HomeMy WebLinkAboutOC1971-1215 - ESTATE OF ROSSFORM 67 REG,WILLS
REV.1-50
b /<-{p 3 -7/-/~/"'s-J
!\ppliratinn fnr 1Jlrttrrs nf !\~ministratinn nn tqr
Estate of .Hav..en C Ro.ss aLkLa,J:l C Ro.s.s.,a/.k/.,a.,.Hav.en Ross ,
late of......No.~.th ....6.e.:thl.ehem....:r.O'Y,{,n.s.bip..Was.h..Cg......r.a..•.,Deceased.
",
Before the Register of Wills of Washington County
personally appeared ~~JJ.~g,~S...4l R~l~$.s.ng ~ayJ:'.~R J..9.n~$...
who,being duly sworn deposdCand sa~that..Hav.en C Ro.s:s ..
70 h'hie 1 f'l ..1 'd''D D ?u·:tY.~nn p~15330a~e ,avmg ll'l'.....ast amI y or prmcIpa resI ence at.~fif M.:,..gu :':':M.M.tr M1 ..
(Street and Number)
fNQr.:t;.h..J~.~!h.;t~.h.~m rQ.~.h;t.P.,Washington County,Pennsylvania,died intestate
(City,Borough,Township)
at...~~~Bi~g¥ga B.il~~;t.~~J ~~.~F..~on the 4.:tmay of QQ.:t;.QQ~!:..
t ,4:30 A '.A.D.,19 :7.1 ,aL ,!M.,possessed of personal estate to the estImated value
$2.,5,.,..QQO.•.QO ,and of real estate in the 'Commonwealth of Pennsylvania to the estimated value of.-
$J1Qne ,situate in ..
.....~,.
The nam¢s and ad,dresses of the decedent's surviving spouse'(if any)and other heirs (including
heirs by adoption)are as follows.
RELATIONSIDP RESIDENCE
....R9.mg;h~~R S.w.~gl.e.;t ~s.is.:t.er;Rlt P.?,~;.9.h~y.'::'..'!.~p..;:.J ~~.'"~.?330
,.....4~!:.~Jh J:9.~.~§..-.sis.t.er R...P..•.?.,.~i..gh:ty.~.fQy.~..,p.~lS.3.:3.P
....W~.!!~9..~§..,)~.Q§.§br,o.theJ:R~P.?.,.~.gb1;.Y.~.f.Qy.*-.,.r..~.~1S.3.~0
....M.g~j,Qt.;i.e..R r.bi.llip.s niece 408 Bur.ton..Av.Q.•..,.Wash P.a 15301
.....................................................................................................................................................~.
........................................................................................................
.......................................................................................................·..·..·..· · · · ··~·;·:i ·..
.........................................................................................................................................,.
That deponenfsMiao;~r 21 years of age,resides at.......~i.gb:t.y..~£OUr.1-....P.a•.~.R.....D.;:.:.2·t..·..15.330
.....~re · · ·..·..· · ·..· ·..· ··8 · · ·..
HxKcitizenSof the United States and a resident of Pennsylvania,and respectfully ap~for Letters of
Administration upon the Estate of said decedent,no letters having been previously issued thereon.
Sworn and subscribed before me this 3.:J::Q .
day Of..~c.e.m.b.e.r.,A.D.,19 7.~..~.;?4~........................................................................................................................
REGISTER
COMMONWEALTH OF PENNSYLVANIA}SS.
WASHINGTON COUNTY,.
And now p.~~~Qe.r.3.*-Q ,19 1.1..,comes WA1.la.~.e S .Ro.s.s a.nd..La.w::a..R.Jones
who being duly sworn doth depose and say that.:t;h~.Y.will well and truly administer the goods and
chattels,rig4ts and credits of J:J.ay.en C .Ro.ss ,deceased,
to the best o~.h.~;!..*-.skill and judgment in striot compliance with the laws of this Commonwealth,mind-
ful of the laws relating to inheritance taxies.
Sworn and subscribed before me this 3.:r.Q .
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REGISTER
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!~APPLICATION FOR
Letters of Administration
ESTATE OF ,
Haven C.Ros:o~.alk/a,H.C.Ross,at kia,
..J:J.ii\v.~.:n RQ§.§.
.Deceased
.,
Letters...............R $..
.·..·· ..·········..······;···$1 ;..~
......................
Extra Alias $.. ...~.~.. ..".....
Certificates ....../.~.~.$!......!!..?..
Renunciations :$.
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ESTATE OF
................................................................................Hay..en..;.C.•....RQ.~~DECEASED
The undersigned S.J,.~.t.e.t'and heirs
of Ha:v.en c..Ros.s .late bf N.•.....a.e:t.b.le.bgm r.9.:w.n~.hi.P..,W9:~.h.It.G.9.,Pa•
deceased,hereby renounces her........right to administer on J).j•.~estate
and respectfully asks that Letters of Administration be issued to W~J,.J~9..~§R.Q§.~.!.R.~P!t ?!.
....E.i.gb.:ty.:::.f..9.y.+.:......p.~.....,.....;I:.~s..3.Q.,.....~n.g.......~y.+.:~....RIl ....J.9..ng§.,....,g.It .P..lt ?,.....?..;.g.h.~.Y.:~fQ:':!~.".:P.~.15330
Signed in the 'pre~ce of:/J
2LZ..7.1,"..L ...~.~..!).~.a~r
....................................................................................................................
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WAS\\\N;:;TOH CO ..PA.
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Q!nmmnumralt4 nf 'ruullyluauia,t SS.
IIUS4itlgtl1tl Q!l1Utlty.\
I,Euaaell Marino ,Register for the Probate of Wills and Granting
administra t ors
.Letters of Administration in and for the County of Washington,in :the Commonwealth of Pennsylvania,
to Wallace S.Ross and Laura R.Jones
R~ll and singU;lar the goods and chattels,rights,andA;K A Haven Ross
credits,which were of Ha vent C.Ross,A KIA H.C.R~$6'IafWashington County,deceased,
GREETING:
I I I H jRossWHEREAS,thesaid Haven C.Ross,A KIA H.C.Ross,A K A ~~I:!-v@n late of(
Noeth Bethlehem'lTownship in the county aforesaid,lately died intest3l1:e
(as is affirmed),possessed of divers goods and chattels,rights and credits,within the said County,
./'
Russell Marino
by reason whereof the power of granting administration thereof doth belong ,to me;I therefore,confiding
in your fidelity,do by ,these presents grant unto you these LETTERS OF ADMINISTRATION,here-
by committing unto you full power to administer the goods and chattels,rights and credits,which were
of said deceased within this Commonwealth,you having taken and subscribed the oath of office pre-
scribed by law;requiring you to well and truly administer the goods and chattels,rights and credits,
which were of said deceased,and to exhibit a true and perfect inventory thereof into the Register's
office,at Washirigton,within ninety days,,and to render a just 'and true account of your administration
at ,the expiration of .six months from the date hereof,and to regard and comply with the provisions of
the laws relating to inheritance taxes.
IN TESTIMONY WHEREOF,I have hereunto set my hand and
caused the seal of said Office to be affixed this 6th.
day of December in ~he year of <!~1~Lor.cl one.thousand
nine hundred and Seuenty On e
..._?zz~
RUSSELL MARINO,Register.
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1Kunm All !I~u iy wq~l1~'r~l1~utli
Haven C.Ross,a/k/a,
::":f~~;:;~;;::;::'~':'~:~}No....of 19.
KNOW ALL MEN BY THESE PRESENTS,
That we,Wa.l.laoe..S•....:RQ$.$.,~W';'.~...~._...J.'o~~s....~~C:i ..1:11.E!..PJ:1:i.~~<i,..~.~C;\~~~F'i.-.~.~.~~ty
....a.nd Guar.al'1t.Y ..COmpany,a.a.lt.;h!~Q.t'.~..,.:.~J;y.~.~~cl .
all of Washington County,Pennsylvania,are held and firmly bound.unto the C.ommonwealth o.f PeJ1~~I-)~~27 000 00vania,for the use of those interested in the estate,in the sum of t'we.nt.Y ..S.eVep....ThQ~.$~llars,to'•
be paid to the said Commonwealth,to which paymen t,well and truly to be made,we do bind ourselves,
jointiy and severally,for and in the whole,our heirs,executors,administrators,successors and assigns,and
each and every of them,firmly by these presents.Sealed with our seals and dated the .....3.r.0..day of
.........Dec.exab.er A.D.,one thousand nine hundred and .S~'V~~~.Y.~()~.E!..J+'?TO
THE CONDITION OF THIS OBLIGATION IS,That if the above bounden ..
...........Wal..1.~e.~..S R9.~.~~4...~a~J;~R~:J.9~~5..
Administratll(ors or any of them,shall well and truly administer
the estate according to law,this obligation shall be void as to those who shall so administer the estate;but
otherwise,it shall remain in force.
Sealed and delivered in the presence of:
__aL~_;fi~_~__.
I....--.---.-.------------------..---.-.-....•surety in the sum of $ _ _on the
administration bond in the estate of - -..---..-------_____,say that I reside at
-..--...---....---.-.----.-...--..-...--..-........-..,Washington County.Pennsylvania;that T·am the owner of real estate.the
title to which is in my own name and duly recorded.situated in .
Washington County,Pennsylvania,worth above all encumbranceS $.._::.::__.._~;and that I am worth the
amount expressed in said bond,over and above my just debts and liabilities..
----------_._---._-+----_••_••_----••_-~~-_._------~.•-----._-_.------_._-----------------------------
Street
&tattmtut of &ufdy
P.O.
.I.----------------------------------------------------------------,---.-------..------------------------•surety !n the sum of $on the
administration bond in the estate of ------------------------------..--------------------------------------.------,--------------..,say that I reside at
-------------------------..-----------------------------------------------------------,Washington County.Pennsylvania;that I am the owner of real estate thev•
title to which is in my own name and duly recorded,situated in _,:,;__________ .
Washington County,Pennsylvania.worth above all encumbrances $...--;and that I am worth the
amount expressed in said bond.over and above my just debts and liabilities.
···············_··••••••u •••••••_••••••••••••••••••••••••••••••••••••••••••••••••••••••••••_••••••••••••••••••••••••••••
._-------------------------------------------------------------------------------
COMMONWEALTH OF PENNSYLVANIA.l SS:
WASHINGTON COUNTY,5
.Street P.O.
And.now ____.__19__comes _..____..
who being duly sworn,says that he is acquainted with the financial standing of the securities to the within bond;that
the said obligors have each executed the said bond and th'lt the sureties thereto are the owners of real estate in their
own right of value more than the penal sum of said bond over and above all incumbrances and exemptions.
Sworn and subscribed before me this _
day of ...__.. ..A.D.19 __
1.
jl
~3 -7 /-/2./s-
No ~7.'-.
·.1\.~miui!itrntinu 1Bnu~
IN THE ESTATE OF
Haven C.Ross,a/kia,
H.C.Ross,a/kia,
.Hav.eIl.-.Rass _.._ _ _
And now p.~.9..~~~.f!l.~...3.,19..7J .
Bond app-r:.oved and Lett@'rs issued to
~70 _
1">rn ::0el)G')C c::;:,
Wallace :S.(;f(cSss and 1
ta"lira···R~·.:'":Jpna:s···-········-···-t-·'iT····-··.~...
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w.b.o.w~r.ct;::.ctuJ.3:Q.ual.~.f1:Erd - .i!_...\,,..1g~!~;.~~
Ru~REJiI;=Ms.r1:no............-...._.::n:-r-:-.."C'••••-•••-••••••••••••••-••••••••••••••••-?"(i;-'+""Register
Bond Book 9.«-.................Page 2.7.0.
-•.l._"SADZIK PRINTING ~.9 DONORA _
Adam L.Sanders-B'.A.Franks
A~~orneys a~Law
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Date of Death:
October 4,1971 ~p(-(/'/~&6~~0'-//-/o2JMi\ffibuuit (@f 1fxerutnr ODr i\bmiuistratnr
j
~tnu of Jrnnsylnnniu.t 1l6:
Cl.tounty of BusQington \.
Personally before me,the undersigned authority,a Na:tar.y.P.:ublic.in and for said
County and State,appeared Wall.ac.e S Ro.s..s a.nd Laur.a R J.one.s who,being duly
sworn according to law,deposes and says that t hey a~he ~administratorSlf the estate of
...................l:Ja~.en C Ro.ss deceased,that the foregoing schedules constitute a
complete inventory and appraisement of the real and personal estate of..Hav.en C Ross ,
deceased,except real estate outside the Commonwealth of Pennsylvania;that the figures opposite each item
of real and personal estate in the foregoing schedules are determined and stated by the undersigned to
be the fair value of said items as of the date of the decedent's death,based upon a just appraisement of each
item made by the above .named ~Jc.Administrators;~StI~,J
.Sworn and subscrzbed before me thlS.../z...~.J_-4~"a.::Ii:::Z_~~=--...4_z....~c..J.:.:=...;~~:--_daY~f~,:~............_72..•~~···~t;;,~;·s..·-
...... ··~..·..·......··..........N........·..·..·..·P..·El·~
My:om.E~p:Mar.26,1975AD~~I<~·NAt INS9:rRUCTIONSWash.WashlCounty',P~nn~~.h ..1.An mvemory must be filed WHam tree months after appomtment of personal representatIve.
2.A supplemental inventory must be filed within thirty days of discovery of additional assets.
3.1 Original and 2 Copies and 2 RCRI-34,Under $10,000;1 Original and 2 Copies and 2 RCRI-33,
Over $10,000,including Copy of Will;1 Original and 3 Copies and 2 RCRI-33,Over $50,000,in-
cluding Copy of Will and copy of Federal Estate Tax Return.
REFERENCE FOR ADDITIONAL COPY
Act of 1947 P.L.513 Sec.5.2,72 P.S.4844.2
lIuututnrg null !\pprni.5rmtut of the goods and chattels,rights and credits which
were of Ha~.en C .RQSs Jate of ,N.or.:th B.eth.le.h.e.m.:co:wnship ..
Washington County,Pa.,taken and made in conformity with the above affidavit.
DOLLARS CENTS
Personalty
Savings Account No.83-2035637-Pittsburgh National
Bank,Washing_ton,Penna.------------------------780.56
Savings Account No.83-2046424-Pittsburgh National
Bank,Washington,Penna.------------------------
Amount of 1971 Income due and rec'd from F.L.Ross
Trust-------------------------------------------.-
310.91
504100
88 shs.Allegheny Power Sys.com.stock @23.375-------
587 shs.Pittsburgh Nat.Corp.com.stock @3.5.50------
4 shs.Col.Gas &Elec.com.stock @33.25----------
To refund rec'd by Estate from Wash.Hospital
Extended Care Faci1ity-----------~--------------91.55
133100
495162
160100
I2,057.00
I20,838.50
IH','-----I-
\$25,371.14Total-------------------------
26 shs.'Diamond Shamrock com.stock @19.0625---------
10 shs.Edgewate~Corp.com.stock @16.
Realty
None
TOTAL ESTATE
Personalty
Realty
$25,371.14
0.00
Total assets-------$25,371.14
.-I
b3-7/--/c2!o
Inventory and Appraisement
IN THE ESTATE OF
Haven C.ROSSi'a/k/a,H.C.Ross,a kia,
Haven Ross.......................................................................................................
·Filed ,19 .
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Adam L.Sanders-BLA.FranksAttorneysataw
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STATE OF PENNSYLVANIA,
WASHINGTON COUNTY,~55:
The within named AccountantSbeing duly sworn according to law,depose and say that the above account
as stated is true and correct as ~~_?-y..__.__._verily believe.
Penna.
,q-t-f
Sworn and subscribed be,fore me this j .
19..12 .
My Com.Exp:March 26,
Washington,Washington
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x;/~...1i,.S1~..
Washington County,s~: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 _.~.3..:.7.2 d3L .
Witness my hand rid official seal thiS_._.dl_~.__._.....
day of l..u.~~~.~..,----.-19.?-J..
~.~~_ _.
Register of Wills
..
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\J f'\411 t ,.',1'1 :oj ~
I i ~(/)(/).~.§~!\""1 ...)1:':""'.j L L.,,)...;:a ~!~i (/)(/):~~'l-t !r!SH!~i ~~~T!:~~;eel.,Pt,...~....,.0 0:en 4 9 a 'ti".0 .~Eli~i U ~~~~~OJ,....,Q)~i ,,~
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The Court is respectfu IIy requested to determine
proper distribution in this estate.
qqlaw,i~-JJ~~
Counsel for Accountant
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1.76'
3.75
6~50
l4.0~
6.87
30.80'
'29.92 .
50-?~23
205.80
.205:'8'0
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$25 3zii.1,14:,.:·--".··;t~.~,~,,;,..,".
50523:i.'
-$2-5-',-8-82 >37/.:',,~
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8,5~0.41.t
$'17,'301.96..{:>
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'Total----------_,..1._..;_...
"'S,:..,
..TOTAL ASSETS.""""J~:•.:~-',>?,·,h,'~'}<\"~}i":.t"~.-',':..,,;'".':,'::~,'";~:Bi'inc:i:pal~Personalty
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':.'\,-.ii ,:.:t:;,.~,-,:.,~.:.."..:"Tncome::'Personalty "~:~..~-<~.::&~~:~':;<;..~';"::,':.-..,.,:~....\.,~,'.
~;T6talE~tat~---;~p'\'ir},tgi'R:"·~ct~edi~t~"cii,ilmed-...~ri·J:J ~,~j.,~\'{'):""t'f'..,~'l \..\.-;~..-i,i..···~rr~';.·!:_'~~~ti~j,t'";;·~';~:<,.,.'",.'ll:>~-'.~,'·~
.·".Balance Due------··..
Pitt..s~Nat '1 B~!lkdivid~nd check
.~"--"
Allegheny Power <Dividend
Pitts':Natli"B?-nk",dividend
.'To.~aiiibunt:of Invel1to1·}1.and 'apprais~:m~nt·.·'f'i~l~'d '.;..r·
,;'':""~'-!~':',~,:~\.~!:'~:AI.l~9I1eri}1.Pdw~:t Di.v.idend'~~{~t·~.~~~gh:'·N9-,t~ll.:iBan~·Interest-Per.
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c't;t~1:Sb;;i:9ti.'~:~}~:~1,Bapk Int.1'.Vi'vos Trust
.';'e01 .:,Gas dl"i5dend1",;~:":~?',)',.........~"..'
.:~dge.V£~t e7:Cdrp..dividend.-.'~'~.:.':;:~':'"..,I51t~ond Sharii~o~kdividland
31
Jan."11...,'....:.
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•H~ien~ROS~:,ae'c'ea~~d.~'lat'eofi;North'·.Bethleh~TOwD.shili,.
;:~'-,f:,''i:...'.''i~}:1:'/.'.:;','".!-".wa~hi~·g£g~:-:~~()ll~·tY..F..~ennSYIVani~.'"
,--','<"~"'"~:'~':,.<"~".i··"'",.;\.)~tTh'e',ac661.ltlt'antsa.re ..charge(f.·~s f~i16ws':'
.Dec;_.J.4
De6.•·14
Apr ···.7.~,'''i ,.':',.•..'.'"',.'
'.;c"':;'j~(:t.,rDr~·F ,~~.:;Ef{"<~,';
The,First and'Fin~1~Account::o£'·W~11ace...S.,RdSS ,and L.aura.R.J;.~?es,
'.Ad;Jiriist:ra£ors·~or';~the:E·§~t·~·t;e~I;.8f;,:Haveri:;·C.';-;~ROSs;'.a!k/a,,''.H.:·\6~Ros s}:
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as,~fo~llows:.:
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197i:.j-c;u·:r mill ta;c~;~'
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.medical'
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·...medical
'11]"63..1"84.
.2.00
£'i liD:g''.iInie.ilt·ories':,.J.oo
d~bt'~f.de¢,edent:~~,·Yr.1 '1
Int¢r'~VivC?~:'Trusteet'fee 400 '008I~r.lriter..~v'i';QS Atty."r ..1'f~.~.",?eb:t:o:(dec'd7.:04°1.0°."
',:1400.'r '.
:.n<?t~rYfe~~A~¢t.&D;&)i..·.'~.OO
I"5"':2,1,~f
4.73..1 .
','6'50 -00':;:..f"·
650.00 .r
1,300.00".I
Il·OO
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$8,580.41 .,I.I'
,.":,
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_.
Russe~~Mari!1o,.R.~g'.
Ba.DeJjt'.'of Revenue
':,,'.."......"-
.;:--:'.
W~11aceS.Ross
'r'''.;'.~"'7 ,,\.~
Malfolni.Morgan,T.·Col.
He,l,en ,Bev.eridge·.....
,"-.,-..,...'.....\...
Kurtz ~·~9ri,.~S:O'.i/"'}~<.."
;:'L~i l~J,~{(t)TL :>',<~,(,;Russel'"l~Mari·:no·f·Reg;,,""••
~·~·1?uCIil~¥:,.I!\~:.;}Co'•.;...',.;',~~"~~.f ~,I;>!~m~iu~.~':"\.'",;'k ~t f-;'~.~.~~'~li -~,'1·"~,.·~(.3",t .:',·f.:~j~.;-Russell~Ma'rino,Agen't f,">ac·C't~.'6finherit~ti&:J::
':f./,','~2
··8····',Dec.'.3J
May
'..
May
".,May
May
.:iJuil~
,~;,
.f
Observer .Repor,ter
WASHINGTON,PENNSYLVANIA
PROOF OF PUBLICATION
In compliance with the Newspaper Advertising Act of 16 May,1929,
P.L.1784,as amended.
Commonwealth of Pennsylvania,County of Washington,SS:.
(Personally appeared before me.a Notary Public in and for said County
and State Ric.haI.d S.•....Cowan who being duly sworn
~ccording to law,deposes and says that he is the ..Vic.e.;Pr.e.si.d.ent
of the Observer Publishing Company.a I"enns,ylvania corporation.and its
agent in this behalf;that the said Company iSi the owner and publisMr of.....
the Observer-Reporter,succ'essor to The Wash~ngton Observer.established
September 18.1871.and The Washington Reporter.established August '15,.
1808,a daily newspaper of··general ,circulation,printed and published and,
havin'g its place of ,busines's at Washington.Washington County.Pennsyl.
vania.where it'or'Its predeces,sors have been established and published
Co:nltinuous'1y for more 'than six months prior to the publication of the notice
hereto attached;that the printed notice or advertisement hereto attached
is a copy of an official advertisement.official notice;legal notice or legal
advertisement.exactly as printed or published iii.th~Obs16rver-Reporter in
its regular editions on the following date or dates;.
.........................De.cember.....8.,..15....anct...-2-2.,.....1·9·7-·1········..·..:···..
that neither thie affiant nOT the Observer Publishing Company is interested
in the subject matter of said notice Or aQ.vertiaing and that all of the allega·
tions of this affidavit as to the time,Pl~ace'3nd char7acter~oy~ubIiCatiOn
are true..'y
.....4r!.r,.d........:.......-:0.:.":':':..
I..
Sworn to andsubscr~fore me tlli~.daY oLD.ec.embe.r..
...........~~.::;I ~~.
MARGARET M.BRADLEY,NOTARY pueue
WASHINGTON,WASHINGTON COUNTY
MY COMMISSION EXPIRES MAY 6,1972
1971
~lf t4:r aruurt uf C!tummuu 'Iran of lJun4ittgtutt aruunty
®rp4uttn'Qtunrt mininiutt
In the matter of the Audit of Account in
j
Estate of Haven C.Ross,a/kia,
H.C.Ross,a/kia,
Haven Ross
TO THE AUDITING JUDGE:
N 63 -71 -12150.__=:--_....:......;=-_--==-==-=_
Enter·__--.:O~u~r'__appearance for ..::A.=;c=c:...::o::.:u=n:...::t:.::a:::::n=-:t:...::s=--_
N.B.-Counsel shall,by separ,rute pape,r,present a concise statement of each
claim,w.ith supporting calculation of any interest claimed.Objections
to an account as filed,shall be concisely stated in a separate 'paper.
Council suggesting proper distribution shall file a separate conctse state-
ment in that regard.
.....'-,
'-,f 'r·'r'"'"r~i L 'f:J,
'72 OCT 24 ptf 4 zo,
RU"(0 r"'Ip ~RINO.~::;<.......L:.L.!..'"".j!Jj ,-
RE Gi STER 0F WI Ll S
il~~S,H.INGTON CO.,PA.
N~63 -71 -1215
In re Audit of Account in EstaJte of
Haven C.Ross.a/k/a.
H.C.Ross,a/kia,Haven Ross
AUDIT.
'rtt~tip~fnr i\pp~ttrttur~
FOR
Wallace S.Ross and Laura R.
Jones.Administrators of the
Estate of Haven C.Ross,a/k/a,
H.C.Ross,a/kia,Haven Ross,
dec'd
Adam L.Sanders-B.A.Franks
Attorneys
~2
o 1-(
(Form where decedent died Intestate)
ltt t4r (@rp~an!i~QInnrt af lIali~ingtau <1tnnuty J
ESTATE OF No.63 -71 -1215~
In the audit of the First and Final
Account of Wallace S.Ross and Laura
R.Jones,Administrators
Haven C.Ross,alkla,
H.C.Ross,alkla,
..Hay..e.n RQ~.s ,.
Deceased
The petition oL Wal.lace..5.•.....RQ.s.s and.L.aur.a R •.....J.Qnes .
(Name of Petitioner)
respectfully repres ents :,,.
(a)The decedent died 'O'ct.Qb.e.,r..A ..,1.91.1 ,intestate and
(Date)
State (l)whether de-
cedent was married or
unmarried;(2)if mar-
ried,whether a husband
or wife survived and
his or her name;(3)
whether or not there
was any marriage settle-
ment;(4)whether or
not family relation,was
maintained until deced-
e,nt's death;and (5)
whether the decedent
left children or issue of
deceased children.
letters of administration on his estate were granted De.cember 6.,~.1.971
(Date)
as per record thereof appearing"in Administration and Bond Book No .'
at page .
Decedent was survived by no wife and no issue--Decedent
was never married.
within(b)At the time of death,the decedent's domicile was ~the Com-
monwealth of Pennsylvania,to-wit,at...N.•.Be.th.lehe11l....:r~JP.....,.Wash".CO."..,..I?a.U.S .A.
(Town or Township,State and Nation)
and residence was at.R D 2.,Eighty..,..£our.,Pa 15330 .
.(Town or Township,State and Nation)
(c)The names of all persons having any interest as heirs or next of kin
with the names of their deceased parents,to show relationship if they take by
representation are as follows:
NAMES Relationship Interest
Of age,sui·
juris,or not,
(write yes or
no).
Name of Guardian,Trustee or Committee,if
any,or beneficiary,manr~er and··place of
record of appointment and is bound suffi-
cient to cover and protect share.
Romaine R.Swag1er sister 1/4 r es.yes
Laura R.Jones sister 14 res.yes
Wallace S.Ross brqther 1/4 r es.yes
Marjorie R.Phillips niece 14 res.yes
State exceptions,if any,
giving names and dates
of death and the names
of their executors or
administrators,or the
names of·their issue as
the same may be mater-
ial.
Describe type of notice.
All of s~id parties in inter'est'are living,except
no exceptions
(d)All parties having any interest have had...ac.tualnotice of the filing
of the account by receiv~ng a copy of the account and notice
of the time and place of audit.
(e)Balance for distribution per Account
(f)Additional debits,not shown by Account
(ltemizelDiV •on p.N.B.stock
Div.on Allegh.Power stock
One addit'-l sh.P.N.B.stock found-.
205.80
30.80·
35.50
$...11.,.3-01,...96
$2.72 .10
Insert word Uriot"where
necessary.
If taxable state wheth-er tax has been paid.
1f too many for the
space.annex a list there-
of;if no such claims,insert the word unone."
If any creditor or other
claimant has not re-
ceived actual notice,thatfactmustbestated.
(g)Additional credits,not shown by Account
6!fg{o/2-To loss on sale of 188 shs.P.N.BA-stock 46~.30
One short cert.1.00
Not~ry fees :"aud.pet.1.50 $..4.1l 80
$..1.1.~.1.Q2 26
(h)Claim for exemption ha~~:n made,and has no.t been paid.
(i)The estate is subject to the payment of inheritance tax to the
State of Pennsylvania.$2422.50 paid-12!31!1971 .
(j)T~estate is subject to the payment of the county 4 mills
tax.1972 and all previous years paid.·
(k)The estate is.......no.t.........subject to the,payment of Federal inheritance
tax.
(1)All creditors (and other person~who have complied with Rule II,
Sec.9),of whose claims the accountant...had notice or knowledge,have
........................received actual notice of this audit;the amounts of their claims and
whether or not they are admitted to be correct are as follows:
All known claims except audit costs and balance of inheri-
tance tax are paid.
Indicate such claims as
may be secured or en-
titled to a preference,and give detailed infor-
mation concerning such
security or preference.
Through their siging of this Petition,'the four heirs at law
of deceased,namely Romaine R•.Swagler,Laura R.Jones,Wallace.
S.Ross,and Marjorie R.Phillips,each elect to take 100 shares
v of p.N.B.common stock --(appr .@$3550.)and 22 shares of
Here insert.a referen.ce Al1e~?ny Power System common stock (appr.@$5l4.25)inkindtoallquestionsreqUlr-J.'~~:te:~~~i~it~o:y ::'~~er:at t eir appraised values,and request the Court to award sameialfactsnotalready! .given.~f none insert the to them as a part of the 1 4 res1due due them.word I none."
If any share has beenassignedorattachedthatfactshouldalsobestatedhere.
Stat.e kind,form.and I (n)The balance for distribution consists of property in kind,form andcharacterofpropertycomposingthebalancehf11fordistribution,and if C aracter,as 0 ows:any part thereof is notcash,whether or nottherehasbeenanye1ec-1 400 h f P N B k @ $!ion.to take such part S s.0 • • •common s toc appr.14,200.00
In kInd.
....-
'.'
88 shs.of Allegheny Power System common
stock appro @
Balance is cash.
2,057.00
Are there any advance·
ments by decedent to be
considered on distribu~
tion and has any distri-
bution on account been
made by accountant to
any distributtee?
(p)None
If prior accounts have
heen iiled,list number
and term.
(q)Give brief location of any real estate sold.
;..None
(r)
No prior accounts
1.
Wherefore your petitioner asks that distribution of principal and income
be awarded to the persons thereunto entitled and suggests that the balance of
principal and income should be awarded respectively as follows (shares being
stated in proportions but not in amounts):-
1.Romaine R.Swagler--l/4 residue
100 shs.p.N.B.common stock
22 shs.Allegheny Power Sys.
1/4 or cash residue
2.Laura R.Jones--l/4 residue
same as (IT
@$3550.--Election
@ 514.25--Election
And your petitioner will,etc.,County of Washington,ss.
The above named petitione\S being duly
sworn doth depose and say that the
::c:~:~e:~r~~:~~;f~rer~:;ie~~~i::~r~e~~:'..()/~..J~Admr.
Sworn to and sub cribed before me this S (Si nature of Petitioner)
.?t:J ~d~L__:'19n~.R..:.~~S':':.Gl~'~.trl/U.J.u:~~~~ya;.~~~~Admr.~:·Notar·Pui>iic M•R..:.•.:.P":'.--':'··;'.J.!..ta~~~:=::'.J).~:::1~&&2!;sIOlliit..::~
My Com.Exp:Ma~ch 26,1975
.Washing.ton,....Washington.,.....eou.n.ty..,.P.enna.
r,
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t
ri
'p,
!
FORM IN CASES OF INTESTACY
NO §.~::..,7..l :::1..~.l.s.~
IN THE
ORPHANS'COURT
WASHINGTON COUNTY,PA.
Haven C.Ross,a/kia,
H.C.Ross,a/kia,
Es-tate of Have.n Ross o•••••••••••••••••••••••
Deceased.
Sur account of ..Wallace S R.oss-and-.
.L.aura...R......Jones..,....Adminis.t.z:ators
PETITION SUR AUDIT
In Conformity with Court Rule III,
Sec.5 (B)
COUNSEL FOR THE ACCOUNTANT WILL
SUBMIT HEREWITH
1.The letters of administration.
2.A copy of the inventory and appraisement.
3.Proof of advertisement of the grant of letters,
if not filed with accountant.
4.An appearance for those represented.
5.Inher'itance tax receipts,if any.
6.Certificate of liens in case any of the funds for
distribution are derived from the sale of real estate.
7.Copy of Federal Estate tax return,if estate is
subject thereto..
8.Signed elections to take in kind,if any.
Adam...L .•....San.der.s.:-::B....A.•.F..~.@~~....
Attorner S for .Accountant.
~9
r't l"r'"f)f •I."to:L j
t720C17.4 PM'4 19
RUS~S ELL Mt\HIN0
REGISTEH OF WILLS
WAS HI NGT0NCO _,PA.
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,"'i·',.:'.'63·,;::"71-1215
AttorneY-':for',the'EstateofHaVen,C~
Ross,a/i</a';H~"C.:R6ss,'a/Ria.,';Haven Ross,deC rd "'.'.'.
,.~'.
,~~'tate6f:
:Hayen ·'~C~··Ross~•...•.a,/~/a/~
H.;..b;.;:·~Ross~'a:!KYa,'"
:Haveri~Ros~·~·.'
Dec~.as~d.
.Y6uare:herebY notified .ttrat.·th.~'·;,~nd~rsigned
~',','.',;;"~.:':.',','",;';/.•:~/"."',''::;..:"';.-'.1-",
'Firsi:;anp ·Final\:A.61p'~nt4ntheqff·4b.~,/6~;.~tli~.R~gister·:C?f~"WilIs
.WaShingtoh~204ht:~',~;k~nns;{~::Clrii:,.~:-i~~':,~~e~;;Ji~6v.e·.caPti~n~4'~·e~tat~'at ...
.~.'./~..~:·.'1.....",.:·..~·i .•'".-"~"~~,"");,.'..,-''-,~~...•, "
,.the'abq";:~.&'\t iB~~t~Jjer ';ti(j~~~k~~~~~I>';~iU .,be .~~~~~li:ed.:fo~
confirmation at·:tli~'t~August Term,'~97~,of;'t~e said OrBJjf\ns r .Court ~
J .;"J.?>:',..,
an~'~00t i.~:,.:w=.ft·.".~~:;;E.'t~t~rDl~d on the...~?tl{day Of:At;gu·~.~;'·~<T972:
un"les's .;excep.ti'qh.s:~ar:e·,.ffled th~reto,.an,d:that th~AU:diit'o£.sai4
.ai;~6u~t;'i l~;~~~~~~~~\';'i,e heId by the sa{~Court the week
'":-,.,~:..,).i';:..\,'.
September 11~'..:A~72 ..~.
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\
ESTATE OF No.__6lool.,'3.J=-=-t-7....]-~'Ju;'2....J.;.z.5 _
Haven C.Ross a/k/a H.C.Ross In the matter of the 'First and Final
aJk/aHaven Ross,
"
Account of '',Wallace S•Ross &Laura. .
deceased.Adm;n'9±.rat·ors
ADJUDICATION AND,DECREE
.-,'t -1'l-
And now October 24,,f92i-,this matter came on for hearing,
audit and distribution at this session and testimony taken;and thereupon,upon due consideration
thereof of the balance for distribution in the hands of the Accountant is determined to be
$.17,102.26 'and ,the ac~unt 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,unless exceptions hereto be filed
sec.reg.or an appeal be taken herefrom sec.leg.''
By the Court
..~~
.'Specially Presiding
SCHEDULE ,OF DISTRIBUTION
Balance per account ~_$17,301.96
Additional debit asked at audit
Additional credit asked at audit
272.10......
471.80
$17,574.06
Balance _
Deduct Clerk's Costs &Receipts _
Attorney---SJ.Ca.J~n~d....eroL'ls!J_'-Qj&~'..F""ramdolMk~sl___..,_---------
Russell Marino,Agent,transfer inheritance tax,$328.00
Interest from 7-4-72 to 10-30-72 6.35
,Romaine R.Swagler,sister,1/4 residue,
Laura R.Jones,sister,1/4 residue,
Wallace S Ross,brother,1/4 residue,
Marjorie R.Phillips,niece,1/4 residue,
$17,102.2634.00~~7,u
.-.......-.....-$17,<1>8.26 ~~
.p
~y
334.35 "~;;~-
-------$16,733.91
4183.48
4183.48
4183.48
4183.!U "
No balance
NOTE:Included in the above balance or residue is 400 s es Pitt burgh
National Bank connnon valued at $1.4200.00 and 88 s ares of egherw
Power System connnon stock valued at $20.57 .00he1dn kind an distributed
~sh~uchra.t;;lthe>}lTalueas ShOWILa:iiCl in the proporti nate sha s as set
forth in the distributive shares therein.
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Jb3--1/-/:2IS-
COMMONWEALTH OF PENNSYLVA.NIA.
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
COUNTY OF WASH.l.NG..!QN ..RESIDENT DECEDENT
Form RCC-33
IMPORTANT:This return must be completed in detail and filed in duplicate,with will attached,with the
Register of Wills of the County where decedent resided;Return is due within one year after
date of death,unless an extension is grantedhy the Secretary of Revenue.(Section 703 of
the Inheritance and Estate Tax Act of 1961.)
lla=;.::s:~;:::~:;:::,:/M,._-1'==°FHavenRoss(State full name of decedent)
Late of .N.or.t.h......B.e.t.h.1.e.h..em.T.wp ,Was..h........County ADMINISTRATORs
state of F.enns:v1.v..ani.a }
County orWashingt.QIl....................................................ss:
Administrators
..Wa.l.la.ce $.•...Ros.s and L.aur.a .R Jones······..'.·.
of the estate of the above-named decedent being duly sworn,deJ1lose S and say S
........~
Decedent dJed ...oc.tober4th ...,19.71......JI)O:~~~K}il1!X\)I:t0400)1:Xb(i~~«}i~}
(Month)(nay)(Yt1Ir)Lintestate
o therNaamuet:::i:::r:::r:fse:tttao;;::::}..Adam..L.Sanders,Attorne.y.......
whom all correspondence should be 611 Washington.Trust Bldg...
mailed.Washington,Penna.15301
That as such adminis.txa.tor.s deponent is familiar with the affairs of said estate and the property con-
(~;x""utor·Administrator).
stituting the assets thereof and their fair market value.
That at the time of death there was no safe deposit box registered in decedent's individual name,or jointly
with,or as agent or deputy of another,or in decedent's individual name,with right of access by another as agent
or deputy,with the exception of the following:-.
NAME AND ADDRESS OF BANK OR OTHER INSTITUTIONINWHICHDECEDENTRENTEDASAFEDEPOSITBOX
THIS SAFE DEPOSIT BOX RENTED'
IN NAME OR NAMES OF RELATIONSHIP OF JOINTHOLDERSTODECEDENT
That the contents of said safe deposit box or boxes are itemized under Schedules ~of this
return,with the exception of the folloWing,for the reasons hereinafter set forth:
That Schedule A attached hereto and made part hereof sets forth fully and in detail all the
real property in the Commonwealth of Pennsylvania of which decedent died having an interest therein.It
also sets forth the mortgage encumbrances upon each parcel of real property at the date of death,giving
the amount still due at death,name of mortgagee,date,rate of interest,and book and page of record
thereof.It also sets forth in the columns provided therefore the assessed valuation of each of said
parcels,the estimated market value thereof as of date of death of decedent.
That Schedule B attached hereto and made part hereof sets forth fully and in detail all personal
property wheresover situated owned by the decedent at the time of death;all moneys left by the decedent
at the time of death,whether in decedent's immediate possession,standing to decedent's credit in banks
of deposit,savings banks,trust companies,or other institutions,whether indiVidually,or in trust for
any other person or persons giving also separately the accrued interest thereon,if any,down to the last
interest day prior to decedent's death in the case of savings banks,and to the date of decedent's death
in all other cases;all bonds,postal savings,treasury certificates or notes and other evidence of in-
debtedness of the United States to the decedent;all obligations,whether by statute or ag~eement they
are designated as tax free,of the United States,or any state,or political subdivision thereo~or of
any foreign c~untry,which are owned at the time of death;all wearing apparel,jewelry,silverware,pic-
tures,books,works of art,household furniture,horses,~arriages,automobiles,boats,and any and all
other personal chattels of whatsoever kind or nature,left by decedent,together with the fairly estimated
market value thereof;all bonds and mortg8e;es held by decedent and of all claims due and owing decedent
at the time of death,and all promissory notes or other instruments in writing for the payment of money
of which decedent died possessed,of whatsoever nature,with interest thereon,if any,giving the face
value and estimated fair market value thereof,and if such estimated fair market value be less than the
face value,it sets forth briefly the reasons for such depreciation as to each item;all moneys payable
to the estate from life insurance polici'es carried by decedent;all annuity and endowment contracts the
proceeds of which were payable upon the dea~h of the decedent;and all the corporate stocks and dividends
due thereon and unpaid as of the date of death,bonds and accrued interest thereon to the date of dece-
dent's death and other investment securities owned by the decedent at the time of death,with the market
value thereof at such time.~.,\.
In the case of securlties of close or family corporations,the values reported are as far as
possible substantiated by financial statements of the corporations,showing the assets and liabilities
.thereof as of .the.date of.death.The schedule also sets forth the interest of decedent at the time of
death iri any co-partnership or business,and in'support of the value of such intere~t there is annexed to
said schedule,financial statements showing the asse'ts and liabilities of said co-partnership or busi~ess.
A copy of the co-partnership agreement,(if oral',a statement setting forth the nature of the'agreement)
together with a statement setting forth the character of the business,its location,and such other facts
pertaining to the business as may be pertinent to a fair and just appraisal'of the decedent's interest
therein must be submitted.It should also set forth in itemized form,together with the fair market value
thereof,any other property owned or bequeathed by the decedent at the time"of'death;,
The Schedule C attached hereto and made part hereof sets forth a true answer to each inquiry
contained therein and in the case of transfers ofproperty,real or personal,within two years of decedent's
death,in contemplation of decedent's death,or intended to ta.ke effect hi possession or enjoyment at or
after death,said schedule sets forth the nature and value of such property,to whom transferred,the
relationship of the transferees to the decedent,the proportionate share received by each transferee and
all other facts of a pertinent nature regarding s!tid transfers.In the ca:e of transfers intended to
take effect in possession or enjoyment at or after death,there is also attached to the schedule a copy
of the deed,trust agreement or other instrument creating the trust.Ther,~is also set forth in said
schedule a list of all property,real and personal,with its value,which passes at decedent's death by
virtue of the exercise by decedent,either individually,orjointly with another,or any power of appoint-
ment vested in decedent,either individually or jointly,by the will,deed,or other instrument of another,
with a copy 0 f the instrument creating such power attached to the s'chedule.
That Schedule D attached hereto and made~art hereof sets forth the names and addresses of all
persons'beneficlally interested in this estate at the time of decedent's death,the nature of their res-
pective interests,their relationship,if any,to the decede?t,together with the ages at the time of
decedent's death of all minors,annuitants and beneficiaries for life under decedent's Will.It also
contains a statement showing which of the beneficiaries named in the decedent's will,if any,died prior
to decedent,the dates of their death,their issue,and the relationship of such issue to the beneficiary.
That Schedule E attached hereto and made a part hereof sets forth all property,real and per-
sonal,owned by the decedent jointly with another or others,including intangible,standing in the name
of the decedent and others,plus the date and place of record of instruments effec·ting the vestiture of
real estate and the date of acquisition of personalty,plus the name,address and relationship,if any,
of co-owners to the decedent.
That Schedule F attached hereto and made a part hereof sets forth fUlly and in detail all debts
and deductions claimed for and on behalf of this decedent's estate,including f\meral expenses paid;
family exemption,where applicable;costs of admlnistration of this estate;counsel fees and fUdiciary's
commissions paid or to be paid;cost expended for burial trusts,tombstones or gravemarkers,and reli-
gious services,in consequence of the death of the decedent;debts and claims owing and unpaid at time of
death;taxes accrued chargeable for period prior to decedent's death (except those allowed under Section
651 of the Inheritance and Estate Tax Act);together with a 'statement of collateral pledged for Obliga-
tions,if any..It is agreed that the fiduciary will present proof of said claimed obligations upon re-
quest,that if the amount actually paid in settlement of any fee',comrriission or debt is less than the
estimated amount claiming and allowed,that the same will be reported to the Register of Wills,and that
the amount of tax assessed can be reassessed in accordance therewith.
That the totals of the appropriate columns in Schedules "A","B", "C","E",and "F"as directed therein,
have been carried forward and properly registered in the Summary.
.r,'L-o"A.:19 7.2 .
Subscribed and sworn to before me this Ll:.."'t!.........~~---------
...........R D 2 .
(Street Number)
My Com.Exp:March 26,Eigh:ty..",£our..,Penna 1.5301 .
Washington,Washington County ,Penna..(City or Town and State)
NOTE:Before signing affidavit make sure all blank spaces in the affidavit and schedules annexed are
filled in with details or the word "None",and in case the assets include rare and unlisted securities,
securities of close or family corporations or an interest in any co-partnership or business,that the
data and statements required under the paragraph above relating to Schedule "B"are attached.Also make
certain that column #1 in the "Summary"has been properly completed as above-directed.
......:~7=7 .~;~of .
......~:.L2:../~/..~u-e--f....L.-:r'1fK.-(~
J
RCC-34 (1-64)
COMMONWE\.\LTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BURE,AU OF COUNTY COLLECTIONS
TRANSFER INHERITANCE TAX
RESIDENT DECEpENT
SCHEDULE IIA",
REAL PROPERTY
Real property in Pennsylvania,with statement of mortgage encumbrances upon each parcel at death of dece-
dent.Where property held as joint tenant or tenancy by entireties,report on Schedule "E".Property held by
the decedent as tenant in common with another or others,should be identified as to quantum of interest and
the estimated value should be that of the decedent's interest only.
The real property located In the Commonwealth of Pennsylvania should be (1)(2)(3)
described by lot and block number,street and street number,together wi th DEPARTMENTageneraldescriptionoftheproperty,with a reference to the record of the ASSESSED VALUE VALUATION
conveyance by which the decedent took title;If a farm state number of a·FOR YEAR OF ESTIMATED CAUTIONcres;also statement of mortgage encumbrances upon each parcel at death DECEDENT'S MARKET VALUE (Do not writeofdecedent.Taxes,assessments,accrued Interest on mortgages,etc.,are DEATH In this space)to be Iisted on Schedule"F"and must not be deducted from this schedule.
None
Insert this total opposite "real property",Schedule "A"in the X X X X X
"As Reported"column on the last page of this return.
o
hCC -65
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "B"
PERSONAL PROPERTY
INSTRUCTIONS;This Schedule must disclose all tangible and intangible personal property PWned indiVidually
by the decedent,at the time of his death.Property owned by the decedent jointly with .another or others
must be listed under Schedule "E".Intangible personal property,titled in the name of the decedent,but
payable at death to another or others,including but not limited to P.O.D.U.S.Savin,gs:Bpnds and tenta-
tive trust accounts,must be listed,despite the fact that they are not of theadminister~destate.
Tangible personal property should be listed first (e.g.jewelry,wearing apparel,household
goods,and furnishings,books,paintings,automobiles,boats,etc.). '..:..
Intangible personal property,such as bonds,treasury certificates,cash on':haTld.imd in bank,
stocks,mortgages,notes,together with accrued interest or dividends,salaries or wages,.insurance pay-
able to the estate or fiduciary in said capacity,partnership interests,interest inanY:'lndistributed
es tate of or income from any property held in trus t under the will or agreement of anoth~r.,'even though
located outside of the State,at the time of death,should be listed in this schedule.
Item
No.
ITEM
List and describe fully
UNIT
VALUE
ESTIMATED
MARKET VALUE
DEPARTMENT VALUATION
(Do not write in
this space)
Savings Acct.No.83-2035637-Pittsburgh
National Bank,WaShington,pa'-~/~~:~rn~
Savings Acct.No.83-2046424-Pit~J~'
National Bank,Washington,pa'---~~L~Jn~
Amount of 1971 Income due and rece~ved 1J fll;1·
from F.L.Ross Trust-------------------~.
780.56
310.91
504.00
S ICJ.9/
D87 shs.Pitts.Nat.Corp.com.stock @35.50
o shs.Edgewater Corp.com.stock @16.
To refund received by Estate from Washing onyn3'
Hospital Extended Care Faci1ity----------~
4 shs.Col.Gas &E1ec.com.stock @33.25-·~.~
~6 shs.Diamond Shamrock com.stock @19.062 1 ~j~~
rt'V#
7 _dJl.f!J~~8 shs.Allegheny Power Sys.com.stock @23.sr'v
*
91.55 9/,56
I ).3~,CJO133.00
495.62 1/9,1("tb2-
160.00 ;6eJ,00
2,057.00 dtJ.6~7,tJtJI
20,838.50 ';<0 !St 5tJI
Insert this total opposite "Personal Property",Schedule "B"in
the "As Reported"column on the last page of this return.x X $25,371.14 /-#c:l~t37/,/"-1
RCC-36
COMMONWEALTH OF PENNSYLVANIA
T,RANSFER INHERITANCE TAX
RESIDE~T DECEDENT
,
SCHEDULE "c"
TRA.NSFERS
(1)Dicl clecedent,wi thin two years of cleath,make any transfer of any material part of his estate,without
receiving a valuable and adequate consideration therefor?(Answer yes or no)no
(2)Did dececlent,within two years of cleath,transfer property from himself to himself and another or
others (inclucling a spouse)in joint ownership?(Answer yes or no)no
(3)If the answer to (1)or (2)above is in the affirmative state:
(a)Age of decedent at time of transfer _
(b)State of decedent's heal th at time of making the transfer.(Note 1).
(c)Cause of dececlent's death.(Note 1).
(4)Did decedent,in his lifetime,make any transfer of property without receiving a valuable or adequate
consideration therefor which was to take effect in possession or enjoyment at or after his death?
(Answer yes or no)_~n~O~_
(a)Was there any possibility that the property transferred might return to transferer or his
estate or be subject to his power of disposition?(Answer yes or no)no
(b)What was the transferee's age at time of decedent's death?__
(5)Did decedent in his lifetime make any transfer without receiving a valuable and adequate consideration
therefor uncler which transferor expressly or impliedly reserves for his life or any period which does
not in fact end before his death:
(a)The possession or enjoyment of or the right to income from the property transferred?
(Answer yes or no)no
(b)The right to designate the persons who shall possess or enjoy the property transferred or
income therefrom?(Answer yes or no)_n~QL-_
(6)If the answer to (5)(b)above is in the affirmative,state whether the right was reservecl in decedent
alone or others -,-_
(7)Did decedent in his lifetime make a transfer,the consideration for which was transferee's promise to
pay income to or for the benefit of care of transferor?(Answer yes or no)no
(8)Dicl clecedent,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 decedent under terms
of transfer or by operation of law?(Answer yes or no)DO
(9)If the answer to (8)above is in the affirmative,was the power to alter,amend,or revoke the inter-
est of the beneficiary reserved in the decedent alone or the decedent and others?
(Answer yes or nO)_~D~O~_
NOTE 1:The answers to these questions should be supported by affidavit by the attending physician as
well as a copy of the death certificate.
NOTE 2:If answer to any of the above questions is yes,set forth below a description of the property
transferred,it's fair market value at date of death,dates of transfers and to whom transferred,with
relationship of transferees to decedent,if any.Submit copy of any trust deed or instrument,if trans-
fers are claimed to be non-taxable,also submit detailed statement of facts on which said claim is based.
NOTE 3:List applicable property below in manner in which provided in Schedules A,B,or E.
ITEM
None
DESCRIPTION MARKET VALUE
(Es Umated)DEPT.VALUATION
(Dept.Only)
Insert this total opposite "Transfers",Schedule "C"in the
"As Reported"column on the last page of this return.D
k.CC-38
CCMMuNWEALIH or rENNSYLVANIA
TH0-NSFEIl INHERITANCE TAX
RESIDENT DECEDENT
,.
SCHEDULE "E"
JOINTLY OWNED PROPERTY
I~srRrCTIO)l;S:This schedule must disclose all property,real and personal,owned by the decedent jointly
with another or others,including intangibles,standing in the name of the decedent and others.List
real estate first,as entireties,or joint tenants,giving brief description,as indicated tmder Schedule
"A",plus the date and place of record of instrument effecting vestiture,but do not include entireties
or out of state real estate value in estate valuation column.Personal property should be listed as in
Schedule "B",plus date of acquisition,and the name,address and relationship (if any)of co-owners to
the decedent.
Description of Property,Date of Acquisition,Name I unit percentage Estate DEPARTMENT VALUATION
Address and Relationship of Co-Owners,and Place I Value Share Valuation CAUTION-Do not Write
of Record of Instrument,where Rea!Estate.1 In This Space.Ililiiiiiiiii~~~mi~mmm~mmmmlmmmlm~m~mlm~i~i~=~v~a~IU~e~~OfValue of
Entire Decedent's
Property Interest
None
I
I
j
Insert this total opposite "Jointly Owned Property",Schedule"E"
in the "As Reported"column on the last page of this return.
..;,,.
RCC-37 !12-63J,
COl\ll\lONWEALTIl OF PENNSYYLANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "D"
BENEFICIARIES
BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED(If step-children or DATE INTEREST OFStatefullnamesandaddressesofallwhoillegitimatechildrenDECEDENTOFBENEFICIARY
ave an interest,vested,contingent or other are involved,set STATE YES IN ESTATE
wise,in estate)forth this fact.)OR NO BIRTH,
Romaine R SwaQ1er sister ves 1/4 of residue
T.~11r~R .Tnnpc:::sister ves 1/A.nf rpc:::idup
R D 2
lH nhTu_fnllr .,..,1 C;~~()-
W~ll~/"'p ~Rnc:::c:::hrnThpr ves 1 /A.nf roc';n11 0
D n .,,
R;nhTu_fnllr -1 S~~O
M:>r~"'''';'''''0 Ph';".;.,..,~n;o/",o upc:::1/LI.nf roc:;n11e>
L1.()s:!.~AHo
{Ab.",hi n .....+nn Ponn:>1 c;~()l
.
-.
\
h
Deponent further says that all the above-named beneficiaries are living at this time except below:
NAME DATE OF DEATH RESIDENCE
OF THE
ESTATE OF
~[ATTER OF THE APPRAISEMENT
Haven C.Ross,a/kia,
H.C.Ross,a/kia,
.H.avgIl~{)~S....
(Executor-Administrator
must complete "As
Reported"column #1.)
0 >-j '"0 ::0........Ctl Ctl0~....e:..'":='"'"'"0......:='"0>-j Ctl e:..........~'"0x'"0 "CJ~Ctl0"'........
~0 ~"CJ
.~Ctl....
'"~
~'<~~Ctl
Year ....
P.o<THE
~No,»Wl
Administration
Deceased
Late of North Be.thlehem.Township
County of Washington.
Commonwealth of Pellns}:lvania
REPORT AND APPRAISAl::-;-,.--.J ..r
~'E ;-~,~.'
:Porn
(I)0
:::en
2-:-----i
-:j")f"7i
--f ;x.t
r:;)ZO
'I
.~~0:,
u r»(f)
enc::s:::~>.::0
en en en >-<(':)r:l r:l::r'::r':r....-.
(-)-c5 >~.:::;.__.t--"":
-00 ~-00 -00 -00 fh
:l\)l\)
\n lJl :».,.'"'"''\.JJ lJJ ::0___.:~~.Ctl_;~r-'Q'g~•!~-""'ti~r-'0 8".~~O c...
~.,
.'
"
Adam L.Sanders-B.A.Franks
Attorneys at Law
-OO-OO-OO-OO-EF!--OO
,~.~.:»,&)'":.0~::lJJ :ct~8"NN....~"-"J..3"..~.~."ct........c...~.~. .
RCC-Bl (6-711
COMMONWEALTH OF PENNSYLVANIA\
DEPARTMENT OF,REVENUE
BUREAU OF COUNTY COLLECTIONS
HARRISBURG
17127
NOTICE OF FILING OF APPRAISEMENT
WALLACE S.ROSS AND LAURA R.JONES
~Administrator)
IN YOUR REPLY PLEASE
REFER TO
Inheritance Tax Division
38=230-3
/
In Re:Estate of HAVEN C.ROSS aX/a
_W_AS_._H_I_N_G_T_ON_·County -Fi Ie No.63-71-1215
You are hereby noti fied that the__o----"-r_i......9<..:i::c::n.::.ca=:1=---_
appra isemen tin the estate of__----=H~A"_'VEN'-=oL-'C""--'!..--"'R"'O'""'SI.ioSoL....;;:_=;;;_===_===__------
has been filed in the office of the Register of Wi lis of__W_AS__HI--'--"-N'-G::....;TO::-·-'--=N:..:..._
County on May 22 ,19~,Said appraisement reflects the following
valuations:
Rea I Estate -=-=---=-==-=-~-:-------
PersonaI Property __-=2:...:S'-','--'3:::..7.=-1=_=1'-"4'"---_
Transfers _
Jointly Owned _
Tota I --"2"-"S~,'_"3'_"7_"'1......_"'1L:i14'_______
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 __M---,-.a=y.&----:2=2"'-1,'----"'1=9:....<7J!!2'--_
DATE OF DEATH:October 4,1971
Note:This is not a bill.
-------------------------------------"
f.
RCC-39 (s-is)
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SUMMARY
Estate of ROSS HAVEN
(Last Name)(First Name)
c.
(Initial)
a/kla DATE OF DEATHIQ-4-71 FILE NO.63-71-1215
REPORT OF INHERITANCE TAX APPRAISER
May 22,1972Dated:--"""""-----'------==------
I,the undersigned duly appointed Inheritance Tax Appraiser in and for the County of __W~AS=H=I=N::..:....::G:..::TO:....=..: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".
/7/-1-.)~'~XAP~-
REPORT OF THE REGISTER OF WILLS
I,the undersigned duly elected Register of Wills in and for County,Pennsylvania,do respect-
fully report that I have allowed deductions in the amounts claimed by deponent,except as to those items where a greater or
lesser amount is set forth in the last column to the right in Schedule "F",which greater or lesser amount represents the sum
allowed as a deduction.
Dated:_
REGISTER OF WILLS
25,37114
NONE
25,371
VALUE AS REPORTED VALUE AS APPRAISED VALUE AS REAPPRAISED
$$$-------+--
CLEAR VALUE OF ESTATE
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)
Valuation of life estates or -t=
FOR USE OF REGISTER ONLYTaxon$-+-__
Tax on $--+__
Tax on $----------+--
Tax on $----------+--
Tax on $----------+--4
Exemptions==========1F==Total Estate --!-__
TOTAL TAX
2%
6%
5%
10~
15%
COMPUTATION OF TAX
$--------+---
$,...-------11---
$------__4--
$------__4--
$~-----__4--
$------_.1--
(*)As evidenced by Charitable
Exemption Certificates issued
by the Secretary of Revenue.
Less tax previously paid
BALANCE
Less 5%of tax if paid within
3 months after death :::::::::::::t==:=
BALANCE OF INHERITANCE TAX DUE $l=
Add interest at rate of 6%from
_____to $---------'
AMOUNT OF ESTATE TAX ASSESSED $----__L-
.Estate tax paid $--'L-
BALANCE DUE $---ll-
Add interest at rate of 6%from t=
------Ito-----$-----~.
TOTAL TAX BALANCE $-------1
PAID $.....J
FOR USE OF REGISTER ONLY ADJUSTMENTS
NOTE:Where subsequent adjustments are made to the above computation of tax by the Register of Wills,for proper reason,
same should be noted below,with short explanation.
Will !...No.AdmInIstration
IN THE
Year .
MATTER OF THE APPRAISEMENT
OF THE
ESTATE OF
.aAWNC..~o.SS~a
Deceased
Late of.N.BETm.EHEM TWP •..
County of WASHINGTON
Commonwealth of Pennsylvania
REPORT AND APPRAISAL
r":
';'.1.
..
,~'
F'unn RCC-~
j
D~A&TME~JT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
HARRISBURG,PENNA.17 127
COMMONWEALTH OF PENNSYLVANIA
RESIDEN'l INHERITANCE TAX
APPRAISEMENT
DATE ..~~9.Y ~.~..,~.~.7..~.
COUNTY ~~~~~.~.9:~.~~.
FILE NO•.....§.~::.?!::.!.?~.?.
Whereas,~~~.~~~~.~~~~late of ~~.~.~.~.:..~.~.
in the County of W~~~.~.G.+'9.N Commonwealth of Pennsylvania,having died on
the f.ourth day of Q.c.tob.er 19 7.3,seized and possessed of an estate
SUbj;~::::r~~~~:;~;:y=':2~lt~.o:::::::::~IYappointed according to law,
having been designated to make a fair and conscionatle 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 OF SCHEDULE B ATTACHED II TO APPRAISEL
Unit
Values
$
Appraisement
Made for Inheritance
Tax Purpoles
25.371 14
Having been duly sworn according to law,I do hereby cer.9-f .tha the above appraisement is made in con-fonnity with law on tbis,,;J,2Q day Of_'>'!i.lj~~;;'~?
.t:!ti!!t::~.·~~:f;,;···'*.,<d/.~.................................................;j..e~Lj..C)ffl~~·i··········,penna"
.,i.
Wll$a~GQT.N.COU~lty
RESIDENT INHERITANCE TAX APPRAISEMENT
Estate of
··..ijA~.c~.~9.§.$...~/j/~....
Deceased.
Late of
N.BETHELEHEM TWP •...............":.
Date of Death,~.9..~..~.7..~.........
Appraisemeilt Docket Vol.,3..$.:.
Page,2~.Q~.3.:No..§.3..~.?;L..~.~.~.;L..~.
Filed in Register's Office,~~y ~.~19..?~
Amount of tax due $,..:..........•.......................................................
DEPARTMENT OF REVENUE
Received,
Examined and Approved,: .
Wrote abo.ut Appra.isement,
Appeal f1'om Appraisement,.·..
Entered and charged,:.
::.:'
"~
..-.-
,~
Form RC C·10
AND AGENT OF THE COMMONWEALTH
~OF _.COUNTY
('
,
/
.,-OFFICE OF THE
REGISTER OF WILLS
o l(,
~3 -;Y-/l.-.Ls-'
STATEMENT OF DEBTS
AND DEDUCTIONS
"DuonD"ACCDwCI'i l/$.1
THE SUM OF $",
l()--h;-77/DAT~APPROVED.A'A t\·~·':u...u..,..u,u..u,."..,..
,~'Vt1A~A'o
Register of WIII(I~r
ESTATE OF __HL.ll:;laUvue;:..nu...-..lIoC......-JRu..loo!O:.;;;lSL.;oiSL-LATE OF
vNorthBethlehemTownship.Wash.Co.Pa.
DATE OF FILING APPRAISEMENT Ma}l 18,1972 OATS OF DEATH _-..lIoQu.c.Jtlo.lolotb~e...r--..:4~,--"1!...9;;:.7J.....:l _
1 1 '2 ";''2
7 RLI.
"nn
q nn
4nn ()()
4()()()()
1 A nn
~nn
f,r::.n nn
f,c:.n nn
,~'"''"'nn
1'7 nn -
~&:..1A'7 10'7
'ill d-()
2--~
-J
filina inventories
~n+~l _
~~,..n·',.,+;:\n+c::fpo
A •
-r;l;,...,.,~
p~T
Debt of decedent-8 yr •.Tn+OT-V;UOC::1'yl1c::1:pp fpo
8 yr.Inter-Vivos Attorney
foo_i1ph+of i1p~'c1
,,..,.
NO.OF NAME OF PAYEE REMARKS AMOUNTVOUCHIiOIIlt
-,
1 Russell Marino.Rea.Letters o£Ac1min 10 00 I
2 Greenlee Funeral Home -'~1 of c1p~'c1 ??77 CiO
~W::l~hinaton County Renorts ".-::I""",...of 1p 1A.00
4 M W Graham morH ~~1 fr-v-.-::I""'~".-::I f,l nn
5 TAT M D"",;11u M n moiH ~~1 TnT 1I0~'II "n nn
CiO 00
,n Kur1:'?Monumpnt Co insl"'rintion On ~tonp
7 Rllc::c::011 M;:\y;no Rpo 1 ~hor1:~oY1:;f;~;:\1:p 1 nn
R Rnt"'~lov Tnc::~o ~l1m nn ,,,.-::Im;n 'hnn.-::l lAc:.nn
lR 11 J.folon ....'11,.,0
1R 12 RUS c::pI 1 Marino Rea ,
)./:.lq W;:\ll;:\/",o S Roc::c::
},b 1A.Ac1::lm L .c::.~nllo,.~
1-1>1r::.()'hC>O....,OT_....'+OT.
'il..1'"J.f"",10,...-'''',.,0
~1,17 1NT~11~~0 S Ro~~
'J..~1R T ......_"D T"....'"'~
lot 10 A.-::I.."...T
C __A.__
a "n Dllc>c>ol'M"Iy;no Do,..
/
Ir)AA6',,>L (J'J""'&-
~~\'0 Au.>4.0.;J/,
1 c:;
T..n,..,.
OJ
M .....
1111 _
DA'"E
1971
Dpl'"~
Dec 3
no/'"n
Dec.15
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF Washington
xx We,WallacQ S.Ross and Laura R •.Iones HEREBY CERTIFY.THAT.TO THE BEn OF
MY KNOWLEDGE AND BELIEF.THE FOREGOING IS A JUST AND TRU E srATEMENT OF DEBTS,FUNERAL EXPENSES AND EXPENSES OP'
ADMINISTRATION SUBMITTED TO THE EST...TE OF Haven C.Ross DECEASED.AS DEDUCTIONS FOR
INHERITANCE TAX PURPOSES.~*'~..JI?~(L.S.lSWOR~SUBSC~B~D BEFORI;:M~IIS 9:-4 DAY 01"--//ru ~~"')(j,,~.;,//le..:z.2::-d~f[.~'--xJ?Z ./L?~\.2'A 7"".,~.I :;/__.R 'J,.,~~:.J:1!-:t!:::Z:::l..!!:::::w.:::~._
TV r ,....~tary Public
My Com;.Exp:March 26,1975
Washington,Washington County,Penna.
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.-f/"IN THE~:ORPHANS'COUR~.OF/iWASHINGTONCOUNTY,PENNA.
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;,,....)Date.•.•·••._O.f dealt.h '..to --I.p·....~1
In the matter of ,the Audit of Acbount filed in the~~tatJ·of ,.
.......'•.....\No,'~~..l5-,Term,1~_.._.,A.A.
~7~7A~:~~<~b.':~kl 9 :H(d·~~;~i).Docket l;'b -.;gO ..3
TO~AUDITING JUDGE:
j!;riter my 'appearance forthe Commori'wearth or'pennsyiViai~~,cIaiming't"ronsfer inheriba~ce tax in the above estate,as follows:
DR.
To .appraised V1alue of Estate:Realty..,..i.__•.•__,•._•..•••.___•.•..._.•..•._+'.$---'---,.----
Personalty~....../.,..__:.....$_~J2""_'."--'-~'""_.-\9'-",:">"'8<L"':-!..";7.:~~_.~_...........:,.:..-!...!.'?'....:....
Additio~al Assets .per Account,'Subject 'to Tax_.;_,.,._..:....__....,,...$-----
AddItionall.ASS~~per Audit,SubjOCt tOl1ax .J :....$------------
GROsS VALUE •:....•.,.•........$--'-_
~----
Clear VaJue ~_
CALCULATioN
Gross VaJue ......
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$~----------
$
T6TALDEDUCTIONS.$
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NOTE:~'I1he'following creditS'ciaimedcin theA'<:cooot are
held not deductible 'as aga:insfthetax:.
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No.•Term,19 __•A.A.
ESTATE OF
Deceased
PRAECIPE FOR APPEARANCE
FOR
COMMONWEALTH OF PENNSYLVANIA
~5
Rcc-n (9-68)
COMMONWEALTH OF PENNSYLVANIA
,DE~RTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
,/
APPLICATION FOR AND CONSENT
TO TRANSFER SECURITIES
REGISTERED IN THE NAME
OF A RESIDENT DECEDENT
f
APPLICATION (MUST BE FILED IN TRIPLICATE)
TO THE PENNSYLVANIA DEPARTMENT OF REVENUE:
Application is hereby made for consent to the transfer of the following securities of a Pennsylvania
Corporation or a National Banking Association located in Pennsylvania:
(a)400 (b)Pittsburgh National Bank (c)_~c....a¥P.....it....a....l _
(NOTE:In describing securities enter in (a),ab Oie,either the number of shares of stock or the face amount of
registered bonds,in (b),the name of the issuing company and in (c)the class of stock or the stated interest rate
and maturity date of registered bonds.)
Oot.12,1959...Aug.l,1960
ISSUED ON jgge 12tlitl--,and having a TOTAL MARKET VAilUE OF $.....l"-"l14~.....2.....00,..·+'.OO~·OL.'_
'DateI '
as of the date of death of the deced~nt,Haven C.Ross ,on OCtober 4,1971
(Name of Decedent)(Date of death)
who was Iate of __~R,......~D:.-..~2C-JJ~E~i~g~h!..!!t'..ZY-=-~f~ou~r....~W~a~8~h~i~n!:l9L!t~o~n~O~o~u~n~t'..ZY--ll.c........:..P~e~n!!!!ns!!!!..ZY~1~v~a~ni~'~a~~1~S~3~3~O~
(Street and Number)(Post Office)(County)(State)
The securities are registered as follows:~__~~~'~~~~~~~~~~'~'~~~O~~~S~_
(Name or names in which certificates are registered)
ADMINISTRATO~
~)
Wallace S.Ross and Laura R.Jones,R.D.2,EightY-f'our,Pa.15330
(Name)(Address)
NAME OF APPLICANT Adam L.Sanders,Attorney
COUNTY FILE NUMBER 1::.3-7/,-1.2.IE"ADDRESS OF APPLICANT 611 Washington Trust Bldg.Washington Penna.15301
BUREAU FILE NUMBER'Same SIGNATURE OF APPLICANT ~7....J.Q.M.-cLeA..<Ll ~
NOTICE:IF YOU FAIL TO PROPERLY FILL IN ANY PORTION OF THIS APPLICATION,IT WILL NOT BE - /
CONSIDERED COMPLETE AND WILL BE RETURNED TO YOU FOR COMPLETION.
COMMONWEALTH OF PENNSYLVANIA -DEPARTMENT OF REVENUE
CONSENT TO TRANSFER SECURITIES
DATE Nov.14th.1972
I hereby consent to the transfer of the above securities now registered in the name of the aforesaid
Decedent and waive the filing of a certificate certifying to the payment of the transfer inheritance tax to which
the property of said Decedent is made subject pursuant to the provisions of the Act of June 20,1919,P.L.521,
as amended and the Act of June 15,1961,P.L.373,as amended.This is also in accordance with the provisions
of the Act of April 9,1929,P.L.343.
This Consent to Transfer the herein described property operates only in reference to the estate of the
above-named Decedent.
Register of Wills
(Title)(County)
Washington
Secretary of Revenuee-e~~~~D
(Signature)
By
Office copy
COMMONWEALTH OF PENNSYL VANIA
DEPARTMENT OF REVENUE
BUREA'U OF COUNTY COLLECTIONS....r;
APPLICATION FOR AND CONSENT
TO TRANSFER SECURITIES
REGISTERED IN THE NMi;E
OF A RESIDENT DECEDENT
DATE-May 30.1972APPLICATION(MUST BE FILED IN TRIPLICATE)
TO THE PENNSYLVANIA DEPARTMENT OF REVENUE:
Application is hereby made for CQ1sent to the transfer of the following securities of a Pennsylvania
Corporation or a Notional Bonking Associalion located in Pennsylvania:
OCtober 4,1971
(Date of death)
____,on
(a)188 (b)PittsburglkNational Bank (Corp.)(c)~~omm~o",."'n,,,-_
(NOTE:In describing securities enter in (0),ab Ole,either the number of shares of stock or the face amount of
registered bonds,in (b),the name of the issuing com pan}'and in (c)the closs of stock or the stated interest Tote
and maturity dote of rE.'gjstered bonds.)
Aug.l 1960~~2e !4 1971'.ISSUED ON ~.~2i:~~ij9.!and hav,~g a TOTAL MARKET VAilUE OF $6,674.00
~(Dat")
as of the dote of death of the decedent,_....!H!.!!la"""vx.:e""n~·-'C~.....-'-."",R~o::>!:s""s,--_
(~a~e of Deceden't)
who was late of R.0,2
(Street and Number)
Eighty-four
(Post Office)
Washington
(County)
Penn~=._
(State)
The securities are registered as follows:_~__~~~'~~~~~.~~.....!~~~.~~~~~S~S~~~~~~~
(Name or name's in which certificates are registered)
ADMINISTRATOR$
~)
Wallaee S.Ross and Laura a.Jonos-R.D.2,Eighty-four,Penna.
(Name)(Address)
_.NAME OF APPLICANT Adam L.Sanders •.Attorney for the
"3'/<.....Estate of Haven C.Ross
COUNTY FILE NUMBER~-7/-0-U ADDRESS OF APPLICANT 611 Washington trust A .
BUREAU FILE NUMBER Same SIGNATURE OF APPLICANT a6¥''?n1 i ~,~
NOTICE:IFYOU FAIL TO PROPERLY FILL IN ANY PORTION OF THIS APPLICATION,IT WILL NOT BE,l j
CONSIDERED COMPLETE AND WILL BE RETURNED TO YOU FOR COMPLETION.
COMMONWEALTH OF PENNSYLVANIA -DEPARTMENT OF REVENUE
CONSENT TO TRANSFER SECURITIES DATE May 30th.1972
I hereby consent to the transfer of the above securities nov.~registered in the name of the aforesaid
Dec~edent and waive the filing of a certificate certifying to the payment of the transfer inheritance tax to which
the property of said Decedent is made subject pursuant to the provisions of the Act of June 20,1919,P.L.521,
as amended and the Act of June 15,1961,P.L.373,as amended.This is o,lso in accordance with the provisions
of the Act of April 9,1929,P.L.343.
This Consent to Transfer the herein described property operates only in reference to the estate of the
above-named Decedent.
(Signature)
RPffi~e'Washington.itrer 1"of Wi (lc.hQ:hty)
ecretary of Revenue
BY_-!L.!:.~~~=--~~·~!:.....~~~~:::'~::=:-::O~Office Copy
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DATE May 30,1972
APPLICATION FOR AND CONSENT
TO TRANSFEI\'SECURITIES
REGISTERED iN THE ~'~AME
OF A RESIDENT DECEDENT
f,PPLlQTION (MUST BE FILED IN TRIPLICATE)
TO THE PENNSYLVANIA.DEPARTMENT OF REVENUE:
Application is hereby made for consent to the transfer of the following securities of a Pennsylvania
Corporation or a National Banking Associalion located in Pennsylvonia:
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU DF COUNTY COLLECTIONS
.-'
/
)1----,,,-~-_..'
(ot 188 (b)PittsburghfNational Bank (Corp.)(c)_--"'c=o=mm=o=n=---_
(NOTE:In describing securities ent.er in 1a),ab Ole,either the number of shares of srock or the face amount of
registered bonds,in (b),the name of the issuing company and in (c)the class of stock or the stated interest rate
and maturity date of registered,bonds.)Aug.1 ,1~60
ISSUED ON~~~1~iQ~5~1.,and having a TOTAL MARKET VAtUE OF $6,674.00
oV'(Datl)
as of the date of death of the decedent,Haven C.Ross ,on October 41-,.1971
(Name of Decedent)(Date of deat;,)
(Street and ~~umber)
who was Iate of __--'-'R......'---"D"-••'--"2"'----"E...i~g;J'h!.!!.t.!!!.,yJ!_--""-f=o=u""'r"-._.W=a=s=h=i=n~g,..,t=o=n:=._·_--=-P..=ec=nn=a::.",.'---_
(Past Office)(County)(State)
The securities are registered as follows:~H~'~~~~~~,~~'~C~.~~~o~s~s~~----~--~
(Nam~or names.in which certificates are registered)
ADMINISTRATOR~
~)
Wallace 5.Ross and Laura R.Jones-R.D.2,Eighty-four,Penna.
(Name)(Address)
NAME OF APPLICANT Adam L.Sanders t'Attorney for the
Estate of Haven C.Ross
COUNTY FILE NUMBER 63-71-1215 ADDRESS OF APPLICANT 611 Washington Trust Bldg.
BUREAU FILE NUMBER Same SIGNATURE OF APPLICANT 4~~£.-Ji~;~
NonCE:IF YOU FAIL TO PROPERLY FILL IN ANY PORTION OF THIS APPLICATION,IT WILL NOT BE -J
CONSIDERED COMPLETE AND WILL BE RETURNED TO YOU FOR COMPLETION.
COMMONWEALTH OF PENNSYLVANIA -DEPARTMENT OF REVENUE
CONSENT TO TRANSFER SECURITIES
DATE May 30th.1972
I hereby consent to the transfer of the above securities now registered in the name of the aforesaid
Decedent and waive the filing of a certificate certifying to the payment of the transfer inheritance tax to which
the properly of said Decedent is made subject pursuant to the provisions of the'Act of June 20,1919,P.L.521,
as amended and the Act of June 15,1961,P.L.373,as amended.This is also in accordance with the provisions
of the Act of April 9,1929,P.L.343.
This Consent to Transfer the herein described property operates only in reference fo the estate of the
above-named Decedent.
Wa shirigton(Signature)Register of Wi1Js
. e Secretary of Revenue
By~_---::.~,-=--_~_~·--:::!n4.h.A~;?J
(Title)(County)
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RECEIVED TWO THOUSAND FOUR HUNDRED TWENTY-T\vO
Wallace S.Ross &Laura R.Jones -Excr.
and 50/100.----------------:-ttollars
representing Pennsylvania Inheritance or
.Estate Tax due from the following estate:From:..D..JLL..L...a--":u.L~L-II.L.&.~LI:SJ:L1.I...I.:I..Illl.1..-.-I!!
Address_6_11_·_W_A_S_H_I_N_G_T_O_N_T_R_U_S_T__B_U.:.-I_L_DI_N_G---j 2%Tax on $--------$--------·I~
6%Tax on $$---------.101
Remarks:
MJR
&£
WASHINGTON,PENNSYLVANIA 15301
I'
F'I N 63-71-1"215 'Ddt~dfDeath 10-4-71Ie0.--:...:...,_.
Date of Pd;;ine nt ~_'-r-T--:;;-.,...:----:-:",,:;=-_3...,1;:?---:::-,1_9-,-7_1_·----1
/('O.SS
Name of D~cedent _~~~~~~~::~~~~~~:-_a,-/_k_/_a__----.,
_WASHINGTON
Cou nty --------'----'----'-::.:..-=-:"::.....•-----_-----1
l
'Ir;-"._,.
15%Tax on $On Account
%Tax on $------
Estate Tax,Act of
May 7,1927
TOTAL TAX CREDIT
Less five percentum of tax if
paid within three months after
date of death
Plus interest at the rate of
__%from _
to _
$_--,-.-=2~,-=5-=5-=0.:...0=...0':::'-_.111
$--------'---·11IlI
$--------
$2,550.00------!..-~=-----1f'JI
$__---:1:::..:2---:7:....;:.c..:;:5c..:;:0__11iI1
$,---------1fI
SEA L TOTAL AMOUNT PAID $1==2=,!=4=2:=2=:.5==:O,=·==I!!J
NOTE:To be delivered to taxpayer 38-230-3 Q.......11/1 JrlA ~
Received b _,AAP...Jl.X-IIV2lrA MA
NOTE:In accepting the transfer inheritance tax on future estates,prior to the deoth of the life '-diU ~e)),
tenant or tenant for years,os evidenced by this receipt,it is understood that the Commonwealth sha}i '..
not be precluded or prevented from hereafter assessing additional inheritance tax at the death of thU "l.....A Q..A....,.
life tenant or tenant for years whenever it appears that such additional tax may be legally due and=./"'*-t¥~=:::.-:='(~T"-1f..-;e)~:l4,,~~~f.,£..----U
collectible for any reason whatsoever..I
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