HomeMy WebLinkAboutOC1968-0104 - ESTATE OF HAZELBAKERIDnmmnuwralt}J.. nf Jruu.ayluauia.} !lB
ma.a[Jiugtnu <Uuuuty. .
KNOW .\.LL MEN EY THESE PRESENTS: Whereas, at Washingtot!, in the County· aforesaid
day of J~ne fl.. D. 19 6 7 , before me,
Jos~phine ~~ Dougl~~ , Register for the Prollate of Wills and Granting
Let:1ers of Ad:ninistration in and for the County of Washington~ in the Commonwealth of Pennsylvania,
be :as1 Will .:hd T~stament of Sheldon R. Hazelbaker
c
13.te of the Borough :of ·Roscoe in the County aforesaid, deceased,
1 a :ruo:. copy wher=of is tc these presents annexed), was duly admit:ed to pro!: ate; and
William F. Ha··zalbaker
the EEe_cutor in .said Will and Testament named, having appeared before mf and taken and subscribed
tilie oaih of ofice p-~e~cribect by law;
NJW, THEREFORE, I, Josephine M. bouglas , Register as aforesaid:, do
f.rarrt these LETTERS TESTAMENTARY, unto the said
William F. Hazelbaker
corrmi:ting u:1to hint th-:: administration of all and singular the go~ds and
~~:ha:tel>, rig his. anc. credits,. which were of said deceased, and requiring b.im
1o ~xhibit a true 3.nd perfuct inventory· thereof into the Register's Office, at ·w a!shington, within ninety
days f~orr. th= d;lt~ hereof~ and to render a just and true account of said adm3-listration at the expiration
d :ix month; from the d;;te hereof, and to regard a:1d comply with the pro7 isions of the laws of this
CooiTDnwcal:h relating to inheritance taxes.
I~ TESTIMONY WHEREOF, I have hereunto s.::t my hand and the seal
of saii:l Office at Washington, this sixth
day d June in the year of our Lord one thousand
nine iundred and ·si~ty-seven •
. '
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. COPY OF INVENTORY
. . . · . nt>t-.:ry pubJ.tc
.. ~
wttliam F'. Ha~olbaker
.. .. ~ .
. ,.
I >, • + •
1Juntutnry aitb. 1\.ppratsttittut at .the goods and chattels, rfghts and credits which were
· Sheldon R. Ha%talbaker Rosc.oo . . ,
?f, ................................ : .................. : ........ : .. ~ .. : ..... ~ ........ :.;, ... , ......... : .............................. :::.: ....... '/ate··of. .......... :····•······ .. :···············': ............... ; ....... :·, ....... :·····: .. : ..... ;,,,;., ........ : .. :··········· .. ··":--····: ..
Washizgton County,, Pa., taken and made in conformin,J.~T.IJith.the.abOTJe affidavit ..
PERSONALTY:
casb
. . . . ·4·
', . _ .. -~
.saving$ -A®ount 26.08,· in Roscoe. Of-tico .o.f •
...
DOLLARS ·CENTS.
. f .
.W.stGrn Pennsylvania .Na'tional Bank· . . .
' : ; ....
Cbeeking Accciu1+,,. 062, ,.7S .. s; 1' i~ .·~(ltooe .· .i .:·
Q:ff'ice 9~ Western 'Pilnn$ylvania· Nattor..al· Be1r1k · ·
. . . . 3',331 07
~'· ., .· ..... -.~-:-,,;-' ., :~ . ,~-·~·~..-. . -_·, ~
. .
81 v.s., savir~ga Bondst·S~ries &, ia various ...
denominations, b'-vin~ ~a~io~a dates .of is•ue. -.
(See List At taohed) ·
ss Shares Stook ofW~stetn P<lnosylvania
Natior:ta1 B•nk @:. $16.~S p$!.' sha+<a ' . . . ,, . . ..
~ . . " · .so Shares Steek of. Pennsylvant• Railroad
Contpany. @ $63. 50 per share
10. Shar~s Stt>6k .· ot Charlestown· ~acing Associ'ati,.Qn,
Inc • , (]!. .$4. 2$ p~x . $hare · · · . · · · · .· ..
Motrcpcli.tan Ui'c;t Insurance Co. Group PC:tlicy
8052•0 .. $a.,oqo fac~, l'educed to $-71 2qo at $Q<:i 65.
·: r:. f
-~ · . ., · t , aos: 1~
·' ,893 1$
3,17~. 00
"• 42 . so . ·.
. 7',200 00···
r '" .. -~·-__ ___. . -__ .....
ESTATE OF SHELDON R • HAZELBAKER
. . . .
LIST OF. U. s. "E" BONDS
Issue Value Value
Amo.m·: ~ane (E.) ·Date 5/24/67. At Sale --
.~ 5JO Sheldon R. Hazelbaker 1-61 $ 467 .oo ~
5JO II R .• II 10-62 4:39.40
5JO II R. II 11-63 421.80
5JO II R. II 11-63 421.80
5JO II II 11-64 406.00
5JO II II 11-64' 406.00
5JO II If. 1-66 386.40
5JO II II 1-66 386.40
ALL TAXABLE -TOTAL $' 3~334.80
r 1)0 Sheldor.. Hazelbaker 8-60 $ 95.32 ~
lJO. II R. II 9-60 95.32
1)0 II R •. II 9-60 95 .• 32
1)0 ·II R. .If 10-60 95.32
1)0 II II 11-60 . 95.32
. 1)0 II II 11-60 95'.32
1)0 II II 12-60 93.40
1)0 II R. II 12-60 93.40
1)0 'tt •If 1-61: 9.3 .40
lJO II R •. II 2-61 93.40
• 1)0 II II 2-61 93.40
1)0 II. RL II .. 2.:.61 93.40
1)0 II " e .. 3-61 93.40
1)0 II II 3-61 93.40
1)0 tt· ·II 3-61 '93.40
lJO II II 4-:!61 93.40
1)0 II II 4.,..·61 93.40
lJO II II 5-61 93.40
1)0 II R. II 1-62 89.68
1,.JO II R. II 1-62 89.68
1)0 II II 1-62 89.68.
1)0 II R. II 2-62 89.68
iJO II II 3-62 89.68
1)0 II II 4-64 82.72
1)0 II II 5-64 82.72
1)0 II II 5-64 82.72 .
1)0 II II 5-64 82.72
DO II II 11-64 81.20
1)0 II II 11-64 81.20
1)0 II II 11-64 81.20
1)0 II II 11-64 81.20 1•)0 II •II ll-64 81.20 1-)0 II II 12-64 7. 9. 68
1•)0 II " 1-65 79.68
1•)0 II II 1-65 79.68
1•)0 II " 2-65 79.68
loJO II II 2-65 i9.68
1•)0 " " 3-65 79.68
1-)0 II R. ... 3-65 79.68
loJO II R. " 3-65 79.68
loJO " " 3-65 79.68
1•)0 " " 4-65 79.68
1•)0 " " 6..:.65 78.12
1•)0 " R~ " 8-65 78.12 . 100. II R. " 8-65 78.12
100 II ·R. " 10-65 78.12
100 II R. " 10-65 78.12
100 " R. " 10-:65 78.12
100 II R. " 10-65 78.12
100 II R. " 10-65 78.12
10.0 II R. " 10-65 .. _78 ~ 12 100 II " 10-65 78.12
SUB-TOTAL $ 4,456.00
I A:.'llo.m-:
$ 1)0
1)0
1)0
1)0
1)0
1)0
1·)0
BO
1•)0
11)0
1•)0
100
100
100
$ :;o
50
. 50 :;o
:-o :;o
:o
:o
:o
:o
~0
:o
~0
GONTINUED
HAZELBAKER LIST OF BONDS
:Name ( s)
SUB-TOTAL,BROUGHT FORWARD
Sheldon Hazelbaker
" R. "
II R. "
II R. ...
" R. "
II R. II
" R. ...
II R. "
II R . " ..
" "
" "
·~ "
" R. "
" R. "
ALL TAXABLE -.TOTAL·
She leon Hazelbaker
II
II
II
"
"
"
"
"
"
"
n
n
"
"
R. "
"
R. "
R. "
"
"
II
" ...
"
ALL TAXABLE -TOTAL
GRAND. TOTAL -ALL BONDS OF
SHELDON HAZELBAKER
Issue Value Value
Date 5/24/67 At Sale --
'$ 4,456.00
10-65 78.12
10-65 78.12
10-65 78.12
10-65 . 78.12
10-65 78.12
11-65 78.12
11-65 78.12'
12-65 77.28
12-65 77.28
2-66 77.28
2-66 77.28
2-66 77.28
2-66 77.28
. . ··4-66 77'.28
$ 5,543.80
6-60 $ 47 •. 66
6-60 47.q6
6-60 47.66
10-60 47.66
5-61 46.70
1-62 44.84
3-62 44.84
4-62 44.84
4-62 44.84
5-62 44.84
6-62 43 .94'
4-64 41.36
3-66 38.64
$ 585.48
$ 9,464.08
-·
STATE: OF PENNSYLVANIA,
WASHINGT,::>N COUN-Y, ~ ss,
T,e within named A~count-:m't being duly sworn acc:>rd'ing to law, deposes and says that th.e above account
as sta~d is 1rue ard coruect as __________ h~---------------------------verily believe.
Sworn on-:l s...JbscribetJ. before me this.2.~d ....
day of ----ganu.a.:r:;y~-----··:·--------------: .. 19.9.a ..... ~·--
-:~w&.)n~--------G~ELIA r¥cv, NO'~ARY. P JBLIC 0
CHARLERG~ BO~OUGH .
'fAS~ INGTON ::omJP'
MY CCJVIM SSIIN EXPIR~S AUG 30, 197!
---""'r" .. ..-...:~~-
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r::l lti z Q.l ~l ~ 0 () <l 9 Q.l IH: 0 ,....): ~ ~ ,....)j ::r: H: "l (/) ~! 0 z
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 Ru~e of Court, as evidenced by proofs
thereof filed to Nc-....... J.f-_{(_ ____ (!~tl._.._ ___ _
Witness my hand and cfficial ·seal this .... ~~-------------
AA~~~ I . ~
day of .. -:.r.~---------------------------------------_-------------19 _____ (_
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The Court is respectfully requested to determine
proper di-stribution in this estate.
,/l~C~
· Counsel for Accountant
-·
hfc(~
THE FIRST AND FINAL ACCOUNT OF
WILLIAM F. HAZELBAKER, EXECUTOR
OF THE ESTATE OF SHELDON R.
HAZELBAKER, LATE OF THE BOROUGH
OF ROSCOE, WASHINGTON COUNT~,PA.
RECEIPTS
The Ac~oLntant is charged as follows:
Per In~e~tory and Appraisement filed January 12, 1968
Income D·:bi ts -Page 2
TOTAL .ASSE:'S AND INCOME
RECAPITULATION
To11:a:. Assa1s and In-:::ome
Less: Cr~dits Claimed Out of Assets -Pa~es 3 & 4
NE'I FOJ! [•I~TRIBUTIO:W
STATUS OF ESTATE
Charl·e~ A . Tag9art E< Co •. -Credit
Cas~ i~ Estate Bank Accounts:
Was-tern Pennsylvania National Bank, Roscoe Office:
Sa.virl9JS Account #2608
Oleck:_n;~ Accoun1:
Advan~ements made tc. Heirs
87 U.3. S~vings Bon~s Valued bn 1/12/68
TOTAL NET" A:3SETS AVAILABLE FOR DISTRIBUTION
1/16/6~
.:
$25,462.12
1,383.30
$26,845.42
$26,845.42
6,943.34
$19,902.08
$ . 28.20
9,000.00
158.16
1,000.00
9,715.72
$19,902.08
..
Date
1967"
June 13
3(•
July 1~
14
27
_Aug. 18
Sept. 5
12
:Cec. 30
1968
Jan. :...2
..
The Ac~ountant is charged with the following debits:
Payor
Pennsylvania Railroad
Western Pennsylvania
National B.ank
Roscoe ~oose Lodge
Western PennsylVania
Natiorta.l Bank
Social Security
Admi.nis tra tion
Description
-Dividend
-Interest on Savings
Account
-Death Benefit
-Dividend
-Death Benefit
Veterans Administration -Death Benefit
Sale of 55 Shares of
National Bank Stock:
Ne-: Sales· Price
Inwentoried at
GA:N
Sale of 50 Shares of
Net Sales Price
Irf\.·er.itoried at
GA.]N
Western Pennsylvania
$1,049 ~97
893.75
Pennsylvania R.R.
$3,245.27
3,175.00
?ennsyl\.ania Railroad -Dividend
~estern Pennsylvania
:"fational Bank
u.s. Savings Bonds
'. -Interest on Savings
Account
-Interest :f.fom
5/24/67 to 1/12/68
TOTAL DEBITS
. -2-
Amount
$ 30.00
62.45
100.00
11.00
2:.55. 00
250.00
156.22
70.27
30.00
166.72
251.64
$1,383.30
•
...
Date
1967
June 28
28
29
Sept. 12
Oct. 30
30
r:ec. s
De"c. 29
1968
Jan. ~0
2::>
"'· . . .•
<... • ..
The Ac~ountant claims credit out of the assets of the Estate,
to wit: -
Payee Description
Ruth Eckert Funeral Home -Complete Funeral
Howard .F.· Carson -Reimbursement for ~wo
Death Certificates :
Joseph~e M. Douglas,
Agent
Mrs. Charles Riley
·Centerville Medical
Group
-On Account of Pa.
Inheritance Tax
-Room Rent Due
-Past Due Account
William F. Hazelbaker -On Account of Executor's
Commission
~:-Iowa::::-d, F. Carson, Esq. -On Account of Attorney's
Fees
We~tern Perinsylvania
National Bank -Box Rent
Sale of 10 Shares of Charles Town Racing Assn.:
Inventoried at $ 42~50
~et Sales Price 28.20
.LOSS
Willi3.m F. Hazelbaker -Reimbursements for:
Reve~end Paul -~un~ral Service $20.00
.~merican Legion-Pcdl Bearers _20!00
Wake Refreshments 20.00
William F". Hazelbaker -Balance of Executor"s
Commission
-Reimbursements for: HJward F. Carson
6/5/67 Jose:J?hine M. Douglas -Probate of
6/12/67
6/12/67
7/31/67
8/.22/67
lo/30/57
il/12/6;3
Will & Short
Certificates $~5.50
Josephine M. Douglas -5 Short
Certificates ' 3.00
Washington County
Reports
Josephine M. Douglas
Valley Independent
Josephine M. Douglas
Russell. Marino
-3-
-Advertising
-1· Short
Certificate
-Advertising
-1 Short
Certificate
-Filing
Inventory
12.50
:...oo
10.50
1.00
:::.oo
Amount
$1,299.00
2.00
2,750.00
28.00
8.00
1 ,ooo·. 09
1,000.00
4.00
14.30
60.00
68.50
Date
1968
Jan.
... ' " .
(Continued from page 3)
The Accountant claims credit out of the assets of the·Estate,
·to wi-::: -
Pcyee
20 Heward F. Carson
20 Gazella Mucy
2C Ru5:ell Marino
Description
-Balance of
Attorney's Fees
-Notary Fees on
Inventory,RCC33,
Debts & Deductions
Account and Audit
Petition
. -Filing Account
TOTAL CREDITS
-4-
Amount
$ 342.27
7.00
18.00
$ 6,943.34
~--
Washington County Reports
~
Washington, Pennsylvania
(PUBL SHED EY WASHINGTON COUNTY BAR ASSOCIATION)
PROOF OF PUBLICATION
In compli<nce 'Vith the Newspaper Advertising Act of·May 16, 1929, P. L.
1784i Sec. 3, par~rapha (3) and (25).
Cou•Tv OF W ASEINOToON .! SS
STA'J"'?: OF .PBNNS:"LVANIIA ~ •
Per,onally appc:;.rec before me, a Notary Public in and for said County and
Com:nonvo;ealth, •:::HA~LES C. KELLER, who, being duly sworn, deposes and
says: tha; he is the ~d2or of the WASHINGTON COUNTY REPORTS, the
officio! legal peri"c-dical fo: said Washington County, publis'hed weekly having its
place of tusiness at VJas)ington, Washington County, Pennsylvania, and is act-
ing ;;s it: agent in ::hie behalf; that the said WASHINGTON COLTNTY
REPORTE was e-:tabli:he.l on March 31, 1920,.and was designated as the official
legal publi::ation :or \FasJington County, Pennsylvania, by order of the several
courte ol &~id Co\Jilty, 3at~d November 11, 1920; that the printed notice or adver-
tisemc.nt a· tached .heret:J i: a copy of a notice or advertisement, exactly as printed
or pu:olishe:l, whiCJ app:::ar:!d in the said legal periodical in its regular issues on the
follow.ng mtes:
June 15, 22, 29, 1967
that tle afiant or 1:he orpration in behalf of which he is acting is not interested
in the subject mat~r of :sai:l notice or advertising and that all of the allegations of
this af:idavir. as to ~e tme, place and char~f the publicatioo are true. (){~ ____ & __ ~
Sworn :o atxl su
KATHf.RINE C. YARD, Yotary
Was•ingt•n, Was:1ingtan ·~o.,
My Commiss:on Elpires
Na vember 1, 1 ~ 69'
-Editor
.:1 :·· ''~ ,~,./
Estate Notices
The Register of Wills has granted letters,
testamentary qr of administration,. in the
following estates. Noti<:e is hereby given
to all person;; inde!Jted thereto to make
payment. without delay and to those hav-
ing claims or demands to present them
for settlement to the Executors or Admin-
istrators or their Attorneys.
••ooeo•o••••• ••••
HAZELBAKER, SHELDON R., Dec' d.
Late of Roscoe, Washington County, Penna. Executor: WHiiam F. Hazelbaker, Box 'in, Roscoe, Penna. Attorney: Howard F. Carson, 212 Fourth St, Charleroi, Penna.
/' ... ~ )
Proof of Publication of Notice ·in The Valley Independent
I
Under Act No. 587, Approved May 16, 1929, P. L. 1784,
as amended by Act. ·No. 51 of April 24, 1931, P. L. 67
State of Pennsyl\o;Qnia
Count-1 of Westmoreland }ss:
Per:;onolly oppeo·ed before me William H. Pore, Secretory of Mon Veney Newspapers, Inc., a Penn-
sylv::m.<J C)rporotbn, publisher of The Volley Independent, who, being culy sworn, deposes and says
ho1 The Volley fndependent is a doily newspaper of general circulation in Fayette, Washington. and
·we!tme'rei-Jnd counties, Pennsylvania, and elsewhere,. published in the Citr of Monessen, Westmoreland
<·ou,t)o. Pu1nsylvonia, that it was established June 28, 1902, since which dote The Volley Independent
h:::Js !:>een rE-gularly issued in said county, and that a copy of the printed notke or publication is attached
hereto exa-:tly as the some was printed and published in the regular editbns and issues of The Volley
I ndeoende -tt on the following dotes, __ __,J<-Iuno6Ulie._..l ..... 5._,,--dtl....!9~6:-~.7 _________________ _
June 22 and June 29 1967
A.ffi:mt furher deposes and says that he is General Manager of The Volley Independent, a
<kily news.:::x:Jp~r. ,~t general circulation, and as such is authorized to verify the foregoing statement urde·~ oath. ondFAlfiont is not interested in the subject matter of the aforesaid notice or advertise·
nent. O""'d that. aU allegations in the foregoing statements as to time, placE' and character of publico-
t·m ere true. t-.,, ' I ~
'·~<;, ..
COPY of r.:~t:I'CE
Lethrs t:~am.entari-'n the estate ·of; Sf.eldoa R. -iazelbaker 'late of Roscoe, ·w ashlrston ·County, d•ceased, having, bean s ran toe ·bY . .th.e RagJs\er of Wash·. Jr,•ton Court•; notice Is hereby given to· ali peiSons ndeoted ·to said estate to' m• ke mmEI ate paymeo t, and to those 1 ha •Ins · clalih6 against tlle same to pre· sert IP.em "'ilh.oul dela-to William F.
HCEelbii ker, ,~xecutor, Bvx 37, Roscoe, PetnSY"Vanl;. Howard F. carson, altar· ne\, 2tl 4tl Streef, Ch orlerol, PennsYI· vaala. ' · · · 6;15,22,291
•.
~...~:.,...e.+-<q,.«<-&..:!~:;;;c:,;H~A=r, ~~..""""-s+P_q->=;t:.'.:'~!::::H::'r~2' ""'rp::t.lfi..,b""t~tc.dy~:""~::l:"·::.lli.::.' ~ ............ (;
l&onesseo, ~ esfmoreland Co., Pa. -
£U.y Commi~n RP.l.~ My commission expires . ·"'· · ... .lantli!l,.~7+ · .
STATEMENT OF ADVERTISING COSTS:
Howard F. Carson, Attorn~
212 Fourth Street
Charleroi, Pa. 15022
TO MON VALLEY NEWSPAPERS, INC., -DR.
For publishing .the notice or advertisement attached hereto in The
Volley Independent on above stated dotes ....... : ........ . $ 10.50
$ / Notary ···~···;····································~·········-················
Total ......................................................... -.............. . $ 10.50
. PUBLISHER'S RECEIPT FOR ADVERTISING COSTS
M~n.Voll::y Newsoopers, Irk., publisher·of The Valley Independent, o dc:ily newspaper of general.
ci ·cui•Jtion, ~reby ocbowledges receipt of the aforesaid advertising and pubLcotion costs ·and certi-
fies tnot· ths scrne hoY:! been duly paid. ·
MON VALLEY NEWSPAPE~S, INC.
By
'[
''
\
!'
' .,
-·
Testate Form/
PETITION .SUR AUDIT
IN THE ORPHANS' COURT-OF WASHINGTON COUNTY
Estate Of ..... ~., .. §:~~]:~.?.~ ___ g_~---~~~-~}:t?.~-~-~---·············· No .... ):9.1: ... <?.!." ... 1.~.?.~---·-···············--···········---~-. ~-
. Fiduciary ..... W.:J:J:.~.i~m . .¥..-. ... tl~?.gJ_R~~g_L_ ....... .
Deceased
Date of Date of Deceden~'s de\:lth, .. }~~X. .. ?1:.L.~2-~?. ............................... Grant of Letters ___ _-_;!~e-~--~-L .. ~.?..?.?. .... : ......... : ..... :··::···--··
This is tbe ..... _X:~E.:>.~---~e-~ . .!.~?.-~~---····························-account ·filed in this estace
If th ' · b f · t f'l d · h' 1· · f''l b' b d None ' ere ,,a-.e een orme1 accoun s 1 e 1n t IS estate, 1st 1 e num er or num er an term ................................... .
Election to take Date Election Place of;
Under~~ostwill. (cross out one) ·Filed ····················-······-·-··· Record ............ , ............... ~--
{By acquiescence) -· · · · · .-_ _ ·
Name of surv:ving. spouse .......................... ~~P.~_:.-........................................... ~.: ........ ··············----------------·-------·: ..... ,-~~-: ..
List is_sue, where mcteria:: . ' '
Non,e .,,
•"-
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Did decec-en! many~cfter ~xecution of will? (indicate) 3t':R:x No. Any children bor-n a_fter execution of will? (indic-cite)
~No. If tJnS'We•· yes, name _them .......................................... : .. ·-······-··:········-··········-~ ·-·-···-'---------····-·--····----······-·--;· ____ __
,: ' ----------.----·---~---~~-----··-----------·--------------------------------------------·----.---------------------------------------------------------------------:: ........................... .
Leg.ate_es Relationship
Rober1: Web":J Nephew
James Webb Nephew
· RichardWebb Nephew
Frank Haze:baker Brother
William F. H~z~lbaker Brother
Amiel Ha2elbo..ker ~ ti."'\.~ ... /~'rBrother
Ber;tha H. Wet-b Sister
. -1. D . ~~ Car o 1.::1e EV 1.ne 111-1 L-t,_..., Sister
List, if exceptions ~o ab6v.e.: Adeemed: Revoked:
None other t)1.an those indica ted above.
If partial i-ltestocy, gi·,e fcr:ts:
None:
Interest Fi.uciary, if deceased or not sui juris
Spe~ific B~q~eei, but items were s6ld
by decedent prior to his death.
Contingent legatee for Spec~fic Be-
quest made to ~obert Webb in case of
his predeceasing James Webb. . -
Contingent legatee for Specific Be-'
quest made to Robert Webb in case of
his pred~ceasing ·Richard Webb.
1/5 money residue Sui Juris
1/5 money residue · Sui Juris
1/5 ~oney residue Deceased,
1/5 money residue
and other residue
1/5 money residue
Lapsed: Abated:
his share
passes to
others
Sui Juris
Deceased,her
share pass~s
to others
Give Cause:
Notice to ir,terested pa1ties. Have all parties, having either vested or contingent interests and all crediors entitled
to notice (:::,u.-t F:ule NJ. 9 ~aragraph C: Section 6: Subdivision c) received written nohce of the filing of the account
and of cal. of tJudit? Yes. ~
If --t' · None any excep 1:::>n g1....e cause ----,·····················:········---·'········
File copy of Netic,:! . · / ·
and date ot rrailing'. ....... ~! ~.'?. ... ?.~ ............. , ................................................... , ..... _., ..... ,-,.,,, .. ,,., .. _ .. ,, .... ,,.,,,,. ........ , .. ,,. .. .
-,
Is estate subject to the filing of a Federal Estate lax Return? .................. : .......... ~~-~ ... : .•......... •=················'···'···'···'·'··':
Actual payment made on Pennsylvania Transfer Inheritance Tax. Amount $.?..2.7.:-?.Q ... '?.~---~~-?..~:!:§ .. ~h-.<?.~J.Y. ..... .
owned ·by decedent, plus payments in full by. survivors o£ jointly held. bonds.
If the Will makes any portion of estate subject to a life-estate, give name and birth date of life tenant ..................... .
None
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.
~. & ~
None
~ .· ... "'!·-
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Give reference to such parts of the will as re.quire interpretation by the 1Court; a reference to all questions re-
quiring adjudicetion, and a statement of any other facts deemed necessary for the preparation of the adjudication:
~ 0 0 •. L • 0 0
L -"" ' ~ ~ ''"'·• • ~ " i: • ~ .. ~ • 0 \ _!:" :: o ' • ~ • f •C ·C. I '1 C. .. ~I '; ,. ··t '"C.
Paragraphs FOURTH and SIXTH seem to be in c;;6n£lict, however,:.'any issues·
have been resolved by a Family Settlement Agreement, ·the origin@:l o£.'which
is· attached hereto £or pre·sentation to the ·court £o-r approval.
~~ r· ::.:· £ .-.,.' ..... .-·,.,..: ... ' ·' . ,., .... ·~ i •, ~~ .I
Balance for distribution per account,
Itemize any additional debits not shown by account: $ .... ~?..1.?..~?.:~.Q~---········
'li
Total .~dditional deb.iJs (Add) $ .............. Q.~_QQ: ........... .
Itemiz-e any additional credits not shown by account:
\
Total additional credits (Subtract) $ .............. ?.:.9.~----~---····-
Balance for distribution $ 19 '902. 08 . ....................................................................
If balance for distribution is not in cash, list each item held in kind, giving appraised Value (or distribution Value);
Western Pennsylvania National Bank, Roscoe O££ice
Savings Account #2608 · · ' $ 9,000.00
.... Checking Ac.count · 186.36
87 U_.S. Sav~ngs Bonds valued on 1/12/68 9,715.72
~ $ l9,902.08
•,·· L
~!:' :.
If Fami!r Exenption claimed by Petition, give place of Record: ............. NQ_I}~---····································-~------~--~--'--------
If F . E .t.. . I . d ··d·t· . I · h" d b · f Cl · None am1 'f xemp r:m IS c c1me at' au 1 , g1ve name, re at1ons 1p an as1s . or a 1m: ............................................... .
List any ::~dvar-cenert or :listribuiion on account that ·has been made, and nature. :md amount of same:
On •October 30, 1967 advancements in sum of $500.00 e·ach.were paid to
Franl-: Haz.e]baker and Bertha H. Webb.
Suggested d :stribu~ior of balance .;hown, both as to principal and income, attaching signed and itemized elections
to take r k nd if lbalbnce is not in cosh: residuary shares being-stated in proportions:
It is ~uc;;.gested tha1: in c9mputing .the shares. of the three distrib~1tees
th= corr:_puted 'value of. the 87 U.S. Savings Bonds be t::eated as cash.
Any increases in value will be distributed equally between the three.
FRANK H.~ZELBAKEP.
WILLI~M· F. HAZELBAKER
',.
COUNTY :)F WA9-IIr.-JGTON, SS:
COMMOt·.fNEAL Tl--OF PE'\INSYLVANIA.
The above nc med =iduciar'=" or re1=7esentative thereof,
being dui1)' •••• _!?.'Y.f.<?.~F.l .. _. _______________ doth depose and say
that the bo:ts :se1 fo·th in the forego"ng petition are true
' \ ... \ ', ~) ,i !; -.
to the .~~=t of ......... 1_:,hi,~;.-··········krowledge and belief.
...... I' , I c _. ol ;{ • ...-.· ~
~~ ~ ' • ,/ ,'ft . _I ------4-.::;~;~-.?~~!.~:,----'::.-': ..... ::; .. to ancl subscribed before ·• .. -~ ) ' •' .
:h; . ;, I IJ?~ ;SJ ' #-68 me t. IS.J •. .!. ..... r ... day--6-f.· .. \...,... .... .... . ...... 19 ....... . ",, • •; . • J':'~-~ ~i
'J, ;// }" '/, •. ";·~~ ·.\: /,_ ')•. -i ~,. /~ ~ " l '. _..... . -""'= ..... \I' l J \, . S gnatur.~-st 1 o_. ffice1 .. : . &2-:J.,.A~--..............•...• . ... . ~ , 1 \f "" __ , \l n ·Tit··,~ of c.f~ic~r .:-.: .. ~ ~~-!~~~---~~!?.~ ~.: ................ : ....... .
Office expires. ...................... -........................................ . ,, .
GhZEllA JIUCY, NOTI!\RY PUBLIC
CHARLEROI BOROUGH,
WASHINGTON CJUNTY
Mr CCMMISS.ON EXPIRE:; AUG. 30! 1971
1/3 of Residue
1/3 o£ Residue
1/3 of Residue
And your petitioner will.e1er pray, etc.
ff~.TAI~------------
~· ..................................................................... ~ .... ~ ~ ....... !'" .......... !" ... ~· .... "':' ...... t ............. ~ t ........ '!'.
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No. ·--~-Qi .. 9.t. .. J.2.9.tL __________________ ~--------~-.
Estate of Shelqon R. Hazelbaker -------------, .. --------------------------______ ; ------~--
...... · .................................. -........ ----.. --.. -·-............. -~-:. .... -............ -----.. -.. .
Deceased
Fiduciary .... ~ft..-~!-~-~~--E! ... H~.?:~J.R~-~~_i· ___ _
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: parogi·aph b-e; dnd divisions
thereof: shown on pages 23-24.
l. 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
litem, if pertinent.
4. Proof of service of above.
5. Letters Testamentary or Administration
C. T. A. or an attest copy of Wi II. '
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 'und. iten-iized elections if any
distribution in kind.
1 O. Copy of Federal Estate Tax return if ,es-
tate is subject thereto.
_______ 12~~~~--!.-· .... ~~~-?.~-~---~~~~~-~:~· ....
Attorney ~2
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:r: the matte· cl the Audit of .Account in
3l~tare of. _ __:S::.:~=e-=l:..:d::.co:::..n=--=R..:....:... • .......:..H::.::a:..:..z---"e-=l:..c.b=-a::..::.:..;k:....:e:..c.r-+--l No. 104 _ _.:o~f::;..;_. ____ , 19.2.§__, x~
Deceased I•
':"'0 ;rHE AUDITING JUDGE:
Ecter_-=--_llllY__, ______ -'appearance foJ; ____ .,--__ L_· _W_i_l_l_i_a_i:n_· _F___:.._H_a_z_e_l_b_a~· _k_e_r __ ~~-
d~i' Je_ .. ~;
22. :ndlday of_'M~a:.:r::...c=h,__ ______ _
N.B.-Counsel stall, by separate paper, present a concise statement of ·each
c aim, wit;). supporting calculation of any interest claimed. Objections
tc· an account as filed, shall be concisely stated in a separate po:tper.
C!:>uncil su;;-gesting proper distribution shall file a separate concise Etate-
rr. en t in th;.t regard.
tl
.•
N:o.l04 £ 68 0 '19 __ ,~*·
In re Audit of Account in Estl!-te, of
Sheldon R. Hazelbaker,
Deceased.
AUDIT
. Jrtttripr fnr 1\pptttrunrr
FOR
William F. Hazelbaker
~~
HOWARD F. CARSON
Attorney
~2
1Jn tl]e ®rpqans~ <nnurt nf llusqingtnn Q!nunty
ESTP.TE OF 104 No ............... Of 19 ... ~.6.8 ... , A*.
S:1eld•)n R. Hazelbaker -------------------------------------------------------------'-----------First and Final In the matter of the ........ --------------------------------
-----------------------------------9,~-~-~-e..~~-g_. ______________ _ Willia~ '· Hazelbaker Account of ... ---------------------------------------------------------
E:xecutor.
ADJUDICATION AND DECREE
And mo...-....... -----~?..:.~-~-------------~----------------/7 .... , 19 ..... ~~ this matte-r came on for hearing,
a'.Jjit ard di:otributic·n at this session and testimohy-taken; and thereupon, up:>n due consideration
tlhe,reof -~~ ~~,l~nfi8 for distribution in ;the hands o_f the Ac_countant.!s d~term_in_ed to be
$. _______ -,. __ .J-------~---------------·---------------and the account IS accord1ngly conf1.med, and 1t IS ordered,
aj_ud;Jed and decre·=d that the said balance be paid out by the Accountant im accordance with the
sched.Jie of distribution hereto attached and made a part hereof, unless exc:eptions hereto be filed
sec.. reg. or c n oppe-JI be taken herefrom sec. leg.
Bai:Jn«:e pe·r ac:count ............ ---------------------------------------------------------------------·
Be loJn c e ... -.----___ ............. ------....... -----... --------------...... --------.... ---.. ---.. ---------------
De·cuc: C erk's Costs 3.: Receipts .............. : ...... : .. :-------: .... : ... : .... :· .. :: ... :: ......... .
AttoJrney ______ --~~Y!-~r_g __ f.!'...P~.:r.~.9XL ................. ---------------------------------·
Russell Marine, Agent, transfer inheritance tax,
Tr_e, :E."olllow:.ng distribution is made under the
terms of a Fan:ily Agreement filed.
Fr·sn1: Hazslb~:ker, 1/3 balance,credit· to be take
by the ac'countant for funds in the amount of $_sco.oo, aj,;-anced prior to distribution by the
Cct:.rt,
Will1arn F. Hazelbaker, 1/3 balance,
Bertt.a H. ltiebb:J 1/3 balance, credit to be taken
by the ac-:::cu.nt9.nt for funds in the amount of
$~OO .. OC• a,J.vanc 3d prior to distribution by the
Co.Jrt,
35.
$-------~~-~-~.9.?. 08
$ ...... J~-~-~9.?. 08
o-·.
$· ~866;·58' .
?kec.-?,2"-G.~
t?~/~J--. ..~~ ~?/-,/~
@~CPf(? $ 19,576.33
~t:(.CI t&-c.r
/~j::' r~/!o..,~J-
~J! /n.v~
art:e-~
No balance
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104 Of No ............. ,. 19~-~-------, ~ .. k
In the matter of the First and Final ·
account of William F •. I:iazel baker
of Estate of Sheldon R.Hazelbaker
. 1\bjubiratintt anb mrrrrr
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~N THE ORPHANS' COURT OF
:A.SHINGTON COUNTY , rENN' A.
0. o£ 1968~
P:u :re:
ESTATE OF SHET.DnN R.
HAZELBAKER,
nere~c;;t:?n.
FAMILY
SETTLEMENT AGREEMENT
~Y~~
~_and~~~..::l/,;.w
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15022
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hfcjgm 1-5 1/18/68
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IN THE ORPHANS' COURT OF WASHINGTON COUNTY, PENNSYLVANIA
~~T~;~ OF SHELDON R. HAZELBAKER,~ No. j(:/ .. tj' .. ~ of 1968
Deceased. )
FAMILY SETTLEMENT AGREEMENT
MADE AND ENTERED INTO this·;l.,ZO(ctay of~< ' 1968,
BY AND BETWEEN Frank Hazelbaker, William F. Hazelbaker and Bertha
H. Webb, all of the Borough of Roscoe, Washington County, Pennsyl-
vania, hereinafter referred to as the "Heirs".
WHEREAS, the Heirs are the surviving brothers and sister· of
Sheldon R. Hazelbaker, the above captioned decedent, who died
May 24, 1967, leaving a Will, a photo-copy of which is attached
hereto, made a part hereof, and marked Exhibit "A", which Will
was duly probated in the Office of the Register of Wills of
Washington County on June 6, 1967.
WHEREAS, in Paragraph FOURTH of said Will it is provided, as
,: follows:
"I give, devise and b.equea th all money or monies in bank
in my name to my brothers, Frank Hazelbaker, William F.
Hazelbaker, Amiel Hazelbaker, and to my sisters, Bertha H.
Webb and Caroline Devine, share and share alike or in
equal shares to the survivors."
WHEREAS, in Paragraph SIXTH of saidWill it is provided, as
follows:
"I give, devise and bequeath to my sister, Bertha Webb,
the remainder and residue of my property."
WHEREAS, realizing that these two Paragraphs raise an issue as
to their meaning, ln relation to each other, in consideration of
the fact that it was the understand1ng and belief of the parties
hereto, elsewhere referred to as the "Heirs'~ that it was the
intention of their late brother, Sheldon R. Hazelbaker, to treat
his brothers and sisters, or the survivors of them as a class,
11 share and share alike or in equal shares",the Heirs do hereby
enter into this Family Settlement Agreement.
NOW, THEREFORE, KNOW ALL MEN BY THESE PRESENTS:
1. In consideration of the love and affection between
our late brother, Sheldon R. Hazelbaker, and each of us, the
one for the other, we, being the three survivors of the original
twelve children, and of the six of us who were living at the
time of the execution of Sheldon's Will on March 24, 1953, we do
hereby enter into this agreement, subject to the approval of the
Orphans' Court of Washington_County.
2. We do agree to jointly request the Orphans' Court of
Washington County, and by the execution of this Agreement we do
hereby request the Orphans' Court of Washington County to carry
out what we believe to have been the wish of our late brother,
Sheldon R. Hazelbaker, that is in distributing the net assets,
the distributive shares of each of us be ordered to be in equal
amounts.
IN WITNESS WHEREOF, with the intention. of being legally
bound hereby, for _ourselves, our heirs and assigns, we have
hereunto affixed our hands and seals on the date first above
·.vri tten.
-2-
_tJ=""'.""""'~~--·~-' ~'/-:-;.H.:...:-. ~;,.;..:(d?=-:::.....:0~(SEAL) Bertha H. Webb
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WILL [single Sheet)
i'ul>lial>ed l>r Tbl!' Plaokeol>o7o Co., Wllliamoporo 2. Pa.
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Tha;J, EHELDON R. HAZELBAKER · , of ROSCOE
in the County o; WASHINGTON and State of Penmylvania, being of sound
mind, 'J!llemor:.J ana understanding, and considering the uncertainty of life, (],() he' eby make, publish.
· and dedare this my last 'OOlili and ~eiitriment, hereby revoking and mcking void any mid all
. farn;.er Wi!ls l!y me at any time heretofore made.
F:RST: 1 ciirect that all my just debts Xi}mJjl.fillifliDllijfa!Nlbbe paid by my Executor
' h~re7.nafte·r nc.med,. as soon after my decease tis may be convenient.
S~CON!J: "X:r.):D~~ww:Jx
I direct that my· funeral ·expenses be paid by. the bene-
fici :lry of. rr:y_ life insurance policy or policies.
I give, devise and bequeath to my-nephe~, Robert Webb,
ny boat, motors, and sporting equipment.
In the event that the said Robert Webb 3hould precede
· ·ne in de:1th, I direct that my nephews, James Webb and Richard ·
·'flebc, sh9.11 receive the above mentioned boat, motors, etc., in
ec~.lal sh9.res or all to the survivor.
FOURT·:I:
· I gi:ve, dev~se and bequeath all·money or monies in
· -~ank. in my name to my. brothers, Frank Hazelbaker, William F.
~azelbaker, Amiel Hazelbaker,-and to my sisters, Bertha H. Webb
i.
,· ;·
'·.
.· and Caroline Devine, share and share alike or in equal shares to· · ·:
the surviVOII'S. · · : ·
.FIFTE: ...
i·
I give, devise and bequeath to my sister, Ella H. Cox, ·. · ··
wr.o~e place of residence is· unk.."lovm to me .I> the s1;m of $1.00 (One· .
Dc·l·_ar), if her whereabouts can be. determined. . •:'
SI4TE:
. · I give.IJ.devise.and bequeath to my-sister, Bertha Webb,
·.the remaincer and residue of my property •
AND LASTLY.-! do make, constitute and appoint William F. Hazelbaker·
to be Execu~ or of this my last Will and Testament.
1In Ur!ttness ~bere9f, I ~ave hereunto sub~cr_ib~d my name. and affixed my seal, the
I'v~enty-fonrth · .. day of March in tie year one thousand nine
h1:ncired ar.d Fifty-three.
~ig1ted, seozled, .iJublished and declared by
S.b .. e.l..o.on. ... R.9 ...... 3.a.z;.~l.:P.~x-~.:r. ........................... .
~h~ tGStat cr above named, as and/or
'his last Ffill and Testament, in the
.. ~rr:ser:ce of us, 'Vilho have at his request,
:;ulscribed O'ittr names in his presence, and
in .thE" presence cf each other, as witnesses
he-;etc.. -:7 r ~~
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--;:JuJ.:rt-.r-f~, ... : .. c. -~~--t.,l.r:K.J..~---:r·)-A-~_--
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IN THE ORPHANS' COURT OF WASHINGTON COUNTY, PENNSYLVANIA
IIT ~E: ESTA1.E OF SHELDON R. HAZELBAKER, ) No. 104 of 1968
deceased. )
PAY TRANSCRIPT . .
AND-NOW, ~hi.s::J: . .O ~day o£ May, 1968, the undersigned do hereby
c..c.~:J.owledge· to have received from William· F. Hazel baker~ Executor o£ the
Es-:at= of S~1eldon R. Hazelbaker, deceased, the sum o£ money set opposite
the::..r-names: Q.Ei.og the sum o£ money awarded at the audit o£ the above
estc:.te, and do :fifrth~r wa,ive the right to file exceptions to the adjudi-
cat:Lo.r: c..nc the ['i_ght of appeal £rom the adjudication' and, agree that the
EY.:e:::utor. may £o=thwi th make distribution in accordance with the'"terms o£
tl:e adjudi-::ation.
RUSSELL NAP.Il\-0, · ·
Clerk's Co~ts .
-,~ _¥:
~US3E:LL MAR:No~,
Agent r
FRAKK HAZELBAKER, 1/3 balance,
c['edi 1: to be taken by the·
accmmtant £o:r; fu.nd.s in the
anount "of $500.00 3.dvanced
prior to distribution by the
Court, '
Due to ·the heir's physical
incapc.ci ty/:te ~·has signed this
by making hi.s !llark.
Witnesses for -:he making ,'Jf the
mark by Fr2nk :Hazelbaker
,I
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WILLIAM F. HAZELBAKER , 1/3
ba:lar:ce, . !r'
BERTHA. H. \\EBB: 1/.3 balance.·
c,redi 1: to be ta.ken by the
accour:; tar. t for £unds in the
amount of. $30D.OO advanced
prior to dist::L:m'tion by the
Court,
\'
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Frank ~~ ~ Hazelbaker
( .· ... ) .
$6,525.44 mark --------------------------------------
$6,525.44 ~ [~
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$6,525.45 23~H. (k(~ -----
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IN THE ORPHANS' COURT OF WASH-
INGTON COUNTY, PENNSYLVANIA.
·'
): No. 104 of :1968
(;.: .·
I.·<:-
IN~:
·'
ESTATE OF SHELDON R ., . HAZELBAKE_F,
Deceased · ··
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Howard F. Carso.n,:-E:sq.
Charleroi ,n Pennsylvania· . ( ;.
; . , i-: : • -:· Attorney for Estate
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Form RCC-3::
.,.... . -·
-:..·•
COMMONWEALTH OF PENNSYL VAN lA
:DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
'• J
RESIDENT I•ECEDENT COUNTY OF ------~~-~J:-~.r:t9..~.?-~ ........................................... ..
lMPCRTANT: '!his re-:.urn must be completed in detail and filed in duplicat:!, ·with will attached, with the·
F.egiste:-of Wills of-the County where decedent ·resided; Return is due within one year after
cate of death, unless an extension is granted by the Secretary of Revenue. (Section 703 of
___ th~ __ In}).erit!ince_.!in!l :E.~t!ite .T.a~ A,ct of l!Hll.)
=~:::::~;~~~~~~~~~~:~~~~-~=:}~
Per:nsvlvania S':'te •f ............ ~ .......... :: ..... : ....................................................................................... :.} ss:
. 'V-ash1.ngton Ccant! of ................. -........ , .............. -...................................................................... .
William F. Hazelbaker Eeeator
of ~e estate of the above-named decedent being duly sworn, depostS and sayS
Decedent dJeal . M ...... a .. :_l24. '··· :.1.. 67 . . copy of which is hereto attached. } ... . . .. (M~~tlll ....... (!;;;·;·;····· ...... , 19.(v~~)· .. ·~{~;:;~~av ing a last w.ll,
Na~e and address of at:orney or}
oth.er a.Jthori:ed :cep:esentative to ·······
who<n alil cor respo,dence should be_ ..
mai.led.
....... JI. 9W.9.-:J::Q ..... F. ~ G.9.,.:J::?QP .................................................... _... .. . .............. ..
... ~-1-~ .... J<:our .. th .. Street, Chq.rle.ro.L, ..... Pa ..•
That ~ st:ch E:<ecutor ...................................................... deponent is familiar with the affairs o: said estate and the property con-
( J:xer.u tor-AdministraLor)
sbtut:ng tre aEsets thereof and their fair market value.
That a~ thE: time ol death there was no safe deposit box registered in dececient's individual name, or jointly
with, or as agwt or ck!puty of another, or in decedent's individual name, with ::-ight of access by another as agent
or deputy, wit}: the e:loception of 'the following:-
N AlliE .\ND AD DRS: s s oF E ANK oR oTHER nisi I TUTI ON THIS SAFE DEPOSiT BO~ RENTED RELATIONSHIP OF JOINT
IN WHICH DECSDENT RENTED A SAFE DEPOSIT BOX IN NAME OR NAMES OF HOLDERS TO_DEC~DENT
We:;tern Pennsylvanl.a Nat1.onal Sheldon R. Hazelbaker Brother
Ba_'1k, Roscoe, Pennsylvania and William F.
Hazel·baker
Tha-:. the c.,ntents of said safe deposit box or boxes are itemized under Schedules B & Eof this
retu:-n, wjth -:.he exc~ption of the followin~ for the reasons hereinafter set forth:
Thart Sc.hec"u/e A attached hereto and made part hereof sets forth full v and in'·detail all the
real proputy in the Commonwealth of Pennsylvania of which decedent died h3.ving an interest therein. It
also sets for-:.h the nortgage encumbrances upon each parcel of real propertr at the date of death, _giving
t~e .unoun-:. still due at death, name of mortgagee, date,. rate of interest. and book and page of record
ther~or. It ~lso-sets forth in the columns provided therefore the. asse&sed valuation of each of said
p~rcels, t!he estimated market value thereof as of date of death of decedent.
Tha>. Sched~le B attached hereto and made part hereof sets forth ~lly and in detail all personal
property WJeresover s.ituated owned by the decedent at the time of death; all moneys left by the decedent
a.t tile tin.e of death_ whether in decedent's immediate possession, standing: to decedent' s . .,credit''in·.banks
olf deposit, s~vings ·Janks, trust companies, or other institutions, whether individual}Y~-0-~·.i.~:):T,u~~;·~~-r
any c·ther [per~on or rersons giving also separately the accrued interest thereon, if apy,,<..-~9~: to . .,~he-,)tas·t
1:-tterest cay Jl'rior to decedent's death in tJ:!e case of sa~ings banks, and tJ the dat!!~ ~f:<d'~c.~dent' ~-~de_a~\
1:1 a:.1 other eases; all bonds, postal savings, treasury certificates or notes and othe:l-eviden·.ce o'f 'in-L
d:!bt~dness of· the Und ted States to the decedent; all obligations, whether by stattfte. ~f~agre'e~ent;::,t_heyt ~ ~ f ~ ~-;.... ( t are d.esigrate• as tax free, of the United States, or any state, or polith:al subdiv·~_sJ.e .... n{:.t[t~~~9(t~:~~'-qr
a1y foreign ccuntry, which are owned at the time of death; all wearing apparel, jewelr.y~·c._Sil:v.~r.l!{i.r.e",{"fli.c
t Jree., bocks, works Jf art, household furniture, horses, carriages, au tome· biles, boat~j>,Afi_a. ~y~·~rr~··~il
. ( fit.,. • .. , otheJ personal chattels of whatsoever kind or nature, left by decedent, together with the fairly· estimated
m~rke-t value -:.hereof all bonds and mortgages held by decedent and of all claims due and owing decedent
at tLe time o~ death. and all promissory notes or other instruments in wrJting for the payment of money
or w&ich c.ece•ent di:!d possessed, of whatsoever nature, with interest thereon, if any, giving the face
v :tlue and ·est:imated i:"air market value thereof, and if such estimated fair :market value be less than the
f~ce value~ i>. sets :"orth briefly the reasons for such depreciation·as to each item; all moneys payable
t·J tte estate from l:.fe insurance polici'es carried by decedent; all annuity and endowment contracts the
p :-oceeds o:f wl::ich wet-e payabl~ upon the death of the decedent; and all the ~orporate stocks and dividends
d'J.e there01 arcd unpa:.d as ·of the date of death, bonds and a·ccrued interest thereon to the date of dece-
d·:!nt •·s death End other investment securities owned by the decedent ~t the :;ime of death, with the market
v ... lue thereof at suet time.
In the case of securities 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 in any co-partnership or business, and in support of the value of such interest there is annexed to
said schedule, financial statements sho·.ving the assets and liabilities of said co-partnership or business.
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. •
"' ~ ., + r-• • .. r-
The Schedule C attached hereto an·d n';ade 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, iri contemplation of decedent's death, or intended to tftke effect in 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 transfe~ee and
all other facts of a pertinent nature regarding said transfer~. In the case of t~ansfers intended to
take effect in possession or enjoyment at or after death, there is also attached to the schedule a co~y
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, or jointly 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 of the instrument creating such po~er attached to the schedule.
That Schedt.:le D attached hereto and made part hereof sets forth the names and addresses of all
persons beneficially interested in this estate at the time of decedent's death, 'the nature of their res-
pective interests, their relationship, if any, to the decedent, 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 her·eto .and made a part hereof sets forth all property, real_ and per-
sonal, owned by
of the decedent
real estate and
the
and
the
decedent jointly with another or others, including intangible, standing in the name
others, plus the date and place of record of instruments effecting the vestiture of
date of acq~is~ hon '.of p_e.rsonal ty, plus the fname, ·address. and relationsliip, 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 funeral expenses paid;
family exemption, where applicable; costs of administration 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 ~f .. . . 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, commission or debt is ·less than the
estimated amount claimin'g 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.
Subs'crlbe(i a~1-S\YOrn to before me this . .:J.::.qd. ..... ·
· .. ,. j· ·_f.'j:.
,. 1 ' J •. II·,..; ~~ .... 1-::::;Y=rJ ......... ~ ....... , ::P .. fda~;; ... J~P.JJ.~.J;.Y. ........................ 19 .. Q.a. .... .
Box 37
(Street Number)
·'
-\~:ft~;~l:;~-. .. ..... -
' / · 'CHARl£RO! Sj}ROUGH,
·' · :-I•Wii.SHINGT6N COUNTY ..................... :g.9 .. ~.<?..9.~.) ...... R.~.!?:P..§.Y.±.Y..9JJ;t.9, .......................... .
(City or Town and State)
MY COMMISSIQNIEXPlRESiAUG. 30. li9d71 it NOTE: BeTore sign ng arf av 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.
R c c~~4 1 t-fl4)
COMMONWEALTH OF PENNS.YLVANIA
DEPARTI'\ENT OF REVENUE BUR~ AU OF COUNTY COLL ::CTIONS
TRANSFER INHERITANCE TAX
RESIDENT DECEDEi!.I.
'· . SCHEDUJ .. E .. A"
·REAL PROPERTY * ' '
;
Re:~l prc,perty in Pennsylvania, with statement of mortgage encumbrances up)n each parcel at death of dece-
del!lt. W1ere proper·-y heid as joint tenant or tenancy by entireties, report on Schedule "E". Property held by
the .de.cedent· as ten,:Jnt in common with another or other_s1 should .be identified as to quantum of interest and
the estinated value should be that of the decedent's interest only.
The real propertr located In the Commo!'lwealth of Pennsylvania should be I (1) I (2) (3)
described lby lot ond block nutlllber, street and street number, together with DEPARTMENT a general :lescrls•tlon of the pnperty, with a reference to the record of the ASSESSED VALUE VALUATION
conveyanoe by wllich the decedent took title; If a farm state number of a-FOR YEAR OF ESTIMATED CAUTION cres; also state11ent of mortga;Je encum~rances upon each parcel at death DECEDENTS MARKET VALUE (Do not write of decedeat. Taces, assessme-nts, accr.ued Interest on mortgages, etc.,are DEATH . In this space) to be liste-d on S:hedule "F" and must· not be deducted from this schedule. .
NONE
.
'
)
'
.
'
'
\'
Insert thfs totcl opposite "real property", Schedule "A" in the X X X X X
"A's Rep>lrted" column on·the last.page of this return.
/
RCC-3S
COML<IONWEALTH OF PENNSYLVANIA
'fRA.:.fSFEL INHERITANCE TAX
RESIDEN'l DECEDENT
..
SCHEDULE "B"
PERSONAL PROPERTY
INS'IRUCTIONS: This Schedule must disclose all tangible and intangible personal property owned individually
·by the dezedent, at ·the time of his death. Property owned by the decedent jointly with another or others
must be listed under. Schedule "E", Inta~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 should be listed first (e.g. jewelry, wearing apparel, household
goods, and fUrnishi~s, books, paintings, automobiles, boats, etc.)
Intangible personal property, such as bonds, treasury certificates, cash on hand and in bank, . .
stoc.cs, ·mertgages, nntes, together with accrued interest or dividends, salaries or wages, insurance pay-
able to t~e estate ~r fiduciary in said capacity, partnership interests, interest in anyundistributed
estate of or income ~rom any property held in trust under the will or .agreement of another, even though
located o•tside of the State, at the time of death, should be listed in this schedule.
Item
NO•
1.
2.
3.
ITEM
L~st and describe fUlly
Cas:::1
Savings Account 2608, in Roscoe O££ice
of "!estern .Pennsylvania National Bank
Checking Account 062 475 54 1 in Roscoe
Office o£ ~estern Pennsylvania National
Bank:
·4. 87 U.S. Savings Bonds, Series E, in
various denominations, having various
dates o£ issue. (See List Attached)
5. 55 Shares ~ock o£ Western Pennsylvania
National Bank
6. 50 Shares Stock o£ Pennsylvania Railroad
Company
7. lO Shares Stock o£ Charles Town Racing
A.ssc·ciation, Inc.
8. :'1etr opal i ta:"l Life Insurance Co. , Group
Policy 8052-G-$8,000 £ace, reduced to
$7,200 at age 65.
Insert tt~s total opposite "Personal Property", Schedule "B" in
the "As Iieport:Jd" column on the last page of this return.
UNIT
VALUE
16 l./4
63¥'2
4 :)14
X X
ESTIMATED
MARKEr VALUE
150.00
. DEPARTMENT VALUATIOI''
(Do not write in
this space)
3,331.07 ~
.-0>1J! ;. 1 '205 0 72 VfY"'t;
9,464.08. ~
893 0 75' hi(
3 ,175.00' K
42.50 ~
25,462.12
v'
ESTATE OF SHELDON R. HAZELBAKER
LIST OF .l.I .• s. . IIEII BONDS
Issue Value Value
A:n,Junt Nc:me (s) 'Date 5/24/67 At Sale
$ 500 St-.eldcn R. Hazelbaker 1-61 $ 467 .oo
500 II R. II 10-62 '4:39 .40
500 II R. II 11-63 421.80
500 II R. II 11-63 421.80
500 II II 11-64 406.90
50«> II II 11-64:. 406.00
50([) II II 1-66 386!40
500 II II 1-66 386.40
ALL TAXABLE -TOTAL $ 3~334~80
$ LOCI Stelden Hazelbaker 8-60 $ 95.32
lOCD II R. II 9-60 95.32
LOO II R. II .-.:· 9"'-60 95.32
100 II R. II 10-60 95.32
lOC II II ll-60 ' 95.32
100 II II 11-60 95.32
LOC II II 12-60 93.40
LOCD II R. II 12-60 93.40
10()) " " 1-61 93.40
100 II R. II 2-61 93.40
lOO II II 2-61 93~40
·~oo II R~ .• II 2-61 93.40
:_0(1 II ,, . 3-61 93.40
:_0(1 II II 3-61 93.40 ·_oo II II 3-61 93.40 ·_oo II " 4Q61 93.40
·~oo II II 4G61 93.40 ·_oo " II 5-61 93.40
:_OC• " R. " 1-62 89.68
:_0(1 II R. " h62 89.68
:_0(1 " II 1-62 89.68
:. 0(1 II R. II 2-62 89.68
:.oo II " 3.,..62 89.68 :.oo " II 4-64 82.72
:.oo II II 5-64 82.72 :.oo II II 5-64 82.72 :..oo II II 5-64 82'.72 :.oo II I! 11-64 81.20 :.oo " " 11-64 81.20 :..oo " I! 11-64 81.20 :..oo " I! 11-64 81.20 :.oo " •I! 11-64 81.20
3.00 II II 12-64 79.68
!00 " II 1-65 79.68 :..oo " " 1-65 79.68
] 00 " II 2-65 79.68
].00 I! II 2-65 79.68 :.oo " II 3-65 79.68
IOO " R. II 3-65 79.68 :oo " R. II 3-65 79.68
100 " II 3-65 79.68
100 II " 4-65 79.68
100 " II 6.:.65 78.12
] 00 " R,~ " 8-65 78.12
100 " R. " 8-65 78.12
lOC II R. " 10-65 78.12
lOC " R. 1f 10-65 78.12
lOC " R. :r 10-:65 78.12
10C II R. " 10-65 78.12
lOC II R. " 10-65 78.12
10C " R. " 10-65 .78~12
10C II " 10-65 78.12
SUB-TOTAL $ 4,456.00
Amount
$ lOC
10C
lOC
lOC
lOC
lOC
lOC
lOC
lOC
lOC
lOC
lOC
lOG·
lOG
~· so so
SG
sc so sc sc
sc
50 so
50
sa
50
CONTINUED
HAZELBAKER LIST OF BONDS
Name ( s)
SU3-TOTAL,BROUGHT FORWARD
Sheldon Hazelbaker
II R. II
II R. II
II R. II
II R. II
II R. II
II R. II.
II R. II
II R •. ·. II
II II
II '' ... II
•• R. II .. R. .II
! ~
ALL TAXABLE -TOTAL·
Sheldon Hazelbaker
II
II
II
II
II
II
II
II
II
••
II
II
II
II
R. II
II
R. II
R.· II
II
II
II
II
II
II
ALL TAXABLE -TOTAL
'GRARD TOTAL -ALL BONDS OF
SHELDON HAZELBAKER
Issue Value Value
Date S/24/67 At Sale
$ 4,4S6.00
10-6S 78.12
10-6S 78.12
10-6S 78.12
,10-6S .78 .12
10-6S 78.12
ll-6S 78.12
ll-6S 78.12'
12-6S 77.28
12-6S 77.28
2-66 77.28
2-66 77.28
2-66 77.28
2-66 77.28
. 4-66 77~28
$ S,S43.80
.
6-60 $ 47.66
6-60 47.66
6:...60 47.66
10-60 47.66
S-61 46.70
1-62 44.84
<. 3-62 44.84
4-62 . 44.84
4-62 44.84
S-62 44.84
6-62 43.94
4-64 41.36
·3-66 38.64
$ S8S.48
$ 9,464.08 rri ..•
C~~mtO:\\IT \LTII 0!: PFNNSYLV . .\NI A
TlL\\'fFFI·~ INHE!UTANCE I'A:X
rm~ IrEXT Dl~G:':DENT
SCHEDULE "C"
TRANSFE!tS
(1) D:..rl decede~t, within two years of death, make any transfer of any material part of his estate, without
receiving a. valuable :J.nd adequate consideration therefor? (Answer yes or no)_n_o __ _
(2) D:..d decedEnt, within two years of death, transfer property from himself to himself and another or
others (in·~lurling a s-:>ouse) in joint ownership? (Answer yes or no) no
(3) Ir the ans'ler to (1) Jr (2) above is in the affirmative state:
(a) Age ·of de.c:!dent at time of tran~fer ·
(b) State of d.:!cedent 1 s health at time of making the transfer. (Note 1),
(c) Cause of d:!cedent' s death. (Note 1),
(4) Did decedeat, in his Lifetime, make any. transfer of property without receiving a valuable or adequate
ccmsiderat:.on therefo • which was to take effect ln possession or enjoyment at or .after his death?
(Answer ye!.: or no) no · · .
(a) Was· there any possibility that the property transferred might return to transferer o·r his
estate or be subject to his power of disposition? (Answer yes or no)-----
(b) :What was tbe transferee's agE at time of decedent's death?------
(5) Dij decedert in his l:..fetime make any transfer without receiving a valuable and adequate consideration·
th3refor urder which ~ransferor expressly or impliedly reserves for his life or any period which does
not i1:1 fact enrl before his death: ·
(a) The posses~ion or enjoyment of or the right to income from the property transferred?
(Answer ye~ or no) no
(b) The right 1.0 rlesignate the persons who shall possess or enjoy the property transferred or
income therefrom? (Answer yes or no) rio .
(6) If the ans¥<er to (5) (1:) ·above is in the affirmative, state whether the right was reserverl in decedent· alQne ~r others ___________________________________________________________ _
(7) Di·3 de-cedent in his lifetime make ~ transfer, the consideration for which was transferee's promise to
pa:.r ir·come to or for the benefit of care of transferor? (Answer yes or no) no
(8) Di• rle.cedent, at any time, transfer property, the beneficial enjoyment of which was subject to change,
beoeause of 3. reserved JlOWer to alter; amend, or revoke, or which could revert to decedent under terms
of tr8Jlsfer-or by oper.ation of law? (Answer yes or no) no
(9) If the answ:!r to (8) above is in the affirmative, was the power to alter, amend, or revoke the j.nter-
esr; of the ::~eneficiar;r reserved in the decedent alone or the decedent anrl others?
(Aaswer yes or no) _________ _
NOl'E 1 ]'he arswers to t,ese··questions should be supporterl by affidavit by the attenrUng physician as
well a:; a oeopy J'f the death cer-tificate.
NOTE 2: Jf answer to any of the above questions is yes, set forth below a description of the prcperty
transf~rred, it's fair ma·ket value at rlate of death, dates of transfers anrl to whom transferred, with
relationsr..:ip of' transferees to rlecedent, if any. Submit copy 'of any trust deed or instrument, tf tr<tns-
fers are claimed to be non-taxable, also submit detailed statement of facts on which said claim is based.
NOTE 3: List a?plicable property below in manner in which provided in Schedules A, B, or E.
ITEM
I i I I I
I
DESCRIPTION
NONE
Insert t.·tiS tnt.ro.] O)l[IOSlte rTransfers"' Schedule "C" in the
"As Reporterl" c0bJmn on the last page of this return.
MARiillT VALUE
(Estimated)
DEPT. VALUATION
(Ue]it. {lnly)
CC~IMONWE:'\LTH OF PENNSYLVANIA
TH1\NSFER INHEH.l1i\KCE TAX
RF.SIDENT DECEDE~T
SCHEDULE "E"
JOINTLY 0\VNED'PROPERTY
Il\STRUCTDl\S: This. schedule must disclose all property, real and personal, owned by the decedent jointly
with another cr o·~hers, including intangibles, standing in the name of the decedent and others. List
real estate fi~st, as entireties, or joint tenants, giving brief description, as indicated under Schedule
"A", plus, the :iate and place of record of instrwnent 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", ?lus date of acquisition, and the name, address and relationship (if any) of co-owners to
the decerl.ent.
Descriptbn of_ Property, Date of Acquisition, Name I Unit.
Address a.1d Relati-:mship of Co-Owners, and Place i Vallll~
of Rec0rd o:~ Instrtunent, where Real Estate. ! ·
X
percentage Estate
Share Valuation
U.S. Sa\/ings Bonds, Series E, in
various den~minations, having variou~
dates off. issue, held by decedent and
persons ind~cated, all retained by
decedent in his Safe:ty Deposit Box. (See List Attc:ched)
1. Mrs. Be=t~ Webb -32 Bonds
2. Frank Hazelbaker -10 Bonds
3.
4.
5.
6.
Willaim Hazelbaker, Sr.
William Hazelbaker -34
(Joint Holder o£ Safety
or
Bond$.
Depos·i t
Box)
Richard Webb, Jr. -4 Bonds
Richa.rd Webb, Sr. -1 Bond
Sheldon Hazelbaker,Jr. -lBbnd
7. Sheldon~ Hc..zelbaker -2 Bonds
8. Sheldon Hazelbaker II, - 2 Bdnds
9. Mrs. Hel·en Webb -2 Bonds
10. Jame3 Webb: Jr. -7 .Bonds
11. Robect ~ebb -12 Bonds
12. HarJld :L. Hazelbaker -3 Bonds
13. HarJld Hazelbaker -3 -Bohds
14. HarJld L. Hazelbaker -6 Bonds
15. Mrs. Lettie Riley -36 Bonds
~,187.40
613.36
2,140.83
310.69
26.88
115.72
242. 7';:.'
75.21
106.50
415.49
753.21
193.36
245.32
310.69
2,197.19
DEPARTMENT VALUATION
CAUTION-Do not WrHe
In This Space.
Value of
Entire
Property
(, ~/..J i
s _J, 7"
Value of
Decedent's
Interest
J
c231~ y{·. ~t.(/tl A~~/
j;)d, (.t w ~y ~j
J? /.J., ~.,0!··.. -~; V r
rs11fY ~ I
&s-o C·<IJ. G 0
.3 .f{., .. ?J..
ff4t'i
c :2_j,.Jf
~ i9t/.3l
+---------4--.----------TOTAL 9,934.5~ I~ jt,I(,Jt/
Ins.::!rt t::tis total opposite "Jointly Owned Property", Schedule "E"
in the ".As Ieported" colwnn on the last page of this return.
$ 50
50
so
50
50
50
50
50
.50
50
s.o
50
50 :o
.:o
.:o
.:o
=o
=o
50
.50
5()
50
.5()
.5()
100
100
100
100
l():::l
25
25
$ 5•)
5•)
so so
SUJ
SID
sa
so
so
so
ESTATE OF SHELDON R. HAZELBAKER
LIST OF JOINTLY HELD U.S. 11E11 BONDS
Nc:mes
Sheldon Hazelbaker or Mrs. Bertha Webb
II , .II II " II
II II II II II II.
II '! II II II II
II " II II' ·II II
II .. 1t II ,. II II
II " . II II II II
II ·" II' II II II
II II II II II II
II II II II II
II II II '' II II ·-
II II " It II II
II II " " II II
II ,II " " II II
II II " " II II
II II " " II ·II
II II ·" " II II
II. " ' " " •II II
II " " " II II
II " " " II II,
II " " ·" II
II " " . " II II
II II " " II 'II
II II ·" " II II'
II II " " II II
II II " " 'II II
II. II " " II II
II "· ,; " II II
II " " " " II
II "· '' ... "·. II ... .. " " " II II
II II " " . II
ONE-HALF TAXABLE TOTAL
3heldo~ Hazelbaker or Frank HazelbakJr
" " " " "
II II II II
II II " II II
'II II 'II .II II
'II II II II II
II II II 'II
II II II II II
II IR. II II II II,
II II II II II
ONE-HALF TAXABLE TOTAL
Issue
Date
8-48
8-48
8-48
8-48
8-48
8-48
3-50
3-50
3-50
3-50
. 3-50.
3-50,
3-:-50
8-50
8-50
~-50
. 8-50
·8-SQ
8-50
1-57
2-57
3-57
3-57
6-57
3-58
3...-54
3-5'4
3-54
3-.54
3-54
·2-57
6-.57
6-49
6-49
6-49
6-49
6-49
6-49
6-49
5-58
5-59
5-59
Value
5/24/67
$ 66.40
66.40
66.40
66.40
66.40
66.40
64.80
64.80
64.80
64.80
64.80
6~.80
64.80
63~76
63.76
63.76
63.76
63.7 6
63.76
53.02
53.7 6
53.76
53.7 6
54.00
. 52.06
115.72
115.72
115.72
115.72
115.72
26.88
27.00
$ 2 ,!87 .40
·$
$
65.86
65.86
65.86
65~86
65~86'
65.86
65.86
52.06
50~14
50.14
613.36
Am:un-:
s J.)O
D.JO
uo
L)O
H.JO
25
50
50
50
. 50
50
50
.50
.50
.50
.50
.50
.50
:.30
so
50
50
so .,-
50
so
50
50
50
50
50
50
50
50
so·
$. -:..oo
-:..oo
so
~5
$ ~5
$ HO
$ ](0
.•
ESTATE OF SHELDON R. HAZELBAKER
LIST OF JOINTLY HELD U. S •. "E" BONDS
Nc:mes
Issue
Date
St-.eldcn Hazel,baker or William Hazel baker
" " " " "
" " " " "
" " " " "
" " " " "
St-.eldcn Hazelbaker or William Hazel baker, Sr.
St-.eldcn Hazelbaker or William Hazelbaker
" " " " "
" " II II II
II " II II II
II " " II "
II " " " "
II " II. II II
S~eiJ:iilcn Hazel baker or William Hazel baker, Sr •
" II " " "
II " II II " ,.
II " " " " "
II II " II " "
II " " II " "
" " " " " "
" " " " "
" " " " " "
" " " " " "
" " " " II "
" " " " " "
" " " " " "
" " " " " "
" " " " " "
" " " " " "
" " " " " "
" ... II II " tt'
" II II II " "
II II II II II tt
" " " II II tt
ONE -HAEE TAXABLE -IJJOTAL
Sheldo·n Hazelbaker or Richard Webb, Jr.
II " II " II "
II II " II II II
" " " " II "
ONE-HALF TAXABLE -TOTAL
Sh.eldo:1. Haze.lbaker or Richard Webb, Sr.
ONE-HALF TAXABLE -TOTAL
Sh~ldo~ Hazelbaker or Sheldon Hazelbaker, Jr.
ONE-HALF TAXABLE -TOTAL
Sh~ldo~ Hazelbaker or Sheldon Hazelbaker
Ro3coe, Pa. Monessen, Pa.
" " " II
ONE -HALF TAXABLE -TOTAL
3-54
3-54.
3-54
3-54
3-54
10-57
6-49
6-49
6-49
6-49
6-49
6-49
6-49
1-57
4-57
5-57
10-57
··l-58.
1-58
3-58
3-58
4-58
4-58
9-58
9-58
ll-58
1-59
2..:59·
2-59
10-59
10-59
4-60
4-60
.S-60
3-54
3~54
11-56
1-57
2-57
3-54
8-52
8-52
value
5/24/67
$ 115.72
115.72
115 ~72
115.72
115.72
26.45
65.86
65.86
65.86
65.86
65.86
65.86
65.86
53.02
53.76
53.7 6
52~90
52.06
52.06
,52.06
52!.06
52~06
52.06
51.08
51.08
51.08
50.14
50.14
50.14
49.66
49.66
48.66
48.66
48.66
$ 2,140.83
$
$
$
$
$
$
$
$
115.72
115.72
52.74
26.51
310.69
26.88
26.88
115.72
115.72
121.36
121.36.
242.72
Am:un::
$ 50
25
$ 50
50
$ LJO
50
25
50
50
50
50
$ .50
.50
.50
.50
.50
.50
50 so
100
~5
:!5
so
$ so so
so
~00
$ ~5
~0
~0
~0
~0
~0
ESTATE OF SHELDON R. HAZELBAKER
LIST OF.J:OINTLY HELD U.S. 11E11 BONDS
Nl:mes
Steldcn Hazelbaker or Sheldon Hazelbaker, II
II II II II II
ONE-HALF TAXABLE -TOTAL
Steldcn Hazelbaker or Mrs. Helen Webb
II II II II II II
ONE-HALF TAXABLE ~ TOTAL
Sreldcn Hazelbaker or James Webb, Jr.
II
II
II
II
II
II
R.
R.
II
II
II
II
"
II
II II II II
II II II II
II II II II
II II II II
II II II II
II II II II
ONE-HALF TAXABLE -TOTAL
Steldcn Hazelbaker or Robert Webb
II " II II II
II II II "
II "I II II II
II "I II II II
II "I II II II
II II II II
II II II II
II "I II II II
II "I II II II
II II II "
II II II "
ONE-HALF TAXABLE -TOTAL
Sooldon Hazelbaker or Harold L. Hazelbaker
II " II II II
II "I II II II II
ONE-HALF TAXABLE -TOTAL
Sheldon Hazelbaker or Harold Hazelbaker
II "I II II II
II "I " II II
ONE-HALF TAXABLE -TOTAL
II
Ha~old L. H~~elbak~r or Sheldon Hazelbaker, Sr.
~OS ~3choonmaker Ave.
Mo::1.essen. Pa.
II " II " Sheldon Hazelbaker
II " II " •II II
" II II. 1'1 II II
II II II " II II
II .II II " II II
ONE-HALF TAXABLE -TOTAL
,,
Issue
Date
5-59
5-59'
11-56
2-57
8-52
8-52
1-57
5-57
11-57
5-59
5-59'
8-48
.3-48
8-48
8-48
8-48
8-48
8-48
8-48
3-54
1-57
.5-57
11-57
12-49
3-50
9-50
4-50
5-50
3-54
2-52
.2-55
2;ss: ..
2-55
2-55
2..:55
$
$
$
Value
5/24/67
50.14
25.07
75.21
52.74
53.76
$ 106.50
$ 121.36
60.68
26.51
53.76
52.90
50.14
50.14
$ 415.49
$ 66.40
66.40
66.40
66.40
66.40
66.40
66.40
66.40
115.72
26.51
26.88
52.90
$ 753.21
$ 64.80
64.80
63 .• 76
$ 193.36
$ 64.80
64.80
115.72
$ 245.32
$ 30.39
56.06
56.06
56.06
56.06
56.06
$ 310.69
. '
-..
ESTATE OF SHELDON R. HAZELBAKER
LIST OF JOINTLY HELD U. s ~ liE II BONDS
Issue Value
Amourt l\am~s I ate 5/24/67 ----
$ 2.= She Ldon.Jlazel baker or Mrs. Lottie Rilley 12-43 $ 38.51
2.= ~I II .II II II II ]2-43 38. 51.
2.= ., II II II II II· 1-44 38.51
25 " II II II II II 1-44 38.51
25 11 .,,t II II II II :2-44 38.51 ,.
25 n ·II II II II II •";2:..44 38.51 sa n II •II II II it .3-44 77.02
.25 n " II II II II 3-44 38.51
100 .. ·II II II· II 'II 4-44 154.04
25· .. II II II II II 5-44 38.51
25 " II II II II II 6-44 37.89
50• " II II II II II 6-44 7 5. 78 so " II II II II II 6-44 75.78
50· ,. ... " II 'II II 6-44 7 5.78
25 ,. " II ... ,If II 7-44 37.89
100 ,. " II II II' "· 8-44 151.56
100 II II 11 II If. 8-44 151.56 -100 II II 11 " II 8-'44 151.56
25 II II ,, II " 3-44 37.89 so II II " II
.,
II ~-44 7 5. 78
25 ,. ,II II .·If II II lJ-44 37.89 so " II II ·II II II 1)-44 75.78
-25,. " II II " ·II " .lL-44 37~89
so ;, II II " II II ll-44 is .78 so " II II II II II ll-44 7 5. 78
25 II • II II " II II· 1~-44 37.28
'25 ,. II II .II II II 1~-44 37.28
25 II II II " ;, II ">45 37.28
25 II II II " II II :!-45 37.28
25 ,. II II " II II o\.-45 37.28 so II' II II " II II 4-45 74.56
25 II' II II " II II S-45 37.28
25 II' II II II " II 5-45 37.28 so II II II II II 'II .5-45 74.56
25 II " " " " " 6-45 ,36~69
25 II II " " " II E--45 36.69
ONE-HALF .TAXABJ:.,E -TOTAL. $ 2; 197 ~19
'·
h
,__..,
. l. ..
RdC~37···· (12-0}
C'OMMCN\~E . .!.L TH CF PE:'lNSYYLANIA
TRANSrEF 11'--IIEFITANC'E TAX
RESIDE.~T DECEDElVT
BE!\EF!CL\RIES AND ADDRESSES
State full nar:1es and addresses .of all who
ave an interest, vested, ccntinge~t or other
wise·, in estate) .
Rober·f Web'";)
2656 Erown Avenue --' -
Manchester:! N. H.
James Welbb
Route ~1
Galion 0 Ohio
Richc..rdf.:.'W'~bb
429 Fark Street
Cal i:forniC!-, -Pennsylvania
.r: r.
Frank Ha2elbaker
Hotel Rnscoe
Roscoe, Penes yl vania
...
William F. Hazelbaker
P.O. Rox 37
Roscoe, ·Pennsyl va.nia
Amiel Hc..zelba.l<:er
-
' .
Bertha. Hl.:-=.Webb
Hotel -.~oscoe
Roscoe'·-p:e;nnsyl va:cia
' ..
Caroline-:Devi.ne ..
·-·
......... . ' . .
~ ·. ' ' ... . ~.; .
SCHEDULE "D"
BENEFICIARIES
RELATIONSHIP SURVIVED (If step-children or DATE INTEREST OF
illegitimate children DECEDENT OF BENEFICIARY
are involved,-set STATE YES IN-ESTATE
.forth 'this fact.) OR NO BIRTH
Nephew yes over 21 None-Bequested items
sold prior to dece-
dent's death
Nephew yes over· 21 None-Continqent up or:
death of Robert Webb
Nephew :ves over 21 None-Continqent uPon
death of Robert Webb
Brother ves over 2i 1/3 of money items
Brother ves over 21 l/3 of monev items
Brother no ~~ an_sed-PrP.dP.~P.::~. sPd
herein decedent
Sister yes over 21 1/3 of monev items
Sister i:lo .,.. Lasped-Predeceased ..
herein decedent
·-
Deponent fu:-ther says that all the above-named beneficiaries are living at this time except below: -...
NA:JJ:E DATE OF DEATH RESIDENCE
Amiel Hazeliba~:e r Dec. 28, 1965 ·columbus, Ohio
Caroline Devir:e Nov. 16. 1963 Columbus~ Ohio
Will l xMm:~ ~No. Year-: .......... ..
f:\l THE
~lATTER OF THE APPRAISEt>.-IENT
OF THE ..
ESTATE OF
SHELDON R. HAZELBAKER,
Deceased
Late of .. R9$G9.~ ,. P.~PI)$y:;I,v~.n:i,9, __
County of ~<=l:!:)hington ......................
Commonwealth of Pennsylvania
-;-Z
,..,.'t t:
( ' ......
REPORT ;;AND APPRAISAL ::-
~::-
. ~
1·.·
~ :.::..:
·-.
>-'
\.;,.) .·
-~;:: ~
4 r -~·
r~·· ..
I
r . ~-~;s;2
t .. ··-t•
"---"
·'\,
HOWARD F. CARSQN, ESQ •.
CHARLEROI, PENNSYLVANIA
' l
i.
.{-. ..
I: j
Jl
' -1:·
;
:li
!·
('. :~-
I .,
i t J ~
'·'
i I ~ -~
I
·• II
: ..
(Executor-Administrator
must complete "As
R~ported" column #1.)
CJ : ,.., ..,. :~ .... 0 :o § Vl Vl 71-'·~ ,..,_ :!:J (I)
II> : c+ ;;1 >< . : 1-' II> cr .'<: (b
trl :::r: :ro Vl ..... 'I-' II> ..... :o. (I)
'"d (I) .... Vl 0 ::l e:...
'"d .... 0 "d (I) .... ..... '<
:::0 (I)
e:...
'"d .... 0 "d (I) .... ~
(/) c: ~ ~ >-:::0 :,-.....--.. (/)w &;-;;><
-oo
:w
:lll .. :w
'1.0 .(j\
:•
:Q\
:1.0
~
O::r-::r' .•
() ()
?" ?" .... r5
ti;._; ~ > : : ... ... ..._,
~ -oo -oo-oo
. : {\) : \() : : lJl .. ,...
\() ;~ : w '0'1 :
,j:>. {\) 0 • :. !
lJl
-...l
~-fn-oo~~~
~· .. .. . '"'-. .( : : :
>-"' :::0 (!)~ '0 ..... 0~ .., ..... ro c..
>-:J: ·~ -~· .. v :· ;:-,~ ' : ~~II ·~: ·~ :~ ('";: 1-.:J ..,~
:~: ~: :~ 3 II :~ ::I : ":-(;: :~ r. ~: : ""--' :...;. . c..
'"<( :~· '"' : . .
·;
•I.
'(
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"";
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\ ;"\:.
fA···
Form RCC-10 DEDUCTIONS AL~OWv.~~ ;:7(
DATI!
1967 --
June
Sept.
Oct.
Dec.
1968 --
Jan
I
-OFFICE OP" THE
REGISTER OF WILLS
T~'E COMMONWiiALTH
STATEMENT OF DEBTS
AND DEDUCTIONS :::, •::.::v,~ .•••••••• '~l
~~
Register o s, Ageot .
ESTATE: OF S~eldon R. Hazelbaker LATE oF_.....;;.R:.;:o:;.;s::;.c=o...;:e'----------------
. 6-/~-6 'if
DAn oF Fl-ING .. PPRAisEMENT January 12,1968 DAu oF DEATH May 24' 1967
NO. Q;" NAME OF PAYEE REMARKS AMOUNT vou:HOIIt .
28 Ruth Eckert Funeral Home Complete Funeral 1,299
28 Howard F. Carson Reimbursement £or two Death Certi£~cates 2
29 Mrs. Charles Riley Room Rent Due 28
12 CEnterville Medical Group Past Due Account 8
30 William F. Hazelbaker On Account o£ Executor's Commission 1,000
30 Howard F. Carson, Esq. On Account o£ Attorney's
Fees 1,000
6 Western Pa. National Bank Box Rent 4
29 Sale o£ 10 Shares o£ Charle ~ Town Racing Assn.:
' Inventoried at ~ 42.50 Net Sales Price 28.20
LOSS 14
;~o Wi:.liam F. Hazelbaker Reimbursements £or:
Reverend ""Pau"T-Funef~l ,~erv Anerican Legion-Pa Beare ~:;:ce s ~~8:88
Wake Re:treshmen"ts .:::.v.vv 60 \
20 William F. Hazelbaker Balance o£ Executor's Commission 342
20 Howard F. Carson Reimbursements £or:
6/5/67 Jos~phine M. Rgu~la~-Pro~ate o£ Will & $35.50 ' o t 1-ert~ ~cates
Of :J..:::;./ 0 I JO!:::it!J?Hine 1'1• 1./UU<.::P-
6/l2/67 Washington Co. Rep f1;:::,-5 ~.Qort_<;e:r;t. prts-Advert~s~ng l~:~g
7~1167 Josephine M. Dougl ~s-1 Short Cert. .1.00
8 22 67 Vallev Independent 1-Advertisina 10.50
1.00 3 00 68
co
00
0:)
0::>
00
00
0()
30
00
27
so
;
t9<~9~~7 lS~se~?tn~. M, Doug~rs:-1 S!fort Cert. 11c:::c:::b l::irino lina nventorv -
20 Howard F. Carson Balance o£ Attorney's Fees 342 27
20 :::iazella Mucy ~8t~§~ g~Efs 0£ ~~~~g{~~~s
2:) Russell Marino
Account and Audit Petition 7 00
Filina Account 18 00
fA /) ./ Total 4,193 34
A~ ~~j~ J..S, .s::._, CO.....,ONVWEAL TH OF PENNSYLVANIA -v
sa: -'I,.,{ ;2 If " f"P COU . ..,TY CF Washjngton
I, --..::"'~~o.ll"". J""""'J-·"..ca;UmLL-.£F_, . .....JH.J.;ala.=z:.Se;;..l!:.!b!:.!9a£k~e~r!:_ _____________ HEREBY CERTIFY, THAT. TO THE BE8T OF
MY I<NCWLED(;E AfoD BELlEr, THE FOREGOING IS A JUST AND TRUE STATEMENT OF DEBTS, FUNERAL EXPENSES AND EXPENSDI OP'
ACMINI5TRATION SIIBIIITTEJ: TO THE ESTATE OF _S""-""ho.::e::.:lo:.;d=O~n::..._;:R~. ~H~a:-:.:z::.e=lc:::b:,:a~k~e=r-___ _ DECEA8EC, AS DECUCTIONii f'OR INHERI"I!.ANCE -AX rUF.POSE£1.
~A~LA ~11C'f. NOTJ!IlY PUBLIC
:HARiERJIBORCUGH,
iJASH NGTON CCUNTY
N':'l C.OMI\.ISSIOI'l EXPIRES AUG. 30, 197J
_(jf;jl..~ 'ld/r~ ~ li~
cAY cw W~ll ~a~'eibakei CL. 5.)
... \.
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! . ''-· .g t :. E · J~lV
l ~ .. . • J
t -. n
+· . !,_.'
. '
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,.
i I.
..
~~·· ~ 'ifee-39 (6·67) ·-• ---.!_,.
COMMONWEJ;L TH C F PENNSYLVANIA
' TRANSFER II'IH:RITAN:E TAX
RESIDENT Di;c:OENT
. \
..
HAZELBAKER., SHELDON R.
'FILE #; 9419-19'7
May 24, 1967
SUMMARY
!~ .. ··-
FILE # 9419•l97 .fl.EPOHT OF INHERITANCT<: TAX APPRAISER
I~ tr e unrl.ers ig1:ed duly appointed Inheritance Tax Appraiser in and for the County of
, Pennsylvania, do respectfully report that I have appraised
property as re~orted in the foregoing return at the values set forth
the last column to the right in Schedules "A"1 "B", "C" and "E".
# 6J Waehington
the rea::.. Fncf personal
opposite Eac~ item in
Dated: 02....(2-68
0~-24-67
REPOR.T OF THE REGISTER OF WILLS
I, the undersigr::·ed duly elected Register of Wills in and for------------
County, P&nr.sylvania,. do respectfully report that I have allowed deductions in the amounts
claimed'bydEpooent, Except as to those items where a greater o-r lesser amount is set forth
in the Last colUJm tc the right in Schedule "F", which greater or lesser amount represents
the sum a::..lcwed as a deduction. /]. ..., ./7 ~~-'--_,_ ~ '-
Dated: ~ -v ~~vtt
REGIST~R OF WILLS
IWJEW'ORY VALUE AS REPORTED VALUE AS APPRAISED VALUE AS REAPPRAISED
Real Property :sched~le A)
Personal PrJpe~ty (S~hedule B)
TransfErs (3chedule J)
Joint-reM. ?ro?erty {Schedule E)
$ $ $
. ___g_s,462.12 :_:_ 25.462~12 :-. ------
TOTAL GR0·3S .!.SSE'fS
LESS DEbts !ind Deductions
(SCI-EOOLE F)
CLEAR YALUE OF' ESTATE
\Taluat:;..oro cf life estates or
annuities
ESTATE T&X ASSESSMENTS
_<;19-,.93.11,~..1_.-
35,396.69
========
$ ____ _
$ _____ _
19,869.14 ·-Ind. La.a&. Pd •. in Ftil:l
45,331:._26':_'-
======== ==
FOR USE IDF REGISTER ONLY COMPUTATION OF TAX
Tax on $ ·--!'5% ·*-----~ Tax on $
Tax on ¢' •e ·-~: _____ _
Tax OTh $ _________________ :=:= $ _________ ~
Exemptions=========(':') Total ~sta:e __________ __
$ '"''\.~ '::.'OTAL TAX --------=-
Less tax previously paid
3ALANCE
Less fi% of taj{ .if paid within
3 months after death
BALANCE OF INHERITANCE TAX DUE
Add ir.tErest :tt rate of o% from
--------to
<~> '~=======·--$ ---------
*============'===
AMOUN'=' GF EST\TE TAX ASSESSED $ _____ _
Estate tax paii.d
BALANCE DUE
Add interEst at rate of 6% from
to
d> ,, _____ _
TOTAL TAX BALANCE
PAID
FOR U3E OF REGISTEF. ONLY ADJUSTMENTS
(':') As ev-idenced by Chari table Exemption
Certificates issued by the Secretary
of Revenue.
~-------------~--
$ ______ _
$ ____________ _
$ ______________ _
$ ______ _
$
NOTE: "'here subser_uent adjustments are made to the above computation of tax by the
~e~ister of Wills, for proper reason, same should be noted below, with short
':!xplaration.
Will
Administration ( No.
I:-< THE
Yea~
:\lATTER OF THE APPRAISEMENT
;· OF THE
EST:\TE OF
··"··-~
S.HELDQN _l:l ~ .ItA...~a~ ..
Deceased
Late of. ~OS.C.O;E. .......................... .
County of . ...... l'/ASHINGll0N .. .
Comp1onwealth of Pennsylvania
REPORT AND APP~AISAL
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COMMONWEALTH OF PENNSYLVANIA
RESIDENT INHERITANCE TAX
.APPRAISEMENT
DATE ..................... F.:~:P.~r£ .. 2.., .... ~19.68. ............... .
DEPARTME"'JT OF REUmUE,
BUREAU OF COVNTY COLLIWTIO\NS
HARRISBUR•J. PENNA. 1'7-72 7
NTY Washington cou .................................................................................................... .
FILE NO ........................ 9.4.+..9::J.97 .......................................... .
Whereas, .................................. ~.h.~.J.a.Qn. .. R .•.... Ha.ze.lbake.r ......................................... late of ............................ Ro:acoe ............................................................ .
in the County of .................................... W.~.§h;i,ngt.QD. ............................................................. Commonwealth of Pennsylvania, having died on
the ..................................... ?4 .... ~ ........................................ day of·.: ................. .J~~Y. ............................................. 19 .. 97 ... , seized and possessed of an estate
subject to Inheritanc.~ ':ax under the laws of the Commonwealth of Pennsylvania;
Therefore, I, .................. , .......... J'i.,.R.! ..... C.ha.n~Y: ............................................................ , an appraiser duly appointed according to law,
having been des:gnazed to make a fair and conscionable appraisement of the said estate, and to assess and fix
the cash va.!ue of all armuities and life estates growing out of said estate, hereby file the following appraisement:
In the er.rent t•at a.:1y future interest in this estate is transferred in possession or enjoyment to collateral heirs of the decedent after
the expiration of an: estLte for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer
inheritance taxes at the law:ful collateral rate on any such future interest.
Appraisement Unit Description of Asset Values Made for Inheritance
Tax Purpoaea
$
'REALTY:
NONE NONE
PERSONALTY:
As oer Schedule nan ?'\ },{...') 1?
TRANSFERS:
..
NONE NONE
JT. HELD: :I ..
As per ·Scheiule "E" h lQ ~{...~ , },
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·.RESIDENT INHERITANCE TAX APPRAISEMENT
. Estate of
SHELDON R. HJ:·ZELBAKER . ......... _ ................................................................................... ..
· ·. Deceased.
Late of
.............................. R®.QOE. .. :.
Date of Death, .......... M.a.y-.... 24., .... 19.67 .............................. .
Appraise1izeHt Docket Vol., ................. .:37 .. :, ....................... .
Page, ...... l.$Q9 ........................... No .... 9419,.l97 .............. ..
Filed in Register's Office, ....... Fe.b ....... 2.,. ......... J9 .. 6.8 ..
Amount of tax due, $ .................................................................. ..
DEPARTMENT OF REVENUE
Received,
Exa-mined and Approved, .................. .
Wrote abo.ut Appra.isement,
Appeal f1'om Appraisement,
Entered and charged, ....
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COPY OF INVENTORY
notary public
William F. Ha2elbaker
X)(XXXXXXXXX
Sheldon R. Hazelbaker
r
Sheldon R. Hazelbaker
January 68
llttttttttnrg attb 1\.ppratstmtttt of the goods and chattels, rights and credits which were
Sheldon R. Hazelbaker Roscoe
of ...... _ ............. ;.. .................................................................................................................... late of. .................................................................................................................................. .
W asi!ingt011 County, Pa., taken and made in conformity with the abuve affidavit.
PERSONAL'IY:
cash
Savings Account 2608, in Roscoe Office of
Western ~nnsylvania National Bank
Checking Acccunt 062 475 54 l in Roacoe
Office of Western Pennsylvania National Bank
87 u.s. Savings Bonds, Series E, in various denom~nations, having ~arious datea of isaue.
(See List Attached)
55 Shares Sto::k o~ Western Pennsylvania
National Bank @ $16.25 per share
50 Shares Stock of Pennsylvania Railroad
Company@ $63.50 per share·
10 Shares Steck of Charlestown Racing Association,
Inc. @ $4.25 per share
Metropolitan Life Insurance Co. Group Policy
8052-G • $8,000 face, reduced to $7,200 at age 65.
Total
DOLLARS CENTS
150 00
3,331 07
1,205 72
9,464 08
893 75
3,175 00
42 so
7,200 00
-
25,462 12