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Home My WebLink AboutOC1968-0209 - ESTATE OF ROMAN--·----------------------------------------------------------------------------------------------, ~ :'CC-~q ( 6-64) R01-~N, NARY aka MARY R. DZUIBA GOWONWEALTH OF PFNNSYLV,\Nl:\ TRAN::'FF.H INimRITANC~.J.:~~ ..... R.RSIDENT DECEDF.NT SUMMARY ·~···~--·a.. FILE # 9314-147 TtEPOH'l' OF INHERITAifCF. TAX APPRAISEH I. the undersigned duly appointed Inheritance Tax ~ppraiser in and for the County of #63 WASHINGTON , Pennsylvania, do respectfully report that I have appraised the real and personal property as reported in the foregoing return at the values set forth ::::::te each 0:;::/:; the last column to the right in Sche:3)'~~r, "C" an;;/4Q. 08/28/66 INHERIHNCE~; ~. REPORT OF THE REGISTER OF WILLS I, the undersigned duly elected Register of Wills in and for _______ W_A_S_H_I_N_G_1D __ N ______ _ County, Pennsylvania, do respectfully report that I have allowed deductions in the amounts claimed by deponent, ~xcept as to those items where a greater or lesser amount is set forth in the last column to the right or lesser amount represents the sum allowed as a deduction. Dated: 08/29/67 INVENTORY Heal Property (Schedule A) Personal Property (Schedule B) Transfers (Schedule C) Joint-Held Property (Schedule TOTAL GROSS ASSETS LESS Debts and Deductions (SCHEDULE F) CLE~~ VALUE OF ESTATE Valuation of life estates or annuities ESTATE TAX ASSESSMENTS E) VALUE $ $ $ AS 10.00 3~h88.~ 2 'l:J:~8 .• 2lt_ 1l567l.40 1, 931.14 ·--- REGIS~~ AS APPRAISED VALUE AS REAPPRAISED $ 10.00 ------ -----......:=:..:.. 3,&88 .54 3,498. 54 1,567~40 == 1, 931.14 ======:= FOR USE OF REGISTER ONLY COMPUTATION OF TAX Tax on $ !'5:.% ~------ Tax on $ ________________ . ___ 10% ~--------~~ Tax on $ 1,931,1!-t_ 2~ $ 38.62 := Tax on $ , ___ 1!'5% $ __________ __ Exemptions:;=======:=(':') Total Estate __________ __ TOTAL TAX Less tax previously paid BALANCE Less 5% of tax if paid within 3 months after death BALANCE OF INHERITANCE TAX DUE Add interest at rate of H% from to ------- $ ____ _ * ======\= $ -------- $===== == AMOUNT OF ESTATE TAX ASSESSED *-~--- Estate tax paid BALANCE DUE Add interest at rate of 6% from to FOB USE OF REGISTER ONLY $ ~----- TOTAL TAX BALANCE PAID ADJUS.TMENTS (':') As evidenced by Chari table Exemption Certificates issued by the Secretary of Revenue. ~---------------- $ _____ _ $-----~- $ ______________ __ $ ______ _ $ NOTE: Where subsel}uent 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 Administration t No. D1 THE Year .......... .. ~lATTER OF THE APPRAISEMENT OF THE ESTATE OF .... HARY. ROMAN .. .aka..J1ARY.R •. DZUIBA .. Deceased Late of .. Vi AS'rl ING TON County of 1~/ASHINGTON Commonwealth of Pennsylvania REPORT AND APPRAISAL ' J C!!nmmnuw.raltq nf J.ruusyluauia,} Ba:s~iugtnn atnuuty. lUi. KNOW ALL MEN BY THESE PRESENTS: Whereas, at Washington, m the County aforesaid on the first day of September A. D. 19 66 , before me, Josephine M. Douglas , Register for the Probate of Wills and Granting Letters of Administration in and for the County of Washington, in the Commonwealth of Pennsylvania, th~ last W:ill and Testament of Mary Roman a/k/a Mary R. Dzuiba late of the City of Washington in the County aforesaid, deceased, (a true copy whereof is to these presents annexed), was duly admitted to probate; and Jennie Roman Wright the Executor m said Will and Testament named, having appeared before me and taken and subscribed the oath of office prescribed by law; NOW, THEREFORE, I, Josephine M. Dougles , Register as aforesaid, do grant these LETTERS TEST AMENT AR Y, unto .the said Jennie Roman Wright committing unto her the administration of all and singu'lar the goods and chattels, rights and credits, which were of said deceased, and requiring her to exhibit a true and perfect inventory thereof into the Register's Office, at Washington, within ninety days from the date hereof, and to render a just and true account of said administration at the expiration of six months from the elate hereof, and to regard and comply with the provisions of the laws of this Commonwealth relating to inheritance taxes. IN TESTIMONY WI-FEREOF, I have hereunto set my hand and the seal of said Off·ice at Was·hington, this first day of September in the year of our Lord one thousand • nine hundred and .,-:: LAST WILL AND TESTAMENT I, MARY ROMAN, widow, of the City of Washington, Washington County, Pennsylvania, do make and publish the following as and for my Last Will and Testament, hereby revoking all former Wills by me at any time heretofore made: FIRST: I direct that my funeral expenses and the expenses of my last illness be paid as soon as possible after my decease. SECOND: To my grandson, Clayton E. Wright, I give and be- queath the sum of One Thousand ($1,000.) Dollars, the same, however, to be held by my Executor hereinafter named, until my~id grandson arrivest at the age of twenty-one years. THIRD: All the rest of my personal property, of whatsoever the same may consist, I give and bequeath unto my daughter, Jennie Roman Wright. FOURTH: My house and lots on Michigan Avenue in the Seventh Ward of the City of Washington, Pennsylvania, as well as any other real estate which I may die seised of, I give, devise and bequeath unto my daughter, Jennie Roman Wright, to have and to hold for end during her lifetime and at her deeth, I give, devise and bequeath the same to my grandson, Clayton E. Wright. AND LASTLY, I do hereby appoint my daughter, Jennie Roman Wright, Executrix of this my Lest Will end Testament. IN WITNESS WHEREOF, I have hereunto set my hand and seal this twenty-first dey of October, A.D. 1947. Mrs Mary Roman (SEAL) Signed, sealed, published and declared by the above named Testatrix, as and for her Last Will and Testament, in the presence of us, who, at her request, and in her presence and in the presence of each other, have hereunto subscribed our names as witnesses thereto. Fez Null Merz Jane Bakaitis II ·--~------...... ~ "' ~ ...... ...... "' ~ ~ ~ :.> ts:t CD!~· Ill ::0 (/) et • ~ . -i t PG"'i::O > ~ t:l ~0 -i ts:t N Q)l~ Ill ...... N c:: 0 ~ H !Z "11 a txJ "' > = ...... ~ ~ Sd j Affi~auit ®f 1£xrrutnr ®r Abministratnr jlta:tr nf Jruusylna:uta:. t HH: C!tnuuty nf Ba:sqtugtnu ~ Personally before me, the undersigned authority, a .................. ~~r.J: .... ~l!~ ................... in and for said County and State, appeared .......... ~!~ ... ~!m!! .. ~.~~.!~ .......................................................... who, being duly sworn according to law, deposes and says that 8 he is the executor of the estate of .. ~.~l ... ~~~~ ... ~¥.~ .... ~!f. ... ~! .... ~!~!~! ............. deceased, that the foregoing schedules constitute a 1 · d · f h al d 1 f ••"' RollftD «l/..fl/a ••r li • comp ete mventory an apprmsement o t e re an persona estate o ............. !'-....... ~ ........... ; ................................. ; ....... , . lb deceased, except real estate outside the Commonwealth of Pennsylvania; that the figures opposite each item f\Btl & 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 Executor Administrator. I Swo~~ a d subscribed before me this .... df!..i.......... l ~ , . ~ jA /;;t _da?QA·::. .............. -;~ .................................. 1 cA.'!.:n · 11 ......... t.{,21.a.t.~~t:. .. (1~~~~ .... ~ / .Z:.r... .. n;o, ........................ ~{~........... I J1l C~l'eft,_. on,: -reel ADDITIONAL INSTRUCTIONS : ~A~,.. .m • 1 1b f'l d · h. h h f · f 1 · 1. n mventory must e 1 e w1t m t ree mont s a ter appomtment o persona 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 Origina'l and 2 Copies and 2 RCRI-33, . Over $10,000, including Copy of Will; 1 Original and 3 Copies a~d 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 ,/ ' lluurutnry au~ 1\ppraiarmrut of the goods and chattels, rights and credits which were -of.~~~J..:..~~ .... ~~~~=· .. ~.! .............. late of ....... ~.~~l ... ~~:··~~.~~~~.~~ ............................. , Washington County, Pa:, taken and made in conformity with the abave affidavit. D~.rJrl• ALr~ ot tbo 1'1sbt• t:1tle end t.ate~aat (be1ag a 1/B 1nteros tl l.n and to ALL ttult certotb lot of g110unct situated in tbe so•en.tb \VGI'd ot «me GltJ of Waab1bgtontc t?cohtngton Count,. • P~l'U'la .. • an4 bttlns ·knowft nn6 4eulgoo,te~ aa Lot No• 19 ltt tl\e Plu ot Lots la1tf out 'by rJaltor n. Ant9epeon and Robert lh s.. Pollook an~ oa11a6 "J!aptevlow f"lnn•. &ltt.'t f'OOoMet1 ln aa14 OotmtJ' 'II·· Plan Bo~k _6, PGBOG 10 and 11• D&all ~Ok '1411, Page ~;t Velue 88.000.,00 '!'OPAL. ~flALTYt. fillS!!I!\J.t~D• DOLLARS CENTS ~1,600 00 $1,800 00 1/S 1ttteroat 10 a&V1taga Aocount fkh; 894t ton tbe tf011on tfational ~.lank lis 'Rn&t CompcttJ' S.ll tho naUWJ ot firs• M&rr Roman neut.ba 01' Iennie W!'lght $31 9'1'1 •. 00 1,1989 6t (AOO-Otmt Opobed ltmU&I!IJ' 8• 1963) ' 1 lot of bouoebottt ttll'ftl tvo 10 00 (WOI.'ilblees • dotmtod ,to d1t1 taoslon) i I "lj .... ~ro~ ;;;-- '~lli !i ... ,~ !2) ......... !"4 ;;:! lan ......... <:l rt• ~ <: <1> :. ;;:! .,.... t o..-sa p ~ Cl tS :1 . ~~ ..... ~ ;i~ :'/Ill ~ ~ ~ 1\) ~ ;;:! ~ Cl:l ~ ~~~ ' "'":l ~ ~~ ~ ~ ~ ...,~; '. c=f" ... . ... 8l...,(t il~ 0 <1> ~ $!f:l ;':J "lj <1> ;::! 1-' ~or: .... -~ r ~ ~ r I I .. --... • -J ~I.\) .... ..... > 0 r l:l Ill~ .... c ~ tll....;J 0 1:1 :J 1:1 0 1-'-~ l~ :::!! .... ~ .... 1:!' ::Sill !::t> ::>::! s (!) .... (!) oqtll !~ {» ~-0 cT:J I!S. .... Ul s· .... ~-0)-.lo !(/) .... !=' 1:!' (!) ::;· .... t:Sts .... .. OQ !o {» {» cT l 1:1 c ~ c ~g-0 !tJ:J t;:j ~ :.< l:l £! . ~r I :'1 t, H.'') > :> 6 .... ~. ~ .. ,, .! .... 't:! .... t:S 1-3"' ~ ~ 0 .... ~-~~'i .... ;:;· (!) 1:1 s· Ul 01 1-' § (!) (!) VI 0 1-' '< 1:1 < 0 .... -, l _I c1" ...., co (!) Ill ~ .... I 0 J ~ l ::StJj ~ .... I • . 0 1-'-j-1 0 .... Ill;:}., .... 1:!' 9 (!) ()Q • 0 9 0 ~ I ;; .... .... SII!M fO JalS!Ba~ ·············~·----~--- --J/6 l ··························-················--------~-fO ,\op ---·------------;;;i/7--·s!Y-l 1oas IDP!HO ~uo puoy ,\w ssaUl!M ·-'}j·,········;t.;p61-2p/-------'ON 0-l pal!f fOOJal.jl SfOOJd ,\q a~uatf!A'fso lJnO:) fO a1n~ puo alnlO-lS ,\q paqp~saJd Jauuow ayl U! lUno~~o U!LJ-l!M ayl fO Bu!l!f ayl fO paUJa~uo~ suosJad 110 Ol a~!.J.OU 1o6a1 uaA!B aAoy 1 .J.Ol.jl A.f!~a~ op 1 I~ i~ z !=l !:u r it:d !a> !~ d ~ i::S i::S ~ lt:t~ il-'-iO i\\ !(J) H !~ !t:d l~ ~ iQ t;:j !a !Ill UJ. >-3 ~ ii!J r-....... > ~==r :::s ;::->;" >-3 r-....... t;:j l~ jill 0 ~ i'i 'OJ ~~ !I-'• OQ !P' it:d r :~ > 1\ c i c 0 ~ l:l .... ! ! 0 ..... ·aAa!laq AI!JaA·--------------------··etrs··---------··so paJJo~ puo anJ-l S! pa.JiO.J.S so .J.unm~o aAoqo ay.J. .J.Ol.j.J. s,\os puo gasodap 'Mol O.J. Bu!pJo~~o uJOMS Alnp Bu!aq .J.UO.J.uno~~v pawou U!LJ.J.!M ay.J. '.UN no::> N0~9N 1 HSY M 'YINYA1ASNN3d :10 3~Y~S • r The Court is respectfully requested to determine proper distribut-io~n.o..in~t~is~.e~st=-a-=t: fi} L f~ountant The First and Final Account of JENNIE ROMAN WRIGHT, Executrix of the Estate'of MARY ROrMN a/k/a MARY R. DZUIBA, Deceased, late of ~Iashirg ton, Washington County, -Pennsylvania. The A'ccountant is charged as follows: PERSONAL PROPERTY: To amount of Inventory and Appraisement REAIJrY:· 1/2 interest to certain lot of ground situate in Seventh Ward of the City of Washington, Washington,County, Pennsyl- vania, being known and designated as Lot No. 69 in Plan of Lots laid out by Walter B. Anderson and Robert A. s. Pollock and called "Ma.pleview Flann. See Plan Book 6, pages 10, 11. Deed Book 747, Page 747. (Value $3,000.00) DR. $ 1,998.54 1,500.00 Total Assets of Estate -... ----- - - -... -.. - --$ 3,498.54 Total Amount of Credits Claimed by Accountant - - - - -1,587.4Q. BALANCE DUE - - - -• - - - - - - - - - - - - - - - -$ 1,911.14 I'• .. The Accountant claims credits of the assets of said estate, to .. wi t: . .. . . DATE NAr~ OF PAYEE · 8/31/1966 Josephine Douglas 8/13/1966 Ambulance & Chair Service 9/2/1966 W.G. Neal Funeral Home 9/2/1966 Church of st. John 9/15/1966 Washington Hospital 9/15/1966 Dr. Bernard Berman 9/15/1966 Dr. Owen D. Benton 9/14/1966 Blue Cross of Penna. 9/8/1966 9/8/1966 9/29/1966 9/8/1966 9/8/1966 9/29/1966 Robert Grimm Qiumbia Gas Company West Penn Power Co. Citizens Water Co. Washington-East Washington Joint A,uthority Bell Telephone Co. L. L. Miller Harry R. Cook, City Treasurer Russ ell Marino Josephine Douglas James c. Bane Margaret Bails Fay Null Mary Jane Bakaitis REMARKS AMOUNT Probate Will 15.00 Ambulance 13.00 Funeral Services 666.65 Funeral Services 62.00 Services 40.00 Medical Services 163.00 Medical Services 50.00 Premiums due June, 1966-106.00 Services rendered Gas Bill Electric Bill Water bill Sewer bill Telephone bill Repairs made May, 1966 1966 Taxes County Taxes File Inventory and Appraisement Attorney's fees Notary Fees 6.00 10.46 1.95 7.08 5.29 3.91 135.00 60.66 8.40 3.00 175.00 5.00 TOTAL $ 1,567.40 Witness Fees 10.00 Witness Fees 10.00 TOTAL - - - -$ 1,587.40 ·. Observer -Reportef WASHINGTON, PENNSYLVANIA PROOF OF PUBLICATION In compliance with the News.paper Advertising Act of 16 May, 1929, P. L. 1784, rus amended. Commonwealth of Pennsylvania, County of Washington, SS: ........... . Pe·rsonally appeared before me, a Notary Public in and for said County Richard s. Cowan . and :State, .............................................................................. , who be1ng duly srworn according to law, deposes and says tha;t he is the :?.~.9.!.~~~---~--.T~~-~-~-· of the Obs,e.rver Publishing Company, a Pennsylvania corporation, and its agent in this behalf; that the said Company is, the owner and publisher of the Observer-Reporter, succ•essor to The Washington Obs·erver, established Seprtembe'r 18, 1871, and The Washington Reporter, established August 15, 1808, a daily newsrpap,er of general circulation, printed and published and having its place of bus·ines'S at Washington, Washington County, Pennsyl- vania, where it or its predecessors have been established and publishied continuous'lY for more than six months' prior to the publication of the notice hereto attached; thrut the printed notice or advertisement hereto attached is a ·copy of an official advertisement, official notice, legal notice or legal advertis·ement, exactly as printed or published in the Obslerver-Reporter in its regular editions on the following date or dates; ................................ ~ugu.s.t. .... l.., ..... 8. .... a.nd .... l.5..,_ .... 1.9.61. ................................. . that neither th!e affiant nor the Observer Publishing Company is interested in the subject matter of ooid notice or advertising and that all of the anega- !~~n~~~!. this affidavit ~~---~·o···t-~~--~i~-~~al~-~~ Sworn to and th. 15 day ofAug~_$ .. "t .. l.9..67 subsce~ >efore me IS............ . ...... . .#flt!41Md._At ~~---· . .. .. .. ..CJ ........ ~~-~~~;E;· ~:·~~A~-~~·;: HOTARYc;JsLIC WASHINGTON, WASHIHGTOH COUNTY MY COMMISSIOH EXPiltfS MAY 6, 1961 EXECuTRix·s -:NOT"icE , "") ESTATE 01!' MARY ROMAN a/k/al MARY R. DZUIBA deceased late of Washington, Washington County, Penna. , Letters Testamentary upon the above estate having been granted to ! the undersigned, all persons having 1: '11 claims against the estate are re-' quested to make known the same · to the undersigned or his attorney and all persons indebted to the de· , cedent are requested to make pay-ment to the undersigned without de- JENNIE R. WRIGHT I lay. ,. R. D. #1 1 Claysville, Pennsylvania 15~23 JAMES C. BANE, Attorney 6778-Tues. -3t --~ ~ ; . ...,.. ,...:·~ ... ~~. ,....,_ ---------- Washington County Reports ~nt:xMAH*:S'~ Washington, Pennsylvania (PUBLISHED BY WASHINGTON COUNTY BAR ASSOCIATION) PROOF OF PUBLICATION In compliance with the Newspaper Advertising Act of May 16, 1929, P. L. 1784 Sec. 3, paragraphs (3) and (25). CouNTY OF WASHINGTON) STATF. 01' PENNSYLVANIA ( ss. Personally appeared before me, a Notary Public in and for said County and Commonwealth, CHARLES C. KELLER, who, being duly sworn, deposes and says: that he is the Editor of the WASHINGTON COUNTY REPORTS, the official legal periodical for said Washington County, publis'hed weekly having its place of business at Washington, Washington County, Pennsylvania, and is act- ing as its agent in this behalf; that the said WASHINGTON COL'NTY REPORTS was established on March 31, 1920, and was designated as the official legal publication for Washington County, Pennsylvania, by order of the several courts of said County, dated November 11, 1920; that the printed notice or adver- tisement attached hereto is a copy of a notice or advertisement, exactly as printed or published, which appeared in the said legal periodical in its regular issues on the following dates: --~~-g~-~-~----~-t .... !.Q.J __ )._?..L.~~-§7. .................... . that the affiant or the corporation in behalf of which he is acting is not interested in the subject matter of said notice or advertising and that all of the allegations of /( _/ n,~ . . this affidavit as to~-ti , place and char act~ thl.1puolic~~-are true. ?/f-{;U/ t. ' ............. ~: .. ;;;::: ... : ........... .Jt-:::.:........... . ......................... :: (,-' ( ,_.. I . _ _, Sworn to and su bs.Cribed before me this .. .1~~}-=/-~ay~ oL..A1l~U.s.t ....... _______________ , 196..-7. .. :~==:~;;;; Washington, Washington Co., Pa. My C·.)nlinission Expires November 1, 1969 Editor '; _)J '~f~!:: Estate Notices The Register of Wills has granted letterS~ testamentary or of administration, in the following estates. Notice is hereby given to all persons indebted thereto to make payment without delay and to those hav- ing claims or demands to present t:hem for settlement to the Executors or Admin- istrators or their Attorneys . • • • • • • • • • • • • • • • • • ROMAN; MARY, a/k/a MARY R. DZUIBA, Dec'd. Late of Washington, Washington County, Penna·. Executrix: .Jennie R. Wright, R. D. #1. Claysville, Pa. 15323 Attorney: .James C. Bane, 247 Wash-ington Trust Bldg., Washington, Pa. ...----....... ------~---_,., _____ _, ________________________ ,.--~· Testate Form V PETITION SUR AUDIT IN THE ORPHANS' COURT OF WASHINGTON COUNTY Estate of ... JIIA'RX .. RQMAW ... ~/~/$. __________________________________ _ No _________ gg_~--~_f. __ J:~-~~-•--A! .. :~.! ______________ _ ................... :MAB.X:.R.t...P.Z.~.l.a.A. ______________________________________ _ Fiduciary ______ J.ENli{;tE. __ RQJM.N ... VfflJ.Q_~-------------- --------·------------·-----·-----------------------------------------------------· Deceased Date of Date of Decedent's deat~:",:.:---Augus:t .... -~_fi, __ _l.9_66 ___________ _. _________ Grant of . Letters ____ S.e~t-~:m.'b.~r .. ~l_, ___ l~§_§: ___________________ _ This is the: ___ F.ir.a.t.,Jlnd .. F."naJ. ____________________________________ account filed in this estate If there have been :forrn~r ac~ounts filed in this estate, list file number or number and term .... -------------------------------· --~ .. , ' .... ' -------------------------------N.Q.P.~----------------------------------------------------·----------------------------------'-------------------------'-------------------------------· Election to take Date Election Place of; Under or Against will. (cross out one) Filed ----------------------------------Record~--•-------.---J·--------------- Name of survi\dng spouse _______ .NQn~~---------------------------------: ... , .. _________________________ ,_ ___ : __ ~-----------------------------------------------------Ll~t: issu~: ~here. ma~~~ial;.. . J • • ) " '' ,I ' ~I~ • ' ·,, Did decedent marry after execution of will? (indicate)~ No. Any children born after execution of will? (indicate) ~No. If answer yes, name them·-···---------------------------·····-------------------------------------------------------------------------------------------· . . ... --........ -...... -.... ------.... -.. --.... --.. --.......... -----.... -.. -.... -.. --.. -...... -.... -...... --.... ------.... ----..... -.... -.. ---..... ---.. -.... -.. --.. -.... -........ ----........ ---........ -.. -...... ---.... -................ -.. -~-........ -'"j-:--.... ~----------------- Legatees Jennie Roman Wright Clayton E. Wright List, if exceptions t-o above: Adeemed: Nona If partial intestacy, give facts: Relationship Daughter Grandson Revoked: Interest Fiduciary, if deceased or not sui juris L1fe~·estata· in real estate and residuary in personalty. Remainder interest in real estate Legacy Lapsed: Abated: Give Cause: Notice to interested parties. Have aiJ parties, having either vested or contingent interests and all crediors entitled to notice (Court Rule No. 9 paragraph C: Section 6: Subdivision c) received written notice of the filing of the account and of call of audit? · Yes. · Jt:tllC · · · · -~ If any exception give cause: ... ------------------------------------------- File copy of Notice and date of mailing ........... Mar.ch. .. 5., ... 1.968 ..................................... ---------·--··-··--·----··-·----·····--··-------···-·---··---------------,, Is estate subject to the filing of_~ Feder:OI Estate Tax Return? ......... J'{9. .......................... , .............................. ,; ............ . Actual payment made on Pennsylvania Transfer Inheritance Tax. Amount $--------~~-~g_? .. Q.~---~~-~Q~~t ............. . If the Will makes any portion of estate subject to a life-estate, give name and birth date of life tenant ..................... . . . ··························--------~~-~~-~~---'R.<?.~~-~--~~-~s.~-~------~-----~~~-~~!.J. ... ~~-~--}-~~-~------············································----- Give Names and addresses of all unpaid creditors who are legally entitled to notice, tog.ether with the amounts of such claims; state whether they are admitted to be correct; and whether the claim is denied. None Give reference to such parts of the will as require interpretation by the Court; a reference to all questions re- quiring adjudication, and a statement of any other facts deemed necessary for the preparation of the adjudication: None . I Balance for distribution per account, Itemize any additional debits not shown by account: None Total additionc:al debits (Add) Itemize any. additional credits not. shown by account: Observer-Reporter, Advertising Est. Washington Cci. Reports, Adv • "Est. · Additiona1Wasl1:1ngton Hospital bill Russell Marino1 Filing Account Mae Her~e~r No~ar.Y Fee Total additlon'O cred1ts (Sutitract) Balance for distribution 12~·50 12~50 1s;oo 16.00 1.00 - $ .... l ... ~ll.~.l~------------- $ ______ None.. ................... . $ .............. 5.5.-.Q.Q _________ _ $ ..... l1.e.5§_,_l_~---·····-··· If balance for distribution is not in cosh, list each item held in kind, giving appraised Value (or distribution Value); Balance dfi P,e~~onalty in Cash. Real Estate to be awarded to Jennie Roman WTight for life with ~ .. -~ .. ~· ..-......,-. ...., .... ··-.. -. .. remainder to Clayton'E. Wright. Ra& estate valued at $1500.00 • . -. , ,; . \' If Family Exemption claimed by Petition, give place of Record: .................. NP.:Q~---············-··-··.·············--··················· t If Family Exemption is claimed at audit, give name, relationship ani:i basis for Claim: .......... N.Q.Jl~---·························· List any advancement or distribution on account that has been made, and nature and amount of same: To Clayton E. Wright the sum ot $1,000.00 as provided in Paragraph •• ·-· ·--.J -• ... ••••• Second of the Will. Receipt given. Suggested distribution of balance shown, both as to principal and income, attaching signed and itemized elections to take in kind if balance is not in cosh: residuary shares being stated in proportions: ., to Clayton E· Wright and balance of~.personalty in cash to Jennie .; 1 .~, 0 -• ... , __ ,,. ~--o . ..O '~'"'""'-. • '-· ~ _. H• .......... ' o' .;; J ,-• Roman Wright. Real Estate valued at $150o.oo, COUNTY OF WASHINGTON, SS: COMMONWEALTH OF PENNSYLVANIA. The above narn..e.d J~jpuciary or representative thereof, being duly ...... JH'{QrtL ................. doth depose and say that the facts set. fqrth in the foregoing petition are true And your petitioner will ever pray, etc. to the best oL .. .he.r .................... knowledge and belief . ......... S.YP. .. :r.~---····················----to and subscribed before -~ ------- me this .... /&' ...... day of ............ Mar..ch .............. l S'6.a ... . Signature of Officer.~~-~T-: .................... . . ... .. .... ..- . -~i:""' !VIAE: HERCEG ·-.. __ . Title of Officer .... Notarj·J!iihlre,:wa;hln~;Wlrsh1n-·QJ;············ . MY. t_Qmmisslon:i:ttP-ite.s JJJ.!!.Q ~b Jm . Office expires ........ :~ .. ; .... :;.~~-~ .... .-................... :.: ............. . ... _: :·t-(!/ ~ ;~· t!-~ I '(' -~-. ·" ..... , ' ,., ., ·' /l ., ·! No. . ......... ~.Q~ ... 9..f. .. l.~9.f~.a ... A.t ... A. •...... Estate of ........ MARY .. R.QMAN ... a/~.f.a .......... . •...................... MAB.X ... 'R.,_-__ P.Z.VJ.aA ............... . Deceased Fiduciary ........ J~ID.U~.JlQM!.W ... WB.IOE'l' ... . 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: paragraph b-e; and divisions thereof: shown on pages.23-24. 1. Written praecipes of all Counsel in the ..... case. : 2. Copy of ord~r.:> appoiQ'ting Guardian ad litem, if perti@f:i1. _)) --,~ -':J -• 3. Copy of Ordj~.:;') appointing Trustee ad litem, if pertine'Rt. ~ -o&....:--.._... ~ 4. Proof of serV.i,<;:.Etof above~ 1 ; 5. Letters Testp_rr;-entary:~or Ad~istration C. T. A. or ~,5i:Jttest copy ol~ill. 6c f .. <n f'\.,:> • . opy o 1nventory ana appraisement. 7. Proof of advertisemeQ;t of grant of letters if not filed with acc~nt. 8. Certificate o{ liens in case any of 'the funds for distribution are from judidal sale of real estate. · 9. Signed and itemized elections if any distribution in kind. 10. Copy of Federal Estate Tax return if es- tate is subject thereto . ...... J:A.:r.ES ... O .•... BANE ................................... . Attorney ~2 I 1\r 'lit 1 \\\ I. 'II '"' ·:.;~ ("'" ~ ~. ''·'\ .......... ~ .:::: .... -..·\4"1'. -.... C'("'t, ... '.-.. ...:::-, .· '"""'-.. "'' ·. ", '"\ -:. ~ !<J • -'> ... ) • . • : := ... r) :\. -;:· :"; ~ : ::: :::-: : :-(~ ' 1 ' : . : : ~r;-1 : <"':. 'I r :r::-:~ ;. c. \ t"":. . ~-; :, .., .• -:: .. ;_ /I • ... """;"" " ,··~'_.:...."" ... : . -/. . . . ~ ~ .. ~ ............. ~ •............ .... .... ....... ............. \....'"' ... ,,, ~, ... ' ,, ~ .. , ,,\ 11111/liH\11' .. ' . • ' . . ' , . IN THE'ORP~ANS' COUR:r OF WASHINGTON COUNTY, PENNSYLVANIA IN RE: ESTATE' OF ) ) MARY ROMAN, a/k/a () ) ) ) ) ) ) No. 209 of 1968 ~ MARY R. DZUIBA, z < ~ Deceased. Ill z z Ill II. i 0 ... Cl z X BEFORE: Ill < ~ .: !:! (!: t,; A;Rl?EARANCES: 0 ..1 < u c :l ~ TIME: .... ,... N IIi (!: Ill ~ THE COURT: 0 0. Ill (!: ... (!: :l deceased • HEARING ON AUDIT THE HONORABLE P. VINCENT MARINO, President Judge of the said Court. JAMES C. BANE, ESQ .• of Washington, :f>enna., repre~ enting the Accountant . Wednesday, March 20, 1968, at 10:00 o'clock A. M., EST. Number 209 of 1968, the estate of Mary Roman, The Executrix is J~nnie Roman Wright and the atforne IT 0 u .J < is James C. Balne. Mr. Bane? u ~ MR. BANE: If the Court please, I have all the necessary 0 papers. There are no complications. . . ~ THE COURT: Are there any claims? MR. BANE: No claims. All creditors and claims have been paid. THE COURT: . Is there anyone else in Court interested in this I .. ,. e e decedent's estate? ( NO RESPONSE ) . THE COURT: The audit of this account is ordered closed by the Court . ( AUDIT CLOSED ) ~ z < > .J >-Ul z .z "' II. i 0 ... I!) ~ X: Ul < ~ ..: u it ... Ul i5 .J < ~ I hereby certify that the proceedings and evidence are contained 0 ':I ., ' ! ~ fully and accurately in the notes taken by me on the hearing of the above ,... ,N cri' cause,· and that this copy is a correct transcript of the same. a: ~ ~ 0 ' ~ • . ·. ~ -::::-'!~~~~~~~...1.-!::~=~u::u:.;:_ __ ... a: :J 0 u .J < u iL Ll. 0 .. Tht: foregoing record of the proceedings upon the hearing of the above cause is hereby approved and directed to be filed. 2 / ' ' ---- . f.l..r "'-l" CJ C\.1 -· ' ~~ ' ' I ··- ~ .. '"" +t I L ' ~ I, ' ~-' E: ' '; .o.l • ... ·~ . '. c. ' C: l> ~-·r:; -~~-" u •:tiJ i1J ~1-:-~ !:. ,~.., v_ n ' .. JA."; ·_lr;_.t -. .J·,·.·:. -·· ~,·! t ... • C-iU ll. .. ·"'· '• ')';· . .!1 I' J.J,; . { .r • 'I • L' i ~' ·i •• i.. .. • \,' •. . ,, ' • ~· e l I ) '· 1Ju t}Jr «.@rp}Jaus 11 C!tnurt nf llas}Jiugtnu C!tnuuty In the matter of the Audit of Account in Estate of MARY 'ROMAN a/k/a No. 209 , , 1998 , A. A. MARY P. DZUIBA TO THE AUDITING JUDGE: Enter my appearance for.---~A""'. ""C:...:C::_::O:...::U~n:.!..::t=..:a=n:..:t~, _______ _:___ _ __;_ ______ _ ... , .. ~ ..... ___ .. , 19~ N. B.-Counsel shall, by separate paper, present a concise statement of each claim, with supporting calculation of any interest claimed. Objections to an account as filed, shall be concisely stated in a separate paper. Council suggesting proper distribution shall file a separate concise state· ment in that regard. I No. 209 , -----"-----• 19___ru:t_, A.A. In re Audit of Account in Estate. of MARY ROMAN a/k/a MARY R. DZUIBA ,_ AUDIT '· · Jratript fnr i\ppraraurr FOR Account; ant ' .. ., ~· -. ::o_ '"":: -t'"r'l .... f ~ G)C 0~~ -~ ..... ;.->--:-;J~ ~- oz ,.,.,,i "" ..... -CJ :£::.0 r=-:z ro f\.J (./) . . t\) !:>- JAMES C. BANE Attorney r IN rHE. ORP"AANS • CJtmT OF ~IASHI!JGTON COUNTY, PENNSYLVANIA ESTA'i'E OF . MARY ROMAN a/k/ a . MARY R. DZUI BA ) ) ) ) NO. ) } } } DI$'I'RJ.BUTION RECEIPT ot 19 • - I, the undereiguod., hereby ackmwledgo to have received . o.f JENNIE ROMAN WRIGHT·, Executrix • .. the o.um of, ·ONE THOUSAND AND N0/100 ($11 000.0'0) ------ .·· . in full payment ~! the nm()unt alllr"nrded to mo by the said· Orphano' Court in the Decree mrl Schedule· of Distribution filed to the above Humber and Term ot said Court and in' consideration thereof, I horeh1 releaae and discharge i.t from any further liabilityon account or same. ·WITNESS my band and $aal this --..-;~=-t/.;.....~_· _.__. __ day of June • 1967 • ----~~~---------------- Attest• '\ ' \ 1' ' . -~ '-. -. ''\>."' . ,.) - _, • :>..-....... '"\I • ~· • ,;.~ ~-·-'f.-'~ !: \ \ j. .<i > ·-( \" ,-t·-·· ' . ·. " .. ; '-\ . l ' 1 ' . IN THE ORPHANS' COURT OF WASHINGTON COUNTY, PENNSYLVANIA IN RE:. ESTATE .. OF ·MARY ROMAN ) ) a/k/a MARY R. DZUI~., } } Deceased. ) ORDER OF COURT NO. 209 of 1968, ~ 4t AND N<lY, this (/'-day of April, 1968, it appearing that I there is not sufficient funds in the above entitled estate from which to pay the audit costs, it is hereby ordered and directed that Jennie Roman Wright, the sole legatee, pay such costs as may be due or become due in said Estate. ESTATE OF MARY ROMAN a/k/ a MARY R. DZUIBA No. 209 of 1968, A. A. REAL ESTATE TO BE AWARDED TO JENNIE ROMAN WRIGHT Life interest in one-half of the following described real estate: ALL that certain lot of ground situated in the Seventh Ward of the City of Washington, Washington County, Pennsylvania, and being known and designated as Lot No. 69 in t:he Pla.n of Lots laid out by Walter B. Anderson and Robert A. s. Pollock and calla "Mapleviaw Plan" and recorded in said County in Plan Book 6, Pagei 10 and 11. Said lot is more particularly bounded and described as follows: Said Lot No. 69 fronts 61.34 feat on P~chigan Street, an~ extends back therefrom in a Nor~herly direction a distance of 130 fee+, to a fiftea n ~oot alley, on which said allay said lot extends 90.81 feat. Said lot is bounded on ~he North by said fifteen foot allay, on the East by Lot No. 68 in said Plan, on ·-- the South by Michigan ·street, and on the West by Lots Nos. 70, 71 and 72 in said plan. EXCEPl'ING AND 'RESERVING all the coal of the Pittsburgh or River Vain and mining rights and privileges as set forth in the deeds' of -·record in the chain of ti tla. BEING the same lot conveyed to Mary Roman and Mrs. Jennie Wright by deed of Mary Boman, Widow, dated september 27, 1948 and of record in the Recorder's Office in Washington County in Deed Book 747, Page 344. REAL ESTATE valued at $1,500.00. Form No. RCC-62 (2-64) THIS FORM REQUIRED IN ALL ESTATES WITH GRoSS ASSETS UNDER $10,000, UNDER SECTION 7 EFF~9-~0IVE JANUARY 1, 1962. (FILE IN DUPUCATE WITH COPY OF WILL ATTACHED) ! .... j ·-oFFICE OF THE REGISTER OF WI~L.s: ~ ·_ -County of~ .. Ytfl}~;rrn~~ 9J:-C ........ ~. ( . ·, "' • '; ' I ....... J.EHIJN:CE. ROMAl~. WBIG.HT ..... ~ .... ·: ' .... · ... of .... C.lay.~v:i:-J.la.~. P~on.s.Jtl:v:a:nia ..... '" .. : :. ~ ; ·. ~ ~ (Name) -· -,_ (Address) · • . • ' . b . dul sworn · -d~ 1-. _.d ---d." h-h.·. -h Execut.,..ix · ~-etng y __________ _. ________________ : ___________ .accor tng to aw, eposes an says t at e 1s t e ------------------------~-------.------------------------~--' · -· · · (Exec., Adm., Legatee, Etc.) ·-' . --. t . ' ' "to - ~f· thb estafe of ____ Mgf~L.RQ_:mgn __ ~JkJ~ ___ M_t!~Y-----whose last residence was ____ lQJ3..Q ___ Iv1:i..c..b..:i_gall< __ A.v., ~.nu.e ___________ _ R D ib (No.) Street . • zu . a ____ ¥\f.§._l?._~~:gg~.Q_:O.t __ ]~~~P-D:@:..! _____ deceased, and· that the whole ·~f th"e estate of said ;decedent, who died ::.:.A.~<D~t., .. 2fl.,_ __ l96 6 (City, Borough or Township) · ·-ate consisted of: / r . -. REAL PROPERTY REAL PROPERTY IN PENNSYLVANIA, WITH STATEMENT OF MORTGAGE ENCUMBRAN<l:ES UPON EACH PARCEL AT DEATH OF DECEDENT, WHERE PROPERTY HJ!:(.D AS JOINT TENANT OR TENANCY BY ENTIRETIES, GIVE NAMES, ADDRESSES AND RELATIONSHIP OF OTHER OWNERS. Real Estate Estimated Value N 0 N E. -., ,, . ,-' - ~ ' . Personal Property 1 lot of Household Fu:r-nitu:r-a !II\ 1 () ._QQ_ (Wo,-.thlass -donatan to Citv Mission\ H~/S)?;, , . --- ---. ' -',- --...... ~ .... ,...l !(,-.. -i . (c' ,;;..o:_,.,-. -. i·•~-t:.j< -~ .. -,.., r , . ,_ -. - <: ·' - 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 signed by a responsible officer of the financial institution or 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 nanies in which the account is registered. Jointly Held Property Estimated Val]le and to ALL that certain lot of ground situated in the Seventh Ward of the Cit of Washin ton Washin ton Count Penns lvanfa an being known and designated as Lot No. 69 in the Plan of Lots laid out by Walter &. Anderson and Robert A. S. Pollock and cal e nMapleview Plan11 and recorded in said County in Plan Book 6, Pages 10 and 11. U on which is erecte a 4 oo fra e we i o e-- badly in need of r~pairs. Recorded in Deed Book 747, Page 344. r . Value 3 000.00 .. 1 2 interest in Savin s Account No. 8744 in the Mel TOTAL ... NONE 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 THIS SAFE DEPOSIT BOX RENTED RELATIONSHIP OF JOINT IN WHICH DECEDENT RENTED A SAFE DEPOSIT BOX IN NAME OR NAMES OF HOLDERS TO DECEDENT Mellon National Bank & Trust Compan Mrs. IVIarv Roman Dzuiba nr:~uQ'hter> South Main Street or> .T Annie V!Tr>iP-'ht Washington~ Pennsylvania -Rox No .. £1296 BENEFICIARIES BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED AGE OF LIFE (If step-children or TENANTS OR INTEREST OF (State fuJI names of all and their addresses who have illegitimate children DECEDENT ANNUITANTS BENEFICIARY STATE YES an interest, vested, contingent or otherwise, in estate.) are involved, set OR NO AT DEATH OF IN ESTATE forth this fact.) DECEDENT -' - Jennie Roman Wright Daughter Yes T.i:fe est::~t.A in R. D. #1 real estate and fn ::IV~Vi11 A PAnns vl v~ni~ res~auary ~n nAT"."lOn~l f.v. v v _Clayton E. Wright Grand's on Yes Remainder interes R. n. 1/tJ f.-.~ oJ:~;;l estate 0 " Claysville1 Pennsylvania t --. ·.~ RESIDENT DECEDENT DEBTS AND DEDUCTIONS CLAIMED NOTE: List fir!)t five items in the spaces so provided, observe notations thereon, and instructions. DEBT OR CLAJM NATURE OF SAME AMOUNT THIS COLUMN .-------~~~~~~~--~----.-----------------~----------------.-~------,--mEGISTERONLY Funeral ex 5 $ Church of St. John Family exemption (will not be allowed unless decedent died residi g with a spouse or children.) e OTHER DEBTS AND CLAIMS Utilities, repairs and taxes Administration Expe Counsel fees * Hospital Fiduciary (*) See Note below 0 0 0 3179 75 Total 50 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 or less than the estimated amount claimed and allowed. -~ Subscribed and sworn to before me this ..... ~~ .......... . ~~~-ooo•o•nt~.f.d.~.#. u 'D T'\ (Executor-~ ··;_;7 • 0. OP~-0 .D .... #1 .... 0 ••• 0 ••••• 0 •••• 0 0 ••.• 0 ••••••• (Street Number) 0 0 0 0 o o o o oo 0 0 o 0 o. 0. 0 0 0 0 0 o day of 0 o o ~ o' 196070 ·~mm~:*.re?i 0 0 0 OQO~~y~yo:qoJ-~. ,0 0 ~~n~o~Y.+:v: ?-OI?-~1?-0 0. 0 0 0 0 0 (City or Town and State) Having been duly sworn according to law, I do hereby certify that the above appraisement is made in conformity with law on this 0 0 0 0 0 • 0 0 . 0 0 . 0 . 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 o 0 day of 0 0 • 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 ° 0 0 0 0 0 0 0 0 0 0 . 0 0 0 0 0 0 • 0 •• 0 0 ••.• , 19 0 0 ••• Appraiser 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 ·inheri- tance taxes at the lawful collateral rate on any such future interest. REPORT OF THE REGISTER OF WILLS I, the undersigned duly elected Register of Wills in and for. 0 .• 0 •••••••• 0 •••• 0 •••. 0 •••• 0 •••••• 0 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 o nt represent the sum allowed as eduction. Dated: ........... 0 ••••••••••••••••••••••••••••••••• .. .. . .. .. R~gi~te; ~f. Jf:? · · ~ '- Form No. RCC-62 (2-641 Will Administration lNo. · · · · ...... Year .... . IN THE . MATTER OF THE APPRAISEMENT OF THE ESTATE OF ~FX. F.Q~~~.l'J. rp.flf./.B:. rAA~¥ .. ~! .. ~~P:~I?A Deceased Late of ..... W~~)+tpgif9.11 ............. . County of .... WJt.~LP.Dltl'QN .................... Commonwealth of Pennsylvania REPORT AND APPRAISAL ·:1 ·o ."!~iT,:"' -:~. · ·· ..; ~~ .. -, ~ -' ' •• I I,, s '; ·~ ~~ {· .. :_. ·._. • 1 ! .J it I -~ ~ ~ :• ('t JAiv'IES C:;!·;;· BMJ,E ;,_'d ESQ• "·:··1 , Z.47 'vVashington Trust" '1B1dg. Washington, Penns y1 vania C]. -., -... 153 01 -...: , 1 l , •~A : >! f.,·; i",., ,.. '....> -. /. •,: -~. • ... RCC-81 (2-64) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS INHERITANCE TAX DIVISION NOTICE OF FILING OF APPRAISEMENT JENNIE ROHAN vm.IGHT IN YOUR REPLY PLEAIJE REFER TO 36-225-4 In Re: Estate of ___ lW_RY_'_R...:...O:_~fl_lAN=--...:...a...:...k=a-=}~JA=R.:.:Y:....:.:R.:..• _:D:...:Z:...:U::.:I:=B:.:..:A:..__ _ _______ ..:..:'\IJ.!!A::::.SH:..:.I~N:.:..:G~TO~N:...__ ___ County -File No. 9314-147 Dear Ms. "Wright You are hereby notified that the ______ ~o~r~l~·g~l~·n~a~l~------------- appraisement in the estate of Ma,.~r Roman, ak"' e+c, has been filed in the office of the Register of Wills of it.Tashing+o!,:l County on A11gJ1 s+ 29 , 19/;Jl_. Said appraisement reflects the following valuations: Jt. Held Pers. Real Estate -----------------~~----- Personal Property ______ ~~~l~0~·~0~0~----~~---------43~,4~88~.5~4~- Tot a 1 -------------j....;,....;4_9_8_._5_4 __ _ 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 one year 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. August 29, 1967 Date ----------------------------- DATE OF DEATH: August 28, 1966 Note: This is not a bill. ~ Fonn. RCC-2· i;. ....... DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS HARRISBURG, PENNA. • 77·1 2 1~ COMMONWEALTH OF PENNSYLVANIA RESIDENT INHERITANCE TAX APPRAISEMENT DATE ......... .August. ..29._. ..... 19.6.7 ......... · COUNTY :YJ.A.$HJNG.TQN. ············· ........ . FILE NO. . .................. ?.?..~~.=~~?. .......................... . Whereas, ..................... ~~ARX.. . .R9.~ .... ~~~ .... NAftX. .. B.~ .... P.~.m.I?.A ......................... late of ................... Y.1.!\~I:qt:JQ:~.9.~ .................................... . in the County of .......................... J.lA~!i.~:NG.':rQN ...................................................................... Commonwealth of Pennsylvania, having died on the .............................................. ?.$.Y..h ................................ day of .......................... f\..l~E~l.~Y. ............................ 19 .... ~~··• seized and possessed of an estate subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore, I, ................. :.~f.~ .... .R.~ .... G..HA~X........................................ .. . ......................... , an appraiser duly appointed according to law, having been designated to make a fair and conscionable appraisement of the said estate, and to assess and fix the cash value of all annuities and life estates growing out of said estate, hereby file the following appraisement: In the event that any future interest in this estate is transferred in possession or enjoyment to collateral heirs of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer inheritance taxes at the lawful collateral rate on any such future interest. =====================================================r=====w=========·- Description of Asset REALTY: NONE PERSONALTY: As per appraisement filed TRANSFERS: NONE JT. HELD PERS.: As per appraisement filed TOTAL Unit Values $ I Appraisement Made for Inheritance Tax Purposes NONE 10 po NONE . 3,488 54 3.498. 54 form:~hbl:": !~1fh~sw<>rJl ~';Q~~ ~~: ~:; .~·~ .. ~~ ~":r~~~~~li~ v ... -,c, ••••••.• , ..... ; .... ~ ppraisrr ~ .... ,,.,,.,,.,,,.,,, .... ,.:· .. ,. ""'' ''''''"'''''''""""&:: .. ••••••••••oo•••••••••••••::L••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• '"-~. ~::,mller~SzU8M"l---~ ....................................................................................... ~ ......................................... , Penna. (P eel ! .......... VtASHD.C.TO.N........................ County RESIDENT INHERITANCE TAX APPRAISEMENT ·Estate of 1-:LARY ROMAN aka lJLCffiY R. DZUIBA Deceased. Late of .... v:ASHINGTON ................................................ .. Date of Death, ............. J'm.gust. ... 28., .. 1966 ............... .. Appraisemei!t Docket Vol., ............... .:?...9. ............................ . Page, ......... ?.?5.~4 ...................... No ............. 9?.;1,.4::::;tb.7 ...... . Filed in Register's Office, .... AP-@.9.:t ..... ?9. .. J99.7 .. . Amount of tax due, $ ................................................................. .. DEPARTMENT OF REVENUE Received, ~· •. ;I :r:JI t Examined and Approved, s 111 .~\ ."l 1' '11 s ] ]!J Wrote abo.ut ApiJra.tSement, ......... T1 ..................................... .. I~H..J~., IJ .... ,):._l/0 . t' z . G J!d 7 J t f! -"f"T Appeal f1'om Appraisement, • ........... ~"., .................................... .. Entered and cha,ad:~.: 'J .. ./.. ... ~ .. 1 ................... ~ .................... .. V· . • • ,.,.~ ' ! Form RCC-10 DEDUCTIONS ALLOWED IN OFFICE OF THE STATEMENT OF DEBTS AND DEDUCTIONS tt'/. fo THE SUM OF . . • . . . . . . . . . $ ... /~ ............... :.......... .. DATE 'APPROVED . •• . . . • . . .... t...~.-~[-:._f;z ESTATE oF Mary Roman aLk/a ~;&,AT oF City of_1ld_as 1ng on Mary R. Dzuiba /i .. t'-.:?f..~~/'1 DATE OF FILING APPRAISEMENT ~~ _q _ _;: f[_ /,ATE OF DEATH _ _.A~U~~~U~S~t~2:::.;8::::..z.t.....=l:..:::9:.;:6:..:6::__ ___ _ /' -, I ~OF PAYEE I REMARKS DATE ----r---+V.;.,;;OUCHO:II! NO. OF AMOUNT ·of \fills a'.5J/ :1966 Josenhine Dou~Zlas. Register Probate Will 1t; nn 8/13 r1966 Ambulance & Chair Service Ambulance 13 00 9/2/ 11966 IW .. G-.. Neal Funeral Home Funeral aarvic.e_a 666 6n ~~---+=~~-~~~c:.l:.:!hl~Ur!~h of St. John Funeral ~ 9/2/ 1966 R? nn 9/15 r19s6 Washin2ton Hosnita1 Services 4() 00 9/15/ 1966 Doctor Bernard Berman Medical services 163 00 9/15 1966 Doctor Owen D. Benton Medical services 50 00 9/14J 1966 Blue Cross of Penns:vl vania Premiums due in J_une_.1 9RR ~~~~~~----+~~~~~ 1 OR on Robert Grimm Services rendered 6 00 9/8/ 1966 Columbia Gas Company Gas bill 10 46 ! 9/8/ 1966 West Penn Power Company Electric bill. 1 95 i 9/29) 1966 Citizens Water Company Water Bill 7 08 9/8/ 1966 Washington-East Washington Sewer bill 5 29 Joint Authoritv 9/8/ 1966 Bell Telephone Company Telephone bill 3 91 9/29/ 1966 L. L. Miller Repairs made .Na_v._ 1966 1RFi nn HarrY R. CookJ City Tres. 1966 Taxes 60 6R Russell Marino County Taxes R 40 men1; JosePhine Douglas Fi 1 e Inventor_y __ & A.JJPraise-3 00 James c. Bane A tto.!'IlaX' s fe.ii..S. 1 ?Fi nn Notary Fees 5 00 -Marrzaret Bails -----+----+-----~----------------------------+------------------------;------+--- $1,567 40 COMMONWEALTH OF PENNSYLVANIA COUNTY OF WASHINGTON I, .JENNIE ROMAN V'iJRIGHT HEREBY CERTIFY, THAT. TO THE BEaT OF MY KNOWLEDGE AND BELIEF, THE FOREGOING IS A JUST AND TRUE SfATEMENT OF DEBTS, FUNERAL EXPENSES AND EXPENSES OP' ADMINISTRATION SUBMITTED TO THE EST-"TE OF Mary BQman a/k/a Jl/fary R • DECEASED. AS DEDUCTIONS FOR INHERITANce: TAx PURPosEs. Dzuiba t . ,. £J ~ /JJ ~ • ~ J _ '-4'24'ZLI.t~441./~/.~~-s.l SWORN AND S SCRIBED BEFORE ME THIS .2. DAY Of'~ .-..<!.-~!-=-. ~~~~~~~~~~~--~ 27, 1971 I I ' ' r ' r ·t r j I, ,. ~ l:.i, .'-I & :;;: w 0 \'\ ·' I r