HomeMy WebLinkAboutOC1970-0722 - ESTATE OF SLACK""
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i\ffi~uuit (@f iExerutnr (@r i\~miui!itrutnr
jS!tatt of 'tnnsylnanta.t lUi:
C!1ounty of Bas~in!lton \
Personally before me,the undersigned authority,a.N.Qj;~r..Y.f.Y:p.J.i.g in and for said
County and State,appeared ~.~.'!::~.Y.!.9..~.h who,being duly
sworn according to law,deposes and says that She is the executor or administrator of the estate of
........~.9.~.~.~~.~.~.9.~deceased,that the foregoing schedules constitute a
complete inventory and appraisement of the real and personal estate of..ASn.e..s S.la.c.k.,
deceased,except real estate outside the Commonwealth of Pennsylvania;that the figures opposite each item
of real and personal estate in the foregoing schedules are determined and stated by the undersigned to
be the fair value of said items as of the date of the decedent's death,based upon a just appraisement of each
item made by the above named ExecutcrixAdministrator.
Sworn and subscribed before me this...~....J he-d
day Of'''1;''~'''::::1'''fj9..7{.-/l...KENNEl J.~';;:AR~·P';Bjj;;··ut~;~i;;;··_·····-......ft~T........~'"':::.ljlA·sHlr,GTON,WASHINGTON COUNTY,
ADDITIONAlLc~NS§RR;U(};WJ(9N$'E 24,1974
1.An inventory must be filea within three mon!l¥i'Sb'af~e~n~pp~Mtm~fi~IJJWi~¥~t~al 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-
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
lJuututorg aub !\ppraistmtul of the goods and chattels,rights and credits which
were of ~9.n~.~§.!.~.9.~Jate of §m!.~h ~.Q~n§.h~.P..
Washington County,Pa.,taken and made in conformity with the ab07Je affidavit.
j
Real Estate:
Personal:
None
DOLLARS CENTS
Savings Account (cash)
Pension check
1964 Pontiac sedan
Personal items
TOTAL
$2,762 49
80 00
250 00
300 00
$3,~92 49
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®rp4uun ~Q!nurt iininlnu
In the m3ltter of the Audit of Account in
Estate of AGNES SLACK,
".j
Deceased.
;.
TO THE AUDITING JUDGE:
Enter our
,__---==.1....-,19~
N.B.-Counsel shall,by separa;te paper,present a concise statement of each
claim,with supporting calculation of any interest claimed.Objections
to an account as filed,shall be concisely stated in a separate paper.
Council sugges,ung proper distribution shall file a separate concLse state-
ment in that regard.
,.I,
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:./~0,
No._'
In re Audit of Account in EstaJte of
AGNES SLACK,Deceased.
AUDIT
'ra.rrip.r fnr App.raraur.r
FOR
<--,ANN DARIAN0.....,
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BLOOM,BLOOM,ROSENBERG &BLOOM
200 Washington ,Trust Bu~lding
Washington,Pennsylvani~15301
Attorney -
~2
STATE OF PENNSYLVANIA,
WASHINGTON COUNTY,~55:
The within named Accountant being duly sworn according to law,depose 5 and sayS that the above account
as stated is true and correct as ~.h~.._.__.__verily believe.
~-~~"-=-'-if----------------------------------
Washington County,55:
Sworn and subscribed be'fore me this ...;(~.....
day af __~__----}----)JlL-_-/~__i~~------
.W.4SHINGTON wSKI,NOTAR PUBLIC
MY COMMlgSION EXA.,'HINGTON COUNTYMemb.'PIREs JUer,Pennsy/vaniaA '.NE 24,1974
SSOClat/onofNotarie
"do certify that 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 Coy~t,as evidence by proofs
thereof filed to No.I?_.3..:,.II-~...:fgO ....
my hand and official seal this__3..0.~.._
daYOf..__..V""-'!:Y.~~-:----------~
Register of_Will~'--1
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The Court is respectf.·uII Y requested ~/Jr~e.
proper distribut~Z ~_
Counsel for ~ccountant
Real Estate:None
I.'GROSS ESTATE:
$3,392.49
$2,762.49
$80.00
$250.00
$300.00
$13.00
14.00
20.00
21.20'
15.00
39.98
50.00
84.00
120.00
$1,329.00
157.12
157.12
$2,020.42
None
1964 Pontiac Sedan
personal Property:
"TOTAL GROSS ESTATE
Savings Account (cash)
Personal items
Pension check
TOTAL DISBURSEMENTS
Kenneth J.Yablonski,Esq.
Betty Toth,Executrix
III..DISBURSEMENTS:
II.RECEIPTS:
ESTATE OF AGNES SLACK
FIRST AND FINAL ACCOUNT OF BETTY TOTH,EXECUTRIX
Register of Wills
Washington County Reports
Harry G.Benz,M.D.
Browns Green House
Observer-Reporter
Repo1e's Department Store
Father J.R.Bostet
J.Paul Proudfit,M.D.
S.White's Sons
Lee Funeral Home
n..
6/17/70
8/4/70
8/8/70
8/8/70
8/13/70
8/16/70
8/26/70
10/4/70
12/26/70
Observer .Repor~er
WASHINGTON,PENNSYLVANIA
PROOF OF PUBLICATION
In compliance with the News,paper Advertising Act of 16 May,1929,
P.L.1784,as amended.
Commonwealth of Pennsylvania,County of Washington,55:.
Personally appeared before file,a Notary Public in and for said County
Richard S.Cowan .and State,,who bemg duly s,worn
according to law,deposes and says that he is the s.e.c.re.t.a.r..y .
of the Observer PUblishing Company,a Bennsylvania corporation,and its
agent in this behalf;that the said Company is the owner and publisher of
the Observer·Reporter,succ'essor to The Washington Observer,established
Septe1mbe'r 18,1871,and The Washington Reporter,established August 15,
1808,a daily newspap'e,r of general cir'culation,printed and published and
haVing its place of business at Washington,Washington County,Pennsyl.
vania,where it or its predecessors have been established and published
continuously for more than six months prior to the publication of the notice
hereto attached;that the printed notice or advertisement hereto attached
is a ,copy of an official advertisement,official notice,legal notice or legal
advertis,ement,exactly as printed or published in the Ob£lerver-Reporter in
its regular editions on the follOWing date or date.s;..
.............................Aug.ust 7.•.14 and .2J.•.....1.9.1.0 ..
that neithe'r tll'e affiant nor the Observer Publishing Company is interested
in the subject matter of said notice or advertising and that all of the aHe,ga-
tions of this affidavit as to the time~Plae and ch2rater of publication
are true.:'//£I
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Esi~late.".'L'e·
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I'to"tini('requ
,to the
landacedent',
'ment ·t6"
I delay.-Y':;,'.'.,\"B~Hy;'
'R.D.#1Burgettstown,Pa.15021KennethJ.Yablonski,Esq..Attorney ,
70185·Fri.·3t
Sworn to and ,"b~~'~:R~£?
WASHINGTON,WASHINGTON COUNTY
MY COMMISSION EXPIRES MAY 6,1972
;..
Washington County Reports
;~/itNtt/.N/.'H J;frN:J:lr
Washington,Pennsylvania
(PUBLISHED BY WASHINGTON COUNTY BAR ASSOCIATION)
PROOF OF PUBLICATION
In compliance with the Newspaper Advertising Act of May 16,1929,P.L.
1784 Sec.3,paragraphs (3)and (25).
COUNTY OF WASHINGTON)
STATE OF PENNSYLVANIA (88.
Personally appeared before me,a Notary Public in and for said County and
Commonwealth,CHARLES C.KELLER,who,being duly sworn,deposes and
says:that he is the Editor of the WASHINGTON COUNTY REPORTS,the
official legal periodical for said Washington County,publis'hed weekly having its
place of business at Washington,Washington County,Pennsylvania,and is act-
ing as its agent in this behalf;that the said WASHINGTON COL'NTY
REPORTS was established on March 31,1920,and was designated as the official
legal publication for Washington County,Pennsylvania,by order of the several
courts of said County,dated November 11,1920;that the printed notice or adver-
tisement attached hereto is a copy of a notice or advertisement,exactly as printed
or published,which appeared in the said legal periodical in its regular issues on the
following dates:
August 6,13,20,1970;
••••••••••••••••••••••••••u •••_•••••••••••••••••••••••••••••••••••••••••••••.••••••••••••
that the affiant or the corporation in behalf of which he is acting is not interested
in the subject matter of sa.i~#a~r advertising an~a~a~tIHy<~llVratio s of
this affidavit as to the ti~er of C!:;.blijjn-/are~ue.~
Sworn to and subscribed ~~··~·..··Edit~;
..?g.~.~day of...~~.~.~.~.~,19(!..?~·
8~Q1.~~A~:-:-:
JOSEPHINE T.SCIAMANNA
Notary Public,Washington,Washington Co.
My Commission Expires July 1,1974
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 ehem
for settlement to the Executors or Admin-
istrators or their Attorneys.
• ••••• • • • • • • • • • • •
SLACK,AGNES,Dec'd.
Late of Smith Township,WashingtonCounty,Penna.
Executrix:Betty Toth,R.D.#1.Burgettstown,Penna.15021'~Attorney:Kenneth J.Yablonski,505WashingtonTrustBuilding,Washing-ton,Penna.15301
--------------------~--------------~-........
..'........:
IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY,PENNSYLVANIA
ORPHANS'COURT DIVISION
IN RE:
ESTATE OF
AGNES SLACK,
DECEASED.
No.-~..5-1//'1<6 rl-
EXCEPTIONS TO THE FIRST
AND FINAL ACCOUNT OF
BETTY TOTH,EXECUTRIX
AND NOW comes ANN DARIANO,by her attorneys,BLOOM,
BLOOM,ROSENBERG &BLOOM,and file the following exceptions to
the First and Final Account of Betty Toth,Executrix of the
Estate of Agnes Slack.
1.That in the total assets in the said First and
·Final Account there appears the following item:Personal items,
$300.00.Since Ann Dariano is the residuary legatee in the
said estate and is entitled to all the moneys thereof,she is
entitled to an itemization of the said personal items and the
amount received by the Executrix for the same,or the fair
market value t~ereof.
2.There appear the foll0Voling items in the said First
and Final Account:S.White's Sons,$120.00 and Lee Funeral
Home,$1,329.00,which was paid for the funeral expenses.The
said Agnes Slack,deceased,took out an insurance policy,which
was made payable to Betty Toth as beneficiary for the purpose of
making payment of her funeral expenses.'The said insurance was
carried with the Prudential Insurance Company on the life of
Agnes Slack in the amount of One Thousand ($l,OOO.OO)Dollars.
,.. .
The said Betty Toth,Executrix,shall be made accountable for the
One Thousand ($1,000.00)Dollars which she received from the said
insurance company for the payment of the funeral expenses for
Agnes Slack,deceased.
3.That no where in the First and Final Account does
there appear among the assets of the said estate a balance in the
Mellon National Bank and Trust Company of Four Hundred Forty Five
($445.01)and 01/100 Dollars.We are herewith attaching a photo-
static copy of the said Mellon National Bank and Trust Company
statement,marked Exhibit "A"showing a balance of $445.01 in
the account of Agnes Slack on June 19,1970.The said Betth Toth,
Executrix,shall be made accountable f0r the said moneys in the
Mellon National Bank and Trust Company and the same shall be
included in the assets of the said estate so that proper distri-
bution can be made of same.".)
,"
Respectfully submitted,
BLOOM.BLOOM.ROSENBERG &BLOOM
BYI2.~if:.•.
/I.C.Bloo
Attorney for Ann Dariano
,.
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662-6282
5
063
15053
$45.23
.10 CENTS HAS SEEN'ADOEO
.,'..F"OREAcH CHECK PAID
S315.96
.'~
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MELBANK EASY-BALANCE ST~TEMENT
A HELPFUL CHECK800;<BAl.ANCING FORM IS PROVIDED ON THE RE.VERSE 5/0£
S114.53
MELLON NATIONAL BANK ,AND TRUST COMPANY .__~,~...".-:-~......
l!5ALANCt.,PREVIOUS Ot!P.OSITS·AND:"*CHECKS AN0 MAINTENANC£~ANCt ,••ST~£Mt:N'T OTHER CREDITS OTHER DEBITS .CHARGE f;#"S STATt::MENT --\..;
$445.01 ;'
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AC:'~.~~ER.STAT£MtN.T:DATE..
6/19110 AGNES Sl AK_____...-.---.80X 18
;.-a,:",JOFFRE PA'.~,
EXHIBIT "A"
,f,\..
IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY e PENNSYLVANIA
ORPHANS'COURT DIVISION
IN RE:
ESTATE OF
AGNES SLACK#
DECEASED.
}
}
}
}No.63-70-722
}
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}
ADD I T I 0 N"A L
EXCEPTIONS TO THE FIRST
.AND ,FINAL ACCOUNT.OF.
BETTY TOTH"EXECUTRIX
AND NOW,comes ANN,DARIANO,by her attorneys,BLOOM e
BLOOM,ROSENBERG &BLOOM,and file the following additional
exceptions to the First and Final Account of Betty Toth,
Executrix of the Estate of Agnes Slack.
1.That the said Betty Toth,Executrix of the above
estate,did not account for a refund received from the Washington
Hospital in the amount of Ninety Nine and 20/100 ($99.20)Dollars
which was made payable to the Estate of Agnes Slack,in the
assets of the said estate.The Executrix is hereby requested to
account for the said asset and to include the same in the
assets of the said estate.
Respectfully submitted,
ROSENBERG &BLOOM
ariano
PETITION SUR AUDIT
IN THE ORPHANS'COURT OF WASHINGTON COUNTY
--~--,
Testate Form J
Estate of ~qn~~L.S.l.~g~--..
Deceased
No ,__A.A.
•Fiduciary ~~.~~y...~.~~!?:.
Date of Date of
Decedent's death g.'d!~~.*.l...!:~7..Q Grant of Letters ~~Jy ~~.,J9..7.Q .
This is the fin.al account filed in this estate
If there have been former accounts filed in this estate,list file number or number and term .
Election to take
Under or~ixlxI»vill.(cross out one)
Date Election Place of;
Fi led Record .____.
Name of surviving spouse ~9.~~.
List issue,where material:
Did decedent marry after execution of will?{indicate)XMXNo.Any children born afterexecution of will?(indicate)
~K No.If answer yes,name them :__..__.
......_-_oo -______~""""""""""""••""._""""""._"""""""_"""_""".,,,,__"".._.
Leg,atees
Anna Dariano
Relationship
daughter
Interest
all
Fiduciary,if deceased or not sui jur'is
List,if exceptions to above:
If partial intestacy,give facts:
Adeemed:Revoked:Lapsed:Abated:Give Cause:
Notice to interested parties.Have all parties,having either vested or contingent interests and all crediors entitled
to notice (Court Rule No.9 paragraph C:Section 6:Subdivision c)received written notice of the filing of the account
and of call of audit?Yes.~x
If any exception give cause:.
File copy of Notice The only interested parties were the executrix and Anna
and date of mailing p.§..~~.@.Q W.1)&.J~*.~P.!:~H?~Dj;!;.9.:..J?.Y.9.Q.W~~.~J....§!WP.9.~~S~}.y,~.q ..J?~pp.~.~.notice..
Is estate subject to the filing of a Federal Estate Tax Return?No .
Actual payment made on Pennsylvania Transfer Inheritance Tax.Amount $.J!.2.,.~.2 .
If the Will makes any portion of estate subject to a life-estate,give name and birth date of life tenant .
Give Names and addresses of all unpaid creditors who a re 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:
None
Balance for distribution per account,
Itemize any additional debits not shown by account:
Total additional debits (Add)
Itemize any additional credits not shown by account:
Total additional credits (Subtract)
Balance for distribution
$.~.!.~.?~.:.~!.
s.~9 !.20 .
'\
$.?~.~}.?.................
$.l.,.~J~.a..•..~.~.
If balance for distribution is not in cash,list each item held in kind,giving appraised Value (or distribution Value);
1964 Pontiac Sedan
Personal Items
$250.00
$300.00
I .------
If Family Exemption claimed by Petition,give place of Record:__.__.__ .
If Family Exemption is claimed at audit,give name,relationship and basis for Claim:.
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:
COUNTY OF WASHINGTON,55:
COMMONWEALTH OF PENNSYLVANIA.
The abover:om~dFiducioryorrepresentative thereof,
"being duly ~w..Q~J-L doth depose and say
that the facts_~et forth in the foregoing petition are true
"to the bestbf ..:._..:..b.e.r knowledge and belief.
.\-.
....................:~to and subscribed before
me th;s .:!-.~j;.I.!doyp;,'W~Afj :19.?.L
Signature of OffiC~~~..F ~_:.
Title of Officer NQ1:.~;r;y.J?~!?)J.9..
Office expires Jgm~..).~.J J~.?~.
ItENNETH J.YABlONS\{I.NOTARY i'1J8UC
WASHINGTON.WP,_~HJ[~GTON COUNTY
MY CQWI'I'''SION EXPIRES JUNE 2,.1974 .
Member.PennsylvaniaAssociation ofiiotarles
And your petitioner will ever pray,etc.
~,.~.<~~.
No..A.A.
'.
Estate of }\gn~p···§·:J.g£~·······················f·:·I I ;:-Pl
i l_t-_oo ~_..f y
HUSSf:,:.-':',;'(;i'l 0
REGISTEH OF 'WILLS
WASHIN\~TOrJ CO,.PA.
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......................................................···D~~~~~~d···t 7I 0CT ??,-(
Fiduciary•......aet.ty TQ'tb .
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:po rag raph b-c;and divisions
thereof:shown on pages 23-24.
1.Written praecipes of all Counsel in the
case.
2.Copy of order appointing Guardian ad
litem/if pertinent.
3.Copy of Order appointing Trustee ad
litem/if pertinent.
4.Proof of service of above.
5.Letters Testamentary or Administration
C.T.A.or an attest copy of Will.
6.Copy of inventory and appraisement.
7.Proof of advertisement of grant of letters
if not filed with account.
8.Certificate of liens in case any of the
funds for distribution are from judicial
sale of real estate.
9.Signed and itemized elections if any
distribution in kind.
10.Copy of Federal Estate Tax return if es-;;;;;;at.~~.."._._----~
Attorney'
2
ptl 3 53
L..,
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IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY,.PENNA
ORPHANSI;COURT DIVISION ..
,.'.."'~
..
••~'t•
INRE:
Estate of
AGNES SLACK,
Deceased.
(
)
(
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(
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(
No.722 6f 1970
«Z«>..I>-IDZZIIIII.
~BEFORE:
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..:APPEARANCES:
~II:I-ID
o
..I«
§TIME:o::l.,
:t~til
HEARING ON AUDIT
The Honorable P.VINCENT MARINO,Judge
of the said Court..
KENNETH J.YABLONSKI,Esq.,of Wash,in.gton,Pp,.
representing the Accountant.
Wednesday,September 15,1971,at 10:00 o'clock
A.M.,EDST.
Kenneth Yablonski IS office.I have here the final Petition for Audit iJ,
.deceased.The Executrix is Betty Toth and the attorney is Kenneth V.
Yablonski.
Number 722 of 1970,the estate of Agnes Slack,
Sir,I am Attorney Samuel Feinberg representingMR.FEINBERG:
ui
/:i-THE CODRT:
~oII.
IIIII:
l-II:::loU
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the estate of :A'gnesSlack.Ther"e were excepti~ns originally taken to
'th~accou~t.b5nrelegatee,Mrs.·Anna Dariano,who is represented
by Mr;I..C.Bloom.However,these exceptions have all been settl d'
and ther:"a:re no further compl~cations.-
THE COURT:And are there any outstand ing c~Mms ?
MR.FEINBERG:
THE COURT:
No,there are not,Your Honor.
Very well.Is there anyone else in Court interest d
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in this decedent's estate?
'(NO RESPONSE)
J •,:~
THE COURT:
the ·Court.
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The audit of this account is ordered·closed by
(A UDIT CLOSED)
,
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In t4t <trourt ofQ!omutun 'Itas of lIas4ingtnn <trounty.
Jtnnsyluunin.®rp4aus 11 Q!ourt iiniswn
ESTATE OF No._6_3_-_7_0_-7_2_2 --:-_
Agnes Slaek
decea.sed
In the matter of the First and Final
Account of BettY'.Toth
Executrix
ADJUDICATION AND DECREE
And now October :e~,19-ll,this matter came on for hearing,
audit and distribution alt this session and testimony taken;and thereupon,upon due consideration
thereof the galance for distribution in the hands of the Accountant is determined to be
$ ,,38 .95 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 DISTRIBUTION
Balance per account 1 $1,372.07
Additional debit asked at audit
Additional credit asked at audit
Balance·_
Deduct Clerk's Costs &Receipts'--_
Afttorney Kenneth Y:Yablonski
Anna Dariano,daughter,residue,including
cash;1964 Pontiac Sedan valued at $250.00;
Personal items valued at $300.00;held in kind
a:nd distriby.ted as such at the appraised value
as shown,
99.20 $1,471.27
I 82.32 $1,388.95
12.00
$1,376.95
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OFFICE OF THE REGISTER OF WILLS
,r.·-·•
County of t:V~~J:I~.I.'1<?r;r~~.
...........,..~~1::t.Y .r;r.cr~!l..,".., "of "..~~fg~1::t;f?1:RW~"..JilSi,•.................,
(Name)(Address)
being duly ~_~~!.~.according to law,deposes and says thaPhe is the -------!?-~~-q~-t~-1d~-~----------E----)----------------(Exec.,A m.,Legatee.cc.
of the estate of ~9_~~_!?.__§.!~_~~--------..whose last residence was .__~m.i..:t;.h __'J'_QWIH~h(-sJp)-,--·------------------
(No.)creec
~_~~~_~~9..~9_~__~_~~_~~Y!~~_~eceased,and that the whole of the estate of said decedent,who died §llJ:(DlI)Q-----------
(Cicy,Borough oc Township)ace
consisted of:
Form No.RCC-62 (7-69)THIS FORM REQUIRED IN ALL ESTATES WIl'H GROSS ASS
EFFECTIViI:JANUARY 1,1962.(FILE IN DUPUCATE WITH COPY OF WILL ATTACHED)
•
REAL PROPERTY
REAL PROPERTY IN PENNSYLVANIA.WITH STATEMENT OF MORTGAGE ENCUMBRANCES UPON EACH PARCEL AT DEATH OF DECEDENT,
WHERE PROPERTY HELD AS JOINT TENANT OR TENANCY BY ENTIRETIES,GIVE NAMES.ADDRESSES Aim RELATIONSHIP OF OTHER OWNERS.
Real Estate Estimated
Value
NONE
I
Personal Property \
/'
Savinas Account (cash)~\S2 762 4q\
pt:ln!::.inn ,,/)/"RO 00
lq64 ';:,oro C!t:lri;:,on /~'l(,c;o nn
'-../',
Personal items {300.00
\
'--
NOTE:You may expedite the processing of this return by filing with it,and as a part of the return,
letters from financial institutions or mortgage holders,certifying to amounts on deposit or owed by the
decedent as of the date of death.Such letters must be signed by a responsible officer of the financial
institution or mortgage holder and indicate clearly amounts of principal and interest in the decedent's
account at the date of death and the type of account,account number and the exact name or names in
which the account is registered.
Estimated
.5 alue
~-------------------~-------,------------'t-;-c--'-----=':-"---..,..:y----".
•J
Transfers within TWO YEARS Prior to Death
NONE
That at the time of death there was no safe deposit box registered ih decedent's individual name,or jointly with,or as agent or deputy of
another,or in decedent's individual name,with right of access by another as agent or deputy,with the exception of the following:-
NAME AND ADDRESS OF BANK OR OTHER INSTITUTION THIS SAFE DEPOSIT BOX RENTED RELATIONSHIP OF JOINT
IN WHICH DECEDENT RENTED A SAFE DEPOSIT BOX IN NAME OR NAMES OF HOLDERS TO DECEDENT
NONE
-
BENEFICIARIES
~BENEFfciARIES AND ADDRESSES
RELATIONSHIP SURVIVED AGE OF LIFE
INTEREST OF(If step-children or DECEDENT TENANTS OR
(State full names of all and their addresses who have illegitimate children STATE YES ANNUITANTS BENEFICIARY
an interest,yested,contingent or otherwise,in estate.)are involved,set OR NO AT DEATH OF IN ESTATE
forth this fact.)DECEDENT .
Anna Dariano 735 (,h;l:!l~t:."S dau-lo.....~-V~g ,-'J all
Pittsburgh,Pa.
-
-
"1'v--........-..~
',.
DEBTS AND DEDUCTIONS CLAIMED
NOTE:'List first ~ve items in the spaces so provided.observe notations thereon.and instructions
RESWEN1:DECEDENTO!l '
DEBT OR CLAIM NATURE OF SAME AMOUNT-TIU~COLUMN
~e Funeral Home,Browns KEGISTER ONLY
~~nllQ'"~Wh;i-""Q Funeral expenses paid $1 52020 $
Sons,Father J.R.Bostet
Family exemption (will not be allowed unless
I~ourt costs,advertise-decedent died residing with a spouse or children.)
Inent,etc.Administration Expenses *42 od
Kenneth J.Yablonski Counsel fees •1 t;7 1 .,1
Betty Toth,Executrix Fiduciary commission •157 1 .,
I
OTHER DEBTS AND CLAIMS
(.)See Note below
H~rry G.Benz,M.D.20 00
Repol~'s Department Store 39 98J.Paul Proudfit,M.D.-84 00
<
,.,..-
.'
,l'.
I
'-'-.;,
\,
I,
I"
".,',
",..
",.
.
i7f.,J ...
Total S ,o,()42 2.1)2.1)'11-.
Note:The estate agrees to advise the Register of Wills if the amount actually paid in settlement of any fee,commission oi'debt is greater
01'less than the estimated amount claimed and allowed.~~
Subscribed and SWOl'n'to before me this :l~..........~A./1~4~./'~'/4"'"~r./.~r-Administrator)
,I~.-""'~.7 /"-........JI:;.;..~jd~of·;··~...·,~~NPldHJ.YABlON~1'"Ill?D.#3-: .,...•.'IV .,'".NOTARY..·l'l3t1c .
;.';~ASHII~r,TON.ViP :;iliJGTON COUNTY (Street Number)
•"Y CO'VIM'"v.,..............,...;. . .i .i .............SlON "PIRE.>JU"E24'Jl~t
.':..,-:..~-!~Member.PennSYIVaniaAssOciation~mo~ailes.~~~''t:-~.~~~.~!..~e:t ~~~.~~.
'\.,\I''(City or Town and State)
\.........
Having been duly sworn accordIng to law,I do cJ::b~J1c;rtifY that the above appraisement is made in conformity with law on this
.....................cX!I.oJ day of 'cr-'~'-'r'n"iA'~i~"£;l!v n.......-..-......-.r ~.\../.0.,..,'"~'~~~I~;I'••••
In the event that any future interest in this estate is transfened in possession 01'enjoyment to collateral heirs of the decedent after the
expiration of any estate for life 01'for years,the Commonwealth hereby expressly reserves the right to appraise and assess transfer'inheri-
•tance taxes at the lawful collateral rate on any such future interest.
REPORT OF THE REGISTER.OF WILLS
I,the undersigned duly elected Register of Wills in and for W~County,Pennsylvania,do respectfully
report that I have allowed debts and deductions in the amounts claimed'b;d'e'p'~e'~t:~~cept as to those items where a greater or lesser amount
is set forth in the last column to the right in said schedule above,which greater or lesser amount represents the sum allowed as a deduction.
Dated:'1.-:.J,.J.-:.7! .............
Register of Wills
..
"
.
.,-',,'::..;:'-'
It'•~"'I"...\,~"/-.'••:{If '~.>.,'J :
.()Ii '0....:•..••,..........<
"'l av I ~.,,:;''/"....\"....~.,q._~\"\'\\\
....J ..MATTER (')1<'1 'I1'lfIE AI'VPRAISEMRN!T.f ~lijII •f fill g-JtJ
OF THE
Form No.ReC-62 (7-69)
ES.TAT'E gF/I:.'\niN0
nEG 1STt d 0 F \'1'ILL S
WASHINf,TON CO.,PA,
Will l~dministration SNo.. . . . . . . . . .Year .....
r I'[,"q'"'I I .f'1 I JoN.Tij'E d ~
~....')
.....
.f
•i,
AGBES .•~De'c~~~~d ............
Late of ~~..~~~~~~.
County of ....~~h1u9t.oc......................
Commonwealth of Pennsylvania
REPORT AND APPRAISAL
",
'1
,
~(
--.....
R CC-SI (2-64)
COMMONWEALTH OF PENNSYLVAN IA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
INHERITANCE TAX DIVISION
NOTICE OF FILING OF APPRAISEMENT
BETTY TOTH
(Executor ~)
IN YOUR REPLY PLEA8E
REFER TO
38-88-8
J
In Re:Estate 0 f -..£!A~G!!!NFSt=!·!>!.-,S!:!!:LA~C!!.!K=--_
___-..IlWASIQ,·loLHu.INoI.moiGu.T~QD.N County -File No.63-70=722
Dear Mrs.Toth,
You are hereby notified that the ~Q~r~i~g~ina~~l ------------
appraisement in the estate of ~A~G~NES~L~SuI~~~C~K~___
has been filed in the office of the Register of Wills qf WARHTNr.TON
County on shlly 23 ,191J-.Said appraisement reflects the
following valuations:
Re al Est ate _
Personal Property ~3~t~3~9~2~.~4u9~__
Transfers _
Total ....3~,3,.L9,JJ.2.........4"""9'-----
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 (8%)percent per annum is charged.
Any party in interest who is aggrieved by an appraisement may
appeal therefrom as provided by law.
Dat e __---:J!!!.,;ull<!o·".lyL...-.::2.....3~,~1..97.LL.oOl........_Signed W~R '"bb'4.1)~LQnw.
TitIe ALFRED TOOl,APPRAISER I
DATE OF DEATH:June 11,10/70
Note:This is not a bill.
"
RCC-39 (5-68)
'!-.
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SUMMARY
Estate of SLACK
(Last Name)
A'GNES
(First Name)
DATE OF DEATH 6-11-70
(Initial)
FILE NO.63-70-722
REPORT OF INHERITANCE TAX APPRAISER
I,the undersigned duly appointed Inheritance Tax Appraiser in and for the County of__W.:.;;.'A_S_H__ING:.;;.T=-O=-N _
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:--><"'_~""-"-iJ---'~""""-----OJ/~d~v ~<~I ERITANCE TAX APPRA ER
REPORT OF THE REGISTER OF WILLS
EGISTER OF WILLS
Dated:_~Jul;v=~2~3,L....:1;;...:'fI...:...;;..1 _
I,the undersigned duly elected Register of Wills in and for WASHINJ.TON County,Pennsylvania,do respect-
fully report that I have allowed deductions in the amounts claimed by deponent,exce t as to those items where a greater or
lesser amount is set forth in the last column to the right in Schedule "F",lch greater r lesser amount represents the sum
allowed as a deduction.
VALUE AS REAPPRAISED
$--------1--
1 372 (J71372(J7
VALUE AS REPORTED VALUE AS APPRAISED
$$-------1--
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 -E
FOR USE OF REGISTER ONLY
Tax on $~i---2%
Tax on $1'6%')0.
Tax on $--------~~-'so/:'
nX~$lK
TU~$l~
Exemptions *
Total Estate --l-__
TOTAL TAX
COMPUTATION OF TAX
$----------l---
$-----~~;l&...-
$----------l---
$----------l---
$--------+--
$--------'----
(*)As evidenced by Charitable
Exemption Certificates issued
by the Secretary of Revenue.
Less tax previously paid
BALANCE
Less 5%of tax if paid within
3 months after death ::::::::::~I===
BALANCE OF INHERITANCE TAX DUE $t=
Add interest at rate of 6%from_____to $----l
AMOUNT OF ESTATE TAX ASSESSED $----~L-
Estate tax paid $......Il-
BALANCE DUE $-----......I~
Add interest at rate of 6%from t=
------Ito-----$-----~
TOTAL TAX BALANCE $-----~PAID $-1
FOR USE OF REGISTER ONLY ADJUSTMENTS
NOTE:Where subsequent adjustments are made to the above computation of tax by the Register of Wills,for proper reason,
same should be noted below,with short explanation.
Will
Administration (No.
IN THE
Year .
MATTER OF THE APPRAISEMENT
OF THE
ESTATE OF
AGNES SlACK
Deceased
Late of ..SMITHTOWNSHIP..
County of ....WMliING'l'ON
Commonwealth of Pennsylvania
REPORT AND APPRAISAL
....2
,"">
,..-:
.:;'~,')
t
Fonn RCC-2
.'...:,....
•DEPART~NT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
HARRISBURG.PENNA.17127
COMMONWEALTH OF PENNSYLVANIA
RESIDENT INHERITANCE TAX
APPRAISEMENT
DATE ~~?3.;;I..97.1..
COUNTY .w.~~M!.lgti,.9.~.•'c,),....
FILE NO•..9.3.~7.~7??.
Whereas,AGNES ,SLACK late of SMITH T.OWNSHIP..
in the County of :W.~.HINQT.QN ·~Commonwealth of Pennsylvania,having died on
the ele:v:enth day of June 19.70 ,seized and possessed of an estate
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore,I,AU:.~~1 ,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 Purpoles
$
PEftSONAL:
SEE COPY ATTACHED TO APPRAJSEMENT 3.392 49
-
,
I
1 ,
l
.'.I ..
Having been duly sworn according to law,I do h~reby certify that the above appraisement is made in con-
formity with law on this ;2..3d day of ··~·Ui1/~·:·;j..~..·..~·..·:··..·........A:9 2:1.
........................................................::-;.~\/.~~~.
Appraiser
(Numb and Str~)...............................................0.....,Penna.
(Peat,)
I
..............WASBINGTON .....County
RESIDENT INHERITANCE TAX APPRAISEMENT
Estate of
.........................AGNES SLACK .
Deceased.
Late of
........SMITH TOWNSHIP .
Date of Death,:~1l~7.Q .
Appraisement Docket Vol.,.3..~.
Page,E!.~~L No 9.J...~7.~7.??.
Filed in Register's Office,~~??19 .7~
Amount of tax due,$.
DEPARTMENT OF REVENUE
Received,
Examined and Approved,.
Wrote abo,ut Appraisement,
Appeal f1'Om Appraisement,..
Entered and charged,.
,r
•
\,
•...,
C
J
38-88-8Docket)Deceased
IN THE ORPHANS'COURT OF WASHINGTON COUNTY,PENNA.
7,-1 (-70 I
)Date of death
\No,~2 of 1979 Term,19__,A.A.
ISlack,Agnes
In the matter of :the Audit of Account filed in the Estate of
TO THE AUDITING JUDGE:
Enter my 'appearaiIlce for the Commonwealth of PennsylViama,claiming tl'ansfer inheribance tax in the above estate,as follows:
DR.
To appraised Vialue of Estate:Realty_________...._...____$_
Personalty ._______.__.....__.._.__._.$__1_}----'~'_t._..___'__¥_l___t;..:.-r_
Additiol1!al Assets per Account,Subject 'to Tax ..__.$_
Additional Assets per Audit,Subject to Trax _._____-$
GROSS VALUE ._._..._...-.$_
CR.
Debts and Expenses per Account;see Note
Additional Debts and Expenses per Audit
II
)
$--------
$-------,----
$-----'----
$-------
$-------$
$---
TOTAL DEDUCTIONS,$
NOTE:The following credits claimed in the Account are
held not deductible 'a'S against the tax:
CALCULATION
Gross v:aIue_____
Less Deductions ~
.,'
Clear Value __
---,----I.m ,.--=----.07r----
$
Tax-
able
at
15%
Total Tax ..._ .._
TAX PAID ON ACCOUNTq-t-1.L$2'z"3v...
$--_._--
$------
$---_.
$-------
\(
$------------_._-
~~,~V$--------------
Less amount previously pa1id m m m m m_m__m $Yr J <:_
~•.;;.;.------r_aoo-=",,=-_.,
Balance .__........__.....$-'_
Interest__yrs.__mos.__days @ __% .$
TOTAL TAX AND INTEREST DUE ....__. .$ _
No..Term,19 __,A.A.
ESTATE OF
Deceased
;:'f ~or:I)"MI..!"'..•
t7 I DC f ?I P'!j 5R
PRAECIPE FOR APPEARANCE
FOR
COMMONWEALTH OF PENNSYLVANIA
~5
t--\:;:~j:-"'"r •/;:(l"JV
r:2GiS TL t",0I·VI!LLS
tH''·'·'ff'--r"'·'·'"r pAl.At:.rt ,..I.'il l.J...JJ.,
J,r ).,SUPPLEMENTAL RETURN
REV-449 (\-eo)A AVIT OF
"COI,{MdN.l'IEALTH OF PENNSYLVANIA FF ID.
'DEPARtMENT OF REVENUE FIDUCIARY
TRANSFER INHERITANCE TAX /}(I R S d)/"'7RESIDENTDECEDENT'/I.tJ.!J,J.nstructions on everse i e b..::J -70 -7dJ..
===========:=£:===========================::::::!':~============
Estate of Agnes Slak Date of Death July 11,1970
Last Add ress __R_._D_._#_3'--_
Burgettstown,Penna.15021
Social Security No._
Bureau File No._,....--_
(CITY)(STATE)(ZIP)
Co un ty Fi Je No._....:..7..=2..=2--=0..=f--=:1..::.9....:..7-=.0 _
1.Decedent died:
( )Intestate (without a will)
( X )Testate (leaving a last wi II--copy attached)
2.Is the filing of a Federal Estate Tax Return required for this estate?Yes __No _X__
3.)Executor/Executrix )Administrator/Administratrix (X)Informant
"
Nome William Rudolph Slak
Address R.D.#3
Burgettstown,Penna.15021
(CITY)(STATE)(ZIP)
4.All correspondence should be moiled to (X)Attorney )Fiduciary.
5.If on attorney is representing the estate,indicate:
Nome Greenlee,Richman,Derrico &Posa
Address 325 Washington Trust Building
Washington,Pennsylvania 15301
(CITY)(STATE)(ZIP)
List all safe deposit boxes registered in the decedent's individual namehor jointly with,,or as an agent or depot)"
of a:1other,or in decedent's individual name with right of access by anot er as agent or deputy.Include the nome
and address of the bank or other insti tution where the safe deposit box is located,the nome (s)in which the box
is registered and the relationship of the joint holders to the decedent.
-:.
NAME AND ADDRESS OF BANK OR OTHER INSTITUTION NAME OR NAMES IN WHICH RELATIONSHIP OF JOINT
IN WHICH DECEDENT MAINTAINED A SAFE DEPOSIT BOX SAFE DEPOSIT BOX IS REGISTERED HOLDERS TO DECEDENT-
:
-
=-
Under penalties of perjury,I declare that I have examined this return,including accompanying schedules end
statements,and to the best of my knowledge and belief it is true,correct and complete.
gI.~Informant 7/4P
.'PENNSYLVANIA INHERITANCE TAX GENERAL INFORMATION
1.PERSONS RESPONSIBLE FOR RETURN
Section 701 of the Inheritance and Estate Tax Act of 1961 provides that the following persons shall prepare and file
a return:.
a.The personal representative of the-estate of the decedent as to property of the decedent administered by him
and such additional property which is or may be subject to Inheritance Tax of which he/she shall have or
acqui re knowl edge;
b.The transferee of property upon the transfer of which Inheritance Tax is or may be imposed by the 1961 Statute,
including atrustee of property transferred in trust,provided that no separate return need be made by the transferee
of property included in the return of apersonal representative.
2.PLACE FOR FILING
The return is to be filed in duplicate with the Register of Wills of the county wherein the decedent resided.
3.TIME FOR FILING
The return is due nine months after the decedent's death,unless an extBnsion for filing has been applied for and
granted by the Secretary of Revenue within the nine-month period.>,;:'
4.FAILURE TO FILE RETURN
Section 791 of the 1961 Statute provides that 1/•••any person who willfully fails to file a return or other report
required of him ...shall be personally liable...to apenalty of25%of the tax ultimately found fa be due or $1,000
whichever is the lesser to be recovered by the Department of Revenue as debts of like amount are recoverable by
law."
5.TAX RATES
Inheritance Tax is payable at the rate of 6%on transfers to lineal descendants,such as father,mother,husband,wife,
son,daughter,grandchildren,grandparent,son-in-law and daughter-in-law and at the rate of 15%as to all others.
6.PAYMENTOFTAX
The tax assessed on the transfer of property reported in the return is due 9 months after the decedent's death.Interest
at the rate of 6%per annum accrues thereafter until payment is made.All payments received are first applied to any
interest which may be due with any remainder applied to the tax.IF TAX IS PAID WITHIN ~MONTHS AFTER THE
DECEDENT'S DEATH,A DISCOUNT OF 5%OF THE TAX PAYMENT IS ALLOWED.
All checks should be made payable to the Register of Will sof the county wherein the decedent resided and are
received subject to the final determination of the Department of Revenue.
7.FAILURE TO PAY
The taxes imposed,together with any interest thereon,are a lien upon real property,which lien remains in effect until
the taxes and interest have been paid in full.The taxes may be sued for against any real property in the decedent's
estate or against any property belonging to atransferee liable for the tax.
8.FILING OF FALSE RETURN
Any person who willfully makes a false return or report required of him shall,in accordance with Section 793 of the
1961 Statute,be guilty of amisdemeanor and,on conviction thereof,shall be sentenced to pay a fine not exceeding
$1,000 or undergo imprisonment not exceeding one year or both.
'.
,"
1'.
REV-450 II-sOl
.CCJMMI3NWEAL TH Ol"PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INH ERITANCE TAX
RESIDENT DECEDENT
ESTATE OF Agnes Slak
SCHEDULE "A"
REAL PROPERTY
(Instructions on Reverse Side)
ITEM ESTIMATED DEPARTMENT
NO.DESCRIPTION MARKET VALUATION
VALUE (OFFICIAL USE
,"..::,"'.ONLY)<
'",..'~...._.r .'~....,.....-,_A'.."
NONE
-
--
,
-,
:
,
TOTAL THIS PAGE
INSTRUCTIONS FOR COMPLETING SCHEDULE "A"-;:-
Schedule "A"should include a detailed description of all real property located in Pennsylvania
and held solely by the decedent or held jointly with another individual (s)as tenants in common.List the
decedent's percentage of ownership and the estimated market value of the decedent's interest.(Property held
as joint tenants with the right of survivorship or tenants by entireties should be reported on Schedule "E".)
All real estate located in Pennsylvania should be described by lot and blo.::k number,street
address,number of acres and general description of land and buildings.Also,include the book and page
number in which the deed is recorded and·the exact title os indicated on the deed.If the property has been"
sold,attach '0'copy 0'£the s'ettlement sheet.If the property is subject to a mortgage encumbrance,include
the name of the mortgagee,date,rate of interest and the outstanding balance on the date of death and
attach a statement f~om the mortgagor verifying the outstanding balance.
Property taxes and interest on mortgages as of the date of death,assessments and other
encumbrances should be listed on Schedule "F".Do not deduct them on Schedule "A".
,."
REV-4S1 (1-801
COMM'ONWEALTH OF PENNSYLVANIA
,[)EPtl~TMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
Agnes Slak
ITEM
NO.DESCRIPTION
SCHEDULE "B"
PERSONAL PROPERTY
(Instructions on Reverse Side)
ESTIMATED
UNIT MARKET
VALUE VALUE
DEPARTMENT
VALUATION
(OFFICIAL USE ONL Y)
•~.;t.'.
1.
'".....~"-1 .......~01..""""".....'~.~""-.....t..."_........".......~••~~1'-;:"."..........-t.."'_'?'..._~..."......."
Life estate in 13.97 acres and 32.50 acres,
both in Smith Township,Washington County,
Pennsylvania.as reserved in the Deed oj
the Decedent and Martin Slak,her husband,
to William Rudolph Slak,dated April 18,
1955,of record in Deed Book 935,at
page 372
TOTAL THIS PAGE
$12,000.00
$12~OOO.OO
I 'J-OOl)
"-.-
'"f"'."._-t."¥""•j ~.•-:•
,~-'-j '.'f':.}
......,;4-
INSTRUCTIONS FOR'COMPLETING SCHEDULE "B"
"",~.
Schedule "B"must include all tangible and intangible personal property
owned individually by the decedent at the time of death.Property owned
jointly with another party or parties should be listed'nn Schedule "E"--Jointly
Owned Property.Intangible personal property,titled in the name of the de_cedent,
but pay.eble at death to another party or parties,including but not limited to
P.O.D.U.S.Savings Bonds and Tentative Trust Accounts,must be listed on
Schedule "B".
Tangible personal property should be listed first.Examples of tangible
personal property are jewelry,wearing apparel,household goods and furnishings,
books,paintings,automobiles,boats,snowmobiles,aircraft,etc.
Intangible personal property includes cash-on-hand and in the bank,stocks,
dividends,bonds,mortgages,treasury certificates,notes,together with accrued
interest,salaries or wages,insurance payable to the estate or fiduciary in said
capacity,partnership interest,etc.An interest in any undistributed estate or
income from any property held in trust under the will or agreement of another
even though located outside of Pennsylvania at the time of death should be
listed on Schedule "B".
A completed Partnership Interest Report (REV-894)must be attached for
each partnership or joint venture,and a completed Closely Held Corporate Stock
Information Report (REV-893)must be attached for each closely-held business
interest or sole proprietorship reported on Schedule "B".
SCHEDULE "C"
TRANSFERS
.
REV-452 (l-eOl
COMMONWEALTH OF PENNSyLVANIA
DEPAIHMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT Agnes SlakESTATEOF--.;;._
..
INSTRUCTIONS:
1.Answer the questions on reverse side.
2.If the answer to any of the questions on the reverse side is "Yes,"provide a description of the property transferred per
Schedules idA,""8,"or idE,"its estimated market value at date of death,dates of transfer,to whom transferred and
relationship of transferees to decedent.Attach a copy of any trust deed or instrument relating to the transferred property.
-~....~-_~..""..,....-j"~:~"t'~........,..,..,...~,.\:-~"'Y'~..~-,..''-,''.,''':',..'
ITEM ESTIMATED DEPT.VALUATION
NO.DESCRIPTION MARKET VALUE (OFFICIAL USEONU
.'.,".'-,.';'1-"''<'.~-•'J-
NONE
~
-
--
""
:
TOTAL THIS PAGE
-,,'..
QUESTIONS CONCERNING PROPERTY TRANSFERS ."1.Did decedent,within two years of death,make any transfer of any material part of his estate without receiving
valuable and adequate consideration?(Answer liVes"or IINo".)_-'-_
2.Did decedent,within two years of death,transfer property from himself/herself to himself/herself and another party'
or parties (including aspouse)in joint ownership?(Answer IIYes"or IINo".)_,",
3.If the answer to one or two above is IIYes"and the transfers are claimed to be nontaxable,provide the following
information:
a.Age of decedent at time of transfer._
b.Copy of death certi fi cate.
c.Affidavit by the attending physician indicating the state of decedent's health at time of transfer'::~
d.All 0 the((lltorm~!j,9,n.:supp_~rti ng non't~.xabi lify'~f;tran.sfer:~··:':~,..-.'".'.,:•
4.Did decedent,in his/her 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/her death?(Answer IIYes"or "No".)_
,a.Was there any possibility thatthe property transferred might return to -transferor or his/her estate or be subject
to his/her power of disposition?(Answer IIYes"or I'No".)
b.What was the transferee's age at time of decedent's death?
5.Did decedent in his/her lifetime make any transfer without receiving avaluable and adequate consideration therefor
under which transferor expressly or impliedly reserves for his/her life or~ny period which does in fact end before his/herdeath:
a.The possession or enjoyment of or the right to income from the property transferred?(Answer liVes"or IINo".)__
b.The right to designate the persons who shall possess or enjoy the property transferred or income therefrom?
(Answer I'Yes"or IINo".)'_
6.If the answer to five b.above is "Yes,"state whether the right was reserved in decedent alone or others._
7.Did decedent in his/her lifetime make atransfer,the consideration for which was transferee's promise to pay income
to or for the benefit or care of transferor?(Answer "Yes"or IINo".)_
8.Did decedent,at any time,transfer property,the beneficial enjoyment of which was subject to change,because of
a reserved power to alter,amend,or revoke,or which could revert to decedent under terms of transfer or by operation of
law?(Answer "Yes"or "No".)_
9.If the answer to eight above is "Yes,"was the power to alter,amend or revoke the interest of the beneficiary reserved
in the decedent alone or the decedent and others?(Answer "Yes"or "No".)_
,
,RE~·454:(l·o'l'())
COMMONWEALTH OF PENNSYLVANIA
,1J..EP~RTMENTOF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "E"
JOINTLY OWNED PROPERTY
(Instructions on Reverse Side)
Estate of A_g..:.._ne_s_S_l_a_k _
P
TOTAL E VALUE OF DEPARTr'J1ENTITEMRDESCRIPTIONMARKETcDECEDl;.NT'S VALUATIONNO.VALUE E INTEREST (Official Use Only).N......,.T
,
NONE II
.',\·{·."'~:";_I .....:;"
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!
I
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I -.),
.
_.
:
-.-
,
~
.
TOTAL THIS PAGE
.
INSTRUCTIONS FOR COMPLETING SCHEDULE liE"
,
Of '"'\••
"",-If 1
'f'''':3 I lil
Schedule "E"must include all property,real and personal,owned by the decedent jointly with another
party or parties as joint tenants with right of survivorship.Both tangible and intangible property are to be
included.List real estate first.
1.Describe all real property as indicated in the instructions for Schedule"A".Describe all personal property
as indicated in the instructions for Schedule "B".Include the name,address and relationship to the
decedent of the co-owner (s)and the date the joint ownership was established.
2.Indicate the total market value of the jointly owned property.
);.
•......:,~.--"'-"....".~'·":"~l •*!'.........".~...........3.Indicate the percentage of the decedent's interest..
4.Indicate the market value of the decedent's interest.
l''"0 t:l (')>-tTl >-:E->-0 0 t:l V"l 0 ....Z CJ (')c:::t:l ..,Z s:Z t""'.1;"",--_.tTl tTl >-0 0 t""',,"~Z :::0 ....Z .Z tTl ..,tTl
..,Z0..,-<tTl -c::::><0 V"l V)tJ)Vl 0.::::2'"I....J 0_'Z 0 ..,
~J 0 "!'j "!'j ~..-..-c'>-00en;,t.c.:..,"'J:jIJJ~I~fo ~...."'J:ja:::::::H_-),PJ ~0 -4,~.j (')W e:::::t Vc.I en Z::T §P ~....to-e::.:r'~>-U')~JJ ..~.1-'-t""'("r):~:J rt('J r-4~,,,,,,~,
'J)0 ~~rt ~Ct~..1 (,./)...,;rt en ~V"l,-,',W",.
_.
\tr.0:::(.){j 0 rt ~tTl0-ct:i..4,c;"'~~:J 0 0::J'~Ze.::t :J t""'co....-<-<-<'-""0 tTl tTl1-'(0 >->-U1 :J ~;:00:JlVPJ
I-'
j
REV·5IB (3·79)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATIONS
P.O~BOX 2970
HARRISBURG
17105 IN YOUR REPLY PLEASE
REFER TO
Investigation Division
NOTICE OF FILING OF APPRAISEMENT
William Slak
(Executor or Administrator)
Agnes SlakInRe:Estate of -_....::::.._--------------
_W_a_sh_in_g_t_o_n County _File No.__6_3_-7_0_-_0_7_22
Dear M r.Slak:
You are hereby notified that the Supplemental
appraisement in the estate of ----=:....:----A.....g"""'n=-e=-s=-.-.S..,r--:::a""k:----------
has been filed in the office of the Register of Wills of wastn.ngton
County on May 19 ,19~.Sa id a p-p-ra--:j-se-m-e-n"""":t-r-e"7.fl-ec"""":t-s-t:-he--:"fo--:I""",o-w"""":j:-n-g-v-a:-'u-a-:tj:-o-n-s:-
Real Estate 1_2.:-,0_0_0_,_0_0 _
Personal Property _
Transfers -------------------Jointly Owned ----..--.....--,....,..,..,.,,.......,.....---_
Total 12,000.00---------------------
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 nine (9)months (fifteen months
when death occurred from December 22,1965 to June 16,1971,inclusive;and twelve months
when death occurred prior to December 22,1965)from date of death,interest at the rate of six
(6%)percent per annum is charged.
Any party in interest who is aggrieved by this notice may object thereto within sixty
days after receipt of said notice as provided by Section 1001 of the Inheritance and Estate Tax
Act of 1961,72 P.S.2485-1001,P.L.373.
Date M_a_y_19_,_1_9_8_0 _
DOD:7-11-70
NOTE:This is not a bill.
•REV~4~EX (2-80),
SUPPLEMENTALINHERITANCETAXSUMMARY SHEET
(BUREAU USE ONLY)
Fi Ie Number 6_3_-_7_°_-°_7_2_2 _
Estate Nom e --=-A=...g--=n-=-e-=-s--=S=-:l=-=a:.::.:k~_-L~L,·~'?~~:..L/9~_---==5.=--=L~ff~e.~.-t:!=....-_
Date of Death _~__7_-_1_1_-7_0 _
Social Securi ty Number
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 tne t column to the righ;+~c~l~~e)ules "~","B", "C",and "E"
Doted,May 20,1980 (:c"~."-JAR!:..Y )j/!Ii~~-J-J-/..A./INHERITANCE TAX AP-P-RAI'SER \;1
INVENTORY
ADJUSTMENTS
VALUE AS APPRAISED CODE (HARRISBURG USE ONLY)
,,,I"\t'\A AA
REMAINDER APPRAISEMENT CODE
Real Property (Schedule A)
Personal Property (Schedule B)
Joint.Held Property (Schedule E)
Transfers (Schedule C)
$00+
10+
20+
30+
92+
---------1---+--_.
TOTAL GROSS ASSETS
Less Debts and Deductions
(SCHEDULE F)
CLEAR VALUE OF ESTATE
___-.1.]k2..,-!.OJ)0 nO
-------1---
-----'--'----r=-I
Valuation of life estates or
annuitieslio •t •"lo'..~&iI ...'IP ~
FOR USE OF REGISTER ONLY
Tax on $
T ax on $
Tax on $
\
Tax on $
Tax on $
RATE FACTOR
6%
15%
PRINCIPLE VALUE
COMPUTATION OF TAX
$
$
s
s
$
CODE
Exemptions ==========4=====
TotaI Esta te ----lL----_
TOTAL TAX
INTEREST FROM _
BALANCE
TO
$-------------l--
$----------+---
$-l-__
Less Credits
DATE OF PAYMENT AMOUNT PAID
$_
DISCOUNT
+$
INTEREST
$----=
TAX CREDIT
$-----------
TO S _
+
INTEREST FROM ----_
BALANCE DUE
BALANCE
----=
$---------_._---
s
(,.
REV-457 (1-80)
*
.:.~tCOMMONWEALTHOFPENNSYLVANIAINHERITANCETAXDEPARTMENTOFREVENUEAPPRAISEMENT~.rTRANSFERINHERITANCETAX
RESIDENT DECEDENT
Agnes Slak File No..63-70-0722
Estate of
Washington 7-11-70CountyDateofDeath
In the event that any future interest in this estate is transferred in possession or enjoymentto 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.
PROPERTY REPORTED BY THE ESTATE DEPARTMENT'S
APPRAISED VALUE
1.TOTAL REAL PROPERTY -SCHEDULE "A"~u~p:e~e~t:~l.l-.l.,uuu.uu.
2.TOTAL PERSONAL PROPERTY -SCHEDULE liB"
3.TOTAL TRANSFERS -SCHEDULE "C"'•....~...'V •-.......01:...,
4.TOTAL JOINTLY OWNED PROPERTY -SCHEDULE "E"i \,',
,TOTAL REPORTED PROPERTY 12,000.00
PROPERTY NOT INCLUDED IN RETURN BUT APPRAISED BY THE COMMONWEALTH
,,
,
I
,
..
,
TOTAL UNREPORTED PROPERTY
TOTAL GROSS ASSETS 12,000.00
LIFE ESTATE OR ANNUITY CALCULATION
-
Ido hereby certify that the above appraisement is made in conf@~~law and has been filed this day
with the Register of Wills.'1",l~Cl,(~1 ~.<\5-19-80 .7 AP~tISER--'"DATF
.,'
(OFFICIAL USE ONLY)
WILL
NO.YEAR _
ADMINISTRATION
NO.,YEAR _
ESTATE OF Agnes Slak
ADDRESS Burgettstown
COUNTY OF Washington
DOCKET NO.._--=.3::::::......r::r~_
PAGE NO.L~--/
LINE NO._
•..•'.I!>
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAtJ OF FIELD OPERATIONS
DATE:
REV·SS6 A (8·78)
William Slak
R.D.if 3
Burgettstown,Pa.1 5021
Re:
May 20,1980 ~'
Agnes Sla
Estate of 7-11-70 /};I/.
D.ate ofDea~~_70_0722 'I\~
FIle No.
Jf-ff-I
Dear Sir:-
We have recently contacted you or your legal representative advising that the above
estate was in a delinquent status.As of this date,the matter has not been resolved.
-Section 701 of the Inheritance and Estate Tax Act of 1961 requires the personal
rel¥esentative of an estate and/or a transferee to make an inheritance tax return.In addition,
Section 711 states that inheritance tax is due at the date of the decedent's death and shall
become delinquent at the expiration of nine (9)months.
i'
Section 791 of this Act provides that any person who wilfully fails to file a returnreq~~rd under the provisions of this Act shall be personally liable for a penalty of twenty-five
pe~E t (25%)of the tax determined to be due or $1,000.00,whichever is less.This penalty
is in ddition to any other liabilities imposed by the Act._
Our review shows that this estate remains open because:
____An inheritance tax return has not been filed;
x 720.00_______Tax in the principal sum oL . ,plus six percent (6%)
annual interest from 1O-1l-71 __remains due and unpaid.
Very truly yours,489.60
1,209.60 -
Accordingly,please be advised that unless the return is fiied or the tax due,
including interest,is paid in full within fifteen days from the date of this letter,proceedings
will be instituted in the Court of Common Pleas by this Department to effect compliance with
the law.
Tax@6%
1n-t.to 6-11-80
Total Tax Due
Address reply to:
-,I
$---------~
$---------n
$720.00
:==.~
$---------
$Einel Payment
$--------
%Tax on $__~_
Estate Tax,Act of
May 7,1927
6%Tax on
2Cf~Tax on
15%Taxon
15021
Date of Death 7/11/70
Burgettst.own,pat
Address 11 ,D!t3
File No.63-70-722
Date of Payment --f!M~alo-:l~'f-T~2~2.....,-1~9~8Q.·J,J.O--------I
Name of Decedent _.z:A4g;.;ol..UiieU;;sl...·--'Su.....l....aukilo.-s.aal!Ckua<L-1
I.Ii RECEIVED -.uO~n,ee~t,.thl-(O).l.U~8~aM:n~d::l-·--1t~'I'1-l'!O:>--Jh~1l,l;.,mn-d@reeQ.d---nn.:a,i1Jn,.€l~~a,.p.n~dH6~OH/~1~O~O:J.-""""'-.-dollars
~,representing Pennsylvania Inheritance or
I.j From:---,WlY..,L1...,jJl...la..1J,."j.::!aWIDi!..--'''QS..!.l,J;auk~r-E_s_ta_te_T_ax_d_u_e_f_ro_m_t_he_fo_I_lo_w_i_ng.:.--e_s_ta_te_:1I~'-1it
'=:~~!I- I~-:
f
I
,County I-JasbingtQo
i Remarks:BM
I .
TOTAL TAX CREDIT
less five percentum of tax if
paid within three months after
date of death
Plus interest at the rate of
.fi-%from 1-/1 1 /7 1
to date
$720.00
$---------11
$1,209.60TOTALAMOUNTPAIDzlrill~[p [L ~@illlr rn SEA l.f.38..88 ...8'NOTE:This T~iplicate Receipt to be retained for aU'ff'gPoses.
.Recei ved by ..,."""/:.....:./..;./--.,--'/::../...;/::......~--;-:_----''---;--I/""7""'-~---.-/-"'/:......c:::-1I!!I
NOTE:In accepting the transfer -inheritance tax on future estates.prior to the death of the lif~,(Signature),/.''-
tenant or tenant for yeors.as evidenced by this receipt,it is understood that the Commonwealth sholl
not be precluded or prevented from hereafter assessing additional inheritance tax at the death of the ~/:.....:...="'~...,-"f../==_:_--------11
life tenant or tenant for years whenever it appears that such additional tax may be legally due and (Title).
collectible for any reoson whatsoever.
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