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HomeMy WebLinkAboutOC1969-0780 - ESTATE OF ELCHAKrr----------------------------------~-------------------~~~-- ' I _/ ' . PETITION SUR AUDIT Testate Form j IN THE ORPHANS' COURT OF WASHINGTON COUNTY Estate of ........... ~C!-EY. .. !?.~-~b~~---····----------------·················· .. N 63-69 ... 780 o ..... -------··--------------------·--------····-----------------··· ···-·---·------------------------·-·-------------------------------·-------------------------· Fiduciary ...... An!J.:rgw __ ~J-~h~~-•------------·-------------,---... Executor Deceased Date of Date of Decedent's death ....... N~Y ... ?..~.1 ... :t~-~~--------------------------------Grant of Letters .... ----~~D-~---~?..) .. J~§-~------------------------······ This is the .... .!.~~~~---~~~---~~~~~---·····-·-----------------------------account filed in this estate H'"' there h~vJT ~ee'"!, fc2,rm~r ac~6unts filed in, this est~t~: list file nU'mber or 9umber and ter~.-~.<?!.l.~:.X:~J-~~-~---------- -~ • ~ .I ---·-··-·--·-------··-----------·-----------------------------------------------------------·--------------------·---·----------------------------------------------------------------···· Election to take Under::oxt-.~:ins.Kw.ldk (cross out one) Not applicable Date Election Filed Place of; ----------------------------------Record ............................. . Name of surviving spouse ..... NQD.~----------------------------------··-------------------------~----L .............................................................. . List issue, where material: See under paragraph below with respect to "Legatees", and the Court's attention is called to Barbara Lee Nestor and Carol -Bedford, being the only two children of Mary Nestor, daughter of Mary Elchak, the instant deceased, which attention is for the purpose of setting forth the prior death of Mary Nestor on August lOth, 1956, prior to the date of death of her late mother, and as a result of which the two said children of Mary Nestor would t,ake their mother's share by representation. Did decedent marry after execution of will? (indicate)x"'tXeo. No. Any children born after execution of will? (indicate) XOOG. No. If answer yes, name them ................................................................................................................................ . -------·---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------· L:-eg.atees ·. . Relationship Interest Fiduciary, if deceased..Jor not sui juris • I .. '· 1 Michael' Elchak /--"'· _ son · · ~ See Will Not applicable Andrew ElchaV. ··..; · " ' IT ~ ·'-' .L. IT IT Julia ·Baker·-=...-<,......,~' ~ ', .J daughter , IT ' IT--fT ..1" John El chak , J r .___:j S"-tJ".P son 11 11 11 IT Barbara Lee Nes:tor \It,. o"'"II"V~ ~ ) grand..;:.daughter . I ) II ~ IT .u fT ' Cl:!.rol . Bedfo:bd ·\'' \,1,~u-v-~:-; ~ '"' 11 ' . •11 ·' · l ~~ 11L -'"'11, n . , ~Th~ 'a~~r~nduc~il~ren ar-e the d~ughtersj, and the orily issue of Mary Nestor,-· daughter1 of;_. Mary Elchak' deceased·,. th!e~ said' Mary Nestor having died on August 10' 1956, a late resident of Washington County, Pennsylvania.) (The above Carol Bedford was inadvertently referred to as Carol Bradford in the application of Andrew Elchak, Executor, for probate of Will, and which error is being called to the attention of the Register of Wills by affidavit of said Executor.) List, if exceptions to above: Adeemed: Revoked: Lapsed: Abated: Give Cause: None ..J If partial intestacy, give facts: None Notice to interested parties. Hove all parties, having either vested or contingent interests and all crediors entitled to notice (Court Rule No. 9 paragraph C: Section 6: SubdivisLon c) received written notice of the filing of the account and of call of audit? Yes. ~ ' ' If any exception give cause: .. J;1.9.t.. .. ~P.P.J;i,~§.Ql~ ........... . J • ..1 File copy of Notice · -S · ' and date of mailing ...... <;::.QJ?$ ••• of .. Noti.c.e .. a.t.tas::b.e.d.~ ... <anR ... $.ii!}]~---~?.~ .. !!!i?:~~~-~----?.~.X-~.l?..: .. ?~.-'---~-~-?-~---········ -·,~ ' ~, ' Is estate subject to the filing of a Federal Estate Tax Return? ......... ~~---······································································· Lj •> • ._j J ._) 0 ..... J 0 Actual payment made on Pennsylvania Transfer Inheritance Tax. Amount $ ....... 1Y:?. .•. .Q.Q ..•.. J:m.t ... :R~iD.& .. a .. .P..:r.mnpt payment, the Estate is credited with having made a payment of $360.00 on account. If the Will makes any portion of estate subject to a life-estate, give name and birth date of life tenant ..................... . ............................................................................ ~~!: .. ~J?J?..~-~-<?..~~~-~---············································································· 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. Not applicable 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: . \. I • Ci ~ ) 'J;~e ·c~:mrt' s attention is respectftlify "calfed·:t-d' the Will of the decedent which mentions ~·daughter named Mary Nestor,-who predeceased her mother oFI·August lOth; 1956; as a result of which this daughter's l/5th share passes on to her two children by representa~. ~aid two""childrert being Barbara Lee Nestor and Carol 1 Bedford, each of whom \'wuld then be etititl'ed to a 1/lOth share of-the residuary estate of the instant decedent. 'J . ~t·so happened in this particular·'Estate that there is no residuary estate for distribution·, but· the real property mentioned in paragraph SECOND of the Will and particularly-described in the Inventory and Appraisement duly filed,-is•made·subject toa char~e of $1,500, $500 of which was payable to the said Mary Nestor aboye mentioned, whicfi $5 OOd.cnarge now should be the grope.rty Qf th~ ~aid two children ot Mary Nestor, lfCIIance for astribufion per account, herelnbetore ldentlfled. Itemize any additional debits not shown by account: $ .... ~.,.?_Qg_:.9.Q .............. . Itemize a'ly additional credits not' shown by account: $ ....... NQD~---·················· 'l -l . Total additional debits (Add) ~ ._) '-> J ~, ;:.J L~ ( .j .J Total additional credits (Subtract) $ ..... None -------------------·----------- Balance .for distr.ibution $ .... ~._,_~Q.O. 00 ----------------------- If balance for distribution is not in cash, list each item held in kind, giving appraised Value (or distribution Value); The balance for distribution consists of the real property of the decedent, having an appraised value per Inventory and Appraisement filed of $9,500.00.· · ) l .-. . s_ ···'• ~~~-~ .. \,. ·~ .. If F ·1 E t· 1 · . d b p t·t· · 1 f R d· :Non~ olattmed ·by P~tit.~on. am1 y xemp 1on c a1me y e 1 1on, g1ve pace o ecor ............... · ...... -_. .. ..... !< ..... _,_. --------------------· If Family Exemption is claimed at audit, give name, relationship and basis for Claim: .. Nona.cla:iinet!. llt .. Audit 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: ItE respectfully suggested to the Court that the real property mentioned in paragraph SECOND of the Will of the decedent and which is particularly described in the Inventory and Appraisement, copy of which is made a part of this Petition, be awarded to Michael Elchak and Andrew Elchak in compliance with said paragraph SECOND subject, however, to the charge of the toti sum of $1,500 payable, as per terms of the said paragraph SECOND, as follows: $500 to be paid to and shared equally by Barbara Lee Nestor and Carol fBedford, children of the said Mary Nestor; $500 ~o be paid to Julia Baker; and $500 to be paid to John Elchak, Jr., and said amounts to remain a charge against said real property until said monies are paid. In order for the real estate to remain intact, the foregoing award of real estate should be subject to the payment of final audit costs and also any balance that may be due on Inheritance Taxes that may be owed on the testamentary assets and upon the non-probate assets, which were jointly-held assets between the decedent and her children and were reported in Pennsylvania Department of Revenue Form RCC-33, being a return of the appraisal of assets of the decedent, both testamentary and jointly-held. The Executor takes the responsibility of seeing to the payment of these Inheritance Taxes, and the surviving owners of the jointly~held assets have agreed to reimburse the Executor for their share of the Inheritance Taxes determined to be due and owing on their share of the taxable Estate. COUNTY OF WASHINGTON, SS: COMMONWEALTH OF PENNSYLVANIA. The above named Fiduciary or representative thereof, being duly ....... S.W9X'.J:l .................... doth depose and say that the facts set forth in the foregoing petition are true And your petitioner will ever pray, etc. to the best of.. _______ hj,~-----------------knowledge and belief . ........ S~Q:rJL ......... :.t. .............. to and subscribed before ~ me th;,_/__Qt_day ~~ ~~-"(,F"19LQ___ ~ "' s;9 n~ture of om.c~,:~T-~ ----------;;;;-~~~~--~;-~);~~------------ Title of Officer ... ~-;-EUZA6.m:U,JQJj_ly_~~m.N~_t_qry_P.Y.bUR......... -------------·---------··-------------------------------------------------------------·-- ;· · ... \ ;~· t..j -. .,:/ ''~ ... No. 63 ~--· ........ :: 6 9 -7 8 Q. cv _.-. ------.:··-·-"------.:---: .... ! ...................... . L [' ' r...J -~ Estate· of .. J1a.r.y. .. £l.c.hak.: ............................ . l' [' Deceased Fiduciary ........ ~~~E-~-~--~-~-~'h~~-_] ... ~?S.~E~:':.?E . l l .l: l r --------------------------------·---·r--------------:----r·---------...... PETITION SUR AUDIT. FROM WHERE DECEDENT LEFT A WILL Counsel of Fidudary will ·submit~ herewith the ~ following, in coMqrmity with Court Rules' adopted effective December 3, ·1951, being rule No. 9: parag·rapli b-e; and divisions thereof: ShOWn. On pagesL23-24. C 1. Written praecipes of all c6unsel in the case. L . [ ( ~ . 2. Copy of order appointing Guardian ad litem, if pertinent. ( -l c 3. Copy of Order oppointing-T.:r.u"sJee ad , I item, if pert.inent.i . t '' L. ~ , · ( • ~ ._ "" . ,. "":' ~ Proof of service of above. ( -Letters Testamen~tar)t or Administration C. T. A. or an .'cittest copy of Will. · Copy of invehtory: and apprais~m~nt. . ~ ,_ -c ( Proof of advertisement of•-grant of letters - if not filed with account. · r. t Certificate of liens tin case anyt of the· funds for distrjbution are from judicial sale of real estate. t l L Signed and· iten1ized elections l if an~ distribution in kind.L ~ Copy of Federal Est<;~te Tax ~return if es- tate is subject thereto. ~ o';, ' l L ' L l ~ r-·~ . i r ' l Victor Et. Riva ......................................................................................................................................... Attorney ~2 (" - l l l'. ':.!" l• l .· c : l l" I > (' - l (' 'Vd ··o~) NO.L;')N\HS'iM S '1llf,\ 3 0 H 31. S I ~ 3 U 0 N \ 1J V W ·1 T3 S S f'n! E 0 i \ U~ L; Hd~ OL '(13·· .,. j \..1-,. l ,_! - l:l ' \-\ ·it 'J ;.. '· -~ .,1' . \• 1 .. ) ~ \ I /] f. • I, lfA~Y ELCH:\K, of the "6o:rou~;h of Ch:rleroi, W:.Jshington County, Pennsylvo.r:h., 1::eing cf sound r:-tind ~.'1cl ~1cnory, do hereby ::-a!.:e, publish, £:.r.G.• declare this to be my Last Will [).nd Test~rnent, in ffi'Wner ~.nd form follm·;ing, hereby revoking P.ny 'Hill or ·,.·;ills heretofore rrw.de by r:w. FI'1ST: I direct th?.t all n~r just debts and func:r-:;1 ex;n:nses "ce fully r~id and satisfied us scon as conveniently m~y be after ~y decease. SECO~TI: I give and devise ny re~l prop~rty consisting of one lot Pennsy l v:; .. :-:ir.~, of Clv:·rleroi, for their oim :;ro~·er use :.'J!d b~nefit forever, <J.s tenc.nts il'l CO"l'TlOn su'='ject, however, "co ti_1c cinrge of f:l500.D0 to ce. p.y:;ble follo~'ling r:ry dea.th as follc'.':s: the sur., of :,;500.00 to be paid to-my daughter., ·:.:~.:~y t ,_ -"' ·"· soo o·• t · · · J.. IlC SUn OI d' ' , '-' 0 Oe p9.J.Q vO my to be paid to ~y son, JOJ:n ':::LCL\K, JJ.., of the s~·i6 };orough o:' Charleroi, ' Fnited .St::-,tes. TEI:1D: !':.11 the ::-est, residue, ,-t,ld renainder. of '~~' est:xte, re:1.l, personal, ~~d nixed, wheresoever situ~ted of ~~ich I ~~y die poss0secd cr to which I may t'e cnti-':;led :>t tl~c tiy'1~ of .T':ly cieo.th, I _;ive, devise, .,--..~d boquc:..t2-: the c::ne to my :msbr>.nd, JCEJ.: ::::LC11AI\, .f'o:r his oy,n _r:ro:::·cr u2e ,,nci ccncfit _{'ors7:::!·; ho'.vever, in the event ny Sl'l.id !msb:..nd sholtld :f'Y"edccease me or in the sve:-~t :~~~-' husbar.d :;,na I shouV becc~c decc:>.sed simult~ncously t~en in such c~se devise, and ~equ~ath ~y SBid residuary ost~te, sh~re and s~~re Rlike, u~to my five children; ~::c:ccly, .. -~~,:?.Y ?:3ST0.R, JliLIA B:\KER, JCEE ELCF ... -),K, Jl.., :~IC::'::l..:i.L ELC~U\, and AYD~~·.r ELC:t-~:.A.l\, \for the :_;r-o_Der use :u:d benefit of e~ch. \ \ \ FOUllTII: I do here·py :::~ke,~· constitute, J.nd :<p;_:;oint my hus":~cnd, JCC:: . I El.CFJil\, to be r::y Executor of t1:is my Last '.'Till Dnd Testa:nent, fJ:id in t'-·"" event my s~id husband is una~lc to so act for a~y reason ~rl:~tsoevcr, I ~~ke, .. ------··---- '-- I, l I ,.,._,~ 1 -..; --~ " --<""-, ., -~ . ti>+~~--~· '""' . ' . -~· constitute, ~mel :J.l1fOint a.s ulter:J;J.te Executors of this my L:i>.st ':'!ill ~·-nd Test- -.:ment, :.·Al.Y ];ESTCR, ;'IC:-:.'\.EL :t:tCIJ!-1~, :;J_;,.d _'\.rD:TS~.' ELCEAK, a.nd to serve in such co.p::tcity ,·fithout the require::le!1t cf filing ony bond. IE ~'fi'I'l~I:SS ~r~?·E~:.EO?, I, l~A.~Y :~LCI:IAK, the Testatrix ~._l,ove n:...-;ned, h:..ve hcret:.nto su'::scribcd :n,fi Y1o.:ne :~!id p_ffixed mv sc~l the.Q<' ~'"''' of ,Jul'.' in the ... .. . " .., ye::.r of our Lord 1954. W1JA!0 ~kk (SEAL) //-,, l''T '-~lC~l'"tlr v "".,; J.__. ........ Si0ncd, se::.led, pu::lished, :;yd decl~tred 'cy the a.'::ove r::1.med ~~!J{Y ELC~L'\J-: :-:.s ::J.nd :··or her 1.-u:.t ~-:7i 11 ::>.r:d T ~sb.mont in the presence of us, ':tho h8.Ve her-:,unto su·t>scribcd cur n~.:r,es ::.t her request :J.S '-·'.'itnessos thereunto, in the presence o: s~id Test~trix, a~d of ench othdr. /~ z!t.~ /}/ __ . # # ~-~ AJ.~IA_) " .._, ·' .. .., \ I , ~2 I PRESENT RECR'JPT W~IEN LIFTING INSTRUMENT I I I I I I j I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I j I I I N~ 12685 Washington, Pa., ....... tf:. .. ~.f.(?....:.ZF.!. ........................ l 9 ........... . ~ REC?RDER'S OFFICE RECEIV~./~·········//o····················-·····:~ ......................................................... . :::;~~;t-;:t{~~-p::::/!!!.~;~-~~::. ba '"""'"' 601J ~ Fees ............... $.................... a St t T $ .so ..... ~ .................................................................... .. ae ax.............................. ·· ·· ·(! Certificate and Seal $ ........... ~-~-~-~ '-R3"' ~ Registration Fee .... $ ................... . Sati.,action ........ l.g- Tota.l •...•.......... $.. .., .. 0 .... -State Realty Tax ... $-------------------- JOHN D. WOODWARD Recorder of Deeds ,. ....,;r~ '------------------------------------------------------~-~---------- -. l\ffibuuit ®f fxrrutnr ®r l\bmiuiatrutnr . !i!l• @'tate nf Jeuusyluauia } C!tnuuty nf 11lltan~iugtnu · . Personally before me, the undersi/ned authority, a ----~9.t:~:r;y __ p_~JJ.~----------in and for said County and State, appeared -----------~I19.!:~~---~J..£h§..~------------------------------------------------.. who, being duly sworn according to law, deposes and sa-is that he is the e~ecutor otX:xdmioisdx~ of the es- tate of ----~~Y. .. ~!~h~~---------------------------~------deceased, that the foregoing schedules constitute a complete inventory and appraisement of the real and personal estate of -------~-~¥.---~~-<?-~~~-----------• 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 bX the above named Executor A~~u. Swo~nd subscribed before me this .?.{..'2..4.} ( ··· :-: -~ 1 . . ~ ~ ~ol.~~(/ ...... r; ... ~.... ~ ... -,(~7-~~~~~i~~·~~ .................... . ?.~.~·?·····~············· ADDITIONAL INSTRUCTIONS 1. An inventory must be filed within three months after appointment of personal r·epresentative. 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, 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 3Juueutnry aub 1\ppraintmtut of the goods and chattels, rights and credits which were of ....... ~~:rY. .. f;.+~h<;t)~ ............................................. .late of ........... Cb.ar.l.er.o.i .............................................. .. Washington County, Pa., taken and made in conformity with the ab01Je affidavit. PERSONAL E S T A T E NONE REAL E S T A T E ALL that lot or piece of land situate in the Borough of Charleroi, Washington County, Pennsylvania, bounded and described as follows, to wit:,.. BEING Lot No. Two Hundred and Ninety-six (296) in the general plan of lots by the Charleroi Land Co., lying on Westerly side of McKean Avenue between Eighth and Ninth St~eet, fronting on said Avenue the distance of Twenty-two (22) feet and running back to Long Alley the distance of One Hundred {100) feet preserving the equal width of said Twenty-two {22) feet. " BEING the same lot of ground conveyed to John Elchak and Mary Elchak, his wife, by deed of Eugene J. Charles et ux., dated November 26, 1917, and duly recorded December ~th, 1917 in the DOLLARS Office of the Recorder of Deeds of Washington County, Pennsylvani , in Deed Book Vol. 449,~age 380, and upon the death of the said John Elchak on December 12, 1963, his wife, Mary Elchak, the instant decedent, became vested with an entire interest in the foregoing described premises-------------------------------------$9,500 00 CENTS j \ "' '•' •" i; " _!; A /~ ... ' 1- lJ. ,- ~63 &,'3-b?-7<;0 Inventory and Appraisement IN THE EST ATE OF .................... ~~-~Y. ... ~~-~~~-~---·····"':.· ............ "'''''' Filed 19 .......... .. ._ (.0 c·) <".::.) ::0 .):>.. l'Tl ;::, c: ~~ :...;c: G) -(.') (nU) 1\) -· -ll'TJ r-f'Tlr-OJ :or- 0-_.... m "'TJJ:> ~ <:o CJ r=;;;;=. ,__ r-o -(I) .. ttl 1'\J VICTOR E. RIVA, ESQ. P .. 0. BOX 115 CHARLEROil PA. 15022 ~-5 D~80-p~ ~?D ,---_ '- l (. ,.. ___ r ( (. v r· - l' I !""J It 1,' I I I I I I I I I I I I I I I I I I I I I I I .I I I I I STATE OF PENNSYLVANIA, WASHINGTON COUNTY, \ \.. The within named Accountant . being duly sworn according to law, deposes and says that the above account as stated is true and correct as·----------------~~---------------------verily believ~. Sworn and subscribed before me this __ cl__o__~-ci.L. £~---!{~---········ day of ........ . . & .. Warshington County, ss: ... 0 Andrew Elchak lo I do certify that I have given leg'OI notice ·to all persons concerned of the filing of the within account in the manner prescribed by Sta·turte and Rule of Court, as evidenced by proofs thereof filed to No .. h3<J0--:::k ................. . Witne s my hand and official •seal this .. d~ .......... \ ".... t ,,, . ., ~~ 38 R LJ (: c:: [:· l ! ' l ~ l'J ILJ 0 v ....,., .. ~ .. '· i•; ti \ r REG!~~Tt:R GF WILLS WASHiN;~TON CO., PA. -• l~ r; J:l'l :~ /<l1 1 M : 0 : .... :p., : Q,) : l'l co: .... >' .s N .,..,:...., t ~:<l1 .: wj ~: o: +-'! .~! >! i • ~. • !-l !J-lS!P JadoJd dsaJ S! .lJnO) a4..L --------------------------------. .. < ' ,. . , J Proof of Publication of Notice· in The Valley Independent Under Act No. 587, Approyed 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: Assistant Personally appeared before me William H. Pore, Secretory of Mon 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, July 3, 1969 July 10 and 17, 1969 Affiant further deposes and says that he is General Manager of The Valley Independent, a dolly 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 ore true. . ) ./ ~ COPY of NOTICE . Letters testameniory ·on'"fl\e estate of . Mary Elc.hak. jate..J!(-C:h.a[Jeroi, Wash-ington County, deceased, having been~ 1 gra~ted by .• .fhe .. ,Register . ., ot, Washington County, notice is hereby given to all per-· sdns indebted to. said .. estate to make Immediate .. payment,, .and.,Jo those hav-· lhg claims against the same to present I them without delay to Andrew Elchak, executor,. 813 McKean Avenue, Charle· roi, Pa. Victor E:, R_ iva, .524. Fallowlield, Avenue, Charleroi, Pa. 7;3,10,17 ---' . _. ~~,.... ... My commission expires CHARLES MNGtQII' ~!if?IJ~I'itl :'UIJiiL Mone~sen, We:;wore:and _co., Pa. M~ commission Exp1res 4auu .. rJ 71 1971 STATEMENT OF ADVERTISING COSTS: Victor E. Riva, Attorney at Law 524 Fallowfield Avenue CbarJeroi. Pa. 15022 TO MON VALLEY NEWSPAPERS, INC., DR. For publishing the notice or advertisement attached hereto in The Valley Independent on above stated dates .................. $ 10. 00 Notary ... , .... · ................................................................ $ • 75 Total .......................................................................... $ 10.75 PUBLISHER'S RECEIPT FOR ADVERTISING COSTS Mon Valley Newspapers, Inc., publisher of The Valley 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 . ""' ....-;:~ I , ~ i ~ . . . I I ,, IN THE COURT OF C OMMON PLEAS OF WASHINGTON COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION RE: ESTATE OF MARY ELCHAK, ) ) NO. 63-69-780 Deceased. ) FIRST AND FINAL ACCOUNT OF ANDREW ELCHAK 2 EXECUTOR SCHEDULE A PRINCIPAL -PERSONALTY Receipts, $ 0.00 Cash advanced by Executor to preserve in kind the real estate of decedent, 32962.4-2 ( $ 3,962 4-2 Disbursements, 3,962 4-2 $ 0 po SCHEDULE B INCOME -PERSONALTY Receipts, 0 00 Disbursements, 0 00 0 bo SCHEDULE C PRINCIPAL -REALTY Receipts, 9,500 00 Disbursements, 0 00 9,500 bo SCHEDULE D INCOME -REALTY Receipts, 0 00 Disbursements, 0 ,Q_Q_ ·-0 po Net balance for distribution, $ 9,500 bo ' l I I I I I , RE: ESTATE OF MARY ELCHAK, Deceased. SCHEDULE A PRINCIPAL -PERSONALTY RECEIPTS Per Inventory and Appraisement filed, Cash advanced by Executor to preserve in kind the real estate of decedent, DISBURSEMENTS Administration Expenses: Russell Marino, Register of Wills, p~obate of Will, Renunciation and issuance of Letters, Guy Rogers, Deputy Register of Wills, trip to Charleroi for attestation of subscribing witnesses to Will of decedent, Washington Record Company, legal advertising, The Valley Independent, legal advertising, Washington County Commissioners, zeroxcopies of Will, Bureau of Vital Statistics of Commonwealth of Pennsylvania, d~ath certificates, Russell Marino, Register of Will, filing fee of Inventory, Russell Marino, Clerk O.C., filing fee of Account, Elizabeth J. Johnson, Notary Public, notary fees to miscellaneous and allied estate papers, Andrew Elchak, Executor's commission, Victor E. Riva, estate counsel fees, Preferred Debts: Michael A. Melinchak, Funeral Director, complete funeral, St. Jerome's Church, opening grave and canopy, Msr. Michael Durisin, funeral services, Steve Levkulich, cantor services, Rev. Andrew Chura, funeral services, Expenses During Last Ill~: Dr. C. R. Perryman, X-rays at Mercy Hospital, Pittsburgh, Pa. Dr. E • .E. Costa, last medical expenses, Charleroi-Monessen Hospital, expenses for last illness, General Debts: Ladies Altar Society of the Holy Ghost Greek Catholic Church, balance on open account, Taxes: Russell Marino, Agent, c/o Inheritance Taxes: Credit received, $360.00 Less 5% discount, 18.00 Actual payment made, Malcolm L. Morgan, County Treasurer, 1969 county taxes, W. Ross Allen, Tax Collector, 1969 Charleroi Area School and Charleroi Borough taxes, Total Disbursements, $ $ 0 00 3,962 4-2 17 DO 20 DO 14-DO 10 75 3 10 9 DO 3 00 18 DO 4-25 4-75 DO 800 DO 1 ,535 4-5 80 DO 4-0 DO 10 00 50 DO 17 50 4-0 DO 237 75 3 4-2 DO 4-3 01 167 61 $ 3. 962 4-2 1,374-10 1,715 4-5 295 25 25 DO 552 62 $ 3, 962 4-2 1--· -' , • "' ~ . ~ ' RE: ESTATE OF MARY ELCHAK, Deceased . • SCHEDULE B INCOME -PERSONALTY RECEIPTS None, 0 00 DISBURSEMENTS None, 0 00 I I I SCHEDULE C PRINCIPAL -REALTY RECEIPTS . Per Inventory and Appraisement filed, $ 9,500 00 DISBURSEMENTS None, 0 00 - I I "' i ' ~ .. ~-.. . .. RE: ESTATE OF MARY ELCHAK, Decea~ed. SCHEDULE D INCOME -REALTY RECEIPTS None, 0 00 DISBURSEMENTS None, 0 00 ' I Washington County Reports 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. S, paragraphs (S) and (25). CouNTY oF WASHINGTON} SS. STATE OF PENNSYLVANIA 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 officiaJ! legal periodical for said Washington County, published weekly hav.ing its place of business at Washington, Washington County, Pennsylvania, and is acting as its agent in this behalf; that the said WASHINGTON COUNTY 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 advertisement 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.¥•••ool0., ..... 1~., .. ,.24., ..... ~9.6.9 ................ ,. 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 this id it as to the time, m and ;j_/er of the publication are true. ~. /Jv. ---=------·=····:!!!!····:::::····::::····::::····=····················· ............................................. Edit;; .... Zi4.th ..... day of ......... J.u.l.Y. ............................... , 19 ... 6..2 ....... . ............. ;.t£...--r;tLd...~.-:: ..... (1_.. ......... . .. . """''" otary Public KATHEBINE C. YARD, Notar ~bile Washington, Washington Co;, Pa. My Commission Expires November 1, 1969 Estate Notices The Register of WiJls 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 having claims or demands to present them for settlement to the Executors or Administrators or their Attorneys. • • • • • • • • • • • • • • • • • ELCHAK, MARY, Dec'd. _ Late of Charleroi, Washington Coun-ty, Penna. . Executor: Andrew Elchak, 813 Mc-Kean Ave., Charleroi, Pa. ' -· Attorney: Victor E. Riva, 524 FaJ,low• field Ave., Charleroi, Penna. -- '\ ~tt tlr~ <ttnurt nf <ttnmmnu Jlra.a nf lla.aijiugtnu <ttnuuty ®rp4aun' <ttnurt iinininu In the m!lltter of the Audit of Account in Estate of_Ma __ r~y_E_l_c_h_a_k ___________ f No.63-69-780 TO THE AUDITING JUDGE: Enter ___ m~yL..,_ ______ appearance for Andrew Elchak, Executor N. B.-Counsel shall, by separa;te paper, present a concise statement of each claim, wHh supporting calculation of any interest claimed. Objections to an account as filed, shall be concisely stated in a separate p!llper. Council suggesting proper distribution shall file a separate conci,se state- ment in that regard. J No. 63-69-780 In re Audit of Account in Esta;te of Mary Elchak -AUDIT ~ Jr~~dp:r fnr 1~ 1\pp~araur~ FOR I Andrew Elchak, Executor l .l Victor E. Riva Attorney ~2 -----' ..:.:.·. \ .. ~ ~n tift <ttnurt nf <ttnmmnn Jlltas nf llas4ingtnn <ttnuntg, Jtnnsgluania, ®rp~uns' <ttnurt Dittisinn ESTATE OF 63-69-780 No,_-=...::._~__:_~--------- Mary Elchak, In the matter of the First and Final deceased. Account of __ .:.::A:!.;n~d~r~e:.:.w!-::E::.:l:.::c::..:h~a~k:.:.._ __ _ Executor ADJUDICATION AND DECREE . And now A ril , 19 70, this matter came on for hearing, audit and distribution O't this session and testimony to en; and thereupon, upon due consideration there.Qf ~ob?>18nce for distribution in the hands of the Ac.countant. is deter~i~·ed to be $ '1, • and the account is accordingly confirmed; and 1t 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 filed sec. reg. or an appeal be taken herefrom sec. leg. SCHEDULE OF DISTRIBUTION Balance per account.------------------ Balance'---------------------- Deduct Clerk's Costs & Receipts _____________ _ Attorney Victor E. Rive Russell Marino, Clerk o. c., costs in certifyi real estate to Recorder, John D. Woodward, Recorder, costs recording ce • tification of real estate, Contribution to maints.in assets of estate in kind, To Michael Elcha.k, son, and to Andrew Elchak, on, to each an undivided 1/2 interest in parcel o real estate as hereinbelow described, said de ise subJect.·to legacy to Julia Baker, a daughter ~ $5oo.--oo and a legacy to John Elchak, Jr., a s n, in the amount of $500.00 and a legacy to Barb ra Lee Nestor, a child of Mary Nestor, a decease daughter, 1/2 of $500.00 legacy and also a legacy to Carol Bedford, a child of Mary ·Nest r, a deceased daughter, 1/2 of e $500.00 legacy; each legacy being charged upon the devise of the real estate; said real estate held in kin and distributed as such at the appraised value, _9 ____ ~ $ 9,500.00 $ 9,5oo.oo No balance J ~ 0 .... ~ ~ :J z i n• .-to• ? 0 :r ~ c (I) a 3 0 .... 0 0 .... ;: ~· ... ' .. , . ' ' '· : ~ t I '~ ) J, o,, 0 ~ ~ .. if .... N l 0' ' = '"" ' .. :r ,,I (I) ~ & s '~ ~ ~ •. REAL ESTATE TO BE CERTIFIED TO THE RECORDE OF WAS BY THE CLERK OF THE ORPHANS 1 COURT DI ISION NGTON COUNTY Mary Elchak, devisor, to Michael Elchak, de interest; to Andrew Elchak, devisee of an undi vise of the real estate being subject to legac i.e. legacy of $5oo.oo to Julie Baker; a legac Jr.; a legacy to Carol Bedford who is entitled £arbara Lee Nestor, who is entitled to $250.00 all the right, title and interest of the devis estate described as, VIZ: ALL that lot or piece of land situate Washington County, Pennsylvania, bounded isee of en undivided 1/2 ided 1/ interest; the de- es char ed on the land - of $56 .00 to John Elchak, to $250.00 and also to intere t represented is r in an to parcel of real of Charleroi, BEING Lot No. Two Hundred end Ninety-si~ (2 6) in t as follows, to-wit: general plan of lots by the Charleroi Land Co., lying on Weste between Eighth and Nineth Street, fronting on Twenty-two (22) feet and running back to tong Hundred (100) feet preserving the equal width BEING the same lot of ground conveyed to Jo e the· distance of dis ta.nce of One enty-two (22} feet and Mary Elchak, his wife, by deed of Eugene J. Charles et ux., dated No ember 26, 1917, and duly recorded December 4th, 1917 in the Office of e Recorder of DeedE of Washington County, Pennsy~vania, in Deed Bo 9, Page 380, and upon the death of the said John Elchak on Dece 963, his wife, Mary Elchak, the instant decedent, became entire interest in the forgoing described premises. CERTIFIED TO RECORDER: APRIL 3 , 1970 I '(' -.., 0 )> :I z ~ n ? n ..... ·>-[ 0 :I" c CD ~ a 3 i CD 0 0 0 ~ ::+ -CD ..... ., ~ 0 t N -~-..... :I" ~ CD = a s ~ ~ +o:), ~ ("V") ~ U) «': . ' C> -1 c.. .... ~ --' : -·-· ... _. " •C: .:a r-- . ~ ...... 0 : ~ ... <.:> -<. • ... u_ z 9 0 -!"rr: 1- L,-1 0::: I 0--.-..-.J --::: .::;::) i.t_ ......... .... L IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY, PENNSYLVANIA-- ORPHANS' COURT DIVISION RE: ESTATE OF MARY ELCHAK, Deceased. ) ) ) FILE NO. 63-69-780 TO THE HONORABLE RUSSELL MARINO, REGISTER OF WILLS AND CLERK OF THE ORPHANS' COURT: With respect to the Adjudication and Decree dated April 17, 1970 in the above matter, wherein, inter alia, an award was made to Michael Elchak and Andrew Elchak of real estate described in said Adjudication and Decree subject, however, to the payment of certain legacies mentioned in said Adjudication and Decree pursuant to the terms of the Last Will and Testament of the said Mary Elchak, deceased, I, the undersigned, as attorney for Andrew Elcha~, Executor of this said above entitled Estate, hereby certify that the above mentioned legacies were duly paid by the said Michael Elchak and Andrew Elchak, devisees of the charged real estate, and that receipts for said payments of said legacies were duly executed by the said legatees, which receipts were duly recorded in the Office of the Recorder of Deeds of Washington County Pennsylvapia, and are of record in said Office as follows: Receipt and Release of Julia Baker, dated March 21, 1970, was recorded in Deed Book 1316, Page 549; and Receipt and Release of John Elchak, Jr., dated March 21, 1970, was recorded in Deed Book 1316, Page 556; and Receipt and Release of Barbara Lee Nestor, dated March 2, 1970, was recorded in Deed Book 1316, Page 552; and Receipt and Release of Carol Bedford was recorded in Deed Book 1316, Page 545; all of said recordings being on the same date of April 30, 1970. You are respectfully requested to file this certification of the undersigned as evidence of the compliance with the Adjudication and Decree above mentioned, with respect to the payment of these legacies as reflected by the above mentioned duly recorded Receipts and ~-· Releases, whereby the said legacies ceased to be charges against such real property, and you are further respectfully requested to note on the margin of the docket where the said Adjudication and Decree appears, of the fact of the filing of this certification so as to be public notice to anyone concerned that said legacies have been paid. Respectfully submitted, Victor E. Riva, attorne Elchak, Executor - 2 - IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION RE: ESTATE OF MARY ELCHAK, ) ) ) NO. 63-69 ... 780 deceased. R E C E I P T S -------- The undersigned hereby acknowledge to have received from the above entitled Estate the items of distribution hereinafter noted opposite the names of the undersigned distributees, being the same awarded by the Adjudication and Decree of said Court in this Estate, which was dated April 17th, 1970; tee undersigned do hereby authorize and request the Clerk of said Court to enter full satisfaction of the records thereof for the items so awarded; and furthermore, the undersigned distributees h~reby make no exception to the Decree of said Court and acknowledge payment of said items listed below from the Executor and forever discharge said Executor from any claim whatsoever by reason of said payments. RUSSELL MARINO, Clerk O.C. Final Clerks' costs, $ 27.50 Receipt is hereby acknowledged this ~0 day of ajuu I , 19 o. RUSSELL MARINO, Clerk O.C. Certification of real estate to Recorder, 4-.50 Receipt is hereby acknowledged this JO day of ~ ,190. Witne~a JOHN D. WOODWARD, Recorder of Deeds Costs to record certification of real estate, Receipt is hereby acknowledged this~ day of ~&-j I Witnes~/ o.c. 7.50 ' 197 • I J. =' .., Form RCC-33 ,7" t..J-t Y -? .Po ..J:l-el.;?1-f' COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REV~NUE · BUREAU OF COUNTY COLLECTIONS j RESIDENT DECEDENT COUNTY OF .W~.~h:i,ngt.9P ................................................ . 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, unless an extension is granted hy the Secretary of Revenue. (Section 703 of th!'!_Inheritance_an!f E_state Tax Act of 19!)1.) IN THE MATTER OF THE·ESTATE OF } AFFIDAVIT OF ............................................... ~~TY.. ..... ~~-~-~-~~... ................................ ........................................... EXECUTOR (State full name of decedent) Late of .. J:.h.?.tP!.§.:r.qJ ' ... .W~?.hJ.ng:!:..QD......... County ~XMU'lt~K state of ....... Pennsylla.ni,~ ...... . ............................. }ss: County of '''' Wash:i,ngtQD...... .. ................................. . And~ew .. Elc.hak. of the estate of the above-named decedent being duly sworn, deposeS Decedent · dJed ''' Mc3.,y ' (Month) Name and address of attorney or} other authorized representative to whom all correspondence should be mailed. ....... ..... .. Es:ecutor and sayS 15022 That as such ............. ~~~.£.q:!;_Q~ ............. deponent is familiar with the affairs of said estate and the property con- < l•:x.,cu tor-A elm in istra tor) 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 NONE 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.hedu!e 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 assessed 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 decedent 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 t~hst for ' \ any other person,or persons giving also separately the accrued interest thereon, if any, do~~ to the last interest day prior to decedent's death in the case of savings banks, and to the date of d~cedent's death , , , .. , ' . C.;, .- in all other cases; al~ bond~, postal savings, treasury certificates or notes and other evidence of in- debtedness of the Unl ted States to the decedent; all obligations, whether by statute or ;greement tti"iy • r> ~ are designated as tax free, of the United States, or any state, or political subdivisio~ tbereo~ or~of , any foreign country, which are owned at the time of death; all wearing apparel, jewelry, s~l~e~ware, pic- tures, books, works of art, household furniture, horses, carriages, automobiles, boats, and, any and all other personal chattels of whatsoever kind or nature, left bydecedent, together with the fairly estimated market value thereof; all bonds and mortgae:es 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 policles 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 f'amily corporations, the values reported. are as f'ar as possible substantiated. oy f'inancial statements of' the corporations, showing the assets and liabilities thereof' as of' the·date of' death. The schedule also sets f'orth 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, f'inancial statements showing the assets and liabilities of' said co-partnership or business. A copy of' the co-partnership agreement, (if' oral, a statement setting f'orth the nature of' the agreement) together with a statement setting f'orth the character of' the business, its location, and such other f'acts pertaining to the business as may be pertinent to a f'air and just appraisal of' the decedent's interest therein must be submitted. It should also set f'orth in itemized f'orm, together with the .fair 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 f'orth a true answer to eadh inquiry contained therein and in the case of' transf'ers of'property, real or personal, within two years of' decedent's death, in contemplation of' decedent's death, or intended to take ef'f'ect in possession or enjoyment at or af'ter death, said schedule sets f'orth the nature and value of' such property, to whom transf'erred, the relationship of' the transf'erees to the decedent, the proportionate share received by each transf'eree and all other f'acts of' a pertinent nature regarding said transf'ers. In~the case of' transf'ers intended to take ef'f'ect in possession or enjoyment at or af'ter 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 f'orth in said r ., schedule a list of' all property, real and p~r:s.onal, 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- *l&tt-vested in decedent, either' indlvfdually o~ 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 benef'icially 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 benef'iciaries f'or lif'e under decedent's Will. It also contains a statement showing which of' the benef'iciaries named in the decedent's will, if' any, died prior to decedent, the dates of' their death, their issue, and the reiationship of' such issue to the benef'iciary. That Schedule E attached hereto and made a part hereof' sets f'orth all property, real and per- sonal, owned by the decedent jointly with another or others, including intangible, standing in the name of' the decedent and others, plus the date and place of' record of' instruments ef'f'ecting the vestiture of' real estate and the date of' acquisition of' personalty, plus the name, address and relationship, if' any, of' co-owners to the decedent. That Schedule F attached hereto and made a part hereof' sets f'orth f'ully and in detail all debts and deductions claimed f'or and on behalf' of' this decedent's estate, including f'uneral expenses paid; f'amily exemption, where applicable; costs of' administration of' this estate; counsel f'ees and fudiciary's commissions paid or to be paid; cost expended f'or burial trusts, tombstones or gravemarkers, and reli- gious services, in consequence of' the death of' the decedent; debts and claims owing and. unpaid at time of' ~ ' death; taxes accrued charge.able f'or 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 f'or obliga- tions, if' any. It is agreed that the f'iduciary will present proof' of' said claimed obligations upon re- quest, that if' the amount actually paid in settlement of' any f'ee, 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 f'orward and properly registered in the Summary. Subscribed and sworn to before me this a?.J...~ ~/--~~ . .................................................................. _.,, ...... -.. . ......................................... , ....... dayof~~--------19 .. Gzl .. ~;~ZAsETHi: iOHNSON,Nntary ~Yilil············-~:~~:;~;~ ---------- CHARLEROI. WASHIN@rON €@,, ~A: ................ Ol:~_;r.+._~_r,_q_j___. __ .. P..eDDS.ylv_ania ........... ~ ................ . MyCommissionexpirtitiApfil~g, i§7~ (City or Town and State) NOTE: Bef'ore signing af'f'idavit make sure all blank spaces in the af'f'idavit and schedules annexed are f'illed in with details or the word "None", and in case the assets include rare and unlisted securities, securities of' close or f'amily corporations or an interest in any co-partnership or business, that the data and statements required under the paragraph above relating to Schedule "B" are attached. Also make certain that column #1 in the "Summary" has been properly completed as above-directed. RCC-34 (1-64) COMMONWEAL''fH OF PENNSYLVANIA DEPAR'iMENT OF REVENUE 'BUREAU OF COUNTY COLLECTIONS TRANSFER INHERITANCE TAX RESIDENT DECEDENT SCHEDULE "A" -REAL PROPERTY 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 Schedule "~". Property ht:'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 In the Commo!lwealth of Pennsylvania should be described by lot and block number, street and street number, together wl th 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 not be deducted from this schedule. ALL that lot or piece of land situate in the Borough of Charleroi, Washington County, Penn- sylvania, bounded and described as follows, to wit:-BEING Lot No. Two Hundred and Ninety-six (296) in the general plan of lots by the Charleroi Land Co., lying on Westerly side of McKean Avenue between Eighth and Ninth Street, fronting on said Avenue the distance of Twenty- two (22) feet and running back to Long Alley the distance of One Hundred (100) feet preserving the equal width of said Twenty-two (22) feet. BEING the same lot of ground conveyed to John Elchak and Mary Elchak, his wife, by deed of Eugene J. Charles et ux., dated November 26, 1917, and duly recorded December 4th, 1917 in the Office of the Recorder of Deeds of Washington County, Pennsylvania, in Deed Book Vol. 449, Eage 380, and upon the death of the said John Elchak on December 12, 1963, his wife, Mary flchak, the instant decedent, became vested with (1) ASSESSED VALUE FOR YEAR OF DECEDENT'S DEATH an entire interest in the foregoing described premises~----------------------------------------$ 2,515.00 Insert this total opposite "real property", Schedule "A'' in the X X X X X "As Reported" column on th·: last page of this return. (2) (3) DEPARTMENT VALUATION ESTIMATED CAUTION MARKET VALUE (Do not write In this space) $ 9,soo.ooJ~· $ 9,500.00 I RCC-35' 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 accrued 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 ITEM UNIT ESTIMATED DEPARTMENT VALUATION NO• List and describe fully VALUE MARKEl' VALUE (Do not write in this space) NONE NONE Insert this total opposite "Personal Property", Schedule "B" in X X NONE the "As Reported" column on the last page of this return. ·RCC-3& CO\n!O:\'I'T<:\LTH OF PENNSYLVANIA T!L\SSFFR INHERITANCE TAX RESIDE~T DECEDENT SCHEDULE "C" TRA.NSFERS (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)~n_o~--- (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) no (3) If the answer to (1) or (2) above is in the affirmative state: (a) Age of decedent at time of transfer not apolicable (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) no (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 Inake any transfer without receiving a val_u_a_b_l_e_a_n_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) __ n~o~------ (b) The right to designate the persons who shall possess or enjoy the property transferred or income therefrom? (Answer yes or no) __ n~o~----- (6) If the answer to (5) (b) above is in the affirmative, state whether the right was reserved in decedent alone or others not applicable (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) --~n~o~---- (8) Did decedent, at any time, transfer property, the beneficial enjoyment of which was sub,ject 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) no (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) not applicable 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 NONE DEPT. VALUATION (Dept. Only) Rcc ... &s · ·-· CCMMONWEt\LTH OF PENNSYLVANIA THANSF'Ell INHERITANCE TAX PiliSIDENT DECEDENT SCHEDULE "E" JOINTLY OWNED PROPERTY I:NSTRl'CTIOI\'S: This schedule must disclose all property, real and personal, owned by the decedent 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 under 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 ~tate valuation column. Personal property should be listed as in Schedule "B", plus date of' acquisition, and the name, address and relationship (if any) of' co-o-wners to the decedent. Description of Property, Date of Acquisition, Name l Unit Address and Relationship of Co-Owners, and Place Value of Record of Instrument, where Real Estate. 1 1. Savings Account # 64~20706 at Mellon National Bank and Trust Company of Charleroi, Pennsylvania, in the joint names of Mary Elchak, the within dece- dent, and her daughter, Julia E. Baker, which account was opened March 6, 1964, and balance on date of death of Mary Elchak is in the amount of $381.12, 1/2 of which is being herewith reported for Inheritance Tax purposes--------------- 2. Savings Account # 10021 at First National Bank, Charleroi of Charleroi, Pennsyl- vania. in the joint names of Mary Elchak. the within decedent, and her son. Andrew Elchak, which account was opened March 5, 1964, and balance on date of death of Mary Elchak is in the amount of hl/7.)7$~~3.00. 1/2 Qf which is being here- with reported for Inheritance Tax 3. 4. purposes------------------------------- Savings Account No. 6473 at Pittsburgh National Bank, Charleroi, Pennsylvania, in the .i oint names of Marv Elchak, ghe within decedent, and her son, Michael Elchak, which account was opened March 5, 1964, and balance on date of death of Mary Elchak is in the amount of $793.01, 1/2 of which is being here- with reported for Inheritance Tax purposes------------------------------- Savings Account # 11185 at Pittsburgh National Bank, Charleroi, Pennsylvania, in the joint names of Mary Elchak, the within decedent, and her son, Andrew Elchak, which account was opened August 3, 1945, and balance on date of death of Mary Elchak is in the amount of $3,931.79, 1/2 of which is being herewith reported for Inheritance Tax purposes-------------------:----------- SEE ATTACHED SHEETS ' percentage Estate DEPARTMENT VALUATION CAUTION-Do not Write In This Space. Share Valuation Value of Entire Property s-s1. iV' 11#, ~cxr, ' 396.5 I 1,965.9~~ I I i I I I Value of Decedent's Interest Page 1 ----~----------~~~~--------------------~----~----------~--------+-----~--~------+-----------Insert this total opposite "Jointly Owned Property", Schedule "E$3 ,114. 4i in the "As Reported" column on the last page of this return. ·· ---·-----Sub-t-ct-al---earried--over--t-c---Page--2-· ··-----· ····---·-·--· --·-----··-----------------·-------·-·---- \ .----------------------------- COMMONWEALTH OF PENNSYL VAN lA R DEPARTMENT OF REVENUE ·~~OUN ·~~%~~1\lfo HARRISBURG .. , . rr;cOfil/ O.F ·.lf. (.fer Jtit!N in ~ c :.· ,·, t!R~s RCC-43 (5-65) NOTE: TO BE SUBMITTED IN TRIPLICATE Pennsylvania Department of Revenue Bureau of County Collections 26 S. 4th Street Harrisburg, Pennsylvania Dear Sir: June 2G, 19(,9 It 'J'fJU j) ;... '·-2fJ.JA.U. '&JJ C':) 11'l'f1 ~ b'i/.J Pursuant to Section 742, Pennsylvania Inheritance and Estate Tax Act of 1961, we herewith submit the following report: NAME OF REPORTING FINANCIAL INSTITUTION Fl: .f NATiu:.:t~L BAm~, Llt'\. :...c :oi ADDRESS • .~. B-• 97. Cifth .~t •• -.,1t.."lrler:oL ,ln. 150?.?. ACCOUNT NO. OF JOINT, TRUST OR INVESTMENT DEPOSIT_·_'a_v_in~t~:...;.c_"....:l;...:.0..:..02::..:1:__ ________ _ NAMES ON ACCOUNT ORINVESTMENT _______ :_t\_.:Y __ u_,._1_\N_D_.,_L._:_:.~L~_·,_~_K __________ =--------z - DECEASED JOINT DEPOSITOR, f7 TRUSTEEORINVESTOR ___ :_~_.Y~l~_·c....:aL::..:~~·~-~~~---------- ADDRESS ____________ J_l_a_:_~_:~_a_n __ ·~ __ n_u_c_,_~_~w_r_l_c_~v_i_, __ rc_. ___ ls_o_2_2 ____ __ DATEOFDEATH ·~1Y 29, 1069,/ SURVIVING DEPOSITOR, ,\!~ &-d ··-• ~ ..• .~\...11 ·/: BENEFICIARY OR INVESTOR---------------- ADDRESS ___ -_~l_~_._c_~_~o_n __ ~v_c_'n_u_c~,-~_M_r_l_c_~0-i~,---'a....:. __ ~l5~0~2~2--------------- RELATIONSHIP TO DECEDENT.~_o_n _____________ _ DATE DEPOSIT OR INVESTMENT WAS ESTABLISHED __ .. _.::lr_c_h--=-5 •:...._:1..:..~o..:...4.;.__ ____________________ _ BALANCE, INCLUDING INTEREST DUE, AT DATE OF DEATH $_1.:;_, l_l_J _. 2_7----'\--#------:!::-------- C.\ :uc: TITLE I /£ RCC-134 (8-65) COMMONWEALTH OF PENNSYLVANIA DEPAifrMENT"C>F REVENUE ·BUREAU OF COUNTY COLLECTIONS INHERITANCE TAX DIVISION -OFFICIAL NOTICE OF INHERITANCE TAX APPRAISEMENT AND ASSESSMENT OF - ASSETS NOT SUBJECT TO ADMINISTRATION TO: ANDREW BLCHAK 813 )fcKEAN AVENUE Date: _ __.,Ju.Uu.t,~-~.V_g.S'~-, ....,.lL-:9;u;b~9L------ County __ l_'lA_S_Il_I_NG_T_O_N _____ _ CHARLEROI, PENNSYLVANIA 15022 ----County File No. _________ _ Bureau File No. _________ _ We have received notice th~t, ~!~~~~~~~~~~~~~~~~~~~~~~~~~~~ on )fAY 29 • 19~, you came into owners ip o certain property t roug · transfer from MARY ELCHAK, DECEASED. Under the Inheritance and Estate Tax Laws of the Commonwealth of Pennsylvania such transfers are taxable and the liability for the payment of the inheritance tax due is imposed upon you, as transferee. The property on which tax is hereby ass.essed consists of: Jt. Say. #10021 held in the FIRST -NATIONAl, BANK, CHARLEROI,· PENNA. , in the names of MARY or ANDREW EI.CHAK. Opened 3·5~64. Balance as of date of death, $1~119.27 appraised by the Commonwealth, as of the date of death, at$ 1,119.27 50 %of this amount is taxable at the rate of 6 % DATE OF ASSESSMENT TAXABLE AMOUNT LESS: ALLOWED DEBTS NET TAXABLE AMOUNT AMOUNT OF TAX DUE 0 If you pay the above amount within three (3) months of the date of death of the decedent, or on or before Aug. 29 19 69 , you may deduct a discount of 5% of the amount of tax due, or 0 This tax became delinquent one year after the date of death of the decedent and, in addition to the tax, statutory interest at the rate of 6% of the tax per annum is also due as of*-------- 19 in the amount of *If the tax is not paid by the above date additional interest is due at the rate of 6% per annum until paid TOTAL AMOUNT DUE ORIGINAL ASSESSMENT AMENDED ASSESSMENT $ _ ___.SoL>5.t.o;9U•.li.l64~-· $--------------- 35.98 $ APPRAISED BY, o-)£ <A--" -- (Inheritance Tax Appr er) 35. 98 $ -=;:::=======·· ASSESSED BY: ----.\....L-~~-4(J:.L-a-4....:.ll:·<:.....c';....:;.4.::.::.:..-~--e.~:...L..!oo:=.il-'-=~·~::;:::;.;::;o-.d'---­(A~ent for the Commonwealth) INSTRUCTIONS TO TAXPAYERS Make checks or money orders payable to: (over) To insure proper credit to your account this Official Notice must accompany your payment. Mai I or bring it to: 'K~JIAL\~ .; uNifllONWEALTH n ... ~ .. • -"'co~JRT .. HOUSE . WASHINGTON •. PENNA. ·-1530JI If you have already paid this tax to an executor, administrator, attorney or other personal representative of the decedent for forwarding to the Commonwealth, list below the date pai.d, name _and ad~ress of the person to whom you made payment, their official title and the amount. ~ Date Paid Name and Address of Payee Official Title Amount Paid Under certain circumstances, if, after the date of death of the decedent, you personally paid funeral expenses or other just debts of the decedent, with funds derived from the property herein taxed, such amounts expended by you may qualify as deductions against the gross value of the property in the computation of tax due. If any such expenditures meet all of the three following tests, it is recommended that you itemize the payme~ts below, execute the affidavit, and return this notice. The Register of Wills will examine the debts claimed and allow those which he determines to be proper. The tax will then be recomputed and you will receive an amended assessment of tax. THE THREE TESTS WHICH MUST BE MET ARE THAT: 1 -You were personally legally responsible for these debts, and 2-You actually paid these debts out of the account or property described above and can furnish proof of such payment, if required, and 3-These same debts are not also claimed, for tax purposes, by an executor, administrator or other person.al representative of the decedent handling the administration of the general estate of the decedent or any other transferee. SCHEDULE OF DEBTS Date Paid Name of Payee Description of Obligation Amount Paid TOTAL $ (attach separate sheet if required) COMMONWEALTH OF PENNSYLVANIA) SS: COUNTY OF: _______ _ I, hereby certify that the foregoing is a just and true statement of funeral expenses and other debts of the decedent, , for which I was legally responsible and which I did pay out of the property herein taxed. I further certify, that to the best of my knowledge and belief, these same debts will not be claimed by any other person, for inheritance tax purposes. SWORN AND SUBSCRIBED BEFORE ME THIS ___ DAY OF ________________ 19 __ Signature of Taxpayer REPORT OF REGISTER OF WILLS I, the undersigned, duly elected Register of Wills in and for the above county, do respectfully report that I have allowed deductions listed above in the total amount of$--------.. Date of Approval: ______________ _ Register of Wills .. RE: ESTATE OF MARY ELCHAK, Deceased. "SCHEDULE E11 JOINTLY OWNED PROPERTY Sub-total carried forward from Page 1---------------------------$ 3,114.4 14 I. The following;Series E US Savings Bonds were issued in II. the joint names of Mrs. Mary Elchak, the within decedent, and her daughter, Mrs. Julia Baker: a. b. c. d. e. 9 $25 bonds issued for the period from June through November, 1945, having a redemption value each in the amount of #39.65, for a total redemption value for the 9 said bonds in the amount of $356.85, 1/2 of which amount is being herewith reported for Inher.- it$~~~ ~~~d p~~~~=~ s ;;~~;;;~;;~;~;~£~~;-J~~~,Ji~~;;;---------$ ~xKmmR~~xl~~i~ having a rede~ion value as of the date of death of Mrs. Mary Elchak, the within de- cedent in the amount of $79.30, 1/2 of which amount is being herewith reported for Inheritance Tax purposes~--­ ! $50 bond issued ~x~~l§X~l§*~:l§gxf*~ March, 1964, having a redemption value as of the date of death of Mrs. Mary Elchak, the within decedent, in the amount of $45.08, 1/2 of which amount is being herewith reported for Inheritance Tax purposes------------------------------------------------ 1 $100 bond issued March, 1964, having a redemption value as of the date of death of Mrs. Mary Elchak, the within decedent, in the amount of $90.16, 1/2 of which amount is being herewith reported for Inheritance Tax purposes----- 2 $500 bollds, both issued March, 1964, having a redemption value~§CHf the date of death of Mrs. Mary Elcha\, the within decedent, in the amount of $450.80, for a total redemption value for the 2 said bonds in the amount of $901.60, 1/2 of which amount is being herewith reported for Inheritance Tax purposes-------------------------------- The following 17 Series E US Savings Bonds were issued in the joint names of Mrs. Mary Elchak, the within decedent, and her son, John Elchak Jr.: a. 1 $100 bond jssued July, 1944, having a redemption value as of the date of death of Mrs. Mary Elchak, the within decedent, in the amount of $163.84, 1/2 of which amount is bejng herewith reported for Inheritance Tax purposes----- b. 9 $25 bonds issaed for the period from January through May, 1945, having a redemption value each as of the date of death of Mrs. Mary Elchak, the within decedent, in the amount of $40.29, for a total redemption value for the 9 said bonds in the amount of $362.61, 1/2 of which amount is being herewith reported for Inheritance Tax purposes----- c. 2 $25 bonds issad December, 1945, having a redemption value each in the amount of $39.33, for a total redemption value of 2 said bonds in the amount of $78.66, 1/2 of which is being herewith reported for Inheritance Tax purposes-------- 178.4 39.6 39.3 bf.- Sub-total carried over to Page 3 $ 4,153.5 Page 2 . ' RE: ESTATE OF MARY ELCHAK, deceased. "SCHEDULE E" JOINTLY O~~ED PROPERTY (CONTD FROM PAGE 2) Sub .... total brought forward from Page 2------------------------$ 4,153.'53 . t<.. d. 2 $25 bonds issarl March, 1964, having a redemption value each as of the date of death of Mrs. Mary Elchak, the within decedent, in the amount of $22.54, for a total redemption value for the 2 said bonds in the amount of $43.08, 1/2 of which is being herewith reported for Inheritance Tax purposes-------------------------------- e. 1 $100 bond isseed March, 1964, having a redemption value as of the date of death of Mrs. Mary Elchak, the within decedent, in the amount of $90.16, 1/2 of which is being herewith reported for Inheritance Tax purposes---------- f. 2 $500 bonds isseudd March, 1964, having a redemption value each as of the date of death of Mrs. Mary Elchak, the within decedent, in the amount of $450.80, for a total redemption value for the 2 said bonds in the amount of $901.60, 1/2 of which is being herewith reported for Inheritance Tax purposes~------------------------------ III. The following 17 Series E US Savings Bonds were issued in the joint names of Mrs. Mary Elchak, the within decedent, and her son, Michael Elchak: a. b. c. d. e. f. 1 $25 bond issued December, 1945, having a redemption value as of the date of death of Mrs. Mary Elchak, the within decedent, in the amount of $39.33, 1/2 of which is being herewith reported for Inheritance Tax purposes----------- 5 $25 bonds issued for the period from June through May, 1946, havinga redemption value each as of the date of death of Mrs. Mary Elchak, the within decedent, in the amount of $39.33, for a total redemption value for 5 said bonds in the amount of $194.65, 1/2 of which is being herewith reported for Inheritance Tax purposes---------------------- 4 $25 bonds issued fnn the period from June through November, 1946, having a redemption value each as of the date of death of Mrs. Marv Elchak, the within decedent, in the amount of $38.70, for a total redemption value for said 4 bonds in the amount of $154.80, 1/2 of which is being herewith reported for Inheritance Tax purposes------------- 1 $25 bond issued April. 1958, having a redemption value as of the date of death of Mrs. Mary Elchak, the within decedent, in the amount of $28.26, 1/2 of which is being herewith reported for Inheritance Tax purposes------------ 1 $50 bond issued December, 1957, having a redemption value as of the date of death of Mrs. Mary Elchak, the within decedent, in the amount of $57.70, 1/2 of which is being herewith reported for Inheritance Tax purposes------------- 2 $100 bonds issued December. 1957, having a redemption value each as of the date of death of Mrs. Marv Elchak, the within decedent, in the amount of $115.40, for a total redemption value for 2 said bonds in the amount of $230.80, 1/2 of which is being herewith reported for Inheritance Tax purposes--------------------------------- Sub-total carried over to Page 4 Page 3 22.54 45.08 /( 45o.8o · ~r( 19.67 6/( 97.33 , . ol< I 77.40 r /< 14.13 . f< 2R.85·o'C 115.40 RE: ESTATE OF MARY ELCHAK. Deceased. "SCHEDULE E" JOINTLY OWNED PROPERTY (CONT'D FROM PAGE 3) Sub-total brought forward from Page 3-~~--------------------$ 5,024.73 /(_ g. 1 $200 bond issued December. 1957, having a redemption value as of the date of death of Mrs. Mary Elchak, the within decedent, in the amount of $230.80, 1/2 of which is being herewith reported for Inheritance Tax purposes-115. ~0 /)t< h. 1 $200 bond issued March, 196~, having a redemption value as of the date of death of Mrs. Mary Elchak, the within decedent, in the amount of $1A0.32, 1/2 of which is being herewith reported for Inheritance Tax purposes----------- i. 1 $500 bond issued March, 196~, having a redemption value as of the date of death of Mrs. Mary Elchak, the within decedent, in the amount of $~50.80, 1/2 of which is being herewith reported for Inheritance Tax purposes-.----------225. ~0 p({ IV. The following 52 Series E US Savings Bonds were issued in the joint names of Mrs. Ma~y Elchak, the within decedent, and her son, Andrew Elchak: a. b. c. d. e. f. g. 1 $25 bond issued November, 19~5, having a redemption value as of the date of death of Mrs. Mary Elchak, the within decedent, in the amount of $39.65, 1/2 of which is being herewith reported for Inheritance Tax purposes-------------19.83 5 $25 bonds issued from the period from June through November, 19~6, having a redemption value each as of the date of death of Mrs. Mary Elchak, the within decedent, in the amount of $38.70, for a total redemption value for 5 said bonds in the amount of $193.50, 1/2 of which amount is being herewith reported for Inheritance Tax purposes-·--96.75 9 $25 bonds issued for the period from Janaary through May, 19~7, having a redemption value each as of the date of death of Mrs. Mary Elchak, the within decedent, in the amount of $38.08, for a total redemption value for 9 said bonds in the amount of $3~2.72, 1/2 of which amount is being herewith reported for Inheritance Tax purposes---171.36 9 $25 bonds issued for the period from June thourgh Novem- ber, 19~7, having a redemption value each as of the date of death of Mrs. Mary Elchak, the within decedent, in the amount of $37.~7, for a total redemption value for 9 said bonds in the amount of $337.23, 1/2 of which amount is being herewith reported for Inheritance Tax purposes-----------------------168.62 2 $25 bonds issued December, 19~7, having a redemption value each as of the date of death of Mrs. Mary Elchak, the within decedent, in the amount of $36.87, for a total redemption value for 2 said bonds in the amount of $73.7~, 1/2 of which is being herewith reported for Inheritance Taxex purposes---36.87 6 $25 bonds issued for the period from January thnough May, 19~8, having a redemption value each as of the date of death of Mrs. Mary Elchak, the within decedent, in the amount of $3~7., for a total redemption value for 6 said bonds in the amount of $221.22, 1/2 of which is being herewith reported for Inheritance Tax purposes------------------------------110.61 7 $25 bonds issued from June through November. 1948, having a redemption value each as of the date of death of Mrs. Mary Elchak, the within decedent, in the amount of $36.29, for a total redemption value fnr 7 said bonds in the amount of $25~.03. 1/2 of which is being herewith reported for Inheritance Tax purposes-----------------------------------127.02 Sub-total carried forward to Page 5 $ 6,186.75 Page 4 !< 1<- ,~ I( " ' ... RE: ESTATE OF MARY ELCHAK, Deceased. "SCHEDULE E" JOINTLY OWNED PROPERTY (CONT'D FROM PAGE ~) Sub~total brought forward from Page ~--------------------------$ 6,186.71 h. l $25 bond issued December, 19~8, having a redemption value as of the date of death of Mrs. Mary Elchak, the within decedent, in the amount of $35.72, 1/2 of which amount is being herewith reported for Inheritance Tax purposes--------------------------------------------------- i. 8 $25 bonds issued for the period from January through May, having a redemption value each as of the date of death of Mrs. Mary Elchak, the within decedent, in the amount of $35.72, for a total redemption value for 8 said bonds in the amount of $285.76, l/2 of which is being reported for Inheritance Tax purposes---------------- j. 3 $25 bonds issued from June through November, 19~9. having a redemption value each as of the date of death of Mrs. Mary Elchak, the within decedent, in the amount of $35.91, .for a total redemption value for 3 said bonds in the amount of $107.73, 1/2 of which amount is being herewith reported for Inheritance Tax purposes-~---------------------------------- k. 1 $50 bond issued June, 1955, having a redemption value as of the date of death of Mrs. Mary Elcha, the within decedent, in the amount of $59.56, b/2 of which is being herewith reported for Inheritance Tax purposes~---------------------- 17 .8f ct.. 1~2 .81 rf 53.8 tt 29.71 Ol( !Utal jointly owned property-----------------------------------$ 6,~3l.lL ~.(I' &. </J.7 J. ;, Page 5 ( h RCC-37 (12-6)) COMMONWEALTH 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) Michael Elchak 813 McKean Avenue Charleroi, Penna. Andrew Elchak 813 McKean Avenue Charleroi, Penna. Julia Baker Shafer Avenue Maoleview Speers , . Penna . John Elchak Jr. 4303 Selkirk Drive Fairfax, Virginia Barbara Lee Nestor 680 s_ MorenQ:o Aot 16 Pasadena, California r;:~l"'l BN!ilfnl"'d 36 Green Road, Knock Belfast 5. North Ireland (The above two Q:randchildr dau~hter of Mary Elchak, I~S6, Cl LClLt:: r•t::::;..LUt::nL U.l 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 yes no.:r app.L~-cable See Will no-r app_n- son ves cable See Will ;; "7" ..: --· .. daughter no.;r: appL~-See Will ves cable not app_u- See Will son ves cable no~ app.L~- SPP Will grand-dauQ:hter ves f'able grand-dauQ:hter ves not app.L~-r;:~hlo C:"'o w; 11 en are the dam hters an [ the onlv lssue of Marv Nestor deceased, the ~ aid Marv ~ester havir g died on August 10, 'IIIClSTI..Lilgl:Oil L.OUT :LV, t't::llll:::> r.Lvan~aJ. Deponent further says that all the above-named beneficiaries are living at this time except below: NAME DATE OF DEATH RESIDENCE NOT APPLICABLE Will Administration ! No. 1ft? Year ... ?/ ....... D< THE :\lATTER OF THE APPRAISEMENT OF THE ESTATE OF Ma.ry . .Elchak Deceased Late of. Char' :L eJ:'()i ............ . County of Washington Commonwealth of Pennsylvania REPORT AND APPRAISAL Sll'''.'; .:l0 H"USID31.l ONitl':ll Tl.:lSS:l'tl ,;;. ,......_, ,. -"· -·~ ;.t,, ("'? r.l, ·, \. ~ ct Z£ ): "~ IIY •. .... '""''. VICTOR .E. RIVA, ESQ, 1 P. 0. BOA J..l~, I I , CHARLEROI~ 'el-.:.iso22 jJ _, (Executor-Administrator must complete "As Reported" column #1.) 0 '"1 0 Vl Vl ...., ~ X ~ C"' (b tr1 Vl ..... ~ ..... ~ :I ~~~ \'"' ~ ~ ~ ::I -Vl ...,.., '"d ~ '"1 ;;l .g . ~ . '"1 ~ ~ '< ~ :~ )-., :~ ~· U'J :(,\ : c: ~· ~ ~ '"-~ > . : " : :::0 ;....._ A.-.;....._ >-<: U'J U'J U'J F3-l(") ?--0 : > :::: :::: :::: -oo-oo-oo-oo-oo-oo .00 .00 -oo .00 '"\_~ . '~! ·~· :~. ·~· '\). * .00 > Vl :::0 ~­'0,_ 0~ '"1 ..... (1) c.. .~ ,,.._> ., ~' '::r. ~~¥ ~: ~ 2''N ~•a3~ ~ 0 ~­ ~o.=: I R C C-81 (2-64) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS INHERITANCE TAX DIVISION NOTICE OF FILING OF APPRAISEMENT ANDREW ELCRAK IN YOUR REPLY PLEA8£ REFER TO 37-237-4 In Re: Est ate of _____ --~.MA~R~Y=---=EL~C~H~AK!:!.,!,_ _______ _ _______ WILAwS>l.IH.....-I~o.~.;Nilo.!Gu.T.loi:ONa.._ ___ County -File No. 63-69-780 Dear Mr. Elchak: You are hereby notified that the original appraisement in the estate of Mary Elchak has been filed in the office of the Register of Wills qf Washington County on September 15 , 19_£9, Said appraisement reflects the following valuations: Real Estate ______ .....:9...:.'..:;.5_0_0_._00 __ _ Jt. Held Personal Property ___ ~~~~~--~----------~~6~,~4~29~-~2~8~--- Tot a l ----------------=1::...5:.....z,~9.:::.29L..;.::...:2::..:8;___ __ _ 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. Date ____ ~S~ep~t~e~mb~e~r~l5~,~1~9~6~9 ____ Signed.h::.f' ~:z J2-.7hj,e Title W.R. CHANEY, F APPRAISER DATE OF DEATH: May 29, 1969 Note: This is not a bill. I RCC•39 (!1-68) COMMONWEALTH OF PENNSYLVANIA' TRANSFER INHERITANCE TAX RESIDENT DECEDENT SUMMARY Estate of ELCHAK, MARY DATE OF DEATH _ _o<.5_:-2=..9~--=6;.L-9_FILE NO. 63-69-780 (Last Name) (First Name) (Initial) REPORT OF INHERITANCE TAX APPRAISER I, the undersigned duly appointed Inheritance Tax Appraiser in and for the County of 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: ____ 0:::..5<---.!2""'9~..,.~6~9~---- 09-15-69 ,da £ ~ Q.__ '2, ~ .INHERITANCE T APPRAISER (/ REPORT OF THE REGISTER OF WILLS I, the undersigned duly elected Register of Wills in and for County, Pennsylvania, do respect- fully 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 Real Property (Schedule A) Personal Property (Schedule B) Transfers (Schedule C) $ 'j1 )VV vv $ g-.1)00 00 Joint-Held Property (Schedule E) TOTAL GROSS ASSETS Less Debts and Deductions (SCHEDULE F) CLEAR VALUE OF ESTATE Valuation of life estates or 6,429 28 6.429 15,929 28 15,929 annuities................... $-------+--- ESTATE TAX ASSESSMENTS $ _____ ~...--_ Tax on $ ---------+---2% Taxon$ ~ Tax on$ 5% $ ________ 4--- $ _______ ~---- $----------~----Tu~$ lK $ __________ ~--- Tuoo$ 1~ $ ____________ ~--- 28 28 VALUE AS REAPPRAISED $ _______ -+--- b~ptioos • Total Estate ---------4--- TOTAL TAX $-------~--- (•) As evidenced by Charitable Exemption Certificates issued by the Secretary of Revenue. Less tax previously paid $=====~F===- BALANCE $---------+--- Less 5% of tax if paid within 3 months after death $======== 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 -----~0------- $-----~-- $------4--- 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 t No. IN THE Year ........... . MATTER OF THE APPRAISEMENT OF THE ESTATE OF MARY ELCHAK Deceased Late of. CHARLEROI ............. . County of . WASHINGTON ... Commonwealth of Pennsylvania REPORT AND APPRAISAL -~· .. ~ }t."· ..... : .n·~· :: _:;;._:._ Fonn RCC-2 DATE ......... $.~~ .. ~mP.~r. ..... J.5. . .7. ...... J:.9..9.9 .................... . DEPARTMENT OF REVENUE . "' BUREAU OF COUNTY COLLECTIONS COMMONWEALTH OF PENNSYLVANIA RESIDENT INHERITANCE TAX APPRAISEMENT COUNTY ................ W.~.l?.h~P.Kt9.n ...................................... . " HARRISBURG, PENNA. 1 7 1 2 7 FILE NO ................... RJ..::.Q9.~7.?i.Q .......................................... . Whereas, ........................... Ma.o. ... Elc..~bk ................................................................................... late of ............................ 9?:~.r.J::E?.:r.C?..i.: ................................................ .. in the County of ........................................................ W.§..~.h.t.P.g0..P. .............................................. Commonwealth of Pennsylvania, having died on the ..................................... ?.9. ... ~.~ .......................................... day of ........... MaY ......................................................... 19 ... 9..9. ... , seized and possessed of an estate 8 ubject to I heritance Tax under the laws of the Commonwealth f Pennsylvania· n 0 , Therefore, I, .................................... W ... R ....... C.haney: ........................................................... , 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. I Description of Auet Unit Appraisement Values Made for Inheritance Tax Purpoaea $ REALTY: All that ilot of piece of land situate in the Borough of Chalreroi. Washington County. Pennsylvania, bounded and deSCY'ibed A.S follows to wit: BeinB: Lot No. 296 in the general plan of lots by the Charleroi Land Co., lying on Westerly Hixx side of McKean Ave. between Eighth and Ninth Street. fronting on said Avenue the distance of Twenty-twoo (22) feet and running back to Long Alley the distance of 100 feet preserving the equal width of said 22 feet. 9.500 00 JT. HElD: See copy of Schedule "E" attached to appraisement 6,429 28 Total 15,929 28 form~·!,':~h b1:: ::~h~w~ ·~'j!!'~l~~: ~.~ .~·~ .. ::~~~~ ~~:~mi;-7:~~·1~ ~? z . ~;;.>;;;, ;;., s;;;.;; ~':': ~<>.-.. ""{!· '-< . iM oo;;; . . . .. , Penna. H •••••••••••••••••••••••••••••• W.A.§i l.N.G'I.'ON ...... ..... County RESIDENT INHERITANCE TAX APPRAISEMENT Estate of MARY ELCHAK ························ .......................... . Deceased. Late of ...... CHARLEROI ...................................................... . Date of Death, ...... Ji¥. .... ?.9..1 .... ~.9.§9. .......................... . AppraisemeHt Docket Vol., 37 Page, ~3..7~4 ................................ No. . ..... 63.~69..~7.80 ......... . Filed in Register's Office, ...... ~§lPt.L.J5., ... 19 6.9 .. Amount of tax due, $ .................................................................. . DEPARTMENT OF REVENUE Received, Examined and Approved, Wrote abo.ut Appraisement, Appeal f1'om ·Appraisement, Entered and charged, "'' .o, DEDUCTIONS ALLOWED IN J ~ ~ 3 ?-tf ?b77r71/ Form RC C ·10 ~-. . ' OFFICE OF TME REGISTER OF WILLS TME SUM OF ............ $ ............................................ . "7t:::;il ~=?4 Register of Wills, Agent ~ Washington OF----~----COUNTY AND DEDUCTIONS AND AGENT OF TME COMMONW&ALTM ESTATE oF Mary El chak LATE oF __ -~C~h~aar~l~e~r~o~i~.~P~e~nunuws~y·l~y~aun~l~·a~----- May 29th, 1969 DATE OF FILING APPRAISEMENT ----------DATE OF DEATH __ __;_~_:........;:;;_:;_.-:.:_:..z._--=:...:....;:;_;:_ _____ _ DATI!: NO. OF NAMii: OF PAYEE REMARKS AMOUNT VOUCMEJt IKussell. Mar1no, Keg1ster ot ll"'rona-ce or Wl.L.L ana .ttenunc1a- ~ills, tion and Letters Testamentary, $ 11 Gul Rogers, Deputy Register of ~~ip t~ Cqaflefoi for attesta-2C lwi ls 1on o W1l o d ecedent ~ashin£ton County Reports, Legal advertisin_g_ ll ~e Valley Independent, Legal advertising lC .<Jash:!-ngton County Comm1ss1oners, Zeroxcopies of Will, 3 ~ureau of Vital Statistics of ommonwealth of Pennsvlvania ~eath Certificates c !Russell Marino, Register of Wilin~ fee of InventorY ., !wills ~ichael A. Melinchak, Funeral S3C irector, Complete funeral 1 st. Jerome's Church !Opening grave and canopy, 8( Msr. Michael Duris in ~uneral services~ lj.[ Steve Levkulirh lr:antor _5_eTilic.es H Rev. Andrew Chura ~uneral services~ C,[ lor. C. R. Perryman, ~-rays at Mercy Hospital, 17 P;t-t-ch,,...,n-h P!:> ~ I I lor. E. E. Costa, ;Last medical expenses, lj.( ~~arleroi-Monessen Hospital, orth Charleroi Pa., j;:xpenses for last illness 237 ~dies Altar Society of Holy Ghost Greek Catholic Church Biance on open account 25 ~flcolm L. rea surer Morgan, County 969 countv taxes 4-3 ~· Ross Allen, Tax .YbY Char.tero1 Area ~choo.l and 167 ollector, ,, Chr~rlf>rni Bnrnugh "taxf>~ !Russell Marino, -.lerk u.c. Filing fee of Account, 18 ~~izabeth J. Johnson, ublic Notary ~otarl fees to allied and lnisce laneou_s_ estate naner~ u !Russell Marino, Clerk o.c. ~stimateduainal 2S at lit rn~ts ~ndrew Elchak Executor Executor's commission, 4-75 Wictor E. Riva. Eso .• estate counsel fees 800 o~~:irtl_.J a ...... ~ ,.,){ 71 w I COMMONWEALTH OF PENNSYLVANIA } COUNTY OF __...;.l1....:?a.;:.:S::..:hc.:c1::c.n:..:;g~t...::O..;;.cn:;__ _____ SS: I, -------oiA;lJnUid..._r.:.s;;e.l!liW:.-..!.E~l...loC~h.!.!a:!.Jk~. ~E~X;!::e~C:..!:U~t:..!O~r:_ __________ H£REBY CERTIFY. THAT. TO THE BEaT OF MY KNOWL!OGE AND BELIEF, TH! FOREGOING IS A JUST AND TRUE SfATEMENT OF DEBTS, FUNERAL EXPENSES AND EXPENSES OP' ACMINISTRATION SUBMITTED TO THE ESTATE OF Mary Elcbak DECEA8ED, AS DEOUCTION!i FOR INHERITANCE TAX PURPOSES. UBSCRIBED SEFORE ME TMIS dud --,~-~a:LJ~..d.d.~.,___,c.+-,-) II 2L oAY OP' Executor ELIZABETH J. JOHNSGrl, i~otory Publlt CHARLEROI, WASHINGTON CO., PA. My Commission expires April 3D, 1973 00 00 00 75 10 00 on 4-5 00 00 nn 00 50 00 75 00 01 61 00 2S no 00 00 5'0 - / • . ..., .. . •' .. s r· _r·· 'I , r 1-I I r ,. ·'· I ' I . I r ·r. I' (' L I,......, I J .-.. l 'I I . ·' I ' Co ~ ·'! s r, ' 1 ..::::: ' ' -s ... ~ c ,. ) 1, .-.,, iJ.J <"',, . ' --J ~ c::l;: •-' t I "-:! --I 1 ~ ,..._ s -,-....,.. ... ( L r' ; s '• '! t. •·t.''·;·--·.-;~..i,-.,-• .-.-...... ~~·.;.,•~--,.·...;:-A·-...-._':?<L., . ._.,~W>Y>""_. • ..,..,__,~......_,,.,,,, . .., ..... _..,,.;:t,~:»-""''""""'>•"""'""''~J:::~·y,~> .. -,.;;..,..,.,.,, .. --,,_,,.,f:"<<--"'71""".·· ---..-><~·-;.-~ J ~~.-... ~. J..,.~""'""-•'~-, ·~~1-f:.._•~'-~-~"""'-v.:,u~,.~~...,~<".,..._...,..,.~~~;-,..~""-~c\ 1"..,~:"'~'\. 1;_'-"""•~..,;d:._,...., ... ~~ ... ~~-"'-~'~ --~---~......,.....~ ..... ~~L~-~~~.,.~'!li:_,..."Jioi.A.~-..,?J<.\."'~_,.--~ f' I!CC-.t to-6a) coMM.O;\~V{f:!\nli OF PENNSYlVANIA rt~ t~ ...... ~ Jl . . ..... •.'·.fl"'d;;..--:~1;) !• ;' . DEPARTMENT OF REVENUE $~'1\~.Jf'~~(t, t~ ~ ,': A_O ~ 0 ~2? OFFICIAL RECEIPT • PENN~~l v AI'IIA INfl ERITANCE AND ESTATE TAX :{<~~;Z":0" ~ Si RECEIVED THREE HUNDRED FORTY -TW'O and no/100 - - - - - - -dollars ; ~~ An<h>ew· Elchak' Excr. . rer ~esenting Perunsyl_vania Inheritance or H ~~ From: c/ 0 VICTOR E. RIVA Estate Tax due from the following estate: 'J ~ Addeo" P • 0. BOX 115 ~ CHARLEROI, PENNSYLVANIA 15022 ~~ 6~ 69 ~so ~ File No. ~')-~ ., _Date of Death : . ~ Dote of Po ym e nt ___ ..,_,i.L.f:...U..;)...l..~""'-'~-J...;;L\~------l ~: Name of Decedent _ MARY ELCHAK 5-29-69 --- WASHINGTON 1 County_, _______________________ ~~ Remarks: · et u . .,. 2% Tax on $ _________________ $ _____________ __ 6% Tax on $ On Account ------------------ 15% Tax on $ ________________ _ %Tax on $ Estate Tax, Act of May 7, 1927 TOTAL TAX CREDIT Less five percentum of fox if paid within three months ofte.r ' date of death ' Plus interest ot the rate of ___ %.from---------------- to _____________ __ !;< \.'f $ __ ~36~o~."-"'o~o __ •1 L tl: e! $ _________________ ~ « -~ $ ________________ " i?. tt $·------tl l!\' 18.00 I < •· ,.... :;: ooc::::; c::::J ,....._ "' RCC-134 (8-65) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE B!~E~J OF COUNTY COLLECTIONS INHERITANCE TAX DIVISION OFFICIAL NOTICE OF INHERITANCE TAX APPRAISEMENT A~D ASSESSMENT OF ASSETS NOT Sl!BJ ECT TO ADMINISTRATION J TO: ___ J_U_L_I_A_B_A_KE_R _____ _ SHAFER A VENUE, MAPLEVIEW Date: _ __:_J...:..:u;:.:n...:..:e__.:..3..:..0..L, _1=-=...96.::...9=------ County _W..:_A:.::..;,:_SH:.::I::...:N:..:...G:....:T:....:O:...:N.:__ ____ _ ----CHARLEROI, PENNSYLVANIA 15022 County File No. _________ _ Bureau File No. h3 -'=-9:-}@ We have received notice tho t ,,XJ!lOD~md:liOllkbbolotmDt:looa::a:xx.xxxxD:.xlOOa::a:xx.xxxx:naoooa.:L_ ----1~¥--~.....---19--6.9 you came into ownership of certain property throughn· ~~~m:x.cxE!i[K;,c:xbdx!x transfer from MARY ELCHAK, Deceased. Under the Inheritance and Estate Tax Laws of the Commonwealth of Pennsylvania such transfers are taxable and the liability for the payment of the inheritance tax due is imposed upon you, as transferee. The property on which tax is hereby ass.essed consists of: Jt • Bank Accounts (1) #24056 ( 2) #C02030 and (3) #20706 held in the MELLON NATIONAL BANK, CHARLEROI OFFICE, CHARLEROI, PENNSYLVANIA in the names of MARY ELCHAK or JULIA BAKER. Opened (1) 2-18-64, (2) 5-13-66 & (3) 3-6-64. Balance as of date of death, (1) $1,000.00, (2) 1,000.00 and (3) 381.12 appraised by the Commonwealth, as of the date of death, at $ 2, 381.12 50 %of this amount is taxable at the rate of 6 % DATE OF ASSESSMENT TAXABLE AMOUNT LESS: ALLOWED DEBTS NET TAXABLE AMOUNT AMOUNT OF TAX DUE 0 If you pay the above amount within three (3) months of the date of death of the decedent, or on or before Aug • 30 19 69 you may deduct a discount of 5% of the amount of tax due, or 0 This tax became delinquent one year after the date of death of the decedent and, in addition to the tax, statutory interest at the rate of 6% of the tax per annum is also due as of*------- 19 in the amount of *If the tax is not paid by the above date additional interest is due at the rate of 6% per annum until paid ORIGINAL ASSESSMENT $ 1,190.56 __ ___:.:._._ ___ _ 71.43 3.57 AMENDED ASSESSMENT $----------- ---------/ TOTAL AMOUNT DUE $ 71. 43 $ ~ 7· y ' ASSESSED By: __ Z..LI..&e.~.::!!ll:-<':...1"~..4£~~~~'l.tl/l~.,£:::=-L~~===<,d:!2:.__ __ (Agent for the Commonwealth) INSTRUCTIONS TO TAXPAYERS ~'f-1'1~/ .PC (over) To insure proper credit to your account this Official Notice must accompany your payment. Mai I or bring it to: l530J If you have already paid this tax to an executor, administrator, attorney or other personal representative of the decedent for forwarding to the Commonwealth, list below the date pai.d, name and address of the person to whom you made payment, their official title and the amount. .. .. ~ ..... Date Paid Name and Address of Payee Official Title Amount Paid Under certain circumstances, if, after the date of death of the decedent, you personally paid funeral expenses or other just debts of the decedent, with funds derived from the property herein taxed, such amounts expended by you may qualify as deductions against the gross value of the property in the computation of tax due. If any such expenditures meet all of the three following tests, it is recommended that you itemize the payments below, execute the affidavit, and return this notice. The Register of Wills will examine the debts claimed and allow those which he determines to be proper. The tax will then be recomputed and you will recefve an amended assessment of tax. THE THREE TESTS WHICH MUST BE MET ARE THAT: 1 -You were personally.legally responsible ·for these debts, and 2 -You actually paid these· debts out of the account or· property described above and can furnish proof · of such payment, if required, and 3-These same debts are not also claimed, for tax purposes, by an executor, administrator or other person,al representative of the decedent handling the administration of the general estate of the decedent or any other transferee. SCHEDULE OF DEBTS Date Paid Name of Payee. Description of Obligation Amount Paid -~- I TOTAL $ (attach separate sheet if required) COMMONWEALTH OF PENNSYLVANIA) SS: COUNTY OF: _______ _ I, hereby certify that the foregoing is a just and true statement of funeral expenses and other debts of the decedent, , for which I was legally responsible and which I did pay out of the property herein taxed. I further certify, that to the best of my knowledge and belief, these same debts will not be claimed by any other person, for inheritance tax purposes. SWORN AND SUBSCRIBED BEFORE ME THIS ___ DAY OF ______________ 19 __ . Signature of Taxpayer REPORT OF REGISTER OF WILLS I, the undersigned, duly elected Register of Wills in and for the above county, do respectfully report that I have allowed deductions listed above in the total amount of $ --------· Date of Approval: _____________ _ Register of Wills Fonn:Rcc-2 - COMMONWEALTH OF PENNSYLVANIA DATE ...................... !:T.~.J.Y ..... ?.9., ....... ±9.9..9 ....... .................. ' DEPARTMENT OF REVENUE RESIDENT INHERITANCE TAX .................. ~~~.~~.~~.~~ .................. BUREAU OF COUNTY COLLECTIONS COUNTY ··············· .,. " ... AP~RAISEMENT .................. 9.2..-:::..9..9~.7..?..9 ..................... -HARRISBURG, PENNA. 17127 FILE NO. ··················· Whereas, ........................... ~.~Y. ... ~~.~b.¥. ................................................................................... late of . ............................. G.h9.:.r.J&r9.~ .................................................. in the County of ...................................... ~~.~~.~.~ .. 9.~ ............................................................... Commonwealth of Pennsylvania, having died on 30th the ............................................................................................... day of ................... May ................................................ 19 ... 6.9 .. , seized and possessed of an estate subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore, I, .............................. W.~R.~ .... C.ban~~r .................................................................. , 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. Unit Appraisement Description of Asset Values Made for Inheritance Tax Purpoaes $ JT. HELD: (3) Jt Bank Account.R hAl cl in t.hA MAll rm N::tt.i rm::t 1 Bank, Charleroi Office, Charleroi_..~. Pennsylvania held in the ioint n:::~mo:>l=: of Mrsv Elch-"lk or Julia Baker l .190 t:,6 Total 1.190 56 j j I " -; form~;viw':fhb~: !.:Ufh:sw~~~r~~~~: ~.~ o~er~~~~~=~~=?~·~~~ ~ A pratser ~¥ ~ .................................. ~.~.~.~~~~ ... :~ ... ~~~~~')'" ............................... , Penna. (Poet Oftlee) I ---------I ........ WAai.INGTO.N................ c OU111)1 ·~ ! ....... ;i.' =======-=====9'9; i '-L1 4 "'-4 I .. . , RESIDENT INHERITANCE TAX APPRAISEMENT 1· ~rr• ,·r.n .... V 11111 r i\ ~~ I I .'1 3 J \ i ! ~ Estate of MARY ELCHAK tllll' 1:: ! t' • ! I tl' " p i i,l Q ,, •J -.....f ~ .. ' :'? \ t;-'1. j 1: ~ ............ jj~~~~;;~:EG!S T i:H OF 'tlllLS Late of WASHINGTON Gd .. Pt1. CHARLEROI Date of Death, ...... J1t:l.Y .. J.9, .... J.99.9 ............................. . AppraisemeHt Docket Vol., ............. 37. ................................ .. Page, ............................................... No. .. .. §J.:::..f?.9~7.?9 .......... . Filed in Register's Office, ........ J.1JlY .... ?..9. . .t .... 19 .... 6.9. Amount of tax due, $ ................................................................. .. DEPARTMENT OF REVENUE Received, Examined and Approved, Wrote abo.ut Appra-isement, Appeal f1'om Appraisement, Entered and charged, .... ~ I ~