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Home My WebLink AboutOC1968-0723 - ESTATE OF MOZDZEN37-117-9 ·' RCC-81 (2-64) COMMONWEALTH OF PENNSYLVANIA •DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS INHERITANCE TAX DIVISION NOTICE OF FILING OF APPRAISEMENT LUDWIK MOZDEN,JR. vVVVYVYYVYYYYYYY .(Exe~t~~) IN YOUR REPLY PLEA8E REFIIR TO In Re:Estate 0 f -'L~U~D~w~'I:::K=::~.M~O:.=Z:=D=ZEN=-'::.:__ ______W:.:..;AS:=':.:.;'H:.;:OO==.;T:.:O;.:.:N:-.-----County - FHe No.63-68-723 Dear Mr.Mozdzen: You are hereby notified that the original appraisement in the estate of Ludwik Mozdzen has been filed in the office of the Register of Wills qf Washington County on Apr;1 .3 ,19.6.9..Said appraisement reflects the following valuations: Re al Est ate _--,3u''-=O~O~O:.::.-=O;.:;O:..-_ Jt.Held ~~_....:1:J1L::J44:::t.O~."-=O=-6 _Transfers _ Total -il.....~Mw..JoO:.a..~O.lol:6---- As to such tax that is paid within three months from date of death,a five (5%)percent discount is allowable.As to any tax that remains unpaid after one year from date of death,interest at the rate of six (6%)percent per annum is charged. Any party in interest who is aggrieved by an appraisement may appeal therefrom as provided by law. Da te __-=Ap~r~i!!:..Ol~3~.-,1~9L:.6:<...49~_ DATE OF DEATH:January 15,1968 Note:This is not a bill. -;."''' R,CC-39 (6-67) 'O-AMONWEALTH OF PENNSYLVANIA. TRANSFER INHERITANCE TAX RESIDENT DECEDENT MOZDZEN;LUDWIK FILE #63-68-723 January 15,1968 SUMMARY " FILE #63-68-723 rmrOHT OF INHERITANCE TAX J\PPRAISEH I.the undersigned duly appointed Inheritance Tax Appraiser in and for the County of #63 Washington ,Pennsylvania,do respectfully report that I have appraised the real and personal property as reported in the foregoing return at the values set forth opposite each item in the last column to the right in Schedules "A","B","C"and "E". Dated:04-03-69 01-15-68 ~~~~'2:::::::'f2 /?tIe ApPRAISER REPORT.OF THE REGISTER OF WILLS I,the undersigned duly elec ted Hegis ter of Wills in and for Washington 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 ,um allowed as a deduction.~..q.. Dated:04-03-69 .U~?(/;;}ah-t-e--t~ REGISTER OF WILLS VALUE AS REPORTED VALUE AS APPRAISED VALUE AS REAPPRAISED $2,500,00 ,_$3,000.00 $_ 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) CLEAR VALUE OF ESTATE Valuation of life estates or annuities . . . . • . . . ESTATE TAX ASSESSMENTS 2,213.60 4,713.60 2,66e.30,,,,:~_ 2,045.30 '_ 4,440.06 2,668.30 ._ 1,771.76 ======1- CO~{PUTATION OF TAXFORUSEOFREGISTERONLY T ax on $._~.f5%$_---'_ Tax on $~~~~_~ Tax on !l;===1,771.7f>=~$-----=1=0~6'i'!!,.o«3~O_ T ax on $.__15%$_ Exemptions~======:_(:::) Total Estate __ TOTAL TAX $___ Less tax previously paid $~~======~~=-- BALANCE $__ Less f5%of tax if paid within 3 months after death $======:- (*)As evidenced by Charitable Exemption Certificates issued by the Secretary of Revenue. .3AI.h.1..NCE OF INHEH.ITANCE 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 $~_ TOTAL TAX BALANCE $_._ PAID $ FOR USE OF REGISTER ONLY ADJUSTMENTS 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 {Administration ~No..Year . IN THE MATTER OF THE APPRAISEMENT OF THE ESTATE OF LUDWIK MOZDZEN Deceased Late of . County of ____ DONORA WASHINGTON Commonwealth of Pennsylvania REPORT AND APPRAISAL ,., .. ! •DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS HARRISBURG.PENNA.17 1Z7 COMMONWEALTH OF PENNSYLVANIA -RESIDENT INHERITANCE TAX "APPRAISEMENT DATE ~~~~:?.I.!.9.§.9.. COUNTY ~~.~.~.~~~.J::l . FILE NO..§.J.~9..?~.7?3._..... Whereas,Ludw.ik Mo.zdz.~m late of PQnQ.~. in the County of .w~.~h~9..~Commonwealth of Pennsylvania,having died on the l5 th day of ~$.P,:w.;.r.y 19..9.lt,seized and possessed of an estate subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore,I,~.~.~..~q.h.~.~y.,an appraiser duly appointed according to law, having been designated to make a fair and conscionable appraisement of the said estate,and to assess and fix the cash value of all annuities and life estates growing out of said estate,hereby file the following appraisement: In the event that any future interest in this estate is transferred in possession or enjoyment to collateral heirs of the decedent after the expiration of any estate for life or for years,the Commonwealth hereby expressly reserves the right to appraise and assess transfer inheritance taxes at the lawful collateral rate on any such future interest. Description of Asset REALTY: 91 Allen Plan,Donora,Pennsylvania:Lot 91 of Allen's Addition to 'Donoaa as recorded in Washington County Plan Book Vol.4,page 135.118.40 x 50.Being the same pareel of land as conveyed to the above decedent by deed of Aloph Mozdzen,et al..dated JUDe 8.1946.and recorded in Deed Book Vol 720 page 182,upon which is constructed a one-story frame house. JT.HELD: Savings Acct.in the Mellon National Bank &Trust Co. Unit Values $ Appraisement Made for Inheritance Tax Purpoles 3,000 00 in the name of Ludwik Mozdzen or Mrs.Anna C.Moleski. Simplified Savings Acct.in the Mellon L~ational B~k 773.55 666.51 and Trut Co.in the name of Ludwik Mozdzen~Louis J.L.!...:.~~_~;....:.:,,--------tc-----tlt------+---1 Mozdeen.Jr. Total 1,440.06 1,440 06 I , 4,440 06 WASHINGTON County ··"ii RESIDENT INHERITANCE TAX APPRAISEMENT Estate of ....................LU.PWI.K.J1Q.ZP..ZE.N . Deceased. Late of DONORA Datc of Death,J..anu.ar.y 15.~1.96..e.,. Appraiseme/!t Docket Vol.,'J.7..:. Page,J:.L.7.~9 No ~'J.::.?~7~}. Filed in Register's Office,J:lP~.~+3..J J9 9..9. Amount of tax due,$. DEPARTMENT OF REVENUE Received, Examined and Approved,. Wrote abo.ut Appra-isement, Appeal f1'om Appraisement,. Entered and charged,. {' .. • ,'r"""f"'~'''~''';~''--~;;l:;~''Y~~r~,;:~,;';;~~~~>i,*'i'~f'''''~~~~~~~~~";~~"t2'~7rj _:......,~I ~~_.~_....~~_.~.3-=..t,.8---z:t.3 I,LUDWIK MOZDZEN,of the Borough of Donora, Washington County,Pennsylv<3,nia,do hereby make my Last Will· and Testament and revoke all Wills hereto~ore made by me. FIRST;I direc·t that my funeral expenses shall be paid by my son;Ludwik Mozdzen,Jr.,from the proceeds he will receive from the Metropolitan Life Insurance policy that has been.. issued through the American Steel &Wire Company •.I am going to make him a beneficiary of said policy so that he may use said proceeds for such purpose.. SECOND:All the rest,residue and remainder of my estate,real and personal,I give,devise and bequeath to my son, Ludwik Mozdzen,Jr.,his heirs and assigns. THIRD:I constitute and appoint my son,Ludwik Mozdzen,Jr.,as Executor of this my Last Will and Testament. IN WITNESS WHEREOF,I,LUDWIK MOZDZEN,the Testator above named,have hereunto subscribed my name and affixed my seal to this my Last Will and Testament this 29th day of September,A.D., 1964. r Signed,sealed,published and declared by the above named,Ludwik Mozdzen,as and for his Last Will and Testament in the presence of us,who have hereunto subscribed our names at his request th~reunto in the presence of the said Testator and of each other. /l i L h2~~/c:i<J.J:'/J1 (Seal) ~/;/ i. t fl fIi[ I IIII !iIIiI! ~-.." Affi~autt (@f 1fxrrutnr'(@r Abmiulstratnr ~tutr of 'rnn.aylnuniu.t 55: <!1ounty of lIu.al1ington \ Personally before me,the undersigned authority,a NQ.t:g,!;.Y.f..YP-JJ&in and for said County and State,appeared ~~.~~!~~.~.~9..~.~.E!..~~E.~who,being duly sworn according to law,deposes and says that he is the executor ~of the estate of .........1ggw.t1s MQ?.g.~.~Il:deceased,that the foregoing schedules constitute a complete inventory and appraisement of the real and personal estate of...1.y.9.Y.?Jk M9..!t..g.~.gn , 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 Executor Administrator. day..~~~:.~:~:;::~:;:~::'::~:Ftld..,Ex~·····o~····....-:-.. Donora,Washington CO'l1nty,Pa.ADDITIONAL INSTRUCTIONS •My Commissl0ll..EJD!\r-'l3 • •••1.An mventor}JaID~:it ftt11jlleU wIthm three months after appomtment of personal representatIve. 2.A supplemental in~entory 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,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 lIuueutnry nub l\pprni.aemeut of the goods and chattels,rights and credits which were of 1.Y.9!'?;h~Ng.~.g.~.~.P.:Jate of Q~E~9..~.~.. Washington County,Pa..,taken and made in conformity with the above affidavit. REAL ESTATE: 91 Allen Plan,Donora,Pennsylvania:Lot 91 of Allen's Addition to Donora as recorded in Washington County Plan Book Vol.4,page 135.118.40 x 50.Being the same parcel of land as conveyed to the above decedent by deed of Adolph Mozdzen,et.a1.,dated June 8,1946, and recorded in Deed Book Vol.720,page 182,upon which is constructed a one-story frame house DOLLARS 2,500.00 CENTS '. ~...-(1) r ..... it'"!;::l S2 <:l:~(1)it:1 ;::l,'.J 1,I ~I '.SI~::·J .,..('-.. 1:E:~c ~'I ~ ,,.~-J'I-,S3r;~J !H ~ .....1.1\..,j ," l~~I:l~~~;::l~t ~,t!,,f"'!,-.. 10 V:l ""/.l·_... ~ ..C,If:',.I ......!N ~it:1 ~~~!N ~~ I\l !tIj-,-~,i I Z 1;;',, 0 (1)I I ~, ~'~(1) ;::l.....~ r \.,-"" 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: Personally appeared 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 County,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 hereto exactly as the same was printed and published in the regular editions and issues of The Valley Independent on the following dates,May 25,1968 ITune 1 and 8.1968 Affiant further deposes and says that he is General Manager of The Valley Independent,a doily newspaper 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 and character of publica- tion are true.~J ,(0 r:--":: COPY of NOTICE f r Letters testamentary on the estate ofILudwikMOIdIenlateofDonora; wa"shington County,deceased,havingbeengrantedbytheRegisterofWash-ington County,notic~is herebY given,' Ito all persons indebted to said estate toImakeimmediatepayment,and to those Ihaving claims against the same to pre-sent them without delay to Ludwik!MOIdIen,Jr.,executor,91 TownviewAve.,Donora,Pa.,Barna and Barna, Iattorney,7th &McKean Ave.,Donora, Pa.L 5:25;6:1,8 day of -=--"=~"..=-~, My commission expires STATEMENT OF ADVERTISING COSTS: Barna and Barna,Attorneys at Law 7th &amcKean Avenue Donora,Fa.15033 TO MON VALLEY NEWSPAPERS,INC.,DR. For publishing the notice or advertisement attached hereto in The Volley Independent on above stated dates $10.00 Notary ;;$.50 Total..........................................................................$10.50 PUBLISHER'S RECEIPT FOR ADVERTISING COSTS Man Volley Newspapers,Inc.,publisher of The Volley Independent,a daily newspaper of general circulation,hereby acknowledges receipt of the aforesaid advertising and publication costs and certi- fies that the same have been duly paid. MON VALLEY NEWSPAPERS,INC. By 5/25/68,~~.PAlO '- .'("',• , ---:~Washington County Reports ~~*W~iIR~~f Wubm~oD,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: ................May 3.0.,1.9-68 . ................JJJn.e 6.~1.3.~19.6.8 .. 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,~,,,w ~h"'tt!ph'IT/;~"~ -·..=~·..........7......·......·........·····0........;......--_'---__Editor Sworn to and subs ibed before me this --------====--<:.-------_..--_... ::~:~:~~:~::?l:~:::::....::..~.~~::::::8 tv,t ry Public KATHERINE C.YARD,N YPublic Washington,Washingtr Co.,Pa. My Commission Expir,es NQvember 1,1969 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 thosehav- ing claims or demands to present them for settlement to the Executors or Admin- istrators or their Attorneys. • •• •••••••••• ••• • M:OZDZEN,LUDWIK,Dec'd. ~ate of Borough of Donora,Wash-Ington County,Penna. Executor:LUdwik Mozden Jr 91TownviewAve.,Donora,Pa:15033Attorneys:Barna and Barna 7th &McKean Ave.,Donora,Pa.15033 ........-- OFFICE OF THE REGISTER OF WILLS Form No.RCC·62 (2·641 THIS FORM REQIDRED IN ALL ESTATES WITH GROSS ASSETS UNDER $10.000.UNDER SECTION 701 OF ACT OF JUNE 16,1961,J EFFECTIVE JANUARY 1.1962.(FILE IN DUPUCATE WITH COpy OF WILL ATTACHED) ."'r}'2"o !l(.v'0"'~ County of ..J.!?~.q:!-!J.gt".'!............J)/-~/ ,.:t·k .,.:t e r'-- . ./'".................L.qy~J,...MQ?:.y~.n,.J.1 •••••••of . (Name)(Address) being duly ~~~E:~~:.according to law,deposes and says that he is the ~~_~_~~_!:~_;:.~_ ...(Exec.,Adm.,Legatee,Etc.) of the estate of 1~.<J..~i_~__~~_~_~~_~~-----whose la~t residence 'was .~J__AJ.J.~!l.J~l~!l ~_._ (No.)(Street) ___!?g_!!gE~..deceased,and that the whole of the estate of said decedent,who died ._J_~!!_~__J_?_)J2_§.8 (City,Borough or Township)_(Date) consisted of: REAL PROPERTY. REAL PROPERTY IN'PENNSYLVANIA,WITH STATEMENT OF MORTGAGE ENCUMBRAN(J;ES UPON EACH PARCEL AT DEATH OF DECEDENT, WHERE PROPERTY HELD AS JOINT TENANT OR TENANCY BY ENTIRETIES,GIVE NAMES,ADDRESSES AND RELATIONSHIP OF OTHER OWNERS. Real Estate Estimated•Value 91 Allen Plan,Donora,Pennsylvania:Lot 91 of Allen's Addition to Donora as recorded in Washington Count'y Plan Book Vol.4.page 135.118.40 x 50.Being the same parcel of land as conveyed to the above decedent by deed of Ad10ph Mozdzen,et '-# a1.,dated June 8,1946,and recorded in Deed Book Vol.720,7-AJ·:~I)I)f)"",2,~page 182,upon which is constructed a one-story frame house J9 t r;.::;.n.~·:t7f<O~-,'I , 7:l()---/£2 l!'~'...,.,.tV 4'~'" Personal Property -- J --., ~ NOTE,:You may expedite the processing of this return by filing with it,and as a part of the return, letters from financial institutions or mortgage holders,certifying to amounts on deposit or owed by the decedent as of the date of death.Such letters must be signed by a responsible officer of the financial institution or mortgage holder and indicate clearly amounts of principal and interest in the decedent's account at the date of death and the type of account,account number and the exact name or names in which the account is registered. Jointly Held Property ~.Estimate<Y]( ()'''7 .!l-1/-IA.~-:;7 .Value rav~,773:S(Sav!ngs Acco¥nt~N.92-gJ-9~~1~01 in the Mellon N?tiona1 Bank &~, .~:1n~p'I;:)"'1-/.u 7 7y'/J.r '~~,-- Anna C.Moleski 1~Trust Co pany in the name of'Ludwik Mozdzen or Mrs., Simplified Savings Account No.192-01-0811-01 in the Mellon Nationc1 Bank &Trust Companv in the name of Ludwik Mozdzen.Louis J.Ok __ Mozdzen,Jr.($1,]33.05)One-half is taxable 666.51 -Ij 7'0 /-~Cj-~'1'q j. ~!AI./y'0J,6 C Transfers within TWO YEARS Prior to Death . That at the time of death there was no safe deposit box registered ih decedent's individual name,or jointly with,or as agent or deputy of another,or in decedent's individual name,with right of access by another as agent or deputy,with the exception of the following:- NAME AND ADDRESS OF BANK OR OTHER INSTITUTION THIS SAFE DEPOSIT BOX RENTED RELATIONSHIP OF JOINT IN WHICH DECEDENT RENTED A SAFE DEPOSIT BOX IN NAME OR NAMES OF HOLDERS TO DECEDENT None . ! BENEFICIARIES BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED AGE OF LIFE (If step-children or DECEDENT TENANTS OR INTEREST OF (State full names of all and their addresses who have illegitimate children STATE YES ANNUITANTS BENEFICIARY an interest,vested,contingent or otherwise,in estate.)are involved,set OR NO AT DEATH OF IN ESTATE forth this fact.)DECEDENT Ludwf.k Mozdzen,Jr.Son Yes All 43 Townview Avenue Donora,Pennsylvania Anna C.Moleski Daughter Yes Joint savings 375 May Street Account Belle Vernon,.Pa. , ~. RESIDENT DECEDENT DEBTS AND DEDUCTIONS CLAIMED.' r-------------------------------------------------------------,. I , DEBT OR CLAIM NATURE OF SAME ,AMOUNT THIS COLUMN KEGIS'i'ER ONLY Funeral expenses paid $$ Family exemption (will not be allowed unless decedent died residingwith aspouse or children.) Administration Expenses * Counsel fees * Fiduciary commission * OTHER DEBTS AND CLAIMS (*)See Note below I , Total 43 TGnview Avenue ••••••••••••••••••••••••••••• 0 ••••••••••00'.0 ••••• ,(Street Number) ...:o9.1).~~.~-'..~~p.p~yj.,'!?'1)..~?. (City or Town and State) TEPHAflA NONACK,~Jotary <'ublig Oonara,Wasbingto~Caunty,PII, My Commi"'S;On Erpire_ Jan.2n,1973 Having been duly sworn according to law,I do .......................~/dayof . Subscribed and Sworn to before me this ~. .......~~t{,.....day o~~..,19.;' ....~..... her y certif that the above appraisement is made in conformity with law on this .·~·'lJP·~~.~~~~~.L.~~~..4 ..A,.-. ppraise} In the event that any future interest in this estate is transferred in possession or enjoyment to coZheirs of the dent after the expiration of any estate for life or for years,the Commonwealth hereby expressly reserves the right to appraise and assess transfer 'inheri- tance taxes at the lawful collateral rate on any such future interest. Note:The estate agrees to advise the Register of Wills if the amount actually paid in settlement of any fee,commission or debt is greater or less than the estimated amount claimed and allowed. I j County,Pennsylvania,do respectfully except as to those items where a greater or lesser amount sseI'aiflotI'presents the sum an;l'd as a de,duction,.,LIe:>~,..~~-~"'t't"4d.-z,,-(................................................--:0 .. Register of Wills R~GISTE I,the undersigned duly elected Register of Wills in and for rp.-<z...--f'.o-.--c-4<:"";7, report that I have allowed debts and deductions in the amou s claimed by depone is set forth in the last column to the right in said schedule a "ve,which greater Dated:4~.~/f'.~?:.. [•"''o~No.RCq,,,..,,•; ..~ WillAdministration INo Year . IN THE MATTER OF THE APPRAISEMENT OF THE ESTATE OF :.;;. .......LJJDWXL<.MQZnZEN . Deceased Late of ~.Jl~..~qr.~qgh¢..:Q9P.(P;~. County of .ti~.~q.~Ag!=~.I)................. Commonwealth of Pennsylvania .::-- REPORT AND APPRAISAL .....-- "\' ,- " c., ;.,)...~ --."--' I.t "l. Form RC C·10 DEDUCTIONS ALLOWED IN OFFICE OF THE REGISTER OF WILLS OF _W_a_s_h_i_n....l:g~t_o_n__COUNTY )I> STATEMENT OF DEBTS AND DEDUCTIONS ~'ttc'THE SUM OF $~I.:c?Q DATE APPROVED........~-:.J=~y Register of Wills,Ag""! ESTATE OF _=L,-"u;;..;;d.;..;.w;;..;;i"",k~M=..;;..o=z;..;;;d=z::....;e;;..;;ne:..-LATE OF Donora DATE OF FILING APPRAISEMENT __~__-.:::J::..----,r£~'?DATS:OF DEATH ~J~a~n~U~aO:1.r:..,;..y---o!:l....5:"':'L-...l=-9L6~8-,..._ (L.S.l INHERITANCE TAX PURPOSES. SUBSCRIBED !lEFORE ME THIS 24th---:--l6----J.~bruat¥~ DATE NO.OF NAMr;:OF PAYEE REMARKS AMOUNTVOUCH"" Paul Macik Funeral 1,Z26.00 Kurtz Monument Lettering on marker 14.00 St.Marie's R.C.Church Funeral Mass 30.00 Ludwik Mozdzen,Jr.Funeral Lunch 105.00 Ludwik Mozdzen,Jr.Telephone calls &Misc.15.00 i Memorial Hospital Final hospital bill 85.00 West Penn Power Company electric bill 12.00 Authority of Boro of Char.Water bill 4.50 Manufacturer's Light &Heat Gas bill 8.30 John Brletich 1968 Borough Real Est.Tax 13.50 John Brletich 1968 Ringgold Tax 36.75 1968 Wash.CO.RIE Tax /007T~udwikMozdzen-;-Jr.Family -exemption 1,000. Washin~ton County Reports Advertisin~Letters 12 50 ' The Vallev Independent Advertisin~Letters 10 50 Russell Marino,Re~.of Wil s Letters o~c 12 00 'R"e::cu::.11 M::n~;nn ~~H~f~t~~tl &-ApPE~~~~m~nt h nf) Barna and Barna Attorneys fee 75 00 Notarv Public Fees 2 25 2.668 10 I I i COMMONWEALTH OF PENNSYLVANIA }s.: COUNTY OF Washington I',T.lldwik Mozdzen,Jr.HEREBY CERTIFY,THAT.TO THE BE.T OF MY l<NOWLe:DGE AND BELIEF,THe:FOREGOING IS A JUST ~ND TRU E STATEMENT OF DEBTS,FUNERAL EXPENSES AND EXPENSES OP' ACMINISTRATION SUBMITTED TO THE ESTATE OF Ludwik Mozdzen DE USED,AS EDUCTIONlO FOR STEPHAitA N~N_ACK,Notary Public Donora,Waslilngton Caunty,Pa. My Cotnli':ssion Expires Jan.29,197:j