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v...ya w~JI••. VI~l~6K il~.lN. t~rturR s~lT10N t~l OF ACT Or JUNt. IJ. l1Jl.
E• ~....Jri JAlIVARY 6 ItNR IFILE 1N DL'~U~AYC Q'ITl1 COtY Ut ~["ILL ATTAtHtU/
37-J ? - t?3~
~ OFF tCE OF' THE REGISTER OF Wt~.~.S
County of f-~~~s!'~re~.5~
fyo•~s~.~ t~+/l of ~l-.~S..~Aw~tOyu rP~~ct~r.?,''~G .
being dulr..~9l.R~t~!? according co law, depoxs and says that he is the.»_fr~.~.e~er~~~~
/ / / IE/a.~. A/Jn . L.e~es. Etc.t
of tht esrate of.....t
4.tes~~.6....~j~r/~~tjr~~w...... whose last residence w-u rQ.O~..~r.~.,/.~~:sf.~~r41~.---.--..».....--....
tNo./ tsa~e.I
_~.y~ deceased, and chat the whole of the sate of said decrdenr, who died _ ~ .l~~.~
IC. . I~oroo~Yot TorwfA~l /
(On3lfted Of ~ ~ / ~ ..~f~f~ O ~ ~/o.~~s'.4
A..P w d • ~7S %.I
REAL PROPERTY
REAL lROTERTY IN !1:?INEYLVANIA. WITH aTATEl1ENT OE ~IORTGAGB ENCtJDt9RANCES UTON EACH TARCLL AT DEATH Olr DOCEDENT.
WHBRE t'ROPF.RTY HELD As JOINT TENANT OR TENANCY dY ENTIRETII31. pVR NAt1ES. ADDRESSES AND RELATIONSHI! Or OTHER OtrY}tlOtlt.
Ti' Stl~tt'f~
Real Estate Value
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Personal Property . '
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F 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 di;posit or owed by the
~ rlc.cccient ss of the date of death, Such letters must he sighed by a responsible ai:lcer of the financial
i~~stitution or mortgage balder and indicate clearly amounts of principal and interest in the 3ecedent's
iu:count at the .dale of death and the ifpe of account, cacc~~ount numbfrr and the exact name or names in
vr,clch the aeccxlnt is registered. ~Ci01~JrrJ P1.Gf 7~