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Home My WebLink About10-02-78 Form No. RCC-62 (6-70) THIS FORM: REQUIRED IN ALL ESTATES WITH GROSS ASSETS UNDER $10,000, UNDER SECTION 701 OF ACT Of' JUNE 16, 1961, EFl"ECTIVE JANUARY I, 1982. (FILE IN DUPUCATE WITH COpy OF. WILL ATTACHED) '*' OFFICE OF' THE REGISTE~ OF WILLS _. . CoU~y of . {.~1-.~ ...~ /IA~Il7/.. .~...9. .~~........ of ..~ 3.[;:... t1:. .~./f..l.~/.. ...~~.tk (N&me> (Addr....>(/ b,;ng nly m_~~;.~~. ~'O<d~/g. to I.w. d,po"" .nd ""ttbat b, ;, th'~~A4a:' of the estate oLl-L""'---c;r:.....----=="-......f.t-:-rt:~;d.~!'J:1../I...?- whose last residence wasm-(N~~).2-------- m--------(St~t)--m- _m~ -----~:o_J_- ~c;::,~mh__dec(;ased, and that the whole of the estate of said decedent, who died ___ ~~(:"?i'- >m~/-/7 78" .n (~itY~~BOrt)j,noi.ilbw~i~) -r-=<Yye / consisted of: . ',/ OCT '0 I') 1"' 1..1 I '.1 REAL PROPERTY REAL PROPERTY IN PENNSYLVANIA. WITH STATEM:ENT OF MORTGAGE ENCUMBRANCES UPON EACH PARCEL AT DEATH OF DECEDENT, WHERE PROPERTY HELD AS JOINT TENANT OR TENANCY BY ENTIRETIES. GIVE NAMES, ADDRESSES A:tIm RELATIONSHIP OF OTHER OWNERS. Real Estate Estimated Value Personal Property () // /1 ./ ./ NOTE: You may expedite the processing of this return by filing with it, and as a part of the return, letters from financial institutions or mortgage holders, certifying to amounts on deposit or owed by the decedent as of the date of death, Such letters must be 8igned by a responsible officer of the financial institution 01' mortgage holder and indicate clearly amounts of principal and interest in the decedent's account at the date of death and the type of account, account number and the exact name or names in which the account is registered, x L E!ltimated' Val,?e Jointly Held Property NOt0t Transfers within TWO YEARS Prior to Death !1J {J Nt I I ~ i i I -l ~--- That at the time of death there was no safe deposit box registered ih decedent's individual name, or jointly with, or as agent or deputy of another, or in decedent's individual name, with right of access by another as agent or deputy, with the exception of the following:- NAME AND ADDRESS OF BANK OR OTHER INSTITUTION IN WHICH DECEDENT RENTED A SAFE DEPOSIT BOX THIS SAFE DEPOSIT BOX RENTED IN NAME OR NAMES OF --I RELATIONSHIP OF JOINT I~LDERS TO DECEDENT BENEFICIARIES RELA TIONSHIP SURVIVED AGE OF LIFE BENEFICIARIES AND ADDRESSES (If step-children or DECEDENT TENANTS OR INTEREST OF (State full names of all and their addresses who have illegitimate children STATE YES ANNUITANTS BENEFICIARY an interest, vested, contingent or otherwise, in estate.) are involved, set OR NO AT DEATH OF IN ESTATE J A, forth this fact.) DECEDENT "t~ /-l .1.11 .A -', ~ o-r~ t ./~ 11- 1-;;-_ y~~ v ~ r1 / ~ -- I I List first five items in the spaces so provided, observe notations thereon, and instructions. DEBT OR CLAIM NATURE OF SAME AMOUNT DEBTS AND DEDt.:'CTIONS CLAIMED Funeral expenses paid $ Family exemption (will not be allowed unless decedent died residing with a spouse or children.) Administration Expenses · Counsel fees · Fiduciary commission · OTHER DEBTS AND CLAIMS " ( .) See Note below Total Note: The estate agrees to advise the Register of Wills if the amount actually paid in settlement of any fee, commission or debt is greater 01' less than the estimated amount claimed and allowed. / Subscribed and sworn to before me this. . . , . . . , . , , , . . . . . . . . . . ,'.. --""'")-: _ (.,' . t. ,_/ t < ~-~~<.- ......... ./.... ..,................................. fE~tdd<lJ ,id...illM.&"s'sr) ~ / ~) ..- ~. -{ ,,' l . . . . . . . . . . . . . . . . . . . . . . . ~~ ...... ~.::. ."~ . .0;"-:; . . . .....: . . .. ~ . . . : : . . . . S .......,...,.... ..2.6. day Of.,....~...,...... .,19:?~ ................~../ffJ,..~.~;c Enola Cu _ My Commi'"cll hpires M~rch 20, 19-1.'t/ Having been duly sworn according to law, I do hereby certify that the above appraisement is made (Street Number) tary Public . .. : .: .);. /.~~ .'-:",1. c~.'. ... .<. ~:. . ., ...< :z~. )':~).. . (City or Town and State) in conformity with law on this day of.... ,.. ... ... ... ." '" " ., '" , ..... ....., ,....,19..... ApprAiser In the event that any futul'e intel'est in this estate is transfel'l'ed in possession 01' enjoyment to collateral heirs of the decedent after the expiration of any estate for life 01' for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer'inheri- tance taxes at the lawful collatel'al rate on any such future interest. REPORT OF THE REGISTER OF WILLS I, the undersigned duly elected Register of Wills in and for. . , . . . . . . . . . . . . . . . . , . , . . . . . . , . . . . . ,. County, Pennsylvania, do respectfully report that I have allowed debts and 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 said schedule above, which greater or lesser amount represents the sum allowed as a deduction. Dated: ............................................. Register of Wills L ~~ ... 0 C'J ~ ~ ?> ~ ~a ~ z \ ~ ~ .... !' a. e. ~ a- w.. ~ ~ a. ~ i"l ~ ~ ~ 'if .... ~ tl) \ ~ ~ ... ~ g go ~ -.z: ~ a. ~ ~ 0 ~ 'i ? ~ ~ ~ '"l ~ ~ ~ C1 ! -\ ~ l"l ~ l"l ~ q-- ~ ; ~ .' ; ~ ~ .... ~': ~ l>' ~ ~ rp l\ ~ ~ ~ ~ ~