HomeMy WebLinkAboutOC1969-1082 - ESTATE OF HAZELBAKERPETITION SUR AUDIT
T3state Form. j
IN THE ORPHANS' COURT OF WASHINGTON COUNTY
Estate of ...... FRA..NK . .HA.Z~I$.-M~~R ...................................... . No ........... ?J.:~?.::-~g-~_?. .................................... A. A
Fiduciary ..... ~~---~~-------------------------··········
................... Ex.e~~t.x-.:iJ!: ........................................... .
Deceased
Date of Date of .
Decedent's death ......... .S.f?.P.~~~~u:: .. ~9.J...~9.~9. .................. ~Grarit of Letters ..... ~-~P.~!~~~--~~-~-}~~?. ........................ .
This is the ........ Firs.t..and . .F.inal.. .................................... account filed in this estate
If there have been former accounts filed in this estate, l.ist file number or number and term ....... None .................... .
Election to take Place of;
Under or Hllifwill. (cross out one)
Date Election
Filed .................................. Record ............................ :.
Name of surviving spouse ............. None ......................................... --------------··········.············-·-······························-··········
List issue, where material:
: ~
Did.decedent marry after execution of will? (indicate) jiH. No. Any children born after execution of will? (indicate)
~No. If answer yes, name them .............................................................................................................................. · .. .
Legatees Relationship Interest Fiduciary, if deceased or not sui juris
Irene Fumier Daughter res. legatee sui juris
Audrey Tirpak, deceased · Daughter res. legatee Andrew A. Tirpak, Executor
June Turnbull Daughter sui juris
Elaine Nichols· Granddaughter "1 ,f,~ l~ ~
William Hager, Jr. Grandson
List, if exceptions to above: Adeemed: Revoked: Lapsed: Abated: Give Cause:
None
If partial intestacy, give facts:
Notice to interested parties. Have all parties, having either v~sted or contingent interests and all crediors entitled
to notice (Court Rule No. 9 paragrcph C: Section 6: Subdivision c) rec_~t~,ed written notice ofthe filing of the account
and of call of audit? Yes. ~ . ·; . · ·
If any exception give cause: ....... .Nooe-: ........... : ................ ·
File copy of Notice
a~d date of mailing ....... P.~g~nt:J?~-~--J., ... 'J-9..7.9. ...........................................................................•.... ,.,,,.,,,,.,,., ........ ,,.,,, .. ,
Is estate subject to the filing of a federal Estate Tax Return? ............................. W~---·············'"····'················'·············
Actual payment made on Pennsylvania Transfer Inheritance Tax. Amount $ ... 800.a00 ............................................ .
If the Will makes any portion of estate subject to a life-estate, give name and birth date of life tenant ..................... .
... NQ~~---··························································································'···········································-·················-·········----------
Give Names and addresses of all unpaid creditors who are legally entitled to notice, together with the amounts
of such claims; state whether they are admitted to be correct; and whether the claim is denied.
None
Give reference to such parts of the will as require interpretation by the Court; a reference to all questions re-
quiring adjudication, and a statement of any other facts deemed necessary for the preparation of the adjudication:
Balance for distribution per account,
Itemize any additional debits not shown by account: $.l..h,.h3.9 .•. 2.7. ............... .
. .... -,
Total' additional debits (Add) $ .......................... ~---······
Itemize any additional credits not shown by account:
: ~ q
Total additional credits (Subtract) $ ................................... .
Balance for distribution $ ... llb.tl3.9.!.?.7 .............. .
If balance for distribution is not in cash, list each item held in kind, giving appraised Value (or distribution Value);
· .... · .. :.
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If Family Exemption claimed by Petition, give place of Record: .................. ~~---·····--·····---··········--··················--·------···-
If Family Exemption is claimed at audit, give name, relationship and basis for Cla.im: ________ , __ N.Q ...... :: ......................... .
List.·any advancement or distribution on account that has been made, and nature and amount of same:
None
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:
· Irene Fumier
Jtme Turnbull
Estate of Audrey Tirpak
William Hager, Jr.
Elaine Nichols
1/4 residuary estate
1/4 residuary estat·e · ·
1/4 .residuary estate
1/8 residuary estate
1/8 residuary estate
COUNTY OF WASHINGTON, SS:
COMMONWEALTH OF PENNSYLVANIA
The above named Fiduciary or representative thereof,
being duly _______ __f~~C?-~-------------·------doth depose and say
that the facts set forth in the foregoing petition are true
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to the best of·-------~~-~---···············knowledge and belief .
....... swom. .......... · .................... to and subscribed 'before
. /bf./.~: "CI.w
me thisl.'~( .. :c.~~~dQY. of::~~)~~~~~~~~----············-19.1P ... . r \.. -.... ~t-... (.u_,. 'r.r; ~ ..• 4 ~..,_... /1 r:
Signature of Officert.~~-C .. ~~----········· \..! '' ·~ : .. •. '.·'' ) : \ . ·t; '. : . . . ~ -:.
Title of .Of,!icer ... S.t~ota.~:·P~®li~---··························.
. :.: . ·, (:of.;':""'t,':>'{:fobRtS;E. HALC
Office exp.~ ~es.::-··Niitii,Y'Jiiltiiii::·cilil~iei-o1:Vfiistiingt'ori'Ci:iunty···--··:······
My Comm!ssion Expires Jt:~e 12!. 1972
And you~ petitioner will ever pray, etc.
No. __________________ 9.3.::9.9.::J:Q~g ____________________ A.A.
FRANK HAZELBAKER Estate of ____________ . ______ ._: ___________________________________ _
Deceased
F.d · IRENE FURNIER, I UC 10 ry -------------------------------------------·-----.----. ·--
-------------------~-~-9-~tr.~-------------·----·------···-··---·
PETITION SUR AUDIT
FROM WHERE DECEDENT LEFT A WILL
Counsel of Fiduciary will submit" herewith the,
following, in conformity with Court Rules
adopted effective December 3, 1951, being
rule No. 9: paragraph b-e; and divisions
thereof: shown on pages 23-24.
1. Written praecipes of all Counsel in the
case.
2. Copy ·of order appointing Guardian ad
litem, if pertinent.
3. Copy of Order appointing Trustee ad
litem, if pertinent.
4. Proof of service of above.
5. Letters Testamentary or Administration
C. T. A or on attest copy of Will.
6. Copy of inventory and appraisement.
7. Proof of advertisement of grant of letters
if not filed with account.
8. Certificate of liens in case any of the
funds for distribution are from judicial
sole of real estate.
9. Signed and itemized elections if any
distribution in kind.
10. Copy of Federal Estate Tax return if es-
tate is subject thereto.
........................................................................................................ ---·--------------:-··
Adrian V. Sa~ Attorney
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C!lnmmnnttttalt4 nf Jrnn.aylnania,}
lla.a~ittgtnu <nnuuty. .as.
KNOW ALL MEN BY THESE PRESENTS: Whereas, au Washington, m the County afore:;aid
on the 29th. day of September A. D. 1969 , before me,
Rus$ell Marino , Register for the Probate of Wills and Granting
Letters of Administration in and for the County of Washington, in the Commonwealth of Pennsylvania,
the last Willi and Testament of
· Frank Hazelbaker
late of Borough Qd Roscoe in the County aforesaid, deceased,
•_a true copy whereof is to these presents annexed), was duly ad!mitted to probate; and
Irene Furnier
:-ix
the ExecutoX m said Will and Testament named, having appeared before me and taken and subscibed
:he oath of office prescribed by law;
NOW, THEREFORE, I, Russell Marino , Register as aforesaid, do
grant these LETTERS TEST AMENT AR Y, unto the said
·committin.5 unto
Irene Furnier
Her the administrat:on of all and singu'lar the goodE and
chattels, rights and credits, which were of said deceased, and requiring Her
to exhibit a true and perfect inventory thereof into the Register'E Office, at Washington, within ninety
days ·frorr. the date hereof, .and to render a just and true account of said administration at the expi:-ation
of six mc·nths from the date hereof, and to regard and comply with the provisions of the laws of this
Commonwealth relating to inheritance taxes.
IN TESTIMONY WHEREOF, I have hereuntc set my hand and the seal
of said Office at Washington, this 29th.
day of September m the year of our Lord one thc·usand
nine hundred and Sixty Nine
Regist::r
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69·CT-Will anrl 'l't•SL~run.nt
Henry Hall, Inc., Indlann, Pa . J
I .. Frank Hazelbaker , of
I Allenport
Col~nty of \'lashineton and State of Penna.
being of sot~nd 1nind, me1nory and u.nder8tanrling·, do maJce and pnblish th_is my
la,st W"ill and 1'Pst£une.nt, hereby revoking and malcinlf void all fanner lYz.lls by
me nt £Lny time heretofore made.
FJRST: I order u.ll of 1rzy-debts and funeral expenses to be J?aid by rw E..'{ecUt:i.x
hereinafter named, as. soon as conveniently after my decease.
. .
s~am;
···I give, devise and bequeath...Jmto Genevieve Hager unto Irene Fumier, I u /fAl .fi •-'}., L..
uhto Audrey Tirpak and mto June :lJ±-RPr±eo these being my daughters and
· only next to kin. All of my real and personal property to be shared and
shared alike to my above named daughters
THJRD:
JUthouG}l that I have insuranee policies and have n~d beneficieries
all monies derived from said policies no matter to uho beneficiary is
made the monies are to be shared and shared al:iJce <.l.mJung the above parties o I
If at the· tdime odi my decease there are c-.n;:r bonds the monies are to be shar8d I
and shared al:iJ(e ld.th the above mentioned parties.
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I do hereby rnnke, vonstitl~>te a,nd a.ppoint :rrw daughter Irene Furnier
to he E:l.~ecutrbr. of this my ln.cd fVill nnrl Testa,lt'bP.nt
·'
· ln i!!i!lttnegg i'mi)ereof, I, Fran.l< Hazelbake , the
Testa~ abooe named, have herennto sub.~cribed my name and a,lfi.xed my seal,
the . lith ·. day of t ebrua.ry in the year of our
Lord one thousand nine hundred fifty~three
(7;,o.vnP< 2f_o;;r/J?-n Jb o ~-~
Signed, b'ealed, published· and declared by the abooe named
Frank Hazelbaker a.~ and for his last rVill
and Testament, in the presence of us, who have ktJrer.tnto .'Jl.{,hscribecl our names at
his reqnest as witnesses thereto in the presence of the said Tcst~-,,t e
and of ea,ch other.. £s~ :£ ~~· ~
2~/3& Y'/'2 ~ ~ .~~:4----
J\ffi[tuuit ®f fxrrutnr. ®r .Abmittistrutnr
~tutr nf Jrnnsyluunia, ~ ss:
cnnunty nf llas~ingtnn \
Personally before me, the undersigned authority, a .... NQ~~r.Y. ... ~JJ.~ .......................... ; ............. in and for said
County and State, appeared ..... ~.r..~.~ ... f.~~.~.~.!: ............................................................................................ who, being duly
sworn according to law, deposes and says that s he is the executor or administrator of the estate of
... f.r.~~~ ... M~~~~~~~.~!. ........................................................................... deceased, that the foregoing schedules constitute a
complete inventory and appraisement of the real and personal estate of ... ¥.r.~.~~.J!~~~±~~~~.!' .......................... ,
deceased, except real estate outside the Commonwealth of Pennsylvania; that the figures opposite each item
of real and personal estate in the foregoing schedules are determined and stated by the undersigned to
be the fair value of said items as of the date of the decedent's death, based upon a just appraisement of each
item made by t~e above .named Executor . Adrn~rator.
aay ot.7.~?~~:; .. !9.19.~' L... .l,-~ ........ ~W;;~·
.............. :, .................. """"' .. ~.... ..... . . '""'""-"""""
. ,Swo:t:t;-;. sub";;}ed before me thw .... i.J........... l Q :j-_ ~
Notary Public. Charler'oi. VIas ngton co.. ADDITIONAL INSTRUCTIONS
MJ Commi]_S~on llfl{efJ~tffll.llffjl~ be filed within three months after appointment of personal representative.
2. A supplemental inventory must be filed within thirty days of discovery of additional assets.
3. 1 Original and 2 Copies and 2 RCRI-34, Under $10,000; 1 Original and 2 Copies and 2 RCRI-33,
Over $10,000, including Copy of Will; 1 Original and 3 Copies and 2 RCRI-33, Over $50,000, in-
, . eluding 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
1Juntntnry anll ,.pprai.armrut of the goods and chattels, rights and credits which
were of .. !..~~ ... ~?.:~.~;!J?.~~~!: .................................................. Jate of ............ RQ:?.~Q~ ...................................................................... ..
j Washington County·, Pa., tq.ken and made in conformity with the abO'Ve affidavit.
REAli ESTATE: None
PERSONALTY:
1. Western Pennsylvania National Bank, Roscoe,· Pennsylvania,
Savings Account #1262 in joint Jjnames of Frank Hazelbaker
and Irene Fumier. '
Balance at date of death
This account was owned solely by. decedent, Frank Hazelbaker,
and Irene Furnier's name was added to said account for
convenience only and not for purpose of vesting any ownership
or interest in said account to Irene Fumier.
2. · Pittsburgh Steei Corp<?ration, FamUy Beneficial Plan,
Beneficiary, Estate of Frank Hazelbaker.
3. Social Security, Funeral Benefit
4. General American Life Instirance Company, Pr~ceeds of group
DOLLARS CENTS
14,457 57
1,233 60
255 00
life insurance at Wheeling-P;tts_burg!!_Steel Co~any. ~--~
Beneficiary, Estate of Frank Hazelbaker. -1,250 00
5. U. S. Government Bonds, Series E. , Proceeds of Sale 945 33
...
TOTAL~---------------------18,141 50
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STATE OF PENNSYLVANIA,
. WASHINGTON COUNTY, ~ SS:
The within named Accountan't being duly sworn according to law, deJose and say -c.· that the above acx::ount
as stated is true and cor.rect as------------------------------------------verily believe.
·., ..
Sworn and subscrib~d before me this ..... & ... .
day of·············-~·-····· 19.2'9. ... . ········~~~-~~
My Commission' Expil es December 31,~73
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Warshington County, ss:
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I do certify tha1 I have given legal notice to all persons
concerned of the filing of the within account in the manner
prescribed by Statute· and Rule of Court, as evidenced by proofs
thereof filed to No, __ t?__.3__--:__j_Q_-::::_.7_l{Q ..
Witness my hand and official ·seal this .... J.Q.--1!. ......... .
doyoL .. ~---··f'\/f.i··· ··:···· 1970. .. ~'11~----------. Register of Wills
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The Court is respectfully requested to determine
proper distributio~ .
~-~·-~ Counsel for Accountant
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FIRST AND FINAL ACCOUNT OF IRENE FURNIER, EXECUTRIX OF THE ESTATE CF
FRANK HAZELBAKER, DECEASED
The Accounta.nt is charged with the following:
As per Inventory and Appraisement 18,141.50
total Credits of Estate 3,705.23
··~ ..:-.~),;' 1 , •• B2lance Due 14,436.27
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10/o6/69
11/06/69
11/06/69
11/15/69
11/28/69
1/17/70
3/26/70
8/31/70
8/31/70
8/31/70
6/31/70
8/31/70
----------------------------------------or------,
The A~countant claims credits as follows:
P.~:.:. ee
Rev. Bodnar
American Legion
Waddington Rest Home
Eckert Funeral Home
Irene Fumier
E. Eckert
AlexA. DuBart
Irene Fumier
Adrian v. Sannier
Irene Furnier ·
Ad~ian V. Sannier
Russell Marino
RUssell Marino
Remarks-
Funeral Service
Funeral Service
Decedent's Care
Funeral
Reimbursement, flowers
for funeral
Death Certificate
Stone:~ttertng
Miscell~neo~s funeral
expe~!:!Eil~
Reimbarsemeni -costs
adva*Qed:
1. '·Russell' Marino rtobat~ Will ' rp ·,•' <•• 2. · Gey Rodgers ,
·probate Wlll
). Valley Indep.
legal advt.
4. Wash. Cty. Reports
.5.
. legal advt.
RusseU Marino,
Sho,rt Certificate
Executnx Commission
Attomey Fee
FUe Inventory ·
File Account
1.5.00
1.5.00
10.75
14.00
1.00
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Amount
10.00
20.00
44.32
1,628.00
50.00
2.00
18.00
44.00
.5.5.7.5
907.06
907.,06
3.'00
16.00
TOTAL-------------------------$3,70.5.23 (
Washington County Reports ..
Washington, Pennsylvania
(PUBLIS:-iED BY WASHINGTON COUNTY BAR ASSOCIATION)
PROOF OF PliBLICATION
In compliar.ce with the Newspaper Advertising Act of May 16, 1929, P. L.
1784 Sec. 3, parag:-aphs (3) and (25).
CouNrY OF W ASHINCTON l
STATE OF PENNSYLVANIA ( SS.
Personally appeared befcre me, a Notary Public in an:! for said County and
Commonwealth, CHARLES C. KELLER, who, being dul? sworn, deposes and
says: that he is the Editor of the WASHINGTON COUNTY REPORTS, the
official legal peric·dical for said Washington County, publis:ted weekly having its
place of business at Washington, Washington County, Pennsylvania, and is act-
ing as its agent in this behalf; that the said WASHINGTON COVNTY
REPORTS was established on March 31, 1920, and was designated as the official
legal publication for Washington County, Pennsylvania, b:r order of the several
courts oi said Co·mty, dated November 11, 1920; that the 1=rinted notice or adver-
tisen:ent attached hereto is a copy of a· notice or advertiserr.ent, exactly as printed
or pmblished, whio:h appeared in the said legal periodical in i:s regular issues on the
following dates:
........... ~9Y.~m~.~.r.. .. ~.7...~._J.~~~., ......................... .
December 4 11 1969, .......................................... !.. ......... ? .................................. .
N otar_1 Public
Estate Notices
The Register of Wills has granted letters,
testamentary or of administration, in the
following estates. Notice is hereby"given·
to all persons indebted thereto to make
payment without delay and to those hav-
ing claims or demands to present them
for settlement to the Executors or Admin-
istrators or their Attorneys .
• • 0 ••••••••••••••
HAZELBAKER, FRANK, Dec.'d.
Late of Borough of Roscoe,· Washing-ton County, Penna. ~ . Executrix: Irene Furriier, Box 162, Allenport, Penna , Attorney: Adrian V. Sannier, 411 Wa~h!ngton Ave., Charleroi, Pa. 15022
,..·,:-)
Proof of Publication of Notice. ia. The Valley Independent
Uwder Act No. 587, Approved Mcy 16, 1929, P. L. 1784,
os amended by Act. No. 51 of April 24, 1931, P. L. 67
State of Pennsylvania
County of Westmoreland }ss:
Assistant
PersonoUy appeared before me William H. Pore, Secretory of Mon Valley Newspapers, Inc:., a Penn-
sylvania corporation, publisher of The Volley Independent, who, being duly sworn, deposes and scys
that The Volley Independent is a daily newspaper of general circulation in Fayette, Washington. and
Westmdrelond counties, Pennsylvania, and elsewhere, published in the City of Monessen, Westmoret"and
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 Volley
Independent on the following dates, _______ ..::.N;_:o'-'v'-'e'-"m.;;;.b;:_e:...cr=-· _2-'--1--<-,_1....:::9'-6-"9'--------c--------
November 28 and December 6, 1969 ·---
Affiant further deposes and says that he is General Manager of The Valley lnd2pcndent, a
dally ri~spoper 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 chcmlcter of publico·
tion ore true. ~, J./. ~
COPY of lZI)TICE
Sworn to and subscribed before me this 8th F • 1 Lett~rs testamentary on the estate of
j Frank: Hazelbaker late 'of Borough of December 6 9 Rosco~. Washington County, deceased, ~.. day Of 19 hav)n~ been granted by the· Register of "~ • ----"'---~-· ~Y!ashi1gtonj~ounty, notice is hereby giv-• ,. q, l /1: . ·
enJ_to ail''persons.lndebted •to. said estate . ;;..,. :;-. Q' /' ~;r U · _
to',mzke_, immediate payment, and to • ~ N p bl' those havirtg claims against the same -~ .._, otary U IC
tcr'lpresent them .wltllout delay to ..,Irene :..:: ~-Fu~nief•J executrix," Sox 162, Allenport · ;.J-MARY A. EVANS, Notary Public P.enns·,lva~ia, 'AdrianfV. Sannier, Es· .~? · M · • · ·
quire, attorney, 411 washington Avenue, • -y COmmiSSIOn expireS ----.:l''~~~<4n:>.~~"Bles"'se~P,.., ¥1WLe!ii-f.dA1RI-QQI:r411el.tlaR~~f-JCr;;._e~t;,· .,,;P~or:-. ----C~arlerol, Pa. . 11:21,28.12~T My Commission Expires July:30, 1973
STATEMENT OF ADVERTISING COSTS::
Adrian V. Sannier, Attorney at Law
4Jl washington Avenue
Charleroi, Pa. 15022
TO MON VALLEY NE\NSPAPERS, INC., -DR.
For publishing the notice or advertisement attached hereto in The
Valley Independent on above stated dates .................. $ :_ 0 • 00 ,..,
Notary ... , ... :..................................... ........ ................... $ • 7 5
Total .......................................................................... $ 10.75
PUBLISHER'S RECEIPT FOR ADVERTISING COSTS
Mon Volley Newspapers, Inc., publisher· of The Valley Independent, a daily newspaper of general
circulation, hereby acknowledges receipt of th~ aforeso1d advertising Ohd publication costs and certi-
fies that the some have been duly paid.
MON VALLEY NEWSPAPERS, INC.
By ll/20/6q ) 'j.lj t
J!n tqt Qtnurt nf Qtnmmnn Jl:ens nf llnsqingtnn <ttnunty,
Jrnusylnnnin, ®rp4nns' Qtnurt Bini.Ginn
ESTATE OF 63-69-+082 No.-~-...:__+----------
First and Final Frank Hazelbaker In the matter of tht:----------
Irene Furnier Account of __________ __:__
Executrix
ADJUDICATION AND DECREE
And now December /~ , 19 70, this matter came on for hearing,
audit and distribution O't this session and testimony token; and thereupon, upon due consideration
thereof t~e Pala11..c-: for distribution in the hands of the Accountant is determined to be
$ 1U,,Y,36.t!:I_ · and the account is accordingly confirmed; and it is ordered,
adjudged and decreed that the said balance be paid out by the Accountant in accordance with the
schedule of distribution hereto attached and made a part hereof, unless exceptions hereto be filed
sec. reg. or an appeal be taken herefrom sec. leg.
SCHEDULE OF OISTRIBUTION
Balance per account ________________ _
Balance ____________________ _
Deduct Clerk's Costs & Receipt:::.--1:!------------
Attorney· ______ A=dr;;...i;;;..a;;...;n~V....; .• =---S...;a.;.;;.n;.;;.n.;..i...;e...;r ______ _
_ Russell M·arino, Agent, transfer inheritance tax,
Irene Furnier, daughter, 1/4 residue,
Audrey Tirpak, daughter, now deceased, Andrew
A. Tlrpak, Executor, 1/4 res-idue, :.. ··
June Turnbull, daughter, 1/4 residue,
Elaine Nichols, _granddaughter, child of Gene~
~ieve Hager, a deceased dau~ter, 1/2 of 1/4
residue,
3588.94
William Hager, Jr., grandson, child of Genevieve
Hager, a deceased daughter, 1/2 of 1/4 residue, 1794.47
.. •· 1·
$ 14, 4-36 I 27
$14,436.27
No balan.ce
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IN THE COURT OF COMMON PLEAS OF WASHIKGTON COUNTY, PENNA.
IN RE:
ESTATE OF
ORPHANS' COURT DIVISION
)
)
) No. 1 0 8 2 of 19 6 9
)
FRANK HAZELBAKER, )
~ Deceased.
o( > .I
=-D z .
tl I. . ~ BEFORE: " z x II ;
ti A FPEARA NCES: ii: I-ll
ll
..1 <C j
~ TI:viE: .,
:t .. ... " ,;
)
)
HEARING ON AUDIT
THE HONORABLE P. VINCENT MARINO, Jt:dge
of the said Court.
ADRIAN·v. SANNIER, ESQ., of Charleroi, Pa.,
representing the Accountant.
Monday, December 14, 1970, at 1:30 o'clock
P. M., EST.
X >~ THE COURT: Number 1082 of 1969, the estate of Frank
./
X :)
l. :d x Hazelbaker, deceased. The Executr~xc is Irene Furnier and the attorne:r
X :J 5 is Adrian V. Saunier. Mr. Saunier?
.I II: ~ "' MR. SANNIER: M§ty it please the Court, there are no (!>rdblems ... :)
in the estate. All the assets are in cash except subsequent to the
death of the decedent, one of the heirs under the Will has died;
and that heir being Audrey Tirpak. And I would be filing with the
Court, probably this week, a short Petition on behalf of Andrew A.
Tir.pak, who was the Executor of her Will, for the distribution of I
the assets to him.
I
."!'_," . /.
c,
THE COURT:
know ledge of?
MR. SANNIER:
THE COURT:
estate?
:! ~THE COURT:
.J > 0· .. .. u I. ..
~ 0 ..
ii o( . ~
.t ·CI
c;i
Court .
.. c ..
U·
Are there any outstanding claims that you have
No, Your· Honor.
Is there anyone in Court interested in this decedtmt's . . .
( NO RESPONSE )
. The audit of this ace oun tis ordered closed by the
(AUDIT CLOSED)
/
·· ~ _l beJ'.eby certify that the proceedinga and evidence are
u c ' . ~-eontaiQed fully and accut-att1y m the notes taken by me on the hearing of
:J 0 0 ~ the above eause, and tbat tbiaJ copy ·18 a cOn"ect t:ran•c.-lpt of the same.
li ii: II. Co
ot the above cause i8 her-eby approved and directed to be filed.
J. )
2
. '
,,
, Form RCe.-33
·•.
COMMONWEALTH OF PENNSVL VANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
RESIDENT DECEDENT COUNTY OF /t~~I:I~~~~ .................................................... ..
IMPORTANT: This return must be completed in detail and filed in duplicate, ·with will attached, with the·
Reglster of Wills of the County where decedent ~esided; Return is due within one year after
date of death, unless an extension is granted by the, Secretary of Revenue. (Section 703 of
the Inheritance and Estate Tax Act of 1961.)
IN THE MATTER OF mE ESTATE OF } AFFIDAVIT OF J.!~ -~:8_~:~~~~~--;;;;,~-;;id;;;;;;;;i)···············-·····--:=:.TOR
Late of ............... a .......... ~........................................................................................................ CoUnty
::.: .:!'::::~·:·:::~:-~:·.-.:~~=} '"
Irene Furnier ......................... · ...................... ,.,_ ......... : .................. ························"'"'''''''''"""'''''''''''''''''''""''''''' Executor
Administrator of the estate of the above-named decedent being duly sworn, deposes and sayS
Decedent died ....... ~.~~~~~~-~M~~-i:j;') ........................ ~t) ......... , 19 (t!~)""{ ~~:::::t~eaving a last will, copy of which is hereto attached. J
otherN:m:t:::i:::r:::r::e:ttt::;:: ::} ...... At.W.~:g,~y _ _Aq_~:l..~ ... .V~ .... S.aM.~.T ............... : ...................................... .
whom all correspondence should be ... _4:JJ. .. W.a::;.~gt.Q~ .. AY.~'!~
mailed. Charleroi, Pennsylvania
That as such ......................... .' ............ -.............. deponent is familiar with the affairs of said estate and the property con-
( ~;x.,cu tor·ii!ll'i!i!Jiili
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 agen.t 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:-
Fumie D
That the contents of said safe deposit box or boxes are itemized under Schedules _____ of thls
return, with the exception of the following, for the reasons hereinafter set forth:
That Sc.hedule A attached hereto. and ·~ade 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 encuiilb.rances upon each parc.el 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 th~ columns provided therefore. the assessed valuation of each of said
parcels, the estimated market valu'e t;hereof 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 deceden-:;
at the time of death, whether in decedent's ·immediate possession, standing to decedent's credit in banks
of deposit, savings bank~, trust companies, or other institutions, whether individually, or in trust for
any other person or persons giving also separately the accrued interest thereon, if any, down to the last
interest day prior to decedent's death in the case of savings banks, and to the date of decedent's dea~h
in all other cases; all bonds, postal savings, treasury certificates or notes and other evidence of im-
<~"\.·· ,-'! debtedness of the United States to the decedent; all obligations, whether by statute or ~~gr.e_ement they
~ ~ are designated as tax free, of the United States, or any state, or political subdivisio~~~ereo~ or of
any foreign country, which are owned at the time of death; all wearing apparel, jewelry, ;e;i'I~erware, pie-~ f'(. _.1
tures, books, works ·of art, household furniture, horses, carriages, automobiles, boats,~~od any and all
other personal chattels of whatsoever kind or nature, leftbydecedent, together with thefra .. i_rly estimated . ~~ market value thereof; all bonds and mortgages held by_decedent and of all claims due an~o~ing decedent
at the time of death, and all promissory notes or other instruments in writing for the pa~jJt 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 payab1e
to the estate from life lnsurance polici'es carried by decedent; all annuity and endowment contracts tt.e
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 de.ath,_ bonds and accrued interest thereon to the date of dece-
dent's death and other investment securities owned by the decedent at ·the time of death, with the market
value thereof at such time.
' .
... ,; . ·~~
...
In the case of securities of close or family corporations, the values reported are as far as
possible substantiated by financial statements of the corporations, showing the assets and liabilities
thereof as of the date of death. The schedule also set·s forth the interest of deceden-t at -the time of
death in any co-partnership or business, and in support of the value of such interest there is annexed _to
said schedule, financial statements showing the assets and liabilities of said co-partnership or business.
A copy of the co-partnership agreement, (if oral, a statement setting forth the nature of the agreement)
together with a statement setting forth the character of the business, its location, and such other facts
pertaining to the business as may be pertinent to a fair and just appraisal of the_ decedent's interest
therein must be submitted, It should also set forth in itemized form, 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 forth a true answer to each inquiry
contained therein and in the case of transfers ofproperty, real or personal, within two years of decedent's
death, in contemplation of decedent's death, or intended to take effect in possession or enjoyment at or
after death, said schedule sets forth the nature and value of such property, to whom transferred, the.
relationship of the transferees to the decedent, the proportionate share received by_ each transferee and
all other facts of a pertinent nature regarding said transfers. In the case of transfers intended to
take effect in possession or enjoyment at or after death, there is also attached to the schedule a COJlY
of the deed, trust agreement or other instrument creating.'th~ trust. TherA is also set forth in said
schedule a list of all property, real and perso'nal, with ·its .value, ··which pa~ses at decedent's death by
virtue of the exercise by decedent, either individually, or jointly with another, or any power of appoint-
ment vestedindecedent, either individually or jointly, bythe will, deed-,-or -other instrument of another,
with a copy of the instrument creating such power attached to the schedule.
That Schedule D attacned hereto and made part hereof sets forth the names and addresses of all_
persons beneficially interested in this estate at the time of decedent's death, the nature of their res-
pective interests, their relationship, if any, to the decedent, together with the ages at the time of
decedent's death of all minors, annul tants and beneficiaries for life under decedent's Will. It also
contains a statement showing which of the beneficiaries named in the decedent's will, if any, died prior
to decedent, th.e dates of their death, their issue, and the relationship of such issue to. the beneficiary.
That Schedule E attached hereto _and made a part hereof sets forth all property, real and per-
sonal, owned by the decedent jointly with another or others, including intangible, standing in the name
of the decedent and others, plus the date and place of record of instruments effecting 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 forth fully and in detail all debts
and deductions claimed for and on behalf of this decedent's estate, including funeral expenses paid;
family exemption, where applicable; costs of administration of this estate; counsel fees and fudiciary's
commissions paid or to be paid; cost expended for burial trusts, tombstones or gravemarkers, and reli-
gious services, in consequence of the death of the decedent; debts and claims owing and unpaid at time of
death; taxes accrued. chargeable for period prior to decedent's death (except those allowed under Section
651 of the Inheritance and Estate Tax Act); together with a statement of collateral pledged for obliga-
tions, if any. It is agreed that the fiduciary will present proof of said claimed obligations upon re-
quest, that if the amount actually paid in settlement of any fee, commission or debt is less than the
estimated amount claiming and allowed, that the same will be reported to the Register of Wills, and that
the amount of tax assessed can be reassessed in accordance therewith.
That the totals of the appropriate columns in Schedules "A", "B", "C", "E", and "F" as directed therein,
have been carried forward and properly registered in the Swrunary •
Subscribed and sworn to before me this ........ ~ ..
-·
::::~:~-~~~ ... .\2.~ ... :1.:~ ....... (;t.1+.:.~ .. ~ ....... -.. .
( Executo1" Acimi1~istt tJ.toi)
Nota:;; c<:~::c. Ch~rieroi. ·:,:a-,hington CO.
/I!J 06mmiss:cn Expires Decernb~r Jl, l~l3---· ..
(Street Number)
(City or Town and Sto.te)
NOTE: Before signing affidavit make sure all blank spaces in the affidavit and schedules annexed are
filled in with details or the word "None", and in case the assets include rare and unlisted securities,
securities of close or family corporations or an interest in any co-partnership or business, that the
data and statements 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-directe~.
RCC-34'(1-64) ,
COMMON~EAL TH OF PENNSYLVANIA 'DEPARTM~NT.OF REVENUE
BUREAU 'OF COUNTY COLLECTIONS
T,RANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "A"
REAL PROPERTY
~ WJfA'
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 "E". Property held by
the decedent 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 Commonwealth 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, a.ssessments, accrued Interest on mortgages, etc.,are
to be listed on Schedule "F" and must not be deducted from this schedule.
NONE
\
(1)
ASSESSED VALUE
FOR YEAR OF
DECEDENT'S
DEATH
Insert this total opposite "real property", Schedule "A" in the X X X X X
"As Reported" column on the last page of this return.
(2) (3)
DEPARTMENT
VALUATION
ESTIMATED CAUTION MARKET VALUE (Do nDt write
In this spoce)
BCC'-35 " ..... , , '
, COMMON~ALTH 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
NO·
ITEM
List and describe fully
UNIT ESTIMATED
VALUE MARKET VALUE
DEPARTMENT VALUATION
(Do not write in
this space)
REAL ESTATE: Nona
PERSONALTY:
l. 1. Western Pe~nia National Bank, Roscoe,
Pennsylvania, Savings Account #1262 in joint name~ of
Frsnk Hazelbaker and Irene Fumier.
Balance at date af death.
This account was owned solely by decedent,
Frank Hazelbaker, and Irene Fumier's name was
added ta said account far con~ and
not far purpose of vesting ani ownersfii.'Y' or -
interest in said account to Irene Furnier.
2. Pittsburgh Steel Carporation, Family
Beneficial Plan, Beneficiary, Estate of Frank
Hazelbaker.
Social Security, Fwiezal Benefit-(7{~ ~ --c ~~ _p_
4. General American Life Insurance Campany,
Proceeds of group life insurance at Wheeling-
Pittsburgh Steel Campany. Beneficiary, Estate
of Frank Hazelbaker.
5. U. S. Government Bands, Series E. , Proceeds
af Sale.
TOTAL-------------------
Insert this total opposite "Personal Property", Schedule "B" in X X
the "As Reported" column on the last page of this return.
14,457.57
1,233.60 ~~ L6 1/ ~33. ) -I'
1,2$0.00 ~o.oO
945.33 ~d3
18zl41.50 1 ~ ;; f' C. s-6
.. R:::C-:-36 ·
COmlO.N'I'EALTH OF PENNSYLVANIA
:TL.:\NSFER INHERITANCE TAX
~~SIDENT DECEDENT
SCHEDULE "C"
TRANSFERS
(1; Did decedent, within two years of·death, make any transfer of any material part of his estate, without
receiving a valuable and adequate consideration therefor? (Answer yes or no) DQ
(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 -----------
(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) DO
(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) __ =n~o~---
(b) What was the transferee's age at time of decedent's death?------
(5) Did decedent in ·his lifetime make any transfer without receiving a valuable and 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 tht· property transfe:-red?
(Answer yes or no) ___ n~o~-----
(b) The right to designate the persons who shall possess or enjoy the property trarcsferred or
income therefrom? (Answer yes or no) __ ~Dy~w_ ____ _
(6) If the answer to (5) (b) above is in the affirmative, state whether the right was reserved in decedent
alone or others ________________________________________________________________________ ~------------
(7) [lid decedent in his lifetime make a transfer, the consideration for which was transferee's promise to
1=ay 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 could revert to decedent under terms
of transfer or by operation of law? (Answer yes or no) __ ~n~o~---
(9) If the answer to (8) above is in the affirmative, was the power to alter, amend, or revoke the inter-
est of the beneficiary reserved in the decedent alone or the decedent and others?
(~nswer yes or no) __ n~o~---
NOTE 1: The answers to these questions should be supportect by affidavit by the attending physician as
well ~s 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
Insert thls total opposite "Transfers", Schedule "C" in the
"As Reported" column on the last page of this return.
MARKET VALUE
(Estimated) DEPT. VALUATION
(Dept. Only)
\
\
< ·, •• I .
. RCC-i38 -. ~.. ' ~
• CC~Ot-.fWEALTH OF PENNSYLVANIA
i1lANSFER INHERITANCE TAX.
RESIDENT DECEDENT
SCHEDULE "E"
JOINTLY OWNED PROPERTY
INSTRUCTIONS: 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 entireti~s
or out of state real estate value in estate valuation column. Personal property should be listed as in
Schedule "B", plus date of acquisition, and the name, address and relationship (if any) of co-owners to
the decedent.
Description of Property, Date of Acquisition, Name!
Address and Relationship of Co-Owners, and Place
of Record of Instrument, where Real Estate. 1
NONE
unit
Value
Percentage
Share
Estate
Valuation
Insert this total opposite "Jointly Owned Property~, Schedule ~E"
in the "As Reported" column on the last page of this return.
DEPARTMENT VALUATION
CAUTION~Do not Write
In This Space.
Value of
Entire
Property
Value of
Decedlen t 1 s
Interest
h
..
·RC.~;,:-37 • (12-63)
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)
Box 162 Irene Furnier, liH ..... u .. -.-
110 Meld~n Avenue Audrev Tir'oal: .Donora enna · ·
June Turnbull. ~~lSnV~~~onr.~.ftve
~
_Ji;P;~.' B~x 2~~ Elaine Nichols no abe a. a.
William Hager, Jr.
~~!lr~~~' ~~e ~~ .. c;c;179
..
• • -.1' .. -' ' --
-...... -:" t•.
SCHEDULE "D"
BENEFICIARIES . .
RELATIONSHIP SURVIVED (If step-children or
illegitimate children DECEDENT
are involved, set STATE YES
forth this fact.) OR NO
T'IJUUI'ht.A,. VDJ:t -
Dli.u"""+ ....... Yi!!!S
Daughter Yes
~randdaugbter Yes
~rands on Yes
. ..
-
'
DATE INTEREST OF
OF BENEFICIARY
"lN ESTATE BIRTH
_sui~ .... ,.( .... 1 AI'.P!I+AA !lftrl v .., .... deviS.ee
sui inris ~asi tin~1"V 1 Aoo~+.qa sand
devisee
sui .tur.is _re.siduarv le!!'atee and
devisee
sui juris residuarv lesratee and
devisee
sui juris residuarY lel!atee .and
devisee
--'
; .,
-I
..
Deponent fUrther says that all the above-named bene~iciaries are living at this time except below:
NAME DATE OF DEATH RESIDENCE
Will
Administration ~ No .. /~.$.~ .... Year ..... 4. .. 7 ....... 1
IS THE
~lA TIER OF THE APPRAISEMENT
OF THE
ESTATE OF
.... FRANK .. HAZELBAKER ........ .
Deceased
Late of .... Borough .. o.f. .. ft.o.~~.Q~ ........................ .
Adrian V .. Sannier, Esq ~
411 Washington Avenue
Charleroi, Pennsylvm:tia
·15022
l
·; I l ·I I
. .. -;, ~-....
:
~
:.
(Executor-Administrator
must compietc ·"As
Reported'' column #1.)
~ c;") ..., '"d !:XI .... .... (Ti (Ti 0 1\:> .... E. "' = "' "' "' 0
(;" = '"d ~ i;l E. ....
~ 0
'"d '"0
1\:> (Ti 0" .... ...
. _;--0 ~ "0
l:'%j ('I) ....
"' ~ ,....
Ill ,....
('I)
C/) c:: ::: ::: > !:XI w C/) C/) -<
(') (') ?" ?" ?" q td. > : :
-&;) 'f/9 --'f/9
I :~ I :(lll) =a > I ... :t "' I :~ :1· I f; :I !:XI_ I :a ('1)-I . :• ,, .5-I V\ :a. .., :I :o. :t ,....
I :I (Ti
I :I c.. ., I :I -
--·--'f/9
~~:. > N~ ~
t:l i·
·~: ~~
·~ tv
··~: '3 -·J ,
( :~ = ~ ' c.. •
I
Form RCC-lU "'"""'""' mowm " 1
OFFICE OF THE
REGISTER OF WILLS STATEMENT OF DEBTS
AND DEDUCTIONS
THE SUM OF ............ $.?...?.?f ... ~ .. .?. ..... 1
/2.. -tt;'--7 0
OF COUNTY
AND AGENT OF THE COMMONWEALTH
ESTATE oF Frank Hazelbaker LATE oF Washington Comty, Pennsylvania
DATE OF FILING APPRAISEMENT ---------DAT5 OF DEATH September 19 t 1969
,
DATE NO. OF NAME OF PAYEE REMARKS AMO.JNT
10/6
11 /~
11/6
1111'
11/2f
11'1.7
~/26
8/11
8/'\l
8/11
8/31
8/31
VOUCH10111
69 Reverand Bodnar Funeral Service 10 bo
~0 ,_ .. .c,.an t~urion Funera~lrftol 20 PO
69 Waddington Rest Home Decedenf) Care 44. ~2.
69 Eckert Funeral Home Funeral 1,628 Po
69 Ireae Furnier M!scellane~~ Funeral Emenee --overs for Funeral so 00
70 E. Eckert Death Certificate i 2. 00
70 Alex A. J)uBart Stone Lettering 18 00
Irene Furnier Ml.scellaneous Funeral Expenses 44 po
' 70 Adrian V. Sannier Reimbursement-costs adwancedt '
l,. Ruseell ·Marino,
Probate WUl $ 1s.oo
2. G~ Ro,ers, Pro ate ill 1S.oo
3. Valler Indep. 10.7~ lesral ad~.
4. 1~::!· 8~~: Reports 14.00 IS. Russell ~rino, Short Certificate 1.00 ss 7S
7n Irene Furnier Executrix Comiss ion 907 08
70 Adrian V. Sennier Attorney Fee /'} 907 08
70 Russell Marino File Inventory 3 00
70 Russell Marino File Account I 16 00
('~ l~h~ Jr~ 5'0
3,7oS 23
COUNTYOF ~·
COMMONWEAWH~OF ,PEN~SY-LVANIA }ss:
1. Irene Fumie., ,. HEREBY CERTIFY. THAT. TO THE BEaT OF
MY KNOWL!,DGE .AND .BELIEF, TH! FOREGOING IS 4..~~kAW)_ZTRe\l,l;. !ii{!!TJ!MENT OF D.EBTS, FUNERAL EXPENSES AND EXPEHSI!:!I. OF
ADMINISTRATION SUBMITTED TO THE ESTATE OF ~ 6 cua 118 ~~aKVr -----------------DECEASED, AS DEDUCTI•:JN$ FOR
INHERITANCE TAX PURPOSES. / . ~
1-d 's I_ ~ #tt.AAU..L-v ! 7. -E:j_~--~__.c:.-=-=...:..:==-...>,~-L...p.~~-=-"=:::::...!..-<L. S. l SWOAN AND,UBSCRIBED BEFORE ME THIS 70 DAY OP' I lvjlliUJ~ '"-
-
RCC-81 (2-64)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
INHERITANCE TAX DIVISION IN YOUR REPLY PLEA8E
REP'I:R TO
38-9-9
NOTICE OF FILING OF APPRAISEMENT
IRENE FURNIER
(Executor~)·
In Re: Estate of ___ .::.F.::.RA::.::::,:N-=K~RA=ZE=L=B=.:AK==::E::.:R:_:__ ___ ....--
____ .uW..aA.wS"-~HI~N~G'-"T.l.IO~N.__ ____ County -File No. 63-69-108 2
DearMrs. Furnier:
You are hereby notified that the original
appraisement in the estate of Frank Hazelbaker -
has been filed in the office of the Register of Wills qf Washington!
County on August ] 8 , 197.0.. Said appraisement reflects· the
following valuations:
Real Estate---'------------
Person a l Pr ope rt y ___ ....al.J7~,f..l8..l-'8u.· .!.16 ..... ...,.Su.OL-_
Transfers _________ ~~~~~~--
Total ------~~·=1~7~,~8~8~6~·~5~0 __
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 ___ ~A~up~s~t_l~8~,~1~9~7~0~---
DATE OF.DEATH: SeRtember 19, 1969
Note: This is not a bill.
j
RCC-,'!9 (5-68)
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
Estate of HAZELBAKER, FRANK
(Last Name) (First Name)
SUMMARY
DATE OF DEATH_9_-_1_9_-_6_9_FILE NO.
(Initial)
/
REPORT OF INHERITANCE TAX APPRAISER
I, the undersigned duly appointed Inheritance Tax Appraiser in and for the County of Washington
63-69-1082
Pennsylvania, do respectfully report that I have appraised the real and personal property as reported in the foregoing return at ,r
the values set forth opposite each item in the last column to the right in Schedules "A", "B", "C", and "E".
Dated: 8-18-70 ------~~~~~---------
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. Q
Dated, e&t.l /9,197() ~ili~QI:rJ REGISTE F WILLS
INVENTORY
Real Property (Schedule A)
Personal Property (Schedule B)
Transfers (Schedule C)
Joint-Held Property (Schedule E)
TOTAL GROSS ASSETS
Less Debts and Deductions
(SCHEDULE F)
CLEAR VALUE OF ESTATE
Valuation of life estates or
VALUE AS REPORTED VALUE AS APPRAISED
$ $~--~=-==~~~
annuities . . . . . . . . . . . . . . . . . . . $ _________ ___... __ __
EST ATE TAX ASSESSMENTS
FOR USE OF REGISTER ONLY
Taxon$ ________________ ~---
Tax on $ -----------------+---{
Tax on $ ----------------+----Taxon$ ________________ -+----
Taxon$ _______________ ___... __ __
$ __________ _L __ __
$
6% $
5% $
10% $
15% $
COMPUTATION OF TAX
0 --------------~--~-. ·~ .. --------------~---'" .._' .......
VALUE AS REAPPRAISED
$ ____________ ~---
Exemptions=======~l== To ta I Estate _____________ __._ __ __
TOTAL TAX
*
$
(*) A's evidenced by Charit.lble
Exemption Certificates issued
,by the Secretary of Revenue.
Less tax previously paid
BALANCE
Less 5% of tax if paid within
3 months after death
BALANCE OF INHERITANCE TAX DUE
Add interest at rate of 6% from
--------to ---------
$
$
$
AMOUNT OF ESTATE TAX ASSESSED $----------+--
Estate tax paid $ __________ ___1 __
BALANCE DUE
Add interest at rate of 6% from
----------~0----------
$ __________ ___... __ _
$-----------.1....--
$ __________ ___l __ _
$ -----------+----
TOTAL TAX BALANCE $-----4----PAID $ ________ .....!...._ __
FOR USE OF REGISTER ONLY ADJUSTMENTS
l'"OTE: Where subsequent adjustments are made to the above computation of tax by the Register of Wills, for proper reason,
same should be noted below, with short explanation.
Will
Administration ( No ............... ·.-.:--Year ....... : .. ..
IN THE
MATTER OF THE APPRAISEMENT
OF THE
ESTATE OF
.... FRANK .. HAZELBAKER ............................. ..
Deceased
Late of .... ROS.C.BE .....
County of WASHINGTON ................ .
Commonwealth of Pennsylvania
REPORT AND APPRAISAL
0
:--.,.
.~
Fonn RCC:-2 . COMMONWEALTH OF PENNSYLVANIA DATE ............ .AU&U.$..t. ....... l.9. .. , ...... l.9. .. 7.9. ...............
DEPAJ1TMENT OF REVENUE RESIDENT INHERITANCE TAX" . .. ......... W.~ .. ~.b..in.g1; .. 9..!1 ..................................... BUREAU OF COUNTY COLLECTIONS COUNTY
I , APPRAISEMENT HARRISBURG. PENNA. 17 12 7 FILE NO ................ 6.3.~.6.9.~.1.0.8.2 ...............................
I
Whereas, ........................... Frank. ... Haz.elbake.r ....................................................... late of ................................. :R.Q.$.~.Q.~ ...................................................
in the County of ................................. lY.a.shingt.o.n ............................................................. Commonwealth of Pennsylvania, having died on
I
the ...................... l9. ..... ~.b. ..................................................... day of .................... §..~.P.~.~~~-~-~···················· 69 seized and possessed of an estate I 19 ............ ,
I subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore, I, ...................... W. .•. R ........ Chaney. ................................................................. , 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 Apprahement Description of Asset Values Made for , nherltance
Tax P~rpoaes
~
PERSONALTY:
See copy of Schedule "B" attached to appraisene nt 17,881 50
C' ,., rt:: ..... , ' e .
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I ~ Tofal . ' 17.886 50 . ~
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form~;•!:;fhbl:~ ::~hi:worJla~~~~· ~~ !e~~~~b~~~§ ~~~·~~ '~ ................... ~4?. ........... . ......... ·:· ·········~~JV"A:"
c!Z!.······························~···································· ············································· L (Number and Street)
A-d .... :O:: •.... ~··o:;;;;;;;······· .......................... , Penna.
,,
..... :~,WASHINGT.ON .............................. . County
RESIDENT INHERITANCE TAX APPRAISEMENT . .;,.
.. '~ ...
Estate of
FRANK HAZELBAKER .................................. ······································ ··············································
Deceased.
Late of
ROSCOE .................................................... ························································ ,·
Date of death, ..... §.~.P!:.~.JI:t!'..~.~ .... J.~.J. ..... ~.~-§..~ ..
Appraisemel!t Docket Vol., ................... 3..e ........................... .
Page, ........ ~.~.~ ........................... No ..... 6..3.~.6.9.~.10.8.2 ..
Filed in Register's Office, .. A.ugu.st ..... l.8.J9 .. 7.0..
Amount of tax due, $ .................................................................... .
DEPARTMENT OF REVENUE
Received, .................................................................................................. .
Exa.mined and Approved, ........................................................... .
Wrote abo.ut Appra.isement, ................................................. ..
t .,
Appeal f1'om Appraisement, ..................................................... .
..~ ..
Entered and charged, .................................................................... . , .... ~
jl
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