HomeMy WebLinkAboutOC1971-0675 - ESTATE OF DAVENPORT·•.· ' • .. ~ I ...
IN THE COURT OF COMMON PLEAS OF vlASHINGTON COUN'IY, PENNSYLVANIA
ORPHANS' COURT DIVISION
IN RE : ESTATE OF .ANDY W. )
DAVENPORT a/k/a .ANDREH W. )
DAVENPORT, ) NO.
)
Deceased )
PETITION FOR SETTLEt1ENT OF SMALL ESTATE
TO THE HONORABLE ~JDGE OF SAID COURT:
The Petition of George W. Davenport respectfully represents:
1. That Andy W. Davenport a/k/ a Andrew W. Davenport died testate n
May 24, 1971, at Roscoe, \vashington County, Pennsylvania.
2. 'TI1at the deceased died leaving a Will, said Will being attache
hereto and made a part hereof.
3. 1hat under said Will, your Petitioner was named as the sole
beneficiary •
. 4. That the total of deceased's estate is as follows:
(1) A Savings Account in the \~estern Pennsylvania National
Bank in the amount of $2,602.55.
(2) A Checking Account in the Western Pennsylvania National
Band in the amount of $376.49.
(3) A Social Security Check in the amount of $58.80.
5. That the deceased died leaving a funeral bill of $1,812.80
payable to Ruth Eckert Funeral Home, Roscoe, Pennsylvania.
6. That your Petitioner avers that other than the above bill, the f'e
are no other bills or creditors or claims against the estate other than menti ned'
WHEREFORE, Your Petitioner prays your Honorable Court to direct
i'
that the said Savings Account, Checking As;count, and Social Security Check be
turned over to him.
HORMELL, TEPJ'EST, SIMMONS,
BIGI & t1ELENYZER
.... . ' . ....... ...
COMMON\-JEAL'IH OF PENNSYLVAI'UA )
) SS:
COUNTY OF vJASHINGTON ) .
Personally appeared before me, the undersigned authority, in and
for the said County and Corrmonweal th, GEORGE W. DAVENPORT, who, being duly ·
sworn according to law deposes and says that the facts set forth in the fore-
going Petition are true and correct to the best of his knowledge, inforrration
and belief.
IN WITNESS WHEREOF, he has hereunto set his hand and seal this . .,,-t,l /1
__ <7 ____ day of ~~p;:.~m::::;..~-' 1971.
(}
SWORN TO N~D SUBSCRIBED
before rne the day and year
first above written
Notary Pll~
ItA HAMILTON. NOTARY PUBLIC
. , CHARLEROI BORO, WASHINGTON COUNW
/ / MY COMMISSION EXPIRES APRIL 8, 1972:
Member. Pennsylvllni~Association of Notari-.
' .. ,: . • ~ . -·~~'<II ·vc. • ;-.... ... 1. ~--. • .. -. •
IN WITNESS WHEREOF, I have hereunto set my hand and sea
the day and year first above written.
I . .
Signed, sea~ed, published and declared by ANDY W.
DAVENPORT a/k/a ANDREW W. DAVENPORT, the within Testator, as and
for his ·Last Will and Testament, in. the presence and sight of
us, and each of us two competent witnesses who at his request
and in his presence, and in the presence of each other, have
hereunto subscribed our names as witnesses thereto the day and
year first above written.
-~ \\-==::> '
')< I ~---. \) ~ l ~,______
EF'FEC'IIVE .JANUARY 1, 1982. (fiLE IN DUPUCATE WITH COPY OF WILL ATTACHED)
OFFICE OF THE REGISTER OF WILLS . .
. -. , . County of ... \·!~~I:t?-!l.g.t.~~ ... ;' ........ .
. . . . . . . . ~~q~g?, ~'~.·. PC!~t:lfP9r:t .. · ................... of . ~P.'f. ?.~9 :J •• J.3.9.S.~9~., .J?.~r;.r,s,y~~~~J~ ....... .
(Name) · (Addreu)
being duly ---------------SWGrn----------"---.according to law, deposes and says that he is the ___ Lxe.cu"toc ______________________________________ _ · (Exec., Adm., Legatee, Etc.)
of the. estate of __ [mgy __ W_. ___ RSJ:Y~P.Qrt .. ~L~L~--f?.n~~hose last residence was _______ f?9_~__?-~-~--------------~-----------------------------w D · rt · (No.) Street) • .avenpo E-~g~_, __ !~.£l!.!.-~Y.~:!~-~-~----------·deceased, and that the whole of the estate of said decedent, who died _____ _t.Jg~--2~_,. __ l~11.
(CitY, Borough or Township) · (Date)
consisted of:
REAL PROPERTY
REAL PROPERTY IN PENNSYLVANIA, WITH STATEMENT OF MORTGAGE ENCUMBRANCES UPON EACH PARCEL AT DEATH OF DECEDENT,
WHERE PROPERTY HELD AS JOINT TENANT OR TENANCY BY ENTIRETIES, GIVE NAMES, ADDRESSES AND RELATIONSHIP OF OTHER OWNERS.
Real Estate Estimated
Value
None
.
Personal Property ..
Savincrs Accou.llt -ides tern ne. 1::>Vlvania N~·ti f'ln~l R=lnk-C:? h.Cl? r..r.. ,
Chec:~inR Account -~;/estern Pennsvlwmin J.T;=rticmr~l Rnnk ":<7h. llLl
Social Security Cneck. , . 58.80
. .
$3,037.84
NOTE: You may expedite the processing of this return by filing with if, and as a part of the return,
letters from financial institutions or mortgage holders, certifying to amounts on deposit or owed by the
decedent as of the date of death. Such letters must be signed by a responsible officer of the financial
. institution or mortgage holder and indicate· clearly amounts of principal and interest in the decedent's
account at the date of death and the type of account, account number and the exact name or names in
which the account -is registered. ·
-----------------------------------------------------------------------------------------------.,
~-=-:ESWENT DECEDENT DEBTS AND DEDL'CTIONS CLAIMED
NOTE: List first five items in the spaces so provided, observe notations the_:eon, and instructions.
~-----=-D:.:E:.:B::..:T:_' ...::O.:.:R:_C=..I.:=' A=l M::__ ____ -. ______ ::..:.N..:.:A=-=T--=U=-=R.:..::E=-::.0:-"-F--=-SA'--'-'-'M=-=E'------..---...:A::..:.M:.::.O..:....::..U::..:.N....:T.---!oTHI S CO L.UM N
f' !KEGISTER ONLY
Ruth Eckert Funeral Home
George 11. Davenport
OTHER DEBTS AND CLAIMS
Russell Ivfa.rino
,.
...
:
"
Funeral expenses paid .. ·-..;:
Family exemption (will not be allowed unless
decedent died residing with a spouse or children.)
Administration Expenses •
Counsel fees •
Fiduciary commission •
(*) See Note below
File Petition for Small Estate
.-
,,
;. ~
.,
Total
$ 1,_812 80 $
1,500 00
150 00 i
13 00
'·
I
.. ,
I
I
3,47.5 ~80
_,_., ote: The estate agrees to advise the Register of Wills if the amount actually paid in settlement of any fee, commission or debt is greater
or less than the estimated amount claimed and allowed. • fJ .
Subscribed and sworn to before me this . . . . . . . . . . . . . . . . . . . . . . ~. ~ ~t!'k? /:'./:.A.-if. ... · .. '· ·f:?,..·y·""r Executor J4:tin~~J'
__ .......... ??~? ....... day of ......... June ......... , 19. 7.1
-· · -~ ~~{tc' · · · · · · ·. · ;u· HAM;,~~~-;);;;;; '"'u'
. B.ox . 3 5.6 ............. _ ....................... .
· (Street Number) •
.~.<??.<;~~-~-.~-~~n~.YJ: Y.~~-t~ ................ .
CHARLEROI BORO, WASHINGTON COUNTY (City or Town and State)
. flY G@MMI881t"l:l [HIRES AFRIL 8. 19/2
::: Having been duly sworn according to l~!,~bf'·S6"~5Jl~~Y~JFfit~0ItH:i\D1ffiP above appraisement is made in conformity with Jaw on this
_ ................................ day of .... · .......................................... , 19 .... .
ApprRiser
t
-In the event that any future interest in this estate is transferred in possession or enjoyment to collateral heir-s of the decedent after the i
~piration of any estate for life or· for years, the Commonwealth hereby expressly r·eserves the right to appraise and assess transfer·inheri-I
snce taxes at the lawful collateral rate on any such future Interest.
REPORT OF THE REGISTER OF WILLS ---. --I
1, the undersigned duly elected Register of Wills in-and for ............ Washington ....... ; .... ' co·tinty,":P~'itn.~yl~.arlia, d~~-;espectf.Ully ·. ~~
peport that I have allowed debts and deductions in the amounts claimed by .deponent, except as to those-items where a greater or lesser amount ·---··-I
::r..::set forth in'the last column to the right in said schedule above, which greater or lesser amount ~ep~es~~t~~~e:~~ allowe~-:~.~-~~d:~-t~:~-_ ~-~-=~~
::::ated: . . . . . . . . . . . . • . . . . . . . . • . . •. . • • . • . . • . . • . . .. . •• . . ...........•... ,·,·, .....•......•..........•.........•
~egister of Wills .. . . I
·~.a· ..
IN THE COURT OF COMMON PLEAS WASHINGTON COUN1Y, PENNSYLVANIA
ORPJ:W~S' COURT DIVISION
IN RE: ESTATE OF ANDY W.
DAVEI\JPORT a/k/ a ANDRE.'\y \tJ.
DAVENPORT,
Deceased
)
)
)
)
)
of tl1e annexed Petition and pursuant to e provisions of tlle Fiduciaries Act
of 1949, P.L. 512, and its amendments, the said Savings Account in the Amount
of $2,602.55, Checking Account in the amount of $376.49 and the Social Securi
Check in the amount of $58.80 is ordered to be distributed and awarded to
George W. Davenport.
B
Form No. RCC-62 (7-69) THIS FORM REQUIRED IN ALL ESTATES WITH GROSS ASSETS UNDER $10,000, UNDER SECTION 701 OF ACT OF JUNE 16, 1961,
EFFECTIVE .JANUARY 1, 1962. !FILE IN DUPUCATE WITH COPY OF WILL ATTACHED)
OFFICE OF THE REGISTER OF WILLS
County of ... v!c;.~I:~!l.~t.~~ ............ .
....... -~~q:rg~. ~v .•. P~'(~l).P?r:t .. · ................... of -~"-~. ?.~€?, .. ~9.~<;9~,.. 1-'.~Q.P.~Y~~~t;l.i,~ ....... .
(Name) · (Addresa)
being duly ---------------SW.or'n.-------------.according to law, deposes and says that he is the ___ .E.xe.cutffi':! ______________________________________ _
(Exec., Adm., Legatee, Etc.)
of the estate of __ An9..Y-.. W.• ___ R9-Y~DRQ~--~~~~~--~g~~hose last residence was _______ .f?..?..~.}~-~-------------------------------------------w D rt (No.) (St"'et) • .avenpo
B-.<?.§_<?~_, ___ ?~~~Y-~:!.CE:~~------------deceased, and that the whole of the estate of said decedent, who died ______ t!gy __ 2!!_,. __ 1~11.
(Cicy, Borough or Township) (Date)
consisted of:
REAL PROPERTY
REAL PROPERTY IN PENNSYLVANIA, WITH STATEMENT OF MORTGAGE ENCUMBRANCES UPON EACH PARCEL AT DEATH OF DECEDENT,
WHERE PROPERTY HELD AS JOINT TENANT OR TENANCY BY ENTIRETIES, GIVE NAMES, ADDRESSES AND RELATIONSHIP OF OTHER OWNERS.
Real Estate Estimated
Value
None
Personal Property
Savimrs Account -vJestern Pennsvlvanin Nr:rt-i nn.=1l R=lnk (;') Jill? t:,t:,
r~.-r~ ,
Checkin2 Account -Wt::~ Lt:. Pennsvlvnni r:1 Nr1t-i nnr1l Rr1nk "7/k.1 +~ :l7C: 110
I
Social Security Cneck 58.80
'
$3,037.84
J
NOTE: You may expedite the processing of this return by filing with it, and as a part of the return,
letters from financial institutions or mortgage holders, certifying to amounts on deposit or owed by the
decedent as of the date of death, Such letters must be signed by a responsible officer of the financial
institution or mortgage holder and indicate clearly amounts of principal and interest in the decedent's
account at the date of death and the type of account, account number and the exact name or names in
which the account is registered.
0
~~;,;,. _______________________________________________ ------
,~------~ ~
I Jointly Held Property
. ·.
-~~~~~~. -~------------------~
Estimated
Value
---------------------------------~---~----------------------~----------~
Transfers within TWO YEARS Prior to Death
That at the time of death there was no safe deposit box registered ih 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
IN WHICH DECEDENT RENTED A SAFE DEPOSIT BOX
THIS SAFE DEPOSIT BOX RENTED
IN NAME OR NAMES OF
BENEFICIARIES
BENEFICIARIES AND ADDRESSES
RELATIONSHIP SURVIVED AGE OF LIFE
(If step-children or DECEDENT TENANTS OR
(State full names of all and their addresses who have illegitimate children STATE YES ANNUITANTS
an interest, vested, contingent or otherwise, in estate.) are involved, set OR NO. AT DEATH OF
forth this fact.) DECEDENT
-
.
RELATIONSHIP OF JOINT
HOLDERS TO DECEDENT
INTEREST OF
BENEFICIARY
IN ESTATE
RESJ.DENT DECEDENT DEBTS AND DEDUCTIONS CLAIMED
NOTE· bist fifst five items in the spaces so provided observe notations thereon and instructions ·• ' ' DEBT OR CLAIM NATURE OF SAME AMOUNT THIS COLUMN
KEGIS'fER ONLY
Ruth Eckert Funeral Home Funeral expenses paid $ 1,812 80 $
George W. Davenport Family exemption (will not be allowed unless 1,500 00
decedent died residing with a spouse or children.)
Administration Expenses *
T1' .T Bioi Esa Counsel fees * 150 oo 1
Fiduciary commission *
:
OTHER DEBTS AND CLAIMS
( *) See Note below
Russell Marino File Petition for Small Estate 13 00
'
:
~ ·:
.
I .. -
Total 3,475 80 ")~1). ~0
Note: The estate agrees to advise the Register of Wills if the amount actually paid in settlement of any fee, commission or debt is greater
or less than the estimated amount claimed and allowed. • f)
Subscribed and sworn to before me this...................... ~~-ff..£k-L/t!'ta.~~-.A-~ ..... .
r. ·W""·y·""(Executor~-
............ ?~.~<:! ....... day of ......... June ......... , 19. 7.1 .B.ox. 35.6 ..................................... .
(Street Number)
. . . . . ~ ~~%;' ........ itA HAM;l~~~. ~;;;;; PUBLIC .~.<?~.<;q~·'· .. J?~~P~.YJ: Y.~~~~ ................ .
CHARLEROI BORO, WASHINGTON COUNTY (City or Town and State)
111' I>@MMI881EJN EXPIRES APRIL 8, 1912
. . Member,Pen?t;vlvaniaAssocl·ation"fNntaril!!l . . · · Havmg been duly sworn accordmg to law, 1 do ereoy cert ry ·tl'l'af' rne-above appraisement IS made in conformity w1th law on this
.............. ~~) .... dayof ......... ~-········ti-/···············191'7~ ~
. -~~_) .. ?X..i.4 ..... Q.J.U. . ......... _. ..... . V --Appnuser
In the event that any future interest in this estate is transfened 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 ·inheri-
tance taxes at the lawful collateral rate on any such future interest. ·
I, the undersigned duly elected Register of Wills in and for ............ Washingt Co nty, Pennsylvania, do respectfully
:::d~o~t·h· ~~ ~~~.7.~ .c.or.~ ~;.J. ~~-~~t. :~ ~~:~ .s~~~~~-1~ .above, which greater or l~s.s~~~~~~~-t~~ ~ ~(~-~:~~~-....
report that _I have allowed debts and ~edu~tion~ in the amounts clai~ed by deponent, ex ept a)to those ite s where a greater or lesser amount
. . \ Register of Wills
r • .. i
..,)
·'
lj
Form No. RCC-62 ( 7-69)
Will Administration }No. · ·. · ...... Year .... .
IN THE
MATTER OF THE APPRAISEMENT
OF THE
ESTATE OF
ANDY 'VJ. DAV.EJ.\JPORT a/k/a
...... @.~~. Yl.·. PA~:GJ1I?Q~'J ........... .
Deceased
Late of .. ~<?~coe ...........................
County of ..... tY?~~~i!l.gtC?-:1. _ .. • • 0 •••••••••
;;::::v .. ,..,.h --.. . -.....; -,...,. Commonwealth §f ~~ ~ylvama-1 t
~ c;; (') c.._ .........._
....;... -· ffo 8 r---·-~1) t:--/ rrJ --... ~
REPOR~ 1\NB APPRAISU"" < 0 ----.J ..
(""") -rl c< r~
.a *.7 ~-~ :;::-:.: .. ·-.. ;:::: ::.:~~ --::
t:J r---~. ·-.):::.. (/) 0 --
v-,
'"'-.;
R C C-81 (2-64)
COMMONWEALTH OF PENNSYL VAN lA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
INHERITANCE TAX DIVISION
NOTICE OF FILING OF APPRAISEMENT
GEORGE \1. DAVENPORT
IN YOUR REPLY PLEA8E
REFER TO
In Re: Estate of ____ A"'-N=-D...;;:.Y.,;... . ..:..:.1v~·-=D=-=AV...:.=E:::..:.N.:....P~O::.;;R.:.T_.l;l:a.._/~k.._/~a-
____ _;'~"A=S:....:H:.::;I::.:N:..:..;G::_T~O:....:N:..:...r ----County -File No. 6 3-71-6 7 5
Dear Mr. Davemport,
You are hereby notified that the original
appraisement in the estate of ANDY DAVEMPORT
has been filed in the office of the Register of Wills qf WASHINGTON
County on July 8 , 19..21. Said appraisement reflects the
following valuations:
Real Estate ------------
Personal Property ____ ~3~,0~3~7~.~8~4~-----
Transfers ______ ~~~~~----
Total --------~3~,~0~3u7~·~8~4L---
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 __ J~u~l~y~8~,~1~9~7~1~-----
Title FRANCES LEO, CHIEF APPRAISER
ESTATE INSOLVENT
DATE OF DEATH: May 24, 1971
Note: This is not a bill.
j
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SUMMARY
-..
~Estate ofDAVENPORT ANDY IV. a/k/a DATE OF DEATH 5-24-71 FILE NO. 63-71-675
I (Last Name) (First Name) (Initial)
REPORT OF INHERITANCE TAX APPRAISER
I, the undersigned duly appointed Inheritance Tax Appraiser in and for the County of \vASHINGTON
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: Julv 8, 1971 ~~ ~ ~~
INHERITANCE TAX APPRAISER~
REPORT OF THE REGISTER OF WILLS
I h d . d d I I d R · f W"ll · d f WASHINGTON c p 1 · d t , t e un ers1gne u y e ecte eg1ster o 1 s man or ounty, ennsy vanta, o respec-
fully report that I have allowed deductions in the amounts claimed by depon t, excep s 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: __ J_u.:....1..t..y_8...L., _1_9_71 __ _
INVENTORY VALUE AS REPORTED VALUE AS APPRAISED VALUE AS REAPPRAISED
Real Property (Schedule A)
Personal Property (Schedule B)
Transfers (Schedule C)
$
3.037 84
$ $ ____________ ~---
3.037 84
Joint-Held Property (Schedule E)
TOTAL GROSS ASSETS
Less Debts and Deductions
(SCHEDULE F)
CLEAR VALUE OF ESTATE
Valuation of life estates or
.. ~ 0.17 84
1 475 80
EST
annuities................... $-------+----
EST ATE TAX ASSESSMENTS $ ----------'---
3 017 84
3.475 80
A TE INSOLVEN111
FOR USE OF REGISTER ONLY COMPUTATION OF TAX
Tax on$ 2% -... _,
Tax on $ ---------+---!.... 6%
$ ___________ -4----
$ ____________ -4 __ --
Tax on$ 5% $-------------4----
Tax on$ 10% $ _______ ~---
Tax on$ 15% $ ___________ -4---
Exemptions *
Total Estate _________ ___J.___
TOTAL TAX $------------~---
Less tax previously paid $=======*===
BALANCE $----------+---
Less 5% of tax if paid within
3 months after death $=========
(*) As evidenced by Charitable
Exemption Certificates issued
by the Secretary of Revenue.
BALANCE OF INHERITANCE TAX DUE $ -------+---
Add interest at rate of 6% from
_______ tO---------
AMOUNT OF ESTATE TAX ASSESSED $------4---
Estate tax paid $ ______ --L.---
BALANCE DUE
Add interest at rate of 6% from
-------~10-----
$ ________ __J,_ __ _
$--------4--
TOTAL TAX BALANCE $ ----------+----
PAID $ --------l.---
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.
J
Will
Administration ! No.
IN THE
Year ........... .
MATTER OF THE APPRAISEMENT
OF THE
ESTATE OF
ANDY 1¥. DAVENPORT
Deceased
Late of ROSC.O.E
County of . iYA$UI:NG.TON
Commonwealth of Pennsylvania
REPORT AND APPRAISAL
'
.J
#r
Form RCC-2
~~PARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
HARRISBURG. PENNA. 77 1 2 7
COMMONWEALTH OF PENNSYLVANIA
RESIDENT INHERITANCE TAX
APPRAISEMENT
DATE July 8, 1971 ........................................................................................
COUNTY ...... ~~~-~-~-~-~~.P.:!. ......................................... .
FILE NO. . .... ..§..~~:: .. !...!.:: .. ?..?..?. ......................................... .
Whereas, ............................. .AND.Y .... W ..•...... DAY.ENP.O.ET ..... a/.k../a ...................... late of .......... RO.S.G..O.~ .......................................................................... .
in the County of ........................... Ji.A.~.HlN.G.TQN. ............................................................... Commonwealth of Pennsylvania, having died on
the .............................. )4.1:4.. ............................................. day of ....................... H9:Y ........................................... 19 ... .7.J, seized and possessed of an estate
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore, I, .............................................. ~.~!.\~.9..~.~ ..... ~~.9. .......................................... , an appraiser duly appointed according to law,
having been designated to make a fair and conscionable appraisement of the said estate, and to assess and fix
the cash value of all annuities and life estates growing out of said estate, hereby file the following appraisement:
In the event that any future interest in this estate is transferred in possession or enjoyment to collateral heirs of the decedent after
the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer
inheritance taxes at the lawful collateral rate on any such future interest.
Description of Asset
PERSONAL:
SEE COPY ATTACHED TO APPRIASEMENT
INSOLVENT
Unit
Values
$
Appraisement
Made for Inheritance
Tax Purpoaes
3,037 84
--------------------------------------------+----.----~r--1 I
Having been duly swo.rn according to law, I do h~reby certt~" t~t the above appraisement is made in con-
formity with law on this .............. V~~····· day of ·······.·.·.·.·.·.·.·.·.·.·.·.·.·.·.·.· .. ·.··.·.~·.·.·-~--~=-· .. :.k~~;:;~;a~;~;f~) .. :::::~J.
Appraiser
.. WM>JlJ.NQ'J:'.QN ... . ................... County
RESIDENT INHERITANCE TAX APPRAISEMENT
Estate of
....................... AN.P.X .... J!..~ ...... PA.Y~N.P..Q~.'I' .............................. .
Deceased.
Late of
ROSCOE
~;;a;:e,~:~:~~~;~~·~····;~~~~·~~:~·7.? .. ···························· ' J... ..................................... .
Page, .. /.1...8...-:: ... ?........... No. .§.:3. .. ~.?.!.~.§.7.$. ........ .
Filed in Register's Office, .... J..~.!.Y ..... ~ ............ 19 ... ?.J
Amount of tax due, $ .................................................................... .
DEPARTMENT OF REVENUE
Received,
Examined and Approved,
Wrote abo.ut Appra.isement,
Appeal f1'om Appraisement,
Entered and charged,
..
,