HomeMy WebLinkAboutOC1968-0710 - ESTATE OF KOZLOWSKI,..~.'~---'-_._-~-..~~--'~---'------------------.-~---------------
PETITION SUR AUDIT
IN THE ORPHANSI COURT OF WASHINGTON COUNTY
Testate Form V
;;
Estate of---_'!()J1.r1_l<T~_!<()"~_()"'~_I<~____--_Na_---7/f)--rr:{..lef6.-""D---A A
....~~~.~~.~~W.~~.<??:.:!_.9~~Xt Fiduciary ~~~!?_.t.~:t::~~.~~E ~.~~~.~.
~-__--------__--_--__-----__-_.------..- -_..'---.._--_..-..---_-_-_-__--..---------_--.------..-..-_..
Deceased
Date of M h 29 1964 Date of.J 8 1964Decedent's death ~E~!Grant of Letters ~.~~~..
••··•..·f,"--;)r._....,."'.__}___..""__
This is the f..:i-.~§.t 9:.nd..f.Jn.9:.1 account filed in this estate
y·)'.'.'tl ~C,-.~.O·~:.•.:-;1;..1 ,-CCC','n.::....C.·.:oJ'".,\··C·!~:)"0
If there have been former accounts filed in this estate,list file number or number and term .
---..--__---______-_---.
Election to take
Under EX~OOXIxwill.(cross out one)
Date Election Place of;
Filed Record .
Name of surviving spouse N9.:n~.
List issue,where material:
None
Did decedent marry after execution of will?(indicate)~.No.Any children born after execution of will?(indicate)
~No.If answer yes,name them .
..........................................................................................._ _-__..__-_.--___.._-_---___--- -..
Legatees Relationship Interest Fiduciary,if not sui juris
Brother
Brother
Joseph P.Kozlowski
Michael W.Kozlowski
Louis Lubecki,minor
(natural parent:Louis
Lubecki)
Karen Lubecki,minor
(natural parent ,Louis Lubecki)
Sharon Lubecki,minor (natural
parent Louis Lubecki)
Paula Mroczek,minor (natural
parent:Joseph Mroczek)
Chairmaine Pykosz,minor
Billy Pykosz,minor
(natural parent:William
Pykosz,Jr 0 )
devisee
devisee
legatee
legatee
legatee
legatee
legatee
legatee
Sui Juris
Sui Juris
Abated:List any exceptions to above legacies:
None
If any partial intestacy,give facts:
None
Adeemed:Revoked:Lapsed:Give Causes:
Notice to interested parties.Have all parties,having either vested or contingent interests and all creditors 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.~
,.
If any exception give cause:.
~~~c~a~eoP:f o~a~~~~~~~~~~~ce A~~.~.~..~~!~~.~.~...........•......•........•...........................................................
Is estate Or any portion subject to Federal Estate'Tax?Ail:9 ____.
Is estate or any portion subject to Personal Property Tax?J}{Q .
Has Pennsylvania Transfer Tax been paid?Ail:Q Amount $.
If any portion of estate subject to life-estate,give name and birth date _.
,',..-_______-__--.-- -..---___--..-_-_-----._-__._---_-_---_.
Give Names and addresses of all unpaid creditors who are legally entitled to notice,together with the amounts
of such claims and whether or not they are admitted to be correct:
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:
Clause regarding $300 bond.
List any advancement or distribution on account that has been made,and nature and amount of same:
1.Louis Lubecki one piano valued at $50 (Louis Lubecki,parent &natural
guardian of Louis Lubecki,Karen Lubecki &Sharon Lubecki,minors)
2.Joseph Mroczek'$100 bond,natural parent &guardian for Paula Mroczek~minor}
3.William Pykosz,Jr.,natural parent &guardian of Chairmaine Pykosz &Billy
Pykosz,minors 2 $100 bonds
Balance for distribution per account,
Itemize any additional debits not shown by account:
Total additional debits
Itemize any additional credits not shown by account:
Total additional credits
Balance for distribution
$~!..9.Qg.:.!?9..
$.
$,..
$, .
If balance for distribution is not in cash,list each item held in kind,giving appraised Value:
ALL that certain lot or parcel of land lying and being situate in,the town
of Donora,Washington County,State of Pennsylvania,and described as
follows:LOT NO.FOURTEEN,in Block Number Thirty-nine,lying between
Bradford and Oregon Alleys,fronting on Waddell Avenue Forty fee and running
back One Hundred Forty-five feet to Washington Alley .
.:-:c~"~.-'.J-
'..~:.~":\
..
~2!_
l.
"
,.;
LAW OFFICES
MANDERINO AND SPARACINO
444 SCHOONMAKER AVENUE
MONESSEN,PENNSYLVANIA 15062
JAMES J.MANDERINO
JACK R.SPARACINO January 14,1971
684.4150
Mr.J.Hanna
Audit Clerk
Orphans'Court of Washington County
Court House
Washington,Pennsylvania
Re:Estate of John W.Kozlowski,Deceased
No.710 of 1968
Dear Mr.Hana:
Regarding the above estate,Mr.DeMedio has
asked me to clarify the matter regarding the provisions
in the Last Will and Testament of Joseph-Kozlowski
concerning distribution of bonds to Paula Mrochek,
William Pykosh,Jr.,and Charmaine Pykosh,each of which
were to receive $100 bonds according to the Will.
There were,however,no bonds in the estate to
distribute according to the,Will.The Executor,however,
purchased bonds in the denominations indicated in the
will in the names of the beneficiaries Paula Mrochek,
william Pykosh,Jr.,and Charmaine Pykosh and distributed
the same to them in an attempt to fullfill the intent of
the testator.
We are enc~osing herein copies of the letters
which were sent Certified mail along with the return
receipts.The letters were sent to the parents of the children
named.
I hope this is the information you require.
JJM:amg
Encls.
,'.•
Family qllowance claimed?~.c?.Paid?~~.
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 cash:residuary shares being stated in proportions:
Michael W.Kozlowski -,one-half unconverted real estate in kind.
Joseph P.Kozlowski -one-half unconverted real estate in kind
)
COUNTY OF WASHINGTON,55:
COMMONWEALTH OF PENNSYLVANIA.
The above named Fiduciary or representative thereof,
being duly ..:?W.9XD doth depose and say
that the facts set forth in the foregoing petition are true
to the best of !!:~~knowledge and belief,
And your petitioner will ever pray,etc,
..w••__•__••__•••• ••••__•__•••••••__.___••• • •
Michael W.Kozlowski,Adm.C.T.A.
...........~w.Q~to and subscribed before
,-,',,,~,-.......•.............................................................
h'·J $.d",f'J 19 67 I'me ~"'s:'?\...:.;-.ay{/~~.u~..........~....'_JJ IJ,,/Sign~ture of Offic~~...•..a ...~.~~...H.L.......I'r:i<'/I.....-:;l......_.,,,.,~Q~
Ti;'e of 6fficer~,~;-.£~L .
,Office expires..~~~.1..~l1..9.~~•...'1 .
..
'.
<',
,
'-
No.----..._.A.A.
Estate of John W.Kozlowski
------------------------_.._-----------_.--------------a
Deceased
Fiduciary ~_~_~~_~~_~~~~S?_~_J:~_~~~~_~__.__
Administrator c.t.a ...-----._.a ,_..__._..••_
PETITION SUR AU.DIT
FROM WHERE DECEDENT LEFT A WILL
Counsel of Fiduciary wil1 submit herewith the
following,in conformity with Court Rules
adopted effective December 3,1951,being
rule No.9:paragraph b-c;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 per:tinent.
3.Copy of Order appointing Trustee ad
litem,if pertinent.
4.Proof of service of above.
5.Letters Testamentary or Administration
C.T.A.or an attest copy of Wi II.
6.Copy of inventory and appraisement.
7.Proof of advertisement of grant of letters
if not filed.with account.
8.Certificate of liens in case any of the
funds for distribution are from judicial
sale of real ,estate.r9.Signed angf itemized elections if any
distribution)n kind.
10.Copy of Federal Estate Tax return if es-
tate is subject thereto.
Manderino &Manderino
Attorney
~2
.'
"
''Vel "00 1\1
Sllll,i,.;jO
~:0 N,t ~J \l ~:'~,[
11 I ~~ld
f
~)NjHSVt~~
tI3.1.SID]U
'n SSrlH
Dc HVr I L
$
1';,;,·;t
~"I'".1
-•...'0'-..
.,\'\I \
•.~\'>'"
.,.
r
:J
'..0,
':...';",.~'#.'r".r .(-,,
I,~9.~.~P..~!.~.~~.!..'.!?~.~~~.~.~Register for the Pr~bate
of Wills and granting Letters of Administration,in and for the County of
lVashington and Commonwealth of Pennsylvania:
.To M~.~~t.!-~.~.~~~.~.~J:.9.~.~.lf~.
Administretor of all and singular,the goods and chattels,rights and credits
.?••d":.d~'J .J ~.f John W.Kozlowski 'Yt mammg una nmnstere "LU UC 't ,uere 0........................................................•_- --=L --_.__late of 'the said County,
deceased,with a copy of deceased's will annexed,GREETING:
Whereas,the said _J..Qhn.._W.~~.9..~.!9:W.~~J _ _ _
.h"l'f'd his l W·ll·d T ....IlL.l..S ~etzme,rna e _ast 1 an estament In wrztzng)
'Which was duly proved on the 8.th__.._day of-J.qn~-A.D.,r.9.9.tl hav.ing,whilst Q..~_
lived,and at the time of~J·~·decease,divers goods and chattels,rights and credits,within the said County,by
'means 'Zc'hereof the full qisposition and power of grcmting 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 remain unadministered,may be well and truly administered,converted and
disposed of according to the tenor and effect of the s:r.id deceased's 'l(}ill and according to law,I do hereby
,g;ant unto you the said _J1tg.h.~~J w.!~.9.~J~!'!.~.~.~__ _.
,
---_.__----------_____---__----..___.._-.._--.._---_._----------__------------_.._------------------------------------------------._---------------_.
....- - --.,--.-----.-------..-..-.-(in 'whose fidelity in this behalf 1 very 111.Uch confide,)full
power by the tenor of these presents,to administer the goods,chattels,rights and credits remaining
unadministered,'l(}hichwere of the said deceased,within the said County,as also to ask,collect levy,re-o .
c~ver and receive the credits whatsoever of the said deceased,which at the time of~~.~.....death were owing,
or did in any way belong toJ~.+..m..and to pay the debts in which the said ¢eceased 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 re1'nainingunadminister-,
ed,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 appraisement thereof,and exhibiting
the same into the Register's Office,at Washington,on or before the §~.~_day of...~~.p..~.~~~.~:..
next,ensuing,and also a true and just account,calculation,and reckoning of your administration,upon
your soleJJl11._.9JLt.h to render at the expiration of six months,or when legally thereunto re-
quired;and 1 do by these presents ordain,constit~tte and depute you,the said __ .
Michael w.Kozlowski......~----------_------..--_.._--..__._-----_--_--- --..-------_---------._--..--_-_---_----------------------.._---:..-----------_------.._-----_------------.
administratOr c.t •f .•I of all and singular the goods and chattels,rights and credits,which
remain unadministered and which were of the said deceased,'lc,'ith a copy of said deceased's Will annexed'.,,
within the limits aforesaid;sa'lJing har111'zess and forever indemnifying m,e and all other officers against
all persons by reason of your administration aforesaid,and saving all others their rights,&c.
aln Wtstimony 114tftOf.1 have hereunto set my hand and affixed the seal of said office at
T·V 1:t tl 8th·d'f June '..v.asmng on,te ay 0 .-•.....................••..•.........................-..-....•.•....._m tlie year of our Lord
olle thousand nine hundred and._....§J~Jy.:_.f.~.~!!..._....
,~j))JJ...../.~.
.....;:--.
'-
March 8~1964
I John WKozlowski in sound mind~bequest my home~car all
saving account pluBs credit union Bavings~also checking account 811
insurance pollcys.I will to my two brothers~Joseph P.Kozlowski
and Michael W.Kozlowski.The piano I will to the chllc.ren of Louis
~.00Lu~ecki,.I also leave $300-Bond to PauJA:-Mroczek Chairmaine lykosz
t\M';;~snd._..-PJkosz.I also went a concret vault.
John W Kozlowski
Michael W.Kozlowski
(Brother)
Marguerite Cerrao R.N
Heed Nurse on 3 Main
Michael Kozlowski to be named as executor of John Kozlowski's estate.
/
•
8~~iC-t
~~:0itt:=iz tI1 §~i~(j)
~>-1->i~0i~tI1 -:0
0 ~asiNit"!~?-~:0
(1~
i:£;:(JJ;~
iH -=:z:
"
.Affi~autt~(@f 1.Exrrutnr ODr .Abmlufstratnr
~tatt of 'tult!l!Jlnunitt.f !lll:
<llounty of lIu!llftngtna f
Personally before me,the undersigned authority,a n.Q..~""J...p.~qlk _in and for said
County and State,appeared _Mte.ba.e1...Vl.~K2;).Q_W.~~_l'ho,.being duly
sworn according '00 law,deposes and says that he is the ~~I1t'Ol"el""'administrat~lort!e estate of
...................................l9..~~W ~~:~~.~."'!f:J.~__..__deceased,that the foregoing schedules constitute a
complete inventory and appraisement of the real and personal estate of...l9..~:w·.~~~~~~@~.t ,
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 E~et't1t!o'!'Administrator,.¢.t.fh
daY;~~~~~~~~w::;;~"f!:ethi;'~_~};..;.~.u.)~~,..}l.o!ar.y...P.ub.bC...Executor-AdmlllIstrator
wESTMOREL.~m~Jh~INSTRUCTIONS
1.An inventory mus~,,~~(F-rertM~rrtre~m6nths after appointment of personal 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 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 $50,000,including Copy
of Will and copy of Federal Estate Tax Return.
REFERENCE FOR ADDITIONAL COpy
Act of 1947 P.L.513 Sec.5.2,72 P.S.4844.2
JUUtnt011l null Apprntstmtut 01 the goods and chattels,rights and credits which were
.lobo W..Koalow,hl ..Borouah of Don.ora01·················..··· · · · ·.late 01..· ·..· · · ·..·..·····..···..··.
Washington County,Pa.,taken and made in conlormity with the above affidavit.
J
.Ret\l Eatate:
""",l!.._Iii,',n""
DOLLARS CENTS
ALL that eeraaio lot 01'parcel ollendlytcg al\4 betq Illuate ia the
towo of Donora,Waeblqtoc eo.-nt,.State of Pen.sylvania.81\4
4et$c_lbec1 1181011owe:LOT NO.i'OU1\TESN.in 8lock Number
l'td:rty-olce.lylogbetw.en 81"adfol'4 $,",Oregon Alleye.'l'oMlug on
Waddell Avenue Vor•.,feet and I'uoutng back 0_1f.....4•.,.Sorty-five
feet to WaehlQstoa Alle.,~For Title lee>:OeedBookV()l.645.P9.16~&,000 00
~!J'8ooal.Pl'~e!r!l;.
19S5 Pontiac Two-door hardtop
Piano
C~~t~".A~::.\;w~:'OQNalloCAl Back.Donol".in tbe aame 01
lointll be14P.o2el"~l:
Mellon NaUotlA1Baftk ..T:rQltt Co.,l)QDol'a Office ..ACcoWlt in tbe
name of loba W;.Koalo.,It!iQ t:ruat tor Michael W.KoelQwekl
Checking Aceout,\C ...MelloQ Nadoaal BaCik &T:ruI'Co••I)oOOI'&'.Pa••
tft tbe aame of lohn W·.Koelowe1d.an4 .To.epbP.Ko"lowekl
Amount:$ZS7.36 111.vatu.•·..••••..•
Wire Works Employees'Jredel'al Creai'UftiQQ ACCOQllt 10 Ih.,tUU'De
of John W.Ko~low$kl aml Michael Ko.lowski ...AmoW\,$l36.51
111.value.·••.•.••.•.•.•.••
100 00
50 00
~51 86!
S.535 17
68 ia
.,
41
t
11>
~:'
(i .:;'l·,.!J_('.1 r 11 '1.1 I"''''''~
(,111'11 t~..)l
'.
~~i!ii
Ii!I!I,
.j...:,..j
1....-.0I!II
iII,:!
I,,
i ~::Ii
IIi!
!iiiI
\
").,
I .
IN THE ORPHANS'COURT OF WASHINGTON COUNTY,PENNSYLVANIA
IN RE:)
)
ESTATE OF JOHN W.KOZLOWSKI,)FIRST AND FINAL ACCOUNT
)
)
DECEASED.)
"7 I (~~17 iof )
NO.)GROSS ESTATE:$6,407.36
)
SUMMARY
As per Schedule "A"
Personalty -Principal
I
Receipts
Disbursements
BALANCE FOR DISTRIBUTION
As per Schedule "B"
Realty -Principal
Receipts
Disbursements
BALANCE FOR DISTRIBUTION
THE BALANCE FOR DISTRIBUTION CONSISTS OF:
$2,468.40
2,468.40
$0,000.00
$6,000.00
0,000.00
$6,000.00
CASH
REALTY (Unconverted)
'NET·BALANCE:
$0,000.00
6,000.00
$6,000.00
SCHEDULE "A"
Personalty -Principal
RECEIPTS
As.per Inventory &Appraisement
filed $407.36
Advanced by Michael W.Kozlowski
DISBURSEMENTS
Administration Expenses
$2,061.04 .••.•.•••••$2,468.40
BALANCE FOR DISTRIBUTION
6/1/64
"
"
"
"
"
"
"
"
"
"
"
"
"
"
"
"
"
"
"
"
"
"
"
Register of Wills
Washington Co.Reports
Valley Independent
Marguerite Carrao
Guy Rodgers
Ann M.Gilmore
Manderino &Manderino
Michael W.Kozlowski
Michael Kozlowski
Dr.Ford
Peoples Gas Co.
West Penn Power
Auth.Boro Charleroi
Bell Telephone
Bell Telephone
County Treasurer
City Treasurer
Quinet Monuments
St.Mary's Church
Vayanski Grocery
Toby's Cleaners
Grant's
Schwerha Funeral
Letters
Est.Notice
Est.Notice
Will Witness
Obtaining oath
Notary fees
Attys fees
Adm.fee
Wake Expenses
Medical
Account
Account
Account
Account
Hospital 'phone
64 Co.tax
Boro tax
Monument
Church Sere
Acc't
Acc't
Acc't
Funeral bill
13.00
10.00
7.50
10.00
15.00
7.00
300.00
300.00
59.47
157.00
26.00
14.00
4.75
10.55
13.63
16.82
26.81
200.00
40.00
10.40
35.00
9.47
1,182.00
SCHEDULE IIB II
Realty -Principal
RECEIPTS
As per Inventory &Appraisement filed
DISBURSEMENTS
NONE
...,
I
BALANCE FOR DISTRIBUTION (UNCONVERTED REALTY)
$6,000.00
$0,000.00
$6,000.00
~.,.,•
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF WESTMORELAND
)
)SS:
}
The undersigned~MICHAEL W.KOZLOWSKI.,
Administrator c.t.a.,of the Estate of JOHN W.KOZLOWSKI,deceased,
does say and depose that at least six (6)months have elapsed from the
date of the first complete advertisement of the Grant of Letters of
Administration c.t.a.,in the Estate of JOHN W.KOZLOWSKI,and that
the disbursements claimed to have been made in the foregoing Account hav~
been made to the parties entitled thereto and de signated in the foregoing
Account and that the complete Account as stated is true and correct.
~7If~'
MICHAEL W.KO~WSKI
SWORN to and.subscribed
before me this 10th day of
lf~'~~:~,L
NOTARY PUBLIC..
My commission expires:
ANNE MARIE Gll~OI\E.Notary r-ubli~
VIES;....J;.,:,_u~.FA.
My Commls~.l.l.c;;...r;;~hlay 12,1969
r-Washington County ReportS'
63 SOUTH MAIN STREET
Wu~on,Pe~YNmUa
(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,publisbed 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:
...............J.ul:y.2.,.9.,.1{}.,1.9.64 .
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
,hi,'ffid<V~:"'"~~~:~_
~.J:-<J Editor
Sworn to a u scribed before me this
~~~
Washington County,'Pennsylvania
My Commission Expires
November 1,1965
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 ~hem
for settlement to the Executors or Admin-
istrators or their Attorneys.
• • • • • • •0 •••••••••
KOZLOWSKI,JOHN W.,Dec'd.
Late of Borough of Donora,Washing-ton County,Penna.,Administrator C.T.A.:Michael W.Kozlowski,635 Summit Avenue,Mon-essen,Penna..Attorneys:Adrian V.Sannier,Charle-
!roi,Penna.and Manderino &Man-,derino,James J.Manderino,Mon-essen,Penna.
.'...
Proof of Publication of Notice in The Valley Independent
\
Under Act No.587,Approved May 16,1929,P.L.1784,
as amended by Act.No.51 of April 24,1931,P.L.67
State of Pennsylvania/,
County of Westmoreland }ss:
."~..My commission expires --------~,...-,mr:T·=------?/J67
STATEMENT OF ADVERTISING COSTS:
James J.Manderino~Attrl.
_-=4=44 Schoonmaker Avenue
Monessen,Pa.
Sworn to and subscribed b
Letters of administration C.T.A.on theestateofJohnW.Kozlowski late of Bor-I,ough of Donora,Washington Countv,
deceased,having been granted·bv ~he,
Register of Washington Countv,notice
is herebv given to all p~r.sons.indebted I,to said estate to make Im~edlate ~aYment,and to ,those h aV'1 n·g .clalms-
against the same to present the,:,
without delav to Michael"W.·.Kozlowskl,
•administrator CTA,635 Summit 'Ave~ue'l!Monessen,Pa.,James J...MandE!n!10r~
Esq.,•Monessen,pennsy,Jvan!a:•Aana,J'v.Sannier,Esq.,CharleroI,Penn-Isylvania..'..'7;2,9.'
._~_.----,.-
Personally appe~red before me William H.Pore,Secretary of Man Valley Newspapers,Inc.,a Penn-
sylvania corporation,publisher of The Valley Independent,who,being duly sworn,depOses and says
that The Valley Independent is a daily newspaper of general circulation in Fayette,Washington and
Westmoreland counties,Pennsylvania,and elsewhere,published in the City of Monessen,Westmoreland
Caunty,'Pennsylvania,that it was established June 28,1902,since which date The Valley Independent
has been regularly issued in said county,and that a copy of the printed notice or publication is attached
.heretp exactly as the same was printed and published in the regular editions and issues of The Valley
Independent an the following dates,-:J==-.'u=lYtL...:...:::2.L·,-=1~9-=6..::!4=--_
July 9 and July 16,1964----------=-------=~-~--~--------------------
Affiant further deposes and says that he is General Manager of The Valley Independent,a
dally newspoper of general circulation,and as such is authorized to verify the foregoing statement
under oath,and Affiant is not interested in the subject matter of the aforesaid notice or advertise·
ment,and that all allegations in the foregoing statements as to time,place on~chcter of publica-
tion are true.~~/J~e:-,~)7,~COpy of 'NOTICE -6-L---..,I:.~~~===-=~........:.<~---,~-L.:.~=::::::_
)
!
TO MON VALLEY NEWSPAPERS,INC.,DR.
For publishing the notice or advertiseme'lt attached hereto in The
Valley Independent on above stated dates $7.50
Notary $ _
Total..........................................................................$7.50
MON VALLEY NEWSPAPERS,INC.
By ~·.o~r/
LISHER'S RECEIPT FOR ADVERTISING COSTS A
c.,publisher of The Volley Independent,a daily newspap~r of general
receipt of the aforesaid advertising and publication costs and certi-
'H>telFr"ouly paid.
...r.....,...............,........
9~~"""
~~'7""'"'
~!;'J THE ORPHANS'COURT 'OF
~W~SHINGTON COUNTY,PA.I~.7jO··ij!7(,T
~'
r
r'".~~~?;-;,ttf:rx:'~~:;\':'.~'''''i·~;;:'''i'~;'''·-·'':'.\''·:,~1if:fl:~'''''':''·:r''_?',!:·;'';:'~T'","-";-1~,-'~'0"i;•.;r"!J,'"-'-:'."'"":"'!~-"'r~:~-,.-,,"~·/·;~.~n""'·,:,;*~/:·'
IN RE:
ESTATE'OF JOHN W.
KOZLOWSKI,
t!\
tJ'
-
;;1
-~J ,',)'t-.,;'M ;~;'~I!J~I Ctl..~'f::::tQ.....~t:!'~S<=l ::;.•~-~:~;,
~~'....-
,:;
'""",...;.",,~:.;'~
lll;"
....j:.
."'A·'.
--JJ.",.~
'~".~~-
';;t:
.'>i
r-
r-"···'!'U'l~··:eI;i
,0
C:J1:C:')
(.)
~S;;
t-.,.&.
01
I\)
.,'"
:!2-'-
-VI
;0
tTi:xl
"-~""...jJ(/..,,_:,)~;'Tl9J;=
CJ~-":x.",:::~;':Jrzr-o
(I)
1+.\.r:f)~/11·t:.!()1C'
MANDERINCJcScMANDERINCI
ATTORNEYS AT LAW
444 SCHOONMAKER AVENUE
MONESSEN,PENr-:iEl'l'LVANIA
lH~
........'/SO:..../f~'.f T7C·'.',~"__'~.~_,.':.',."\::,."V ,;-;",,>'ill.'~Ji"'-'··_''''''''·',b~-·~-c<;~",,-i';'C.."
;'f-IJ>'",'-1'\
~;'.
int \t~nl\t'\l,f~U'".:tl!>cto.zd
1')!~l*nb~J It (n,*-~~~a\~QJ',
.'
,.6+'Cq.sa'g'J:tt'~:
OUTWJ:e'.j.ap O'.}.
ST.~J:nO;)BlU,
.....l
In the matter of the Audit of Account in
Estate of J.ahn..W KozloW'.ski .
TO THE AUDITING JUDGE:
No..1.J.0',,19 6.8....A.A.
Enter m.y.appearance for t.he.Ac.c.QUnt.ant.in..the a..P.QVe.e.ntitle.Q ..
matter.,--_____.__-.-_~_.
,--___-_._-___-_____..__- -.
..-.--_~.
.................................................................................................................................................................................................................................................
.................................................................................................................................................................................................................................................
.................................................................................................................................................................................................................................................•
.9.t.b.day of S.e.pt.~.m.1?~.r..,..................19__..f?8
N.B.-Counsel shall,by separate paper,present a concise statement of
each claim.with suppor,ting calculation of any interest claimed.
Objections to an account as filed,shall be concisely stated in a
separate paper.Counsel suggesting proper distribution shall file
a separate concise statement in that regard.
No..1.J.Q ;,19 6.~.,A.A.
In re Audit of Account in Estate of
..LO'HN....W......KQZ..~QY:f..9.J5.~J .....;Q.~.~.~.~.f?.~.Q.~.
AU 0 IT
'raecipe fnr 1\ppearance
FOR
--__--_--_-___--_---._..
..c:-r ~..-0..--.......
J>0")0
-_._-_.._.__~-_...::.:.:..._._.._-_.._~._._---=~~~~.~_..__.___.
'"'-'-_.J
l>m Al
--_._-----____-:---~~~..__.--_._~_--:~:~~__.____.
~~;,~~:
+"
........_A~.J.~.._DeMe_dio.,_Esq.~_
Attorney
.....8
.::;..
~n tqr QInurt nf aInntmnn Jkua nf lJua4ingtnn aInunty,
Jruuaylnuniu,®rpqnna'aInurt 13ittialnu
ESTATE OF No.710 of 1968
John W.KozloW5ki~
deceased.
In the matter of the First and Final
Account of Michael W.Kozloswki
Administrator C T A
$6.000.00Balanceperaccount·_
ADJUDICATION AND DECREE
And now January ~()191!.-,this matter came on for hearing,
audit and distribution a't this session and testimony taken;'and thereupon,upon due consideration
thereof the balance for distribution in the hands of the Ac.countant.is deterrn.i~ed to be
$6~000.00 and the account is accordingly confirmed;and It IS ordered,
adjudged and decreed that the said balance be paid out by the Accountant in accordance with .the
schedule of distribution hereto attached and made a part hereof,unless exceptions hereto be flied
sec.reg.or an appeal be taken herefrom sec.leg.
SCHEDULE OF DISTRIBUTION
Bolance:_$6.000.00
Deduct Clerk's Costs &Receipts _
At'tomey'.:QA..L.~J~•...:!D~e::.;;;Mlolie~d....i¥o _
18.50
$5,981.50
Russell ~4rino,Clerk O.C.,costs in certifying real
estate to Recorder,
John Mazza,Recorder,costs recording certification of
real estate,
Contribution to maintain assets of estate in kind,
Louis Lubecki,father and natural guardian of Louis
Lubecki,(Jr.),Karen Lubecki,and Sharon Lubecki,bequesl
in kind of piano,held in kind and distributed as such at
the appraised value,credit to be taken by the accountant
for item advanced prior to distribution by the Court,O.
Joseph Mroczek,father and natural guardian of Paula
}~oczek,a minor,specific bequest in kind of $100.00
bond,held in kind and distributed as such credit to be
taken by the accountant for bond advanced prior to -
distribution by the Court,
William Pykosz,Jr.,father and natural guardian of
Charmaine Pyk05Z,~mihO~1 specific bequest in kind
of $100.00 bond,held in kind and distributed as such
credit to be taken by the accountant for item advanced
prior to distribution by the Court,
100.00
100.00
$6,200,00
$6,100.00
t
III
"'.
,.'.r
-•I
'.
o....
~,
,'
.;.....
William Pykosz,Jr.,father and natural guardian of
Billy Pykosz,a minor,specific bequest of $100.00 bond,
held in kind and distributed as such,credit to be
taken by the accountant for item advanced prior to
distribution by the CoUrt,
Michael Kozlowski,brother,devise of real estate as
hereinbelow described.Distributee takes the fee title
to said real estate,1/2 in his own right as devisee unde~
the will and the remaining undivided 1/2 interest devised
to Joseph P.Kozlo\'lski,by virtue of and through deed
executed by the said ~oseph P.Kozlowski vdth ¥uchael
Kozlowski as grantee thereof,conveying the said undivide~
1/2 interest,deed of.record in Deed Book 127S at page
289-deed dated June 25,1965,
100.00
6000.00
$6,000.00
No balance
REAL ESTATE TO BE CERTIFIED TO THE RECORDER OF W~SHINGTON
COUNTY BY THE CLERK OF .THE ORPHANS'COURT DI~ISION
John W.Kozlowski,devisor,to Michael Kozlowski,devise~of,an undivided 1/2
interest;to Joseph P.Kozlowski,devisee of an undivide~1/2 intelest and grantor
of same to the aforesaid Michael Kozlowski,thus placing the fee in the said Michael
Kozlowski by deed dated June 25,1965 recorded in Deed BDok 1278 at page 289;subject
real estate being all the right,title and interest of JDhn W.Koz]owski,devisor,
in parcel of real~estate described as,VIZ:
ALL THAT CERTAIN PART AND PARCEL OF REAL ESTATE lyi!g and bew g situate in the
Town of Donora,Washington County,State of Pennsylvania and descr~bed as follows:
l£>t No.Fourteen,in Block Number Thirty-nine,lying bet veen Bra.dford and Oregon Alleys,
fronting on Waddell Avenue Forty feet and running back a~e Hundred Worty-five feet to
Washington Alley.
t..i '....-.~
t •
~•~<..
0 0 z
AL-
-t..():J
m ()-+9
~III 0 ::r.....c0 (l)
~f~CI .....~3(l)
yo++0 0 0=-t..-t............
CI
(l).,
\
.....0 0...,.,.~
-t..-t.......
t
..-+.::r.....CD
b:::
II>~~
:::t ,..'
,CI ,1'-":
S ',
~...,?>
~~?>
~.•1
.,
.::r
0 0?<!
Z --1 CL
..::i'"--1
;;r;:0
~-(..)
,~...a.......,:..L\._
r~<,C):Z
';-_J 0
c::::~0::f-
!.."!'('",.---,j W c..!)
J..,.!.....l :..LJ f-
X to U)--
c:::rJ)---:J :.:J (9 (f)a::lu <!
j iI r--c::>--~......,.~..,..
J,
'FO~M NO.RCRI-34-150M-2-60
-.~Copy of Will to be attached.OFFICE OF THE REGISTER OF WILLS In case of jointly owned,....,U.S.Saving Bonds,a
THIS FORM MUST'BE FILED IN DUPLICATE list of such bonds givingWillfullinformationmustbe
Admn.No 19........County of W9:~.4.~.~gt.9P,..............................attached.
Misc....
...M.~<::hct.~~..W.~K9.~1.9.~sJ~.i of ~.J~..W.ct9:4.~~~..Av.~.q..~~.1...P~m.9~.ct.,p.ct.~~.(Name).....(Address)
being duly ~.~.9:r.q.according to law,deposes and says that he is the .L\9:J:rl.i.Il~f3.t.~ClJ.().r <:.~J~..ctu .
.(Exec.;Adm.,Legatee,Etc.)
of the estate of l9.HN.:W!~.9.~.~.Q:w.$.~Late of J3..<?~.().~gP.:..<?LP.<?Il().~'i.L...
(City,Borough or Township)
Charlerolt Paw Estimated
Value
deceased)and that the whole of the estate of said decedent,who died ?i Mar.cb..2.9 1 ..1964 · :..
.(Date)
consisted of:Attomey..iv1~~g.i~.~~~..~a~~~~~.~.i~?,.
Adrian V.Sannier,Esq.
Real Estate
ALL that certain lot or parcel of land lying and being situate in the town of
-!?onoral Washington County,State of Pennsylvania,and described as follow
LOT NO.FOURTEEN,in Block Number Thirty..nine,lying between Bradfo d
.a!J-d Oregon Alleys t •fronting on Waddell Avenue Forty feet and xunnin ba.ck
One Hundred Forty...five feet to Washington Alle •For title see:Deed Boo
Volume 645,p •162
------------------.-----------------------1------
Persona,l Property
1955 Pontiac Two...door hardto
Piano
l}~t:l'100.00 .50.000~
Checking Account ...Mellon National Bank &Trust Co.,Donora,Paw
in the name of John W.Kozlowski 257.36*
(Additional personal property may be listed on reverse side of this sheet.)
,.'
",
r "t ' ,-
j-
j , 1 j
(
"
..
(,."••.Jr'f •.••,tf
........-.
•'.•f'l'r:-....'It ,..".,.iii'"If ~<:.>_.J '-_
,_'c:....._
-.....r-__________+-..:"-"-_.:.-:.--:~---..J.'-'~
-,'"
,.
...--
(panUnU03)Al-!9dO.Id lUUOS.Iad
---,
BENEFICIARIES
Deponent further says that all t1fwbove-named beneficiaries are Iivinl at this time with the exceptle of:-,~t ...,.J __~.
BENEFICIARIES AND ADDRESSES ULATIONSHiP SURVIVED AGE OF LIFE
(If step-children or TENANTS OR INTEREST OF(State full names of all and their addresses who illegitimate children DECEDENT ANNUITANTS BENEFICIARYhaveanlllterest,Yelted,contingent or other-are invol"ed,set STATE YES AT DEATH OF IN ESTATEwise,in estate.)forth this fact.)OR NO DECEDENT.,
Joseph P.Kozlowski Brother Yes devisee
Z31 Waddell Avenue
Donora,Pennsylvania
.":l .~-,J .
Micha,el W./Ko~towski Brother Yes devisee
Z31 Wad(~ep Avenue
~~A'"...I.',,,~
Doriora"~~nns~yania
c
~
Louis Lubecki Yes 16 years leaatee
1578 Meldon Avenue--...•'.
'\
,.,
Karen Lubecki
YflJS lZ.,years lf1!O'atAA.1578 Meldon Avenue
Donora,Pennsylvania
-
Sharon Lubecki
1578 Meldon Av.:e.n.ue Yea --11.years -l~H!atee
Donora,Pennsylvania
Paula Mroczek (Marchek)"Yes
,,'"j w ••"A 6 years legatee
Donora,Pa.
I
''Chairmaine rtkosz.':'=112:1 Countr'\l lub Rd.Yes 11 years legatee
Monongahela,Pennsylvania
....,,.........
M
Billy Pykosz .-t y'as
1121 Country C{ub Road
-14 years legatee--giHe "'-'O...lMonon.la,Pa.:!::=
i 1 I '<!.-s;;;::,..j''''-
."".--<..."
-:J
~-"'\----f'~·.,~'_i '.',••,.~'.....~o'I ~\,I 1':::.,~
DATE OF DEATH
\',
, . .•••••••••,~'RESIDENCE -•i<t
-------------::z -1
I
" I
7
a
7""J
~----.1-;;-
c..-V--"""'~~:J.I
.
Jointly Held Property Estimated
Value
Mellon National Bank 8t Trust Co.,Donora'Offi~e •Account in th~,name of .
John W.Kozlowski in.trust for Michael'W.Kozlowski ,$3,53$..J
~j If;
.J ,I
Savings",'r Account -Mellon National Bank &Trust Co••Donora,Pa••in the._.·.i·','
name of lobo.W.Kozlowski and Joseph P.Kozlowski -Amoupt;$35'4.44 ...."~..:~~r~tl4£.-.lIz value.....~••~~•••,~•••'~~'i 77.22
"I .....;.....':
Wire 'Works;EmploYees'Federal Ctedit Union Acc~unt i~~h~n~~e ~~John
w.i{ozt~~~ki'and'Mic~el'Ko~l~W$ki ~Am~unt~$136~57:','J....;, ,
I •' ".'!,'l . I , ,.':i '.I.·": .~'..,I • \I.'.•
D~II?value.;,..;,••;,••••••••~;,•68.ZE
'."":• \\ ',"',I_-:1,<.;I
,
\ .• •. ,, •L I ' •~•.•...
,
;;4L ..'1 JPo/t
Transfers within One Year Prior to Death
'~:~-"
None.
,.
l ~
,-.
~,,
,
-----------------I -----------1------.
~)
".•.1 i-'l'"r -.:...-x~;,;~'I I~------------·------__II-----'---
~.
.............s..~e.~....C"•••'"•••••••••••••••••and subscribed before m~e.'.t'fJ .-,j <~/'.-{.-l.l---j).;
...3rd March·65·.'Ut:k'(I..J:.../f.,_tt;;~~oL;i....•......••••••••
th7J :;::~..•.:.."t day of ·~····ANNE··MARjE·iijLMOR~~N~ti:-Publfc~-./..~~•••••••••••••W~~.lMS2Jig~e..~Q..~Q.".p.~
-..'-1&)Commission Expirell May 10.1965
This fo~,required in all estates with gro~S ~ssets under $10,000.00,under Section 15 of the Act of June
20,1919,P.L~521,as amended,and Section 1201 (a)of the Act of April 9,1929,P.L.343,as amended.
'IMPORTANT-5EE REVERSE SIDE
(ATTACH ADDITIONAL S~EETS 'F NECESSARY)
"~.
.J
R....~SIDENT nECEDSNT
KOZL01tlSKI,JOHN W.
FILE #63-68-710
March 29,1964
SUMMARY
06-03-68
03-29-64
Dated:
FILE #63-68-710 TtEPORT OF INHERITANCE TAX ~PPRAISER
I.the undersigned duly appointed Inheritance Tax Appraiser in and for the County of
#63 Washingt.on ,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",
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,~xcept 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
VALUE AS REPORTED VALUE AS APPRAISED V~A~L~U~E~1~A~S~~RE~AP~P~RA~.~I~S~E~D
3>6,000.00 ._$6,000.00 ._$__~_
407.36-·-/.0+.;;6 .-.-
INVENTORY
Real Property (Schedule A)
Personal Property (SchedUle B)
Transfers (Schedule C)
J oint-Held Property (Schedule E)
TOTAL GROSS ASSETS
LESS Debts and Deductions
(SCHEDULE F)
CLEA.cq VALUE OF ESTATE
;;,780.6+.-
lO,lee.03
=====:::--
lO,lse.OJ
======.~=======:=
Valuation of life estates or
annuities . . . • . • . .$~__
ESTATE TAX ASSESS~mNTS $
COMPUTATION OF TAXFORUSEOFREGISTERONLY
Tax on $;__5;10 $_
T ax on $.__10%~_
Tax on $2~$
Tax on $:=V~~$-----~
Exemptions :===(*)
Total Estate __
TOTAL TAX $_
Less tax previously paid *============\===
BALANCE $_
Less 5%of tax if paid within
3 months after death $=====:=
(,;,)As evidenced by Charitable Exemption
Certificates issued by the Secretary
of Revenue.
BALANCE 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%fromto $_
TOTAL TAX BALANCE $_
PAID $
FOR USE OF REGISTER ONLY ADJUST~NTS
NOTE:Where subsequent 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 l N
Administration ~o.
I~THE
Year .
~IATTER OF THE APPRAISEMENT
OF THE
ESTATE OF
JOHN.W.KOZLOWSKI ..,
Deceased
,
Late of ....
County of
..DONORA,.
.W1.\,Sli:r:WL1T.()N.....
Commonwealth of Pennsylvania
REPORT AND APPRAISAL
'\
<!
~
"....~
FILE NO...Q.),.~9.$..::7+.Q _.
Fonn RCC-2·~.r~~"
.PARTMENT OF REVENUE
Bt1ltEAU OF COUNTY COLlECTIONS
HARRISBURG.PENNA.17127
~COMMONWEALTH OF PENNSYLVANiA')I)ATE _JlUl~..3"l96$..
RESIDENT INHERITANCE TAX COUNTY W9.§l.hiPg.tQ.n ..
APPRAISEMENT
Whereas,;John..W Ko.zlow.ski.;;::;;;;;late of ;p.QP.-g;r.~..
in the County of Washington ;;;Commonwealth of Pennsylvania,having died on
the 29 th day of Ma.rc.h.;;;;;.;"..........19.9.4 ,seized and possessed of an estate
subject to Inheritance Tax under the laws of t-he Commonwealth of Pennsylvania'~,
Therefore,I,...................................W...R.......Chaney.........................,.....................;............,an appraiser duly appointed according to law,
having been designated to make a fair and conscionable appraisetnent 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 exprtlssly reserves the right to appraise and assess transfer
inheritance taxes at the lawful collateral rate on any such future interest.
-.-.
Unit AppraisementDescriptionofAssetValuesMadeforInheritanceTaxPurpoles
.---..
$
...-
REALTY:.......
As per appraisenent filed 6,000 00
.--_.-....I
......
PERSONALITY ...--~.-
As per appraisenent filed 407 36
-~._._--~
-~--.~
TRANSFERS:...---
NONE NONE
-------!
----
JT.HELD:
As per appraisement filed 3,780 67
----
.---...
--_.
TotaJ,....10,188 03
_0.._-..
.,.-.-
Having been duly sworn according to law,I do hereb~rtifY that the above appraisement is made in con-
fonntty with law on this ..........~~.................day of ..~£......~..."........"..".....1fi:.........~;r 19....~.E.-....•..........•••...•..•;~~~.................................................~~:~
~.~..............~..._.....:~.~.::.~~:;~~~~.~.................................,Penna.
WASHINGTON ..County
..,-,......I ..,I;,
!.,,~.ttl:'
RESIDENT INHERITANCE TAX APPRAISEMENT
Estate of
'-a.;if 1""~t
'-! /I I,,,
~'1 j"!JH:'I n/.l 11 t.{.Pf·r rJ,.J.f frr:J,
...JOHN.111[•..KOZLOWSKI ·
Deceased.
Late of
DONORA .
Date of Death,Mar.c.h...29,l9.64 ..
Appraisement Docket Vol.,.3.7 .
Page,1l6~5 No 63.~6.8~7l0 .
Filed in Register's Office,June J"J9 6S.
Amount of tax due,$_-
DEPARIMENT OF REVENUE
Received,
Examined and Approved,.
Wrote abo.ut Appra,isement,
Appeal j"om Appraisement,.
Entered and charged,..
r'iY·,,'t f ,','",.,•IJ C.ri d 0 v l.",;."1(.j
nEGISTI.:H or WILLS
i¥J\$HINt';rON co.,PA •.
'.
-.'
4.
7/0 1 /9l!l t/
Form RC C"~O-RI [;.i?DUCTlONS ALLOWED IN
--\..~..,'-
THE SUM OF ............$....u.2..1!f..r:...'!!?u.-OFFICE OF THE STATEMENT OF DEBTS
REGISTER OF WILLS AND DEDUCTIONS uuu.uZ-:.':!.I!.:u~.~Washington DATE APPROVED ........OF COUNTY ~~a~~Q ~~~C?~GENT OF THE COMMONW:ALTH
-~;e ~?-&r-/'/()6J /S-~Regis'er of Wills,Age"'
ESTATE OF JOHN W.KOZLOWSKI L.ATE OF Borough of Donora
DATE OF FILING APPRAISEMENT }J-.:Y/-~p DATE OF DEATH March 29,1964
D....TE NO.OF NAME OF PAYEE REMARKS AMOUNTVOUCH"~
Register of Wills Letters 13 00
Washington County Reports E state Notice 10 00
Valley lndenendent Estate Notice 7 50
Mar~!Uerite Carrao Will Witness 10 00
Guv RodQers ObtaininQ Will Witnes ~Oath 15 00
Anne M.Gilmore Notarv fees 7 00
Manderino &Manderino Attornevs'fee ~oo 00
Michael W.Kozlowski Administrator c.t.a ~oo 00
Dr.Ford Medical Expenses 157 00
Michael W.Kozlowski Wake Expenses 5q 47
Peonles Natural Gas Co.Gas Account balance ?h 00
West Penn Power Electric account balance 14 00
Authority of Boro of Charleroi Water Bill 4 75
Bell Telephone Company Hospital phone 10 55
Bell Telephone Company Telephone Acc't balance 13 63
County treasurer County Tax 16 82
BoroUQh Treasurer BoroUQh Tax /.h Hl
Quinet Monument Comnanv Monument and Engraving 200 00
St.Marv's Church Church Service 40 00
Vayanski Grocery Grocery Account balance 10 40
Toby's Cleaners CleaninQ Account ~5 00
Grant's Account g 47
Schwerha Funeral Home Funeral Bill 1,182 00
."l.tMAJ!-()If A;J ;:;;f ~(i g IJ.l';-;-rLA-"7lll:/'l ?()ltO
l-II "t/
2,4&8 1 40
COMMONWEALTH OF PENNSThVANIA
}SS:
,
COUNT'{OF Westmoreland
1,Michael W.Kozlowski HEREBY CERTIFY,THAT.TO THE BE.T OF.
MY KNOWLEDGE "'.1lI0 ~El.IEF,THE FOREGOING ISA JUST AND TRU E STATEMENT OF DEBTS,FUNERAL EXPENSES AND EXPENSES 01"
AtlMINISTRATION SUBMITTED TO THE ESTATE OF John W.&ozlows~~."'.••DEDUCT'ON''OR
INHERITAN:::E TAX PURPOSES._9'1L/./L-<..J;i ----'/Aj".I~J~,(L.S.)
SWORN .'NO S,",BSCluaED BEFORE ME THIS 3rd DAY 01't7M~r;th 11I~Z2=!'2J;i::w ,~
ANNE MARIE GllMO~£,Notary Public
WESTMOREL.AND (;0.,PA.
~Commlulon lxpiresMay 101 1965 .
- -
.-
"~!J~-
s ,[L ::::['.~~c;--
••1 r-'
::1 ~ir
c;::"1 r~-c'r r~"
I
"j
I
I
.,(
""\....._I.'
;-
'.
\S.l
c;SJ
S'
~L'
..-w
--....
•I
::...r __
[~1 C
:J
SJ
L'
L
JJ
1
i
S L S \.oJ '-
S L'J'
::.C _IJ
o.,"
,~-i,
s '-
I·
e.
u .!J ,I J
"("
\'"
v•
FormRCC-4-RI-3-66 ~9 COMMONWEALTH OF PENNSYLVANIA
RESIDENT DECEDENTS
949096 OFFICIAL RECEIPT
No.Transfer Inheritance and Estate Tax File No.63...68.710
Date .August 26.19'68
Office REGISTER OF WILLS.tfAWu1NCTot~Pa.
tiA.SltINOTON County,ss:Received from "..'bi ...ffu'ZloW'skiJEi:tC~e7 u,.
~,A~1f!trator~)of the estate of Jomt tlIi KOZLOttSItI
who died ~a.~h 29 1964-,the sum of n~;s TRUnSIVill Ttm.B!f!1JN»~~'Bl00u.!HRIm&?S{llOO-ars,
being TRANSFER INHERITANCE TAX arid/or ESTATE TAX due the Commonwealth as follows:
Appraisements Made and Filed Computation of Tax
Real Estate Tax on $5%$Date Valuation
6....3-~a $6,000.00 Tax on $10%$
$Tax on $2%$
Total $6.000.00 Tax on $1,11r"63 15%$],157.94
Personal Property Exemptions *$
Date Valuation
6-3-68 $401.36 Total Estate $
Jt.Held S.780.61 Total Tax $1.157.94
$
Total $4,188..03 Less Tax Previously Paid (if any)$
Total Gross Assets $10.188.03 Balance $
Less Debts and Expenses of 2,468.40 Less five per centum of tax if paid
Administration $within 3 months after date of death $
,Clear Value of Estate $1$119.63 Amount of Estate Tax Assessedunder
Valuation of Life Estates or Annuities the Act of May 7,1927.$
Date 19__$($Add interest at the rate of 'Yd19__$from 3w,g...65
Estate Tax Assessments dAte'$225.81to
Date 19__$1.383.15Total$19__$*As evidenced by Charitable Exemption Certificates issued by thE)Secretary of
.NOTE:In accepting the transfer ~nherltance tax on future estates prior to the death of Revenue under Act of May 28,1956,P.L.1757,effective June 1,1957,as amended
the hfe tenant or tenant for years,as eVIdenced by this receipt,it is understood that the Com-by Act No.381,approved July II,1957,and Act No.207,1961,Section 302.monwealth shall not be precluded or prevented from hereafter assessing additional inheritancetaxatthedeathofthehfetenantortenantforyearswheneveritappearsthatsuchadditional S EA-t<'.tax may be legally due and collectible for any reason whatsoever.it':;,R'~''-;;1t11~~""l:-...W'r)1YOOD [P)[LD @£lYlE 31...116.5 I .'f.,.j-";j.,.t:;..,,..t:.-A:..,.
NOTE,This triplicate Receipt to be retained by the Register of Wills cmd filed in numerical Register of Wills
sequence for audit purposes.MOORE BUSINESS FORMS,INC••ELMIRA,R.Y.
FORM RCC-4-RI
tBANSFER INHERITANCE and/or ESTATE TAX.
BFSIDENT DECEDENTS.
RECEIPT
31 Pagell6 5Docket...__-",_,....I...ine'_
Estate oLf_-=J-=O=81::..:..._'t.;....:··.~KO..:....Z:......:.t..:....OW_.·._SR_I_
omCE OF REGISTER OF WILLS
WASHINGTONI Fa.
68
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 lllltINO .
Register of Wills
1201 (g).Act of April 9.1929.P.L.343.as amended.viz:-"To receive from Registers of Wills all duplicate ,reoceiptsfortaxespaidtothembyexecutorsoradminis-trators and to·charge the Registers receiving the money
with the amount receipted for.The original of each suchreceiptshallbesignedandseededbytheRegisterofWillsandtransmittedtotheexecutororadministrator.whereupon it shall be a proper voucher in the settlementoftheestate.In no event shall the executor or adminis-trator be enlitled to a credit in his account by theRegisterunlessthereceiptissosignedandsealedbytheRegisterofWills,"
Fill in below name and address of person to whom
tax receipt is delivered:
A1TY.JA){ES J..MANnERING
444 SCHOONMAKER AVFJroE
L
MONESSEN t PENNSYLVANIA ti 1506%.--.J