS,SR., Deceased. ( ) ( ) ( ) ( No.34 of 1971 BEFORE: APPEARANCES: TIME: HEARING ON AUDIT The Honorable P.VINCENT MARINO ,Judge of the said Court. JAMES C.BANE,Esquire,of Washington,Pa., representing the Accountant. Friday,December 17,1971,at 10:00 A.M.,EST vi ffiTHE COUF\T:Number 34 of 1971,the estate of William H.~o~Davis,Sr.,deceased.The Executor is William H.Davis,Jr.and t1e l-ll:5 attorney is James C.Bane.Mr.Bane?u .Jc( 2lV.lR.BANE:If the Court please,I have all of the necessany......o papers in th is estate.The balance ~or distribution is all in cash,an< we ask that it be dis tributed as such in accordance with the Will.There are no outstanding claims. THE COURT: decedent's estate? Is there anyone else in Court inte rested in t is (NO RESPONSE) ,./,-,;r-.....::.-----1:I--------------~__,~-:2-._ r! HE COUR'T: by the Cou rt . The audit of this account.is ordered closed A UDIT CLOSED) The foregoing record of the proceedings upon the hearing of the abov . [j f- =3 1 hereby certify that the proceedings and evidence are contatned z«>.)fully and accurately in the notes tak.en by me on the hearing of the above ~.zztause,and that this copy is a correct transcript of the same. io~zXIII~. ~ii:I-!!!Q...«o C:J... :J: t::N ai~ause is hereby approved and directed to be filed. I-0:oI.III0: I-0::Joo...«oii:\Lo J. IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY,PENNSYLVANIA ORPHANS'COURT DIVISION J ESTATE OF WILLIAM H.DAVIS,SR., DECEASED. ) ) ) ) ) ) NO.63-71-34 DISTRIBUTION RECEIPT I,the undersigned,hereby acknowledge to have received of WILLIAJ.11 H.DAVIS,JR., the sum of Four Thousand Three Hundred Fourteen and 80/100 _ in full payment of the ~ount awarded to me by the said Orphans' Court in the Decree and Schedule of Distribution filed to the above Number and Term of said Court and in consideration thereof, I hereby release and discharge it from any further liability on accoun t of the same. .WITNESS my hand and seal this 1972. /l-~-day of January ATTEST: (SEALJ ):r- " WILLIAM H.DAVIS,SR., DECEASED. l~O.63-71-34 1,tho nndc~o1@1od,bx:oba"aokn0'U1cdlP to belvo ~oolvod -.of 1f.JILLIAM H.DAVIS,JR.,EXECUTOR, tho ~.ot Four Thousand Three Hundred Fourteen and 81/100 ----- in .tun »~t 01 th:J OO'Unt aua:rdc(l to t:W by tJ:o oGid ~Ol Cou.r.'t 114 tlho Dco~o¢and t"ob.oaulo o£Dist:J?l'butlon tilod to tho ."nbovo lfuAlbQZl'nndi\)~ofotUdo~t and in OOAo1dG»'ationtbGl1'Oof,- I korob7rolcAoo llnd dlooho.reo it hcrJ1 ftIl7 f't.1rthor ltabl1tt7 on c.ccount of tho 00t10. :1972. (In'ft''of __Jan_u_a_ry lJ~.,". 11 d •1 it IN THE OO'URT OF COMl-iON PLEAS OF blASRINGTON OQUin,PENNSYLVANIAORPlIANStOOURTDIVISION ESTATE OF Ii WILLIAM H.DAVIS,SR., oj> ..:.Deceased." '\ ) )J.NO.63-71-34 ) DISTRISO'T:tON RECEIPT 'I of WILLIM1 H.DAVIS,JR.,EXECUTOR,• :1 tho mtal.of Four Thousand Three Hundred Fourteen and 81/100 -~---,I 1t1 hU l'O$m.ont at thG=ount at-sardod to mo b1 ~Qaid Ol'phnns f c~t 1n tho DOCl'GQond ~~6U.loot Distribu.tlon filed to th~ , u abOvQ NUt:1bGl!Q1d ··!')~ot "aid c~t and 1ntrQnold&XJntlon thoroot,. I ho:r&})-yreleQ,Qo end dlso~go it frd.n1 t;f1.l"'l f~thor liabl11t1 on e.OOQ'Unt of thQ stunG. January 1 .'..' J.972. ,., i ATTEST: .,.~Gittd: Glenna Petti t (SEAL) .'''..C .1 _{~u·.."~.,:,". '. ,. i . Ii fl ( "r Deceased.' WILLIAM H.DAVIS,SR., e flI,ESTllTn 01',; II ) no.63-71-34 I,tho atlOi7o!01¢d,h:jrc~i'aotncnAoaso to J::t.uvo 1'COOIVCt! t:f1 WILLIAM H.DAVIS,JR.,EXECUTOR tbo C~,O~Four Thousand Three Hundred Fourteen and 81/100 _ ,~Mol ~tt C2 th:l ~;:nmt tt:or.a~t~tao bF tb on!tl Ct;vb:u'1O' ,1' C0\!7f,;SxJ,"tho D-vWoo cnrJrohQ6ulo e1 D.1tJ~lb:,~l~tUot!to tho j .,o.~et1a'~'boob.ttd ~.fd r.rnla caw~c~ac moonoltlQt;ntien-~~~Of'D '" "1'1 l,! I I', '. :ziLv ~~~~~r_r_........(GOO4) Helen Dickman L.f tJ .. Form RCC-33 RESIDENT DECEDENT j~ONWEALTH OF PENNSYLVANIA /_.._~EPARTMENT OF REVENUE .BUREAU OF COUNTY COLLECTIONS COUNTY OF WA$RJ,N..O:'rON .. 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.) IN THE MATTER OF THE ESTATE OF _....W1.LL.J:AM.....H.,.uuu..:O'.Av..1.s...tuu....S.R.~.u (State full name of decedent) Late of uuuu WA$H.J.N.G:':J:lQI.'{..C01U1ty AFFIDAVIT OF EXECUTOR State of u.u..:r~~Thv.AN..~uu }ss: County of.....W.4~I:lJ.N.G..~.QN _. .u.u ......uWThItJ.A.N.I:l,.......p.AVr..S.".......J.R. of the estate of the above-named decedent being duly sworn,depose S and say S ...u.u........Eueutor Decedent died u.J.anuary.6.,. (Month) .uuu uuu.'19u7ul uuu,J testate leaving a last will,copy of which is hereto attached.} (nay)(Y~ar)L1fiJiX0i1lE Name and address of attorney or} other authorized representative to whom all correspondence should be mailed. JAMES C.,J?4N~,~§Q.,3Q7 .Wl::t.::3,~.~g~<::>~Trust~~~.q~~g". .Wa,s:b.:i,.ng1:iQ:n"P~:n:n.sylv.ania1.53Ql ,..,.,.,.,.,..............u..uuu..uuuu uuu.u..uu That as such ~~.~.~.~?~deponent is familiar with the affairs of said estate and the property con- •(ExN~utor·Admini8trator) 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 JOINT IN WHICH DECEDENT RENTED A SAFE DEPOSIT BOX IN NAME OR NAMES OF HOLDERS TO DECEDENT Pittsbur~National Bank Wrn.H.Davis Washington Office South Main Street Washin~ton.Pennsvlvania It:;101 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 fullv and in detail all the real property in the Commonwealth of Pennsylvania of which decedent died haVing an interest 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 all personal property wheresover situated owned by the decedent at the time of death;all moneys left by the decedent at the time of death,whether in decedent's immediate possession,standing to decedent's c~edi~in banks of deposit,saVings banks,trus t companies,or 0 ther insti tutions,whether individually,or in trust for any other person or persons giving also separately the accrued interest thereon,if any,~oWn'to the last interest day prior ~o decedent's death in the case of saVings banks,and to the date orideced;nt's death -:,0.f .~•in all other cases;all bonds,postal savings,treasury certificates or notes and other evidence of 1n-- ...~•t 1-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.>ther,e~f;or of ,,' any for~ign country,whicQ are owned,at the time of death;all wearing apparel,jewelry,sil~~r~~~e;Plc-~~~. tures,books,works of art,household furniture,horses,carriages,automobiles,boats,an<i"'~i and.,al{ other personal chattels of whatsoever kind or nature,left by decedent,together with the fairly es timated 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,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 vaiue 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 ~f dea£h.·• 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 p~ss~s~id~o~enjoyment at or after death,said schedule sets forth the nature and value of such property,.to.whom.t!ansferred,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 traQsfers.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 se~forth in said schedule a list of all property,real ~nd personal,.with its value,which passes-at :decedent's death by virtue of the exercise by decedent,either individually,or jointly with another,or any power of appoint- mentt ves.ted.i~'deceiien't,-:eitner;individuallY,'or~j~intly,by the will,'deed,.or,other instrument of another, with a copy of the instrument creating such power.att~ched to t~e .schedul~~t ..L That Schedule D attached hereto and made part hereof sets forth the na~es and addresses of all persons beneficially interested in this estate at the time of decedent's death,'th~'~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 acquisiti~n of persorralty,plus the name,addr'ess and reiationshlp,:if any, of co-owners to the decedent. That Schedule F attached hereto and made a part hereoi s~ts .fo'r.Uifully·and,:in:de~ail ~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 unpaid 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 upori 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. i Subscribed and sworn to before me this l4.t.b... ................~.;Tfj.........~day of .. ....~UJ::l:E1.:19 7.~..:':Lll~irAEZ~-----_._- Notary i'tltl6c.,WaShington.Washington CQ. My COmmission Expires June 28.1911 td£;~~~;::l ...J?.7.~.~.~p.~.Y..~.A B.9.g~t _.. (Street Number) .....W~.~.:li §.~A.~.~..?-.I.N.~.w X9.r.!J.4??.4 . (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'-34 (1-1;41 COMMON,WEALTH OF PENNSYLVANIA DEPARTM,ENT OF R'EVENUE BUREAU OF COUNTY COLLECTIONS TRANSFER INHERITANCE TAX RESIDENT DECEDENT 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 shou'ld be that of the decedent's interest only. The real property located In the Commonwealth of Pennsylvania should be described by lot and block number,street and street number,together wi th a general description of the property,with a reference to the record of the conveyance by which the decedent took title;If a form state number of a- cres;also statement of mortgage encumbrances upon each parcel at death of decedent.Taxes,assessments,accrued Interest on mortgages,etc.,are to be listed on Schedule "F"and must not be deducted from this schedule. ALL that certain lot or parcel of ground situate in Seventh Ward,City of Washington, Washington County,Pennsylvania,known and designated as Lot No.56 in Plan known and designated as Montgomery Place Plan Addi- tion No.4 and of record in Plan Book 2, Page 106.SOLD FOR BEGINNlliG at a point on Duncan Avenue,on the line diViding Lots No.56 and 57 in saic Plan;thence along diViding line between said Lots a distance of 160 feet to a point on Alley C;thence along Alley C,50.2 feet to Northwest corner of said Lot No.56;-- thence along line of said Lot No.56 a dis- tance of 17~.3 feet to point on Duncan Avenue;thence along said Duncan Avenue a distance of 58.15 feet to a point on divid- ing line between Lots No.56 and 57,the place of beginning. HAVlliG ERECTED thereon a,one and one-half story frame.6 room and bath dwelling and garage. BElliG SAME lot of ground conveyed to Willian: H.Davis and Helen Davis,his wife,by Deed of Ivan K.Leech and Marie M.Leech,his wife,by Deed dated May 31,1930,and re- corded in Said County in the Recorder's Office in Deed Book 569,Page 399. THE SAID HELEN DAVIS died January 28,1968, thereby vesting full and complete title in William H.Davis as the survivor of an estate by the entireties. (1 ) ASSESSED VALUE FOR YEAR OF DECEDENT'S DEATH (2) ESTIMATED MARKET VALUE $1.6,.000.00 (3) DEPARTMENT VALUATION CAUTION (Do not write In this space) -- 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 .COMMqN·WEALTH OF PENNSYLVANIA ~TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "B" PERSONAL PROPERTY ,, INSTRUCTIONS:This Schedule must disclose all tangible and intangible personal property owned individually by the decedent,at the time of his death.Property owned by the decedent jointly with another or others must be listed under Schedule "E".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 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 of or income from any property held in trust under the will or agreement of another,even though located outside of the State,at the time of death,should be listed in this schedule. Item No. ITEM List and describe fully UNIT ES:rIMATED DEPARTMENT VALUATION VALUE MARKET VALUE (Do not write in this space) 1. 2. Checking Account No.0433-0751, Mellon National Bank and Trust Company, Canonsburg,Pennsylvania Office, Savings Account No.6261, First National Bank of Washington, Washington,Pennsylvania Office, 1963 Dodge Tudor Sedan u.S.Savings Bonds,Series E,issued to William Davis or Mrs.Helen E.Davis (wife -deceased); 5,234.76 1,022.50 425.00 I-p25.00 "issued July,1959 1-,,25.00 -issued August,1959 1-~25.00 ...issued September,1959 1-)25.00 -issued October,1959 1-,,25.00 issued December,1958 1->25.00 issued November,1958 1...,,25.00 -issued October,1958 1->25.00 ...issued September,1958 1-25.00 -issued August,1958 1-25.00 -issued June,1958 1-)25.00 ...issued January,1961 1-25.00 -issued January,1957 1-)25.00 -issued July,1958 1-p25.00 -issued January,1958 1-,,25.00 -issued April,1958 1-~25.00 -issued March,1958 1...~25.00 -issued February~1958 1-)25.00 -issued May,19,5tj 1-)25.00 -issued November,1959 1-(25.00 -issued December,1959 1-~25.00 -issued January,1959 1"'152.5.00 -issued February,1959 1-)25.00 -issued December,1957 1-)25.00 -issued March,1959 1-)25.00 -issued April,1959 1-~25.00 -issued May,1959 1-5 25.00 -issued June,1959 1-~25.00 -issued October,1960 I-p25.00 ...issued September,1960 1...~25.00 -issued November,1960 1-025.00 -issued July,1960 1...,,25.00 -issued June,1960 1-)25.00 ...issued May,1960 1-25.00 -issued October,1957 (CONTINUED ON ATTACHBD SHE ~T) 29.05 29.05 29.15 29.15 29.93 29.60 29.60 29.60 30.31 30.21 27.49 30.64 30.31 30.83 30.08 30.08 30.83 30.08 28·46 28.51 29.83 29.83 30.71 29.12 29.12 29.12 29.0528.08 28.08 27.4=!. 27.98 27.98 27.92 30.57 ~f,CQ 2f/06 ;;,t(/5 d-.t1 /S c2 9·tlS01'7.~o c2?o'GtJ ;:le;o'tf)O $,.//.31~O,2/ ~?:/It?:81J.6q .30,31 30.tf~ :3(},,05 3{),(J! 3GJ.tf.3 ~o,tJP ,;:(t:.~6 e:<g,S/ c?9,j>..:f .;<tj,j>~ sCJ.7/ c:<9;/2- ..:29.1:2.-.:;.f,/:2.. ~9,05 C:::;~O? c:J"$.to"dl7 c// c:<7.9'? ~7,'?tf' -2792 3 tJ,0-7 Insert this total opposite "Personal Property",Schedule "B"in X X the "As Reported"column on the last page of this return. ,RCC-35 COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT PAGE 2 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 of or income from any property held in trust under the will or agreement of another,even though located outside of the State,at the time of death,should be listed in this schedule. Item No. ITEM List and describe fully UNIT VALUE ESTIMATED MARKET VALUE 28.60 28.60 28.51 28.51 27.98 27·4726.91 27 ..56 27.56 27·47 100.00 DEPARTMENT VALUATION (Do not write in this space) ·· ·. ···.·....·-· "··-· -·· ·.. ·.-.- .. Insert this total opposite "Personal Property",Schedule "B"in the "As Reported"column on the last page of this return. x X 8,059.19 ,'RCC-3f> COMMO~'WEALTM OF PENNSYLVANIA TRANS}~R INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "c" TRA.N SFEllS (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)lSfo (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)lSfo (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 prope~ty 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)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 wa~reserved in decedent alone or other·s ----:-_ (7)Did,decedent in his lifetime make a transfer,the consideration for which was transferee's promise to pay.income to or for the benefit of care of transferor?(Answer yes or no)No (8)Did decedent,at any time,transfer property,the beneficial enjoyment of which'was subject to change, be~"ause of a reserved power to alter,amend,or revoke,or which could revert to decedent under terms of 'transfer or'by operation of law?(Answer yes or no)No (9)If'the answer to (8)above is in the 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)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 NOlSfE DESCRIPTION MARKET VALUE (Estimated)DEPT.VALUATION (Dept.Only) Insert this total opposite "Transfers",Schedule "C"in the "As Reported"column on the last page of this return.lSfOlSfE l .' SCHEDULE "E" JOINTLY OWNED PROPERTY , ReC-3a RESIDENT DECEDENT COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX INSTRl'CTIONS: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 any)of co-owners to the decedent. Description of Property,Date of Acquisition,Name Unit Address and Relationship of Co-Owners,and Place Value of Record of Instrument,where Real Estate. percentage Estate Share Valuation DEPARTMENT VALUATION CAUTION-Do not Write In This Space. Value of Value of Entire Decedent's NONE Insert this total opposite "Jointly Owned Property",Schedule ,"E" in the "As Reported"colW1U'1 on the last page of this return.NONE RCC-37 (12-63) COl\1l\it)N'\\'EALTH OF PENNSYYLANIA TF.ANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "0" BENEFICIARIES ( h 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 William Ivan Forgie Grandson Yes Legatee 800 nm"l,.l:l'n Avtj:U.e ~ Washington.Penna. William H.Davis.Jr.Son Yes 1/21.L/31.L Devisee 127 Treehaven Road West Seneca.New York 111;:>::>11 Joyce Forgie Daughter Yes 8/9/28 De'l1;~ee 800 Duncan Avenue W~hington§Penna. Helen Dickman DaulZhter Yes t:;/18/27 Devisee 940 Arbor Drive San Leandro§Calif. Glenna Pettit n .,.Yes i/20/22 DeVisee lRo 'Whi te ReJl r.h,>,.1 A 1nTo1 1 qbuJ"Q'We~t Vj,....O'~rdR " 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 ~ Will Administration !No. P.oI THE Year . (Executor-Administrator must complete "As Reported"column #1.) ;,!I.I 0 >---'l '"0 ~...,...,(b (b0III...,e:-lI...en ::l en en en 0.....,::l '"'C'"'II >---'l -(b e:-...,...,III en 0:><'"0 "0III(bcr-...,...,co 0 ~"0 ~(b..., en ,....,....'<III,.... (b '~ I WILLIAM H.P1\VIS,,~I\~ Deceased Late of ..OJ ~Y.():r)J~~l:l:4lgt()n.. <:::l -C" Commonwealth of Pennsylvania County ofWaslli.n.g~OJ:l .r-- lJ ?-;r;,.~O ~, :>I-'en:co 0"~~~~.-.o 0'0"'-\nO 0-"-0 :0 ~:.:.~ 1-'0 .::::~o :1\)+:-. lo :0\.T1 : :--0 enc::~~>~ W en en ><n n?"'?"'::r'o ca >::::•-- -(,19 -(,19:-00 -(,19 -(,19 -(,19 :1-':-,0 .:. .' .-~~, I J ...~".-'t.; ......,.,.: '-...J '"'"0'::.1: REPORT :J\ND APPRAISAl;; ..'-f-r,:::c -'OJ G"')c:-~~..-~.~==;;:;(()c.-"')..-=--::rz........(.f);:~..-1 ..-......, oJ.'lij ~j --!---.J:)-. <~;."() <:)~.::..;. --.j c '.rt' ,.."""-(,19 -00 -(,19 -(,19 -(,19 JAMES C.BANE,ESQ.307 Washington Trust Build'ing Washington,pennsylvania 15301 ,. (~. (~~ c,~ .'\.~: ,.:fi)l:...~. .~ -~ .............-.. ",~,~> i9 ~;~~CS It;'0 .~8"t::;,"-,;'-""3- ~:'-.:}-':o~c.. r ""·w:.'For!"R~. f OFFIC'i OF THE FI£hisTER OF WILLS OF __W.;.;.;:.:;A.;.:.S_H...:;;I;.;;;.N;...G_T_O_N,,--_COUNTY ~3-7/-df STATEMENT OF DEBTS AND DEDUCTIONS DEDUCTIONS ALLOWED IN THE SUM OF ,....,......$ ,... DATE APPROVED ,, j AND AGENT OF THE COMMONWEALTH Register of Wills,Agent ESTATE OF WILLIAM H.DAVIS,SR.L.ATE of_~C~i:..;t~Yx..-:o~f!:..-WJt.Las~h~in::::Qg.:::t~o..:..:n:..--_ DATE OF FIL.ING APPRAISEMENT DAT5 OF DEATH __...s.Ju:an~u~a::!:.:r!:.aY3--6~.-.::!::1.....9:....L7.:!:1:.....-_ DATE NO.OF NAME OF PAYEE REMARKS AMOUNTVOUCH"" 19 r1 Certificate III Russell Marino,Reg.Probate Will &Short 22 C;o I/llP Washington County Reports Advertise Letters lL-00 ?/1 Observer-Renorter Advertise Letters 11.1 00 2/1 Bell Telephone Comnany Ecount 9 C;9 2/1 West Penn Power ComnanY Account C;97 2/1 Columbia Gas Company Account 18 00 2/1 S.Charles Badiali,M.D.Medical Services 7 00 2/1t Brownlee Funeral Home Funeral EJmenses 867 C;o 1/2 Citizens Water Company Account 7 66 1.1/2 Columbia Gas Company Account 3L-90 ll/2 West Penn Power Company Account 11 56 h/2 Pirris.Ruben &Underwood Medical Services 100 00 II/?S.Whitels Sons Monument Inscrintion C;C;16 lJ 12 Citizens Water ComnanY Account 7 66 r:;/h Harry R.Cook,City Treas.1971 City Taxes 84 00 hi?We~t 'Penn Power Comnanv AccOmlt 8 Lt2 6/2 Mitzi Chambers Ins.A~encY Homeowners PrEIlium 51 00 hi?'Mal colm L.MorQ'all Co.Trea •1971 County Taxes 61.1 98 6/2 William H.DaVis,Jr.Haul Garbage -Re imbursemer.t 18 00 7/7 R"0 0",,11 MQ,.,;,.,f"\RAO'.~hort c;A",ti l'i ~~tA 1 00 7/?lATe ~t 'P Ann ~'WH c;omn~nv AC~()llnt (2 1g""") 7/2 D Washington-East Washington ,Joint AuthDI1ity AccO'lll1t 8 82 7/2B Columbia Gas Company Account 39 13 7/2 ~l Harry Cook.City Treasurer 1971 School Taxes 193 65 (CONTINUED ON ATTACHED SHEE'l) COMMONWEALTH OF PENNSYLVANIA } COUNTY OF WASHINGTON so: t.WILLIAM H.DAVIS,JR. ington,vashington Co. es July 14,1975 Notary Public,WaMyCommissionExp HEREBY CERTIFY,THAT,TO THE BEGT OF MY KNOWLEDGE AND BELIEF,THE FOREGOING IS A JUST AND TRU E STATEMENT OF DEBTS,FUNERAL.EXPENSES AND EXPENSES OF ADMINISTRATION SUBMITTED TO THE ESTATE OF WILLIAM H.DAVIS,SR.~/jSED,AS DEDUCTIONS FOR 'NH'."ANc<TAX PU....,.".V;;~~~J,:t \SWORN .-ND Q,lJBSCRIBED BEFORE ME THIS ..::JI4"DAY OP'~:Lam H.D~~~"'/'(L..5,) .U t '8~ , tf , PAGE 2 STATEMENT OF DEBTS AND DEDUCTIONS WILLIAM H.DAVIS.SR.ESTATE OF LATE OF --=::;.=..:::.cL.--=o~f___:W;.:a=sh=_=in::.:.s;g;o.t:...o::.:n==___ DATE OF FILING APPRAISEMENT ...:...DAT5:OF DEATH __...JJOl.an~~u:t.Sarillz!:...YJ-~6w.~l::!:...ol9:..J7-=1!::.-_ OFFIC;.'i OF THE IJE··<;;'IBTER OF WILLS WASHINGTONOF__~~.:;:;::.;~COUNTY ,.....ForfJ!RC . ; DATE NO.OF NAME OF PAYEE REMARKS AMOUNTVOUCH,"" Russell Marino,Reg.File Inventory and Appraisement L-00 Rus sell Mar ino ,Reg.File Account 17 00 Mae Herceg:Notary Fees 8 00 Wi lliarn H.Davis Jr.Executor's Cornrni ssion 1,202 96 James C.Bane Attorneyls Fees 1.200 00 -TOTAL $l.L.078 8C5 ~UJ;~;"1Ua Gc~,tj'hO 0-()j,,~~...,,~~.'<1.....~-A"~t"-A fW ~AJ/1 C~?7r O 0~~J~;~~~-,Ad d-3S'-5'd COMMONWEALTH OF PENNSYLVANIA } COUNTY OF WASHINGTON 8.: I,WILLIAM H.DAVIS.JR. Co.,Pa. .\ /, ,'.'"j ~.' ,, ... -',.,.~ ~..' A. ••\~'.'I.1~", ,I ..) (I f\~f'I',"...,..... ."r~,r".......1'I ....1"..'V -.." .'",:.l "....,.~"~-\f\' .".... \"1',~'''''1 \............~.... ~...~~:::;1 -..:.1:>-rfj ;.,U:·C)C "''''--'1.:'''- :J::-.~:C"'..l ~~t'""")(/')v').~l IZ-tC.)tTl ,-'1 ..-.,~f'"...}~~,'tj.()r~-..,~C'~.--.I "l:j ..(") 0 ~:·1:-r-Z :....J-p r- 0'.::~G~I:;') r-...., en RCC-81 (6-711 ,3 /'?(d -7 -J'f COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS HARRISBURG 17127 NOTICE OF FILING OF APPRAISEMENT WILLID1 H.DAVIS,JR. (Executor~ IN YOUR REPLY PLEASE REFER TO Inheritance Tax Division 38-131-5 J In Re:Estate of __~W~T~I.I:=:,I=:A1~V1=-.:.::H~.--.:D:::A~V:...:I=S.2..,--.:S=R~.=---_~_~_ __--:.;l:l=R=SH=I=N.:...=G=T..::..;ON::..:....-__County -Fi Ie No.--=6~3_-7!....:1=---..:::..3~4 _ Dear Mr.Davis:, You are hereby notified that the__--=-:---=.o=::r~:=.·gQJ.Il='=::::a:::1=-=----=-=-_ appraisement in the estate of WILLIAM H.DAVIS,SR. has been filed in the office of the Register of Wi lis of__.lt\(W.I:l.JAS.;tHu"J-JiN.llI.n:.LiTu.O..l.lCNiL-_ County on November 24 ,19R,Said appraisement reflects the following valuations: Real Estate 1..,6~i~O'-"'OO=.!L~OO~_ Persona I P roperty_--"S..y,f-300""5'-1-9.........J9+.------- Transfers _ Jointly Owned _ Tota I -=2=4:2...:,Q59 .19 As to such tax that is paid within three months from date of death,a five (5%) percent discount is allowable.As to any tax that remains unpaid after nine (9)months (fifteen months when death occurred from December 22,1965 to June 16,1971,inclusive; and twelve months when death occurred prior to December 22,1965)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 _---=N-""ov--'-em=b:c..:e~r___=2:::t42'--.:1=-9LJ7~1~__ TitIe APPRAISER I DATE OF DEATH:January 6,1971 Note:This is not a bill. ~ ~~(5-68)' COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SUMMARY 63-71-34 JMO Estate of_D_A_V_I_S WI_L_L_I_A_M H_._S_R_.DATE OF DEATH 1-6-71 (Last Name)(First Name)(Initial) FILE NO.63-71-34 REPORT OF INHERITANCE TAX APPRAISER I,the undersigned duly appointed Inheritance Tax Appraiser in and for the County of__W_A_S_H_I_N--=.G--=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". November 24,1971Dated:------------- ,d~ INHERITANCE TAX APPRAIS~ 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 9 ,h nn r)nn 87 05 q 1q 24.0 59 1 NONE 24,059 19 Ih 000 00 8.05C 19 24,059 19 NONE 24,059 19 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 $---------t--2% Tax on $---------t----""-.% Tax on $---------t--5% nxoo$lK Tax on $15% ~~ptioos * Total Estate -1-__ TOTAL TAX COMPUTATION OF TAX $---------+-- $---------+-- $--------1-- $---------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 $l= Add interest at rate of 6%from_____to $-----'---- AMOUNT OF ESTATE TAX ASSESSED $-------.1L- Estate tax paid $---"L- BALANCE DUE $---Jl- Add interest at rate of 6%from ~ ------Ito-----$--------4' TOTAL TAX BALANCE $-------l 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. I I Will (...No.AdmInIstration IN THE Year .. MATTER OF THE APPRAISEMENT OF THE ESTATE OF WILLIAM H.DAVIS Deceased Late of . County of WASHINGTON WASHINGTON Commonwealth of Pennsylvania REPORT AND APPRAISAL l ... l... Fonn RCC-2 •./DEPAltt;MEN,!,OF REVENUE•BUREAU OF COUNTY COLLECTIONS HARRISBURG.PENNA.17 127 63-71-34 COMMONWEALTH O~PENNSYLVANIA RESIDENT INHERITANCE TAX APPRAISEMENT DATE ~~.y.~.~1?~.~~4...t !..~.?!. COUNTY "W,.~.~.h.~.P.:g.~..~.!!.. FILE NO ~..~.:..?..t::..~.~. WILLIAM H.DAVIS,SR.WASHINGTONWhereas..late of . in the County of ~~~~.!.~~.~2.~Commonwealth'of Pennsylvania.having died on the ~.~.~~.~day of ~.~.~.~~:.:r.19 .?.~.seized and possessed of an estate subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore.I,MAP.~.~I~r!.~.~.x ,an appraiser duly appointed according to law, having been designated to make a fair and conscionable appraisement of the said estate,and to assess and fix the cash value of all annuities and life estates growing out of said estate,hereby file the following appraisement: In the event that any future interest in this estate is transferred in possession or enjoyment to collateral heirs of the decedent after the expiration of any estate for life or for years,the Commonwealth hereby expressly reserves the right to appraise and assess transfer inheritance taxes at the lawful collateral rate on any such future interest. Description of Asset REALTY: SEE COPY OF SCHEDULE '!A"ATTACHED TO APPRAISEMENT PERSONAL: SEE COPY OF SCHEDULE "B"ATTACHED TO APPRAISEMENT total Unit Values $ Appraisement Made for Inheritance Tax Purpo.es 16,000 00 8,059 19 24,059 19 I--------------------+---tl~---+-- -------------------------------------t----tt-------- !---------t----tt---_+__ Having been duly sworn according to law.I do h~reby certify that the above appraisement is made in C~t formity with law on this 2.4.t.h day of N.Q.Y~mp.·~·:r.···kr·j..··..................................1~..........2tu:)d'.L.~:u ..~J.-~~. 244 \vASH (J Ap raiser....................................................:I.NQT.QN T.RUSr BU.I.LDING ..................WOolL~ii.Z;')Penna. WASHINGTON County Date of Death, RESIDENT INHERITANCE TAX APPRAISEMENT Estate of WILLIAM H.DAVIS,SR. Deceased. Late of wA.:~BJ.NQI9..N . 1-6-71 Appraisement Docket Vol 38.,;. Po.e 131-5 T 63-71-34g,No .. Filed in Register's Office,~~.y..~~.4 19...?.!. Amount of tax due,$. DEPARTMENT OF REVENUE Received, Exa.mined and Approved,.. Wrote a.bo.ut Appra.isement, 'Vd "0:)i~O.L:JH1I1S1/,\ STl !"'.~!'~.':J:l LSI 0j J Oi<:·'·~-·.f~t ,~SSntl Appeal ft-om Appraisement,1 I Entered and charged,.. t:!;1~ 4 .'ii :,~~jJJ I L " /' ~. -~ -----------...... RCC-4 (8-68j No·B --~~------------~--J COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE45844OFFICIALRECEIPT0PENNSYLVANIAINHERITANCE AND ESTATE TAX RECEIVED OIiE 'l'iIOUS/dff)OUE H'01if.mEf}TitENl'! From:\'JILLIAM H.DAVIS ..JR. \1'l ' t:J2/lr»-,..,.tll"".'"R'•••If'.'l,.PtUI"1"-"U Ifrepresenrlngt'ennsy vania nnerlTance or Estate Tax due from the following estate: dollars 2%Tax on $_$,--------_.~~ 6%Tax on $---.:,.,....-,.."..-,_-==----$,--~~".",...~~---111t18,66 7.OJ 1,1200 02 File NO._L..."........,.............~__Date of Death--....--,............._-----1v3-71-34 Dote of Payment -----i====-"""'-"I"T_r-------! Nom e of Deced ent ---'WGtIAfrH;;lOOr.r.S;-Sffi:--i•>~.. County ----mlSttrJlltrrON'-----------, Remarks: 15%Tax on $,-'-_ %Tax on $_ Estate Tax,Act of May 7,1927 TOTAL TAX CREDIT Less five percentum of tax if paid within three months after date of death Plus interest at the rate of __%from _ to _ $--------1] $--------hll $--------1t.II $---------0 $---------.111I SEA L TOTAL AMOUNT PAID $==1=*91=Ff!p)====I~1.120.02 NOTE,!hI,T••"....R~.I~..b.~..,"..10.""'""".......()'\(\~7lJ.. 3$w]31"";Received b'y~.J'Jk..JLX.t L!~pJu~Q NOTE:In accepting the transfer inheritance tax an future estates,prior to the death of th,(life -'I ~.(Sigl)"a'turj II tenant or tenant for years,as evidenced by this receipt,it is understood thot the Commonwealth ~hall ../.j J IIII ' not be precluded or prevented from hereafter assessing additional inheritonce tox at the death 01'111...::,./'i-,,~.Lt ~Q./~G,(t..C<~:::tQ) life tenant or tenant for years whenever it appears that such additional tax may be legally due and ..\:.'\,,'!I.tie) collectible for ony reason whatsoever.,-)!'1