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OC1968-0334 - ESTATE OF KUBACHKA
Testate Fo~ PETITION SUR AUDIT IN THE ORPHANS' COURT OF WASHINGTON COUNTY Estate of ...... JMLKlJ»AC.RKA, ... a/k/.a ................................ . No ....... 6.3.<!.6.8.~.3.3.4 ......................................... . .................... :!.Q~~--~~..t .. ~~-~---································· Fiduciary ... ANNE .. BDBB~ .......................................... . Administratrix C•T.A • ........................................................................................................................................................... Deceased Date of Date of Decedent's death ... J.~.l:\~_:r;y_J~_, __ J?.~~---·························· Grant of Letters ... f~l:n:::P.SlJ.:Y-.. 29.~ .. 1.968 ............................ . This is the .......... Fir~.t .. ~.mLF.i~-~-l ................................... account filed in this estate__.... If there h~ve been form:r accounts fi_led in this estate, list-file number or. nu':'ber and term .........•. ~---····-'················· r. Election to take Date Election Place of; Under or Against will. (cross out one) Neither Filed .................................. Record' · ... ,.: .... · ................... . Name of surviving spouse .. Ka.th~r.:lQ.~ . .F..~v:~~a .. K'P.~a~l*~--=-=--9i~~--J.YJY..'.l~., ... l.9.6.~ ................ · .. ;,·: ........... · ......... : .. . List issue, where material: JOHN KUBACKA, JR• Son ANDREW i<UBACKA. ·) Son MICHAEL KUBACHKA Son JOSEPH KUBACHKA Son EDWARD KUBACHKA Son MRS. EMALIE WILLMOTT Daughter ANNE BUBB Daughter Did decedent marry after execution of will? (indicate)~No. Any children born after.execution of will? (indicate) ~ No. If answer yes, name them ...............................................................................•................................................. . . ' ...................................................................................................................................................................................................................................................................................................................................................................... Leg.atees ~OHN KUBACKA, JR. ANDREW KUBACKA ~MICHAEL KUBACHKA ""--JOSEPH KUBACHKA ""EDWARD KUBACHKA ~. EMALIE WILlMOTT ~BUBB ., List, if exceptions to above: If partial intestacy, give facts: Adeemed: Relationship Sou Son Son SGn Son Daughter J?aughter Revoked: NONE ( . . NONE Interest !/7th/ 1/7th<"" 1/7th.- 1/7th 1/7th ..... 1/7th- .1/7th- Lapsed: Fiduciary, if deceased or not sui juris Abated: Give Cause: Notice to interested parties. Have all 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. IXIl§X If any exception give cause: ...... .NONE .............................. , Is estate subject to the filii)Q of a Federal Estate Tax Return? ............. ~~---··································································· Actual payment made on Pennsylvania Transfer Inheritance Tax. Amount $ ... 3.42. •. 0.0. ........................................... . If the Will makes any portion of estate subject to a life-estate, give name and birth date of life tenant ..................... . 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 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: All parties in interest agree that the intent of the Will of tthe decedent is to divide the estate qually among the children. Balance for distribution per account, Itemize any additional debits not shown by account: $ ... (3 .•. ~~-~-~ . .?.7. ................ . . ( Total additional debits (Add) $ .. ___ -: ___ 0._:~ ..................... . Itemize any aaditional credits not shown by account: '\." ·"' Bond Premium (2.pmts.). $112.00 Total additional credits (Subtract) $---~~-'!~g·················· 112.00 Balance for distribution $.Jt,ll.0.-5.7 ................. . If balance for distribution is not in cash, list each item held in kind, giving appraised Value (or distribution Value); Real Estate Cash ,/0 •••• ~,_ ... .,#"'o.r .. 1/1 Acre and house, Independence Township, Washington County, Penna.· $3,200.00 5,510.57 ,, I If Family Exemption claimed by Petition, give place of Record: .................................................................................. . IfF ·1 E . . I . d t d"t · I t· h" d b · f· Cl · NONE CLAIMED am1 y xempt10n IS c a1me a· au 1 , g1ve name, rea 1ons 1p an as1s or a1m: ............................................... . List any advancement or distribution on account that has been made, and nature and amount of same: 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: JOHN _KUBAC~, JR. ~ ANDREW KUBACKA ~ MICHAEL KUBACHKA . JOSEPH KUBACHKA EDWARD KliJBACHKA MRS. EMALIE WILlMOTT ANNE BUBB COUNTY OF WASHINGTON, SS: COMMONWEALTH OF PENNSYLVANIA The above named Fiduciary or representative thereof, being duly .......... s.wot:n .................. doth depose and say that the facts set forth in the foregoing petition are true to the best oL ..... het: ................... knowledge and belief . .................. S:w.orn ................... to and subscribed before me this .... ~-~-~day of ........ Marr:.h ....... !:.;.__·~~-#--19.6.9 ... . S;gnatu•e of om, ••. ~ ~~~--4:--Wj{..w.l .. Trtle of Off1cer ...•... : ....................................................... . om,. exp;,es ..... : ...... ·····~~1~~~~;;g:;;~;N[;1 .. . l/7th l/7.th l/7th l/7th 1/7th l/7th l/7th residue residue residue residue residue residue residue And your,petitioner will ever pray, etc. ,,~~ . . .... ···· ·····"(Anne··nuoo ························································ . ....................................................... ~ .............................................................................................. ·~. ,:.#"\ 1 No. ------63"68 .. 334---------------------------------· Estate of ... -I~--~1m~9~.!--~-~_(~----------------· ····-·····---------IQ~--~~~..1.--~~-~---------------·--· Deceased Fiduciary ....... ~---~-~-~----·····--------------········· ........... .Adminiatx:a.tx:ix .. c ... :r ... A.. .................. . 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 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 Will. 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 and itemized elections if any distribution in kind. 10. Copy of Federal Estate Tax return if es- tate is subject thereto. JAMES R. DONAlDSON Attorney ~2 ''Vd ··on NOl':JN\HS'i~\ Sll\M 30 'd31SI~3U ON\U\i'W TDSSIIB 'tt Z\ "ti \ \ ~n~ G9, &o:t-\\' .J .'J. , ... ,. J 'fil, p ~.' ,,\ -~ '·· ,, . ~ ,,, .. <::> "> .. , .... .:')..' ,.•"r" i ._' ..... ' • J : : . : 4: -1:. : 'I~ -. ,::> .. ·. c..·. r • ··~, (} ... :,. . "' ..... ~ -.... ,.. ;; J:" ~~" .. , ... .,~ f• .• ' "'· . ,-~ 'frn•t·1• ' .' llns4ingtnn <t!nunty1 ss: I, ........ R~.~-~~-:u .... M~r.~.Q ....................................... Register for the Pr~bate of Wills and granting Letters of Adntinistration, in and for the County of Washington and C onwwnwealth of Pennsylvania: To ......... An.n ...... a.Y..b:b. .................................................................................. . C. T. A. . Administra trW all and singular, the goods and chattels, rights and cred~ts ~.'Dptltooxi~ which ~uere of. ........ :T-I~~---~~J:?~~-~-~ ............... . .... ~J~~~---~~~---~~P.~-~~~-L-~~-~ ...................... late of the said County, deceased, with a copy of deceased's will annexed, GREETING: /. . -13.n~-:Kuba.cbka, A/K/A John Kubachka, Sr. ~~ hereas, the sazd.................................................................................................. . · His l'f · d Hi s l W "ll d T . . . IlL.: .............. t etzme, ma e ...................... ast 1 an estament tn wrztzng, 'i.(Jhich was duly proved on the ... ?..~~~-! ..... day of. .. ~~~-~~~~Y. .. : ......... A. D., I..96.8having, zvhilst... .. "fl~ ..... lived, and at the time of.~.U:.f!decease, divers goods and chattels, rights and credits, within the said County, by ·means 'Whereof the full disposition and power of granting letters of administration thereof, is manifestly knmcn to belong to me; Therefore desiring that the goods and chattels, rights and credits which were of the said deceased, and which 1xam;i.xx~~iri:xad, may be well and truly administered, converted and disposed of according to the tenor and effect of the nid deceased's will and according to law, I do hereby grant unto you the said ........ AnnQ ... 6.ubb., ... Adm.in.1.s.tr.~.1:ir.1~ ... Q.! .... ~.! ... ~ .. ~----·----·-----------................. · .. .. ------------------------------------------------------------------------------------------·-----·-----------------....................................................................................................................................... . ............................................................................ (in whose fidelity in this behalf I very much confide,) full power by the tenor of these presents, to administer the goods, chattels, rights and credits remaining unadministered, which were of the said deceased, within the said County, as also to ask, collect levy, re- cover and receive the credits whatsoever of the said deceased, which at the time of.J..J.J..e.. ... death were owing, or did in any way belong to.tl1m .... and to pay the debts in which the said deceased stood obliged, so far forth as the said goods and chattels, rights and credits will extend, according to their rate and order of law; especially of well and truly administering the goods and chattels, rights and credits~JUJX U, which were of the said deceased, according to the tenor and effect of said deceased's will, and according to law; and making a true and perfect inventory and conscionable appraisen~ent thereof, and exhibiting the same into the Register's Office, at Washington, on or before the .................... day of. ............................. .. next, ensuing, and also a true and just account, calculation, and reckoning of your administration, upon your solenm .... Q~!i.~ ...................... to render at the expiration of six months, or when legally thereunto re- quired; and I do by these presents ordain, constitztte and depute you, the said .............................................. .. Anne Bubb --·------------·---------·--·----·------·-·---·-------------------·----·------------------·------------------------------------------·-----·-----------------------------------------· administratrix C • T • A • of all and singular the goods and chattels, rights and credits, which remain unadministered and which were of the said deceased, zc;ith a copy of said deceased's Will annexed,· within the limits aforesaid; sa7Jing harmless and forever indemnifying Hie and all other officers against all persons by reason of )'Our administration aforesaid, and saving all others their rights, &c. 3ftt Wt.atimnttg lf4trtnf, I ha·ve hereunto set my hand and affixed the seal of said office at Washington, the .... ~-~.!i.P.:! ........ day of. ......... ~.!~.~-~~-~l .......................................... .in the year of our Lord one thousand nine hundred and ..... $.~~-~.Y. ... ~!S.~.t .......................... . ~~l ................................................... ~ ........... .. Register. :z:: 9 c:s:: ~ ~ ~ t; ...:: • < .. H -til :z:: ~ ~ ~ -0 ::liie .. Q u (oil d. ~ < ft E--1l ..c: -< 0 """-E--~ aS = [f) ~! ,0 (oil ::s c::n a ::4 ~ ~ . .a Eo--- 0 "";) ~ ! ~- ' ... '\ \ •. ·~ •. ,ft. ... For Sale by P. 0. Naly Co., Law. Blank Publishers ) 415 Grant St., Pgh. 19, Pa. V ~FOR~! NALY No. i12-S WILL . -'-' ·•. of ·,County of and State of being of sound mind and memoryj do hereby make} publish and declare this to be my Last Will and Testament} in manner and form tonowing} hereby .. ___ .r..evoking any win or wills heretofore made by me .. F·irst. I direct that an my just debts and funeral expenses be f'ully paid and satisfied, as soon as conveniently may be} after my decease. c. /1 . I ) ! ! I );v"t/c..yv ,) I I I I, ,1,- ~---~;,,.-.. Last Will and Testament ! of •I• County of and State of :: being of sound mind and memory, do ~ere by· make, publish and dqclare thi1s to be my Last Will and Testament, in manner and · form following, hereby revoking any wills heretofore made by me. First. I direct that all, my debts and funeral expenses be fully paid and satisfied, a~ soon as co·n~niently my be, after my decease. If anything should happen t~ me suddenly, if I should dio , everything I posses I leave to my Qhildren. Everything has to be divided equally among them. First, if I should be ill this child who would take care of me, or any other person, should be paid for, and what is left has to be divided in equal parts among my children. \. Further~ what I mentioned to each child during my life ~hey should take. Accor4ing to the notes I made in my book, in the book where e.verythi:ng is pit ten during my life. ' ;~ Executor -. Mrs Anne Bubb Witness -Michael Kubachka Witness*-JohnKubacka Jr. Translated by · Barbara· Chmielinski 623 Gif.hn ave Canons burg, Pa 15317 ,' Your Father Jan Xubachka II l\ffi~auit ®f 1fxrrutnr ®r 1\bministratnr iltatr nf Jrnnsgluania. t .as: cnnunty nf Bas4ingtnn \ Personally before me, the undersigned authority, a ............... ~Q~~l:Y. .. ,f.gJ?..U~ .............................. in and for said County and State, appeared ................. .ANNJ:: ... lUil\1\ ............................................................................................ who,r.being duly sworn according to law, deposes and says that she is theXSJII!Qlll»m administratW.:of "the ~state of ~~ ... ~~~.~.~.~~~~~ ...... ~~~ ... ~~~~~.! ... ~~.~ ............. deceased, that thej~e¥u1ia~~ul~s~%sti~ifH~ KUBACHKA, complete inventory and appraisement of the real and personal estate of... ........................................................................... , SR. deceased, except real estate outside the Commonwealth of Pennsylvania; that the figures opposite each item of real and personal estate in the foregoing schedules are determined and stated by the undersigned to be the fair value of said items as of the date of the decedent's death, based upon a just appraisement of each item made by the above named i'xxQDld)Qx Administrator::ix c. t. a. Sworn and subscribed before me this ...... ~ .. ?.::.d.-l /) A 11 /) RUTH day o7~M;,u;~~: ..... f .... 'CiJ19 ..... ~.9... .. .............. ~~i~i~t;~titx"·c:t.a. "'::;s f•:E:,~~:·;~~ . ·········~;;;;:;~~-·INSTRUCTIONS OMMISSION EXPIR£8 2/ pplemental inventory must be filed within thirty days of discovery of additional assets. MARq:ti.~entory must be filed within three months after appointment of personal representative. 3. 1 rigitial and 2 Copies and 2 RCRI-34, Under $10,000; 1 Original and 2 Copies and 2 RCRI-33, Over $10,000, including Copy of Will; 1 Original and 3 Copies and 2 RCRI-33, Over $50,000, in- cluding Copy of Will and copy of Federal Estate Tax Return. REFERENCE FOR ADDITIONAL COPY Act of 1947 P. L. 513 Sec. 5.2, 72 P. S. 4844.2 1Juurutnry au!l J\pprat!irmrut of the goods and chattels, rights and credits which JAN. KUBACHKA, a/k /a J()HN were of .................. lQJBACm{A, ... SR. ............................................. Jate of .......... J.!'!g.~.P.~~g-~'!?:£~ ... !~~~;1?. ........................... .. Washington County, Pa., taken and made in conformity with the above affidavit. DATE OF DEATH'::', January 16th, 1968 PERSONAL PROPERTY Savings Account -Pittsburgh National Bank, Washington Office Savings Account -Mellon National Bank and Trust Co., Burgettstown Office HOUSEHOLD FURNISHINGS: Sofa Chair Desk ~ESTATE TwO-story frame house and Lots Nos. 2, 3,:t4'and 5~ Westside Property Plan of Lots, situate in Inde- pendence Twp., washington County, Pa. (D. B. 547, P• 143) T 0 T A L ---------------- DOLLARS CENTS 4,119 81 3,516 07 15 00 5 00 5 00 7,660 88 3,200 00 10,860 88 ... ,'l -· :_) ~~ ~ • t ~ , •• f~ • .· ,,,; ,. C5 .... ,_ ... ~ .. --) L _ ~. . .. ." .. ~~.S STATE OF PENNSYLVANIA, WASHINGTON COUNTY, ~ SS: The within named Accountan't being duly sworn according to law, deposes and says that the above account as stated is true and correct as ........... §D.~------------------------verily believe. s. Sworn and subscribed before me this ... ~~~~----------- day of ---------~~~~~~:r;Y. ............................. 19 ... §JL .. . ... :£<~./f<.v~~L ............... . -..: t.._1~'1'"" , " ~ DAGUE Uotary ?u-.l~ . .., ' tO lilt L. -•. ~ t'·ll County, Pa. . i '·on was.iiu9 •. ') '\ • ~--Wash n::• ~ E ires r.~ar. :;.a, 'Ill~ .,_ • ., comm\es1on J:P "''" Wa•shington County, ss: ; .... 0 ...., ><:! ~ z! ;::l •r-ii 0 IJ::i t) $-4! t) 0! ~ ~: 1-;)i (Ui . $-4i cUi ~: ~ '-...i Ul! ~ ~: ·r-ii ~: 0 '-...! 1::! ~ "; ·~ "~ "'t 1.__;·: j cUj •r-ii (y)j P:'l J. ....... ~ E-< <(: Ei Z! 'tJ! ~ E-< 1-1 --~------~~---···················--- I do certify that I have given leg·al notice to all persons concerned of the filing of the within account in the manner prescribed by Statute and Rule of Court, as evidenced by proofs thereof Hied to No.,/ll~ ... /f.~f:. ................. . Witness my hand and official seal thV~---------······ doy oL~/:;F··· ;;; .. .. .. . 19?{. -----~---~~-------' : .. j(~;ter of Wills ...., ...., ... ~ ;::l 0 ol 0 ...., 0 ~ ~ 0 ;::l Q) 0 ,<:I .... t) _..., t) . ' .. 0 0 ~ I 0 l .. _..., ~ t ... ... J -'0 Q) 0 Q) ..... ~::! .... _..., 0 ~ O! » N~ Q) Q) "' Uli ~ Q) 't)i ... I 1 . -~ --... 0 .'; J "' ....-l! _..., I ,j _..., _..., cUi ~ ~ ~::: ;::l 0 O! •s ~.;~ l1 ..:r:: t) w. 00 ~ r .. :,--. I ~ ~ . ,... "'! t) ~i ~ P'l IJ::i ..: . ' ol '-r: ... r ' ., ' •" U! .. pi co! .... 4 --·· ~-.. ,..._ __ ..) ~ ~ §~~ fgj :a ~: ~ <%! _..., ~! co: -~ ooi ::.::~~! . 0 Q) (l)i _..., !<:l:l (ll; fi:li ~ ,<:I Ei ~ Zt:Q ~! ~: ~~ t'3! <%!~I-Ii ~~: 1-;)1 IJ ~i <:!j C,) '0 i ci ~ . z i ! ~ ~ \ ' . ' \ 4- ·<(' ~ _4_. j I . -. / ; . "9-J,D_JSa S!Lj-l U! Jnq!J.JS!P JadoJd au!WJa,.J..ap Ol pa.JsanbaJ All np::>adseJ S! .JJnO) a4.l -:-· "': .. ... . :·· .::. .... ~,#, •' I ', f J I ' f f' ~ '~ * • FIRST AND FINAL ACCOUNT of ANNE BUBB, Administratrix C.T.A. of the Estate of JAN KUBACHKA, also knownas JOHN KUBACHKA, SR., deceased, late of Independence Township, Washington County, Pennsylvania. The Accountant is charged as follows: PRINCIPAL PERSONALTY Amount of Inventory and Appraisement INCOME PERSONALTY Interest on Savings Accounts: Mellon National Bank & Trust Co~ Pittsburgh National Bank PRINCIPAL REALTY Amount of Inventory and Appraisement INCOME REALTY None $213.30 166.42 $ 7,660.88 379.72 3,200.00 None Total Charges ..... ~$11,240.60 The Accountant claims credit as follows: PRINCIPAL AND INCOME PERSONALTY Administration Expenses, Preferred Debts, Other Debts and Taxes as set forth in Schedule "A" PRINCIPAL REALTY None INCOME REALTY None 2,418.03 Total Charges . . Balance for distribution 2,418.03 . . $ 8 7 822.57 SCHEDULE "A" Administration Expenses James R. Donaldson Costs Advanced 2/29/68 Russell Marino -Probate of Will and 1 Short Certificate 2/29/68 Barbara Chmielinski -Translation of Will 3/11/68 Observer Publishing Co. -Advertising of Letters 3/11/68 Washington County Reports -Advertising of Letters 2/ 1/68 L. A. Withum Liability Insurance Affidavits 17.00 10.00 12.50 12.50 Notary Anne Bubb Administratrix Commission James R. Donaldson Russell Marino Preferred Debts 2/24/68 W. H. Thompson Other Debts and Taxes 4/15/68 Russell Marino, Agent, Attorney's fee Filing Account Funeral expenses Paid by Social Security Payment on account of Inheritance Tax Total . . . . . . . 1062.00 205.00 52.00 10.00 3.00 562.03 575.00 17.00 857.00 342.00 $2,418.03 Washington· County Reports ~t.ml:N~ 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) STATE OF 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, publiShed weekly having its place of business at Washington. Washington County, Pennsylvania, and is act- ing as its agent in t'his behalf; that the said WASHINGTON COVNTY 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: ...... }~_;_~-~-.. ?..~ .. L..?..? .. t....!.~~~---························ April 4, 1968 that the affiant .or the corporation in behalf of which he is acting is not interested in the subject ~atmtr sai notice 0. r advertisin?-.imd that. all of the allegations of ,, ... ~_;<' this affidavit as to t i , place awl charactei1oti the p_!lhllic!l·ti\~oo are rue. /j If / !''/ / 'I n Sr r · · t : · · ,;') " -vvr, . . . __.r___... ................................................................................................ .A.t~day of... .... ~.P..f;J ............. c ••••••• , 196 .... ?. .. ...... /..CK~ ... a ... ~~-___________ _ otary Public V<ATHS-RJNE C. YARD, Notary Ic Washington, Washington Co., Pa. My C~mmisslon Expii'8S November 1, 1969 Editor Estate Notices The Register of Wills has granted letters, testamentary or ,of adminjstration, 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 them for settlement to the Executors or Admin- istrators or their Attorneys . • • • • • • • • • • • • • • • • • KUBACHKA. JAN, a/k/a JOHN KUB-ACHKA, SR., Dec'd. Late of Independence Township Washington County, Penna. ' Administratrix C.T.A.: Anne Bubb 1138 Charles St., McKees Rocks Pa' 15136 ' . Attorney: James R. Donald. 614 Washington Trust Bldg., Washing-ton, Pa. 15301 , • I · Observer -Reporter WASHINGTON, PENNSYLVANIA PROOF OF PUBLICATION In compliance with the Newspaper Advertising Act of 16 May, 1929, P. L. 1784, Ills amended. Commonwealth of Pennsylvania, County of Washington, SS: ........... . Personally appea!'ed before me, a Notary Public in and for said County and .state, ......... Ri.c.ha.rd .... S .•..... C.Ow.a.n ............... , who being duly sworn according to law, deposes and says that he is the S.e(: .. !.y. .•.... ~ ... Tr.e.as .• of the Obs•erver Publishing Company, a Penns.ylvania corporation, and its agent in this behalf; that the s·aid Company is• the owner and puhlisher of the Observer-Reporter, suCC'essor to The Washington Observer, established Sept·ember 18, 1871, and The . Washington Reporter, established August 15, 1808, a daily newspaper of general circulation, printed and published and haviil'g its place of bus.ines•s at Washington, Washington County, Pennsyl- vania, where it or its predecessors have been established and published continuous•ly for more than six monthsi prior to the publication of the notice hereto actached; that the printed notice or advertisement hereto attached is a ·copy of an official advertisement, of.ficial notice, legal notice or legal adve:rtis·ement, exactly a:s printed or published in the Obslerver-Reporter in its regular editions on the following date or dates; ........................................... . March 13 20 and 27 1968 ····················································-···'····································"····················································· that neither th'e affiant nor the Observer Publishing Company is intereSJted in the subject matter of said notice or advertising and that all of the aUega- !~~~r~!. this affidavit ~~---t·o···t-~~--~i~-~·---~~:i~~i-~~ Sworn to and subscribed before me this .. 2.7. .... day of .... M~J'.~.J:l .... l9..68 M~~~;~~ w. 28752 WASHINCT(l" ·~'"' ·h•• •. , •• , :·r ~c:.:;.l,\S.J: Ur!Rf~ :·~· b, ·q~; ·IADMINIS'T,RATR1x c:T;•A.~!NiHfc . .8j Estate o~( JAN KUBACHKA. "nso I known as."'. JOHN KUBACHKA, SR. I decea&{d; . ·, late . <?f · Independence TownSli1JCU' W,W_. mgton County, Penna. -,.: ·'r ·~y · Letters of~d.9'iinistration C.T.A. upon the abov.~_state having beenl granted to the.;_undersigned, notice isl hereby. ~those indebted there-• to to mali' .. epiate payment, and: to' those claims or demands• to present til m· for settlement. ' ANNE;jBUBB ' 1138 Chai;les Street McKees Rt,lcks, Penna. 15136 ""'Adininistti£l;ilt'C. T.A.¥,.. AMES R.·DONAnDSON Attorney 614 Washington T~ust Bldg. o•r.t Washington, Penna. 15301· ·, ·• I 6862· Wed. ·3t 3Ju t~r {@rp ~ann. arnurt nf llan~iugtnu Olnuuty In the matter of the Audit of Account in Estate of JAN KUBACHKA, a/k/a No .. ___ , 6~3~-~6,_,8"---_,.3.:.!.3.::!:4 __ ---=..-;-~~----; -.h."*r ~ JOHN KUBACHKA, SR. TO THE AUDITING JUDGE: Enter· ___ m~y~ _____ ,appearance for· __ __.!Aec~c~o~u~n!.!t~a~n!J..!.t'--------------~----- ~~ 1~~ ,19_69_ 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. .J No. 63-68-334 , 19 __ , A.A. In re Audit of Account in Estate of JAN KUBACHKA. a/k/a JOHN KUBACBKA, SR. AUDIT Jrarripr fnr i\ppraraurr FOR .JAMES R. DON.Al.DSON Attorney -..r~;,~ .. 2 ~n t4r <!tnurt nf <ttnmmnn Jlrns nf lins~tngtnn <ttnunty. Jrnnsylnnntn. ®rp~uns · <ttnurt llitrisinn ESTATE OF Jan Kubachka, e/kla In the matter ofthe First and Final John Knbachka, Sr., Account of·_----'A2nn.u.rr..!o~e~B:lo!lu.wb.wb.,.., ___ _ deceased. Admin:tstratrix. ADJUDICATION AND DECREE And ·now August ~ 19..6.9-, this matter came on for hearing, audit and distribution a;t this session and testimony'~(;ken; 'and thereupon, upon due consideration th~reof the balance for di.stribution in .the hands of the Ac.countant. is deter~i~ed to be $lj1 71 a. 57 and the account is accordmg ly conf~rmed; and 1t IS o~dered, adjudged and decreed that the said balance be paid out by the Accountant in accordance w1th the schedule of distribution hereto attached and made· a part hereof, unless exceptions hereto be filed sec. reg. or an appeal be taken herefrom sec. leg. ~-/ / J C~/ v SCHEDULE OF DISTRIBUTION Balance per account-----'"-------------- Additional credit asked at audit Balance ____________________ _ Deduct Clerk's Costs & Receipk'::i-------------- Attomey ____ ....... Iu.aumw:eus:~-.,~;B;)..,.__..D.un.un.u:a:L,jl"""d~su.a~n..__ ______ _ i Russell Merino, Clerk o. c., costs in certifying reel estate to Recorder, John D. Woodward, Recorder, costs recording certification of real estate, Russell Marino, Agent, transfer inheritance tax; Estate liability (balance) Interest from 4-16-69 to 8-22-69 Individual liability of Anne Bubb on jointly held assets Interest from 4-16-69 to 8-22-69 $158.06 3.32 107.171 2.25 112.00 27.00 270.80 John Kubacke., Jr., son, 1/7 residue, including an undivided 1/7 interest in real estate as hereinbelow described, held in kind and dis- tributed as such at the appraised value, 1215.82 Andrew Kubacka, son, 1/7 .residue, including an I undivided 1/7 interest in real estate as herein- below described, held in kind and distributed as such at the appraised value, 1215.82 Michael Kubachka, son, 1/7 residue, including an undivided 1/7 interest in real estate as herein- below described, held in kind and distributed as such at the appraised value, 1215.81 ,- t .. • I . , • c r r • . -~ . ( r r r' . _r ,~F . I. t • ~ i ~· ta § ta = t:l ~ ~ ~ ~. r' l • ( r· r \ r \ r \ ') r 0 .... w i a. '.) > if c ~ 0 .... r j'_ '' 5" z " r ~-p .g:. CD 3 Q ~ .... 0 -g:. CD .I ( ,. I ~ r r -· r r-. -( )I Joseph Kubachka, son, 1/7 residue, including an Q~divided 1/7 interest in real estate as herein below described, held in kind and distributed a such at the appraised value, 1215.81 Edward Kubachka, son, 1/7 residue, including an undivideq 1/7 interest in real estate as herein below described, held in.kind and distributed a such at the appraised value, 1215.81 Mrs. Emelie Willmott, daughter, 1/7 residue, including an undivided 1/7 interest in real estate as hereinbelow describeq, held in kind and distributed as such at the appraised value. 1215.81 Anne Bubb, daughter, 1/7 residue, including an undivided 1/7 interest in real estate as herein below described, held in kind and distributed as such at the appraised value; minus, however, $109.42 representing transfer inheritance tax and interest due on individual liability for said tax on jointly held s.ssets -said tax distributed hereinabove, 1106.39 No balance REAL ESTATE TO BE CERTIFIED TO THE RECORDER OF ~ASHINGTO COUNTY BY THE CLERlC OF THE ORPHANS' COURT DIV SION Jan Kubachka, a/k/a John Kubachka, Sr., devisor to John Kubacka, Jr., devisee of an undivided 1/7 interest; to Andrew Kubacka, devisee of an undivided 1/7 interest;1 to Michael Kubachka, de isee of n undivided 1/7 interest; to Joseph Kubachka, devisee of an undivide 1/7 interest; to Edward Kubachka, devisee of an undivided 1/7 interest; to Mrs. Emalie Willmott, devisee of an undivided 1/7 interest; to Anne ubb, devisee of an undivided 1/7 interest; each undivided in erest be·ng in and to all the right, title and interest of the deviso in pare ls of real estate described, as, VIZ: ALL those certain lots of ground, situate ·n the to ship of Independence, County of Washington and State of Pennsylv ia, and being Lots Nos. 2, 3, 4 and 5, in the Westside lan of Lots, to be recorded, and bounded and described.as fo EACH lot fronting 80 feet on the Westerly ide of and extending back of equal width at right angl 115 feet to line of lands of Duquesne Coal bounded and described as one tract as follows: BEGINNING at a corner of Lot No. 1 on the esterly side of First Street; thence along First Street, South 27° 49 West, 3 0 feet to the corner of Lot No. 6; thence along said Lot No. , North 62° 11' West, 115 feet to lands of Duquesne Coal & Coke Compa along lands of said company, North 27° 49 1 East, 320 feet t corner of Lot No. 1, and thence along line of Lot No. 1, South 62° 1 ' East, 15 feet to the place of beginning. f ' r ( r , r .. , , . r ~._ r . ) I.[" \~ r • .\ r r r t " \ r ., ,. r 0 ..... ')£ r r -· ~ ::J ·z n -+" ? 0 :::r c (1) ::J 3 -+ 0 0 ..... ~ .... 0 -+--+ :r (1) ( ) c \ \ \ TOGETHER with a right-of-way in common and across a certain road, thirty-three {33) fe located, beginning at the easterly end of Main and extending southeastwardly to a Creek Road, and, also, together with the right water. well and the ·pump therein, o~ Second Stre line between Lots Nos~ 17 and 18, in said Plan, water from said well in common with others. others road, access and the over now said Plan, own as the to a certain near the ight to use CERTIFIED TO RECORDER: DECEM ER 15, 969 -... <,. ~· , .. .. •. ~ t_ > . Ul ::E .i> :r: > :,,. Ul ""' -:r 111 Z:z>(J) ~ Gl :I 'o 6 o ::a z z ::0. . z ·ui~o rnc:>o ,zm-~ z-1 Z (Jl!!t!;:> -<~:trrr 0 < ~ '!I > z ' zo 0 :;; 2 "' ~ ·~ ·1 r, II " II A IN THE COURT OF CD MMON PLEAS OF WASHINGTON COUNTY, PENNSYLVANIA ORPHANS 1 COURT DIVISION NO. 63-68-334 ESTATE OF JAN KUBACHKA, a/k/a JOHN KUBACHKA, SR., Deceased. PAY TRANSCRIPT ,_. r. £~} f;_ti 1., . ..:._} ::O:'l rJ r•1::0 T f i (;"')~·· '--C.> -i-· . 0i5~ ~~ ... , - :.:>:Ji-v· i .1:0 C::>--· -.. ::·· m :;~~:; -~"""' ::..:.; r=::-:: 0 ro ....... i-""* (/) .. 0 -.J // JAMES R. DONALD~0N ATTORNEY AT LA~ WASHINGTON~RUST OILDING WASHINGTON, PE SYLVANIA l 1- , IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION ESTATE OF JAN KUBACHKA, a/k/a JOHN KUBACHKA, .. SR. , • Deceased. '· . ) ' ( . NO • 63~68-334 ,·. )' . ' : ( PAY TRANSCRIPT The undersigned hereby acknowledge to have received from the above Estate the amounts awarded to each by the Adjudication and Decree of the Orphans' Court at the above number, said amounts appearing opposite the signatures of the under- signed; Russell Marino, Clerk 0. C., Costs$ Russell Marino, Clerk 0. C., Costs in certifying real estate to Recorder John D. Woodward, Recorder, costs recording certification of real estate Russell Marino, Agent, Transfer In- heritance Tax Estate liability (balance $158.06 Int. from 4·16-69 to 8-22-69 3.32 Individual liabi li tyr of Anne Bubb on jointly held assets Int. from 4-16-69 to 8-22-69 107.17 2.25 27.00. ______________ ~-------------- 4.00 ____________________________ __ 7.50 ____________________________ __ 270.80 ____________________________ __ John Kubacka, Jr., son, 1/7 residue, 'including an undi- vided 1/7 interest in real estate held in kind and dis- tributed as such at the ap- praised value 1, 215. 82. ___ (~S_E_E_A_;T;_T __ A __ CHE=D~RE.::.C.:..:E.:..:I;;::;P..::T.!..) ----- Andrew Kubacka, son, 1/7 resi- due, including an undivided 1/7 interest in real estate held in kind and distributed as such at the appraised value 1, 215. 82~--'(~S--EE;::;_;;A.:..:T;.:;T.:..:AC.:..:H:.::.;:E:.;::D~RE::..C:.:E:.:I:.::.P..::T!....) ---- Michael Kubachka, son, 1/7 residue, including an undivided 1/7 in- terest in real estate held in kind and distributed as such at the appraised value Joseph Kubachka, son, 1/7 residue, including an undivided 1/7 in- terest in real estate held in kind and distributed as such at the appraised value Edward Kubachka, son, 1/7 residue, including an undivided 1/7 in- terest in real estate held in 1-:.' kind and distributed as such at the appraised value Mrs. Emalie Willmott, daughter, 1/7 residue, including an un- divided 1/7 interest in real estate held in kind and dis- tributed as such at the appra- ised value Anne Bubb, daughter, 1/7 residue, including an undivided 1/7 in- terest in real estate, held in kind and distributed as such at the appraised value; minus, however, $109.42 representing transfer inheritance tax and interest due on individual liability for said tax on jointly held assets -said tax distributed hereinabove I ~ 1, 215. 81._---l(~SE:::.!E~A~T.!:!TA:!::C::.!:HE~D~R!::E~C.!::!;EI~P~T:J.) ____ _ 1, 215. 81~~(S:::E:::E::.._::A~TT:::A:.:.:C~HE::::D::_:RE~CE:::..:I=:P:...::T~) ----- 1, 215. 81:-...---.l(.::.S:EE~A~T~TA2C~HE~D~RE~C::::E~I.:..P.:..T)'------- 1,215.8l. __ ~(~S~E~E~A~T~T~A~C~HE~D~BE~C~E.IP~T~>~------- .1, 106. 39_~(.::.SE::.:E~A~T~TA~C~HE=D-'RE=C::!:E~I.:...PT.:..)'------- IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION ESTATE OF JAN KUBACHKA, a/k/a JOHN KUBACHKA, SR., Deceased. ) ( ) ( NO. 63-68-334 R E C .E l P T KNOW ALL MEN BY THESE PRESENTS, that I, JOHN KUBACKA, JR. do hereby acknowledge to have received from ANNE BU~B, Administratrix C.T.A. of the Estate of JAN KUBACHKA,. a/k/a JOHN KUBACHKA, SR., Deceased, the sum of --------ONE THOUSAND TWO HUNDRED FIFTEEN & 82/100 ---------------------------($1,215.82) -~-----:-----~--------------------DOLLARS, including therein my share, if any, in the real estate held in kind and distributed as such at the appraised value, all as awarded to me under Decree of the Orphans' Court Division of Washington County, dated August 11th, 1969, at the above number and year; and I do hereby authorize and empower the Register of Wills in and for said County to enter and file this Receipt. IN WITNESS WHEREOF, I have hereunto set my hand and seal at ------- ----------' this ··z. £f e1 day of _--""&,4.'.;;;;::;~~-=· ;.q;.r----' 19_6_9 _ _ jj_~J.~. a,~A, ___,.~~-~·r.m"l''"· ~Q~__._ __ (SEAL) c:;· (John KUDAOKA, ~; WITNESS: I ESTATE OF IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION ) JAN KUBACHKA, a/k/a ( NO. 63-68-334 JOHN KUBACHKA, SR. , ) Deceased. ( R E C E I P T KNOW ALL MEN BY THESE PRESENTS, that I, ANDREW KuBACKA do hereby acknowledge to have received from ANNE BUBB, AdminiStratrix C.T.A. of the Estate of JAN KUBACHKA, a/k/a JOHN KUBACHKA, SR., Deceased, the sum of ----------ONE THOUSAND TWO HUNDRED FIFTEEN & 82/100 -------- ----------------------------($1,215.82) ;-----;-------------~------------DOLLARS, including therein my share, if any, in the real estate held in kind and distributed as such at the appraised value, all as awarded to me under Decree of the Orphans' Court Division of Washington County, dated August 11th, 1969, at the above number and year; and I do hereby authorize and empower the Register of Wills in and for said County to enter and file this Receipt. IN WITNESS WHEREOF, I have hereunto set my hand and seal at ------- -----------' this ::Z:f day of _..~..&~~::;.,jl,£;;,~·4-----' 19._6_9_ WITNESS: I ESTATE OF IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION ) JAN KUBACHKA, a/k/a ( JOHN KUBACHKA, SR., NO. 63-68-334 ) Deceased. ( R E C E I P T . ' -. . KNOW ALL MEN BY THESE PRESENTS-, that I, MICHAEL KUBACl:U<A do hereby acknowledge to have received from ANNE B~B, Administratrix C.T.A. of the Estate of JAN KUBACHKA, a/k/a JOHN KUBACHKA, SR., Deceased, the sum of ------------ONE THOUSAND TWO HUNDRED FIFTEEN & 81/100 --------- ------------------------($1, 215 ~ 81) -----:-,------.---------------------------DOLLARS, . including therein my share, if any, in the real estate held in kind and distributed as such at the appraised value, all as awarded to me under Decree of the Orphans' Court Division of Washington County, dated August 11th, 1969, at the above number and year; and I do hereby authorize and empower the Register of Wills in and for said County to enter and file this Receipt. IN WITNESS WHEREOF, I have hereunto set my hand and seal at ------- ----------' this -~Lj~. day of ~ J 19_6;;..;9;._,_ _ _ ..:.....~ba~£ kfl--,...n~· ~-,~~· ~eLk:--. ·-----~ ____ (SEAL) (M1chael Ru6achka) WITNESS: / ESTATE OF IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION JAN KUBACHKA, a/k/a JOHN KUBACHKA, SR., ) ( ) ( NO. 63-68-334 Deceased. R E C E I P T . . KNOW ALL MEN BY THESE PRESENTS, that ,I, JOSEPH KUBACHKA do hereby acknowledge to have received from ~BUB~, Administratrix C.T.A. of the Estate of JAN KUBACHKA, a/k/a JOHN KUBACHKA, SR.,. Deceased, the sum of-----------ONE THOUSAND TWO HUNDRED FIFTEEN & 81/100 --------------------------( $1, 215. 81) --:,------.-------------..,-------------DOLLARS, including therein my share, if any, in the real estate held in kind and distributed as such at the appraised value, all as awarded to me under Decree of the Orphans' ,- Court Division of Washington County, dated August 11th, 1969.,. at the above number and year; and I do hereby authorize and empower the Register of Wills in and for said County to enter and file this Receipt. IN WITNESS WHEREOF, I have hereunto set my hand and seal at ------- ------------· this " zqt:L:Iday of ---~ ......... --~~----' 19_6.-9...__ WITNESS: / ---?!-'~~·· ---.......-: .. :-.--~I"T""""'('-~--· _(SEAL) ·~ Kubachka) ESTATE OF IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION ) JAN KUBACHKA, a/k/a ( JOHN KUBACHKA, SR., NO. 63~68-334 ) Deceased. ( R E C E I P T KNOW ALL MEN BY THESE PRESENTS, that I, EDWARD KUBACHKA do hereby acknowledge to have received from ANNE B~B, Administratrix C.T.A. of the Estate of JAN.KUBACHKA, a/k/a JOHN .KUBACHKA, SR., Deceased,· the sum of-----------ONE THOUSAND TWO HUNDRED FIFTEEN & 81/100 --------- -----.:.------------------($1,215.81) ----:;------;--------------:-------------DOLLARS, including therein my share, if any, in the real estate held in kind and distributed as such at the appraised value, all as awarded to me under Decree of the Orphans' Court Division of Washington County, dated August 11th, 1969, at the above number and year; and I do hereby authorize and empower the Register of Wills in and for said County to enter and file this Receipt. IN WITNESS ·WHEREOF, I have hereunto set my hand and seal at ------- -------------------------------' this 3rd day of __ ..,:D::.;e;.:c:::.;:e;;::m:,::b;.:e;,:.r ______ , 19 69 WITNESS: ( ESTATE OF IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION ) JAN KUBACHKA, a/k/a ( NO. 63-68-334. JOHN KUBACHKA, SR., ) Deceased. ( R E C E I P T KNOW ALL MEN BY THESE PRESENTS, that I, MRS. EMALIE WILLMOTT do hereby acknowledge to have received from ANNE BUBB~ Administratrix C.T.A. of the Estate of JAN KUBACHKA,' a/k/a JOHN KUBACHKA, SR. Deceased, the sum of----------ONE THOUSAND TWO HUNDRED FIFTEEN & 81/100 -------- ------------------------( $1,215. 81} ----~~------.---------------------------DOLLARS, including therein my share, if any, in the real estate held in kind and distributed as such at the appraised value, all as awarded to me under Decree of the Orphans' Court Division of Washington County, dated August 11th, 1969, at the above number and year; and I do hereby authorize and empower the Register of Wills in and for said County to enter and file this Receipt. IN WITNESS WHEREOF, I have hereunto set my hand and seal at ------- }tl~~;t;;, Pe , this ·· b ~ day of 2z4At=e--..m_,4wz ~ 0~ ' 19 69 _/IJ._~_~£~n-,~al~~n-~~U/~;~/;~;;-~_~ ___ (SEAL) (Mrs. Emalie Willmott) WITNESS: ,. ESTATE OF IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY, PENNSYLVANIA ORPHANS 1 COURT DIVISION JAN KUBACHKA, a/k/a JOHN KUBACHKA, SR., ) ( ) ( NO. 63-68-334 Deceased. R E C E I P T KNOW ALL MEN BY THESE PRESENTS, that I, ANNE BUBB do hereby acknowledge to have received from ANNE B~B, Administratrix C.T.A. of the Estate of JAN KUBACHKA, a/k/a JOHN KUBACHKA, SR. Deceased, the sum of ----------ONE THOUSAND ONE HUNDRED SIX & 39/100 ------------ ------------------------~-($1,106.39) --j-----~---------------------------DOLLARS, i~cluding therein my share, if any, in the real estate held in kind and distributed as such at the appraised value, all as awarded to me under Decree of the Orphans' Court Division of Washington County, dated August 11th, 1969, at the above number and year; and I do hereby authorize and empower the Register of Wills in and for said County to enter and file this Receipt. IN WITNESS WHEREOF, I have hereunto set my hand and seal at ------- this "6't£ day of --~.;;.....:;;.· ~~....,...,z"""M~'/7""'--' 19 69 __ • ..::;.~_ .. _' -+-~Wo~..wh~....,...._ __ . _ ___;_ ____ (SEAL) (Atme 'BU'bb) WITNESS: ------------------------------------------------ IN THE ORPHANS 1 COURT OF WASHINGTON COUNTY, PENNSYLVANIA ESTATE OF JAN KUBACHKA, a/k/a JOHN IWBACHKA, SR. , Deceased. ) ( . . ) ( 63-68-334· FAMILY AGREEMENT AS TO INTERPRETATION OF THE WILL OF JAN KUBACHKA TO THE HONORABLE, P. · J. MARINO, PRESIDENT JUDGE OF SAID COURTz WHEREAS, there may be some questions by reason of the. last two paragraphs of the Will of Jan Kubachka, and WHEREAS, it is the desire of the several children that the estate be divided equally among the children, The undersigned, a child and heir at law of Jan Kubacbka, hereby requests your Honorable Court to distribute the estate in equal shares to the seven children. I certify that I have no claim for care of Jan Kubachka and no clata under the last paragraph in the Will. March 13 , 1969. ·' J IN THE ORPHANS 1 COURT OF WASHINGTON COUNTY, PENNSYLVANIA ESTATE OF ) JAN KUBACHKA, a/k/a ( . 63-68-334 . JOHN KUBACHKA, SR. , ) Deceased. ( FAMILY AGREEMENT AS TO INTERPRETATION OF THE WILL OF JAN KUBACHKA TO THE HONORABLE, P. J. MARINO, PRESIDENT JUDGE OF SAID COURT: WHEREAS, there may be some questions by reason of the last two paragraphs of the Will of Jan Kubachka, and wtmREAS, it is the desire of the several children that the estate be divided equally among the children, The undersigned, a child and heir at law of Jan Kubachka, hereby requests your Honorable Court to distribute the estate in equal shares to the seven children. . ... I certify that I have no claim for care of Jan Kubachka and no clat. under the last paragraph in the Will. YV2~·l, I K ·. (Michael Kubachka) March IS , 1969. IN THE ORPHANS ' COURT OF WASHINGTON COUNTY, PENNSYLV AHIA ESTATE OF JAN KUBACHKA, a/k/a JOHN KUBACHKA, SR. , Deceased. ) • . ( ) ( . 63-68-334 FAMILY AGREEMENT AS TO INTERPRETATION OF THE WILL OF JAN KUBACHKA I TO THE HONORABLE, P. · J. MARINO, PRESIDENT JUDGE OF SAID COURT: WHEREAS, there may be some questions by reason of the last two paragraphs of the Will of Jan Kubachka, and WHEREAS, it is the desire of the several children that the estate be divided equally among the children, The undersigned, a child and heir at law of Jan Kubachka, hereby requests your Honorable Court to distribute the estate in equal shares to the seven children. I certify that I have no claim for care of Jan Kubachka and no clata under the last paragraph in the Will. March ___./,_..'3;;..._._, 1969. IN THE ORPHANS ' COURT OF WASHINGTON COUNTY, PENNSYLVANIA ESTATE OF JAN KUBACHICA, a/k/a .JOHN KUBACHKA, SR., Deceased. ) ( . . ) ( 63-68-334 ,. FAMILY AGREEMENT AS TO INTERPRETATION OF THE WILL OF JAN KliiBACHKA TO THE HONORABLE, P. J. MARINO, PRESIDENT JUDGE OF SAID COURT: ' . WHEREAS, there may be some questions by ~eason of the last two parag~aphs of the Will of Jan Kubachka, and WHEREAS, it is the desire of the several children that the estate be divided equally among the children, The undersigned, a child and heir at law of Jan Kubachka, hereby requests your Honorable Cou~t to distribute the estate in equal shares to the seven children. I certify that I have no claim for care of Jan Kubachka and no claim under the last paragraph in the Will. (An~ March /3 , 1969. • 0 I ! , 1 I I IN THE ORPHANS' COURT OF WASHINGTON COUNTY, PENNSYLVANIA ESTATE OF ) JAN KUBACHKA, a/k/a ( . 63-68-334 . JOHN KUBACHKA, SR. , ) Deceased. ( FAMILY AGREEMENT AS TO INTERPRETATION OF THE WILL OF JAN KUBACHKA TO THE HONORABLE, P. · J. ·MARINO, PRESIDENT JUDGE OF SAID COURT: WHEREAS, there may be some questions by reason of the last two paragraphs of the Will of Jan Kubachka, and WHEREAS, it is the desire of the several children that the estate be divided equally among the children, The undersigned, a child and heir at law.of Jan Kubachka, hereby requests your Honorable Court to distribute the estate in equal shares to the seven children. · I certify that I have no claim for care of Jan Kubachka and no.claia under the last paragraph in the Will. March·~, 1969. • ' ' I ' I • I IN THE ORPHANS' COURT OF WASHINGTON COUNTY, PENNSYLVANIA ESTATE OF ) JAN KUBACHKA, a/k/a ( . 63-·68-334 . JOHN KUBACHKA, SR. , ) Deceased. ( FAMILY AGREEMENT AS TO INTERPRETATION OF THE WILL OF JAN KUBACHKA TO THE HONORABLE, P. J. MARINO, PRESIDENT JUDGE OF SAID COURT: WHEREAS, there may be some questions by reason of the last two paragraphs of the Will of Jan Kubachka, and WHEREAS, it is the desire of the several children that the estate be divided equally among the children, The undersigned, a child and heir at law of Jan Kubachka, hereby requests your Honorable Court to distribute the estate in equal shares to· the seven children. I certify that I have no claim for care of Jan Kubachka and no clat. under the last paragraph in the Will. March /1 , 1969. ' . ' ' '' IN l'HE ORPHANS ' COURT OF WASHINGTON COUNTY, PENNSYLVANIA ESTATE OF JAN KUllACIIKA~ a/k/a ) ( JOHN Iam.A.CHI<A, SR. , Deceased •. . . ) ( 63·68-334 FA!·IILY AGREEMENT AS TO INTERPRE'l'ATION OF THE 't-1ILL OF JAN KUBACHI\A TO THE HONORABLE, P. J. r-iARINO, PRESIDENT JUDGE OF SAID COURT: l~iEREAS, there may be some questions by reason of the last two paragraphs of the vlill of Jan I<ubachka, and WHEREAS, it is the desire of the several children that the estate be divided equally among the children, The undersigned, a child and heir at law of Jan Kubachka, hereby 'I requests your Honorable Court to distribute the estate in equal shares to the ~ seven children • . t I certify that I have no claim for care of Jan Kubachka and no claim ~· unde~ the last paragraph in the Will. EMAJ1,IE ·. · WIIJLMOTT By _.her St.atutory Commit tee, The Publ ic Trustee i ' Public Trustee lmXrtile May 5t}t 1969. lot' Form RCC-33 f--................ COMMONWEALTH OF PENNSYlVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS ./I RESIDENT DECEDENT COUNTY OFW. A. S . .JLl. .. N .. JL! .. .9.Jt ...................... . IMPORTANT: This return must be completed in detail and filed in duplicate, with will attached, with the Register of Wills of the County where decedent resided; Return is due within one year after/" date of death, u-nless __ an e_xtensio. n is g. ranted by the Secretary of Revenue. (Se.ption 703. oJo · th~_Inheritance_ an!} E_state Tax Act of 19!31.) / . JAMES R. DONALDSON Name and address of attorney or} other authorized representative to whom all correspondence should be_ mailed. 614 Washington Trust Bldg., Washington, Penna. l5.30l C. T .A. That as such ~.~.~~~-;:?.~.;::!:;;(. ...... deponent is familiar with the affairs of said estate and the property con- < Ex1~cu tor-Administrator) stituting the assets thereof and their fair market value. That at the time of death there was no safe deposit box registered in decedent's individual name, or jointly with, or as agent or deputy of another, or in decedent's individual name, with right of access by another as agent or deputy, with the exception of the following:- NAME AND ADDRESS OF BANK OR OTHER 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 Pit,t.~hnT'P'h N.R+.; nn::~1 Bank Washineton Office John Kubacbka. Sr. and Daughter Anne_ Bubb That the contents of said safe deposit box or boxes are itemized under Schedules _____ of this return, with the exception of the following, for the reasons hereinafter set forth: That Sc.hedule A attached hereto and made part hereof sets forth full v and in· detail all the real property in the Commonwealth of Pennsylvania of which decedent died having. an interest therein. It also sets forth the mortgage encumbrances upon each parcel of real property at the date of death, giving the amount still due at death, name of mortgagee, date, rate of interest, and book and page of record thereof. It also sets forth in the columns provided therefore the asses-sed valuation of each of said parcels, the estimated market value thereof as of date of death of decedent. That Schedule 8 attached hereto and made part hereof sets forth fully and in detail all personal property wheresover situated owned by the decedent at the time of death; all moneys left by the dec~dent at the time of death, whether in decedent's immediate possession, standing to decedent's credit in banks of deposit, savings banks, trust companies, or other institutions, whether individually, or in trust for any other person or persons giving also separately the accrued interest thereon, if any, down to the last i~t~re~t day prior to decedent's death in the case of savings banks, and to the date of decedent's death in all other cases; all bonds, postal savings, treasury certificates or notes and other evidence of in- debtedness of the United States to the decedent; all obligations, whether by statute or agreement they are designated as tax free, of the United States, or any state, or political subdivision thereof, or of any foreign country, which are owned at the time of death; all wearing apparel, jewelry, silverware, pic- tures, books, works of art, household furniture, horses, carriages, automobiles, boats, and any and all other personal chattels of whatsoever kind or nature, leftbydecedent, together with the fairly estimated market value thereof; all bonds and mortgat.tes held by decedent and of all claims due and owing decedent at the time of death, and all promissory notes or other instruments in writing for the payment of money of which decedent died possessed, of whatsoever nature, with interest thereon, if any, giving the face value and estimated fair market value thereof, and if such estimated fair market value be less than the face value, it sets forth briefly the reasons for such depreciation-as to each item; all moneys payable to the estate from life insurance polici-es carried by decedent; all annuity and endowment contracts the proceeds of which were payable upon the death of the decedent; and all the corporate stocks and dividends due thereon and unpaid as of the date of death, bonds and accrued interest thereon to the date of dece- dent's death and other investment securities owned by the decedent at the time of death, with the market value thereof at such time. .... .. .... In the case of 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 showing 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 ite111ized.form, together with the f~ir market value thereof, any other property owned or bequeathed by the decedent at the time of death. The Schedule C attached hereto and made part hereof sets forth a. true answer to each inquiry contained therein and in the case of transfers ofproperty, real or personal, within two years of decedent's death, in contemplation of decedent's death, or intended to take 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 transferee and all other facts of a pertinent nature regarding said transfers. In the case of transfers 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 power attached to the schedule. That Schedule D attached hereto and made part hereof sets f.orth 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, andthe relationship of such issue to the beneficiary. That Schedule E attached hereto and made a part hereof sets forth all property, real and per- sonal, owned by the decedent jointly with another or others, including intangible, standing in the name of the dec.edent and others, plus the date and place of record of instruments effecting the vesti ture of real estate ·a~d the date of acquisition of personalty, plus the name, address and relationship, it: any, of co-owners to the decedent. That Schedule F attached hereto and made a part hereof sets forth fuily 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 anrl lmpaid at time of " . death; taxes accrued charge.able 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 claiming and allowed, that the same will be reported to the Register of Wills, and that the amount of tax assessed can be reassessed in accordance therewith. That the totals of the appropriate columns in Schedules "A", "B", "C", "E", and "F" as directed therein,. have been carried forward and properly registered in the Summary. Subscribed and sworn to before me this ................................ . .................... ~ .. ~ ... !.:.:-.... . day of .. J.a.nuary.; ......................... 19 .. 69 ... .. --~R~t,;,s:?~···· - McKEES ROCKS, ALLEGHf.NY COUNTY. f'{/ MY COMMISSION EXPIRES MARCH 2, l-969 ct h --!. ........ ~ .... ~.: ............................................. ~ ............. . ~dministra~ c.t.a. ....... ll3.8 ... Charles .... St.re.et ......................................................... ,. (Street Number) ...... l.vl:gK~~§ .... :R9..9~~b ..... P..~.lli},! ..... l..5l.3.9 ............................... . (City or Town and State) NOTE: Before signing affidavit make sure all blank spaces in the affidavit and schedules annexed are filled in with details or the word "None", and in case the assets include rare and unlisted securities, securities of close or family corporations or an interest in any co-partnership or business, that the data and statements requirerl 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. -------------------- RCC-34 (1-64) CO.MMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE .. A" .iEAL PROPERT.Y Real property in Pennsylvania, with statement of mortgage encumbrances upon each parcel at death of dece- dent. Where property held as joint tenant or tenancy by entireties, report on Schedul~ "E". Property hl:'ld by the de.cedent as tenant in common with another or others, should .be identified as to quantum of interest and the estimated value should be that of the decedent's interest only. The real property located ln'the Commo!'wealth of Pennsylvania should be described by lot and block number, str'~et and street number, together with a general description of the property, with a reference to the record of the conveyance by which the decedent took title; If a farm state number of a- cres; also statement of mortgage encumbrances upon each parcel at death of decedent. Taxes, assessments, accrued Interest on mortgages, etc.,are to be listed on Schedule "F" and must nat be deducted from this schedule. Two-story frame house and Lots Nos. 2, 3, 4 and 5, Westside Property Plan of Lots, situate in Inde- pendence Twp., Washington County, Pa. (D. B. 547, P• (1) (2) ASSESSED VALUE FOR YEAR OF ESTIMATED DECEDENT'S MARKET VALUE DEATH ~ 3,200.00 Insert this.total opposite "real property", Schedule .. A" in the X X X X X .. As Reported" column on the last page of this return. $3,200.00 (3) DEPARTMENT VALUATION CAUTION (Do not write In this space) I RCC-.'P5 COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "B" PERSONAL PROPERTY INSTRUCTIONS: This Schedule must disclose all tangible and intangible personal property owned individually by the decedent, at the time of his death. Property owned by the decedent jointly with another or others must be listed under Schedule "E". Intangible personal property, titled in the name of the decedent, but payable at death to another or others, including but not limited to P.O.D. U. S. 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 furnishings, books, paintings, automobiles, boats, etc.) Intangible personal property, such as bonds, treasury certificates, cash on hand and in bank, . . . stocks, ·mortgages, notes, together with accru~d interest or dividends, salaries or wages, insurance pay- able to the estate or fiduciary in said capacity, partnership interests, interest in anyundistributed estate of or income from any property held in trust under the will or agreement of another, even though located outside of the State, at the time of death, should be listed in this schedule. Item NO• ITEM List and describe fully Savings Account -Pittsburgh National Bank, Wash- ington Office UNIT VALUE Savings Account -I-1e11on National Bank and Trust C< • , Burgettstown Office HOUSEHOLD FURNISHINGS: Sofa Chair Desk Insert this total opposite "Personal Property", Schedule "B" in the "As Reported" column on the last page of this return. X X ESTIMATED MARKEr VALUE 3,516.07 15.0~ 5.00 5.0 7,660.88 DEPARTMENT VALUATION (Do not write in this space) RCC-:30 C:OM,fONli'EALTH OF PENNSYLVANIA TIUNSFER INHERITANCE TAX ~~SIDENT DECEDENT SCHEDULE "C" TRANSFERS (1) Did decedent, within two years of death, make any transfer of any material part of his estate, without receiving a valuable and adequate consideration therefor? (Answer yes or no) No (2) Did decedent, within two years of death, transfer property from himself to himself and another or others (including a spouse) in joint ownership? (Answer yes or no) -"N..,.o,__ __ _ (3) If the answer to (1) or (2) above is in the affirmative state: (a) Age of decedent at time of transfer ------ (b) State of decedent's health at time of making the transfer. (Note 1). (c) Cause of decedent's death. (Note 1). (4) Did decedent, in his lifetime, make any transfer of property without receiving a valuable or adequate consideration therefor which was to take effect in possession or enjoyment at or after his death? (Answer yes or no)_~N~o~--- (a) Was there any possibility that the property transferred might return to transferer or his estate or be subject to his power of disposition? (Answer yes or no) ______ _ (b) What was the transferee's age at time of decedent's death? (5) Did decedent in his lifetime make any transfer without receiving a val_u_a_b_l_e_an-d--adequate consideration therefor under which transferor expressly or impliedly reserves for his life or any period which does not in fact end before his death: (a) The possession or enjoyment of or the right to income from the property transferred? (Answer yes or no) _,~~~0~----- (b) The right to designate the persons who shall possess or enjoy the property transferred or income therefrom? (Answer yes or no) No , (6) If the answer to (5) (b) above is in the affirmative, state whether the right ~as reserved in decedent alone or others _______________________________________ ~-------- (7) Did decedent in his lifetime make a transfer, the consideration for which was transferee's promise to pay income to or for the benefit of care of transferor? (Answer yes or no) __ Nuwo~-- (8) Did decedent, at any time, transfer property, the beneficial enjoyment of which was subject to change, because of a reserved power to alter, amend, or revoke, or which co11ld revert,to decedent under terms of transfer or by operation of law? (Answer yes or no) __ N~o~--- (9) If the answer to (8) above is in the affirmative, was the power to alter, amend, or revoke the inter- est of the beneficiary reserved in the decedent alone or the decedent and others? (Answer yes or no) ________ __ NOTE 1: The answers to these questions should be supported by affidavit by the attending physician as well as a copy of the death certificate. NOTE 2: If answer to any of the above questions is yes, set forth below a description of the property transferred, it's fair market value at date of death, dates of transfers and to whom transferred, with relationship of transferees to decedent, if any. Submit copy of any trust deed or instrument, if trans- fers are claimed to be non-taxable, also submit detailed statement of facts on which said claim is based. NOTE 3: List applicable property below in manner in which provided in Schedules A, B, or E. ITEM DESCRIPTION NONE Insert this total opposite "Transfers", Schedule "C" in the "As Reported" column on the last page of this return. MARKET VALUE (Estimated) NONE DEPT. VALUATION (Dept. Only) COM\It)NWFi\LTH OF PENNSYLVANIA r:\ \\~FFB Tl\HE!HTANCE TAX • lU~~InENT DECEDENT -·· ..) SCHEDULE "E" JOINTLY OWNED PROPERTY DiSTRl"CTIO~S: This schenule must disclose all property, real and personal, owned by the necedent jointly with another or others, . including intangibles, standing in the name of the decedent and others. List real estate first, as entireties, or joint tenants, giving brief description, as indicated tmner Schedule "A", plus the date and place of record of instrument effecting vestiture, but do not include entireties or out of state real estate value in estate valuation column. Personal property should be listed as in Schedule "B", plus date of acquisition, and the name, address and relationship (i:f any) of co-o-wners to the decedent. Description of Property, !Date of Acquisition, Name I unit Address and Relationship/Of Co-Owners, and Place :Value I { of Record of Instrum~'nt, w_~ere .Rea! ~state. ! . U, s. SaVin~ Bonds, issued in the ll$110& of :· -,i_ohn Kubaohka1 Sr. and Mrs. Anne· Bubbt I ··, 4 .... tmo.oo, ismed sept., 1960 o $19!&.961 1 • $ 2S~t001 issued Aug., 1960 0 • 24.)7 I 1 .... e.:;so.oo" :tssued. AufJ•.t 1960 0 • 38.?4 3• $100.00.; issued Aug.1 19!0 @ $ 97.48 1 -t5oo.oo, issued Aug., l96o 0 $487•40 2 41000.00, iSS'Iled Aug. 1 1960@ $974.80 percentage·-Estate I Share Valuation I 119.64 24.37 38.?4 292·4b I 487,ltJ \ 1.9119.60 Insert this total opposite "Jointly Owned Property", Schedule "E" in the "As Reported" colunm on the last page of this return. $.3,572•) DEPART~lENT VALUATION CAUTION-Do not Write In This Space. Value of Entire Property Value of Decedent's Interest s 8 r .9;/_ ~~-~~ -If .51 /f. 0--~;. ~f) .. to , //1 l,j~f,:1l: D / :Fe . ...?o l f DV/1/!A ~-----'-11 ,-<e1ili i -r I ( h Rcc:..3t • (12-63) C'Ol\1!\lONWEALTH OF PENNSYYLANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT BENEFICIARIES AND ADDRESSES State full names and addresses of all who ave an interest, vested, contingent or other- wise, in estate) JOHN KUBACKA JR. R D. \#1 · Bt'ire:ettstowm.. Pa. ANiREW KUBACKA. Box 366, Avella, !enna. MICHAEL KUBACHKA R. D. #1. Whealine:. W. va. JOSEPH KUBACHKA 14 Dee~To'ln f\n n..... ,1i: . "J.l~ T't. fo,..rl . Conn 'F.TlW'A"'RTI KUBACHKA I ?71R c:.. ·~ ~k1P.s La_ne Redondo Beach, California MRS RMTT.TF. WILLMOTT Beaumaris, Ontario, Canada ANNE BUBB ·- 1138 Charles Street M~Kt=!P.R Ro~k~ Penna.. ...; . .., .. 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 Son fes Lee:atee Son Yes T.Aa~t.AA Son Yes Legatee Son 'Mes LAa:.ttee Son Yes Lee:atee Daughter Yes Lee: a_ tee Daughter Yes L ........... +.,..,. - . . ./ Deponent further says that all the above-named beneficiaries are living/at this time except below: NAME DATE OF DEATH .I v RESIDENCE / \ / \ / \ / .__.. ,-·- l"' CJ ~ ., "\ &3-~t!-;)3 v Will t No. 37-Y/ .. ~ Year DJ THE :\lATTER OF THE APPRAISEMENT OF THE ESTATE OF JAN KUBACHKA, a/k/a JOHN KUBACHKA, SR. Deceased Late of. Ind~p~nd~nce Township. County of Washington .. Commonwealth of Pennsylvania REPORT AND APPRAISAL . II r· II (Executor-Administrator must complete "As II . ' . Reported" column #1.) CJ ~ t-1 ""d ~ .... 0 .... ('!) ('!) 0 j;-1• ~ .... E.. "' ::I "' "' ~ "' 0 C+ ...... ::I ""d t-1 !;-I ('!) E.. .... .... 0 ~ <.<:~ "' X ""d"';j ~ §' .... ~ C" ~ .g ~ ('!) trJ it .... p. ,... "' '< ,... ~ "tf ..... ('!) ~ 'tj tb ¢t C<l II :t ,.. II (/) c II .. ~ ~ •' """' ~ (/) > () . ~ t;:r"-....-.....-... >-<: • w w w . ::r' ::r' ::r' ~ ... --n~> : : :: --- -GI:l-GI:l'(I.)-GI:)-GI:)-GI:) 1'-1 ..;.., ~"-"-t:-'" "' ,."' i-.:, r;-t:-\rl :a \;.U ......:1 :o ~ 8 ~-'f "" • • ' ' ('!) :e • "0-1'1) \.oJ :1 :cngo-""" '0 :CO ' ..... .... ('!) c... - -Ge -Ge ·~ -Ge ~ -Ge ~· 0 ~ K.,,;: : '., . ., ~ "'~ v ~·· ~. ~: (t ..-... • () (t tv ·~· \::) ·~ ... -:1 : • . 3 ·~ ~ ·~·~ ~· • ~c... ' 0 .()::) -< "'C~--519 (6-67) '.':O.MMONWEAL TH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT FILE # 63-68-334 KUBACHKA, JAN a/k/a KUBACHKA, JOHN, SR. FILE # 63-68-334 January 16, 1968 SUMMARY TtEPOilT OF INHERITANCE TAX APPRAISER I~ the undersigned duly appointed Inheritance Tax 4ppraiser in and for the County of # 63 Washingion , Pennsylvania, do respectfully report that I have appraised the real and personal property as reported in the foregoing return at the values set forth opposite each item in the last column to the right in Schedules "A", "B", "C" and "E". Dated: 02-04-69 01-16-68 INHERITANCE TAX APPRAISER REPORT OF THE REGISTER OF WILLS I, the undersigned duly elected Register of Wills in and for------------ County, Pennsylvania, do respectfully report that I have allowed deductions in the amounts claimed by deponent, except as to those items where a greater or lesser amount is set forth in the last column to the right in Schedule "F", which greater or lesser amount represents the sum allowed as a deduction. Dated: REGISTER OF WILLS INVENTORY VALUE AS REPORTED VALUE AS APPRAISED VAL~U~E~<~J~\S~,RE~~~AP~P~RA~I~S~E=D Real Property (Rche~Ile A) Personal Property (Schedule B) Transfers (Schedule C) Joint-Held Property (Schedule E) $ 3,200.00 $ 3,200.00 $ _____ _ 7,660.88 7,660.88 TOTAL GROSS ASSETS LESS Debts and Deductions (SCHEDULE F) CLSAR VALUE OF ESTATE Valuation of life estates or annuities ESTATE TAX ASSESSMENTS 3.572.32 1,786.ao 14.433.27 12,647.08 =====c::--======:= $ ___ _ FOR USE OF REGISTER ONLY CO:MPUTATION OF TAX Tax on $_________________ ~% ~~---------- Tax on ~ ----------------l01o ~------------- Tax on;,-~~------- Tax on $ , __ lFl% $ _____ ~ =======:= J Exemptions := (':') .Total Estate _____ _ TOTAL TAX Less tax previously paid BALANCE $ ____ _ As evidenced by Charitable Exemption Certificates issued. by the Secretary of Revenue. $ =====~-. *-~----Less 5% of tax if paid within 3 months after death *~==========:=== JALANCE OF INHERITANCE TAX DUE Add interest at rate of 6% from to AMOUNT OF ESTATE TAX ASSESSED $ _____ _ Estate tax paid BALANCE DUE Add interest at rate of 6% from to FOR USE OF REGISTER ONLY $ ------ TOTAL TAX BALANCE PAID ADJUSTMENTS ~---------------- $--~-~~- $ ______ _ $~------$ ______ _ $ NOTE: Where subsequent adjustments are made to the above computation of tax by the Itegister of Wills, for proper reason, same should be noted below, with short explanation. Will Administration t No. IN THE Year MATTER OF THE APPRAISEMENT OF THE ESTATE OF JAN KUBACHY.A a/k/a . ..... ... ········ ........................... . Deceased Late of . IN.Il:E:P:ENP.ENCE .TWP.-. .. County of .. W.A$I{J:NQ'rO.N .... Commonwealth of Pennsylvania REPORT AND APPRAISAL '-/ ';/ .< Fonn RCC-2 " COMMONWEALTH OF PENNSYLVANIA RESIDENT INHERITANCE TAX DATE ................. !.:.~P.~~i3.::r::Y. ..... 4..?. ...... ~.?..?..?. ............ . ~DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTION~ HARRISBURG, PENNA. 1 7 1 2 7 ' . ... -APPRAISEMENT COUNTY .................. ~'3.:~~.~.~~?..~ .............................. . FILE NO. . .................. QJ..:::7.Q.$.::J.3..4.. ................................. . Whereas, ....................................... ol.~ .... ~.'99..~g.h~~ .... ~./'15:/.~ ............................................... late of .............................. ~.~?:~.P..~.~?:~?.~.~ .... !.':'P..~ .................... . in the County of ........................................ ~9.:.l?.hJ.~.K~9.~ ...................................................... Commonwealth of Pennsylvania, having died on the .. ...... .. ................ ~? .... ~.l:l ............................................... day of ................ ~.~?.~.!:'.!. ...................................... 19 ... ?..~, seized and possessed of an estate subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore, I, ........................................ ~ .. ~.f.t .. ~ ..... ~.~~.~~.!. ....................................................... , 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 deeedent 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. Unit Appraisement Description of Asset Values Made for Inheritance Tax Purpo1ea $ REALTY: Two-story frame house and Lots Nos. 2,3, 4 and 5, Westside Propety Plan of Lots, situate in Independence T1vp., Washington Countv Pa. 3,200.00 3,200 00 PERSONALTY: Savin!!S Acct -Pittsburgh National Bank, vlashington Office 4,119.81 Savings Acct -Mellon National Bank & Tr. Co., Burgettstown 3,516.07 Household furnishings 2,2.00 !lL JiliD .. 88_ 7.660 88 JT. HELD: u.s. Sa~ings Bonds, issued in the names of John - Kubachka, Sr. and l-lrs. Anne Bubb. 1,786.19 1,786 ~~ - Total 12,647 08 form~;vi.::fhbl:~ :::h:sw~ 8~ ~~·~· ~:; o~·~~b~~~e ·~~~~;~?i:~i~ ~ .2 ~---" ........................................................... , Penna. Ollt Ofllc:e) WASHINGTON County RESIDENT INHERITANCE TAX APPRAISEMENT Estate of . .J.AN. .. l\P.l?.!I:.9H:l\:A. ... C3:/~/~ ....................... . Deceased. Late of INDEPENDENCE THP. Date of Death, .............. ~¥.luar.y ... l6., .... 19.68 ............. . Appraisemel!t Docket Vol., ........... }? .................................. . Page, ...... 9.7·:::5.. ........................ No .... ?.J..:::.?.?.::::J..J..4. ........... . ·········· ··················Februa:ty·························· ···· Filed in Register's Office, ~ ...... .4..L19.?..9. .. Amount of tax due, $ .................................................................. . DEPARTMENT OF REVENUE Received, Examined and Approved, Wrote abo.ut Appra.isement, Appeal j1'om Appraisement, Entered and charged, .... ·' i I Form RC C -10 • OFFICE OF TME REGISTER OF WILLS .;r oF W A S H I N G T Oc1fuNTY AND AGENT OF THE COMMONWEALTH ' DEDUCTIONS ALLOWED IN STATEMENT OF DEBTS THE SUM OF ...•........ $ . 22.26 .• 5.3 ... AND DEDUCTIONS DATE·~········ !' ' Register of JHIIs,_ Agent JAN KUBACHKA, a/k a ESTATE oF --'~JFPO~mRI1~f--if~'fldM'ftt1eP."HK:A:Mfft-:-, -!S~RR-.::-----LATE oF Icd ependence Township DATE OF FILING APPRAISEMENT Jan. 24, 1969 DAT&: OJI' DEATH _...Ju;Au.U""Ur.s;A .. r.J.y~l~6~,--=1"'9;:::6;:::8 _____ _ DATE NO. OF NAME OF PAYEE REMARKS AMOUNT VOUCH5'11f .l~ ~~ 29 Russell Marino Probate of Will and 1 17 00 Feb. ~1-.n-r+. r.e,.t.H·'icR.te ,.._,. ~Q 'Rarbara Cbmielinski II' ... .._,..c.±...c,. ... of WUl 10 00 u--,, ()\. ... PublishiM Co. Adveb)iS1 nl7 T.etters 12 1)0' u.-ll v.r-.. l-..C..,at.nn r., . +-R •• Advertisine: Letters 12 50 -... li'eh 1 I A Withum T.iR.hi1itv Insurance. 10 nn Nl"+~ ... -Affidavits 3 00 .A.nne Bubb A.dministratrtJt;'-"s Commission 562 03 J A.mes R Donaldson AttorneY'ts Fee 575 00 "Rnc.c. .. 11 M .. -rinn F il inP' llccnnnt 1'7 00 li'eh ')_),__ W H Thomoson --Funeral Exg_ense 857 00 Two Pavments of Fiduciaries Bond Premiums 112 00 Audit costs as set by the CoUrt ' 27 00 Costs of certification of real es ~ate 11 50 . 2226 '3 TnT A L 2.076 03 COMMONWEALTH OF PENNSYLVANIA }sa: COUNTY OF I, .A.mlE BIIBB HEREBY CERTIFY. THAT. TO THE BEaT OF '-'IY kNOWLEDGE AND BELIEF, TH!: FOREGOING IS A JUST AND TRUE STATEMENT OF DEBTS, FUNERAL EXPENSES AND EXPENSES OF ACMINISTRATION SUBMITTED TO THE ESTATE OF .IAN KTTRACHKA, a.lkLa JOHN DECEASED. AS DEDUCTIONS FOR INHERITANCE TAX PURPOSES. KUBACH~, SR. u . A ~4. (L. 5.) . d . "7~ "'"!'"..£/ j . ~ swo•• ••o '"""~"'"'" ·~·· •• v••• if -o•v.,; (Anne Bubb) ~~~ "£ I ~ ... 'i .. 6<L Notary Publl~ Washington, Washington County, Pa. My Commission Expires Mar. 26, 1969 ' ------~---- Form RCC-4-RI-3-66 ~9 COMMONWEALTH OF PENNSYLVANIA RESIDENT DECEDENTS No 948691 OFFICIAL RECEIPT Transfer Inheritance and Estate Tax File No 63-68-334 Date April 15 19~ Office REGISTER OF WILLS. WASHINGTON' Pa. ____ W_A_S_H_I_N_G_T_O_N _____ ICounty, ss: Received from ___ A_n_n_a_B_u_b_b ________________ _ (Executor, X f the estate of JOHN KUBACHKO , SR. who died January 16 , 19~, the sum of THREE HUNDRED FORTY-TWO and no /100 - -Dollars, being TRANSFER INHERITANCE TAX and/or ESTATE TAX due the Commonwealth as follows: Appraisements Made and Filed Real Estate Date Valuation $·------ $. _____ _ Total Personal Property Date· Valuation $, _____ _ $ _____ _ Total Total Gross Assets Less Debts and Expenses of Administration Clear Value of Estate Valuation of Life Estates or Annuities $. _____ _ $. _____ _ $ $·------ $ INCOMPLETE Date 19__ $'----'------ ________ 19 __ !:$====== Estate Tax Assessments Date 19__ $•------- ________ 19 __ ~$====== NOTE: Iri accepting the transfer inheritance tax on future estates prior to the death of the life tenant or tenant for years, as evidenced by this receipt, it is understood that the Com- monwealth shall not be precluded or prevented from hereafter assessing additional inheritance tax at the death of the life tenant or tenant for years whenever it appears that such additional tax may be legally due and collectible for any reason whatsoever. ®000@30~£[L 1/37-97-5 NOTE: To be delivered to taxpayer by Register ol Wills Computation of Tax Tax on$ 5% $ Tax on$ 10% $ Tax on$ On Acct. 6% ~0 $ 360.00 Tax on$ IS% $ Exemptions * $ Total Estate $ Total Tax $ ------------ Less Tax Previously Paid (if =y) $=============== Bal=ce $ ----------- Less five per centum of tax if paid within 3 months after date of death $ 18 • 00 Amount of Estate Tax Assessed under the Act of May 7, 1927. Add interest at the rate o %' rrom _____________ ~--- to ----------------------------------- Total $ _______ _ $=============== $ 342.00 *'As evidenced by Charitable Exemption Certificates issued by the Secretary of Revenue under Act of May 28, 1956, P. L. 1757, effective June I. 1957, as amended by Act No. 381, approved Iuly II, 1957, and Act No. 207, i961, Section 302. SEAL ~~~ Register of Wills MOORE BUSINESS FORMS, INC., ELMIRA, N. Y, ./ ~ FORM RCC-4-RI TRANSFER INHERITANCE and/or ESTATE TAX. . BESIDENT DECEDENTS. RECEIPT Docke·t._ _3_7__.Page 97 5 Iin,e_ ___ _ Estate ot JOHN KUBACHKO , SR. OffiCE OF REGISTER OF WILLS _____ W_A __ SH_I_N_G_T_O_N ________ ~p~ April 15, 68 Date, __________ l9 __ SIGNED AND SEALED AS PROVIDED BY SECTION I201, ACT APRIL 9. 1929. P. L. 343 AS AMENDED BY ACT MAY 15, 1945, P. L. 528 RUSSELL MARINO Register of Wills 1201 (g), Act of April 9, 1929, P. L. 343, as amended, viz:-"To receive from Registers of Wills all duplicate ,re• ceipts for taxes paid to them by executors or adminis- trators and to charge the Registers receiving the money with the amount receipted for. The original of each such receipt shall be signed and sealed by the Register of Wills and transmitted to the executor or administrator, whereupon it shall be a proper voucher in the settlement of the estate. In no event shall the executor or adminis- trator be entitled to a credit in his account by the Register unless the receipt is so signed and sealed by the Register of Wills.'' Fill in below name and address of person to whom tax receipt is delivered: To ATTY. JAMES R. DONALDSON ----------------------------------------- L 614 WASHINGTON TRUST BUILDING WASHINGTON, PENNSYLVANIA 15301 _j Form RCC-4-Rl-3-66 ~9 COMMONWEALTH OF PENNSYLVANIA IIESIDENT DECEDENTS 948691 OFFICIAL RECEIPT No. Transfer Inheritance and Estate Tax File No 63 .... 68-334 Date April 15 19 68 Office REGISTER OF WILLS. 'iASHINGTON, Pa. \vASHIKCTON Anna Bubb County, ss: Received from ( ~.~·v·:.KilU~m~~~ JOHN l\tmACRK0 1 SR. Executor, -dm1-· · • · · " · · f the estate of who died Januarr 16, 19 GS, the sum of THREE HUNDRTID FORTY-TlvO and no/100 -.. Dollars, being TRANSFER INHERITANCE TAX and/or ESTATE TAX due the Commonwealth as follows: Appraisements Made and Filed Computation of Tax Real Estate Tax on$ 5% $ Date Valuation $ Tax on$ 10% $ On Acct. o%q 360.00 $ Tax on$ $ Total $ Tax on$ 15% $ Personal Property Exemptions * $ Date Valuation $ Total Estate $ $ Total Tax $ Total $ Less Tax Previously Paid (if any) $ Total Gross Assets $ Balance $ Less Debts and Expenses of Less five per centum of tax if paid 16 .. 00 Administration $ within 3 months after date of death $ Clear Value of Estate $ INCOlJPLETE Amount of Estate Tax Assessed under Valuation of Life Estates or Annuities the Act of May 7, 1927. $ Date 19 __ $ Add interest at the rate of %1 19 __ $ from Estate Tax Assessments to $ Date 19 __ $ 342~00 Total $ 19 __ $ * As evidenced by Charitable Exemption Certificates issued by the Secretary of . NOTE: In accepting the transfer ~nheritai:tce tax on future estates prior to the death of Revenue under Act of May 28, 1956, P. L. 1757, effective June 1, 1957, as =ended the hfe tenant or tenant for years, as evidenced by this receipt, it is understood that the Com-by Act No. 381, approved July 11, 1957, and Act No. 207, 1961, Section 302. monweal!h shall not be precluded or prevented from hereafter assessing additional inheritance tax at the death of the hfe tenant or tenant for years whenever it appears that such additional S~~,A L tax may be legally due and collectible for any reason whatsoever. t·< } .· ~ ~ irrn1D ~[LD ©£ iJ[E ••• >>~>' '•~ '.# #37-97-5 j/;;t·-.. , .. -"-.~( ::;1;.. e/ ...... -:;.--;:...-£--f· NOTE: This Tdplicate Receipt to be retained by the Register of Wills cmd filed iD numedcal Register of Wills sequence for audit purposes. · MOORE BUSINESS FORMS, INC., ELMIRA, R. y. FORM RCC-4-RI TRANSFER INHERITANCE and/or ESTATE TAX. RESIDENT DECEDENTS. RECEIPT 37 97 5 Docket Page Une, ____ _ JOHN KUDACHKO, SR. Estate o"--------------- OFFICE OF REGISTER OF WILLS WASHIJ\'!QTON ------~-=~~------~~~ April 15, QO Date __________ }g __ SIGNED AND SEALED AS PROVIDED BY SECTION 1201. ACT APRIL 9. 1929, P. L. 343 AS AMENDED BY ACT MAY 15, 1945, P. L. 528 RUSSELL . ~1ARINO Register of Wills 1201 (g), Act of April 9, 1929, P. L. 343, as amended, viz:-"To receive from Registers of Wills all duplicate ,re-ceipts for taxes paid to them by executors or adminis-trators and te> charge the Registers receiving the money with the amount receipted for. The original of each such receipt shall be signed and sealed by the Register of Wills and transmitted to the executor or administrator, whereupon it shall be a proper voucher in the settlement of the estate. In no event shall the executor or adminis-trator be entitled to a credit in his account by the Register unless the receipt is so signed and sealed by the Register of Wills." Fill in below name and address of person to whom tax receipt is delivered: I To L ATTY. JAMES R.. DONALDSON ---------~----------~--ljl4 t!ASHTh~TOll TRUST BUILDING WASHINGTON, PEbilJ•->YLVANIA 15301 _j -----~--------~------~--------------