The URL can be used to link to this page

Home My WebLink AboutOC1971-0490 - ESTATE OF BROBERG~3-7/-~7'Oi\ffi~nuit (@f iExrrutnr (@r i\bministrntnr i.'tatt of 'tltl\lt~~~~~i:nt ss: (!1.nultty nf ~lfl11~1 P II b f h d . d h'notary'nub lic .d f 'dersonay e ore me,te un erslgne aut onty,a /h m an or Sal County and State,appeared B)J.gg.J..l?h 9..:E?r..<?.9..~.r..g who,being duly sworn according to law,deposes and says that he is the executor or administrator of the estate of Olga Broberg ........,;deceased,that the foregomg schedules constltute a complete inventory and appraisement of the real and personal estate of 9.Jg.9:~.~g.!?.~.E.~, 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,mad~by the above .named Executor .A:dmi7<Jr., .:'S't!!0r..nd subscrzbed before me thzs.......I..S........l iJ~!.r//.,m~;~~c~;:··~:~·'r···········19...3...j;U....·E~~~~'ff····· Pit1sL~rgh,'f~;f3glier;Y'iiuii',a~..·..·..·......13.... My Commission Expires ~!yMf'lVl~'NAL INSTRUCTIONS "rAlI/lUst 7'1973 'b f'l d .h'h h f .fl'. ;'Ali mventory must e 1e WIt m tree mont sater appomtment 0 persona representatlve. 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 Copies and 2 RCRI-33, Over $10,000,including Copy of Will;1 Original and 3 Copies and 2 RCRI-33,Over $50,000,in- cluding Copy of Will and copy of Federal Estate Tax Return. REFERENCE FOR ADDITIONAL COPY Act of 1947 P.L.513 Sec.5.2,72 P.S.4844.2 lJuututnrg aub i\ppraispmtut of the goods and chattels,rights and credits which were of Q..+..g.(~t ?>;r..Q.l?.~.r.,g late of g~.~..c;:.:.~~.~~.~.~.9..~.p.. Washington County,Pa.,taken and made in conformity with ,the above affidavit. J Mutual of Omaha -insurance ben,efits Allstate Insurance Co.-net proceeds settlement of accident claim vs.Gordan Wellman Total Personalty DOLLARS ~34 8 693 3 6000 00 6,728 21 CENTS ..... All that certain lot or piece of ground in Peters Township,Washington County,Pennsylvania,with five room frame dwelling erected thereon,acquired by Deed dated 6/30/50 recorded in Deed Book Volume 788,Page 511 (sold 9/7/71). Total Realty 5500 00 5,50000 / I •,/1, 0<s-9L/ Inventory and Appraisement IN THE ESTATE OF Olga Broberg........................................................................................................ Filed :.,19 . c... ;::;:;0 :b ;:;1 :::0 (/)0C::r:-cn:::;:(I)(rJ;;;;:~ -{:1)i~-<::.> :<:0 _.'....-rJ ~...,=-:,~6 ~..i;.:;::::~ <:Jr-::;:-f>(/)~-> '"~t..v ~ ~-~- ",) /;.,0 ~b :.:::;r t..v e...." ~ ~.,,-1- :-;-;~~t W.Reid Lowe,Esquire Meyer,Unkovic &Scott 1424 Frick Building Pittsburgh,Pa.15219 ~9~nf~3 ..4••tgMAQ$~_...__.-.-..-._----------------------------- Q!nmmnuUttttl:t4 nf JtuU!iglttttuttt.~ lItt!i4tugtnu Q!nuutg.\!iIi: KNOW ALL MEN BY THESE PRESENTS:Whereas,at Washington,in the County aforesaid on the 13 day of May A.D.19 71,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 Olga Broberg late of R.D.1,Venetia in the County aforesaid,deceased, (a true copy whereof is to these presents annexed),was duly admitted to probate;and Rudolph C.Broberg the Executor in said Will and Testament named,having appeared before me and taken and subscribed the oath of office pr,escribed by law; NOW,THEREFORE,I,Russell Marino ,Register as aforesaid,do grant these LETTERS TESTAMENTARY,unto the said Rudolph C.Broberg 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 inheritanc-e taxes. IN TESTIMONY WHEREOF,I have hereunto set my hand and the seal of said Office at Washington,this thirteenth day of May .in ,the year of our Lord one thousand nine hundred and se vent y-one ~\...................................................................~ Register N ._......-....;- ---~-- / I,Ol[';a C.Broberg,of RD III Venetia,Penn.sylvania,beinf.~of sour:d To my children: Almeda B.Shephard P.~dolph C.Broberg Josephine B.Leddon Hilliam L.Broberg Hartha B.Stevj.ck· Harry R.Broberg or their sur\Tinc;spouse if any of them should precede me in death; or to their surviving children,if·both should precede me in death, I bequeath all my property,both real and personal,to be diyided equally among the six parties• .~'-Iy five-room dwelling is to be disposed of ao statec ~~n Deed !.J211l4, Rec~rded 7f\S-5l1 and the proceeds a.re to be divided equally as statec3 above. I hereby appoint,Rudolph C.Broberg',the executor of this my last ,·;ill and testament•. In Hitness i'Thereof,I.hereunto set my hand and seal Si::::ned and sealed by said Olga C.Broberg,vlho at the S<:L'n8 time,.published "-and declared the same,as 3.J.'1d for her last ,rill and testament,in the presence of us,who,in her presence,and in the precence of each other,a.nd at her 7 27 "I, ....-:.) I ~r.-;..I/1')1.'IIII" witr,esses. • J _. ! I '.! r= STATE OF PENNSYLVANIA, ~COUNTY, ALLEGHENY The wif'hin named Accountant being duly sworn according to lawl deposES and says that the above account as stated is true'and correct a5.-Jle.veri Iy believe, ..-~Sworn and subscribed before me this .J.~. " Washington CountYI ss: ..~.~~. I do certify that I have given leg'al notice to all persons concerned of the filing of the within account in the manner prescribed by Statute and Rule of Courtl as evidenced by proofs thereof filed to No Ce..~.~.l3..--::..!. Witness my hand and official 'seal this £. day of ~19.L-.Z. ;G1~~ ···············;:·····················R·~gi~t~~··;f··Wi'ii~"C9 ~·1,...0:+>+>0 ...I'l +>.p,::l 0 oJ::l!..0 +>I'l .~I......~~,L....._..;.....'"Q I'l::l 0,::l\)1 0 o>i Q)0 ~<.l ,.<:I <.l<.l ><:,~.vt ~,.+><.l 'di ~~.~~r:Lli 0 0>,\.'~+>.......',0>(/)!.,:"0 ~0 ,Q)...~j cd,ad.\+>i'I"!"'.~:..i.:',I'l ·rl :>.o>i ~,..t )..Q)::l qJ~0,0>'l-J L.'II ,.,~rtl 0<,I'l 0 -'Q)......00>'rl .D >:>0 (/),+>N 1 i P:l °i cd 0 r:Lli +>tEo<.....,~~~I'l,<~":·rl i=Q r;U:;:JEi_L f.~/~:~.\1N0 ::l ,,:Eo<0 bO'II-<<.l~U1 <.l 0>P:l ~1\Eel s'r E~\(\~VllLLS oj :s ~0>'d 0 \.,I'l 0 I !.0 ~\'lAS HIHere ii cO~I PA,...;:a f-=! 0 cd .c .....,'"~0.,J .~.~'d~i i=Q .p rl,0 Q)·rl ~(/)0,.....,,.<:I 0>~.....,~cd ~'d!0 ~0::: bOo ·rl ::l,I'l rl,II-<0::::"0 N .0 OJ I'l 0;~z ~r-i ...-: ...."..._........ ..,...) .ifJI-· "...,.....-......... J 'aWlsa U!UO!lnqplS!p JadoJd au!wJa..l,ap O.j.palSanbaJ All np::>adsaJ S!lJnoJ a41. ••J \, } ,-.--. >\ ... ,,._....,.. .~....~.. r .10.... IN THE ORPHANS.'COURT OF WASHINGTON COUNTY,PENNSYLVANIA ESTATE OF OLGA BROBERG,DECEASED •<. FIRST AND FINAL ACCOUNT OF RUDOLPH C.BROBERG,EXECUTOR. November 24,1972 S.U M M A R.Y SCHEDULE A Amount transferred from Principal- Realty.Account for Distribution Receipts .Disbursements R~.ceip~s Disbursements Page 2 Pages 2..and 3 Balance SCHEDULE C Page 4 Page 4 Net Balance $6,728.21 5,445.00 12,173.21 4,094.43 5,500.00 5,500.00 $8,078.78 o .00 o THE BALANCE CONSISTS OF THE FOLLOWING: Cash on hand Cash (distributed to legatee)2,250.00 .$8,078.78 ... SCHEDULE A PRINCIPAL-PERSONALTY ., RECEIPTS 1972 Inventory and appraisement filed,., Amount tran..sferre.d from P,rihcipaL-.,\Realty,·Acc.ount for Distr~bution DISBURSEMENTS•I' ~I .' ,Administrative,Expenses 1971 $6,728.21 5,445.00 ..$12,173.21 Rus~e11 Marino,Registe,r of Wi11s--_.. grant of Letters ;Te~t~erltary.$ Observer PUblishing Co.-~advertistng . . "t·.f;..".,.',....-:;~<".",, Was~1,ngton County Rep~I"ts--advertising Russell Marino,Register-:'fil~ng" inveh.tory and :.additional,cos,ts of letters 12.50./ 14.00./ 14.00 or' IF'OO v.......',' Nota;r'yfe~:s ~ndmisce1~aneous ..••~~arge~ Russell Marino,'Register--:f11ing Account •..'-.• •\1 .t-..1.•,-.....',. • Meyer,Unkovic &Scot~--~ttorney~'.fees . .13.42 ./ '.. .19.00/ 6600.00 v 1971 Total Administrat~~e Expenses.., Preferred Debts 684.92 Oct •.27,Kurtz Monument Co.--headstone ThomasL.,Nied--~uneral services Dr.Donald C.Brown--professional services . Bortz Lewis Asso'c.--professional services ,Carried Forward -2- 145.00 V' .,'...., 1,440.60 v 70.00 v 7.00/ $1,662.60 $684.92 ... 1972 Oct.7 Oct.7 1971 July 20 1971 June 6 June 6 Sept.3 Brqught,Forward Martha Stevick--nursing,serv~ces Almeda Shephrrd~~?ur~ing serv~ces Total Preferred Debts . Other Taxes Russell Marino"Agent--paynient on account of Pa.Inh.Tax Less discount Other.Debts, G.Raymond Baird"'Collect'or" Peters Township Real Estate Tax Malcolm L.Morgan'" County Real Est,ate Tax C.Raymond Baird"Collector School District ·.Real Estate Tax $J,,662.60 720.00 1/ 720.00 v 186.00 9.30 ,' .12.35./ $684.92 $3,,102.60 176.70 130.21 Total Disbursements -3- $4,,094.43 ,.' ,.' 1972 SCHEDULE C PRINCIPAL,.,.REALTY RECEIPTS Inventory and appraisement filed ,D!SBURSEMENTS Loss ,on Sale of Residence 1971 Sept.7 Proceeds'sale property in" ,Peters'Township;'Washington County,Pennsylvania t'o''. Lowry.Andrew Shepherd E:lt ux LESS Loc~l 'real estate transfer taxes Net proceeds...~ Inventory value ,$5,500.00 55.00 5,445.00 5,500.00 55.00 Amount transferred to Principal- PersonaltY,Account for distribution Total disbursements -4- 5,4'45.00 15,500.00 1971 Dec.6 ... ""., EXHIBIT NO.1 Payment on account of distributive shares: 'Josephine Leddon Almeda Shepherd., Harry R.Broberg .Martha Stevick William Broberg ,Rudolph C.Broberg Total $375.00 375.00 375.00 375.00 375.00 375.00 $2,,250.00 Observer -Reporter WASHINGTON,PENNSYLVANIA PROOF OF PUBLICATION In compliance with the News,paper Advertising Act of 16 May,1929, P.L.1784,ll;S amended. Commonwealth of Pennsylvania,County of Washington,55:........•... Personally ap·peared before file,a Notary Public in and for said County and State,.Ri.c.hard S •....c.ow.an ,who being duly s,worn according to law,deposes ,and says that he is the .Yic.e~.Pre..s.i.den.t of the Obs'erver PUblishing Company,a Bennsylvania corporation,and its agent in this behalf;that the said Com.pany is,the owner and publisher of the Observer-Reporter,succ'essor.to The Washington Observer,established September 18,1871,and The Washington Reporter,established August 15, 1808,a daily news,pape,r of general circulation,printed and publis,hed and having its place of busines's at Washington,Washington County,Pennsyl· vania,where it or its predecessors have been established and published continuous'ly for more than six months prior to the publica;tion of the notice hereto attached;thaJt the pr.inted noticfJ~~I'dvertisement hereto attached is a ,copy of an official advertisement,01:1.A .:lOtice,legal notice or legal advertis·ement,exactly as printed or publLhed '1 the Obs1erver-Reporter in its regular editions on the following dlate o.i);es;. ...................................May.26.,J.un.e 2 and 9.,.1.9.11 . that neither tae affiant nOT the Observer PUblishing Company is interested in the subject matter of s,aid notice or advertising and that all of the ane,ga· tions of this affidavit as to the time,pl~and character of publication are true...!&i~.i..~.... "" r '.. I .. Sworn to and sUb9mibedbefore me this..9.day of J'~p.~.1.91.1~..V(".-L '7tI..........--'d.. MARGARET :':.BRADLEY.NOTARY PU WASHING]L.,\'/ASI-IIi:C feN COUN',{ MY COt.H111SSION EXPIRES MAY G.1972. Washington Co!nty Reports Washington,Pennsylvania (PUBLISHED BY WASHINGTON COUNTY BAR ASSOCIATION) PROOF OF PUBLICATION In compliance with the Newspaper Advertising Act of May 16,1929, P.L.1784 Sec.3,paragraphs (3)and (25). COUNTY OF WASHINGTON}SS. 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 officiatl.legal periodical for said Washington County,published weekly hav,ing 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 31,1920,and was designated as the official legal publication for Washington County,Pennsylvania,by order of the several courts of said County,dated November 11,1920;that the printed notice or 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: ........~.~y.?z..L ~..~.7..L . ........J.une 3..t .l.O ..I..9.1..1 .. ES.Notices e Register of wms has granted letters,testamentary or of administration, in the following estates.Notice is hereby given to all persons indebted thereto to make payment without delay and to those having claims or demands to present them for settlement to the Executors or Administrators or their Attorneys. • •••• • •• ••••• •• •• BROBERG.OLGA.Dec·d. Late of R.D.#1,Venetia,WashingtonCount)',Penna. Executor:Rudolph C.Broberg Attorneys:W.Reid Lowe.MeyerUnkovic&Scott,1424 Frick Building' Pittsburgh,Penna.15219 ' , 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 time,place and character of the publication ore <ro,.--t1fmk--.-(Q--~~ Sworn to and subscribed before ~~ ~.'.~'''''daY of.:,~.~.~~..~,19n..L.::::O-··rJ.-!N~~ JOSEf'::HJE T.S~IMiANrlA Notary Public,Viashingt~~,Washir.gton Co. My Commission Expires July 1.1974 ~1t t4r Qrnurt nf Qrnmmnu 'Irun nf lIun4iugtnu Qrnuuty ®rp4uun'Qrnurt minininu In the matter of the Audit of Account in Estate Of_~~=-·-=L='C;;:;'=":~~~--!..-L-=--R-.::...~=--~-=-8tG~:..;:::..( TO THE AUDITING JUDGE: No._---'4'--q:...-()=---.::~:..LP_\.:_q_L,.....!........L\_ Enter 'f"\:f appearance for__~"::!-=--~--=">;>,;,,Lt>~l-::..LP...l:t!:!-__~,::::::::~=----=::~{L:::.~~~..£..sJ.§~~/T-'_ ~'"t...v~reR. N.B.-Counsel sh<all,by separa:te paper,present a concise statement of each claim,w.ith supporting calculation of any interest claimed.Objections to an account as filed,shall be concisely stated in a separate paper. Council suggesting proper distribution shall file a separate concise state- ment in that regard. Testate Form PETITION SUR AUDIT IN THE ORPHANS'COURT OF WASHINGTON COUNTY Estate of Q.1K(iL;e.:r.9.P.~.:rK ____ . ........................._--_.__ __.__-__-_.._----_.._.._---_.._-----------_.._--"-------- Deceased No,4:~.~.._~!::J.~.IL __A. A. Fiduciary.~~9.2J..P.~Q.!~~_9-~~K.__._.. Place of; ........._ _ _.._........Record _ _.._._.. Date of Date of Decedent's death ~.P.r.+.J ?9..?._J9.7J ___Grant of Le,tters N~.Y...13..1 J.971.__..__._. This is the Fir.s.t and...F.inal _account filed in this estate If there have been former accounts filed in this estate,list file number or number and term __. ....._--_---_--__.._--_._--_.:.__.__._----.____---_.._----.-_.._----_--._-_..__ ___--_ _--__----.---__--________-.--_..-. Election to take Date Election Under or Against will.(cross out one)Not applicable Filed Name of surviving spouse N9.~~_ _ ;_._._;:_~-------.------..----------.._..__...,. List issue,where material: Not material:' Did decedent marry after execution of will?(indicate)X]GC No.Any children born after execution of will?(indicate) B.No.If answer yes,name them __.__.._.___.___..___.__, Leg,atees Relationship Interest Fiduciary,if deceased or not sui juris ~lmeda B.Shephard Josephine B.Leddon artha B.Stevick Rudolph C.Broberg William L.Broberg Harry R.Broberg Daughter Daughter Daughter Son Son Son 1/6 residue 1/6 residue 1/6 residue 1/6 residue 1/6 residue 1/6 residue List,if exceptions to above: None If partial 'intestacy,give facts: None 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.JlSf£K If any exception give cause::N9.I]~L _ . File copy of Notice and date of mailing Q.QI2y...attachedi dat.e Ql'...ma111D.g..:-:F.eb.r.uary...~9~19.'l3-"..,,, Is estate subject to the filing of a Federal Estate Tax Return?···N.Q·····················i;ess···········'·~i80:·Q"cf················. Actual payment made on Pennsylvania Transfer Inheritance Tax.Amount $..dis.c.0J.U1t.....:::..9.Jl3Q.....:=:=...$.1.16.70 If the Will makes any portion of estate subject to a life-estate,give name and birth date of life tenant . ..............N9.~..~..P.P.*;1;..9..?-p.~~. 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. All creditors have been paid 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 Balance for distribution per account, Itemize any additional debits not shown by account: 1 • Total ''additional debits (Add) Itemize any additional credits not shown by account: Almeda B.Shephard,advance distribution Josephine B.Leddon,advance distribution- Martha B.Stevick,advance distribution - Rudolph C.Broberg,advance distribution - William L.Broberg,advance distribution - Total additional credits (Subtract) Balance for distribution $8~.Q7a.•.7.a . $:N9.~~. 1,100.001,100.00 Harry R.Broberg,advance 1,100.00 distribution -$1,100.00 1,100.00 1,100.00 $.6,.9..QQ,.Q.Q . $11.~.7.~.!.7.~. I If balance for distribution is not in cash,list each item held in kind,giving appraised Value (or distribution Value); Balance for distribution is all cash• .".--......... ----~--- • If Family Exemption claimed by Petition,give place of Record:J{Qt Q.l..a.:LJJH~.~L . If F '1 E ..I'd d"I'h'd b -'f CI'Not claimedamiyxemptlonIScalmeatauIt,give name,re atlOns Ip an aSls or aim:. List any advancement or distribution on account that has been made,and nature and amount of same: Almeda B.Shephard,cash -1,475.00 Josephine B.Leddon,cash-1,475.00 Martha B.SteVick,cash 1,475.00 Rudolph C.Broberg,cash -1,475.00 William L.Broberg,cash 1,475.00 Harry R.Broberg,cash 1,475.00 Suggested distribution of balance shown,both as to principal and income,attaching signed and to take in kind if balance is not in cosh:residuary shares being stated in proportions: Almeda B.Shephard :;-1/6 balance Josephine B.Leddon;-1/6 balance Martha B.Stevick 1/6 balance Rudolph C.Broberg -1/6 balance William L.Broberg 1/6 balance Harry R.Broberg 1/6 balance ~t..t.CG~~UCOUNTYOF'W"StiIt~GT ,SS: COMMONWEALTH OF PENNSYLVANIA. The above named Fiduciary or representative thereof, itemized elections being duly .s.W9.:rn doth depose and say that the facts set forth in the foregoing petition are true to the best of his knowledge and belief. ..................~Y!.~~.~to and subscribed before me th;s ;?2.f.,Lday aL~)J l9.7.;L Signature of Officer.~£.~..~. Title of Officer 21...~;(~.~~~~4lLEN POST,NOTARY PUBLIC Office expi res.....,..wHm~,\J•.L-.~g:',eJJG~,.}J.:.EG~.f"'I.~.W.!l'J!y •••••••••••••••••• MY COMMISSION EXPIRES DECEM3ER 29.i970 And your petitioner will ever pray,etc. ......................................................................................'!"!'!". .# I.J, u: .:. (. No..~~.~~.~~.~..J..\A.A. Estate of OLGA BROBERG.............................._---..--._.----_--___-----.. Deceased F'd'RUDOLPH C.BROBERG,I uc10ry . ;Executor.---_--__--"','"------ --__",. _PETITION SUR AUDIT FROM WHERE DECEDENT 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:paragraph b-c;and divisions thereof:shown on pages 23-24. 1.Written praecipes of all Counsel in the case. 2.Copy of order appointing Guardian ad litem,if pertinent. 3.Copy .of Order appointing Trustee ad litem,if pertinent. 4.Proof of service of above. 5.Letters Testamentary or Administration C.T.A.or an attest copy of Will. 6.Copy of inventory and appraisement. 7.Proof of advertisement of grant of letters if not filed with account. 8.Certificate of liens in case any of the funds for distribution are from judicial sale of real estate. 9.Signed and itemized elections if any distribution in kind. 10.Copy of Federal Estate Tax return if es- tate is subject thereto. W.Reid Lowe,Esq. Meyer,Unkovic &Scott .....:.t:~.?~:f:;r;.:i.Qk..f?JJ1.lQing.------.-..---.. Pittsburgh,Pa.15219 Attorney ~2 -: \.\ Ft LEDJ\""~:~ \'13ftAy 9 r»f,?l3..j \,Rue SE:lJ lAA~mo REGlSTEH Or WilL§ WASHIN<iiON QO.,PA, ,. ... " -" > -~------.--- j IN THE COUR T OF COMMON PLEAS OF WASHINGTON COUNTY,PENNA. ORPHANS'COURT DIVISION HEARING ON AUDIT -\ INRE: Estate of OLGA BROBERG, Deceased. "z"~>-Ul ZZ IIID. ( ) ( ) ( ) ( No.490 of 1971 Broberg.Executor.with W.Reid Lowe,Esquire.Mr.Lowe? Petition Sur Audit in the estate of Olga Broberg,with the necessGry I.'\ gBEFORE:I-elZ J:Ulc( ~ ..:APPEARANCES: u itIii c .J"u §TIME:., :t..,.. III tti~THE COURT: II:oD- IIIII: I-0: ::J8 MIL LOW:E: .Jc( U i;: Il.o The Honorable ALEXANDER R.CURRAN,Judge W.REID LOWE,Esquire,of Pittsburgh,Pa., representing the Accountant. Friday,March 23,1973,at 9:30 A.M.,EST ,The estate of Olga Broberg'..Rudolph S'. If the Court please.I present herewith the exhibits attached.All the creditors of the estate have been paid. There is a balance of Inheritance Tax due.Otherwise,there are no problems and no matters which require the Cou rt1s adjudicatic n. THE COURT: of Olga Broberg? Is anybody else in Court interested in the es ate (,NO RESPONSE ) -I I , " ; '"?',~.,.,' THE COURT:We will consider the audit closed. ( A UDIT CLOSED),_. •,.' I e t hereby certify that the proceedinqs and evidence are 0( z0(contained fUlly and accurately tn the notes taken by me on the beartnq of>..J>-Ulz the above cause,and that this copy IS Ii correet transcript of the same.zIII0.. ~.:•":-.~~-. "....C)'.~Iz~ "'.Ix.-I.I Ul ]Ol I~0(.Of~4~1 8t,~grapher3:- \.. I i ..:u '0:V'....,Ulec .".-I•0(:u c .The foreqolnq record of the proceedings upon the:J., :tI-,.. hearing of the above cause is hereby approved and direeted to be fUed.(II rtin:III By the Court,...n: 00..IIIa:~1t!!f~I ...n: :J0 I u.~..J, 0( u d-r~~1.ii:1 7I"-'~,U.0 e ~.~':....,.,.,\~.;.....,...t-:.,'"-,• _.1:>-r,- •I I I ~" '.i ., .' '"." \. .:...t •.f .,,, .. ,..~!. ,, ..-'t~ --Jv->""'J'.... :::It ---!:::;rn r-O 0.,. ,"'\ ~n tqe Qtum uf Qtummnn 'leas uf IIns4ingtnn <ttnunty, 'ennsylnnnia,(@rp4nns'Qtum linisinn ) ESTATE OF Olga Broberg, Deceased. N~63-71-490 In the matter of the First and Final Account of_----'R~u~d.:;.o l=.l,;p;.;;h;;....C~.-=B;:;.;r;;..;o:;..;;b:;..;e:;.;;r-=gu.__ Executor ADJUDICATION AND DECREE And now May 11l;"I 19~1 this matter came on for hearinglauditanddistributionatthissessionandtestimonytaken;and thereuponl upon due cons ideration thereof of the balance for distribution in the hands of the Accountant is determined to be $8078.78 and the account is accordingly confirmed;and it is orderedladjudgedanddecreedthatthesaidbalancebepaidoutbytheAccountantinaccordancewiththe schedule of disribution hereto attached and'made part hereofl unless exceptions hereto be filed sec.reg.or an appeal be taken herefrom sec.leg. By the Court, ~p(l~.-¥ J. SCHEDULE OF DISTRIBUTION Balance per account _ Balance _ Deduct Clerk/s Costs &Receipts _ Attorney W...........~B.....,""'e'""'id..........I......dQ"'_'w"'_'·e"'___ Russell Marino,Agent,balance of transfer inheritance tax,$307.89 Interest from 7/20/72 to 5/21/73,15.39 Almeda B.Shephard,1/6 residue,credit to be taken by Accountant for advanced distribution for $1100.00, Josephine B.Leddon,1/6 reSidue,credit to be taken by Accountant for advanced distribution for $1100.00, Martha B.Stevick,1/6 reSidue,credit to be taken by Accountant for advanced distribution for $1100.00, Rudolph C.Broberg,1/6 residue,credit to be taken by Accountant for advanced distribution for $1100.00, William L.Broberg,1/6 reSidue,credit to be taken by Accountant for advanced distribution for $1100.00, 24.00 1288.59 1288.59 1288.5E 1288.5E 1288.5E Harry R.Broberg,1/6 residue,credit to be taken by Accountant for advanced distribution for $1100.00,1288.5E No balance N (Y") t"..J (',..> ::t'....Q, b ct ~~t 1 ~ -----'::c -.-.,,~"V,')• 1 1 r--"""-C> ,' ,,' "'- c. ~ 0*'» m n :l Z (II n .",... 0- 0 ....9 ~ ....c::r (\) :l (\).~.... 0 0 3 +"\ ..,., ~ ..,.,0.... ~ it., := 0..,.,.... ~ :r(\) & ~::l~~ .' WILLIAM A.MEYER ALEXANDER UNKOVIC HOWARD I.SCOTT WILLIAM G.BOYLE W.REID LOWE MICHAEL J.BOYLE LAWRENCE B.NIEMANN WILLIAM A .MEYER,JR. FREDERICK J.FRANCIS RICHARD G.KOTARDA P.CHRISTIAN HAOUE CHARLES W.ISALY WILLIAM P.GETTY JEROME J.PURCELL June ·6,1973 MEYER,UNKOVIC &SCOTT AT':fORNEYS AT LAW 1424 FRICK BUILDING PITTSBURGH,PA.15219 AREA CODE 412 281-5700 J Mr.Russell Marino Register or Wills Court House Washington,Pa. HE:Estate or Olga Broberg,Deceased No.63-71-490 Dear Mr.Marino: I am enclosing herewith a check drawn on the above estate account in the amount or $24.00 in payment or the clerks costa and receipts as shown on the Decree dated May 8,1973. Sincerely yours, :r~d~ W.Reid Lowe WRL:cae Enclosure RCC-43 (4-69) COMMOhlWE~LTHOF PENNSYLVANIA D'fPARTMENT OF REVENUE HARRISBURG J NOTE:TO BE SUBMITTED IN TRIPLICATE Pennsylvania Department of Revenue Bureau of County Collections 26 S.4th Street Harri sburg,PennsyIvan ia or The UniQn NatiQnal Bank Qf Pittsburgh Dear Sir: NAME OF REPORTINGFINANCIALINSTITUTION _ P.o.Box 837,Pittsburgh,Pa.152.30 Att:GeQr~e K.steinbaugh.Asaft Vice President f!72-00.3524-5(Savings) ADDRESS ACCOUNT NO.OF JOINT, TRUST OR INVESTMENT DEPOSIT -=--~----=--------- NAMES ON ACCOUNT Olga BrQberg OR INVESTMENT ----------;=--;:"-r=~-r.--~==---Mrs.llineda b.Shephard Pursuant to Section 742,Pennsylvania Inheritance and Estate Tax Act of 1961, we herewith submit the following report: DECEASED JOINT DEPOSITOR,Olga BrQberg l.-/ TRUSTEE OR INVESTOR _ ADDRESS R.D.#1,Box 30,Venetia,Pa.15.367ANDCOUNTY _ AprU 20,1971DATEOFDEATH _ SURVIVING DEPOSITOR,Mrs.Almeda D.Shephard BENEFICIARY OR INVESTORR.D.#1,B-Q-x-:3::-::':O-,~~O::-Te-n-et~i:-a-,-:P::-a-.-,1::-:5:-::3~6~7 -------- ADDRESS ...........,,~=~-------_Daughter RELATIONSHI P TO DECEDENT ---m~m___Jr.__'~~-----_ DATE DEPOSIT OR INVESTMENT lVI8l'ch 4,196a WAS ESTABLISHED -------r."!:'k-~--------448."BALANCE,INCLUDING INTEREST DUE,AT DATE OF DEATH $_ ~t ¥'I'J',!.J.;.,1..;1.'iiI7 ,.~/ _/..!,Lf..!'t ~)j.t(1-(7 J"~.)C~SSR~ADS OFFICE RCC-134·(1-69) COMMONWEI\L TH OF PENNSY LVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS ~INjiERITANCE TAX DIVISION~_.....'J-" OFFIC!AL..N~nCE 01=INHERITANCE TAX APP"RAISEMENT AND AsseSSMENT OF ASSETS NOT SUBJECT TO ADMINISTRATION 0:;. TO:~4ES 1:.LNLPr\D.5H.l:.PMARD R,n.iJ1HQX ;30, Date:-----£'H~~~/-:J~,rll~9'+7+-1 _ County -~l+J:JAr£SrHH-fUNiQl:TI~TPfetJiNt------- County File No._ Bureau File No._ We have received notice thot,~ootlC.g{xXX)'".X':_Y3_Y_Y-X.xJ3JOQ{..v]XX..Y.x:a.xx..y]_u..XXxx..y_y_'XXx..Y_XXx...y-xx on April 20,19.2L.,you came into ownership of certain property through ~~~ w~cr.sdw)OOtw.rRm.i~Boc.~TttANSFER from OLeA BHOi3EHG Deceased. Under the Inheritance and Estate Tax Laws of the Commonwealth of Pennsylvania such transfers are taxable and the liability for the payment of the inheritance tax due is imposed upon you,as transferee. The property on which tax ishere byassessed con sists of:.....,d:rtt;;;.;fhlt:e::3::1:fld~S~a:·"d't1:i1·lrtllr:~,,5HA["l"'C"T"C'T10mU"'/"!il+-t....,#t:'''t9''2~-o=PlrO¥ij~5'''''24*.-+rh'Z'l'el'hdrt- ift tHe 'Hii.milON i\I~.'nONAL B1'\p;KOF ?I'1"H;BtJRGH P.O.BOi{S37,PITTSBUEGH,P1:.NNSYLlJANIA.1ft tHe names of OLGA DHOBERG OR HRS.AL1!£DA D.SHEPHAnD.Opened j\ia.rch 4,1968.Balance as of date of death,$448.33 appraised by the Commonwealth,as of the date of death,at $4k8.33 50 %of this amount is taxable at the rate of e % ORIGINAL ASSESSMENT AMENDED ASSESSMENT (Agent for the Commonwealth) ASSESSED BY:_ DATE OF ASSESSMENT TAXABLE AMOUNT LESS:ALLOWED DEBTS NET TAXABLE AMOUNT AMOUNT OF TAX DU E D If you pay the above amount within three (3)months of the date of death of the decedent,or on or before .Jul~'20 _19 71 you may deduct a discount of 5 0 of tf;';amount of tax due,or D This tax became delinquent,fifteen (15)months after the date of death and;in addition to the· tax,statutory interest at the rate of 6%of the .tax per annum is also due as of *_.,.--,...__~~ 19__in the amount of .*If the tax is not paid by the above date additional interest is due at the rate of 6%per annum until paid TOTAL AMOUNT DUE APPRAISED BY~~.'77~ (Inheritance Tax Appraiser) $ $--,2~24~.+.::191----- -- -....-'7------ 13.45 $-------- $:::::::=============== INSTRUCTIONS TO TAXPAYERS Make checks or money orders payable to:To insure proper credit to your account this Official Notice must accompany your payment.Mai I or bring it to: J530l. If you have already paid this tax to an executor,administrator,attorney or other personal representative of the decedent for forward ing to the Commonwealth,Iist below the.date pa id,name and address of the'person,to whom you made payment,their official title and the amount...~" .~~... •l ••• Date Paid Name and Address of Payee·Official Title Amount Paid Under certain circumstances,if,after the date of death of the decedent,you personally paid funeral expenses or other just debts of the decedent,with funds derived from the property herein taxed,such amounts expended by you may qualify as deductions against the gross value of the property in the comput~tion of tax due.If any such expenditures meet all of the three following tests,it is recommended that you itemize the payments below, execute the affidavit,and return this notice.The Register of Wills will exa~irie the debts claimed and allow those which he determines to be proper.The tax will then be recomputed and you will receive an amended assessment of tax. THE THREE TESTS WHICH MUST BE MET ARE THAT: 1-You were personally legally responsible for these debts,and 2-You actually paid these debts out of the account or property described above and can furnish proof of such payment,if required,and 3 -These same debts are not also claimed,for tax purposes,by an executor,administrator or other personal representative of the decedent handling the administration of the general estate of the decedent or any other transferee. SCHEDULE OF DEBTS Date Paid Name of Payee Description of Obligation Amount Paid , TOTAL $ (attach separate sheet if required) COMMONWEALTH OF PENNSYLVANIA) COUNTY OF:_ SS: I,hereby certify that the foregoing is a.just and true statement of funeral expenses and other debts of the decedent,,for which I was legally responsible and which I did payout of the property herein taxed.I further certify, that to the best of my knowledge and belief,these same debts will not be claimed by any other person,for inheritance tax purposes. SWORN AND SUBSCRIBED BEFORE ME THIS DAY OF____________19 __. REPORT OF REGISTER OF WILLS Si gnature of Taxpayer I,the undersigned,duly elected Register of Wills in and for the above county,do respectfully report that I have allowed deductions listed above in the total amount of $0 Date of Approval:_ Register of Wills RC C~43 (4-69) J NOTE:TO BE SUBMITTED IN TRIPLICATE Pennsylvania Department of Revenue Bureau of County Collections 26 S.4th Street Harrisburg,Pennsylvania Dear Sir: .Pursuant to Section 742,Pennsylvania Inheritance and Estate Tax Act of 1961 we herewith submit the following report:' NAME OF REPORTING FINANCIAL INSTITUTION The Union National Bank or Pittsburgh ADDRESS P.O.Box 837,Pittsburgh,Pa.15230 ACCOUNT NO.OF JOINT,Att:George K.Steiii6augh,Assft Vice President TRUST OR INVESTMENT DEPOSIT #72-004575-6(Savings) NAMES ON ACCOUNT OR INVESTMENT _.~0:71_g_a_B:-::r:_o-b_:_er-g_=___=_o-r__:____:_---- Mrs.Almeda D.Shephard Speoial Aooount DECEASED JOINT DEPOSITOR, TRUSTEE OR INVESTOR Olga Broberg ~ ADDRESSANDCOUNTY R.D.#1,Box 30,Venetia,Pa.15367 DA TE OF DEATH April 20,1971 SURVIVING DEPOS:;:IT::O:::R:-,--~--~~---=---------- BENEFICIARY OR INVESTOR Mr_S._A_lm_e_d_a_D_._S_h_e_ph_a_r_d _ ADDRESS R_._D_._#_l~,_Bo_x...:.,_V_en_e_t_ia......:,=--P_a_._1..:...'=-36_7 _ DaughterRELATIONSHIPTODECEDENT DATE DEPOSIT OR INVESTMEN'-=T:-----Jul-Y-1-4-,-1-9-69-------- WAS ESTABLISHED ==_ BALANCE,INCLUDING INTEREST 744.32 DUE,AT DATE OF DEATH $_ 4fcg-;~;gat\:re ~E Assistant Vice President CROSSROADS OFFICE RCC-134 (1-69) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BURE/.fU OF COUNTY COLLECTIONS ••-'INHERITANCE TAX DIVISION 'OFFICIAL NOTIC.E O.f INHERITANCE TAX APPRAISEMENT AND ASSESSMENT OF ASSETS NOT SUBJECT TO ADMINISTRATION ~: TO:Ml<S Agni:nA n,sHEPHARD p.D.Ul BOX \(euet.ia,pennf'Q1')"aniB. 15'367 Date:__....IM;:u:ByJl_)..J+,lL.;9l.4:7..J..1 _ 'Coun ty 1...';....4S:l!l:...1Tuf>l..r.:..l:'T.L.OWNI-.-_ County File No . _ Bureau File No._ We have received notice that,~~Ke:~lXXXX)'..xxx.x.x:x.xxx'(XXXXXXXXX.x.:xxxx.xx:xxx on .April 20,,-19.1.L,you came into ownership of certain property throughX~QjKVJil:5JJ~OCXXX :&1~myYJi*".n.)b1y:X~~X Transfer from OLGA BROBERG Deceased. Under the Inheritance and Estate Tax Laws of the Commonwealth of Pennsylvania such transfers are taxable and the liability for the payment of the inheritance tax due is imposed upon you,as transferee. The property on which tax is hereby assessed consists of:--tt~l:Ield Sa3dngs ACCOllI:lt #72..001,575 be]d in t,be THE tINTON NATIONt,I.BANK ali'PITTSBllBGH p~O.BOX P37,pT'!'Tsnm?GH,pl.;:,)t,rsyr,vwItl •TN 1'HE appraised by the Commonwealth,as of the date of death,at $744.32 100 %ofthisamountistaxableattherateof 1§% ORIGINAL ASSESSMENT J AMENDED ASSESSMENT ASSESSED BY:,_ (Agent for the Commonwealth) DATE OF ASSESSMEHT TAXABLE AMOUHT LESS:ALLOWED DEBTS HET TAXABLE AMOUHT AMOUHT OF TAX DUE o If you pay th'e above amount within three (3)months of the date of death of the decedent,or on or before .In1 y 20,19 71 you may deduct a discount of 5%of the amount of tax due,or o This tax became delinquent,fifteen (15)months after th'e date of death and,in addition to the tax,statutory interest at the rate of 6%of the tax per annu!TI is also due as of*~- 19__in the amount of *If the tax is not paid by the above date additional interes.t is due at the rate of 6%per annum until paid TOTAL AMOUNT DUE APPRAISED BYo2f.~~-12-0 7J.~. (Inheritance Tax Appraiser) $ $__.LJ'lLw.L....eu].6<,2__ 111.65 $------ "..)================= .INSTRUCTIONS TO 'TAXPAYERS 15301 Make checks or money orders payable to:To insure proper credit to your account this Official Notice must accompany your payment.Mail or bring it to: v"~·..c :"'~.a.f~l hCOURTHOUSE .....,., WASHINGTON,PENNA. If you have already paid this tax to on executor,administrator,attorney or other personal representative of the decedent for forwarding to the Commonwealth,list beloY{.the ;date pajd,nome and address of the 'person .to whom you mode payment,their official title and the amount.~..~... Dote Paid Nome and Address of Payee Official Title Amount Paid SS: Under certain circumstances,if,after the dote of death of the decedent,you personally paid funeral expenses or other just debts of the decedent,with funds derived from the property herein taxed,such amounts expended by you may qualify as deductions against the gross value of the property in the computation of tax due.If any such expenditures meet all of the three following tests,it is recommended that you itemize the payments below, execute the affidavit,and return this notice.The Register of Wills will examine the debts claimed and allow those which he determines to be proper.The tax will then be recomputed and you will receive on amended assessment of tax. THE THREE TESTS WHICH MUST BE MET ARE THAT: 1 -You were personally legally responsible for these debts,and 2-You actually paid these debts out of the account or property described above and can furnish proof of such payment,if required,and 3 -These some debts are not also claimed,for tax purposes,by on executor,administrator or other personal representative of the decedent handl ing the admin istration of the general estate of the decedent or any other transferee... SCHEDULE OF DEBTS Date Paid Nome of Payee Description of Obligation Amount Paid TOTAL $ (attach separate sheet if required) COMMONWEALTH OF PENNSYLVANIA) COUNTY OF:_ I,hereby certify that the foreg~ing is a just and true statement of funeral expenses and other debts of the decedent,,for which I was legally responsible qnd which I did payout of the property herein taxed.I further certify, that to the best of my knowledge and belief,these some debts will not be claimed by any other person,for inheritance tax purposes. SWORN AND SUBSCRIBED BEFORE ME THIS DAY OF____________19 __. REPORT OF REGISTER OF WILLS Signature of Taxpayer I,the undersigned,duly elected Register of Wills in and for the above county,do respectfully report that I have allowed deductions listed above in the total amount of $" Dote of Approval:_ Register of Wills J Form RGC-33 RESIDENT DECEDENT COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS COUNTY OF .W~~.9.~.f.lg.~.cm . I~~RTANT: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.) and sayS ................................I~~::;~;:~.;:::;;T~~.E ~F }:::U:v~:OF (State full name of decedent) Late of Washi.ng.ton.....County ~::.:.~P::::::::-~~::_:J M' .......R.:ud.Qlph.C Br..Qb.erg....... of the estate of the above-named decedent being duly sworn,deposeS ............Executor Decedent died Name and address of attorney or} other authorized rePfesentative to whom all correspondence should be mailed. .W..Reid....Lowe,..Esq.•,.Meyer.,.....Unkovi.c.&..Scott 1424 Frick Bui1ding,.'Pitt.sburgh,.....Pa...15219 That as such Exe.c..ut.o.r deponent is familiar with the affairs of said estate and the property con-(1':X(~Clltor~ 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 Nonp 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 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 date 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 ta~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,left by decedent,together with the fairly estimated market value thereof;all bonds and mortg8ltes 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 value of such interest there is annexed to said schedule,financial statements showing the assets and liabilities of said co-partnership or business. A copy of the co-partnership agreement,(if oral,a statement setting forth the nature of the agreement) together with a statement setting forth the character of the business,its location,and such other facts pertaining to the business as may be pertinent to a fair and just appraisal of the decedent's interest therein must be submitted.It should also set forth in itemized form,together with the fair market value thereof,any other property owned or bequeathed by the decedent at the time of death. The Schedule C attached hereto and made part hereof sets forth a true answer to each inquiry contained therein and in the case of transfers ofproperty,real or personal,within two years of decedent's death,in contemplation of decedent's death,or intended to take effect in possession or enjoyment at or after death,said schedule sets forth the nature and value of such property,to whom transferred,the relationship of the transferees to the decedent,the proportionate share received by each transferee and all other facts of'a pertinent nature regarding said transfers.In the case of transfers intended to take effect in possession or enjoyment at or after death,there is also attached to the schedule a copy 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,or jointly 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 ann 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 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 ".."".. ..............................1..1 ~day of ~19 ~1... ....................~~~.~........ MARY EllEN POST,NOTARY PIJBlIC I WHITEHAll B'~0UGH,WfSHE:JY COUNTY MY COMMISSION EXPIRES DECEMBER 28,19~ NOTE:Before signing affidavit make sure all blank spaces in the affidavit and schedules annexed are filled in with details or the worn "None",ann 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 requiren 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 (1-64)_ COMMONWEALTH.OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS TRANSF~R INHERITANCE TAX R,ESIDENT 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 liE".Property held by the decedent as tenant in common with another or others,should be identified as to quantum of interest and the estimated value should be that of the decedent's interest only. The real property located In the Commonwealth of Pennsylvania should be described by lot and block number,street and street number,together with a general description of the property,with a reference to the record of the conveyance by which the decedent took title;If a farm 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. (1 ) ASSESSED VALUE FOR YEAR OF DECEDENT'S DEATH (2) ESTIMATED MARKET VALUE (3) DePARTMENT VALUATION CAUTION (Do not write In this space) ALL THAT CERTAIN LOT or piece of ground situate in the Township of Peters,County of Washington,Pennsylvania,bounded and described as follows,to-wit:- BEGINNING on a line dividing land of the parties of the first part hereto and land of Simon S.Whitaker,(said line being the northerly line of the land conveyed by said Simon S.Whitaker to the parties of the first part hereto,by deed hereinafter recited),at a point distant along said line(North 800 05'East,Two hundred twenty (220)feet from an iron pin in a public black top road leading to Finleyville,which iron pin is also located in the northwesterl~ corner of Premises described in said deed to the parties of the first part heretoj thence along said line,North 800 05'East,a dis- tance of Two hundred twenty-five and 92/100(225.92)feet to a pointj thence South ge55' East,a distance of Forty (40)feet to a pointj thence South 800 05'West,a distance of Two hundred twenty-five and 92/100 (225.92)feet to a pointj thence North 90 , 55'West,a distance of Forty (40)feet to the point at the place of beginning aforesaid. TOGETHER with a right of way leading from the premises herein described to the public black top road referred to in the above description as a means of ingress,egress and regress to and from the premises herein conveyed,which right of way shall be for the common use of the parties of the first part and second part hereto,their heirs and assigns,and the occupiers and users of their respective properties.Said right of way being more particularly bounded and described as follows,to-wit:- BEGINNING at the iron pin in the public black top road referred to in the descrip- tion hereinabovej thence along the dividing line between land now or late of Simon S. Whitaker and the parties of the first part hereto,North 800 05'East,Two hundred twenty (220)feet to the westerly line of premises hereinabove describedj thence along said last mentioned line(South 90 55'East, a distance of Eleven (11)feet to a pointj thence extending South 800 05'west,along the aforesaid dividing line between land of Simon S.Whitaker and the parties of the 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-34 (1-64)• COMMONWEALTH.OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS TRANSFER INHERITANCE TAX RESIDENT DECEDENT 'SCHEDULE "A" REAL PROPERTY (Continued) Real property in Pennsylvania,with statement of mortgage encumbrances upon each porcel at death of dece- dent.Where property held as joint tenant or tenancy by entireties,report on Schedule "E".Property held by the decedent as tenant in common with another or others,should be identified as to quantum of interest and the estimated value should be that of the decedent's interest only. The real property located In the Commonwealth of Pennsylvania should be described by lot and block number,street and street number,together with a general description of the property,with a reference to the record of the conveyance by whlch the decedent took title;if a farm 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. first part hereto,preserving a uniform width of Eleven (11)feet throughout,to the afore- said public black top road. BEING the same premises which LOWRY ANDREW SHEPHARD and ALMEDA D.SHEPHARD,his wife, conveyed to CARL A.BROBERG and OLGA BROBERG, his Wife,by Deed dated June 30,1950, recorded in the Office of the Recorder of Deeds of Washington County,Pennsylvania in Deed Book Volume 788,page 511. EXCEPTING AND RESERVING the Pittsburgh or River Vein of coal and mining rights as heretofore conveyed. (1) ASSESSED VALUE FOR YEAR OF DECEDENT'S DEATH (2) ESTIMA TED MARKET VALUE Irl<fh-3'~ $5,500.00 (3) DEPARTMENT VALUATION CAUTION (Do not write In this space) s-SOD.00r 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. SCHEDULE "B" PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT .-,.... RCC-35 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 ITEM UNIT ESTIMATED DEPARTMENT VALUATION No.List and describe fully VALUE MARKET 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. '..A RCC-3D comWN'\'K\LTH OF PENNSYLVANIA TIUNSFER INHERITANCE TAX. ~S~IDENT DECEDENT SCHEDULE "c" TRA.NSFEIlS (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)~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)Yes (3)If the answer to (1)or (2)above is in the affirmaJi"ive state: (a)Age of decedent at time of transfer ~Q (b)State of decedent's health at time of making the transfer.(Note 1).Good (c)Cause of decedent's death.(Note 1).Cerebral thrombosis (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)~o (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)~o (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)~o (b)The right to designate the persons who shall possess or enjoy the property transferred or income therefrom?(Answer yes or no)~o (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 b'enefit of care of transferor?(Answer yes or no)No (8)Did decedent,at any time,transfer property,the beneficial enjoyment of which was sUbject to change, because of a 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)__ 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 DESCRIPTION MARKET VALUE (EsUmated)DEPT.VALUATION (Dept.Only) Insert this total opposite "Transfers",Schedule "C"in the "As Reported"column on the last page of this return. ,~.•-.r.0. Rec-38. CQMMONWEALTH OF PENNSYLVANIA TRANSF~R INHERITANCE TAX. RESIDENT DECEDENT SCHEDULE "E" JOINTLY OWNED PROPERTY INSTRUCTIOKS: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,Namel unit percentage Estate Address and Relationship of Co-Owners,and Place Value Share Valuation of Record of Instrument,where Real'Estate.I DEPARTMENT VALUATION CAUTION-Do not Write In This Space. Value of Value of Entire Decedent's Property Interest ·The Union National Bank of Pittsburgh Savings Account #72-003524 registered Mrs.Olga Broberg or Mrs.Almeda D. Shepherd.Opened March 4,1968. Balance as of date of death,$448.33 The Union National Bank of Pittsburgh Savings Account #72-004575-6 registered Almeda D.Shephard or Olga Broberg.Opened July 14 1969. Balance as of date of death,~744.32iJ~Yfl-I7/ ,r»;r~ 1/2 (fit $224.17 ;)2.4.17 Insert this total opposite "Jointly Owned Property",Schedule "E" in the "As Reported"column on the last page of this return. RCC-37 (*2-631' COMMONWEALTH OF I'ENi\SYYLANIA TRANSFER INHERITANCE TAX RESIDE~l'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 Almeda B.Shenhard . Box qO.R D.:HI . Venetia.Pa.11:)';),.67 D~illZhter Yes 1/6 T:t_oIa_oIa_ Rudolnh C.Brober9= Box q·:u.McCombs Road R.D.#l.Venetia.Pa.ls~67 Son Yes 1/6 Est:lT.e .To ,.-':nA B Leddon 2826 McKelvev Road Pi P~1 t;2?1 -VPP.1/f;-~C! William L.Brobe:rsz ~Ot;li'if't:h ~...,,&. Carrollton.Kentuckv Son Yes 1/6 ~ M .R ....-",.tr 610 Ella Street Wilkinsbursz.Pa.1'1221 DaillZhter Yes 1/6 -H~"U.t- H~:r:rv 'R R'rtOhAl"a- l~Q Jil,...i:ll"T.:lnp McMurrav.Pa.lS~17 Son Yes 1/6 Es t::lte ,. '. ( h Deponent fUrther says that all the above-named beneficiaries are living at this time except below: NAME DATE OF DEATH RESIDENCE OF THE ESTATE OF .\IATTER OF THE APPRAISEMENT OLGA BROBERG..... ..... . . . . . . . ....................... Deceased (Executor-Administrator must complete "As Reported"column #1.) 0 ...,'"0 ::c""l ""l ('l)('l)0 II>""l E..en ::3 en en en 0...,......::3 '"0('l)E.....""lII>en 0X'"0 '0II>('l) 0'"...""l (b 0 ~'0 t%j i:f.l ('l)...'en (')........l:J"'<II>....(1)('l) 0..s::: }D' i:ti Year . P.oI THE !No. Will Administration Late of ..Veneti.a .. REPORT AND APPRAISAL Commonwealth of Pennsylvania County of Washington C/)c:: ~~>::c---~W C/)C/) ()()?"'?"'?"n ~>::::::..................... -00-00-00-00-00-00 -00-00-00-00-00-00 •Vd •.0J ;,\).L ')i!1.:.1 SVM W..id!I4QWe,J1E},q IMe~'l "'Urlkov1hJ "-&'1ScottY~I,\....",:.1.,_"I142~'Fr1ck ~u1~diling Pittsburgh,Pa.15219 9S ti ~l~~~Il1r IL (.'-• I ,i tU.:il-.J :0\' ~, .~:0\ <X>•J::;- \..0 .: ~.". 8::.'~..~. ~; :~. \.00\ex>•J::;- \..0 .--C:'J.~ .~ -t:.... ~ -\.]I>...en ~~-O ":l ...... : 0 ---..""lOce02: h-:> '"':;r.{~tJ:grt_·.... •<'t ~·""l_,:30_. '<;)~e.- I ••... -'t THE SUM OF $;s.~94".?~ DATE APPROVED ~1?1~.~. Form RC C·lO ."..\)FFICE OF THE ~'REGISTER OF WILLS 'OF Washington COUNTY &3-7/-t/yo STATEfJfENt OF DEBTS AND DEDUCTIONS DEDUCTIONS ALLOWED IN j AND AGENT OF THE COMMONWIiALTH ESTATE OF Olga BroberE,?; Regl,ter of Wills,Agent LATE OF Peters Township"Pennsylvania DATE OF FILING APPRAISEMENT September 24,,197~TEOFD~TH April 20"1971 DATE NO.OF NAM&:OF PAYEE REMARKS AMOUNTVOUCH"" 5/13 71 Russell Marino"Register Grant of letters 12 50 r:;124 71 Observer Publishing Company Advertising letters 14 00, 5/27 71 Washington County Reports Advertising letters 14 00 12/11 Russell Marino"Register I}l'll~ng ~nventory ana aaa~t~C na.L 71 costs of letters 12 00 12/11 71 Russell Marino"Register Filing account 19 00 12/11 71 Meyer"Unkovic &:Scott Attorneys'fees 600 00 12/11 71 Notary fees and miscellaneo s charges 13 42 10/27 71 Kurtz Monument Company Headstone 145 00 10/27 71 Thomas L.Nied Funeral services 1,,44C 60 10/27 71 Dr.Donald C.Brown Professional services 7C 00 10/27 7:l:I.Bortz Lewis Associates Professional services 7 00 10/7 72 Martha Stevick Nursing services 72C 00 10/7 72 Almeda Shepherd Nursing services 720 00 6/6 71 C.Raymond Baird"Collector ¥~ers Township Real Estate 12 35 6/6 71 Malcolm L.Morgan County Real Estate Tax 21 55 g/~71 Baird"Collector School District Real Estate 9E 31C.Raymond Tax 9/7 71 C.Raymond Baird"Collector Real Estate Transfer Tax 51=00 I 3J972 73 I - CO........ONWEALTH OF PENNSYLVANIA } COUNTY OF Allegheny S8: I,Rudolph C.Broberg HEREBY CERTIFY.THAT.TO THE BEfIT OF PooIY kNOWLEDGE AND BELIEF.THE FOREGOING 18 A JUST AND TRU E STATEMENT OF DEBTS.FUNERAL EXPENSES AND EXPENSES 0'- ADMINISTRATlON SUBMITTED TO THE ESTATE OF __O.;;;...=l'""'-=a=---B_r_o_b_e_r--=-::::or _ INHERITANCE TAX PURPOSES. MILDRED SUCCOP,No 8IY Public PiI,sburgh,Aiie2heny County,PI. My Commission Expires August 7,1973 p"J ~);~(~U..:;,',\\\H0 r,EG\SltY,or \;IL\"S\~;..,S'1\\H\~"f)\4 cO..?p.. I .'"":\: .,.~...",....·;rt·:.'.;:- .'.ESTATE OF -d1~d:&0 /c~j> ADJUSTi-1EI~TS -FILE NO.63-'7/-7"fo DEBTS &DEDUCTIONS FORM'-AMOUNT,CLAIMED LESS ITEi·rs DISALLOVlED : .~: .'. .,-',''"4':7 .--."..,..';" «y 00 " ,0' $'..c:r/00-' sJr9C:,/3. $._--- ':'$---- ". $---------------._-----., $,----- $._---- ,TO.TAL ;U.Lm-:.ABLE DEDUCTIONS" 1fI '. j I .1: I :.:0=;l-.5~-?3 .I5ate Approved .. ..~'.....,:/ .',:-.."".. . .-.' "..,'.':.:.' -:..'. ..'.. ."....'. .',..' '. '.. ~.-.'.-..,".'.-.. ..'..':"; .. .,~. '.-...-.-' :..: ~.'., ",-...... p' .".:. Form RCC-33 RESIDENT DECEDENT SUPp·LEMENTAL COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS COUNTY OF j .....W~s..h~ng.t.qp,. 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.) ...........................;,.~.::~!?~~:;;;:~~E .~~.~~~~.~~}:~::UA:;:OF (State full name of decedent) Late of Y.!..9.:~.h~~g~9.~....County state of f.~Il.n~yJy§,l.)+.9.,}ss:.~ County ofAll~gh~ny.......~~}F9)( ...........B:~g():I:.ph C.~ob.~pg........".........~.. . ~of the estate of the above-named decedent .duly sworn,deposeS .Executor and sayS Decedent died ....Ap:r:.':i.,::l,... (Month) Name and address of attorney or} other authorized representative to whom all correspondence should be mailed. ".......(i~P.........,19(·y~~t..·,{~aVing a last will,copy of which is hereto attached.} w•..Ee.:Lq,LQwe."Esquire.".Meye..r UnkQV1c &..SCQtt . 1424 FrickBuilding"Pit.tsburgh,tPa..15219 . That as such §~~.9.}!~5?.~deponent is familiar with the affairs of said estate and the property con-(Exep.\Itor.~ stituting the assets thereof and their fair market value. That at the time of death there was no safe deposit bux registered in decedent's individual name,or jointly with,or as agent or deputy of another,or in decedent's individual name,with right of access by another as agent or deputy,with the exception of the following:- NAME AND ADDRESS OF BANK OR OTHER INSTITUTION THIS SAFE DEPosiT BOX RENTED RELATIONSHIP OF JOINT IN WHICH DECEDENT RENTED A SAFE DEPOSIT BOX IN NAME OR NAMES OF HOLDERS TO DECEDENT None 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 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 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 date of decedent's death in all other cases;all bonds,postal savings,treasury certificates or notes and other evidence of in- debtedness of the"Uni ted 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 .owrted 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,left bydecedent,together with the fairly estimated market value thereof;all bonds and mortgaltes 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 polictes 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.' l In the case of securities of close or family corporations,the values reported.are as far as possible substantiated by financial statements of the corporations,showing the assets and liabilities thereof as of the date of'death.The schedule also sets forth the interest of decedent at the time of death in any co-partnership or business,and in support of the value of such interest there is annexed to said schedule,financial statements showing the assets and liabilities of said co-partnership or business. A copy of the co-partnership agreement,(if oral,a statement setting forth the nature of the agreement) together with a statement setting forth the character of the business,its location,and such other facts pertaining to the business as may be pertinent to a fair and just appraisal of the decedent's interest therein must be submitted.It should also set forth in itemi~ed 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 sched.ule 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 CORY 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 passes at decedent's death by virtue of the exercise by decedent,either individually,orjointly with another,or any power of appoint- ment vested in decedent,.either individually or jointly,by the Will,de~d,or other instrument of another, with a copy of the instrument creating such power attached to the schedule. Ii'-.~_•• 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,andthe relationship of such issue to the beneficiary. That Schedule E attached hereto and made a part hereof sets forth all property,real and per- sonal,owned by the decedent jointly with another or others,including intangible,standing in the name of the decedent and others,plus the date and place of record of instruments effecting the vestiture of real estate and the date of acquisition of personalty,plus the name,address and relationship,if any, of co-owners to the decedent. That Schedule F attached hereto and made a part hereof sets forth fUlly and in detail all debts and deductions claimed for and on behalf of this decedent's estate,including fUneral expenses paid; family exemption,where applicable;costs of administration of this estate;counsel fees and fUdiciary's commissions paid or to be paid;cost expended for burial trusts,tombstones or gravemarkers,and reli- gious serVices,in consequence of the death of the decedent;debts and claims OWing and 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 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",nCR,"E",and "F"as directed therein, have been carried forward and properly registered in the Summary. l :J;)'~Subscribed and sworn to before me this . .........................................day of ·111~19..7.3 . ·································.·~~EN~;f1= WHITLHt.LL B0RCUGil,ALLEGHENY COUNTY MY COMMISSIOIl EXPIRES OECEM~ER 28,1970 (E :j?9.~.....33.~.;.H •.r)~,#1: (Street Number) y~p..~t..1g...t r..a.~l5367 :.. (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-35I COMMONWEALTH OF PENNSYLVANIA ·TF~SFER 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 any undistributed estate of or income from any property held in trust under the will or agreement of another,even though located outside of the State,at the time of death,should be listed in this schedule. Item No. ITEM List and describe fully UNIT VALUE ESTIMATED M.ARKJn'VALUE DEPARTMENT VALUATION (Do not write in this space) Mutual of Omaha -insurance benefits Allstate Insurance Co.-net proceeds settlement of accident claim vs. Gordan Wellman 34.28 693.93 6,000.00 Insert this total opposite "Personal Property",Schedule "B"in the "As Reported"column on the last page of this return. x x 6,728.21 .. RCC.-37 '(\2-63) COMMONWEALTH OF PENNSYYLANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "D" BENEFICIARIES ';! .'t. ( h BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED(If step-children or DATE INTEREST OFStatefullnamesandaddressesofallwhoillegitimatechildrenDECEDENTOFBENEFICIARY ave an interest,vested,contingent or other are involved,set STATE YES IN ESTATE wise,in estate)forth this fact.)OR NO BIRTH FILED WJ TH ORIGINAL RPC-33 -- Deponent further says that all the above-named beneficiaries are living at this time except below: NAME DATE OF DEATH RESIDENCE ~IATTER OF THE APPRAISEMENT OF THE ESTATE OF Will Administration !No. D<THE Year . (Executor-Administrator must complete "As Reported"column #1.) CJ ....,'"d =:c'"l '"l (I)(I)0 ~'"l e:...til ::l til til til 0....,it'::l '"de:...'"l~'"l 0tilX'"d 't:l~(I)C""'"l '"l ~0 ~'t:l t'%:t (I)'"l til ........'<~....(I) / QJAM..13.Jl.o:s.~RG. Deceased Late of ......Venetia County of Washingt on ~. . Commonwealth of Pennsylvania REPORT AND APPRAISAL r/.~_tP /) ,3'3 ,/) enc::~~>-=:cwen~O-< ?"?-?- ri ~:>;:;:: 00-<.0000 W.Reid Lowe~Esq. Meyer,Unkovic &Scott 1424 Frick Building Pittsburgh,Pa.15219' ~l, ~:~ .~." :0\•.. ~ :1\). :00 :.. I\) 1-1 >-til =:c(1)-'0 .... o~ '"l....~ ~ *0-<.00** ~. ~: N "'s> :~."'. ~ N.~. .~. .~: "" >-or. tl~-r::l'o:l.,~ ~.::Ir::.c..i • ....- R CCoB I (2-64) COMM0NWEALTH OF PENNSYL VAN IA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS INHERITANCE TAX DIVISION NOTICE OF FILING OF APPRAISEMENT N.RUDOLPH C.BROBERG IN YOUR REPLY PLEA8E REF'ER TO 38-170-4 j In Re:Estate of OLGA BROBERG-------'------------- -'-__....;W:.:;.A=.::S:.:H.::.:I::..::N~G:..:T::....:O~N.:.--County -File No.63-71-49° Dear Mr.Broberg, You are hereby notified that the original appraisement in'the estate of OLGA BROBERG has been filed in t:h~~ffice of the Register of Wills qf WASHINGTON County on September 24 ,19 71.Said appraisement reflects'the following valuations: Jt.Held Real Estate 5_,....5_0_0..;..._0-'0 _ ~XX_--"9,-",6,",,,,8~......49"'--_ Transfers =--=-:""'="'"--:-~---- Tota1 ~6~,~4~6~8~•..;;;l4'"'"9~--_ As to such tax that is paid within three months from date of death,a five (5%)percent discount is allowable.As to any tax that remains unpaid after one year from date of death,interest at the rate of six (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;::..e::::..pl::.t.=..e.=.:m:::.b=-e=.:r::-..:2=..4.:..J-,--,1=.9=..7..:..;1=--_ DATE OF DEATH:April 20,1971 Note:This is not a bill. Signed Title 0ta~d~;2uJtw MADELINE.FINNEY,APPRAISER I .. RO:C-39 '(5-'138) COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SUMMARY Estate of BROBERG (Last Name) OLGA (First Name)(Initial) DATE OF DEATH 4-20-71 FILE NO.63-71-490 REPORT OF INHERITANCE TAX APPRAISER I,the undersigned duly appointed Inheritance Tax Appraiser in and for the County of WASHINGTON Pennsylvania,do respectfully report that I have appraised the real and personal property as reported in the foregoing return at the values set forth opposite each item in the last column to the right in Schedules "A","B","C",and "E"• ....-rl Dated:September 24,1971 ~~~~~INHERITANCE TAXAPPRAiSE'. 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 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 6 468 49 6 468 49 VALUE AS REAPPRAISED $-------+-- FOR USE OF REGISTER ONLY Tax on $-----------4--2% Tax on $~ Tax on $5% Tax on $10% Tax on $15% Exemptions * Total Estate --1-__ TOTAL TAX COMPUTATION OF TAX $--------+--- $---------4-- $---------4-- $--------4--- $--------+--- $--------'--- (*)As evidenced by Charitable Exemption Certificates issued by the Secretary of Revenue. Less tax previously paid BALANCE Less 5%of tax if paid within 3 months after death :::::::::=t== BALANCE OF INHERITANCE TAX DUE $t= Add interest at rate of 6%from _____to $------ AMOUNT OF ESTATE TAX ASSESSED $--------l~ Estate tax paid $-JL- BALANCE DUE $~~ Add interest at rate of 6%from ------tto-----$---------It=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. Will l Administration ~No. IN THE Year . MATTER OF THE APPRAISEMENT OF THE ESTATE OF OLGA BROBERG Deceased Late of . County of VENETIA WASHINGTON Commonwealth of Pennsylvania REPORT AND APPRAISAL ,. Fonn RCC-2 "...''.- DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS HARRISBURG.PENNA.17 127 COMMONW~ALTHOF PENNSYLVANIA". RESIDENT INHERITANCE TAX APPRAISEMENT DATE ,,,,,~,~P.~,,~~p.,~,!:,,,,,,?4.,,t.....J,~,?.:.t.,,,,, COUNTY ,,,..,liAS.,,H,I.N.G.T.o.,N,,..,,,,..,,..,,.,,,,,,,,.,,,,,,,,, FILE NO.,§"~,:"?.!":.4.,~,9 ".""""".."",,,,,,,..,,,,,, Whereas,, ,..,",OLGA..,.BRO.GERG ,""" ,late of .Y..~~~.~.~A , , ,..",.. in the County of :...:.................."....WA.S,.HJN.QT..O.N..."......"..............................................."...Commonwealth of Pennsylvania,having died on the "..""""""",.........:?'O.t.,b.",..............,,,...,,...,,,............,'...."day of "............""A,p,:r.,!,l"""""""..,...""",.."...",..19...Tt seized and possessed of an estate subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore,I,..................}fA;p,~~,~,~.....¥..~~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. Unit ApprallementDelcrlptlonofAlletValuelMadeforInheritance Tax Purpolel I $ REALTY: SEE COPY OF SCHEDULE "A"ATTACHED TO APPRAISEMENT 5.500 00 JT.HELD: SEE COpy OF SCHEDULE "E"ATTACHED TO APPRAISEMENT 968 49 total 6.468 49 , .' .. - ,~~~~~~~~,Penna. WASHINGTON County ,/ RESIDENT INHERITANCE TAX APPRAISEMENT Estate of OLGA BROBERG Deceased. Late of VENETIA Date of Death,.4..~.~Q.:.?J... Appraisemeilt Docket Vol 38OJ•...••....•••..••••.•••...•••••••••.••••••••.••••• Page,!?.~:~No ~..~.:.?~.:.~~.9 Filed in Register's OfJice,§~.P~.~~4...J97..~. Amount of tax due,$. DEPARTMENT OF REVENUE Received, Examined and Approved,. Wrote abo.!lt Appraisement,. Appeal f,.om Appraisement,.. Entered and charged,.. ",v iJ"OQH01~N \I1S\tM C'l'I\~'I"'\\\:)\("C\·3\.1',;;J l.n"\;:JlJ \,-,-,J_;;.)\"-'0 '0 \.\\~W 't'l 113t;SnB {'_HI'11.1 -ttll cL{.L "1 II';u f1ldrt {., ~r<;.-\••.\ \\U :1 .J , • I . ,...- RCC-Bl (6-71) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS HARRISBURG 17127 NOTICE OF FILING OF APPRAISEMENT RUDOLPHC.BROBERG (Executor ,*Dau'lQ~I£4i* IN YOUR REPLY PLEASE REFER TO 38-170-4 Inheritance Tax Division ) In Re:Estate of --=o:...=L=-=G~A~B~R.:..=O~B:..=E~R~G~_ \vASHINGTON County - FileNo._---'6....."""3-=-.L.7.....1 =-.::z:4.-1.9.....0:...-_ You are hereby notified that the supplemental appraisement in the estate of OJ ga BroberWhasbeenfiledintheofficeoftheRegisterofWillsofashingtQn County on March 26 ,19 73,Said appraisement reflects the following valuations: Real Estate --=----..,_ PersonaI Property -----=:6:....l,~7~2::..:8~.2~1=----_ Transfers _ Jointly Owned _ Total .:::...6-1-,7-,---,2~8~.~2~1~__ 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 March 26,1973 Signed ;./'<~~..e:~ Title _A_P_P_RA_I_S_E_R_I _ DATE OF DEATH:April 20,1971 Note:This is not a bi II. RCC-39 U5-ee) COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SUPPLEMENTAL SUMMARY Estate of BROBERG,OLGA (Last Name)(First Name) DATE OF DEATH 4-20-71 (Initial) FILE NO.63-71-490 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 ::,::loe,,:::~:oP~:',ae:::h3item io ilie La"colomo w ilie righ'i~'~nd ":~« ;>INHERITANCE TAX APPRAISER cJl 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:_ SUPPLEMENTAL REGISTER OF WILLS 6.728 21 6.728 21 None fi 728 21 $ 6.728 21 6 728 21 None fi 72R 21 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 $6%0 . Tax on $----------+-- Thxoo$lK Tax on $15% Exemptions * Total Estate ~_- TOTAL TAX COMPUTATION OF TAX $--------f--- $---------1--- $---------1--- $--------+--- $--------+--- $....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=== TOTAL TAX BALANCE :---if- PAID $......JL BALANCE OF INHERITANCE TAX DUE $t= Add interest at rate of 6%from_____to $---..J AMOUNT OF ESTATE TAX ASSESSED $------Il- Estate tax paid $--JL- BALANCE DUE $---Jl- Add interest at rate of 6%from ------Ito----- FOR USE OF REGISTER ONLY ADJUSTMENTS NOTE:Where subsequent adjustments are made to the above computation of tax by the Register of Wills,for proper reason, same should be noted below,with short explanation.. :~~inistration t No . IN THE Year . MATTER OF THE APPRAISEMENT OF THE ESTATE OF OLGA BROBERG Deceased Late of Vl!.:N.:~r.rA . County of .......W'A.~liI~GTON Commonwealth of Pennsylvania REPORT AND APPRAISAL ........,Penna. ,..._.....··"·gtr.et) l-"onn RCC-2 SUPPLEMENTAL I COMMONWEALTH OF PENNSYLVANIA DATE March 26 1973....................................................,............................................ DEPAl':.T~"\1E~:T OF REVENUE RESIDENT INHERITANCE TAX ..............W..~.$..h~.J:}gtQ.~.............COUNTY•BURl:l\U OF COUNTY COLLECTIONS ............. HARRISBURG.PENNA.17127 APPRAISEMENT FILE NO.........§.I~..7.l~.4.Q.Q.................................... Whereas,.................Q.lg~.....a.r.Qb..~.:r.g .................................................................................late of ........................y.~.~~t..:i,.~....................................................... in the County of ..................w:~..s.h.i.gt..Q.n................................................................................Commonwealth of Pennsylvania,having died on the ............7..Q.....t..4...............................................................day of ...............AP.~.!.J.:..........................................19.7J..,seized and possessed of an estate subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore,I,Fred Tosi an appraiser duly appointed according to law,......................................................................................................................................., having been designated to make a fair and conscionable appraisement of the said estate,and to assess and fix the cash value of all annuities and life estates growing out of said estate,hereby file the following appraisement: In the event that any future interest in this estate is transferred in possession or enjoyment to collateral heirs of the decedent after the expiration of any estate for life or for years.the Commonwealth hereby expressly reserves the right to appraise and assess transfer inheritance taxes at the lawful collateral rate on any such future interest. Unit Appraisement Description of As.et Value.Made for InherltanceSUPPLEMENTALTaxPurpose. $ PERSO NALTY:- See Schedule "B"attached hereto:6,728 21 ,. I J : .' .. '. " .Total..6,728 21 , : form~;v:fhbl::::~h~wo<lla~~~~,~a~o~e~~b~~eZ(~~e~;~ei?~ ~.~.d..Appra,ser ................................................................................................,..................................................... SUPPLEMENTAL \vASHINGTON County •.I, RESIDENT INHERITANCE TAX APPRAISEMENT Estate of ·OLGA BROBERG . Deceased. Late of ....y~N.~'J,'.:I:A . Date of Death,AP.E.~.!~9..L.!.~.?~.. Appraisemeilt Docket Vol.38,. Page,J.7.Q.~4 No..9..J.~.7.J~.4.9.Q . Filed in Register's Office,....H.a.r.ch....2.6...J 9....7.3 A11t-Ount of tax due,$.. .DEPARTMENT OF REVENUE Received, Examined and Approved,. Wrote abo.ut Appra.isement,.. Appeal f1'om.Appraisement,.. Entered and charged,,.. 'Vd "00 NOlflNlHSVAt . S111M :10 U31 SW3~ ONP:J'Vf':'rD~;Sntl £2 li Ud 6 AV~fL '03-11.:1 . .! • r---~'~--~~~--------------~--- ~3-e3 1 Dollars ,19-ZS Clerk of Orphans'Court Washington,Pa.,~.Z OFFICE oP' -N~18364 CLERK OF ORPHANS'COURT DIVISION For ~,. Total State,etc..••$====== County !~, u\n \, p I I IIr, II o !~o I DI, IrII, r Ir I I I I D¥i.'I'.4'.".'i \'1"""4 5 k 0 0 0 0 5 k 0 0 0 0 s- 2 2 4 1 7 7 4 4 :3 2 6 !1 6 8 4 9 s 6 ,1.6 8 4 9 ,I,',' ,I,',' ~••••·.e__·.'•,,',••,ttm•..........+.......................... L 3-7.E-4 CftJ ..1,Olr,a C.Broberg,of ED /;tl Venetia,Pennsylvania,being of sound .mind and in gO'JL~b:'C1lth,declare this my last uill and testament. To my children: Almeda B.Shephard P.~dolph C.Broberg Josephine B.Leddon Hilliam L.Broberg l-:artha·B.Stevick HaTry R.3roberg or their surving spouse if any of·them should precede me in death; or to their surviving children,if both should precede me ,in death, I bequeath all my property,both real and personal,to be divided equally among the·six p·arti.es. Ny five-room dV>Telling is to be disposed of ao statec :L'.1 Deed ?f21Lh, Recorded 788-511 and.the proceeds are to be d:Lvided equ.ally as stated above.' I hereby appoint,Eudolph C.Broberg,the executor of thism;v last ;·;ill and testc:Lment. In 'Hitness i'rhereof,I hereunto set Thy hand .and seal j Si~ned and sealed by said Olga C.Broberg,.vrho at the same time,published and declared ,the same,as and for her last Hill and testarr.ent,in the p:!:"esence of us ,~vho,;_n her prBseilce,and in the precence of each other,<,md at her uitr.esses. 34-28 + 693-93 ~ €?OOO-Oo ~ f1728-21 * ~;;o ..-rr-.I l>f"l1:::O c....> (l)0C --:z:-c.n :::z: zc.nc.n ::z:,.r- -1 ,--=c:.rn f1 rrl-1 ~o ;:0 r-t.O <::0 C..:.:; ""'11 ":;t... Q _........-c .. ~:E p =x:;;::1- r-- -0 r-Z rv ?>c.n 0 rv c....> i\ffiilanit (@f 1fxrrutnr (@r i\~minilitratnr 8tmI'of ,r~.mu (nuniu.~1 eghen BB:CIlounty of "ftl!J1tHF P all b f h d . d h'notary'nub lic \.d f 'derson.y e ore me,t .e un erslgne aut orIty,a OM m an or Sal County and State,appeared .B)J.g..Q.+...P.h .Q..:)?r.g.9..~.:r.g who,being duly sworn according to law,deposes and says that he is the executor or administrator of the estate of ...~,~.!?~~~9..~.=.:..f!?._deceased,that the foregoing schedules constitute a complete inventory and appraisement of the real and personal estate of 9.1:f~.9:!?£9..!?.~.EJ~;, 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 .kdnrirri~ar..1 Swonnd subscnbed before me thzs.......!..S.........l j)-/h;l r!y/';;.- day of..·..~;;;~..119.~.3....f;Lc:U.afl-t:f.:l.f........:..\./."2c-d!:.-:..'!!-:.:L.~.......P~lll~RED,'~~;;.,.~'!'.1.!'J;I~~-.~""""'1it.--..__....(J Executor-Admm~jrI:~~/~'~·:'~:i~~;~~I~·YE.;;i~:-~.a./I~~~~.'/NAL INSTRUCTIONS ~J f uousl7 1973 b f'l d .h'h h f .fl'•b 1\f1 Inventory must e Ie WIt m tree mont sater appomtment 0 persona representatIve. 2.A supplemental inventory must be filed within thirty days of discovery of additional assets. 3.1 Original and 2 Copies and 2 RCRI-34,Under $10,000;1 Original and 2 Copies and 2 RCRI-33, Over $10,000,including Copy of Will;1 Original and 3 Copies and 2 RCRI-33,Over $50,000,in- cluding Copy of Will and copy of Federal Estate Tax Return. REFERENCE FOR ADDITIONAL COpy Act of 1947 P.L.513 Sec.5.2,72 P.S.4844.2 lbttttntnry aub 1\ppraiStmtut of the goods and chattels,rights and credits which were of Ql.g.?:~:r.Q.t?.§;.£.€L Jate of ~.~.~.~.:.~~.~~.~.~.~.~.p... Washington County,Pa.,taken imd made in conformity with the abO'Ve affidavit. Mutual of Omaha -insurance benefits Allstate Insurance Co.-net proceeds settlement of accident claim vs.Gordan Wellman Total Personalty DOLLARS $34 ~8 693 93 6'.000 00 6,728 21 CENTS All that certain lot or piece of ground in Peters Township,Washington County,P~nnsylvania,with five room frame dwelling erected thereon,acquired by Deed dated 6/30/50 recorded in Deed Book Volume 788,Page 511 (sold 9/7/71). Total Realty lI I I, 5.500 00 I I5,500 00 1I, \' ",....... • •j ~ ! ' •-,j .',~.~. •',"t. o.,of .;'f v.r , " ,' ! • February 19.'1973 ' I-ir.HarJ?Y R.B3?ober;;; 129 li1j."lw Lane Ncl·hu'Tey,Pa.15311 I " .f ,\ ;. '.~\ \' ,c ,",.;: ~.i ,, ,' ....,:.. HE:~t~t.e .of ,Ol~a It.l?ob~ ,Dear Ml".Bl~oooJ?'ciS_-, -, " The audit of your mother's estate has been scheduled before the Ol"'phnna ,.Court Division oi~tlanhington County on Hm?ch 23"19'/3 at 9:30 0..n1.,E.S.T.The audit \'1'111 be held in the'Orphans I COUl-at room·ot: the Co)tu--t House.At ,thnt time a Petition 1~or ,Distribution t1il1 be presented to the COlll'"t and' shortly thereafter t110 Court Will issue ita final ,deOl'"'eO • It \'nll not be necessary tor you to be presetlt at the audit a,lthougll you are ent:l.tled to.be there 11'you so c1e~irc. ,S1nceroly yotu:'S # i' \'3.,Reid Lowe ' \ffiL:cae / "