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Home My WebLink AboutOC1971-0824 - ESTATE OF JACKMANy.~.I.~'.~ ,F -- -I"J Q!onunOttUlta1t~of ~tntt11YIUattia,} lIa5~ittgtott Q!OUtttg,55. KNOW ALL MEN BY THESE PRESENTS:Whncas,at Washington,In the County aforesaid on the 12th.day of August A.D.1971 ,before me, Russell Marino ,Register for the Probate of Wills and Granting Letters of Administration in and for the County of Washington,in t:he Commonweal th of Pennsylvania, the last Will and Testament of Leoni1da Jackman late of Fa.11owfie1d Township in the County aforesaid,deceased, (a true copy whereof is to these presents annexed),was duly admitted to probate;and Anna J.Cernuska rix the ·ExecutQX In said Will and Testament named,having appeared before me and taken and subscribed the oath of office prescribed by law; NOW,THEREFORE;I;Rus se11 Marino ,Register as aforesaid,do grant these LETTERS TESTAMENTARY,unto t he said .,, committing unto Her chattels,rights and credits,which were of said deceased,and requiring Her to exhibit a true and perfect inventory thereof into the H..egister's Office,at.W wshington,within ninety days from the date hereof,and to render 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 TESTIl\10NY WHEREOF,I have hereunto set my hand and the seal of said Office at Washington,this 12th. ,.1 I,,, day of August 111 the year·of our Lord one thousand _&DIS nine hundred and Seventy One _fP~~~~. Register & ., i,. ·1i: ( I .. ~,~ .., ".....CD ..... 0 .., :::1 t-tII.....m f-I .1'11 Gfp,en-iP'»..,t -i m~ITI .... 0 ~III (')"TI ag.., ~.:=:::1 -~t-tt= ,,I ?' '"J ~'f..'f "t., :rr I LAST ~vILL !,ND TESTAMENT ., published and declared by the above named, for her Last Will and Testament in the hereunto subscribed our ~ames at her presence of the said Testatrix and of .I,LEONILDA JACKMAN,of Fallo-vlfield To-vmship,Washington II County,Pennsylvania,do hereby make my Last Will and Tpstament I and revoke all Wills heretofore made by me.I; II FIRST:I direct the payment out of my estate of theIexpensesofmyillnessandfuneral. II .SECOND:All the rest,residue and remainder of my estate, I,real and personal,I give,devise ,and bequeath to·my children, !namely,Mary J.Mann,Anna J.Ccrnuska,Dominick Jackman and ~Gustina J.Rossi,their heirs and assigns,share and share alike. II·THIRD:I constitute and appoint my daughter,Anlila J. Ii C~rnuska,as Executor of this my Last Will and Testament.If she II is not living at the time of my decease,I then appoint Mary J.~Mann as such Executor.Neither of my Executors shall charge any Ii compensation for their services., iI IN WITNESS \vHEREOF,I,LEONILDA JACKMAN,:·the Te.statri:x I above named,have hereunto set my hand and seal this 30 day of i Ja~uary"1964..,' IiiIIII II'I Signed,sealed, I LeonildaJackman,as and presence of us,who have I request thereunto in theIeachother.. I I ,,',..'_.,. J~ '.'--_..J J~3 ~7/..gd'/ l\ffi~uutt (@f lExrrutnr ®r l\~mtut!ltrutnr V7Y~tatt nf 'tttttsyluattht t atnnttty nf lIas~ittgtntt )ss: Personally before me,the undersigned authority,a N.9.:t~r.y.l'.~Ql~.~in and for said County and State,appeared ,An-na·..J.•··.-Ge·r-nu·s-ka·r··········..···who,being duly sworn according to law,deposes and says that he is the executor or administrator of the es- tate of LEONIL.DA ..J.ACKMAN~deceased,that the foregoing schedules constitute a :z complete inventory and appraisement of the real and personal estate of LEONl.LDA..J.ACKMAN.., 3:~deceased,except real estate outside the Commonwealth of Pennsylvania;that the figures opposite '<'"C">~each item..of real and personal estate in the foregoing schedules are determined and stated by the 3 ;p undersigned to be the fair value of said items as of the date of the decedent's death,based upon a!Hd justSf~~;~~~~.cr~:e;a::lf9~~7-::e:;~eab~}ve2Z::UQ,....f?~:~J~~~.ayo .....~.;..............un..........~~~t~Jl~tm~~~~..t2..~-t..,j..:&jk~.~~z ~,_~t 8 .\.'.~ADDITIONAL INSTRUCTIONS ::0 ~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 Oopies and 2 RCRI-33, Over $10,000,including Copy of Will;1 Original and 3 Copies and 2 RCRI-33,Over $50,000,in- cluding Copy of Will and copy of Federal Estate Tax Return. REFERENCE FOR ADDITIONAL COpy Act of 1947 P.L.513 Sec.5.2,72 P.S.4844.2 " 3Jttuttttnry aub .Appraistmtttt of the goods and chattels,rights and credits which were of ..·.··.·.···Leonild·a···Jackman···················.late of P.al.l.ow.£ield T.o.w.nsh.ip.~. Washington County,Pa.,taken and made in conformity with the above affidavit. DOLLARS CENTS ALL that certain piece or parcel of land being a part of the Marie Elias Plan of lots situate in Fallowfield Township,Washington County,Pennsylvanic and being more particularly described in the Recorder's Office of Washington County,Pa.,in Deed Book Volume 732 ,Page 133 25,50000 ALL that certain piece or parcel of land being a part of the Marie Elias Plan of Lots situate in Fallowfiel_9-.Township,Washington County,Penna.,and being more'particularly described in the Recorder's Office of Washington County,Pennsylvania,in Deed Book Volume ,Page 3,00000 Household Furnishings See Schedule A attached hereto and made a part hereof 28000 "'.... :. ... ~ :' 'Vd "00 IV'l(\Sllif.I IV"·J·I,m4 SVIA ".J C ;,=i I C'I ,()1>1 Ij 1"•....-..)~3U"I~.~,.r-J !-~J_r...,"p'~.t t:>Sf1H j £2 lid ---...--\ "'-.V) W -:.~ ~~., ~ Refrigerator Dinette set,buffet Couch Mr.and Mrs.Chairs Television set Coffee table 2 End Tables Drum table Desk and chair Four-piece bedroom suite Twin beds Chest of drawers Freezer Portable Television Spin drier,wash machine $50.00 10.00 10.00 10.00 100.00 5.00 5.00 5.00 10.00 15.00 15.00 5.00 15.00 10.00 15.00 $280.00 TOTAL Schedule A STATE OF PENNSYLVANIA, WASHINGTON COUNTY,~55: The within named Accountant being duly sworn according to law,depose and say that ~he above account as stated is true and correct as S.he..verily believe. Sworn and subscribed before me this d1~.... day of ___Oc.to.be.r :;./._19.~..7.2 .--¥~~~----e~!e:::d--- MONONGAHELA,VolASHINGTr,\!cr;u;',ITY MY COMMISSION :;XPIRES ItJi..:t <:1,1975 Washington County,ss:I do certify that I have given legal notice to all persons concerned of the filing of the within account in the manner prescribed by Statute and Rule of Court,as evidence by proofs thereof filed to No.__Ie__~_-::'.Z_~.":..7.~_~ Witness my hand and official seal this ~__7 .. ...., >:l;:l0r:.>r:.>CIl >:l:<l =....,.8.~...., CIl <1l S.<:l .:::....,....>:l0r:.> .,;...0,.-i .... ....,;;oo o...., day of /Y'..r?.v._~-J?.._~._..19__7:?:- ....~~ Register ~f Wi!Ir-::Dj~--.:::---CD.....,-tJ _./ ~l RUSSE LL /,;,e.HI N0 REGISTEr<OF WILLS WASHINGTON GO .•PA. II'....,~,-,.r I L c 0, -72 ocr 25 PM 4 '~:~-:~~'?~ .........:y~.""i~ I / I. \-,." r . I I The Court is respectfully requested to determine proper dist:<a_io-,,-~-=in.::::.~th--,i~s_e~s...:,Q$~t-,-e~.'--~_.,unt~ IN THE ORPHANS'COURT OF WASHINGTON COUNTY,PENNSYLVANIA ESTATE OF LEONILDA JACKMAN FIRST AND FINAL ACCOUNT II 63-71"824 SUM MAR Y SCHEDULE A PRINCIPAL ..PERSONALTY Amount transferred from Principal -Realty Total Inventory Disbursements Page 1 Page 4 $280.00 c. 28,104.73 0- $28,384.73 ~ $6,063.09 c... Balance $22,321.64 v SCHEDULE B INCOME ..PERSONALTY None .',' SCHEDULE C PRINCIPAL -REALTY Receipts Page 2 $28,104.73C- Amount transferred to Principal -Personalty gs ,104.73 c. Balance SCHEDULE D INCOME ..REALTY $00.00 Receipts Page 3 $250.00 Net Balance $250.00 $22,571.64 Net balance consists of the following: Household furniture as per Inventory $280.00 Cash for Distribution $22,291.64 $22,571.64 L~ ESTATE OF LEONILDA JACKMAN SCHEDULE A Principal -Personalty RECEIPTS As per Inventory Filed Additional Assets $280.00 None $00.00 $00.00 Amount transferred from Principal -Realty Account·· for Distribution SCHEDULE B Income -Personalty None -1- $28,104.73 $28,384.73 ESTATE OF LEONILDA JACKMAN SCHEDULE C PRINCIPAL -REALTY Inventory Filed: 1.Parcel A -Deed Book Volume 732,Page 133-- - - - - - --$25,500.00 2.Parcel B -Deed Book Volume ,Page ---3,000.00 Total -- --- • - - - --$28,500.0C RECEIPTS 87.73 248.0/0 1.Proceeds on Sale of Parcel A in Deed Book Volume 732, Page 133 - - - - - - - - ---$24,800.00Plus: Pro-Ration of 1972 taxes~-6--Less:----- 1%Realty Transfer Tax- $24,639.73 Net loss on sale of Parcel A in Deed Book Volume 732, Page 133------ - - - --- - - --- - --($860.27)~ $.3,500.00 .,. 35.00 $3,46s.orr Proceeds onlSale of Parcel B in Deed'Book Volume Page - - --- - - - - Less: 1%Realty Transfer Tax-- - - ---''''--'--;'''';''':'-';'''' 2. Net Gain on Sale of Parcel B in Deed Book Volume "Page - ---- - --- --$465\OC Amount transferred to Principal -Personalty for Distribution - - - - - - --- - - - --$28 ,104.7~~ -2- ESTATE OF LEONILDA JACKMAN SCHEDULE D Income -Realty RECEIPTS Forfeiture of hand money on real estate sale $250.'00 Total -3- $250.00 ESTATE OF LEONILDA JACKMAN DISBURSEMENTS Monongahela Valley Memorial Park Funeral Expenses Equitable Gas Company Final Gas Bills Bell Telephone Company Final Telephone Bill Valley Independent Funeral Advertising Daily Republican Funeral Advertising Anne Cernuska Albert Mann Robert Rossi Al Landrin's Flower~· Shop Gustina Rossi Francis C.Slezak Harold Lambert Tri-Community Ambulance Service' Alfieri Realty West Penn Power, Albert Mann Funeral Expense Reimbursement Funeral Expense Reimbursement Funeral Expense Reimbursement Funeral Flowers Funeral Expense Reimbursement Funeral Services Funeral Expense Reimbursement Ambulance Service Appraisal of Land Final Electric Bills Reimbursement for ~ire Insurance $111.00 66.50 24.76 124.02 61.00 1,815.00 5.00. 16.00 109.80 3.45 2.90 3.00 50.00 60.00 42.62 12.00 j Samuel M.Bitonti,R.E.Lot Survey and Lan4 Description 65.00 Russell Marino Inheritance Tax 1,600.00 Elizabeth Bavin Malcolm L.Morgan .J. Reimbursemeni on Outdoor Lights Taxes 25.23 57.80 Ben Cooper Ann Cernuska Russell Marino Guy Rogers Valley Independent Washington County Reports Russell Marino Hormell,Tempest, Simmons,Bigi,& Melenyzer Taxes 234.56 Reimbursement on Outdoor Lights 4.20 Probating Will 21.50 Probating Will 15.00 Advertising Estate 12.75 Advertising Estate 16.00 Filing Inventory 4.00 Attorneys fees 1,500.00 Total-------$6,063.09~ -4- COMMONWEALTH OF PENNSYLVANIA ) )SS: COUN'IY OF WASHINGTON ) The above named Accountant being duly sworn according to law deposes and says that Letters Testamentary were granted to Anna J.Cernuska and advertised more than six months prior to the filing hereof;that the disbursements shown in the account have been made to the parties entitled thereto and that the account as stated is true and correct as she verily believes. Sworn to and"subscribed before me this eli'£:!..;day of __a~cJ;Htc;:1wy~'__,1972. CORA BANE APESSOS,NOTARY PmJtt~ MONONGAHELA,WASHiNGTON CCUmY Z~~;P~~li''A;IOiI::..tl';:J:.;;;91;:::&:;;.'_'_~Notary PUb11c REQUEST FOR DISTRIBUTION Accountant requests that distribution be determined by the Court in accordance with the Petition for Distribution to be offered in evidence at the audit of this Account. 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.S,paragraphs (S)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 officiail legal periodical for said Washington County,published weekly having its place of business at Washington,Washington County,Pennsylvania, and is acting as its agent in this behalf;that the said WASHINGTON COUNTY REPORTS was established on March SI,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: 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. • ••••••••••• ••••• JACKMAN,LEONILDA,Dec'd. Late of Township of Fallowfield. Washington County,penkna.BoX 176Executrix:Ann Cemus a,'R D #2 Monongahela,Pa.15063 Attorney!D.Keith Melenyzer,.~or&-T st Simmons.Blgl . .:~\~nyze~Ptll'Washington Avenue, Charleroi,Pa.15022 ...................~~!.Y.?.Q.L..?.?...';.~.?.?.. ..................A~:Hi~.Y..~t ..}..t J.9.7.?. 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~',pi e and ch~aracter of the publication are true.(Q ~ N.........................:."..--1.L:.!&L-/~=,Editor Sworn to and subscribed before ~~~- .....~.f.9:day of !!:.Y.g~.~.tJL ,19??.. !frM~--c;ol(~~;;"- JOSEPHINE T.SCIAMANNA Notary Public.Washington,Washington Co. My Commission Expires July 1,1974 .\ Under Act No.587,Approved May 16,1929,P.L.1784, alom,nded by Act Mo.51 of April 24,1931,P.L.67 State of Pennsylvania }1i6' County of.Westmoreland • Personally appeared before me William H.Pore,General Manager of The Valley Independent,who being duly sworn,deposes and says that The Valley Independent is a daily newspaper of general circulation in Fayette,Washington and Westmoreland counties;.Pennsylvania,and elsewhere,published in the City of Monessen,Westmoreland County,Pennsylvania,that it was established June 28,1902,since which date The Valley Independent has been regularly issued in said county,and that a copy of the.printed notice or publication is attached hereto exactly as the same was printed and published in the regular editions and issues of The Valley Independent on the following dotes,Aug US t 20,1971 August 27 and September 3,1971 Affiant further deposes and says that he is General Manager of The Valley Independent,a daily newspaper of general circulation,and as such is authorized to verify the foregoing statement under oath,and Affiant is not interested in the subject matter of the aforesaid notice or advertisement,and that all allegations in the foregoing statements as to time,place and character of publication are true. COpy of NOTICE .letters testamentary on tha estate of'LeqnUl!a Jackman late of Fallowfh!ldITowns\liP.W~shington,County,_deceased, 'having Men granted by the Register of Washlnnton County.notice is hereby giv- j en to dll persons indebted to said estate • .to m::,e immediate payment.and to those having claims against the same to prC'imt 1hem without delay to Ann Cern-uslta,~xecutrix,Box 176 R.0.2 Mononga.fhiie,Pennsylvania 15063,Hormell.Tem·I"pe~tl Simmons,·Bigl &Melenyzer,0./1Kelln Melenyzer,anornlYs,411 Wash-,Ington Avenue,Charleroi,Pennsylvaniat!..SO~:__ _____~0.2?/9:3 I • :J----r-~/)/~~ Sworn to and s",bscribed before me this 7 th day of Septemb~!i9-:=_o 2L.1.AJl Notary.Public .MARY •EVANS,Notary PubliC M .Monessen,Westmoreland Co.,Pa.y commission explres~__~",,=,;.;...;~:--_...--....,....,..,.....,.,...,........__My Commission EXpires July 3D,1973 STATEME.~T OF ADVERTISING 'COSTS: Harme11,Tempest,,_Simmons,Bigi &Me1enyzer Attorneys .a t LawL.411 'Wash1ngton Avenue Charleroi,pa.150;...2_2_------_ TO THE VALLEY INDEPENDENT,DR. For publishing tt-ie not:ce or advertisement attached hereto in The Valley Independf!nt an a~\/e !tated dates $12.00 Notary .'$.75 Tot~I $12.75 ,niCEI";OR ADVERTISING COST& The Valley,Independent,a daily new!ij):lper of general circulation,hereby acknowledges receipt of th-e aforesaid advertising ond publication costs and certifies that the same have been duly paid. THE VALlEY INDEPENDENT 81------------- ~u t4~Qtuurt uf Qtummnn _Jlruli nf ltun4iugtnu Q!uunt.y ®rpqunn~Qtuurt ilittiniun In the matter of the Audit of Account in J Es,tate of LEONI LDA .JACKMAN I TO THE AUDITING JUDGE: No.63-71-8 24 Enter our appearance for Anna J.Cernuska,Executrix of f"hp.Ec;f"ate of LEONILDA JACKMAN,Deceac:ed HORMELL,TEMPEST,SIMMONS,BIGI, &MELENYZER ~_ By )3 I lc~e.,(·H.c lllti!fMJOOt1 /5"~aY of December ,19-ZL N.B.-Counsel shall,by separa:te paper,present a concise statement of each claim,woith supporting calculation of any interest claimed.Objections to an account as filed,shall be concisely stated in a separate paper. Council suggesting proper distribution shall file a separate concise state- ment in that regard. No.63-71 - 824 In ra Audit of Account in Esta.te of LEONILDA JACKMAN,Deceased AUDIT Jrarript fnr.Appraraurr FOR Anna .1.Cernuska., Executrix of the Estate of LEONILDA JAC~1AN,Deceased HORMELL,TEMPEST,SIMMONS, BIGI,&MELENYZER .. A[~~ ey ~2 • I 1 Io:u 3: IIIF -IIII3: "UIII(/l;; 4 t No.63-71-824 ESTATE OF LEONILDA JACK~~N Fiduciary: Anna J.Cernuska, Executrix f '" (/l of"->3::E 3:0o:::z·(;(/l rt1•C1l [D ~ lP 3: III.r IIIZ~III:u II ; .... PETITION SUR AUDIT ·l'.•, " I :/'" HORMELL.TEMPEST.SIJ'vtivT0NS• BIGI &MELENYZER _..- \!.<---.ytf ATTORNEYS AT LAW 411 WASHINGTON AVENUE CHARLEROI.PENNSYLVANIA PETITION SUR AUDIT I r IN THE ORPHANS'COURT OF WASHINGTON COUNTY Testate Form Estate of L.liON.IL.:O'A ..JAC.KMA.N~...la.t.~Qf_.._.__ ....Ea.llS).wf.i~J.d ..I9.\in.~.h.i.p-.,W.~.$.bJngt.Q.n . No 63.:-.11::8.2A A.A. Fiduciary Anna..J cer.uuska.,. ....coun.ty..,l?.e.nnsy.lvania -..e.~.~~Mtx.i~--. Deceased ~~cl ~~cl Decedent's death .July.21.,19.1.1 _Grant of Leltters Au.gus.t.1Z l.9.1.1 . This is the F.ir.s.:t and Einal account filed in this estate If there have been former accounts filed in this estate,list file number or number and term None . ..__.__'_---_._-_____-----..-____._-----_..----_._-----____._-_..__..---_--__---_-..----------.----.--_..-.----.-------__.._._---_..--. Election to take Under or ~)(KI.(cross out one) Date Election Place of; Filed Record _ _ . Name of surviving spouse N.Q.t.-.app.licabl.e _,__.__._.._.___.._.__.._ _.. List issue,where material: Did decedent marry after execution of will?(indicate)~§l:§c No.Any children born after execution of will?(indidate) "6tex.No.If answer yes,name them ____._._. Leg.atees Relationship Interest Fiduciary,if deceased or not sui juris Anna J.Cernuska Daughter 1/4 Residuary sui juris Gustina J.Rossi Daughter 1/4 Residuary sui juris Mary J.Mann Daughter 1/4 Residuary sui juris Dominick Jackman Son 1/4 Residuary sui juris List,if exceptions to above: Not applicable If partial intestacy,give facts: Not applicable Adeemed:Revoked:Lapsed:Aboted: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 oii,the account and of call of audit?Yes.~. ".> If any exception give cause:. File copy of Notice and date of mailing D.e.cemb.e.l:l.,1.9.7.2 ~-,,,,.•,"..,",." Is estate subject to the filing of a Federal Estate Tax Return?__N.o ..__..._.___._. . .__. Actual payment made on Pe.nnsylvania Transfer Inheritance Tax.Amount $__l .•.6.Q_O__._.Q.U ._..._. If the Will makes any portion of estate subject to a life-e.:;tate,give name and birth date of life tenant _.._ _ . .....__.No:t_..ap.plic.able _ _ __..__.____... 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. Not applicable 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: Not applicable Balance for distribution per account, Itemize any additional debits not shown by account: Refund from utility company Total additional debits (Add) Itemize any additional credits not shown by account: S.M.Bitonti -survey Total additional credits (Subtract) Balance for distribution 1.99 $..__._1.•.99 . 100.00 $ -..--1.0D.•.O'O'. $..f.?.1.~.?).:.§.4 . $..2.2.~A.7.3.•.6.3 . If balance for distribution is not in cash,list each item held in kind,giving appraised Value (or distribution Value); Household Furnishings: Refrigerator Dinette set.buffet Couch Mr.and Mrs.chairs Television set Coffee table 2 End Tables Drum table Desk and chair Four-piece bedroom suite Twin beds Chest of drawers -Freezer Portable Television -Spin drier,wash machine TOTAL $50.00 10.00 10.00 10.00 100.00 5.00 5.00 5.00 10.00 15.00 15.00 5.00 15.00 10.00 15.00 $280.00 If Family Exemption claimed by Petition,give place of Record:N.9.t ~p..p.;U.~~J;~J.~. If Family Exemption is claimed at audit,give name,relationship and basis for Claim:N.9..~~P.p.JJ~.(~J~l~. List any advancement or distribution on account that has been made,and nature and amount of same: Not applicable • 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: Anna J.Cernuska 1/4 residuary,1/4 household Gustina J.Rossi 1/4 residuary,1/4 household Mary J.Mann 1/4 residuary,1/4 household Dominick Jackman 1/4 residuary,1/4 household COUNTY OF WASHINGTON,SS: COMMONWEALTH OF PENNSYLVANIA. The above natlled Fiduciary or representative thereof, being duly .s.wo.'I:n doth depose and say that the facts set forth in the foregoing petition are true to the best oL her knowledge and belief. And your petitioner will ever pray,etc. ....Swarn to and subscribed before ~ me thiS iX.~..day of D.~.~.~.mp.~x.~19.7..f.../);'/7 .A7 ;. .,',·7·.j,A lL Lt-~~a;"C'··n~~·k~Signature of Officer..~..L~!b&~.t2Y_. .~I .Title of Officer J:{9.:t.~r.y...P.1J~A.c;. I~UDREY D.SENKO Off' . .1 P.l'hl'r r,~?rlrroi.W~GhingtanC:n:r:tyIceexplres~·~taty•.u"J•••".•••••••••••••••••••••••••••••••••••••••• lVlY Commission Expires h~gust 4,1975 ,•••••••••••••••••••,,,•••,.,•••.•••,••••••••,,,.,..,,•••,,,,,.p ,.,., ! No..6.3..~.7.1.:-.82.4 A.A. Estate of LliONlLDA...J.AGKMAN.. Deceased Fiduciary Ann.a J.•....Ge.r.uu.s.ka.,... .....................E.x.e.cu.tr-ix.----.--.-----------.. 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:pa rag raph 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 Iitem,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. A£.__~_~~ ~2 ~\.\P\I.t'ttlllfll...,,\\~:.(~~f,.~,.\...,...."........C(i~'.~-#, .........":::>•••~"':..~c::...'<.~..;-:-t ...:"'-,,~~,. ~"-1':'("j',....'~i_l.., ~_:\~'I,'\..~,\--:.",,,.r J_'.<:)',<'.., .....~f'''".,.;")".","""t ...... .,\."-".It ..1>""",~f'IIC "-/J~IJ \"," .J,J i,1'~j {t\',\\' LAW OFFICES HORMELL,TEMPEST,SIMMONS,BIGI &MELENYZER OLIVER N.HORMELL CLYDE G.TEMPEST PAUL A.SIMMONS HERMAN J.BIGI D.KEITH MELENYZER December 1,1972 NOTICE OF FILING OF AN ACCOUNT (As required by the Rules of Practice of the Orphans' Court of Washington County,Pennsylvania). Mrs.Anna J.Cernuska Box 176 R.D.#I 2 Monongahela,Pennsylvania 15063 In Re:Estate of LEONILDA JACKMAN Place of Audit:Third Floor,Court ~o~se,Washington,Pennsylvania Date of Audit:December 20,1972 Time of Audit:10:00 a.m.,E.S.T. Dear Mrs.Cernuska: I am sending you this letter in order to comply with the rules of the Orphans' Court of Washington County,Pennsylvania. The account on the above captioned estate has been filed in the Office of the Register of Wills of Washington County,Pennsylvania.On the above date and time, there will be presented to the Orphans'Court of Washington County,Pennsylvania, a petition to audit this account.An heir of the estate,as well as any creditor,is entitled to notice of the filing of this petition and audit,and,should you so desire, you may appear there at that time. You are not compelled to appear at the audit,but you may have some questions on this estate.If you have any questions,please do not hesitate to write or call me. I shall be happy to give you any information I can,and will do everything I possibly can to answer any questions you may have. Ve ry truly yours, D.Keith Melenyzer File No.M-7l-20l CE RTIFIED MAIL RETURN RECEIPT REQUESTED. LAW OFFICES HORMELL.TEMPEST,?IMM,ON,S.BIGI &MELENYZER OLIVER N.HORMELL CLYDE G.TEMPEST PAUL A.SIMMONS HERMAN J.BIGI D.KEITH MELENYZER December 1,1972 NOTICE OF FILING OF AN ACCOUNT (As required by the Rules of Practice of the Orphans' Court of Washington County,Pennsylvania). Mrs.Gustina J.Rossi Box 311,Mar Rick Manor R.D.'1 Monongahela,Pennsylvania 15063 In Re:Estate of LEONILDA JACKMAN Place of Audit:Third Floor,Court House,Washington,Pennsylvania Date of Audit:December 20,1972 . Time of Audit:10:00 a.m.,E.S.T. Dear Mrs.Rossi: I am sending you this letter in order to comply with the rules of the Orphans' Court of Washington County,Pennsylvania. The account on the above captioned estate has been filed in the Office of the Register of Wills of Washington County,Pennsylvania.On the above date and time, there will be presented to the Orphans'Court of Washington County,Pennsylvania, a petition to audit this account.An heir of the estate,as well as any creditor,is entitled to notice of the filing of this petition and audit,and,should you so desire, you may appear there at that time. You are not compelled to appear at the audit,but you may have some questions on this estate.If you have any questions,please do not hesitate to write or call me. I shall be happy to give you any information I can,and will do everything I possibly can to answer any questions you may have. Very truly yours, D.Keith Melenyzer File No.M-71-20l CERTIFIED MAIL RETURN RECEIPT REQUESTED. LAW OFFICES HORMELL.TEMPEST.SIMMONS,BIGI &MELENYZER..' OLIVER N.HORMELL CLYDE G.TEMPEST PAUL A.SIMMONS HERMAN J.BIGI D.KEITH MELENYZER December 1,1972 NOTICE OF FILING OF AN ACCOUNT (As required by the Rules of Practice of the Orphans' Court of Washington County,Pennsylvania). Mrs.Mary J.Mann Box 179 R.D.12 Monongahela,Pennsylvania 15063 In Re:Estate of LBONILDA JACKMAN Place of Audit:Third Floor,Court House,Washington,Pennsylvania Date of Audit:December ZO,197Z'. Time of Audit:10:00 a.m.,E.S.T. Dear Mrs.Mann: I am sending you this letter in order to comply with the rules of the Orphans' Court of Washington County,Pennsylvania. The account on the above captioned estate has been filed in the Office of the Register of Wills of Washington County,Pennsylvania.On the above date and time, there will be presented to the Orphans'Court of Washington County,Pennsylvania, a petition to audit this account.An heir of the estate,as well as any creditor,is entitled to notice of the filing of this petition and audit,and,should you so desire, you may appear there at that time. You are not compelled to appear at the audit,but you may have some questions on this estate.If you have any questions,please do not hesitate to write or call me. I shall be happy to give you any information I can,and will do everything I possibly can to answer any questions you may have. Very truly yours, D.Keith Me1enyzer File No.M-71-Z01 CE RTIFIED MAIL RETURN RECEIPT REQUESTED. ," LAW OFFICES HORMELL.TEMPEST,SIMMONS.BlGI &MELENYZER >•I OLIVER N.HORMELL CLYDE G.TEMPEST PAUL A.SIMMONS HERMAN J.BIGI D.KEITH MELENYZER December 1,1972 NOTICE OF FILING OF AN ACCOUNT (As required by the Rules of Practice of the Orphans' Court of Washington County,Pennsylvania). Mr.Dominick Jackman Box 178, R.D.tl2 Monongahela,Pennsylvania 15063 In Re:Estate of LBONILDA JACKMAN Place of Audit:Third Floor,Court fI0':lse,Washington,Pennsylvania Date of Audit:December 20,1972 Time of Audit:10:00 a.m.,E.S.T. Dear Mr.Jackman: I am sending you this letter in order to comply with the rules of the Orphans I Court of Washington County,Pennsylvania. The account on the above captioned estate has been filed in the Office of the Register of Wills of Washington County,Pennsylvania.On the above date and time, there will be presented to the Orphans'Court of Washington County,Pennsylvania, a petition to audit this account.An heir of the estate,as well as any creditor,is entitled to notice of the filing of this petition and audit,and,should you so desire, you may appear there at that time. You are not compelled to appear at the audit,but you may have some questions on this estate.If you have any questions,please do not hesitate to write or call me. I shall be happy to give you any information I can,and will do everything I possibly can to answer any questions you may have. Ve ry truly yours, D.Keith Me1enyzer File No.M-71-201 CE RTIFIED MAIL RETURN RECEIPT REQUESTED. ') IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY,PENNA ORPHANS'COURT DNISION HEARING ON AUDIT:.f - ~'·f ".- I f ~, •I ( ,) ( ) ( ), (< ..••,. \ r , .I ,. '(\. LEONILDA JACKM.AN, INRE: Estate of Deceased. <z<>-..I>UlZ ZIIIII. ~BEFORE:I-oZ J:Ul<~ The Honorable ALEXANDER R.CURRAN,J., Specially Presiding ~..~APPEARANCES: ~o ..I< U o::>.., ~TIME: l"-N ,D.KEITH MELENYZER,Esquire,of Charleroi,Pa , representing the Accountant. Wednesday,December 20,1972,at 10:00 o'clock A.M.,EST to this estate and there are no problems or complications . Melenyzer?J.VIr . If the Court please,I have the final papers in re ard Number 824 of 1971.the estate of Leonilda Jackman. MR.MELENYZER: uill: III l-ll:o0..III :THE COURT: ll:::>ou ..I<uii:II.o THE COURT:.Is there anybody else in Court interested in the estat of Leonilda Jackman? (NO RESPONSE ) THE COURT:The Court will 'consider the audit closed. (AUDIT CLOSED) ,,..~. I,) • " 1 hereby certify that the proe~edings and,evidence are contained The foregoing record of the proceedings upon the bearing of the " " \ '(. ~uii:l-ll)a .J0( ~o::l.., :tI-~above cause ,ie hereq;approv~d and direc~ed to be fUed. 0( z0(>~(ully and accurate1y in the notes taken by me on the hearing of the above zz~cause,and that this copy 'is a correct transcript of the same. iol-t' Z XlI) 0( 3: r/l - iiiIl:11/l-ll:oa..11/Il: l-ll: ::loU .J0( uii:ll.o ,r ,',. .,, f.'v .' ~u t4t Qtnurt nf Qtnmmnu 'Itan nf lIan4iugtnu QtnuutYf Jtuunyluauiaf ®rp4aun f <1tnurt lIittininu J ESTATE OF Leonilda Jackman, deceased. N 63-71-82ho.,.=._~_~~_OL-_ In the matter of the:_--=-F=ir::..:s::...;t=--=an=d=--=F~in=al=-_ Account of·_~Am=l~a~J~.~Ce~m~,~uOlii!sk~a~_ Exe~)ltrix ADJUDICATION AND DECREE And now February 28 , ,19-.11-,this matter came on for hearing, audit and distribution at this session and testimony taken;and thereupon,upon due consideration thereof of ~f bglance for distribution in the hands of the Accountant is determined to be $22,3.3 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 disribut'ion hereto attached and made part hereof,unles cept h eto be flied sec.reg.or an appeal be taken herefrom sec.leg. SCHEDULE OF DISTRIBUTION Balance per account~1 Additional debit asked at audit Additional credit asked at audit Balance:_ 1.99- 100.00 $22,571.6h $22,573.63 $22,473063, " Deduct Clerk's Costs &Receipts,i Attorney =D~._'Ke=i=th=,-'M=e=ll=en:~n~e:.ot.r--------- Russell Marino,Agent,transfer inheritance tax, including tax of'estate and jointly held bonds,$3.22 Interest from 4-22-12 to 3~7-73 .17 Anna J.Cemuska,daughter,1/4 residue,including a i of household goods and furnishings,held in kind and distributed as such at the appraised value, Gustina J.Rossi,daughter,1/4.residue,inclUding a t of the household goods and furnishings,held in kind and distributed as such at the appraised value, Mary Jo Mann,daughter,1/4 residue,inclUding a i of the household goods and furnishings,held in kind and distributed as such at the appraised value, Dominick Jackman,son,1/4 residue,including a i of the "'household goods and furnishings,held in kind and distribu.ted as such at the appraised value, 5607.81 5607.81 ·.•...','·H.... 0 ~ -+.~m ::l Z III ()9 ~ 0 -+ .......0 C'.::J ~ .~'::l CD CD ~ 0 0'3 ~. -+. 0 ~ -+.-+ ~ -+CD = ., e 0-+. ::: -+::JCD ~& s~~~~~ .' I _____~i IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY, PENNSYLVANIA,ORPHANS'COURT DIVISION J ESTATE OF LEONILDA JACKMAN,) ) Deceased,) No.63-71-824 R E C E I P T AND NOW,this __~~day of March,1973,I,Anna J.Cernuska,hereby acknowledge to have received the sum of Five Thousand Six Hundred Seven ($5,607.81)and 81/100 Dollars, as my distributive share of the above referenced estate. ~()~ Anna ~iernuska ... .................... IN THE COURT OF CO~WON PLEAS OF WASHINGTON COUNTY, PENNSYLVANIA,ORPHANS'COURT DIVISION ESTATE OF LEONILDA JACKMAN,) )No.63-71-824 Deceased,) R E C E I P T AND NOW,this day of March,1973,I, Dominick Jackman,hereby acknowledge to have received the sum of Five Thousand Six Hundred Seven ($5,607.81)and 81/100 Dollars,as my distributive share of the above referenced estate. .-;;...;~ -----------------l I IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY, PENNSYLVANIA,ORPHANS'COURT DIVISION ESTATE OF LEONILDA JACKMAN,) ) Deceased,) No.63-71-824 R E C E I P T AND NOW,this j;:t:1.;day of March,1973,I,Mary J. Mann,hereby acknowledge to have received the sum of Five Thousand Six Hundred Seven ($5,607.81)and 81/100 Dollars,as my distributive share of the above referenced estate. !fhJAh_;J..-#.~~~~Mann .-,- IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY, PENNSYLVANIA,ORPHANS'COURT DIVISION ESTATE OF LEONILDA JACKMAN,) )No.63-71-824 Deceased,) AND NOW,this R E C E I P T ~aY of March,1973,I,Gustina J.Rossi,hereby acknowledge to have received the sum of Five Thousand Six Hundred Seven ($5,607.81)and 81/100 Dollars, as my distributive share of the above referenced estate. ~~~'~.~.L ;Gustina J.oss r-.,.I,..po ,~--'--: )":f~.I .'".-.• . I . :.~/~...~ s•.',"'4 COMMONWEAL TH OF PENNSYLVANIA :J~{l~EOOr: DEPARTMENT OF REVENU~OIJtHY COLLf.t:TfOt;JS HARRISBURG AUG l7 2 Lt6 f~'71 ., t ..,.~. 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 oaooo ~n ~()i~Cbo FINANCIAL INSTITUTION _~__cx1__tl1_!':o_,_ ADDRESS Do Cg C:J 000 f:v:1PorA1\o 1ico nr.;wn ACCOUNT NO.OF JOINT, TRUST OR INVESTMENT DEPOSIT ~·M wt;;Q12 0 C:1 NAMES ON ACCOUNT . 0RINVESTMEN T r:~)\(II),!I""t::'J. ~0C:0t> DECEASED JOINT DEPOSITOR, TRUSTEE OR INVESTOR _-=Q\W,J&'bI:U>-!-=!Jr"=:)I.....---..;.1.....-_ ADDRESS C::1 '¥Fa a,O.ODD c:::-=:":Jnoo Po.Rp:;jll DATE OF DEATH V-mt1V!. SURVIVING DEPOSITOR, BENEFICIARY OR INVESTOR _~£;mQ.l:Ul=h:.-.J.....&J:.I)?d..:u.·~_ ADDRESS o.10.OA,~p'Do.1~3 RELATIONSHIP TO DECEDENT_...;~=·=;.;;;.t1'_ DATE DEPOSIT OR INVESTMENT WAS ESTABLISHED ~---..({I&..oli,r",gj~/..ac;(,+i _I...f_",,_t-f..:-,_ BALANCE,'INCLUDiNG INTEREST DUE,AT DATE OF DEATH $__-.KQl=.::l::";;'~';':':.=.".;:;..l ~.A _ (C...v ,<"./:/:-:_(,~,d -tf(~~ TITLE ~...~p;.:. ~1"'4..:f!!X..R~C-~(1-69)~ 1 ".COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS ._~lNtt€RITANCE TAX DIVISION o..FFICIAL NOTICE OF INHERITANCE TAX APPRAISEMENT AND ASSESSMENT OF ASSETS NOT SU BJ ECT TO ADMINISTRA TION TO:GUElTnu;~ROSSI r'D All~.•,f , HONOEGMlliLA,PA..15063 Date:__SE_'E_?1'_E_liB_ER__2.,.!:.,_197.:..:....1 _ County __.:.;.\o,fAS:.:'c:...:H:::n="l\~rG:.::'lD.:..·.:.::H _ County Fi Ie No._0_'25""'"'"---_/Q_'7_-~/__ Bureau File No.----"'-&_3_-_7_1_-fc_J.-+i__ We have received notice that,''"'srC'l'\;no-..~+.·...~·+'l..erAft·.....bxRk:Or:r'{Vy-j._:Yyyvg)"·,yVy-Gff yvvY""x"/y'{XX¥yyyy'cuxxXX.h:Jl;;l....i·t'~.2'RHl~=::c..c.l:lUu duc......_U:"'-==~-..,W •.•__-.L.___.eft-4 on July 21,19.-2!.,you came into ownership of certain property )iIID5JiljlGELg:1UXat{si(~~iW&Ii~h ~&mmw:bt~~~tJ.TranGfer from Ni.a:~_a Jaclm1LlIl,deceased (H6nongahela)cf:0 IlJ II...()II-Under the Inheritance and Estate Tax Laws of the Commonweafth of Pennsylvania such transfers are taxable and the Iiability for the payment of the inheritance tax due is imposed upon you,as transferee. The property on which tax is hereby assessed consists of:Jt.First National Bank &.Trust Co. Charleroi Office.Charleroi.Permsylvaniao .Checldng 02 02467 5 06.In the name of Gustina Rossi.Opened October 16,1964.Balance as of date of death $1,164.71. appraised by the Commonwealth,as of the date of death,at $1,164.71 50 %of this amount is taxable at the rate of 6 % ORIGINAL ASSESSMENT AMENDED ASSESSMENT DATE OF ASSESSMENT TAXABLE AMOUNT LESS:ALLOWED DEBTS NET TAXABLE AMOUNT $5$2.36 $--------- AMOUNT OF TAX DUE 34.94 o If you pay the above amount within three (3)months of the date of death of the decedent,or on or before Oct.21,19 71 you may deduct a discount of 5%of the amount of tax due,or __J...7i _ o This tax became delinquent,fifteen (15)months after the date of death and,in addition to the tax,statutory interest qt 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 ~. ASSESSED By:RUSSEl~MA~.~ (Agent for the Commonweal/h) TOTAL AMOUNT DUE-t~ APPRAISED BY:'7~i?:<;,:,..c:.&r:;(1J ;i'f·/if.V ..-/(Inheritance Tax Appraiser) $$======== INSTRUCTIONS TO TAXPAYERS 16301 AGENT fOR TtiE (OMNiONWfAUH .COU!iT HOUSe WASHmGTOH,'U~NAr /Ma~hecks or money orders payable to:'...To insure proper credit to your account/Q /this Official Notice must accompanyW32,/7 J\~I 11.t.(~0",poyment.Moil 0'b,;ng it to: ~-riB l/bsl )0 -/-7/ If you have already paid this tax to an executor,administrator,attorney or other personal repre~enta!iv,e ~~\v. decedent for forwarding to the Commonwealth,list below the date paid,name and address of the person t&whom you made payment,their official title and the amount..iJ".. 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 computation of tax due.ILany such expenditures meet all of the three following tests,it is recommende.d 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 an amended assessment of tax. THE THREE TESTS WHICH MUST BE MET ARE THAT: 1 -'You were personally legally responsibl~for these de~ts,and 2-You actually paid these debts out of the account or property described above and can furnish proof o'f 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 requ Ired) COMMONWEALTH OF PENNSYLVANIA). SS: COUNTY Of -), 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_'._': Signature of Taxpayer REPORT OF REGISTER OF WILLS 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 $" Date of Approval:._ Register of Wills Fonn RCC-2 DEPARTMENT OF REVENUE ~YREAl1 OF COUNTY COLLECTIONS HARRISBURG.PENNA.17 127 COMMONWEALTH OF PENNSYLVANIA ..'RE~IDENT INHERITANCE TAX APPRAISEMENT DATE .......Q.<;.t..Q..h~.r.......B....!19...7.1 . COUNTY ~A.§.~I.~Q.T...Q~. FILE NO ?}..~..?!..~..~..?~. Whereas..L.E.QNIL.DA .J.A.C.KMAN late of FAL.L.QW:FIE..L.D .T.WP . in the County of .~W.AS..H.J..NG:T..QN Commonwealth of Pennsylvania,having died on the ~1.~.~day of J~!y.19.?.~seized and possessed of an estate subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore,I .F..RANC.E.S.L.E..Q 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 Ufe 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 Asset Values Made for Inheritance Tax Purpoles $ JT.FIRST NATIONAL BANK f1'~T~UST.COMPAl\TY,CHARLEROI OFFICE· ("UAIHH''Q(H PENNSYLVANIA.Checking 02 02467 '5 06.In the names, nf'Eallstina Ros~i.One ned 10-16-64.Balance as of date of dp1"n $1 1 h4 71 1.164 71 • , ~ .................................................................-;. ..........................~~~~~t.)·~.~~~···;~:~:·:···..··:··......·....·..······i~···oiii~~) = .WASHINGTON ....County c ~I j"-r",; j '1..t,~·U.' .19 71............ RESIDENT INHERITANCE TAX APPRAISEMENT Estate of LEONILDA JACKMAN Deceased. Late of ...KHX FALLQWFIE..LD TJY.P . Date of Death,...7:~.~.1~.71...... Appraisemeilt Docket Vol.,.3.8..,.. Page,197-.9 No.6.3 .71 .8.24 . F 'l d'R ''OfJi Oc t.8temegtstersce,~... Amount of tax due,~. DEPARTMENT OF REVENUE Received, Examined and Approved,. Wrote abo.ut Appraisement, Appeal j,.om Appraisement,. Entered and charged,. ''13 FEB iH PH 3 26 RUS Sc'l I.;.iM:j NO nEGiSTEn .OF WilLS WASHiNGTON CO.,PA. "~,-~ t( " t. ;; \ RESIDENT DECEDENT 63-71-824 COMMONWEALTH OF PENNSVlVANIA DEPARTMENT OF REVENUE BUREAU Of COUNTY COllECTIONS COUN'l'Y OF .JVASHI lo-IGTON...... 'j..'.- ___~..""'_._,~.....1U~_'.,~~......~..~""",_~~_-..--r.=_I IMPORTA~T:This return must oe completed tn detail and f'iled in duplicate,with will a.ttached,with t.he Register of'Wills of'the County whel'''~decedent resided;Return is due within one year after. dat.e of death,unless an extens ion is gl'anted by the Secre tary of Revenue.(Section 703 of the Inheritance and Estate Tax Act ?!~.~.(_:ll_._)_.__.__...__... _,...J1'l THEj\JJ\Ar.~~OF THE ESTATE OFLEONILDAJACK01AN XX~XXI~XXXXXXXXXXXX State of "H Pennsylvania :''j~ss: County of Was hing.ton ........ANNAJ.CERNUSKA.... -1 AJ"J-'ilMVIT OI~ 'H"',"~~CXJX«CJ(/Lxccutr i XJOCi);l~Jm)lX'KQ:JOC H"COWlty .I Executrix ~/ of the estate of the abovt~-l1amerl decelh~llt being duly SWO:'fi,depos"S and sayS Decedent died Ju ly 21 st.. (Month) last will.copy of which is hereto attached.}' Name and address of attorney other authorized representative whom all.correspondence should mailed. orl to ( be I -' ,191.1:,..,J testate Icaving ~j (pa.l')('I'(-n.-)LX~~~X-X HORMELL,THIPEST,SHIMONS, D.Kei th :.lelellyzer 411 Washington Ave. Charleroi,PA 150~2 BIGI &HELENYZER That as such E.x.c.c.ut.r..i.x deponent i;,;familiar with trw affairs of said e~;t&.te and the property eOI1- (!o:.\:I'j'ldnr-ArimIIIil11 rat.(.r) stituting the assets thereof and their fair markd value, That"at the timp of death tlHTC was no safe d(~p():iit box regi:.;tpn:d in dl:ecdent',s individual name,or jointly wit.h,Or as ag(~nt or d(~Pllty ()f :lllut!wr,or in dCCI:dclIL's !lidividual name,with ri1!,fJt of ae(:e~iS by ;.l.lIoUI\'r as agent or deputy,with the w<cepUo/1of Uh;roll(IWIl!~~:--- NAME AND AD.DRESS OF BANK'OR OtHER INS;I.TUTIo~::=-=----r·.~II~~-='~AFIC "~~~~~~-~~~.-B';;:-;~~:~~t=--:-R~:~~~·ION~~;;~OF..JOINT. IN WHICH DEd:DENT RTNTED A SAFE·DEPosrr BOX_..E'---.l::~~~_<!~~!:l!l~~...!!!~.__HOLDERS TO DECEDE~T Fir5 t--.-..Na t i Qnal----.liank+__Char_le..r~__Le..onilda_Ja.ckmalL Penns.tlvan..La ..._..__...-;_ ====-=._=-_._==::---.::~-=.:::--==::::.!==--==..--=::---=-~===-===----=-_:-:]====----.., That the eontents of said safe depost t.box or boxes are :1 I;emtzed under Schedules ....A.__.at'this return,with the exceptton of the follOWing,for the reasons hel'etnafti')r set forth: That Schedule A attached hereto a.nd made pal'(;hel'eot'sets forth full v and In··det.a.il.all the real property l.n t.he Commonwealth ()f'Pe/llIsylvania.of wh.lch decedent r!Jed haVing an Interest therein.It Itl so !'wts l'or t.h the mo I'tgagc encllIlih ralJces upon e /lch pa/'cel 0 r 1·(Hl1.property a t the drd.e of death,gtving the IIm01l/lt st../1.1 .hll'/It.dent.h,IIl1l11e of'1II01·t1!,IlI!;(~e,da.te,l'llt"l)f'illU~r''''lst,lind llOok 1j1J(.f jlllgl:ot'rocOJ'(1 t.lll:'f'(~nl'.11,111';0 Silts 1'01'1."III I.hl'i:o'llIlIIns prnvldl'd t.hc/'i,(·ol'"Lhi:1I,';s",~sed valwtt.l.ol1 of'"'/lch of said 11I.1I,c:..d.s,tlte "stilllIlL..~d lIlIlI'ket.V/ll.IH~thereof'liS of'ditt(~of d.-,ath of ff'-,ce(irmL. That.Schedule B attached hereto and made part hereof'sets fOl'th fully'lind in <Ietai1 all per-sonhI propertywheresover sJ tllated owned by the decedent at the time of deiitIl;all money"left by the decedent at the time of death,whether in decedent's immediate poss..~sst()n,stunding to decedent's credit in bll.riks of deposit,savings banks,trust companies,0\'o the I'institutions,whether indivldU/.l.]ly,.·'Ol"dn,.t,rust for any other person or persons giving also separat.ely the accrued interest thereon,Ifany;.dowll"to the last interest day prior to decedent's death :In the case of savjng~;banks,and to the dal,e::'of'·iie~·e(l€nt.'·S\j.eath -,.'".'--".,.../in fill ot.h..,r (:ases;nil hOIl<ls,post-HI savln;!;s;tr(~asul'y cer-t1fleates or notes f1nd'ot,11'~i'ev:l(Jence.of in- debLedlli~Ss 01'Lite Unl.ted'St.ates t.o t.he <Iece('h~/IL;a.ll ohllgaUolls,\'/hel.ltel'by S~Il:Lll;.e:;:..agroem"Ht.·they are d~sjgnated as tax free,of the Uni ted SUites,or any state,or political su1{d~?-V.:Ls1~_n the~)f,or of any foreign count.ry,which are owned at the time of'death;1111 wearing apparel,.I~wei·t:'y;-:silve~~l1r6-'pic- tures,books,works of art,household filrni ture,horses,carriliges,automobiles''':!l;)~t;~~'and_~ny lind all other personal chattels of whatsoever kind or nature,left by decedent.,together witil .t:he "Ta.':i;'ly·'"estillllited market value thereof;a.ll 'bonds lind mortglif!es held IJy decedent and of all claims due"'ahd'owtn'g"decedent dl,t.hl~t,ime of deat.h,lind 11.11 promJssory notes or ot.herl.Ilf:I./·uments til writ.ing for the payment of money ..I'w/ll(:/I flnerll·IHO!.dll'fI pOf;s.:ssed,01'Wllll.t,sonvel'1111.Lu I'll,wlU,Illl.er·est I.hereon,lf'any,giv:l.ng the face 'v"I'I"1.lld "l'll.IIIIIII,,,d 1'1111'IIIHI'),cl,VIIIIl"UlPl'i'OI',IIlId ,,.Slid,i':,l.IUllltlH!rutr'mllr'ket vlIlue be less Ullin the 1',,,:.-VI.IIl':,It.S\·t,;1'0,'1./1 hl'lpl'ly 1./1"l'l!IJSOIIS 1'01'sllcll di'pl·el~llIt.lon liS to eilch l.telll;/Ill·moneys payable I,ll I,I,,~"sl.l,t.•~I'I'CIlJl lire IIISIII'/IIIl:"f'0lti:.h~s i:llr,/·t.:ld by df:eedent;Idl annuity lind endowment contracts the 11I'oceetls 01'which were payable upon the deat.h of the decedent;and all the COi'pOl'ate stocks and dividends due thereon and unpain as of the date of death,bonds and accrl.ll~ll i'ritei-est t!lEireoh ttl the dlit.~;of dece- dent's death a.nd other investment securities owned by t.he daCI~l:1ent at th,,j time of deat.h,wit.h t.he Inarket value thereof at such time. '. I';\ I·,: .' 7-..-----·-- "" In the ca.se of securJt.l.es of close or fllrn1.1y corporlttJons,t.he values reporteo are as fal"as possible substantiat.ed by financial stat.ellllmts of thf~corporaL1.ons,showing the asset",and.liublilties thereof flS of ttl!)·dHte of df~ilth.The sehedllle III so sets forth the interest of decedent at the ll.me of dp.llth··:!n ILlIy.(~o-·prtr"nf~rshifJ (,I'busin(,ss,and in SIlI,))I'I"".of'ttl('va.lue of.'slIeh ·interp.st there 'Is 'mnex(~11 to said schedule,financial statements showinl!;the assets ann l:iabi11ties of saJd co-partnership or busIness. A copy of the co-partnershIp agreement,(jf oral,a stat(~ment setting forth the nature of the agl'eement) together wIth a statement setting;forth the character of the llllsiness,its location,and such other facts pertainlng t.o the business ItS may he pert:inent to a fair Ilnd just appratsal of the'-decedent's interest t1lf~rein mllst b(~submittell.It should also set f'ol'th In itenrized form,tog;ether with thefal.r rn/!rket value thereof,any ot.lter property ownell 01'be quell thed hy tile (ll.~eedent I'lt the Lime of death. The Schedule C attached hereto ilnd ml'lde par thereof'set.s f'orth a true answer to each inquiry (:(lnt.rlirH~d t11l~rl',itl /UJl1 in t1J1~(;tJS'~of'l,ntnSrl~I>Sof'prop.:rl.y,",,/1.]or IJI~r'sonlll,w·lthi,n two Y';/lrs of'ol"(~'~d(~'~t's del1th,in eonternpll1tion oj'Ih~I~':d"nt's d"lil.h,or Int.ended 1.0 t.'lke (dTeet.l.n po::;session or nn.l0Ylllf:nt at or after death,said schedule sets fort.h t:he nature and value of'such property,t.o whom transferred,the relationship of'the transferees to the deeedent,"the proportionat.e share received by each transferee and all other facts of a pertinant naUlre regarding said transfers.In the case of transfers intended to take e,f'fect in possession or enjoyment at 01'.after death,there 1s also attached to th.~schedule a COllY of the deed,trust agl'eement or othel'instrument creating the trust.Ther'~is Itlso,set forth in said sclledule a list of'all property,real and personal,with its value,which pR~ses ht decedent's death by vIrtue of the exercise by dece(/ent,e;i,thel'in(ltvidllally,or ,jointly with another,'.11'any power of appoint- ment vesterllndpl;(~dent,pjUI,~t'ind)vldu/lI'Jyor .IolnUy,by thp wl.ll,(leBel,or'oU,pr 'Instrument of'11IIother, wI.th a copy of'tlte lnstrllm':lIl,I~relltlll.t.:;slleh I'ownr Il.ttlH:II("t.t.o tile seherlu.ll:. ,I That Schedule D attached heret.o and made part hereof set.s forth the names and addresses of all persons benefie-tally :interested in this estate Elt the time of decedent's ele1\,th,the IIIJl.u\'e of their res- pect.iYe interf~sts,their l'e]lli:.ionship,If any,t.o the deep-dellt,together wltlt the ages at the Ume of decedent's death?f all minors,unnu.ltunt,s and heneficiartes for life 1I1lcier decedent's Will.It also contatlls a statement showing which of U'f']lcnef1c:\arJes·nlunec]1n the deeerlent's will,if any,died prior to elecp.dfmt,thp.dittes of't.he-It'death,thwi,'issue,lind the 1'p.ll,tionsYJ1p ot'sticl'I.ssue to the henefj,ciary.~ " That Scfipdl1le r ;1I.ta<:II..«1 II0.rf:t.o /llId Il\adf~It pal't,I,,·,rnot'set.s 1"01'1.1,:dl prol'.~rty,r'=!/J..1 and per- sonll.1,owned by the decedent Joint.ly wi 1,11 nnoUlel'01'others,incllllUng intnngible,standi.ng;in the name of the decedent all']others,plus the dl1h~and 1']ac'=!of r.~eord of'Jnstruments eff'ectillg the vestiture of' rea1 es tate and the date 0 I'Itc(Jlli~;j ti on of personal ty,pIus tlte name,altd ress and relit ti.onship,if any, of c:o-owners to the decedent. 'fhllt 5cfi'?duI e Fattached here to /lno made /J.part hereof sets forth fully and in detail all debts <ind deducLions claimed J'or ll11f1 on j)l,'1'101 for thi s decedell t.'s es tate)lnclueling funeral expenses pald; filmily exemption~where appl icalJle;f~nsts of admlnJs tration of'tbis estate;counsel fees all,l f'ulliciary's eomnl.lssions pl:dd or to 1J8 pldd;f~OSt e){pell(II~c1 for lJlIrjal trllsts,tombstones or gravernarkers,and reli- giml::;servIces,ill cOllsellllen.~e of t11~~deat.h or the deeedellt.;debt.s and claJms owing ancl Illlil/l,il]at tJme of,'.dea.th;taxes accrlled chargeable for perIod pr:l.or to decedent's deatb (except.those allowed under Section 651 of the Inheritance and Estate Tax Act);toget.her with Il statement of collateral pledgeri for obliga- tions,if any.It is a.greed that.the fiduciary will present proof of'said claimed obligaUons u])on re- quest,that if the amount actllll.1ly paid 1n sett.lement of'any fee,commission or rlebt is less than the esti.matt,d amount ,:1 aiming and Illl",w(~iI,Ulitt Ute same will !)e repor·ted to the Register of'WiLlS,and that tile Il.InOllllt ",I't.ax assessl·)d eanlle ...~itss('ss0.d in IH,coroance t.her'ew1th. That th"totals of Ule Ilppl'Op,'ill!,I!colulllns iu Schedules "A","n","C",liE",and "F"as (ljl'eeted therein,· have hefm eat'l'led fOl'wlln]anti p"oper'ly t·'~gl,~;t.er·nd in the SllmnJll.ry. 'II, ~I , ) I, I~i Suhscrihed 8nd sworn to before me this .l9,th , ,"-'J>'..................~:··..-::.'!Jay of .,.January.., ,19....7..3 .. ..:"'J ~_......~-~r:./:.. !1 -I ":..J (.-.:~I /l ......,t.L.k~L.l1;,_,hi:,~"VL~AUDREYD:SENKO ..····..· No t.a ry Pufu 11.C:Notary Public.Charleroi,Washington County .'""My Commission Expires August 4,1975 ~;;;:,;1:fJ~~~~'·j ..J39.X .17.6...,R D /l.2.. (Street Number) ...MQ.IJQIJgah.~.la ..,P.ennsylv.,ania . (City or Town and State) NOTE:B'~fore sfg;ni~g affidavit make ".llre al.!hlank spaces in the affidavit and schedules annexed are filled in with details or t.he word "None",and jn case thc assets include rare and un11sted securities, secllri ties of'close or family corporations or an lnterest in any co-partnership or business,that the data ,md st><tements requi red Hncler the pllrap;rapll above reI 'lUng to Scheelllie "B"are Ilttuche,l.Also make (;"rl.t,In UJIl t.(;o.lllnm N1 tn t.h(~"SHI1i1ual'y"hilS l)!~en properly completed as above-directed. .i f ,I I •..i D'.... r, RCC-34 .(1-64), COMMONW~ALTH OF PENNSYLVANIA DE'PARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE CIA" REAL PROPERTY Real property in Pennsylvania,with statement of r710rtgage encumbrances u'pon each parcel at deatn of dece- dent.Where property held as joint tenant or tenancy by entireties,report on\Schedule "r::".Property hl"ld 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 t.he Commo!"wealth of Pennsylvania should be described by lot and block number,street and street number,together wi th a general description of the property,with a reference to the record of t.he 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 martgages,etc.,are to be listed on Schedule."F"and must not.be deducted from this schedule. (1)(2)D) D£:PARTMENT . ASSESSED VALUE VALUATION FOR YEAR OF ESTIMATED CAUTION DECEDENT'S MARKET VALUE (Do not.write DEATH In t.h I,5 poce) ALL that certain piece or parcel of land being a part of the Matie Elias Plan of lots situate in Fallowfield Township, Washington County,Pennsylvania and being more particularly described in the Recordert.s Office of Washington County, Pa.,in Deed Book Volume 732,Page 133 ALL that certain piece or parcel of Land beinf~a part of the Maric Elias Plan of Lots situate In Fallowfield Township,Washington County,Penna., and being more particularly described 'in the Recordert.s Office of Washington County,Pennsylvania,In Deed Book Volu~1C 756 ,Page 585. 25,500.00 3,000.00 3v oO 'OU t 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. .,,. i r---:\ 28,500.00 ... 'W". RCC-35 " CO~WONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDUlE "13" PERSONAL PROPERTY " INSTRUCTIONS:This Schedule must disclose all tangible and tntangible personal property owned inrl1.vl(lually 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".Intar:'gible personal property,titled in the name of the decedent,but payable at death to another or others,inclUding but not limited to P.O.D.U.S.SaVings Bonds and tenta- tive trust accounts,must be listed,despite the fact that they are not of the administered estate. Tangible personal property shoulcl be listed first (e.g.,jewelry,wearing apparel,household goods,and furnishings,books,paintings,automobiles,boats,etc.) Intangible personal property,such as boncls,treasury certificates,cash on 'hand and in bank,•stocks,'mortgages,notes,together with accrued interest or c1ividends,salaries or wages,insurance'pay- nlde to 1,110 est./lt.e or firlll(;i/lry III s/lid (:/lI'I,,:lty,IlIlrl,nershlp 111f,erpsl.s,111t.f!rpst 111Il11y1111r1If1tr'lhut,'!d "s t/l.t.!of'0"111';01111'1'1'<>111 lilly pl'''I"'I't.y h,'ld In 1.I'IISf,II'''.'!I'1.1..,will 01'/lgl·':i~IlI"nl.of'Illlolllel',.':Vim I.holl~h located outside of the State,at the time of'death,should be listed in this schedule. Item No. ITEM List and describe fully Refrigerator Dinette set,buffet Couch UNIT VALUE ESTIMATED MARKEr VAUJE 50.00 10.00 10.00 DEPARTMENT VALUATION (Do not write in this space) ~lr.and Hrs.Chairs Television set Cpffee table 2 End Tables Drum table Desk and chair Four-piece bedroom suite Twin beds Chest of draHers Freezer Portable Television Spin drier,wash machjne Insert this total opposite "Personal Property",Schedule "B"in the "As Reported"column on the last.page of this return• . ' x X 10.00 100.00 5.00 5.00 5.00 10.00 15.00 15.00 s.oo 15.00 10.00 IS.00 280.00 O CJ/0, CUd.OO ...-6 '()0 C,..0 () o--',..()0 I Q.0 6 is'(}(J /-S'~d {6'O () (0 r ()d /6,G d ,, t!!""'?..,,"'!,...,.,....~_.""i!-.--""'·.~,.;...i--·:~;;-c--~~~---~--------------;---------------------------------,., RCC-50 rO\f\ION1I'EALTH OF PENNSYLVANH. TIUNSFER INHERITANCE TAX RESIDE\'T DECEDENT SCHEDULE "c" TFtA NSIi1<:ItS (1)Dilt <fecedent,within two Yf~ars or death,mllkr~any transfer of'any mltterlal par.t or hts estate,without receiving a valuable and adequate consideration therefor?(Answer yes or no)---,N~o,,---__ (2)Did rlecedent,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)_tw~u.O,,-__ (3)If the answer to (1)or (2)above is in the affirmative state: (a)Age of decedent at time ,of'transfer N/A (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 wtthout receiving a valuable or adequate consi(!crlltion therefor wlrlch W/lS 1.0 tllk,~errf'ct tn possnsslon or enjoyment lit or lifter his denth? (i\nswf'I'yl's 01'Ilo)_,No",_,",,_._ (II)Was I.h"I'(:allY I'0ssl hilI ty I.hlll.1.11"I"'opel't.y I.l'llllsf<:rr,,:d mlg;ht l'el.ul'n t,o trullsJ'ol'er or hll;! estate or he subject to hIs power'of disposition?(Answer,yes or no)No (b)What was the transferee's age at time of decedent's death?_~i....J,",o,--__ (5)Did decedent in his lifetime make IIny trnnsfer wtthout recctving a valuable and adequate consideration therefor lmder wlli ch transferor expressl y or impl iedly reserves for his life or any period which does not in fact end ]lef'ore Ids death: (<1)The POSsI'!ssion or enjoyment of or tlte right to income from the property transferred? (Answer yes or no)No (11)The rii;ht to designate the persons who'shall possess or enjoy the property transferred or ineornl':I,hf~r(~f'rnm?'(Answer yf~S or no)l~O (G)If'the IJ.nSWf~r to ('i)(Il)al/ove .Is In the aff'ITlllatlve,sl.at,,,whether t1ie rlgllt was reservl~d in decedent alone or others Not applicable - (7)Did decedent in his lifetime make a transfer,the considerati.on for which was transferee's promise to pay income to or for the uenefit of care of'tl'ansferor?(Answer yes or no)_...£-1-10""-_ (8)Did decedent,at any time,transfer property,the beneficial enjoyment of which was subject to Change, because of a reserverl power to alter,amend,or revoke,or which could revert to r1ecedent under terms of transfer'or hy opcrat'lon of law?(/\nswf~r yes or no)N"-Co",-'_ (9)If the answer to (H)above is ]11 t1lf~1I1'1'11'IIIatlVI',was th'~powel'1.0 litter,alll'~lId,or I'evoke the tnter- est of the beneficlill'y 1'l!Sel'Veci tn t.1t(·d..e,~d,,'1I1,alone 01'tit.'dccf~delll IIl1d OUH~I'S? (Answer yes or no)_...IN.:il,O'--_ NOTE 1:'The answers to these 'Juest.lolls sllollid h.:supported lIy affidavit hy tllc attendi.ng physIcian as wpl'l lUi fl I:Opy of th'~dell.t.h r;prt.1 1'1 (:/It.<~. NOTE;;!:II'11Il"Wt~r to /Lily of t1,,~"llOV"'1""st.lols Is yes,St~t 1'01'1,11 lIelow II.descl'Iptl.on of't11f~property transferred,it's fair market vallie at date of'death,dates of transfers awl to whom trllnsferred,with relationship of transferees to decedent,jf any.Submit copy of flny trust need or instrument,if trans- fers are claimed to be non-taxable,also suhmit rletlliled st.atement of filets on wh1ch said claim is bused. NOTE 3:List appl icable property below 1n manner in which provil!ed in Schedules A,B,01'E. '1 .'l• ITEM Not applicable DESCHIPTION MArumT VALUE (Es timated)DEPT.VALUATION (Dept.Only) -! 'f I,.. i ir I'I I 't , " \ _ii_a _ 1 ·11 -/ Insert this total opposite "Transfers",Schedule "C"in the "As Reported"column on the Illst page of tIlls retllrn. ,"'(','.,..'\l -')I~.. ":'\~\I\)\""i:':\U'il In:I'r!\:-;~YLV:\NL\ ,:\\:<",:It f\lW1UT\;-;n·:T:\\ SfI!EDlJLE: I,\ <f0 INTLY O'I'NED PHOPEllTY I\~Ti11'l'Trn\s:This selwrl\llc !TillS!.disclose all !'J'(lppr't,y,real Ilwl person,d,owner]l,y t.hf'd8(~""!:nt .I?lnt].1. \\i!ll i111'(,tlIPr'f)r'tl1.h""l'o;.inc'lllllillJ',illl.llflJ_',lhll':.,~'I..'lrllll"l",ill I.IIP IIfllUt •01't.JiI'""('"d"lll.'Irld 1If.1""'li.'11nl, 1,,"ll (,,,11,1,-I'jl·s!..,","III,il'<'I.I,'s,01',1,>1111.1.'~lIltlII.S,!-!:ivill!-!:1)/'i,·1'd'~s':l'jpl.ion,a:.;illdj':al.f:d \llIder Selierlul,) "A".plus tlie dat.e illl(J place of'r'ccor'd of'illsLr'lIl1\('nt'.efTectillg veslitllre,1>111,do not include entiret.Ies ,)!'out (1f'SCit,.'rl~il.1 estat.e val'lIc ill est.ate valuiltion eollllnll.l"':rsonal prol,crty should be listert as in ~('hE'dllle "an,pIllS date of aC'l\lisi Li.on,illld the nalll'),adrlr'css and relationshi.p (if any)of co-owners to t he-dt:'ct>~dAllt.~---"=:-:====-::::====--===-::-::-==::-: D"sc-riptinll of'PJ'operly,Date of'Acquisition,'Narr;~'r IJn:i't~'l-i;~~-~~er;t~-i,g-~fl---'r~~t;~t:~----'---"DEPAiiTi,mNT VAl,uAi~ A,iCh''''':,iUl,i Helation~ldp of'Co-Owners,~nrt PIILce ;Value Share V!l.luation CAUTION-Do r~()t..Writ.e ,f .keorlJ of Instl'lImrmt,where IV~ld 'hstat,c.",In ThIs Spap.\~.~~,-'.~:\:::~Z.~S:~N-;/:;XY;/~'.S:;t%·;;{{);:;:'/';~~~/,t~~~?'1!~;;;:~:;';/A(>'.;:/?:'~;:<--."v;;';';~;'--;:;:--'--'-V-l-:i~;~-'--;;-~>:<;::»:;·'Y.%X~(Z<./1·;;~~m:{./;(/0,,«·:;>;;~~/$,'"r/'."'W,,,',1~Ilt.l.r..:Ikef:dent'sX,-<;X:'..,?'></',I'X',>,.(;.(/,<>(>(/)(Y'x',")«(:.'Pr'operty lllLer'est 4,000.00,50%Schedule E-l attached hereto. '$8,000.00 See Total " '; ,'. ", r " lll~,;er·t.LIds tol;ul "(I(1usiU:",/"i,IIt.ly ()wllf:d I'r'operty",~:eltedille "E" in ti,e "As I\r~T'orted"COl'WI!1 on Ute last pagp.or t.his return. IIIiI! L..J t/0 0 (\,0 Cl (J t<.'-/ c77'II -;'>'~,..,~ zaax: ,~;.;:":,:':_,::;<'~,/:;; U~ltfD ~st-nT£5 SnV'jrJGS .(_~0 (\)]),j ""''4~..''\ r ..~ .___AWI aLt VI t Se\-i eS "Sc.r i a1 ill <11'11 b~J~...I_IJ>s!\L_b"lt~Ilm.t<.· .'.I._~5C.?o ..~._-:-._I(.7J__J7<2-_?f_:J_·"~_C?.._/~__+._~.r.!.:._..{j..b~_:,'..._~/aJ!n ________.i."'./}tJo.::.;:II ~Pot!6'..-Jill!,-i_rh.~__I_q_~~._/!~!!~ .j''5fspo.~If J)to?b 36';2.II J~I~~/16 S-.._!!l'!:.t!..11 ", -_",~'.~---'-'j 71;-00,~1-1 ~?J Po i 6'36"f II Ja-n./16.J 1t1a.nn. ~j-,~.500,t?.!!_+_-....;f!'])tfo'd'6 3 t,;/.·II Jtt n.:f._?._6r t..~!:.t~~lJ_!/t-' _..,.._~{~/I.....:;"..52;;:.....e..;...;l2.;...-'_~_o ----+__;1 ..lJ pCJ ft .7R3 II ~!::/_,:.IC/..!~(~-.~~_~~_s~ 7.1StXJ~~II ~fl Po ££3%/II Jet 11,/qtr Ce.f-I1£{J~---!---,~;....;;;;..;.~--t------t--:===-----=---------+-------,-_.-,- Jl..~C;-(!)0 ,.~II "r;J Yo R £..'1cf0 //Ja...n I"/9 t j-Ce.1-11u.SIt..-----+L-"":=:;O"----+---------l---=:::...-.......: c;/IStJo ,~II .JJ ?oi t3J6/-/Ja..n,(ere r 'J..~ck;!!.~ _____.LQ.~t)Oo (<!!?II .__~~_£('_!6',:Z~1'!i .~!£t...!~/9££rIrJ~~)~,~ __....-1/fI.!:oC',~;I ,)y0 rt 3 S7 /I (k h I c;t J~..~!LJ!m~_!.L ___..__I.;L.~S't:o,-~II ~'7)ff0 t t 3 ss )I dt?h /9t J ..JItC'/Cmt(~. ._.__L.l~~OOI'~II ,-fl '1000l:6h911 f/4.h~/9bA ~sS'/ .__....,__/~_f(50or ~II .:},.!/(-L..0 <;L.7-1::..7~.d_._r.-~f--:,I q (')...£ss ;: ___/s.-:(s'7JOr ~;I J Yo it 3'7~/1 tkl/~,/9{r k:S9/', /b~7f000..~(-(:J)?{)rt 3"71 II deth./96 s-tt?assi:..:.-.::..~---J.._'___ N1}-s.Nil Ll tl JlAo L ~I11lU1 ~1 r5.~~dJ.fL (ftttKrYltLh mr5,fl1 ;Lla.Lfa.c!<~nl tU1 fY1rs,t1;!cLtl dllci!.Man· Or tVlt6.d1{o-;ft1ann /1 tht·u,t/) Or f{lr~.Ann Cernus,J(a.-(.!liIJl-a g ) Dr Oh_rlJDtl1;n;C 1(.(j~cKrYul.n (c;ilu-u IJ-) b r n1r.c;,Cs-tL'1 t ;ntL r./.«lJ .s 5 ; (12 'thru.I/:;) {'---!./...,:t'~',..h,..;:t~~,,-J L 3Ca~~.c-t:....(~--£Y-v ..I"~1 .......v-~./V.,..........JCL1r U./~f.~J-.~:"t(~.> ... SCHEDULE E-1 ..' ... '.'\ "" ',' -~_.~..'".,. " RCC ...37·'(i2-63) rOI\ll\IONWEALTH OF PENNSYYLANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "D" BEl\:EFICIAHIES BENEFICIARIES AND ADDRESSES RELATIONSHIP SUHVIVF:D(If sl('p·ehildren or J)I\Tli;INTEREST OFStatl?1'111 1 namps and addrr's;;es or all who ilil'/~it irn;lll'(,llildn'll DI':Cfo:DI':N'I'()I"HI':N1';I"IClllItY aVI'all 1111,('1'1':>[..vI:~41,I'd ,(;Oll Li IIf~l;nI,01'ot,h"r-aI'"illVolv('d,sd STATI';YI';S IN I':STATI'; wIse,in estate)forth lhis fact.)Ol(N(l II 11t'1'11 Ann~.T r'prnllc::."k::l D:luo-hter Yes 1/4 Rp',;r111~rv Hen 17()R n #2 --1----------- Monongo he1 a,Pt\- r..,C'+~......,T Dr'\~c:i Tl'll1 IT 11 t-pr Vpc:!1/4 Residuary,"I P.ny ~1 1 \l::l.r Rick \Ianor I_._-+--f--. -R.n #1 ----,--1,-- Honol1o-ahe1a PA !\Iary .I i\l~nn 1)::1 UghtC_L___.....Ye.s...._._.--l/4 Residuary. Box 179.T)D.#2l\.•-_. Mono~ahc1a,PA ~.-._- Dominick Jackman SOI}'(~-~1/4 Residuarv: _Bo....'C 178,R.D.#2 1-----.-----._.__.---_._-.,'~-_.._--.._--.._---...__.....-------_._. ~,lQnQl1gahc la,P1\-1---------.----------1--- ._-----------~------------._-,~---_._---.t-e-.. -- I - - .-_.- ( h Deponent further says that all the above-named beTIf:ficiaries are liVing at this time except below: _________N_A_M_E -+-__D._A_T_E_O._F_D_E_A_T_H_~~t--------_-R-E-S-ID-E-N-C-E_'~- -----------'------------t-------------f-----------------_ .--.--------------------...-.-----+---.------------f----.-.--------------_._-_.._--_..._._---_..._-----_..,.._----_._..-._--_..-.....-_._.._._-_._...-----._-_._-.-.._----_._._----'-------------- I----.------.__.._.~....___l ....__._------------_.._--------_..__.._---_._-_._-----_._---- Deceased OF THE REPORT AND APPRAISAL EST.-\TE OF .,.J .-....L__...._-~-..~-,_~'k.JC_ ,Executor·Administrator must complete "As 0 Reported"column #1.).\ ,,o ....,"'tJ ..::;;~':~..~..:e-..~£!i re-:~:O::1 tn _ ttl of-'.Vl 0:-,:l "0~:=~e:..""I_:r-t Vl 0 ;..,''0s:.::~"0 (1)~'-<3'";::.'O~_:0 (1) ~"~~~:::;3 '< --:(J)~.0,.. :'Ij '-i:0 ':0 :(J) H ~I C/)IIcl~I.~I....-->-• C/l .::::l:n ------------>-<.::T i=?W W '0 ?"'-':r :~cl ~~II II:-----------..11....:;I .~*~~~~Ii .jJ .'.I L'Y{~'!.\~~:~~:~~II _doll '.";.'.:~.'.~,;.~~I .:~:-.t~.~;i "-.10 :NtJ1 ;:t-I I'"'-;..z,;."';;1....~-I '1fi:CO :0 ,000 o~·o :0 :0:0.."~~:~~~~~i I :0 000 ---- Year 1:'<THE ~No . .\'.'ashington Late of ..Fallo\\'fieldTOl:!Ilshir' ',V d :.(.1 ~..~r'~:~J.~.f~~ti-i l3\1."1; ~:;1~1~'1.A.~,;'~,~f]1.13 !~):1 d LEONILDA JACKMAN .. .\IATTER OF TilE APPRAISE.\1E~T Will Administration Commonwealth of Pennsylvania County of />\.'1' (;:1.;'0 ';":"j "~:'::::S ('I !J EL ..:r.~~v>~oo <.1 • ../f-r ..."'-"'. lIORMELL,TE-iP&£T ,II Sji.~.n\10NSrU BIGI,&r:IELENYZER ,c,....j ''',f Do Ke i th J.lelenyzer ,j 411 Washington Aveo Charleroi,PA 15022 ..:....-..:.-~..........,..."<tA.'_;;.-s-.."."..J-.-~......--,,;.;:~.i >-,I :r.II!v I;?.~'Il3~~l §.l'i~il ~....,......'.".•~J•.~t''"'.~ ". , "'"j' J. -.,....'.j:'~..,if CE OF THE GISTER OF WILLS OF _}u.ti""a~s.!.!:h~i~n,""g..,l:t~o~n::...-_COUNTY AND AGENT OF THE COMMONWEALTH STATEMENT OF DEBTS AND DEDUCTIONS ESTATE OF LEONI LDA ,JACKMAN LATE OF Fa]lowfield Township ,'Washington County,Pennsylvania DATE OF FILING APPRAISEMENT DATS OF DEATH July 21,1 971 DATE NO.OF /-'>..J1 ~A~9f y,*REMARKSVOUCHEIIl ~7A 717 \'"V ....Funeral Expense....v Anne rPTnnska Reimbursement Funeral Expense Illh~,.~M<lnn RpimhuTsement Funeral Expense Rnhp,.~Rnc::c::i Rpimbursement III T<>nrl ...i n I c::Flower Shan Funeral Flowers r.l1<::t,ina Rossi Fun~!~l ExpenseDo;m 11..."pment 'C,...n,.....r c::.l~7~1c Funeral Services J..I~,.nlrl T--1..~-T Funeral Expensen"".....-1" /7PV 111 00 hh E:;O 24 76 174 02 nl 00 ,Qlt;;00 5 00 Park H -IT ...h,,,l<l \T~11ev Memorial -11 Exnenses 1 n 00 '0 -Pnlli~<>hl~Gas Comnanv.'C';,.,<>1 r.~<::RillS 109 80 "Ro"'T'o'onhnn~rnmT\~nv -Pin~l Tp1enhone Bill 3 45 \T~11~"\T Tnc1pnendent Fllnpr~l Advertising 2 90 Fllneral Advertising ~00 -r Service T...i-rnmmunitv Ambulance E:;O 00 III of;~...;Rp~1 TV AnnTaisal of Land nO 00 TATo",+Do....,.,~Final Electric Bills 47 n2 A1hpTt Mann Reimbursement for Fire T....~,....,.....,.o 12 00 c::.<>..."ol M Ri1"nn1:i R.E.Lot Survey and Land 65.00n.......-.....n+;n,., Reimbursement on Out-door ,_,~E1i7.abeth Bavin Tinfifc::..." Malcglm L.Morgan Taxes 5A7.~Qlio'"(._--"'....'T'<>v~c::')'2:r:::h Hormell Tempest,S1mmons,'"1 -o·n 0"U ...~C 'l1l01 '...1\++n ...n~'\T'<::fees ...II 'II lor on "0 ~ c"..."ol M Bitonti.R.E.Tn+c::. O"e-e-oll M<l ...inn Ol17a O.Woodward 19.:Realtv Transfer Tax l(00 ,I 00 .A,ell.8§)TOTAL DAY 01'SWORN AND SUJ9SCRIBED BEFORE ME THIS 19th .Janua9":'4---.'~Ie ~dJd-ewy /),Z;;13 COUNTY OF Washington I,Anna J.Cernuska COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX PURPOSES. HEREBY CERTIFY.THAT.TO THE BEOT OF MY KNOWLEDGE AND BELIEF,THE FOREGOING IS A JUST AND TRU E srATEMENT OF DEBTS.FUNERAL EXPENSES AND EXPENse OF ADMINISTRATION SUBMlnED TO THE ESTATE OF T onn i 1c1 a Jackman DECEASED.AS DEDUCTIONS f'OR17~(~/~~AZ_,f-4J CL.S.) /' AUDREY D.SENKO NI!~I'Y Public.Charleroi.Washington County M~CommiSSion Expires August 4,1975 JACKMAN ,Leonilda " In the matter of :bhe Audit of Account filed in the Estate of IN THE ORPHANS'COURT OF WASHINGTON COUNTY,PENNA. )Oat<>of deotb__'7_-z..--=--.I---::....-7.-1--1_ \No,~4 of 1971 ,Term,19__,A.A. Dec..,,")Docket ~fI-/'I J-e;__ TO THE AUDITING JUDGE: Enter my ,appearance for the Commonwearth of PennsylViania.claiming tI'ansfer inheritance tax in the ah(we estate.as follows: ) $ CALCULATION Gro..V",ue __m "2 t--l HJ .'_~_m __ Less Deductions ··..····m......~5'(,-':.4~ Clear Value .......m ......'"~~I L-3-~-_-!_~3'(~'J---E-ft------L- $.. $.. TOTAL DEDUCTIONS,$_~..-!lJ----'lt.}-~_ Tax-)- able ( at i 15%\ 1 ---- $----~'----- $---,~ $---F---- $-~'------- $- Additional Debts and Expenses per Audit CR. Debts rand Expenses per Account;see Note AdditioIllal Assets per Account,Subject ,to Tax __ . DR.1J,g ~'tW,V1)To apPI'aised V1alue of Estate:Realty..........___.______..__$__-------"L-_ z>'N>4CJ{j NOTE:The following credits claimed in the ccount are held not deductible 'll'S against the :~,~t,".@ "'lJ 11 /1 ?~,q r $----Y /~(?~V PAl:ON;~;:e"l)Total TaL $_16_~J~_t(),_ $ct'};f,",L Less amount previously pralid _m.••$__I ~r ~'.~~_:ffl'1,8't Balon"'_________?______1 1-!.'m z.,~. -Interest__yrs.~mos.-iJ....days@ __% -..-$,IT $TOTAL TAX AND INTER~DUE _..m ••__••••.._$,I ")" /),,../C?~3 ...6>'1._t7///(.~;/--0-/ //'~'_~.~1r~\_f/Q:~..,/~~'"~- ~"'~)~.~ ", z 0 r0s:11s::II 0 »z III~0 III 11»III tzjr~t -l "11:r:"11 0 ~0 0 :II "11 :II »11 11 0'"III 11 >:j ~Z IIIZ»~(f>:JJ0(»r z ...~0 COIII Iz i:; ll>>~~~ RCC-81 (6-70 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS HARRISBURG 17127 NOTICE OF FILING OF APPRAISEMENT ANNA J.CERNUSKA (Executor or Administrator) IN YOUR REPL Y PLEASE REFER TO Inheritance Tax Division j Dear In Re:Estate of __LE_O.:....:N_I_ill_A_J_A_C_KI_>U_lli _ _~~-.:.NA.:....:S.:....:HI::..:N.:..:.G-=.T..::..:ON=-=--__Cou nty -File No.-...:.6.:::...3-_7:.....:1=--8_24-=--~_ MADAM: You are hereby notified that the__O_R_IG_IN_A_L ~__ appraisement in the estate of LEONII,DA ,JACKMAN has been filed in the office of the Re,.gister of Wills of _ County on FEBRUARY 21,,19~,Said appraisement reflects the following valuations: Real Estate __---=2::.=e~,~500~.!..;O~O;...------- Personal Property 2_80_o0_0 _ T ransfers ---;~=c_==-------- J 0 inti y Owned __----'4~J_OO_O_._OO _ Tota I ----,;3)A2~'47.Q80~.Q.80L-------- 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 FEBRUfiRY 21,1973 DATE OF DEATH:JULY 21,1971 Note:This is not a bi II. Signed __----=.FRA.=:"I:.:.:~C::.:E=S=--=.LEO='=---_ CHIEF APPRAISERTitle _ ,-. .;~ RCC-39 (5-68) COMMONWEALTH OF PENNSYLVANIA TRANSFER 'INHERITANCE TAX RESIDENT DECEDENT SUMMARY Estate of JACKMAN,LEONILDA (Last Name)(First Name) DATE OF DEATH 7-21-71 (Ini tial) FILE NO.63-71-82l. REPORT OF INHERITANCE TAX APPRAISER I,the undersigned duly appointed Inheritance Tax Appraiser in and for the County of__W~A....;;S..:...H-=I..:...N:..:.G-=T:..:.O-=N:--_ Pennsylvania,do respectfully report that I have appraised the real and personal property as reported in the foregoing return at the values set forth opposite each item in the last column to the right in Schedules "A","B", "C",and "E". Dated:FEBRUARY 21,1973 FRANCES LEO,CHIEF APPRATSER INHERITANCE TAX APPRAISER REPORT OF THE REGISTER OF WILLS I,the undersigned duly elected Register of Wills in and for YlASt:Tl\1C~TCP 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 VALUE AS REAPPRAISED $-------+-- Valuation of life estates or (*)As evidenced by Charitable Exemption Certificates issued by the Secretary of Revenue. COMPUTATION OF TAX $--------+-- $--------+-- $-------4--- $-------+-- $-------4-- $-----_---1._- 10% 15% * FOR USE OF REGISTER ONLY Tax on $---------t--2% Tax on $/R)o' Tax on $---------t--~ Tax on $---------t-- Tax on $---------t-- Exemptions========~=Total Estate ---+.__ TOTAL TAX 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 $--.J AMOUNT OF ESTATE TAX ASSESSED $------1L- Estate tax paid $---'l- BALANCE DUE $----~~ Add interest at rate of 6%from t= -------tto-----$---------<. TOTAL TAX BALANCE $-----~ 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. r ~'====/==================== Will lAdministration\No.Year . IN THE MATTER OF THE APPRAISEMENT OF THE ESTATE OF ..LEONl.L.D.J\.rAGrcNAN Deceased Late of ..FA:"LOv~fIE.lp.',['t·rp... County of\JASEIKGTON. Commonwealth of Pennsylvania REPORT AND APPRAISAL " "iJ f ...~!r'un:.:~:\~\;_.2 ..~FEBRUARY 21",1973. COMMONWEALTH PENNSYLVANIA DATE,.OF .................................................................,.......................,DEPAP..T!\-!E!':T OF REVENIJIE WASHINGTON , RESIDENT INHERITANCE TAX COUNTYBUREAUOFCOU~TY COLLECTIONS ................................................................................................. HARRISBURG,PENNA.17127 APPRAISEMENT FILE NO....~~:?~.~.~...................................................... Whereas,LEONILDA JACKMAN late of ..............r.A~~P~~I.f.~1.:P.....~~.!...................................................,........................................................................................................................................... in the County of ............................."'i.A§~P~g.'J;QN ........................................................................Commonwealth of Pennsylvania,having died on the ........................................................~~.t...........................day of .........................~JJ.~l ......................................19..71...,seized and possessed of an estate sUbj~~t to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore,I,FRANCES LEO 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 AppraisementDescriptionofAssetValuesMadeforInheritanceTaxPurpoles REAL ESTATE,$ SEE SCHEDULE "A"OF APPRAISENENT 28al)00 00 .-RERSONAL SEE SCHEDULE liB"OF APPRAISEHENT 280 00 JO INTLY-oVJ~JED SEE SCHEDULE "E"OF APPRAISJj·iE;NT 4,000 00 TOTAL 32,780 00 , . - fonn~;v~fhbl:~::rh:,w<>rrlacgrt'U°~~'~:;o~e~~y~~7~~~~7~is~~~el~n~!~ Appraiser .................................................................................................................................................................(Number and Street) ......................................................................,...................................,........................,Penna.(Post Offlee) \1ASHINGTON County . t. RESIDENT INHERIT.\NCE TAX APPRAISEMENT Estate of L.EONILDA JACKNAN Deceased. Late of F,MJ.P.Y.1f.~g>..rV'/.p..". Date of Deatlz,JULY .21.,197J.. Appraisemcl!t Docket Vol.,}.~:':. P~ge,..197~9 No 63~71~24········· Filed in Register's OfJice,~~:t:>.~.'.19.'l?.. A11WUnt of tax due,$. DEPARTMENT OF REVENUE Received, Examined and Approved,......"......""""""'"'''''''''''''''''''''''' Wrote abo,Ht Appraisement, Appeal fl'om Appraisement,.. Entered and charged,. \1 IRCC·4 (8·68) No·8 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE11654OFFICIALRECEIPT0PENNSYLVANIAINHERITANCE AND ESTATE TAX RECEIVED -TJHlltrY-.JlliBE~--8.mLlJlt.t.l.Ol{h-~-~-~-~-~-~...~-~-~-~-~-~-~-=-~-~-~-~-~-~-~-=-~-~-~-~-~-:"':-::':"'~-~-!.-"-::':-!!;-""""-'-"-!!.!-!!!.:e.--",,-o.a...-dolla rs representing Pennsylvania Inheritance or Estate Tax due from the following estate:From:Gt~r-:INirl~~l-,.pJ~ING--rnIi-DlJ},rlb±AII~.~---"'::':=:""':":~=-':':':::':':':"":':':':::"":':::==:"":=':"::":"'------I~1 Address-u.........ILJt..~-----l 2%Tax on $_$--------.r.:J MONONGAHELA PENNSYLVANIA 15063 6 %Tax on $__5"..8c..2....~3~6'--__$_~34:!!L+-•.;l.9~4----n File No.63-7]..824 Date of Death_I--.............I---.I._---i 15%Tax on $_$--------101 $·--------·0 Date of Payment ----"'~~.g.(~--:I,...,.....-dz4-;~----___1 Name of Decedent ----:LE~UU)A--JW:a<WUl.---_l %Tax on $$----------Id Estate Tax,Act of May 7,1927 County -----.JiA.SWOO~Obl~-------..j Remarks: JMO -' TOTAL TAX CREDIT Less five percentum of tax if paid within three months after date of death Plus interest at the rate of __%from _ to _ $----.3~4h.4;l9u:t4~---1\'J $_---"1......w7l.Jo,Sl--n $,---------111 SEA L TOTAL AMOUNT PAID,...----....,..$,======3=3==:,l=9====lgl NOTE:This.Triplicate Receipt ta be retained for audit purposes.'/1/'.. 38 ...197..9 Received by"---<:-'::J,...t:.J,/J/Y"-"!~l.J _...;'..{) NOTE:In accepting the transfer Inheritance tax an future estates,prior to the death of the Ii e \'\..I (Sig nature ). tenant or tenant for years,as evidenced by this receipt,It is understood that the Commonwealth shall .'-....-, not be precluded or prevented from hereafter assessing additional Inheritance tax at the death of the "..".,'/'/,_-,.i.-'ld (",:",.'. life tenant or tenant for years whenever it appears that such additional tax may be legally due and \')(Title)'\ ._.cica=lIiieciltlb~le~fiar=a~nDYillrej[asi:°iln.wh:lat:itsiloei:jvcer•.EO::i.:ZElCDlLl_i::Bl_EElI:B__:3,:l,ml=:r:::ta::s:,m:z::J::ml:Il:lIlll:I::a:a:E_:Il[]!l.ajj·~5c::::llm::lilJ[I:I~_:IB:m::::::l_I:i!:_tilJf~ RCC-4 (8-68) No·8 -----~---.~.~--------..--~-.............--..----.----...,......----.---------------.----~~--._.....--_._-~............-••!. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE11707OFFICIALRECEIPT0PENNSYLVANIAINHERITANCE AND ESTATE TAX 2%Tax on i RECEIVf.O...ONE !ImiBKI THOUSAND SIX HUNDRED and ANN J.CERNUSKA From:ATTY.D.KEITH mLENYZER 411 \>JASHINGTON AVENUEAddress ---I OO/lOO......-....-..........-----------.......-doliars representing Pennsylvania Inheritance or Estate Tax due from the following estate: $--------$--------·Ir.:ll File No.63-71-824 CHARLEROI,PENNSYLVANIA 15022 7..21.71DateofDeath ---i 6 ~T $ON ACCOUNT $1,684.21'if)ax on ----=--------1111 15%Tax on $$---------11'1 $--------.iI'.lI October 18,1971 Date of Payment ----------------1 LEONILDA JACKMAN Name of Decedent -----------------1 %Tax on $$---------lId Estate Tax,Act of May 7,1927 llASItINGTON County ---------------------1 Remarks: Jf.fO -,~/f 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 _ 84.21 $--------Ilil $1---------1l!I1 1,600..00 $,========:II:!ITOTALAMOUNTPAIDSEAL,.....-"NOTE:This Trip~c?te Receipt to be retained lor auJ~"JsS7....9 ()ibLi'-:(. .....\-(,'\1/.'.'",Received by ~_x../,)..<..i-<'.I,-~""j /)vV NOTE:In accepting the transfer inheritance tax on future estates,prior to the death of the l'~'J""~(Signatu,7e)JllaJ'/' tenant or tenant for years,as evidenced by t~is receipt,it is understood that the Commonwealth shall,;~,J ./,J not be precluded or prevented from hereafter assessing additional inheritance tax at the.death of t~e--'..".•./,J.(A..,.-~'.'~U .A life tenant or tenant for years whenever It appears that such additional tax may be legally due and \0'\(Titlk collectible for any reason whatsoever.J ~ ~I..\_..-..._~~-__....-M .-------,----_--__- - -------~-"---~------._--~.-.......,- iltI •I '1;'111I1'""" 4 6 ~~•,J-r.....:3 9 o 0 1 1 1 o 0 6 6 5 0 2 4 7 6 1 2 4 o 2 6 1 o 0 1 8 1 5 o 0 5 o 0 1 6 o 0 1 0 9 8 0 'Z 4 5-' 2 9 0 :3 o 0 5 0 o 0 6 0 o 0 4 2 6 2 1 2 o 0 6 500 2 5 2 :3 5 7 8 0 2 :3 4 5 6 420 2 1 5 0 1 5 o 0 1 2 7 5 1 6 o 0 4 o 0 1 5 0 0 o 0 1 0 0 o 0 1 9 o 0 :3 500 4 6 5 6 o 9 .'-'I' ~:( ,. ,~.,. ~ I \\ '-, $22,4730 63 $22.571 0 6h 5607 081 5607.81 5607081 ,t, Execntrix Account of_~Ann~~a~Jo~b~e~m!.!.u~sii!k!:.5aL---'-__ In the matter of the:_--::.F.::i.::..rs=-t::.....:::an=d.....;F1nal~=~_ N 63-71-824,o.,:::!..L_:=J..,l~.!:.H._ '.:,\ ADJUDICATION AND DECREE deceased. IsonUda Jackman, I~', J.1 ;•l ~ Russell Marino,Agent,transfer inheritance tax, including tax of estate and jointly held bonds,$3.22 Interest from 4-22-72 t03~7-73 017 Anna,'J.Cemuska,daughter,1/4 residue,including a i ot holls~hold goods and furnishings,held in kind and distributed as 'such at the appraised value, Gustina J.R08Si,daughter,'1/4,residue,including a i ot the household goods and~misbings,held in kind and d~stributed as such at the appraised value, Attorney_......:-__~D~o_',K~e~.i~th~M~e~ll~'~e~n:!oLyz""e~r"---_ '.t':0. Balance _ Deduct Clerk's Costs &ReceiptS---_ SCHEDULE OF DISTRIBUTION Balqnce per account _ Additional debit asked at audit Additional credit asked at audit, ESTATE OF ,'. IlaryJo Jlann,daughter,1/4 residue,including a i of tile household goods"and furnishings,held in kind ,and distributed as such at ''the apprais~d value,,'. ,.And now February 28 ..,19.1L,this matter came on for'hearing, audit and distribution at this session and testimony taken;and thereupon,upon due consideration thereof of )i'e bolance for distribution in the hands of the Accountant is determined to be $.22,73003 ,,and the account is accordingly confirmed;and it is ordered, adjudged and decreed that the said balance be paid out'by the Accountant in accordance with the, ,schedule of disribution hereto attached and made part hereof,unles cepf h eto be filed sec.reg.or on oppeol be token herefrom sec.leg.r/ DoJn1zi1ck Jaclanan,Bon,1/4 residue,including,a i of the -hou~ehpld goods and furnishings,held in kind and distributed as such at the appraised value'g "5607.e}. " ~I,•1;,1 ~ ,.'4.'"i", .,.,r ,. .\. ;, ,;;, " I·~•t In't4~'atourt 'nf atnmmon Jt1~un ,of lIanlrtnirtnn,atount!}, 'tnnsyluania,®rp4ann"mour!iittinwn " '., ": 11.',: ". ~~:j,:'f ~.," 11'1''"'f .,""~,.,1 ..p to,)~~.~,:f;.~·t'~~)~1!~':.v:~;Y'."~:":"J \'~.', 11= N~17635 Washington,Pa.,~l~~,19Jq, OFFICII OF CLERK OF ORPHANS'COURT DIVISION Ct-u Total ..•- -."c!2 <;t - ~2 ~ollar8 Per /1 ,J;;./v -. -l .00-\ ,3 0 .00 /.hOOQl:)Q 32,18 0 .001 FIRST:I (direct .the payment ~ut of my estate of,the ,;exp¢nses of my illnes.s ,clOd f~nera1..,,'',,'"','c '"','.•. ,,""'.'.:i :',,','", "".'~ "l r •I.) tt.1.~-.i :(~~ LAST WILL AND TESTAMEN'T','", I,LEONIJ.,DA JACKMAN~Qf Fallowfield Town~hip,W~shington County',Pennsylvania,do herepy'make my Last Will Clnd..TeStament and revoi<e all,Wills heretofore ~ade by me. ., • ,.,.I),.',~.,:..' IN WITNESS WHEREOF,I,'LEONI)'..DAJACKMAN"the T~,$tatri:x above named;'hClve hereunto s~t:my hand andsea'l this 30./(lay of January,1964~'"' )\'1'".;. .f\'.(.ir'b .': '.'~-,:j ,...:".. \' /, " .,','•i,,··... •I".ll: ...",.'~.'P}1ql~sped'a.nddeclp.redby thea~ovel1all,led; for her Last ,Will and Testament in theh~re~ritqsubscribed~ur'rt~mes 'at "herpr~$ence of the saiql'es:tatrix an'd·bf THIRD:I cOBstitute ~ndappoi9t I!1y dp~ghter;Anna J. Cetnusk~,,as Executor ofthi~myr.Clst Wi,llandTestament.If,she is not ltving at the time of'my'decease,I'then ·appo'int Mary j.' Manl?-as such ExeGutor..Neither of myExecutors,sJ;1~llchilrgeany compensation for thei:J::',service~~:;.,.,'"';.",,\' ,~ SECOND:All the rest ,residue 'ppd reIl1ainder,O:f"rlty est~te, real and per~ona1;;,~-I give,devise,'and'p~qtieath to my childb~n,' namely,Mary'J.Mann,Ahna··;:J.Gerl1qska,Dominic~,Jackmanan9 " ddstiria J~Rossi,iheir heirs and ~ssign~,share and sba~ealike. ',,:."'- ~~gned,seated, Leoniida Jac'ltinan,as arid presence Qfus,who have request thereuntO in the each other. ..' .,I t. \ t, , 1 '..'",j.,h ~',I /, ",; .~-;'---. l\ffi~uuit (@f 1£xl'rutnr ®r l\~miui!itrutnr 1.An im;enfory must be filed within three months after appointment of personal representative. 2.A siipplemental 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 §tttb~nf 'tttttllylUttttttt } <!tnutlty nf IItt114tttgtntt 1111: Personally before me,the undersigned authority,a ...J:L9.t~I):P.~.QJj.<;.in and for said County and State,appeared An.na..,J.•....ce·rn-u.s-k-a·;········.··who,being duly sworn according to law,deposes and says that he is the executor or administrator of the es- tate of LEONILDA..J.ACKMAN~deceased,that the foregoing schedules constitute a :z complete inventory and appraisement of the real and personal estate of LEONl.LDA..J.ACKI1AN.., ;::?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 3 2'undersigped·to be the fair value of said items as of the date of the decedent's death,based upon a~.~§-just apprrti~~~nt of each item made by the above named Exeficutor ~Administrator .. o'';'~,:,S -..d"1.'b d b f h'/..:1 vcJ a /J J::J ~~•worn".4n mV~CT1 e e ore me t IS .>/.}I ?//~~0 d"f'JJ~t"rJL)-1917).!.c../.Y?:"-<:'''Y.".<.../l,""7L,,-:-.~.<'-·/C/,","L_~.~~,ay.-::o ;··~C··~·:..f.~...ecutor '»~~~~~",..~?-UI.1(~·Ie·&!···. , . "'":r Z •r;.r..~~8 ."ADDITIONAL INSTRUCTIONS """a•::J_0 <D 0-..c"";:;'< ~ttUttttnry ttttb .Apprtttlltmtttt of the goods and chattels,rights and credits which were,of ······..·······Leonild·a···Jackman··..···· ····..·.late of F.al.l.ow.field...T.o.w.nsh.ip.,.. Washington County,Pa.,taken and made in conformity with the above affidavit. DOLLARS CENTS 28000 .. ALL that certain piece or parcel of land being a ~ part of the Marie Elias Plan of lots situate in If Fallowfield Township,Washington County,Pennsylvania and being more particularly described in the ' Recorder's Office of Washington County,Pa.,in tIDeedBookVolume732,Page 133 ~25,50~00 ALL that certain piece or parcel of land being II a part of the Marie El ias Plan of Lots si tua te in Ii Fallowfield Township,Washington County,Penna.,and' being more particularly described in the Recorder's Ii Office of Washington County,Pennsylvania,in I' Deed Book Volume ,Page n 3,00900 Household Furnishings See Schedule A attached hereto and made a part hereof 'I "I !I hII ,11. 1 ...",I \ Iilj "',.II .. 1 {J r : ~' Re fr i gC r:1t or.., Dinette set,buffet Couch Mr.and Mrs.Chairs Television set Coffee table 2 End Tables Drum table Desk and chair Four-piece bedroom suite Twin heds Chest of drawers Freezer if T"'o,•.1-.".'.'"...'II r 1,).1.l.<.tu J..L: Spin drier,wash machine Ii i'.I\..;:", i ·1