Loading...
HomeMy WebLinkAboutOC1971-0528 - ESTATE OF ANDREOLLI0 I~ PETITION SUR AUDIT Testate Form J IN THE ORPHANS' COURT OF WASHINGTON COUNTY Estate of .... M.ar.y ... N.agy .. Andr.e.o.lli., ... a/k/a., ________ _ No ......... 63 ... :-= ... 7l .. :-= ... 5.28 __________________________ _ .................. MaJ:Y. .. .An.dt:.e.ol.li., ___ a/k/a, _____________________ _ Fiduciary ... .Ma~Y ... S.w.amp_ __ an.d .. Ann.a .. May _____ _ .................. !'1~~-·---M~;r;.Y. ... M.ct~.e.Q.l.J.i. ............................ . . ..... a..exn.ar.d., ... Exec.u:tx.i.c.es __________________________ . Deceased Date of Date of Decedent's death ....... May. .. .ls:t.,. ... 19.7 L ..... _______ .... ________ Grant of Letters ........ .May. . .2.5th., ... 19.7.~ __ ..... ___ .. __________ _ This is the ........ .F.i.r.s.t .. and .. Eina.l ............................... account filed in this estate " ., .. If _there have been form_er accounts filed in this estate, list file nurrb~r o_r number and term ..... ~ne .................... . Election to take no spouse survived Under or Against will. (cross out one) Date Election Place of; Filed ····-····-------------------------Record _ _. _________ : _________________ _ Name of surviving spouse ...... N.one.,.,_Husband., ... Angelo. .. Andr.eo.lli ... di.ed ... 7/9/l9.60----------------------------· List issue;-whe.re material: - See below Did d"ecedent marry after execution of will? (indicate)~ No. Any children born after execution of will? (indicate) . . . ~No. If answer yes, ·name them.:.: ......... ·-··-----------··············--·--~------------------------------------------------·----·-·------------------------· Legatees Relationship Interest Fiduciary, if deceased or not sui juris Mary Swamp daughter 1/2 of all sui juris Anna May Bernard daughter 1/2 of all sui juris List, if exceptions to above: Adeemed: Revoked: Lapsed: Abated: Give Cause: If partial intestacy, give facts: none Notice to interested parties. Hove 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. ~ If any exception give cause: .............. N.o .. excep.tions. File copy of Notice and date of mailing ........... l/28/19.7.2. ....................................................................................................................... . Is estate subject to the filing of a Federal Estate Tax Return? ............ N.o ....................................................... :: ............ . Actual payment made on Pennsylvania Transfer Inheritance Tax. Amount $.2622 .•. 0Q::p.ai.d .. 9/2.8(l2.7.1 .... . If the Will makes any portion of estate subject to a life-estate, give name and birth date of life tenant ..... N9.~~ ... : .... ---·----·---------·-------------------------·-----------------------------------------------·---------------.................................................................................................................................... . Give Names and addresses of all unpaid creditors who are legally entitled to notice, tog.ether with the amounts of such claims; state whether they are admitted to be correct; and whether the claim is denied. All known clai1ns except audit costs and balance o:f inheritance tax are ,paid. The 1971-1041 Fed. Income Tax is paid, as is the 1971 Penna.Income Tax .. 'The 1972 :four mill tax is paid. A small 1972 Pa. Income Tax will be owed; but the two executors will personally pay this. The two executors will personally pay audit" costs arid balance o:f inheritance tax, i:f necessary, to keep assets intact. 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: The Will is clear. Through their execution o:f this Petition, the two executrices and sole legatees elect to take the household goods, appraised at $100. and all stocks in the estate, appraised at $51,573.95, in kind, at their appraised values, 1/2 to each o:f them, and request the Court to award same to them in kind. Nothing on the Inventory (attached) was sold. The stocks will all divide evenly •. The household goods should be awarded to the two o:f them, share and share alike. Balance for distribution per account, Itemize any additional debits not shown by account: Mar.72-div.-Lone Star stock Mar.72-div.-Northern Nat.Gas Mar.72-div.-Consol.Edison Mar.72-div.-Atlantic Rich:field-com. Total additional debits (Add) Itemize any a'dditional credits not shown by account: 2/8/72-1041-Fed.Income Tax~l971 2/8/72-Pa.l97l·income tax 2/8/72.;..1972-:four mill tax 3/ /72-notary :fees-aud.pet. Total additional credits (Subtract) Balance for distribution 436.56 122.20 27.00 21.00 $.606-.-7-6-··················· 148.88 / 44. 74'../ 111.98 I 1.50. $.3.67 ... ~0., ................. . $ .. 5~y6.7.3. •. 9S--~---······ $ . .5~r9J.3 .•. 6l ........... . If balance for distribution is not in cash~ list each item held in kind, giving appraised Value (or distribution Value); 1. Seven (7) stocks appraised at $51,573.95---see inventory 2. Household QOOd~ appraised at 100.00---see inventory -.' Balance is cash .. -~------ ,. If Family Exemption claimed by Petition, give place of Record: .... .none ... c~aime.d ................................... : ............ . If Family Exemption is claimed at audit, give name, relationship and basis for Claim: ...... n.one. .. c.laime.d ............ . List any advancement or distribution on account that has been made, and nature and amount of same: none Suggested distribution of balance shown, both as to principal and income, attaching signed and itemized elections to take in kind if balance is not in cosh: residuary shares being stated in proportions: Household goods-$100.--to Mary Swamp_and Anna May Bernard, share and share alike. Mary Swamp and Anna May Bernard, each: 642 shares Lone Star Gas Corp. common stock 20 shares United Corporation common stock 4 shares ·Niagara Mohawk common stock 94 shares· Northern Natural Gas common stock 30 shs. Consolidated Edison common stock 21 shares Atlantic Richfield common stock 35 shares Atlantic Richfield cu.pref .2-.80 Balance of cas~, if any, 1/2 to each legatee. Appraised 16,290.75 196.25 67.50 4,885.06 816.57 1,550.06 1 ,980. 78 If.no balance, each legatee will pay one-half of any amount needed to pay audit costs and balance of inheritance tax. COUNTY OF WASHINGTON, SS: COMMONWEALTH OF PENNSYLVANIA. The above named Fiduciary or representative thereof, being duly ......... swo:r::n. ................ dQJdx depose and say that the facts set forth in the foregoing petition are true And your petitioner will ever pray, etc. to the best oL ........ their ........... knowledge and belief . ....... S.wor.n ............................. to and subscribed before me th;s . ./~~--day af _______ Man;:h ... ~--R 9 .. 7.2.. s;gnatu•e af Offke•~~ Title of Officer ......... Nota:r::y ... P..ub~ic. ...................... . ~---tJJ/.~-~:------------------- _1( ____ ~_}/2~-~ Office expires ...... Marc.h..26., ... l97.5 ......................... . . ........................................................................................................................ ,.. Washington, Wash.County, Penna. ·' No. ______ J?.~---"=-"--Zl ... :: ... ~~-8------------------- Estate oLM.ar.}c.Na.gy .. Andr.eo~li.,.a/k/ a,, Mary Andr~olli, a/k/a, ····-------------M.:r.s ..... Mary. __ Andl:e.al~i---------· Deceased Fiducia_ry .. Ma~-Y--.Sw.amp--a.ad--,Amla--Ma:y . ' -----~g-~n~~9_, ____ ~K~gJJ._th_ic.e.s __________________ __ 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-e; and divisions thereof: shown on pages 23-24. 1. Written praecipes of all Co_ynsel 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. , · Adam L. Sanders-B.A.Franks ------------·------------·--·---·---------------------------------------· ~2 Attorneys .. ' ' ' ...,.,. i; t'."""" r ;rt !L l-.. ' ,-17. ~.no ,., · • r-.rn 1 1 r~~ ~ I ·' tr 3 . HUSSLl : .. !'.~UHO REGIS 1ET, OF WILLS \'!ASHiN~~TOH CO., P1\. ·' I t I C!tnmmnuntrttlt4 nf Jruungluauta. ! .!ill: 1ltlltt.a4tugtnu C!tnuutg. KNOW ALL MEN BY THESE PRESENTS: Whereas, at Washington, in the County aforesaid on the 25th. 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 liJary Nagy Andreolli,A/K/A Mary Andreolli, 11/K/A Mrs. Mary Andreolli late qf Chartiers Township in the County aforesaid, deceased, (a true copy whereof is to these presents annexed), was duly admitted to probate; and rices and Anna May Bernard> the ExecutiXt in said Will and Testament named, having appeared before me and taken and subscribed the oath of office pvescribed by law; NOW, THEREFORE, I, Russell Marino , Register as aforesaid, do grant these LETTERS TESTAMENTARY, unto the said Mary Swamp and Anna May Bernard committing unto Them the administration of all and singular the goods and chattels, rights and credits, which were of said deceased, and requiring Them to exhibit a true and perfect inventory thereof into ·the Register's Office, at Washington, within ninety days from the date hereof, and to r.ender a just and true account of said administration at the expiration of six months from the date hereof, and to regard and comply with the provisions of the laws of this Commonwealth relating to inheritance taxes. IN TESTIMONY WHEREOF, I have hereunto set my hand and the seal of said Office at Washington, this 25th. day of May in ·the year of our Lord one thousand nine hundred and Seventy One Register J \ ' Date of Death: o I( J "3-7/--S ;;_<g May 1, 1971 (_t) 1\ffibuuit ®f fxrrutnr ®r 1\bmiutatrutnr §tatr nf Jruungluauia } C!tnuuty nf llan4iugtnu an: Personally before me, the undersigned authority, a .... no.t~X'Y--J?.!J.bl.ic ___________ in and for said County and State, appeared .J~_cy __ SJ::l1lJil.:P ... ~.mt.AmJ.~~d~~~·Y--.Bern~m ...................... who, being duly sworn according to law, deposes and says that t haY Xl@Cthe executm:a~of the es- tate of ---~cy __ &ldJ::e9lli ______________________________ deceased, that the foregoing schedules constitute a complete inventory and appraisement of the real and personal estate of _____ Ma.ry_..Andr.eolli ________ , 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 th_:~ove named_ Executors~ Sworn and subscribed before me this .... 4.'-?. ........... } .__h' ~ " tJ day Of( '-~~ 19·./77.-~ /. K .. ;y..IJ .... a ........ -~/ ................. _.. . ................. . -¥ ~:jj~~-~ J·' , · · Exe utrix My com.-~od~1975···············N6ta~c···· ..l..I.,....~;Jo;::L~~'.ft..+<""'fl-1fio~:;...u.~~~~!:c=-:. Wash.Washington County,Penna. ADDITIONAL INSTRUCTIONS rl.X 1. An inventory must be filed within three months after appointment of personal 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 ,p .n Act of 1947 P.L. 513 Sec. 5.2, 72 P.S. 4844.2 iuurutnrg UtW 1\pprainrmrut of the goods and chattels, rights and credits which were of . .--: ... Mary .. .Andr.eolli ......................................... .late of .... Chartie.r~? ... T.ownehiP. ................................. . Washington County, Pa., taken and made in conformity with the above affidavit. Personalty 1284 shares common stock-Lone Star Gas Corp. @25 .375 40 shs. com. stock-United Corp. @9.8125 8 shs. com. stock-Niagara Mohawk @16.875 188 shs. com. stock-N.Natural Gas Co. @51.96875 60 shs. com. stock-Consolidated Edison @27.21875 42 shs. com. stock-Atlantic Richfiled @73.8125 70 shs. cu.pref. (2~8o) stock-Atlantic Richfield @56.59375 Household goods-see attached itemization--------------------- Total--------------------------------- Realty None TOTAL ESTATE Personalty $51,673-95 Realty 0.00 Total Assets------------$51,673-95 DOLLARS $32,58l.J50 392 50 135Joo I 9,770.13 ::::j:: 3,961.56 1oofoo I $51,673!95 CENTS J ~, Y~f c;..J-7/--6-,u/ ~ Inventory and Appraisement IN THE EST ATE OF ' M3.ry Nagy Andreolli, a/k/a, • r M3.ry Andreolli, a/k/a, , .. M+.~_,.,.Mar.y. .. Andreoll.i .............................. . Filed 19 .......... .. "' I ' ~::0 -..; ' ~"">..: -~-->rn:;;:; (/)G')C:: c._ ·-·-::r: -(·I =· ! -(/) (f) ~--~ ::: fY~ r-"-> ... ~1 ' • ; r -.J., -j ::t: 1-... ,. __ C) 0 \,......,..! . ..._ .. ..., -'""U 0 --»· ~ 0 ·.:: ~~ --,....., ' r-:2!: ""Dr-0 :;:::.. (.') L., en ~y~/ . /) I ~/<-/?;;£, Adam L. Sanders-B. A. Franks Attorneys at Law ~-5 #IJ3,od I. ·· .... STATE OF PENNSYLVANIA; WASHINGTO.N ·coUNTY, ~ SS: ·; .. ;~;.·.The withfb)'lamed ,Accountant being:cluly sworn according to law; depose ~K state.d is t~d~:>~nd ~-orrect· as ________________ ';I;'h~Y. __________________ veri ly believe. :, '• ·.;, and say that the above account :· . ' ' . . ~'y-!L Sworn and ~ybscrib~d b~.fore me this ----------,.--.:---~~-- . :-.··:· ':. -'~-~11Z.~------.~ ( . . '• . . Washington County, ss: •, ~ ·,, .- ci z • r1 ...... --------~.....-.... :-_-.. :--- .:-·· ~ '. ·- . t ·, ·,.· . .. ,_ : ' ~:( ~ t. ··. . c::;;;r; ' .. ' . (\ /) -~-. ~:z __ ::r------------~~~-----------· _____ ,· -----------. .· . . , . . :-..... :-._' . . •. . ·I do certify that I have given legal notice to all persons . 'concerned of the fillng of t~e ~ithin account in the manner prescribed by Statute_ and Ryle of Court, as evidence by proofs 'thereof file~ to No. {d,J,.-:-:.2~-;_J.. ________________ ~---- ¥. • ... Witness my hand and official se~l this .... ~ .. #-.......... . '· -~-.?-· . . ·-b-K . . . : '~~~~~'~:~u~~ , / -.:~-~ ~~cr-'J: ~rtJ ·a~o~sa S!4l U! UO!~nqp~S!P JadoJd 3U!WJa~ap o~ palsanbaJ .A 11 np::>adsaJ S! ~JnO) a4.1 \. ,; . ! : "' II ---------------------------------,-------, The First and Final Account of Anna May Bernard and Mary Swamp, Executrices of the Estate of Mary Nagy Andreolli, a/k/a, Mary Andreolli, a/k/a, Mrs. Mary Andreolli1 deceased, late of Chartiers Township, Washington County, Penna. The Accountants are charged as follows: 1972 Principal-Personalty Jan. 25 To amount of Inventory and Appraisement filed 1971-2 To refund from Washington Hospital E.C.F. (Manor) To amounts advanced by accountants personally to pay debts and costs of administration and keep assets intact-------------------------------------------- Total------------------------- Income-Personalty To dividends received from Lone Star Gas stock- death to 1/25/72------------------------------ To dividends received from United Corp.stock- death to 1/25/72------------------------------ To dividends received from Niagara Mohawk stock- death to 1/25/72--------------------------------- To dnadends received from Northern Natural Gas stock-death to 1/25/72---------------------------- To dividends received from Consolidated Edison stock-death to 1/25/72---------------------------- To dividends received from Atlantic-Richfield com. stock-death to 1/25/72----------------------------- To dividends received from Atlantic-Richfield pfd. stock-death to l/25/72------------------------------ Total----------------------- Principal-Realty None Income-Realty None TC11'AL ESTATE Principal-Personalty Income-Personalty Total assets-------------- Total credits claimed------------------- Balance Due--------------- $57,187.72 1,945.36 $59,133.08 7,459-13 $51,673-95 I $51,673.951 22.50! I I 5,491.27: $57,187.721 I 1,271.16 10.00 6.60 I 366.6o I I 81.00 63.001 147.00 $ 1,945.36, I The AccoUQtants claim credits out of the assets of said estate, to-wit: N¢.o II Date Vo~cher Payee Remarks May 17 Ml.y 25 May 20 May 25 June 7 June 11 June ll June 11 June 28 June 28 June 28 June 28 June 28 June 30 Dec. 7 1972 ___..,.... Jan. 25 Jan. 25 Jan . .! !?- Jan. l ~ Jan. 1. 8- Jan. ~ 8- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 Russell Marino, Reg. U!tters Testamentary Guy Rogers, Deputy Trip to prove will Rev. Hubacky ministerial services Washington Co.Reports adver.grant of letters Catholic Cemeteries Assoc. grave services Speakman Funeral Home funeral of dec'd Frank Bakewell, M.D. medical for dec'd M. MOrgan, Co. Treas. 1970-four mill tax Wa.shilgton Orthopedic Assoc. bill of dec 'd Gordon Funeral Home ambulance service Russell Marino, Agent acct. of inher. tax Gaydos Monument Co. inscription on stone Dr. M. w. Graham M. D. medical for dec'd Karl c. Randall M. D. medical for dec'd Washington Hospital bill of deceased Helen Beveridge notary fees-inventories Russell Marino, Reg. filing inventories Observer-Reporter adver.grant of letters Adam L. Sanders attorney fee Helen Beveridge notary fees-acct.& D & E Russell Marino, Reg. filing account Total credits claimed--------------------- Amount 251·50 lOLOO 27loo 141.oo I l,:::i:: 251.oo ' 1711.63 100.00 225.00 2,622.00 I I 18.00 I 7l00 45l00 15 .. 00 I ~.00 I 3.00 1J.oo 2,000.00 i 2.00 I 17.00 $7,459.13 I I ;;;; '- Observer -Reporter WASHINGTON, PENNSYLVANIA PROOF OF PUBLICATION In compliance with the Newspaper Advertising Act of 16 May, 1929, P. L. 1784, a;s am~mded. Commonwealth of Pennsylvania, County of Washington, SS: ........... . Personally appear-ed before me, a Notary Public in and for said County and State, ..... Ri.C.A~X.9. .... ~.~ .... G.QW.~.~ ................... , who being duly s•worn according to la;w, deposes and says tha;t he is the .. Vice-Pr.e.siden.t of the Obs•e.rver Publishing Company, a Ptenns.ylvania corporation, and its agent in this behalf; that the said Company is• the owner and publisher of the Observer-Reporter, succ•essor to The Washington Observer, established SeptembEl!r 18, 1871, and The Washington Reporter, ·established August 15, 1808, a daily news•pape.r of general circulation, printed and published 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 publication of the notice hereto attached; tha;t the printed notice o:-advertisement hereto attached is a -copy of an official advertisement, of':'.~i.:.,i notice, legal notice or legal advertis·ement, exactly as printed or publi£hed :n the ObSJerver-Reporter in its regular editions on the following date o;;-6 1tes; ............ _______ , ______________ , ______ _ .......................... .M.ay ... 27., .... J.~p-~_ .. __ 3. ____ ~;g._g ____ ;J,Q_, _____ l_9._7__~--------------.. --........ .. that neithEl!r the affian-t nor the Observer Publishing Company is interested in the subject matter of said notice or advertising and that all of the allega- tions• of this affidavit as to the time, place and character of pub ication are true. .. .... e~d ... -.............. .. Sworn to and subsc~_}efore me this .. lO ... day }jJ.~~-~-~-?.?.J._ m~~~~y,;;~~ WASHINGTON, WASHINGTON COUNTY MY COMMISSION EXPIRES MAY 6, 1972 ·Meadow Anna May 154%'•Haft Houston, Pa. • Executrices Adam L. Sanders B. A. Franks .... 611 Wash. TrustTB!dg .. Washington, Pa. 15301 Attorneys • , , 1 _________ '1~,!!!._urs~- Washington County Reports,. Washington, Pennsylvania (PUBLISHED BY WASHINGTON COUNTY BAR ASSOCIATION) PROOF OF PUBLICATION In compliance with the Newspaper Advertising Act of May 16, 1929, P. L. 1784 Sec. 3, paragraphs ( 3) and ( 25). CouNTY oF WASHINGTON} 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 officiru 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: May 27, 1971 June 3 1 0, 1971 ............................................ !. ............................................................. . '• that the affiant or the corpora·tion in behalf of which he is acting ·is not interested in the subject matter of said notice or advertising and that all of the Estate Notices The Register of WiHs 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. • • • • • • • • • • • • • • • • • ANDREOLLI. MARY NAGY, a/k/a MARY ANDREOLLI. a/k/a MRS. MARY ANDREOLLI, Dec'd. Late of Chartiers Township, Washing-ton County, Penna. Executrices: Mary Swamp. Box ~8. Meadowlands. Penna. 15347: Anna May Bernard. 154% Haft Street, Houston, Penna. 15342 Attorneys: B. A. Franks and Adam L. Sanders, 611 Washington Trust Bldg., Washington, Penna 15301 ~~".:.':'' of tJu. •llid"" M to the ?Jt:AmctM (f? pub~~ _ ................. ?/Z ........ ~d. ........................ : ...... li ... ttv~ ditor Sworn to and subscribed before ,. . . ...... · 1 0 b of..: ..................... ~.J..1.!.n ............... , 19 ....... ~1.., .. ~ .. d. ... ~~.~ Notary Public JOSEPHINE T. SC!.<\MANNA Notary Public, Wa5hington, Washington Co. My Commission Expires July 1, 1974 F ' ~tt tlf~ <trnurt nf Q!nmmnu Jll~a.a nf .. lla.a4iugtnu <trnunty ®rplfaun~ arnurt iinininu In the ma:tter of the Audit of Account in Estate or Mary Nagy Andreolli ,a/k/a, Mary Andreolli, a/k/a, Mrs. Mary Andreolli TO THE AUDITLNG JUDGE: No .. __ ..o:6:..:::3:__-_7.:.....:.1_---=5:..:2:..:8=-------- Enter ___ _,o...,u......,r _____ .appearance for ___ ~A~c~c~o.!2u!:!..!.JnL!t<.Ja~nut~s2.,_ ______________ _ c:2::2../ day of __ .:...M:.::a::..:r:..;c:::..ch:..:..._ _____ ,, 19~ N. B.-Counsel shall, by separate pape·r, present a concis~ statement of each claim, with supporting calculation of any interest claimed. Objections to an account as filed, shall be concisely stated in a separate paper. Council suggesting proper distribution shall file a separate concise state- ment in that regard. j ~-~ n . .. ! J L. ,_, , ''7?. 1\PR ll Pt'~ 1 43 R u s '~~ i l_ \ u :'. , .. , 1 no ;:EG\S fEh Of-WILLS V!f,S HI t·; .. ::r 0 N C 0 .. PA. No. 63 -71 -528 In re Audit of Account in Esta.te of Mary Nagy Andreolli, a/k/a, Mary Andreolli, a(k/a, Mrs. Mary Andreolli AUDIT Jrardpt fnr 1\pprarautr FOR Mary Swamp and Anna May Bernard, Executrices of the Estate of Mary Nagy Andreolli, a/k/a, Mary Andreolli, a/k/a, Mrs. Marv Andreolli. dec'd Adam L. Sanders-B.A.Franks Attorney S ~2 ·~ ,, IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY, PENNA . . ORPHANS' COURT DNISION INRE: Estate of MARY NAGY ANDREOLLI, a/k/a MARY ANDREOLLI, a/k/a ( ) ( ) ( ) ( ) ( No. 528 of 1971 MRS. MARY ANDREOLLI, ~Deceased. z >( > ..1 >-Ill z z Ill II. i g ~BEFORE: x Ill >( ~ ~ ~ a: 1-~ APPEARANCES: ~· § Q :I .., ~ ~TIME: .. a: Ill ... a: 0 .. Ill a: ... a: 5. THE COUI\T: u ..1 >( ·' HEARING ON AUDIT The Honorable P. VINCENT MARINO, Judge of the said Court. SANDERS & FRANKS, Esqs., of Washington, Pa., representing the Accountants. Wednesday, March 22, 1972, at 10:00 A. M., EST Number 528 of 1971, the estate of Mary Nagy u iL IL 0 Andreollt, deceased. The Executrices are Anna May Bernard and J Mary Swamp and the attorneys are Sanders and Franks. Mr. Sand~rs? MR. SANDEI\S: There are no outstanding claims in this estate. Nothing on the Inventory was sold. There are only two tpeop,le who share. in the estate, two daughters. They have elected to take all the stocks in the estate in kind. They will divide evenly. There is a small amount of household goods. They have requested that thEy le I ' ' } 2 be awarded in kind, justmwarded to the two of them share and sha e alike instead of any division. There is very little cash in the es tat There may be enough from dividends on the stock to pay the audit and balance of Inheritance Tax. If not, the two legatees will pay bo h. No complications. THE COURT: Is there anyone else in Court interested in this :! z decedent's estate? ~ ... > ~ ( NO .8ESPONSE ) z Ill 0.. ~ THE COURT: ... ~ z x the Court. Ul o( 3:: :t The audit of this account is ordered closed by (AUDIT CLOSED) I hereby certify that the proceedings' and evidence are ~ contained fully and accurately in the notes taken by me on the hearing of ui II: ~ the above cause, and that this copy is a correct transcript of the same. II: 0 L Ill II: I-ll: ::l 0 I) ... o( ij ii: IL 0 The foregoing record of the proceedings upon the hearing of the above cause is hereby approved and directed to be filed. , -- ~ j j 1 . :J •" c~ ., l " ~- r· V· .-~ \.. ('V') .::r- 0 cY"l :r~ ., . .... ~--- "" CL r-· I I. n:::: 0..... '; ..;:;:: : \,.,...:.:) u:: I"...J r--_.,. -- -/ .. ' ~ (.f) <( _, u. __J ~:-~ c) <-.J J 2: c t.: 1- !l.l ...._ : __ ,/';· ::!:: ~,. ',U( !.:u .q: r:: :-~ -~ . .. ('' !. ... • J '·: (. ...... ~ ~,,.' J -· ~N· ........ '. ' •• J, ,( ,. '(1 ' L.' '· ,, . ' ,, .J ''' -" f': .. ,. ... lu t4~ Qtnurt nf Qtnmutnu iflrus nf llas4ingtnu QI:nunty. Jruusylnauia. ®rp4aus · Q!nurt iittisinu ESTATE OF No. 63-71-528 Mary Nagy Andreolli a/k/a Mary Andreolli a/k/a Mrs. Mary In the matter of the First And Final Account of Anna May Bernard & Mary Swamp Andreolli, deceased Executrices ADJUDICATION AND DECREE And now April /7 , 19_1g, this matter came on for hearing, audit and distribution at this session and testimony taken; and thereupon, upon due consideration thereofr:-the9bqJap'e for distribution in ifhe hands of the Accountant is determined to be $ 2.1, 1l_l.t>J. and the account is accordingly confirmed; and it is ordered, adjudged and decreed that the said balance be paid out by the Accountant in accordance with the schedule of distribution hereto attached and made a part hereof, unless exceptions hereto be filed sec. reg. or an appeal be taken herefrom sec. leg. . SCHEDULE OF DISTRIBUTION Balance per account ________________ _ Additiona.l debit asked at audit Ad.di tiona 1 credit asked at a udi t Balance'--------------------- Deduct Clerk's Costs & Receipt::>-------------- Attomey· __ __:S~a~n~d~e~r~s!:::,._;&~F:-r~a~ni;.l;.;k~s~---------- Rus~ell Marino, Agent, transfer inheritance tax, Contribution to maintain assets of estate in kind, Mary Swamp, daughter, 1/2 residue, including the following assets, held in kind and distri- buted as such at the appraised value:- An undivided 1/2 interest in hous~hold goods and furnishings valued at $100.00, $ 50.00 642 shares Lone Star Gas Corp. connnon stock 20 shares United Corporation common stock, 4 shares Niagara Mohawk com. stock 94 shares Northern Natural Gas com. stock 30 shares Consolidated Edison com stock 21 shares Atlantic Richfield com stock 16,290.75 196.25 67.50 4,885.06 816.57 1,55o.o6 35 shares Atlantic Richfield cu. pref. 2.80 1,980.78 Anna May Bernard, daughter, 1/2 residue, in- cluding the following assets, held in kind and distributed as such at the appraised value:- Undivided 1/2 interest in household good~ and furnishings valued at $100.00 $5o.oo 606, 25936.9 $ 21.913.61 • r ) I . \ r 0 ~ .... ~~ ~ I ~'-, z t:Y a ~ ~ a :r ~· s:: C1) = C1) :s 3 .... t:Y 0 0 0 .... .... ~ -· ., t ,. M ~ ...... 0 -· .... ~ ~ :r = C1) ~ & ~ %:i ~· ~ r I I. 1 r ( ( ' r ') j-. r '1 ,. I I ' I,~ ') '-lr ) ) ') ') ~, r r . rr '-, I r ,. r ~-( ,..., r ., r -J ' r 642 shares Lone Star Gas Corp. com stock 16,290.75 20 shares United Corp. com. stock 196.25 4 shares Niagara Mohawk com stock 67.50 94 shares Northern Natural Ga.s com stock 4,885.06 30 ~hares Consolidated Edison com stock 816.57 21 shares Atlantic Richfield com stock 1,550.06 35 shares Atlantic Richfield cu.pref. 2.80 1,980.78 No balance _t /' • ,j • / J w '- . . . j :- L L L ) "'· -, {' 0 y '- r ' No. ______________ _ L In the matter of the Account of of Estate of 1\bjubitntinn nub lttrtt -~. I " ~a ~\~ -· I t ~-· ;·'\ -; I 1 '· '7 2 h P R i 7 P t1 3 l~ 2 RU~~:I.. t··.~.~:·~C: r.::Gls:-Ef. Or= V!ILLS W/1SIIIN~-TO~J CO .. P;.\. . / / ,, <il' :~'\ !!J /' // ,. .-~ , .. ~~~ L.__ ., .. r.- ~--... _ I \ I : i l 'i ! t \'' ' ,, " ·-~ " r' • IN THE COURT OF. COMMON PLEAS OF WASHINGTON COUNTY, PENNA. No.· 63-71-528 Estate of: Mary Nagy Andreoll~1 a/k/a, Mary Andreolli, a/~, Mrs. Mary Andreolli, Deceased PAY TRANSCRIPTS ., , .. --=-:"""· -·-' .. 1 ~ ::o f'V •"':-·.·:u }.> rn ":l:" . ~ (f) G1 c c_ r--. ~--c=. :t: ··-~ {,0 ' --"-(f) (.i1 ~-~:t'"j .z -j r ~ ·-G"> (TI ,--,_,..., ---{ """ .. -i:-~~1 ....... -c:l t_:) "' ..... -;:J -Oj ---,o ~-·-..... _; 0 -~·· ·-...... f"'-J r· .,._ u r· C) :» (f) '"" .--co ,·. ADAM L. SANDERS ATTORNEY AT LA.W WASHINGTON, PA. " ...... . ~-~ ~~l· ;~~ . ' "• I~ . l)}l;AtJ ' 'f~-.<./tJ "" J' ~ ; .. "· . " ' '} -.,_) 'WASHINGTON TRUST BUILDING II ' (, i j' ~l •f' .tj IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY, PENNSYLVANIA Estate of: ) ORPHANS' COURT DIVISION : Mary Nagy Andreolli, a/k/a, ) Mary Andreolli, a/k/a, Mrs. Mary Andreolli, ) Deceased No. 63 -71 -528 PAY TRANSCRIPT We, the undersigned, do hereby on the date set forth below, acknowledge to have received from Anna May Bernard and Mary Swamp, Executrices of the Estate of Mary Nagy Andreolli, a/k/a, Mary Andreolli, a/k/a, Mrs. Mary Andreolli, deceased, late of Chartiers Township, Washington County, Pennsylvania, the sums set forth belo , being the balance in distribution due us in said estate, awarded by the Orphans' Court of Washington County, Pennsylvania, by Deere of Distribution dated April 17, 1972. Mary Swamp, daughter, 1/2 residue, including the following assets, held in kind and distributed as such at the appraised value: An undivided 1/2 interest in household oods and furnishings valued at $100.00 '42 shs. Lone Star Gas Corp.com.stock 20 shs. United Corporation com. stock 4 shs. Niagara Mohawk com. stock 94 shs. Northern Natural Gas com. stock vf~O shs. Consolidated Edison com.stock ~21 shs. Atlantic Richfield com. stock shs. Atlantic Richfield cu.pref.2.80 50.00 16,290.75 196.25 67.50 4,885.06 816.57 1,550.06 1,980.78 $25,936.97 ~~ $25,936.97 (Seal} Anna May Bernard, daughter, 1/2 residue, 1nclud1ng the following assets, held in kind and distributed as such at the app- raised value: Undivided 1/2 interest in household goods and furnishings valued at $100.00 642 shs. Lone Star Gas Corp. com. stock ~0 shs. United Corp. com. stock ~4 shs. Niagara Mohawk com. stock v94 shs. Northern Natural Gas com. stock v30 shs. Consolidated Edison com. stock v21 shs. Atlantic Richfield com. stock ~35 shs. Atlantic Richfield cu.pref.2.80 50.00 16,290.75 196.25 67.50 4,885.06 816.57 1,550.06 1,980.78 Form RCC-33 ' COMMONWEALTH OF DEPARTMENT OF PENNSYLVANIA REVENUE J RESIDENT DECEDENT BUREAU OF COUNTY COLLECTIONS COUNTY OF ... WASHINGTON ................................................ . IMPORTANT: This return must be completed in detail and filed in duplicate, with will attached, with the Register of Wills of the County where decedent resided; Return is due within one year after date of death, unless an extension is granted by the Secretary of Revenue. (Section 703 of the Inheritance and Estate Tax Act of 1961.) IJY THE 1\IA'(TER ~~TilE ESTAT~ QF }, Mary Nagy AndreOJ..LJ.1 at K, a, Mary .Andreolli, AFFIDAVIT OF a/k/.a..~ ..... Mr.s. ........ .Mary. .... .Andr.e.olli ..... · .......................................................................... EXECUTORs ute of .... Q~.~Y-~~-;;~~;:~,~~;~;;;:_1-.QP. ........................ County ~ County of .... Washington ....................................... ~.nr. .... ~P .... ~d .... Amla. .... ~ .... Bernard. Executors of the estate of the above-named decedent being duly sworn, depose and say Decedent d.Jed ....... lS:IJ .. , 19 ..... 7l .... ,J testate leaving a last will, copy of which is hereto attached. } (Jiay) (Year) L ~ ............................... May .. (Month) Name and address of attorney or} other authorized representative to whom all correspondence should be mailed. . Adam L •. Sanders, Attorney at ... La.w.............. .. ..... ........ . .................... .... .. . .611 Wash:l.tgton Trust Bldg. Washington, Penna. That as such ..... ~~-g.Y:t9..:r.!?. ................... deponent is familiar with the affairs of said .estate and the property con- < ~;x.,cu tor-Administrator) Rtituting 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 :Ei:t:tsburgh National Bank WR.shi n.c1tnn . Pl'l Mrs ~:rv Ann,..,.n1 1 i n,.. anna May Bernard nl'!.n.crht,..,.. That the contents of said safe deposit box or boxes are itemized under Schedules ___ of this return, with the exception of the following, for the reasons hereinafter set forth: That Sc.hedule A attached hereto and made part hereof sets forth full v and in detail all 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 8 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·th~ 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 tax free, of the United States, or any state, or political subdivision thereof, or of any foreign country,_which are owned at the time of death; all wearing appare), 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 mortgae;es held by decedent and of all claims due and owing decedent at the time of death, and all promissory notes or other instruments in writing for the payment of money of which decedent died possessed, of whatsoever nature, with interest thereon, if _any, giving the face value and estimated fair market value thereof, and if such estimated fair market value be less than the face value, it sets forth briefly the reasons for such depreciation as to each item; all moneys payable to the estate from life insurance 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. I f 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 o'r 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 ite~ized for~, tog~ther 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 cony 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, or jointly with another, or any power of appoint- ment vested in decedent, either individually or jointly, by the wi~l, 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, 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, inciuding intangible, s.tanding in the name of the decedent and others, plus the date and place of record of instruments effecting the vesti ture 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 anrl 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", "C", "E", and "F" as directed therein, have been carried forward and properly registered in the Summary. Subscribed and sworn/to-before me this ................................ . ~~:1~~~~~---······192~ :t{y Com.Exp: March 26, 1975 Washington, Washington County, Penna. M.S.~~'-"'~7-c~~:t::::::::z:~~;l.e::-­ Box 68, adow1ands, P~. 15347 A.M.B .• ."'-4k~_Mfu.td __ _ ... l.5!+.i. ... H~f.~ .... $.~.*.~.~:t .......................................................... ~·············· (Street Number) ... H9~t.on., .... :ra~ ........ l5.34.? .............................................................. . (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 worrl "None", anrl 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 requirerl 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) COM-MONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS TRANSFER INHERITANCE TAX RESIDENT DECEQENT ,. SCHEDULE UA" REAL PROPERTY Real property in Pennsylvania, with statement of mortgage encumbrances upon each parcel at death of dece- dent. Where property held as joint tenant or tenancy by entireties, report on Schedule "E". Property held by the decedent as tenant in common with another or others, should be identified as to quantum of interest and the estimated value should be that of the decedent's interest only. The real property located In the Commonwealth of Pennsylvania should be (1) (2) (3\ described by lot and block number, street and street number, together with '-· DEPARTMENT a general description of the property, with a reference. to the record of the ASSESSED VALUE VALUATION conveyance by which the decedent took title; If a furm state number of a-FOR YEAR OF ESTIMATED CAUTION cres; also statement of mortgage encumbrances upon each parcel at death DECEDENT'S MARKET VALUE (Do not write of decedent. Taxes, assessments, accrued Interest on mortgages, etc.,are DEATH In this space) to be listed on Schedule "F" and must not be deducted from this schedule. None ' Insert this total opposite "real property", Schedule "A" in the X X X X X 0 "As Reported" column on the last page of this return. -'''· RCC-.35 , COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "B" PERSONAL PROPERTY INSTRUCTIONS: This Schedule must disclose all tangible and intangible personal property owned individually by the decedent, at the time of his death. Property owned by the decedent jointly with another or others must be listed under Schedule "E". Intangible personal property, titled in the name of the decedent, but payable at death to another or others, including but not limited to P.O.D. u. S. Savings Bonds and tenta- tive trust accounts, must be listed, despite the fact that they are not of the administered estate. Tangible personal property should be listed first (e.g. jewelry, wearing apparel, household goods, and furnishings, books, paintings, automobiles, boats, etc.) Intangible personal property, such as bonds, treasurj certificates, cash on hand and in bank, stocks, mortgages, notes, together with accrued interest or dividends, salaries or wages, insurance pay- able to the estate or fiduciary in said capacity, partnership interests, interest in anyundistributed estate of or income from any property held in trust under the will or agreement of another, even though located outside of the State, at the time of death, should be listed in this schedule. Item No. ITEM UNIT List and describe fully VALUE 1284 shs. com. stock-Lone star Gas Corp .@25. 375 II 40 shs~ com. stock~United Corp. @9.8125 v 8 shs. com. stock-Niagara Mohawk @16.875~ 188 shs. com. stock-N.Natural Gas Co. @51.96875""' · 60 shs. com. stock-Consolidated Edison @27.2187 ·v' 42 shs. com. stock-Atlantic Richfield @73.8125~~ 70 shs. cu.pref.(2.80) stock-Atlantic Richfield~- @56. 59375 {j.f< . Household goods--see attached itemization------ Insert this total opposite "Personal Property", Schedule "B" in the "As Reported" column on the last page of this return. X X ESTIMATED MARKET VALUE DEPARTMENT VALUATION (Do not write in this space) $32,581.50 1/'3:<15! I, :!:J-o 392.50/_~ lJCl~, 50 135.00~~1 13 5:0 0 9, 770.13 _,_,"I 9.; 7 7 !J' I:; 1)633·/3 1,633.13 3 I OCJ-1.3 3,100.13 I 100.00 $51,673·95 RCC-3b , -GQ\!)[QN'I'EALTH OF PENNSYLVANIA TlUNSFER INHERITANCE TAX ~~SIDENT DECEDENT . ~. SCHEDULE "C" T!l.\.NSFEllS (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) no (2) Did decedent, within two years of death, transfer property from himself to himself and another or others (including a spouse) in joint ownership? (Answer yes or no) no (3) If the answer to (1) or (2) above is in the affirmative state: (a) Age of decedent at time of transfer ----------- (b) State of decedent's health at time of making the transfer. (Note 1). (c) Cause of decedent's death. (Note 1). (4) Did decedent, in his lifetime, make any transfer of property without receiving a valuable or adequate consideration therefor which was to take effect in possession or enjoyment at or after his death? (Answer yes or no) __ ~n~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) no (b) What was the transferee's age at time of decedent's death? (5) Did decedent in his lifetime make any transfer without receiving a val_u_a_b_l __ e_a_n_d-adequate consideration therefor under which transferor expressly or impliedly reserves for his life or any period which does not in fact end before his death: (a) The possession or enjoyment of or the right to income from the property transferred? (Answer yes or no) --~n~o~------ (b) The right to designate the persons who shall possess or enjoy the property transferred or income therefrom? (Answer yes or no) no (6) If the answer to (5) (b) above is in the affirmative, state whether the right was reserved in decedent alone or others----------------------------------------------------------------------------~-----------­(7) Did decedent in his lifetime make a transfer, the consideration for which was transferee's promise to pay income to or for the benefit of care of transferor? (Answer yes or no) ___ n~o~--- (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) 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 None Insert this total opposite "Transfers", Schedule "C" in the "As Reported" column on the last page of this return. MARKET VALUE (Estimated) DEPT. VALUATION (Dept. Only) RCC-38 COMMONWEALTH OF PENNSYLVANIA THANSFER INHERITANCE TAX RESIDENT DECEDENT " . SCHEDULE "E" JOINTLY OWNED PROPERTY INSTRl'CTIONS: This schedule must disclose all property, real and personal, owned by the decedent jointly with another or others, including intangibles, standing in the name of the decedent and others. List real estate first, as entireties, or joint tenants, giving brief description, as indicated under Schedule "A", plus the date and place of record of instrument effecting vestiture, but do not include entireties or out of state real estate value in estate valuation column. Personal .property should be listed as in Schedule "B", plus date of acquisition, and the name, address and relationship (if any) of co-owners to the decedent. Description of Property, Date of Acquisition, Name! Address and Relationship of Co-Owners, and Place I of Record of Instrument, where Rea~ Estate. ! None Unit Value Percentage Share Estate Valuation Insert this total opposite "Jointly Owned Property", Schedule "E" in the "As Reported" column on the last page of this return. DEPARTMENT VALUATION CAUTION-Do not Write In This Space. Value of Entire Property Value of Decedent's Interest h RCQ-37 (12-63) GOMMONWEAL TH OF PENNSYYLANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT BENEFICIARIES AND ADDRESSES State full names and addresses of all who ave an interest, vested, contingent or.other- wise, in estate) Ma;ry: Swa.m12 'Rox 68 t.Pru1 owl ands "Pa 1'1~47 Anna MaY Bernard 1S~ Haf't Street Houston. Penna. 15342 ·~ SCHEDULE "D" BENEFICIARIES RELATIONSHIP SURVIVED (If step-children or DATE INTEREST OF illegitimate children DECEDENT OF BENEFICIARY are involved, set STATE YES IN ESTATE forth this fact.) OR NO BIRTH daUB:hter ves 1/2 -ns:~,u:rhter ves 1/2 Deponent further says that all the above-named beneficiaries are living at this time except below: NAME DATE OF DEATH RESIDENCE Will MMPWH"M¥ ( No. Year ........... . D< THE :\lATTER OF THE APPRAISEMENT OF THE ESTATE OF Mary Nagy Andreolli, a/k/ a, Mary Andreolli, a/k/a, ~13. ~-. ~:cy . 1\Il<lr.~o:L:l:l .. Deceased Late of Chartiers Town~hip County of WE113h:lngtoi1 Commonwealth of Pennsylvania REPORT AND APPRAISAL 9j "Y'd ··oo NJi.SN!HS'VfA 5'711/.\ J;J d?IS!Ei3GJ 0.'!;:;:;.-; ~l1SSntJ c 'l ~ (. •IG ... , . , .. ,.., ,l 2lc~'•11 (.'" ' ·t'"; '":a. •... I ' t ; '•I· j ' ,. j Adam L. Sa.nders-B.A.Ffunlfs .~:.~ Attorneys at Law (Executor-Administrator must complete "As Reported" column #1.) CJ ...., '"C ~ .... .... (b (b 0 II:> .... e:... "' :s "' "' "' 0 ....., :s '"C ...., (b e:... .... .... II:> "' 0 >< "C II:> '"C (b cr ... ..., co 0 ~ "C ~ (b ..., "' ..... ..... '< II:> ..... (b Vl c: ~ ~ > ~ w Vl Vl .....:: (") (") ?" ?" ?" r1 oa > :: ::: ::: ..__.. ..__.. ..__.. ~ ~ * ~ ~ ~ \11 IJ1 ~ 1-' ... ... > 0\ : 0'\ "' .p..J : ~ 'o ~ w :ow :• :• .. :. ~:: ~ :o \() :o o-:o \11 :o..., ..... (b c.. ~~*~-~ > ;r. u ~~ ...,_ 3 ::I r. c.. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS HARRISBURG RCC-61 (6-71) 17127 IN YOUR REPLY PLEASE REFER TO 8 1 3 -73-5 Inheritance Tax Division NOTICE OF FILING OF APPRAISEMENT MARY SWAMP In Re: Estate of __ MA_R_Y __ NA_G_Y_A_ND_R_E_0::-11=-...:.:.I _________ _ _ _..:.:W=A=S=H=I:..:..NG:=:....T=-O::..::N:..:.___ County - F i I e No. 6 3-71-5 28 Dear Mrs. Swamp: You are hereby notified that the-----'o"'-r""-""i-l:::g~i~n~a~1~---------- appraisement in the estate of Mary Nagy And reo] lj a/k/a has been filed in the office of the Register of Wills of liashington County on January 28 ; 19 72 , Said appraisement reflects the following valuations: Real Estate _____________ _ Person a I Prop erty _ ___.S..__l..._,_, ...._6_._7....,3'""'.--"9...,..5L_ ___ _ Transfers ______________ _ Joint I y Owned __ ___,5"'-'1""-+, 6"'-7-'--"'-3_._. -""-9""'-5 ____ _ Total ________________ ___ 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 January 28, 1972 DATE OF DEATH: May 1, 1971 Note: This is not a bi II. J ,. RCC-39 (5-68) COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT Estate of ANDREOLLI, MARY (Last Name) (First Name) SUMMARY NAGY alkla I I DATE OF DEATH 5-1-71 FILE NO. 63-71-528 (Initial) REPORT OF INHERITANCE TAX APPRAISER I, the undersigned duly appointed Inheritance Tax Appraiser in and for the County of lvashington Pennsylvania, do respectfully report that I have appraised the real and personal property as reported in the foregoing return at the values set forth opposite each item in the last column to the right in Schedules "A", "B", "C", and "E". Dated: __ J:::;_,;:;:.a=n=ua.::..:..=:...ryo~....-=2-=-8-1-, --=1-=-9..:...7=2- 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) None CLEAR VALUE OF ESTATE 51 673 95 51 673 95 Valuation of life estates or annuities . . . . . . . • . . . . . . . . . . . $-------+-- ESTATE TAX ASSESSMENTS $ _____ J..__ FOR USE OF REGISTER ONLY COMPUTATION OF TAX $ ____________ ~--- $ ________ ~--- $------------~---$ _______ ~--$ _______ ,_ __ TOTAL TAX $ _______ ....__ __ Less tax previously paid $======!== BALANCE $------+--- Less 5% of tax if paid within 3 months after death $=====~== Add interest at rate of 6% from -----to -------- AMOUNT OF ESTATE TAX ASSESSED $------+-- Estate tax paid $ _____ ---.~ __ (*) As evidenced by Charitable Exemption Certificates issued by the Secretary of Revenue. BALANCE DUE $ _________ -J __ __ Add interest at rate of 6% from ---------~0-----$-----------4--- TOTAL TAX BALANCE $ ----------+--- PAID $-------'--- FOR USE OF REGISTER ONLY ADJUSTMENTS NOTE: Where subsequent adjustments are made to the above computation of tax by the Register of Wills, for proper reason, same should be noted below, with short explanation. Will Administration ~ No. IN THE Year ........... . MATTER OF THE APPRAISEMENT OF THE ESTATE OF 1-fl\RY ~A~Y A~D~<?LLI a/~/a. Deceased Late of ....... 6hartiers Twp. County of \vASHINGTON Commonwealth of Pennsylvania REPORT AND APPRAISAL I I ' Fonn RCC-2 COMMONWEALTH OF PENNSYLVANIA RESIDENT INHERITANCE TAX APPRAISEMENT DATE January 28, 1972 DEPAR.TME'l'~T OF RF;V~NUE -# • ~ 'BUREAU OF COUNTY COLLECTIONS COUNTY ........... W..~§.h.i.ngt..Q.!! ........... . HARRISBURG, PENNA. 1 7 1 2 7 FILE NO ........ §}:..?..!.:.:?. .. ~.~ .................... .. Whereas, .............. Mary .... N.a.gy.. ... And.r..e.o.lli. ...................................................... late of ...................... 9. .. 4.~r.!:.~.~.r.:.~ ..... :r~~P.~ .......................... . in the County of ................ Wa.s.h.i.n.g.t.o.n ............................................................................. Commonwealth of Pennsylvania, having died on the ................................... l.s.t ................................................. day of ................. M.B.:.Y ................................................ 19 ... ?..~ .• seized and possessed of an estate subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore I a:!./..¢~ SL.2~ 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 Deacrlptlon of Asset Values Made for Inheritance Tax Purpose& $ PERSONALTY: See Schedule "B" attached to appraisement 51,673 95 Total 51,673 95 form~;·:~ht;:~ ::~hi:w~a~".1r~·=: ~~ o~~~~~i::,:~?~ ····~···························~···································~ ~~ and Street) ................................................................. . .... :.............................. . ............................. , Penna. (Post O!llee) I I I I WASHINGTON County RESIDENT INHERITANCE TAX APPRAISEMENT Estate of MARY NAGY ANDREOLLI Deceased. Late of CHARTIERS TWP. Date of Death, ..... M~Y .... J .. , .... J~Tt ........................ .. Appraiseme1Jt Docket Vol.,· ............. J..f3.... .......................... .. Page, .... ),.7.3..~~ .............. No ..... 6 .. 3..~.7.1.~.5.4 .. 8 .... . Filed in Register's Ojjice, .. J.an ........ Z..8.., ..... 19.i.2. Amount of tax due, $ ................................... , .............................. . DEPARTMENT OF REVENUE Received, Examined and Approved, Wrote abo.ut Appra.isement, Appeal fMm Appraisement, Entered and charged, t , Form RC C-10 . OFFICii OF THE R-EGISTER OF WILLS oF Washinston couNTY AND AGENT OF THE COMMONWEALTH ESTATE OF Mary AndreolJ i t\.. (p 3-71 .,·S ;;> g STATEMENT OF DEBTS AND DEDUCTIONS DATE OF FILING APPRA IS EM ENT _..J.J,!.Sa!o!:n:!..l•~2 .... 5~,'--'0!:l..;;i9~7.!::2.___DAT&: OF DEATH --Ma,I..!A.~¥-l.&.,l,_.l~.;9;z..71-l~------- , DATE NO. OF NAME OF PAYEE REMARKS AMOUNT VOUCHiii'llt 1971 Mav 17 1 Russell Marino. Reg. TA++..,..,.~:! rr.:.~:!+,.m<:>n+.J:a'I""\T ?I:\ I c;n M=l;r ?t; ? ~uv Roaers Denutv Tl"in to nrove· will 10 loo M:::..v 20 ~ Rev Kuback.v ministerial services 27 00 M!li'\T -;>t; h tJ::~ R hi n a+rm l"'nnn +.v ;R adVE'!l" . ara.n+ nf' 1 Pt+.PrR 1h nn .Tune 7 5 Catholic Cemeteries Assoc. D'T"::I~TP RPT"Vi I"P!': 1t;n !nn .Tune 11 6 Sneakman Funeral Home funeral of dec 'd 1 4o~ 00 .TnnP u 7 Frank Bakewell M. D. medical for dec'd ?t; loo .T11n"" , R M Mnrga.n r.o Tl"e~'t!': 1 070-f'nur mi l1 ta.x , 71 I;:;~ .Tnnto 28 q Washington Orthopedic Assoc. bill of dec 1d 1nn loo .T1me 28 10 Gordon Funeral Home ambulance service ??t; Inn .Tnnl'> ?R 11 r.avilnF! ... r.n inRI"rin+.inn nn s+.nnP. 1.R Inn .Tnnl'> ?.R 12 Dr M. W Graham M. n. medical for dec'd 71:i loo .T11n.,. <n 1< T<".!ll.r1 r! 'R::~nil.!'!.l 1 M. D mE'!ilica.l for dec 1d hc;n Inn Dec. 7 14 Washington Hos-oital bill of dec'd lS 00 ' 107? - .T:::~.n ?t; 1t; Helen .... ldge nota.l"V fees-inventories 2 00 .TJ:>n ?t; 1h RnR RP 1 1 M:!.ri nn RPt:r f'ilini< inventol"ies. ~ 'nn .T<>n .JJJ' 17 nh~ n ... J:>t'hr,..,. arl'ln+ nf' 1~'>++PrR lh Inn .TR.n 1.8-18 Ada.m 'L Sandel"s attornevs at Law ?.nnn I no .ran. 2:.1 19 Helen Beveridge notarv t'ees-a.6ct &D&'F. ? loo .TR.n 2-f?--?0 Russell Marino. Rea. filina account 17 loo ..... 11 Total---------------!R4 8~7 11~ Qi ~ ~""'~-./ t;'JJ!.~ 4 ~ ..4' ,c;:f t; q / 7l( 1-1. ) 'r;f-5' ~ .. S'?) :. f t?tf 7tf ,-., I -------- COMMONWEALTH OF PENNSYLVANIA }se: COUNTY OF rla.sbjng:ton We X l)arlDa Ma~ :Bernard a.nd Ma.~ Swam:12 HEREBY CERTIFY, THAT. TO THE BEaT OF MY KNOWL.I!:OGE AND BELIEF, THE FOREGOING IS A JUST AND TRUE SfATEMENT OF DEBTS, FUNERAL EXPENSES AND EXPENSES OP' ADMINISTRATION SUBMITTED TO THE ESTATE OF Min:~ AndreQll;i. DECEASED. AS DEDUCTION$ FOR INHERITANCE TAX PURPOSES. . a 77leu-J-~A/~_, ~ }( /?.-A ,-., .h (L. 5.) SWORN;ND suss~hED liEF" THIS dJ.../ DAY 01" 0/,_ ~A .Tapua /} 18--'~-::J.. .. /?AAA ·~ -4_/ (L.S.) vL,/_--" '1...7./"J. --1 / / / / / NotaryV PublJ.c - ~ Com.Exp: March 26, 1975 Washington, Washington County, Penna. I I I ' - ... '\ \'' I"' " •• ' ~' '" ' \ I \ (">'") <!) < 0 -l a... z _) {V'J c..:: ·~-c -.. c ~--· ....... :i..f L:.... -.~ "'· 0... b ;:_~ ,..-... u:: l-----c;c . '..lJ ·" T''t « • I ( ....... \ :..:J 1·-...:!".-....... .J (j) :.o ........ :.:J..: t.? .... 1_ ~:: ~ (.;) (./) ""' ....... " -:l :.:r.: l.IJ >«! ,.,.,.l1'l.~· !'-1 r.::.::.: 3:l· t!.-r--... -N~l-.. -/L.~--;'"-. COMMO·t~L TH OF PENNSYLVANIA ~ARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS APPLICATION FOR AND CONSENT TO TRANSFER SECURITIES REGISTERED IN THE NAME OF A RESIDENT DECEDENT APPLICATION (MUST BE FILED IN TRIPLICATE) DATE May 11, 1972 TO THE PENNSYLVANIA DEPARTMENT OF REVENUE: Application is hereby made for consent to the transfer of the following securities of a Pennsylvania Corporation or a National Banking Associalion locajed in Pennsylvania: Atlantic Richfield Company a.ao (a) 70 (b) Cu.Conv,Pref. (c)_P_r_e_f-"-•------- (NOTE: In describing securities enter in {a), ab CNe, either the number of shares of stock or the fcce amount of registered bonds, in (b), the name of the issuing company and in (c) the class of stock or the stated interest rate and maturity date of registered bonds.) ISSUED ON April 4, 1969 ,·and havin'g a TOTAL MARKET VA1LUE OF $..:::3'-'-9--'6_1_,_,_5_6 ______ _ (Date) as of the date of death of the decedent, Mrs • Mary Andraoili , on May 1, 1971 (Dote of deoth) (Name of Decedent) wh(l wc;s. late of Chartie:rs Twp. Washington (Street and Number) (Post Office) Washington (County) Penna. (State) The securities are registered as follo~s: Mrs, Mary Andreolli --------~----~------------------------------------ (Name or names in which certificates are registered) Anna May Bernard~-154! Haft Street, Houston, Pa. 15342 ~)Mary Swamp--Box 68, Meadowlands, Penna. 15347 ~CES) NAME OF APPLICANT (Address) Adam 1 ... ~ Sanders, Attorney (Name) COUNTY FILE NUMBER 63-?1-528 ADDRESS OF APPLICANT6ll ~aabingtS!n Trust Bldg. "Wasluugtou, rldiUla, lSSOl BUREAU FILE NUMBER Same SIGNATURE OF APPLICANT a~avt !_, ~~J ~ NOTICE: IF YOU FAIL TO PROPERLY FILL IN ANY PORTION OF THIS APPLICATION, IT WILL NOT BE · CONSIDERED COMPLETE AND WILL BE RETURNED TO YOU FOR COMPLETION. COMMONWEALTH OF PENNSYLVANIA-DEPARTMENT OF REVENUE CONSENT TO TRANSFER SECURITIES DATEMay 11th. 1972 I hereby consent to the transfer of the above securities now registered in the name of the aforesaid Decedent and waive the filing of a certificate certifying to the payment of the transfer inheritance tax to which the property of said Decedent is made subject pursuant to the provisions of the Act of June 20, 1919, P.L. 521, as amended and the Act of June 15, 1961, P.L. 373, os amended. This is also in accordance with the provisions of the Act of April 9, 1929, P.L. 343. This Consent to Transfer the herein described property operates only in reference to the estate of the above-named Decedent. Office copy 1e Secretary of Revenue (Signature) Register of Wills Washington / (Title) (County) /7~---- / COMMONWfv\LTH OF PENNSYLVANIA .)'.:'P.ARTMENT OF REVENUE BUREA.U OF COUNTY COLLECTIONS APPLICATION FOR AND CONSENT TO TRANSFER SECURITIES REGISTERED IN THE NAME OF A RESIDENT DECEDENT APPLICATION (MUST BE FILED iN TRiPLiCATE) -TO THE PENNSYLVANIA DEPARTMENT OF REVENUE: DATE · May 11_, 1972 Application is hereby made for consent to the transfer of the fo!lowiilg securities of a Pennsylvania Corporation or a National Bllnking Associalion located in Pennsylvania: (a) 42 (b) Atlantic Richfield Company (c)_-_e_o_mm_on ____ _ (NOTE: In describing securities enter i.1 (a), ob 01e, either the number of shares of stock or the face amount of registered bonds, in (b), the nome of the issuing company and in (c) the class of stock or the stated interest rote and _maturity date of registered bonds;) ISSUED ON April 4• l969 , and having a TOTAL MARKET VAtUE OF $_3_l_OO____;_._l_S _____ _ (Dote) · as of the dote of death of the decedent, f.Srs. Mary Androolli · . on May 1, 1971 __ , ·----=-- (Nome of Decedent) (Dote of deathi who was late of t-lashington Penna. Charticrs t~vnsbip Washington --------------------~--------------------------------- (Street and Number) (Post Office) (County) (State) . The securities are registered as ·follows: f.!rs. t.ftlry Andreolli_. ________________ _ Anna May .Bernard--ls4l'mRmm~t'rt:~t ,cewbf.fifton;e 9fs~a. 15342 ~ Mary swamp Box 68 Meadowlands, . Penna. 15347 EXECUT~RIC48 (Name) !Address) NAME OF APPLICANT Adam L. Sanders t Attorney COUNTY FILE NUMBER 63 -?1-528 ADDRESS OF APPLICANT 611 tfasbington Tr~st,..Bldg. . · ·· t~asbxngtou, Pmlna-. i-:'J301 BUREAU FILE NUMBER Same __ SIGNATURE OF APPLICANT qq/4-wt f.·~ 6i:l:r NOTICE: IF YOU FAIL TO PROPERLY FILL IN ANY PORTION OF THIS APPLICATION, IT WILL NOT BE J -J CONSIDERED COMPLETE AND WILL BE RETURNED TO YOU.FOR COMPLETION. COMMONWEALTH OF PENNSYLVANIA-DEPARTMENT OF REVENUE CONSENT TO TRANSFER SECURITIES DATE May 11th. 1972 I hereby consent to the transfer of the above securities now registered in the nome of the afCJresaid Decedent and waive the filing of o certificate certifying to the poymeni' of the transfer inheritance tax to which the property of said Decedent is mode subject pursuant to the provisions of the~ Act of June 20, 1919, P.L. 521, as amended and the Act of June 15, 1961, P.L. 373, as amended. This is also in accordance with the provisions of the Act of April 9, 1929, P.L. 343. This Consent to Transfer the herein described property 'operates only L1 reference to the estate of the above-named Decedent. Office copy Signe~the Secretory o~ Revenue., By~~ee-/~tva (Signat.,reL Register of WilJs (Title) (County) wa s hi:qg ton r---• RECEIVED TWO THOUSAND SIX HUNDRED TWENTY-TWO and 00/100 ----------------dollars representlng Pennsylvania Inheritance or Estate Tax due from the following estate: Mary S"t~amp & Anna Mae Bernard From:~~~L_~~~~L-~~~~~------------,----------------------------------------------------Im Address 611 \·lASHINGTON TRUST BUILDING 2% Tax on $ __________________ ~·------------------11~1 YASHINGTON PENNSYLVANIA 15301 File No. 63-71-528 Date of De 5-1-71 Name of Decedent ___.:.~_1A_R_Y..:...._N_A_G_Y_A_N_D_R_E_O_L_L_I _ ___, County ___ \:.....:vA:.:.S......:H::..:..=.I:.....N_:_G..::.T....:.O:.....N..:...._ _______ ---l Remarks: HJR ;;t;.l SEAL NOTE: To be delivered to laxpoyer 38-173-5 6% Tax on $ On Account 15% Tax on $. ______________ _ % Tax on $ ________________ _ Estate Tax, Act of May 7, 1927 TOTAL TAX CREDIT Less five percentum of tax if paid within three months after date of death Plus interest at the rate of __ %from---------------- to ______________________ __ TOTAL AMOUNT PAID Received NOTE: In accepting the transfer inheritance tax on future estates, prior to the death of tenant or tenant for years, as evidenced by this receipt, it is understood that the Commonwealth not be precluded or prevented from hereafter assessing additional inheritance tax at the death life tenant or tenant for years whenever it appears that such additional tax may be legally due collectible for reason whatsoever. $ _______ _ $ _______________ ___ $ _______ _ 2,760.00 $_--=xn::z:::=::xxx=~x:...___ 138.00 $ ______ m~Y!;XredN~N.___ ___ $ _______ _ $=::€!!2!:::!::•::!::!:6~2~2 ~-0~0~= 5167395 516739 s~::