HomeMy WebLinkAboutOC1970-1164 - ESTATE OF GALLIK&3-1~-//&f J
1\ffi~ulltt (@f iExrrutnr ®r i\~mtt1t!itrutnr
~tate of 'euu.ayluattia l
C!1ouuty of 1It1Ia.a4ingtou ).an:
Personally before me,the undersigned authority,a N_<?!_?:!.Y.._~:Y.I?n<;....in and for said
County and State,appeared __~~_i?_~p.hAn._~Zgy"g~..htJ;L .who,being duly
sworn according to law,deposes and says that she is the executor or administrator of the es-
tate of __~~_~!?-._Q_~~~~~~!._?:l~l.?:__.;J:~~_g_~~!~eceased,that the foregoing schedules constitute a
..//John GallikcompleteInventoryandappraIsementoftherealandpersonalestateof--------------------------------------------,8 Ie deceased,except real estate outside the Commonwealth of Pennsylvania;that the figures opposite
§~each item of real and person~estate in the foregoing schedules are determined and stated by the
~c.O undersigned to be the fair value of said items as of the date of the decedent's death,based upon a
z :c -:just appraisement of each item made by the above named Executor Administrator.~E~~o~g'g i d SfW,0,airnv a~::u~s~r~l;ed be
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0re m;lthis ./..}~~i ~..~.<:!/~.en ~~ali .(X,&?~Q.....f>C"'~TrE~~~~t~~'.~d.e .....:..x~;:.;~._xt..L0~..........................1/Z U lI).;1 ·To
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c(:g'~..,:';-,.,~".-".);/_",ADDITIONAL INSTRUCTIONS
c-E"'.)!_.:_:;,;..'~~1.,Ah invtmtory:,must be filed within three months after appointment of personal representative.~~-'2.,A s~ppl,~melltal inventory must be filed within thirty days of discovery of additional assets.
3.·1 Or,~igin~and 2 Copies and 2 RCRI-34,Under $10,000;1 Original and 2 Oopies and 2 RCRI-33,
."'Over $l9,0~O;'ineluding Copy of Will;1 Original and 3 Copies and 2 RCRI-33,Over $50,000,in-
•\'t,cluding\"Copy'of Will and copy of Federal Estate Tax Return.
'\y••.".<\\'REFERENCE FOR ADDITIONAL COpy."'\I.,,,,,,,:,,.).~,,,.,.Act of 1947 P.L.513 Sec.5.2,72 P.S.4844.2
3Juueutory aUIl 1\pprainemeut ,of the goods and chattels,rights and credits which
were of ...J..<?hp..q~1.1.~.~}..~.I.~.I.~..J.9.h_.~..G:~.~~~late of ~.:~)Hqrp.~.~,, , , .
Washington County,Pa.,taken and made in conformity with the above affidavit.
DOLLARS
REALTY
Lots :N>s.5 and 16 in the Underwood Plan,in the Borough of
California,(formerly East Pike Run Township);,Washington
County,Penna.,upon which there is erected a four-room
frame bungalow.For chain of title see Deed Book Volume
764,Page 477.5,000.00
PERSONALTY
CENTS
h
National Slovak Society,death benefits
Social Security death benefits
70-110
662.08
255100
5,917108
/~OoU
"~"~'-7 ()- /I b "l-.'"~\•J/
-'~~~,..'l~;iiet:~y,.and Appraisement
_"I f I '-'.".'!'.\'-,INTME.ESTATE OF
::.~.JOHN GALI1IK.also known as
!. \,--.,t...._-~\"I."'-,•,10...:....."..:;.>.i JOHN,'GALIK
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Filed .19 .
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HORMELL,TEMPEST,SIMMONS,
BIGI &MELENYZER
Attorneys at Law
423 Third Street
California,Pa.15419
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C!tnuuununttttlt4 nf 'tuuaylttttuitt.~
IItta4iugtnu Qtnuuty.\aa:
KNOW ALL MEN BY THESE PRESENTS:Whereas,at Washington,in the County aforesaid
"on the 24th.day of November A.D.19 70,before me,
Russell 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 Will and Testament of
John 'Gallik a/k/a John Galik
late of California in the County aforesaid,deceased,
(a true copy whereof is to these presents annexed),was duly admitted to probate;and
Josephine Zavachin
rix
the Executqx in said Will and Testament named,having appeared before me and taken and subscribed
the oath of office prescribed by law;
NOW,THEREFORE,I,Russell Marino ,Register as aforesaid,do
grant these LETTERS TESTAMENTARY,unto the said
Josephine Zavachin
committing unto her the administration of all and singular the goods and
chattels,rights and credits,which were of said deceased,and requiring her
to exhibit a true and perfect inventory thereof into the Register's Office,at Washington,within ninety
days from the date hereof,and to r,ender a just and true account of said administration at the expiration
of six months from the date hereof,and to regard and comply with the provisions of the laws of this
Commonwealth relating to inheritanoe taxes.
IN TESTIMONY WHEREOF,I have hereunto set my hand and the seal of said
Office at Washington,this 24th.
day of November in the year of our Lord one thousand
nine hundred and seventy
.,
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Of'
I,J"Olm GALLIK,of BiZ6 Orchard Street,C8~l:Uornia,Hashington County,
Pennsylvania,do hersby 1,1E1};:C,pu.blish and.declare th:l.G to bE:my L-:A.st Hill 8XU:.t
Ter5tcl.ment,b:8reby revoking and E1al:hlG void.any ami [,11 vlil18 by me at any time
;!,
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FIRST:.,...---
SJI:COlID:
I direct my Executrix,Josephine Zavachin,to pc.y all my ju.s.t debts 2nd.
funer2~ex~~nses as soon as may be practicable after my decease.
I give j devise j "mel l-,equeath 13.11 of my property,real J.R.rsonal,and
mixed,of ,·rhich I die seized or possessed,or to "I,rhieh I.may be entitled
at my decease,to my beloved children in:cg,u2l.shares,share snd Shl?.re
aUke .The n:;:tmeS of my child:ren are:.
L Leonard Gallik
2.Jolm GAllik
"
3.Josephine Zavachin
4.Albert GiUlik
5-William Gallik
6.Elj.z8beth C~\llik
"
........
THIRD:
Proviclc;el,hOi-leVer,tb...'1t my bcloveo.idfe !viary shall':nave the choice a.nd
power,should she so desire,to occupy my home on Orchard Street in
Cr.'.liforni;:;",H8.shingtoll Cou,,'1ty:Pennsylvania,_fOT [-J.nd during the term of
her natural l:i.fe,Iv:Lthout th-:;p2.yment of rent,if she keeps the house in
good.re"P<'l.:lr and PSi.y8 the taxes.
I have illud.e the provision for my \.{J.fe lv1ary as aforesaid ",-1 th f'uJ~
•
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ImO\lledge that oh;~hns surr~:ndered 8.'11(1 relNi.cecl "my stGttutory riEhts
she mo..;f huve in TIl.y erJtate by her oigll:l.ng eUl Antenuptial Agreement d.:2ted
St"l)~-eln'o"''''':>6 19J'-h::....v............,._,\..•
1!'OUH'l'II=I l1orilinate,constitute and appoint my beloved.daught.er,Joscphine ZttVQ(~lin!
Executrt:x:of thts my Last HE1 <In(l 'I'estament,2.11d I direct that shr;511,'].11'
not be required to enter security in any jurisdiction in '....hich she r.J.O-y
act.
IN HITNESS vHIEREOF,I I1fwe hereunto Get my,hand and se".l.t,o this hiG
.:Iv
page L'tst Htll I;.l.nd Testament,tIllS rtfrldC'cy of september,1956.
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'.J U /I"~//f '7,'.-(,,"",';~y'.-'.~{2-J(f~!:t!!:4'__\0~..L)(Inn Gallik
"
TIff.FO:t~.Q0INQ:INS..T;?l}l,'1I~NT,'"e.onsisting of tva (2)pC:,ges in:tS on this ;;.?~.
day of SEptember,1956,isgned,sealed,published and declal~e(l by SO~r GJ\.:h~,IK,the
'Test~tor,as and for his Last Will and Test~ment,in the presence of each of us,
\ir.:o J 3.1:h.:Ls re'1.1JJ.?:$t,in,b.is I-Jresence J 21Ll.d in tb.0 In·t~SerlCe)of e;'cb.other·.,rill -b2i:~.:.;
\jresent at the same time,have hereunto subscribed our nQmes 3,S ,TltnesseD thereto.
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Residing at
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NO.63 -70 -1164
FIRST AND FINAL ACCOUNT
of JOSEPHINE ZAVACHIN,Executrix of the Estate of John Gallik,also known
as John Galik,deceased,late of the'Borough of California,Washington County,
Pennsylvania.
1.Balance as per inventory and appraisement filed on
Novelnber1,1971
2.Conversion of assets:
II
Sale of real estate:\
I'
Consideration
Less Costs:
$12,000.00
$5,917.08
1%state transfer tax
Preparation of deed
Seller's closing fee
Notary P:ublie:fee
~of sales agreement
Tax ·certificate
Pro-rata share of
1972 taxes ~r .,
I ;'
$120.00
$25.00
$30.00
$1.00
,.$17.~50.
$2.00
$22.35."
$21 7~85 \'~,$217.85
1Netproceedsfromsale
Inventory iValue of real estate
$11,782.15
.$5,000.00
Net gain from rransfer of real estate $6,782.15 $6,782.15
$12,699.23
...1....1._..I....I..","""I'"','",'* * * **** * * * * * * *=~** ** *
RECAPITULATION OF ACCOUNT
70-110
Total Assets of Estate
Total Credits of Estate
Total Balance of Estate
Balance consists of:
Cash.
-1-
$12,699.23
$2,760.68
$9,938.55
$9,938.55
?-
ACCOUNTANT CLAIMS CREDIT FOR:
1970
Nov.24
1971
I;
"
"Russell Ma:'rino,Reg.of Wills
Washington County Reports
Brownsville ::Telegraph
Probate of will and 1 short
certificate
estate advertising
estate advertising
$
$
$
14.00
14.00
9.00
Reimbursement to Josephine Zavachin for:
,
D'Alto rio Funeral Home -funeral expense
Quinet Monument Co.-headstone engraving
Tax collector -California borough taxes
Nichols Flowers -funeral flowers
Groceries -for funeral dinner
California Water Co.-wat~r service
West Penn Power Co.-electric service
Bell Telephone -telephone service
ColuJtnbia Gas Co.-gas service
Angelo Cole &Sons -gas repair
$1,160.,00 ,~
$20.00
$16.80
$39.75
$40.85
$9.14
$7.44
$8.63
$17.57
$7.50
$1,327.68 $1,327.68
Oct.19 Borough of California Sewage $7.35
Oct.27 Julia McDonald,tax collector 1971 school tax $70.25
Nov.1 Russ:ell Marino,Reg.of Wills Balance on lette'rs 4.00-,',
filing inventory 3.00
I'
~'filing renunciation 1.00 $8.00
i
Dec.20 West Penn Power Co.electric service $5.21..
1972
Jan.31 Borough o{California sewage $7,35
ii
West Penn Power Co.electric service $10.15
I
Feb.23 West Penn'Power Co.electric service $9.73
Mar.21 West Penn Power Co.electric service $1.76
Mar.27 Oliver N.Hormell attorney fee $791.38
Josephine Zavachin executrix fee $474.82
Wash.Co.Bar Assn.Bar Assn.fee $10.00
-2-
Total $2,760.68
,I'
Washington Coufi"Reports'
~x~~¥~~x*¥~~
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,paragrap/ts (3)and (25).
COUNTY OF WASHINGTON)
STATE OF PENNSYLVANIA (SS.
Personally appeared before me,a Notary Public in and for said County and
Commonwealth,CHARLES C.KELLER,who,being duly sworn,deposes and
says:that he is the Editor of the WASHINGTON COUNTY REPORTS,the
official legal periodical for said Washington County,publisned 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:
..._.p..~.~.~.mt?~.r..3 .lQ.•...J.l ..J.9.1.Q .
•',
Estate es
The Re •,-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.
•••••••••••••••••
GALLIK,.JOHN,a/k/a .JOHN GALIK,Dec'd.'
Late of California,Washington
County,Penna.Executrix:.Josephine.Zavachin,Box313,Richeyville,Penna.15358
Attorney:Oliver N.Hormell,423ThirdStreet,California,Penna.
,,I.
that the affiant or the corporation in behalf of which he is acting is not interested
in the subject matter of said notice or adver~ingJIJl1d that all of the~",tio~S0
this affidavit as to the time.place and char!l'~,Jf the ~Ub'cation ar..-ra~I /C~'II7)r ~j ,//?/~t::,~(.(,;t-<'J --"--t ~
Sworn to and subscribed before me thi~"""C:==-==='~":'-~~~
17th December '70.',F:i:"4~
Jcsr:p:n:JE T.SCl.'\/.1."JWA
rl:!"ry PL",'j',':'~$Li":..;.1,\';",hinirton Co.
tl1y CC!l1;::~~:L";n Erp,·rcs JU!j 1,1974
Proof of Publica!n of Noti~e ~BrowSwUe Telegraph '
Under Act No.687.Approved May 16.1929.
State of Pennsylvania,
County of.Fayette
C_~:::':~~.~...!!~.:...~~.~~.~.~..~!..!....~.~.::..:.~::~:::.:...of the BROWNSVILLE PUBLISHING CORPORATION,
of the County and State aforesaid,bein~duly sworn,deposes and says that the BROWNSVILLE TELE-
GRAPH,a newspaper of ~eneral circulation published at 16-18 Bridge Street,Brownsville,County and
State aforesaid,was established January 27,1915 since which date the BROWNSVILLE TELEGRAPH
has been regularly issued in said County,and that the printed notice or publication attached hereto is ex-
actly the same as was printed and published in the regular editions and issues of the said BROWNS-
VILLE TELEGRAPH on the following dates,viz:
..........................................~~.~~.~~E..~T.~..?••?..t !?...?..••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••_••••••••••••A.D.19 ?.Q.
Affiant further deposes that he is an officer duly authorized by the BROWNSVILLE PUBLISH-
ING CORPORATION,a.corporation,publisher of said BRO\VNSVILLE TELEGRAPH a newspaper
of general circulation,to verify the foregoin~statement under oath,and affiant is not interested in the
subject matter of the afo:resaid notice or advertisement,and that all allegations in the fore~oing state-
ments as to time,place and character of pnbIiCa~?ji?~~iJ(~~'~4
Brownsville Publishing '~;;..~
ESTATE NOTICE
Es1'ate of JOHN GALI_IK,a-k-a
JOHN GALIK,latl~of the
borough,of C:alifornia
Wa~hington County,Penn-
:.ylvania.,
Letters Jestamentilry upon
the above estate having been
granted,.to,,:',the unclersigned,
notic~;i~~peby givt~n to all
thosein,a,e,l:l.t~,dthereto"to makeimmeaia,t~'payirlenf,~ll1dto all
those.havirig'f'Claims ortaemands
to',P'i:esent}tnem for"s'e'ttlem ent.,';'11r
Joseph'ihe Zav'ai::hine
ExecutriX :1
Box 313 II
Richeyville,Pa.15358
'Oliver N.Hormell
/Attorney at Law1~423 Th ird Str-eetCalifornia,Pa.
I.;;:::===---_.~"'=......~~--
Sworn to and subscribed before me this }~.~~_•...
~ecember ~--'.70daY/Of.......···········~·······~·.···n··T··H··A····Ni.···-=::.:.~.,,1:~..::.:....~~~::y nii.,~!'-
B "'00 ,.~'T'(",1\h l'..lWN .."..:A(.:JUt-l,,"r"..,j'....,~.~i··~··MY-~Ul'J.il.t~···__·
JAN.23,19'71
Statement of Advertising Costs
Oliver N.Hormell,Attroney at law..--..:..
423 Third Street-Box 637......................................................................_.
.Q§;.l1.f.~.~g.Ll?:.t.P.~.~g.~.~}.?.4.!.2 .
TO BROWNSVILLE PUBLISHING
CORPORATION,DR.
For publishing the notice or publication at-9 00
tached hereto on the above stated dates $~.
Probating same $.
Total ;$~.!.Q.g .
Pu.blisher's Receipt for Advertising Costs
THE BROWNSVILLE PUBLISHING CORPORATION,publisher of the BROWNSVILLE TELE-
GRAPH,a newspaper of general circulation,hereby acknowledges receipt of the aforesaid notice and
publication costs and certifi,es that the same have been duly paid.
BROWNSVILLE PUBLISHING CORPORATION,a Corporation
Publisher of Brownsville Telegraph,a Newspaper of
General Circulation _ .
By : .
STATE OF PENNSYLVANIA,
WASHINGTON COUNTY,~55:
The within named Accountant being duly sworn according to law,deposes and says that the above account
as stated is true and correct as ~h-.~verily believe,
\a,."';'\~i 'l·,1~~-...\-'·h Qu
.."V.. •';:,~?
Sworn ahd subg¢rioed beforE~me this .
•7'\.."'.;'I
..:"'.:;)._~'","J ).'~/}7/[-4(;/~?;L/day ot \.-:19 .
,j)~U--L£4~~~/_.".\ .~.;J!..-:;"'-..-::..~Y.;.,..=...
",,\ANNA S.DZAVAN
I......'.
""'q!'I?~l1ry·public,California,Washington Co.
My Commission Expires JU!l'e 15,1975
I do certify that I have given legal notice to all persons
concerned of the filing of the within account in the manner
prescribed by Stat'ute and Rule of Court,as evidenced by proofs
thereof filed to No:.b.3~.7;L'::.'t:9 .
Witness my hand and official 'Seal thiS..!!!!!!!::..
,..~~
---------------~_._._.
Register of Wills
day of .
Wa1shington County,ss:
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J11 tl1r <1tnurt nf Qtnmmnu JUras nflltllan4ingtnu <trnuijty
®rp4aus~Qrnuit Ilinisinu
In the m3ltter of the Audit of Account in
J
Estate of JOHN GALLIK a/k/a
JOlIN.GALIK (
TO THE AUDITING JUDGE:
N~63~70-1164
::
70-110
Enter my appearance for Josephine Zavachin,Executrix
~/7 _./7-7)---.7
// ///_A /_
~a:!_'_~_·M_a-=---y_·__
N.B.-Counsel shall,by separ,aJte 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 suggesting proper distribution shall file a separate concise state-
ment in that regard.
~1Z ti ~\/\9 Pti 7.S1
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No.63-70-1164
In re Audit of Account in Est3!te of.
'RUSS'ELL \',',\'(\N0
n t:'GIc:.~':",(,'::\n \LLc:I\i-~i,.ll tl",)."V
'1't S.I \'"~r'-,.,"('D P'v'ii".h.i\\·1 UNj(·,A'I
JOHN GALLIK a/k/a
JOHN GALIK,deceased
AUDIT
'ra~rip~fnr '!\pp~araur~
FOR
Josephine Zavachin,
Executrix
aliver iN.Hormell Att,orney
~2
•&>3-7,J-:·//'::;~
COpy OF INVENTORY
Notary Public
I:
I
Josepb1no .Zavac.btn
"..$John O.1111~,a/it/a JobnqaUk,
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JobnQantk
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00 lInnrutnrn anb !\ppratsrmrut of'the goods and chll;tels,'rights 0 and credits which were
..-Jobn QalltkJ,./k/a John aalik,-:CaUfornia .,',
of ;,;late of..
""..
Washington ,County,Pa.,taJ.:en and made in conformity with the above affidavit.
;.~~,.;....,
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:R~ALTY
DOLLARS CENTS
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Lota N>f..5 .n~-6 ~~,tbe UnderwOOd Plan.in tbe Borougb of
.""j"...-..'~
CaUtomla,(fonn~~11 East PUtt)Bun To.......ldp).We.bIQalt0n
~~.,
CO\l."Pe_.,.~po.wtdcbtbe"i.e.reetlld •tour-room
tnm.bUbpl~"."For ellataot 'Ul._d.need Book Volume
'84,Pag-.".
PSasONALTY
..
!iaUoaa!Slovak SO,~tetl.death benefits
.I!
,.-
";4-
5,000,,00
~6a.08
15&.00
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4891
.RENUNCIATION ,'RELEASE AND ASSIGNMENT
KNOW ALL MEN BY THESE PRESENTS:
That I,Mary Galik,also known as Mary Gallik,the undersigned
being fully aware of my right to reside in the residence known as
826 Orchard Street,Borough of California,Wa~nington County,
Pennsylvania,which was given to 'me under the Will of my late
husband,Jc:hn Galik,also known as John Gallik,deceased,dated
September 29,1956,a copy of which is attached hereto an'd made a
part hereof as Exhibit "A",and wherein was recited'the Antenuptial
Agreement dated September 26,1956,a copy of which is attached
hereto and made a part hereof as E:x;hibit "B",wherein I surrendered
and released all o£:~my statutory rights in the estate of my late
husband,John Galik,also known as John Gallik,deceased,and which
antenuptial agreement I hereby reaffirm and agree to;that I do
hereby,witpfull knowledge.of my rights,release and renounce for-
ever all o£my rights and interest under said Will as set forth in
paragraph Second thereof,for the reason that I do not wish to
occupy the said Orchard Street residence.
And further this instrument is and may be considered as an
assignment cind conveyance,and I do hereby assign,grant and convey
all of my rights and interest of any kind whatsoever under the
aforementioned ·Will of John Galik,also known as John Gallik,::,:~
deceased,to and for the benefit of Leonard Gallik,John Gallik,
..
j
I
-1-
70-110
{':
known to me (or satisfactoril
•
JOsephine Zavachin,Albert Gallik,William Gallik,Elizabeth Gallik
Palgutta,the heirs and children of John Galik,also known as John
Gallik,deceased,and their heirs and assigns.
~'
Intending to be legally bound hereby,I hereunto set my hand
and seal thisJ,~1J:aay ofOctb:.er 1971.
Mh~':-ar-y""'::'~G;'=:a"-,f'~k.&..4..J.'r/I'~·)d,c.a::..;+i=--'_'(se 1)
~iM14~,r__(se 1)
•State of New ¥ork )
County Of~l 55:
On this,the~¢"~ay of a-f;;b~.,.,1971,before me,
NA~lBl.Y.ELUOTT ,the undersigned officer,personally
appeared-'-"--...E...f-.u.,..J,.~.+,.':.::.'/:Je_":_~_'_~.,,_.,_'_
proven to be rson whose name is subscribed to the within
instrument,and acknowledged that she executed the same for the
purposes therein contairied.
In Witness Whereof,I hereunto set my hand and official seal.
/,.",.~
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33
.'
OF
GALLIK
LAS'T,WILL .~ND TES'i'AJ\OOfl'
EXHIBIT nAt'
-,'-,------,-.-,--'-;--'--.--'-,-...~_.--
I have made the pr3vtsion for my wife Hary as ..foresald
""",-.
'..'..4.".Albert·GAllik_.
good.rl!~ir'and pays the taxes.
6.E1L~a[~th aAliik
'3.J08ephine ~l,av"chin
.,
\'/
·2.Johri GAllik
5.,William GaJJik
power,~hould 5'1.6 00 de~ire,to occupy my
1.Leonard Gallik
"
C:d..lifo:~la,Wash1~gton County,Pennsylvania,'for
alike.,The names of my ch~lidren are:,
j::.
a.t my decease,to Dl"V beloved/chHllren in equal.'ahares,sha:re and lha.i'e":;>
t
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fUneral expenies U lIOon al may be practicable-after my deceaae.
I direct my Executrix,Josephine Zavachln,to
I,JOHN GALLIK,
,Prbv1de~d,powever,ti1at my ~lbvcd v t i"
,be r natural life,,rtthout t~pa.yment of ,rent,if
.mixed ,of which I d1e seized or poliiiessed,or to which I !!lay be ent1tl~4-
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IIPe~,ylvania,do bereby make,publish and declare this to be rjy Last Will and
I ' ".,.
i Testament,hereby revoking and making void any lind all wHlli by me at any tiDe"I -.,
II b4tretofore ~.
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a*:0JIID:"I give,devise,and be~ueath e.ll of ii&,property,'real personal,
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MADlI DIS 26th dlLy ot Septqber;1956,.,aacl "Be_11 .''
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PETITION SUR AUDIT
IN THE ORPHANS'COURT OF WASHINGTON COUNTY
Testate Form J
..J OHN GALLIK a/k/aEstateof .
JOHN GALIK
Deceased
No ~~.~.!.~~~~.t?~A. A.
Fiduciary ~.~.~.~P.~~.~~~~.y.~,?~.~.~.
Date of Date of
Decedent's death ~~.y..~~1.1 ~~.?~Grant of Letters ~~.y..:~~.?..~~.?.~.
This is the f.:j.;r.~t ~Il:.9:..J?:_.~~J 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 Against will.(cross out one)
Date Election Place of;
Filed Record c :.
Name of surviving spouse ~.~r.yJ!.~J.JM.\~j~j~M:~~Y...Q~;:!-.~~:..:.
List issue,where material:
Leonard Gallik son
John Gallik'son
Josephine Zavachin -daughter
Albert Gallik son
William Gallik son
Elizabeth G.qllik _.daughter .'Pa~gutta
Did decedent marry after execution of will?(indicate~No.Any children born after execution of will?(indicate)
~No.If answer yes,name them .-.
Leg.atees
Leonard Gallik
John Gallik
JosephineZavachin
Albert Gallik
.William Gallik
Elizabeth Gallik Palgutta
Relationship
son
son
daughter
son
son
daughter
Interest
Residuary
\
Residuary
Residuary
Residuary
Residuary
Residuary
Fiduciary,if deceased or not sui juris \
List,if exceptions to above:
If partial intestacy,give facts:
Adeemed:Revoked:Lapsed:Abated:Give Cause:
70-110
Notice to interested parties.Have all parties,having either vested or contingent interests and all crediors entitled
to notice (Court Rule No.9 pClragr9J?1'C:SeCction 6:Subdivision c)received written notice of the filing of the account
and of call of audit?Yes.N4.
If any exception give cause:.
File copy of Notice
and date of mailing W:r.d:tt.en;..n.o.ti.ce sent b¥...c.er.tii.ied..mail.,r.eturU.,r.ec.eip.t ,..",..,
requested on April 18,1972.
..~l'
-......
...........'1""".
Is estate subject to the filing of a Federal Estate Tax Return?,~~,~.
Actual payment made on Pennsylvania Transfer Inheritance Tax.Amount $_~~g~.
If the Will makes any portion of estate subject to a life-estate,give name and birth date of life tenant w:t;f.~.1 .
Mary Gallik a/k/a Mary Galik.Date of birth:Feb.7,1896.
Give Names and addresses of all unpaid creditors who are legally entitled to notice,together with the amounts
of such claims;state whether they are admitted to be correct;and whether the claim is denied.
None
Give reference to such parts of the will as require interpretation by the Court;a reference to all questions re-
quiring adjudication,and a statement of any other facts deemed necessary for the preparation of the adjudication:
Paragraph Second:"wife Mary shall have the choice and power,should she so desire
to occupy my home-on Orchard Street in 'California,Washington County,Pennsylvanij
for and during the term of her natural lifei!l.Paragraph Third:"I have made the
provision for my wife Mary as aforesaid with full knowledge that she has surren-
dered and released any statutory rights she may have in my estate by her signing
an Antenuptial Agreement dated September 26,1956."
RENUNCIATION,RELEASE AND ASSIGNMENT signed by Mary Galik a/k/a Mary Gallik
on October 26,1971,filed with Register of Wills,Washington County,Penna.on
Nov.4,1971,"wherein I surrendered and released all of my statutory rights in
the estate of my late husband~John Galik,also known a~John Gallik,decea~ed,----for ~he reason tnat 1 do not wlsh to occupy the saldBala~ce for dist~i~ution pe~account,Orchard ~treet residence."9,938.55
Itemize,any addltlon,al debits not shown by account,-$.
!.:.r~
•.
$~.::.~.
not shown by account:
$16.00
7.35
1.65
86.36
~
j .;
Total additional debits (Add)
I·,Itemize any additional creditsFilingAcct.
--'..(\y1stQm.arter Sewage
West Penn-final bill
Columbia Gas-final bill
Total additional credits (Subtract)
Balance for distribution
$~~.~.~}6.................
$~.1.~.??.~.~~.
If balance for distribution is not in cash,list each item held in kind,giving appraised Value (or distribution Value);
Cash only
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:
!\\
\,
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:
'Leonard Gallik 1/6th Residue~j
John Gallik 1/6th ,Residue
Josephine'Zavachin 1/6th Residue
Albert Gallik 1/6th Residue
William Gallik 1/6th Residue
Elizabeth Gallik Palgutta 1/6th Residue
COUNTY OF WASH INGTOl\I,SS:
COMMONWEALTH OF PENNSYLVANIA.
The above named Fiduciary or representative thereof,
being duly ~~~!.~,doth depose and say
that the facts set forth in the foregoing petition are true
to the best oL h~.~knowledge and belief.
........§~~.C?~!1:.to and subscribed before
me this M?.th day of ,M~y.;19.7.~..:
Signature of Officer..~~~.:7.2:L~:.
Title of Officer ~~~.~~.Y...;~~P.~~.~.
Office expires ~.~.~~~.~..~:.~~I.~,.~~.t.~~y..~~.~!!~.
CALIFORNIA,WASHINGTON CO.,PAl
My Commission expires July 14,1973
And your petitioner will ever pray,etc.
.~~.....................•.....
.r··································
'72 f4AV !9 PH 2 56
~~No..§~.._::_..7_Q ::..JJ._9.~__.___A.A.
Estate of ..~_9.~~__9:~!__~~~_.~lIsl~.
JOHN GALIK
Deceased
L:'I I
~!M-,-,~r
Fiducia ry ...~.9.§~-?~!~_~,ZAVACHI N..................__._.-------
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-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-"
~~ject the,et~oz;'~'A:.~~::::..e::..-
······oii~·;;·-·:~r.-H-ormeu···-···--··-·-·Att~~~~y···"""2
RUS~~;f:~L'_:~~-'~-::H0
REG 1ST EF\C1-'VI tLLS
Vi ASH It,{~;TCt~CO.,PA.
"
OLIVER N.HORMELL
AITORNEY AT I,AW
423 THIRD STREET,BOX 637,CALIFORNIA,PENNSYLVANIA 15419
Area Code 412
Phone 938-8970
938-2522
NOTICE OF FILING OF AN ACCOUNT
(As required by the Rules of Practice of the Orphans'
Court of Washington County,Pennsylvania).
April 18,1972
Mr.William Gallik
1073 Plaza Circle
Joppatowne~Maryland,21085
In Re:Estate of ,John Gallik;deceased
Place of Audit:Third Floor,Court House,Washington,Pennsylvania
Date of Audit:Thursday~May 18~19'12
Time of Audit:10:00
Dear Mr.Gallik:
I am sending you this letter in order to comply with the rules of the Orphans'
Court of Washington County,Pennsylvania.
The account on the above captioned estate has been filed in the Office of the
Register of Wills of Washington County,Pennsylvania.On the above date and time,
there will be presented to the Orphans'Court of Washington County,Pennsylvania,:<..
a petition to audit this account.An heir of the estate,as well as any creditor,.is.•.:.
entitled to notice of the filing of this petition and audit,and,should you so desi:r;e,
you may appear there at that time.\
You are not compelled to appear at the audit,but you may have some questions
on this estate.If you have any questions,please do not hesitate to write or call me.
I shall be happy to give you any information I can,and will do everything I possibly
can to answer any questions you may have.
ONH:aed
File No.70-110
CERTIFIED MAIL
RETURN RECEIPT REQUESTED.
Very truly yours,
~'o/
OLIVER N.HORMELL
ATTORNEY AT LAW
423 THIRD STREET,BOX 637,CALIFORNIA,PENNSYLVANIA 15419
Area Code 412
Phone 938-8970
938-2522
NOTICE OF FILING OF AN ACCOUNT
(As required by the Rules of Practice of the Orphans'
Court of Washington County,Pennsylvania).
Mrs.Josephine ZaV'achin
Box'313
Richeyville,Pennsylvania,15358
In Re:Estate of ~rohn Gal1ik~deceased
Place of Audit:Third Floor,Court House,Washington,Pennsylvania
Date of Audit:Thursday,MEiY 18,1972.'...Ii ' 'Time of Audit:10:00 A.M•.I
Dear M~.Zava~hiu:
I am sending you this letter in order to comply with the rules of the Orphans'
Court of Washington County,Pennsylvania.
The account on the above captionea.estate has bee'n filed in the Office of the
Register of Wills of Washington County,Pennsylvania.On the above date and time,
there will be presented to the Orphans'Court of Washington County,Pennsylvania,
a petition to audit this account.An heir of the estate,as well as any creditor,is
entitled to notice of the filing of this petition and audit,and,should you so desire,
you may appear there at that time.
You are not compelled to appear at the audit,but you may have some questions
on this estate.If you have any questions,please do not hesitate to write or call me.
I shall be happy to give you any information I can,and will do everything I possibly
can to answer any questions you may have.
ONHA asd
File No.70...110
CE RTIFIED MAIL
RETURN RECEIPT REQUESTED.
Very truly yours,
~?/
OLIVER N.HORMELL
ATIORNEY AT LAW
423 THIRD STREET,BOX 637,CALIFORNIA,PENNSYLVANIA 15419
Area Code 412
Phone 938·8970
938·2522
NOTICE OF FILING OF AN ACCOUNT
(As required by the Rules of Practice of the Orphans'
Court of Washington County,Pennsylvania).
April,18,1972
Mr.Leonard Gallik,
337 Irene Street
Deer Park,Texas,77536
In Re:Estate of ~rohn Gallik,deceased
Place of Audit:Third Floor;Court House,Washington,Pennsylvania
Date of Audit:Thursday,May 18,1972
Time of Audit:10.00 A.M.
Dear Mr.Gallik:
I am sending you this letter in order to comply with the rules of the Orphans'
Court of Washington County,Pennsylvania.
The account on the above captioned estate has been filed in the Office of the
Register of Wills of Washington County,Pennsylvania.On the above date and time,
there will be presented to the Orphans'Court of Washington County,Pennsylvania,
a petition to audit this account.An heir of the estate,as well as any creditor,is
entitled to notice of the filing of this petition and audit,and,should you so desire,
you may appear there at that time.
You are not compelled to appear at the audit,but you may have some questions
on this estate.If you have any questions,please do not hesitate to write or call me.
I shall be happy to give you any information I can,and will do everything I possibly
can to answer any questions you may have.
ONH :asd
File No.70-110
CERTIFIED MAIL
RETURN RECEIPT REQUESTED.
Very truly yours,
~9/
OLIVER N.HORMELL
ATIORNEY AT LAW
423 THIRD STREET,BOX 637,CALIFORNIA,PENNSYLVANIA 15419
Area Code 412
Phone 938-8970
938-2522
NOTICE OF FILING OF AN ACCOUNT
(As required by the Rules of Practice of the Orphans'
Court of Washington County,Pennsylvania).
April 18,1972
Mr.Albert M.Gallik
1385 East Lafayette Drive
Lee Hall,Virginia,236-3
In Re:Estate of ~rohn Gallik,deceased
,Place of Audit:Third Floor,Court House,Washington,Pennsylvania
Date of Audit:Thursday,May 18,1972
Time of Audit:10:00 A.M.
Dear M r.·Gallik:
I am sending you this letter in order to comply with the rules of the Orphans'
Court of'Washingto:ri County,Pennsylvania.
The account on the above captioned estate has been filed in the Office of the
Register of Wills of Washington County,Pennsylvania.On the above date and time,
there will be presented to the Orphans'Court of Washington County,Pennsylvania,
a petition to audit this account.An heir of the estate,as well as any creditor,is
entitled to notice of the filing of this petition and audit,and,should you so desire,
you may appear there at that time.
You are not compelled to appear at the audit,but you may have some questions
on this estate.If you have any questions,please do not hesitate to write or call me.
I shall be happy to give you any information I can,and will do everything I possibly
can to answer any questions you may have.
ONH:e.sd
File No.70..110
CE RTIFIED MAIL
RETURN RECEIPT REQUESTED.
Very truly yours,
~o/
OLIVER N.HORMELL
AITORNEY AT LAW
423 THIRD STREET,BOX 637,CALIFORNIA,PENNSYLVANIA 15419
Area Code 412
Phone 938-8970
938-2522
NOTICE OF FILING OF AN ACCOUNT
(As required by the Rules of Practice of the Orphans'
Court of Washington County,Pennsylvania).
April 18,1972
William J.Yarworttl,Esquire
2 Market Place
Dundalk,Maryland.21222
In Re:Es~ate of Irohn Gallik,deceased
Place of Audit:Third Floor,'Court House,Washington,Pennsylvania
Date of Audit:Thursday,May 18,1972
Time of Audit:10:00 A.M.
Dear Mr.Yarworth:
I am sending you this letter in order to comply with the rules of the Orphans'
Court of Washington County,Pennsylvania.
The account on the above captioned estate has been filed in the Office of the
Register of Wills of Washington County,Pennsylvania.On the above date and time,
there will be presented to the Orphans'Court of Washington County,Pennsylvania,
a petition to audit this account.An heir of the estate,as well as any creditor,is
entitled to notice of the filing of this petition and audit,and,should you so desire,
you may appear there at that time.
You are not compelled to appear at the audit,but you may have some questions
on this estate.If you have any questions,please do-not hesitate to write or call me.
I shall be happy to give you any information I can,and will do everything I possibly
can to answer any questions you may have.
ONH:asd
File No.70"110
CE RTIFIED MAIL
RETURN RECEIPT REQUESTED.
Very truly yours,
~'l/
OLIVER N.HORMELL
ATIORNEY AT Lt\W
423 THIRD STREET,BOX 637,CALIFORNIA,PENNSYLVANIA 15419
Area Code 412
Phone 938-8970
938-2522
NOTICE OF FILING OF AN ACCOUNT
(As required by the Rules of Practice of the Orphans'
Court of Washington County,Pennsylvania).
April 18,1972
JAMES HOOK,ESQUIRE
301-5 County Office Building
Waynesburg,Penns;ylvania,15370
In Re:Estate of ~rohn Gallik,deceased
Place of Audit:Third Floor,Court House,Washington,Pennsylvania
Date of Audit:Thursday,May 18,1972
Time of Al;Ldit:10:00 A.M~
Dear Mr.Hook:
I am sending you this letter in order to comply with the rules of the Orphans'
Court of Washington County,Pennsylvania.
The account on the above captioned estate has been filed in the Office of the
Register of Wills of Washington County,Pennsylvania.On the above date and time,
there will be presented to the Orphans'Court of Washington County,Pennsylvania,
a petition to audit this account.An heir of the estate,as well as any creditor,is
entitled to notice of the filing of this petition and audit,and,should you so desire,
you may appear there at that time.
You are not compelled to appear at the audit,but you may have some questions
on this estate.If you have any questions,please do not hesitate to write or call me.
I shall be happy to give you any information I can,and will do everything I possibly
can to answer any questions you may have.
Very truly yours,
ONH :ssd
File No.70-110
CERTIFIED MAIL
RETURN RECEIPT REQUESTED.
OLIVER N.HORMELL
AITORNEY AT LAW
423 THIRD STREET,BOX 637,CALIFORNIA,PENNSYLVANIA 15419
Area Code 412
Phone 938·8970
938·2522
NOTICE OF FILING OF AN ACCOUNT
(As required by the Rules of Practice of the Orphans'
Court of Washington County,Pennsylvania).
April 18;1972
Mars.Elizabeth Gallik Palgutta
.113 Larimer Avenu,e
Bobtown,Pennsylv.mia,15315
In Re:Estate of ~;rohn Gallik,deceased
.Place of Audit:Third Floor,Court House,Washington,Pennsylvania
Date of Audit:Thursday,May 18,1972
Time of Audit:10:00 A.M.
Dear Mrs.Palgutta.:
I am sending you this letter in order to comply with the rules of the Orphans'
Court of Washington County,Pennsylvania.
The account on the above captioned estate has been filed in the Office of the
Register of Wills of Washington County,Pennsylvania.On the above date and time,
there will be presented to the Orphans'Court of Washington County,Pennsylvania,
a petition to audit this account.An heir of the estate,as well as any creditor,is
entitled to notice of the filing of this petition and audit,and,should you so desire,
you may appear there at that time.
You are not compelled to appear at the audit,but you may have some questions
on this estate.If you have any questions,please do not hesitate to write or call me.
I shall be happy to give you any information I can,and will do everything I possibly
can to answer any questions you may have.
ONH :asd
File No.70..110
CERTIFIED MAIL
RETURN RECEIPT REQUESTED.
Very truly yours,
~7/
OLIVER N.HORMELL
ATTORNEY AT LAW
423 THIRD STREET,BOX 637,CALIFORNIA,PENNSYLVANIA 15419
Area Code 412
Phone 938-8970
938-2522
NOTICE OF FILING OF AN ACCOUNT
(As required by the Rules of Practice of the Orphans'
Court of Washington County,Pennsylvania).'
April 18 11 1972
Mr.John M.Gallik
1930 Stanhope Road
Dundalk.Maryland,21220 .
In Re:Estate of ~rohn Gallik,deceased
Place of Audit:Third Floo'r~Court House,Washington,Pennsylvania
Date of Audit:Thursday,May 18,1972
Time of Audit:10:00
Dear Mr.Gallik:
I am sending you this letter in order to comply with the rules of the Orphans'
Court of Washington County,Pennsylvania.
The account on the above captioned estate has been filed in the Office of the
Register of Wills of Washington County,Pennsylvania.On the above date and time,
there will be presented to the Orphans'Court of Washington County,Pennsylvania,
a petition to audit this account.An heir of the estate,as well as any creditor,is
entitled to notice of the filing of this petition and audit,and,should you so desire,
you may appear there at that time.
You are not compelled to appear at the audit,but you may have some questions
on this estate.If you have any questions,please do not hesitate to write or call me.
I shall be happy to give you any information I can,and will do everything I possibly
can to answer any questions you may have.
ONH :aad
File No.70...110
CERTIFIED MAIL
RETURN RECEIPT REQUESTED.
Very truly yours,
~?f
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IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY,PENNA
, " "',1"'i ORRBANS'COURT DIVISION "
,,
No.1f64'of 1970
,.-..
HEARING ON AUDIT
,.
The Honorable P.VINCENT MARINO;Judge o~the
said Court.
,OLNER N.HORMELL,Esquire,o~California,Pa.,
representing the Accountant.
~ri,"o '
I-",,~~I
ffi BEFORE:[,<c,~.'
INRE:
~
JOHN GALIK,..
,"
.~~,~
0:l-.!!!a ,
~APPEARANCES:
~ii·o ',;:).,
J:,I::
'N
i ~,ii
"e('.'•,'"' >Deceased.,I
,~,.
Ulz'Z
IIID.
"
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deems to be all relevant papers 'in the matt~r.He repo rts that the::r
de(~eased.The EX,ecutr~x is'Josephine Zavachin and the'~ttorney.
is ,OUver N:Hor:mell.Again,Mr.Hormell has filed what he
':1'.••'•
".'
Number 1164 of 1970,the estate of John Gallik~
Thursday,May 18,1972,at 10:00A.M.,EDS:r-'.'~I,
,I[
,~
II
.THE COD J~T.:
viII:~TIME:
0:oII.III0:
I-0::JoU
.I'e(o
ii:II.o
e'
.
).,
f
are no questions for adjudication by the ~ourt,nor any outstanding
cia,ims of which they have know ledge:Is there anyone else inCour
11'•
:1 ..
interested in this decedent's estate?
'Ij~~l
\yILLIAMj:.GALLIK:Yes,si~,~'J(He'sl'mo/~faj{h'€:dand Hormell was'theattor ey,
:~.
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And we'
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The audit of this a~~ount'isor<;leredcloseg by·the C
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What is your-nam~?
'William',Gallik.
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war~t to kn~w what'the acc;ount on the estate "Yas,what.the'fe~~irer",,,\
""':';'-y ~;-,,'••~
.'ir ~........"..","l .....-..,~
ho~:much"was being paid out and sofortl)..And we ~eren~ver,nonfi
II ..~.'•..."'"'•and:~welve 'never,received any.information from Ho,rmeH.
,~.~f_~.~-~-iI'"..~"."t:""y •'..'•~;_
'I~(an~:tl}ing onthis .
,,
I'~..
THE COUf~T:
..:ui.,,~THE COU1~T:
Q'.....
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'.
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.IiMR.GALLIK:";,"j~.~!~""Ir._'+...,"'....'Ii ".."J<,~•"....~;'.'..
,.",'Z.THE COU.t\T:You'are ason,of the decedent.>,".....~...:,',:,.,'.'.~:II~'..,'_',.;,-.'"J.:;.':.,....I..oi"~':~,.....,
.~,"M1C GALiJ~IK:.Yes,Your Honor.'~Is he'suPPbs~;dtogiV~'~'s'a lis tinz;:..~-~.~;~f f"~,_'.
bI 'I~""''',d F,"....."D.'{.'..'..'.:, .".
ionShis or'do we have to 'get this on our own?'"..
~,·il ". ...-.',.,':'.'.._ •~..;.._ •r ..4.;...,"_...i (AtJthe direction 'of the Cs>urt,off-the-record discussion:~vas,notenti•.,""••-l"•
.0('"•1'1 •,~'c. .rec:orded by the,stenographer).~
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Jtttusyluttuitt,(@rp4aus'<lJ:nurt 1Binisinu
ESTATE OF No.63 ..70-1161+
.Tohn Gallic·It,In the matter of the__.=.F-=i....r-==s~t~a...n..wd.:.......F...i.l.lnu::lA'-Io1
John Gal i k,Account of Josephine Zayachin
Executrix
ADJUDICATION AND DECREE
And now 1.4,.,.,..ICf ,19-+2-,this matter came on for he~'ring,
audit anddistribution at this session and testimony t~l4n;and thereupon,upon due cons ideration,
thereof of the balance i:or distribution in the hands of the Accountant is determined to be
$-9,827.'9 .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 disribution hereto attached and made part hereof,unless exceptions hereto be filed
sec.reg.or an appeal be taken herefrom sec.leg.
SCHEDULE OF DISTRIBUTION
Balance per account ___'___'_$9,938 .55
Additional credit asked at audit 111.36
Balance:_$9,827.19
27.50
"No balance
9,799.69
~/91~
;;1.7•.00~toh
j,../11.'lie.
168.41
7.50
l603~97 '
1603.97
1603.96
1603.96
1603.96
1603.96
Deduct Clerk's Costs &Receipts,-,--_
Attorney '----'-OL...l]_.I;-\lVu::e::..Lr~l\T.........__.J_H4;ou.r~m~e:..lli..ll:.__-----'---__
Russell',"'Marino,Agent"transr~r inheritance.tax·,,.;~.)f -$165.56
Interest-from 2-17"'72 to 5-30-72 ,12;'85.,
Th~survi~ing'Spouse has filed a renunciation
'pp.,,,release which has been ordered recorded.
Olga O.Woodward,'Recorder,costs recording
renunciation,,
'leonard Gailik,son,1/6 'reSidue,
John Gallik,son,1/6 r6~idue,
Josephine Zavachin,d~ughter,1/6 residue,
Albert Gallik,son~1/6 residue t
William Gallik,B~n,1/6 residue,
Elizabeth Gallik Palgutta,daughter,1/6 residue
RELEASE &RENUNCIATION RECORDED:JUNE 6,1972
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RCc;-43 (5-65)
J
NOTE:TO BE SUBMITTED IN TRIPLICATE
Pennsylvania Department of Revenue
Bureau of County Collections
26 S.4th Street ..
Harrisburg,Pennsylvania
.",or
Dear Sir:
Pursuant to Section 742,Pennsylvania Inheritance and Estate Tax Act of 1961,
we herewith surbmit the following report:.
NAME OF REPORTING ---
FINANCIAL INSTITUTIO~tUbWgh IaUaJm1 &mk. .~
1~~~~~~~~J=,"""lla1'''mo ..~!IJ~jo-P
~~~~~g~~N~~CE~J~iNT DEPOS~=""".__"'.a:lIIK.Jt,*__·OO:llll3···_·._iIIII!·.~-"".·_O---,-______~10
OR INVESTMENT'.CIa1Uk or A1le~QalIitc
..
DECEASED JOINT DEPOSITOR,
TRUSTEE OR INVESTOR ....!'~o!!!!ba!!..aa!!!!!'·'yl!ill1UM!IIL-_
ADDRESS.0r0bar4 "Ne'CaUI.rap.lSf4t
DATE OF DEATH"''''17.1910
SURVIVING DEPOSITOR,'.
BENEFICIARY OR INVESTORAl~•.M~:"!...·~(f.~I~lac~,~_
ADDRES~!~.1,·Ia'"",.Dr.JM.BaU.VuafJda USOJ
/6-?3
/sl
RELATIONSHIP TO DECEDENT"DATE DEPOSIT OR INVESTMEN'=T-------:-----------
WAS ESTABLISHED'=U='=.,,=....-=1"""9&:.1.....=·:::-·_
BALANCE,INCLUDING INTEREST./lA,.
DUE,AT DATE OF DEATH $-""'.-;;."~7;...._VJP:...-__-'7'/;;;:"~-+-_/2 '..,.t::::J ..r2~~~'.~~,:TITLE~/;lYtfsW&;'t-=
S-%iJ~.o!-/l~,7~-
LEE HALL,VIRGINIA 23603
TO:ALBEHT GALLIK
1385E.LAFAYET'.rE DRIVE
OFFICIAL NOTICE OF INHERITANCE TAX
APPRAI'SEMEN"T AND ASSESSMENT OF
ASSETS NOT SUBJI:CT TO ADMINISTRATION
Dote:December 29,1970
County Washington
County File No.J.,P-/.,.1/-;~
Bureau File No.C:3 -/10 -8:L-'
~e have receivedn6tice that,~~~~~~~~~
on November 17 19...1Q.,you carne into ownership of certain property through ~~
~~~~~~~~~X transfer from,JOHN GALLIK,deceased.
RCC-134 (1-69)
COMMONWEAL THr9F PENNSYLVANIA
,DE'PARTMEN,"OF REVENUE
BUREAU OF 'COUNTY COLLECTIONS
INHERITANCE TAX DIVISION
Under the Inheritance and Estate Tax Laws of the Commonwealth of :Pennsylvania such transfers are taxable
and the liability for the payment of the inheritance tax due is imposed upon you,as transferee.
The property on which taxis hereby assessed consists of:Jt.Savings No.00 0009910,held in
the PITTSBURGH NATIONAL BANK,CALIFORNIA OFFICE,CALIFORNIA,PENNSYLVNNIA._
In the names of JOJINGALLIK or ALBERT GALLIK.Opened,1-19-66.Balance as
of date'of death,~~351.69.
appraised by the Commonwealth,as of the tlate of death,at $357.69
50 %of this amount is taxable at the rate of 6 %
ORIGINAL ASSESSMENT AMENDED ASSESSMfHI
DATE OF ASSESSMENT
TAXABLE AMOUNT
LESS:ALLOWED DEBTS
NET TAXABLE AMOUNT
$178.85 $----------
AMOUNT OF TAX DUE 10.73
D If.you pay the above Omo,unt within three (3)months
of the dote of death of the decedent,or on or
before Feb.17!..1971 ,you moy deduct a
discount of 5%of the am,ount of tax due,or .54_....---------
D This tax became delinqu1ent,fifteen(1S)months
after the date of death clnd,in addition to the
tax,statutory interest af.the rate of 6%of the
tax per annum is also due as of *~~~~~
19__in the amount of
$=====::==:==========
(Agent for the Commonwealth)
10.73$
ASSESSEDBY:_~~__~~_
UCTIONSTO TAXPAYERS
*If the tax is notpaid by the above dote additional
interest is due at the rOlteof 6%per annum until
paid
Make checks or money orders payable to:To insure proper credit to your account
this Official Notice must accompany
your payment.Moil or bring it to:
If you have already paid this tax to an executor,administrator,attorney or other personal representative of the
decedent for forwarding to the Commonwealth,list below the date paid,name and address-of the person to whom
you made payment,their official title and the amount.,..,._;"-.,"",.•.•
Date Paid Name and Address of Payee .Official Tiil¢.·'AmoUnt Paid ,•
SS:
Under certain circumstances,if,after the date of death of the decedent,you personally paid funeral expenses
or other just debts of the decedent,with funds derived from the property herein taxed,such amounts expended
by you may qualify as deductions against the gross value of the property in the cql1)putationo{tax due.If any
such expenditures meet all of the three following tests,it is recommended that you itemize the payments below,
execute the affidavit,and return this notice.The Register of Wills will examine the debts'claimed and allow
those which he determines to be proper.The tax will then be recomputed and y~~will receive an amended
assessment of tax.
THE THREE TESTS WHICH MUST BE MET ARE THAT:
1-You were personally legally responsible for these debts,and
2-You actually paid these debts out of the account or property described above and can furnish pr~of
of such payment,if required,and
3 -These same debts are not also claimed,for tax purposes,by an executor,'administrator or other
personal representative of the decedent handling the administration of the general estate of the
decedent or any other transferee.'..
SCHEDULE OF DEBTS
Date Paid Name of Payee Description of Obligation Amount Paid
..
"
""
TOTAL $
(attach separate sheet if requ ired)
COMMONWEALTH OF PENNSYLVANIA)
COUNTY OF:_
I,hereby certify that the foregoing isa iustand true statement of
funeral expenses and other debts of the decedent,',for which I
was legally responsible and which I did payout of the property 'herein taxed.I further certify,that to the
best of my knowledge and belief,these same'debts will not be claimed by any other person,for inheritance
tax purposes.
SWORN AND SUBSCRIBED BEFORE ME THIS DAY OF____________19 __.
REPORT OF REGISTER OF WILLS
Signature of Taxpayer
I,the undersigned,duly elected Register of Wills in and for the above county,do respectfully report that I
have allowed deductions listed above in the total amount of $•
Date of Approval:_
Register of Wills
Fonn RCC-2
COMMONWEALTH OF PENNSYLVANIA DATE .....JanUi3,r.y.....8.,.....l.97.l.....................
DEPAItTMEN'E OF REVENUE RESIDENT INHERITANCE TAX .........W1?:.§.!1.;j,pgt.9.n.................................BUREAU OF COUNTY COLLECTIONS COUNTY
•HARRISBURG.PENNA.17127 APPRAISEMENT FILE NO•...............?.?..=.7.9:~?..~..................................
Whereas,...............................................Jobn...Gallik...............................................................late of ...............................Callif.or.nia.......................................
I in the County of ......................................................Y:~§..§.DJngi:,.9.n ...............................................Commonwealth of Pennsylvania,having died on
the ..........................................l7.th........................................day of ..............N.Qy.~mp..~r......................................19.....7.0,seized and possessed of an estate
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 annuitie:3 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 AppraisementDescriptionofAssetValuesMadeforInheritanceTaxPurpoles
$
sIt.•Sav;nes No.00 000OQ1()hpl r1 ;n t.hF>PITTSBUH.GH NATIONAL BANK
CALIFORNIA OFFICE,CALIFORNIA •PENNSYLVANIA.In the names of
JOHN GALLIK or ALBERT GALLIK.Opend,1-19-66.Balance as of date
of death,$357.69.357 69
Total 357 69
.
,
..
...';
.'J<...
..
"
.
Having been duly sworn according .to law,I do hereby certify that the above appraisement is made in con-
formity with law on this .......\.._<~........day of .............CJ::o.t~~....................................................................19 .7L.
....................~.L....R.,....~..................................~.~d Appra ser
................................................................................................................................................................
.............kJ..~~ffiZ~~t)....\.............................,Penna.
I
-
tY~?b~~.~?Il .H ••••••County
RESIDENT INHERITANCE TAX APPRAISEMENT
Estate of
John Uallik.......................................
Deceased.
Late of
Valifornia......,,..,.
Date of Death,).J~J,7:':779..
Appraisemel!t Docket Vol.,-3$.
Page,~?~.:.{,No..??:7..~:.~.§4
Filed in Register's Office,~~??.19.?.~..
Amount of tax due,$.
DEPARTMENT OF REVENUE
Received,
Examined and Approved,.
Wrote abo.ut Appra.isement,
Appeal f1'om Appraisement,...
Entered and charged,....H •••••••••••••••••••••••••••••••••••••••••••••••••••••••••
.~
i
-'
R CC-43 (5-65)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
HARRISBURG
J
NOTE:TO BE SUBMITTED IN TRIPLICATE
Pennsylvania Department of Revenue
Bureau of County Collections
26 S.4th Street
Harrisburg,Pennsylvania
Dear Sir:
Pursuant tel Section 742,Pennsylvania Inheritance and Estate Tax Act of 1961,
we herewith submit the following report:
NAME OF REPORTING
FINANCIALINS1'1TUTION __W..:.:.e;;.;a;..;;t.:;;e1'l:.:.1~Penne=·::::·::IIllt.=1:..:.::V~=·.•=.•·::::.a...;:,Na=~tl==ona~l~·.~Ba~t~.lk:....,_
ADDRESS ~4 &Liberty,CRllt~1"4a.·Pa.15419
.ACCOUNT NO.OF JOINT,
TRUST OR INVESTMENT DEPOSIT savings Aeo(t\unt 1I!")8'
NAMES ON ACCOUNT
OR INVESTMENT .John .QaU1k8r.01"
ADDRESS e26·Orchard street,CalltoJ'l'l1a.PAt lSlJ.9
DATE OF DEATH ."':"":"'::-..:::t:=-OV~.=b=.:lo=r....;f1:il.!7r...at_1~970~·~·_
SURVIVING DEPOSITOR,
BENEFICIARY OR INVESTOR __.....!w~i::!!:U!!::!!lo~tU!~Ga~l~Uk:!!!!·tL _
ADDRESS
HBAD~'
TITLE
RELATIONSHIP TO DECEDENT SonDATEDEPOSITORINVESTMEN":""T--=~---:------------
WAS ESTA.BLlSHED --...,;;.-.:I'.....;,Ob.:..:...·.•·.....;,.1~,-.:1..:..96.:,.:6:.....,......;.._
BALANCE,INCILUDING INTEREST 1!!1t!l>.t.•.~I.h~!Qd,l .,.
DUE,AT DATE OF DEATH $__---:..--:'1U:......:.........:.:...:.....-.:....~.,...--!..I=-ltJ1..:....:..-<--=---__----
if ..#///4/
=J j J ./f::,"7/~f/t~:W
./"Signature
~0«j
RCC-1~4·o~1-69)
c..
COMMONWEAL TH OF PENNSYLVANIA.
..UEPhRTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
INHERITANCE TAX DIVISION
OFFICIAL NOTICE OF INHERITANCE TAX
APPRAISEMENT AND ASSESSMENT OF
ASSETS NOT SUBJECT TO ADMINISTRATION
"-'':';l\~,TO:_li'l!f:TJ,TAM GAlJ,TK
1073 PLAZA CIRCl:.E
Jo.j'JPAT-OH~Jg)MARYT.AND 21 08;
Date:February 9,).97J
County \-JASHIOOTON
County File No.V,;;-/~/tb'
Bureau File No.ckJ-,76 -//6 </
We have received notice frhat,XXXXXXXXXX
.:0~n~~N;e;Y;em;ab;$!'~l:~7.~~~loc9_..!l-O'you came into ownership of certain property through .
)1 .~transfer from JOHN GALLIK,SR.,Deceased.
Under the Inheritance and Estate Tax Laws of the Commonwealth of Pennsylvania such transfers are taxable
and the Iiability for the payment of the inheritance tax due is imposed upon you,as transferee.
The property on which tax is hereby assessed consists of:Jt.Savings Account #5085 held in the
).\9IBTERN PENNSYLVAl-JIA NATIONAL BPJU,CALll?OItNIA OFFICE,CALIFORNIA.PENtJSYLVANIA.In the
names of JOHN GAlLIK SR.OR vlIIJ..I1l.H Gtl.LIK.Opened 3-1..66.Balance as of date of death,
$196•.24
appraised by the Commonwl~alth,as of the date of death,at $196.24
50 %of this amount is taxable at the rate of 6 %
ORIGINAL ASSESSMENT AMENDED ASSESSMENT
DATE OF ASSESSMENT
TAXABLE AMOUNT
LESS:ALLOWED DEBTS
NET TAXABLE AMOUNT
AMOUNT OF TAX DUE
D If you pay the above amount within three (3)months
of the date of death of the decedent,or on or
before February 17'.19 71 you may deduct a
discount of 5%of the amount of tax due,or
D This tax became delinquent,fifteen (lS)months
after the date of death and,in addition to the
tax,statutory interest at the rate of 6%of the
tax per annum is also Jdue as of*----..,._
19__in the amount of
*lfthe tax is not paid by the above date additional
interest is due at the rate of 6%per annum until
paid
$__---L9~B.L:!l12::::._
_______~t _
$--------
TOTAL AMOUNT DUE $5.89 $:=::::===============
APPRAISED BY,1//Zh ASSESSED BY,_
(I eritance Tax Appraiser)(Agent for the Commonwealth)
INSTRUCTIONS TO TAXPAYERS
Make checks or money ordl~rs payable to:
~.fJ/
y~/;:/);:;,/
/2/~/.;'Y/r6
To insure proper credit to your account
thiS Official Notice must accompany
your payment.Mail or bring it to:
AGEi~T d)LiE Oi,111 N,JULJd
COURT HO.,St
WASHINGTON,PENiM.'530t
If you have already paid this tax to an executor,administrator,attorney or other personal representative o.rt.he .
decedent for forwarding to the Commonwealth,list below the date paid,name and address of the person to whom'
you made payment,their official title and the amount....
"Date Paid Name and Address of Payee Official Title Amount Paid
Under certain circumstances,if,after the date of death of the decedent,you personally paid funeral expenses
or other just debts of the decedent,with funds derived from the property herein taxed,such amounts expended
by you may qualify as deductions against the gross value of the property in the computation of tax due.If any
such expenditures meet all of the three following tests,it is recommended that you itemize the payments below,
execute the affidavit,.and return this notice.The Register of Wills will examine the debts claimed and allow
those which he determines to be proper.The tax will then be recomputed and you will receive an amended
assessment of tax.
THE THREE TESTS WHICH MUST BE MET ARE THAT:
1 -You were personally legally responsible for these debts,and
2-You actually paid these debts out of the account or property described above and can furnish proof
of such payment,if required,and
3 -These same debts are not also claimed,for tax purposes,by an executor,administrator or other
personal representative of the decedent handling the administration of the general estate of the
decedent or any other transferee.
SCHEDULE OF DEBTS
Date Paid Name of Payee Description of Obligation Amount Paid
TOTAL $
(attach separate sheet if requ ired)
COMMONWEALTH OF PENNSYLVANIA)
COUNTY Of _
SS:
I,hereby certify that the foregoing is a just and true statement of
funeral expenses and other debts of the decedent,,for which I
was legally responsible and which I did payout of the property herein taxed.I further certify,that to the
best of my knowledge and belief,these same debts will not be claimed by any other person,for inheritance
tax purposes.
SWORN AND SUBSCRIBED BEFORE ME THIS DAY OF____________19__.
Signature of Taxpayer
REPORT OF REGISTER OF WILLS
I,the undersigned,duly elected Register of Wills in and for the above county,do respectfully report that I
have allowed deductions listed above in the total amount of $--------0
Date of Approval:_
Register of Wills
Fonn RCC-2 16,1971...February..COMMONWEALTH OF PENNSYLVANIA DATE .......................................................................................................
DEPARTMENT OF REVENUE RESIDENT INHERITANCE TAX ..........w.~.§h.~~9..g ....................................BUREAU OF COUNTY COLLECTIONS COUNTY..,.APPRAISEMENTHARRISBURG.PENNA.17127 FILE NO•...........9..3..~7.~.J.J.,.9.4 ........................................
I
Whereas,....................................;~QhP.....G:9;U.;\,~'.....p.;r..~..........................................................late of ........................9..Cl:;bg.<:?r.:~....................................................
in the County of ........................................Washi.ngt.on.............................................................Commonwealth of Pennsylvania,having died on
the ......................................17th............................................day of ..............N9.Y.~mp~;r......................................19.....7Q,seized and possessed of an estate
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore,I,AI"FRED TOSI 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 lif,e or for years,the Commonwealth hereby expressly reserves the right to appraise and assess transfer
inheritance taxes at the lawful col1ateral rate on any such future interest.
Unit Appraisement .
Description of Asset Values Made for Inheritance
Tax Purposes
$
Jt.Sav ings Account #5085 held in the WESTERN PENNSYLVANIA
NATIONAL BANK,CALIFORNIA OFFICE,CALIFORNIA,PENNSYLVANIA.In the
names of JOHN GALLIK SR.OR WILLIAl\i GALLIK.Opened 3-1-66.Balance
as of date of death.$196.24 196 24
I
.
I
form~V:fh~:::~h:Sw':af£()~i~g~~.~:;::r~~y~e~~~s;::~;;~
Appr er
n~.;:=~.j
s-----~-
.........................yJ'1.~l1::i:~~c:>l1 ....County
11-17-70
RESIDENT INHERITANCE TAX APPRAISEMENT
Estate of
..........J.9.00 Q::l..+JJ;l<:e:~.~.
Deceased.
Late of
California
Date of Death,
Appraisemel!t Docket Vol.,..3..?-.
Page,@~.9.No..?..?.::7.Q::.J+.?.4 .
Filed in Register's Office,~.E3.?.!..)A 19 ..71
Amount of tax due $,.
DEPARTMENT OF REVENUE
Received,
Examined and Approved,,
Wrote abo.ut Appra.isement,,.,.
Appeal jt-om Appraisement,..
Entered and charged,...
•
l'...
\.'.,V
.\.J.
NOTE:TO BE SUBMITTED IN TRIPLICATE
Pennsylvania Department of Revenue
Bureau of County Collections
26 S.4th Street
Harrisburg,Pennsylvania
COMMONWI:=ALTH OF PENNSYLVM4d~IVEO
DEPARTMENT OF REVENUIBUREAU OF
HARRISBURG COUNTY COLLF,CTiOHS
fEB 5 10 30 AM '71R CC-43 (5-65)
Dear Sir:
Pursuanttol Section 742,Pennsylvania Inheritance and Estate Tax Act of 1961,
'!'e herewith submit the following report:
NAME OF REPORTING
FINANCIAL INSTI TUTION W_e_stG_',;,;:.,_n_P,;,;:.·erma,;,;:..;.;;.'·=....:11::...",...;:;;0ni4::.;;;;·.:.:::....:N:..:.:8.:.:.ti:::.;.o:::.:l1::;:lIl1=..,..::.&::::nk=::"..:..,.'__
DECEASED JOINT DEPOSITOR,•:/.
TRUSTEE OR INVESTOR J_o....;.hn__O_s,l,;,;:.l;.;,.:.ik,;,;:.·...;,:S.:..¥'.;;..._V.:::.-~._
ADDRESS fbUd It L1b~•.Cttl1tomia"Pl..15419
ACCOUNT NO.OIF JOINT,.
TRUST OR INVESTMENT DEPOSIT sa,"1nSe 'Accoint IS21'
NAMES ON ACCOUNT
OR INVESTMENT John OaU.1k sr.or L~nerd QajJjk
;//
ADDRESS 826 Orobo.l."d St.Co,l1tcumu"fa.1'419---------~-----=----------:.:.:::.:.----.:...:......::=.:::.::.::..-
DATE OF DEATH tlovEil.'lbexo t7,19?CSURVIVINGDEPOS:7.IT=O:':R:-,---~-.:.=.-...:...:..::.-..:...:....:..:.--------
BENEFICIARY OR INVESTOR __Loo__M_N_'_'_GaJ.__.llk_lI......;·--,-__--,-_
ADDRESS --::..3'::..7:....._XI'_al_l_._S_·t.N;....··:....;.e.:..!t,=-=-De.:..:cw:.:.....:P:..::tm=.:k~,:..-·.:.:Texa:::=IS=-....=:.77.!..:;~36=-·
RELATIONSHIP TO DECEDENT ion
DATE DEPOSIT OR INVESTMEN=T----:---"------------
WAS ESTABILISHED'.11411;,1966..-
BALANCE,INCLUDING INTEREST ~~~d.84 h _Y/JI
DUE,AT DATE OIF DEATH $'W;N·,-;..-/7f,I L I
/(y,1 ~/.~:fjiJ,71 JI/"/,/11/h /0 I f:~1-1 .l:t:?,~~J ...;(7 //~~l (iJ2Jl&\D fEIJ'..lm
S ~iO.....u.-u,-:,.,§/Signature TITLE
DEAR PARK,TEXAS 77536
.".."..,
OFFICIAL NOTICE OF INHERITANCE TAX
APPRAISEMENT AND ASSESSMENT OF
ASS,ETS NOT SUBJECT TO ADMINISTRATION
TO:LEONARD GALLIK
337 IRENE STRE]~T
Date:,February 9,1971
County Washington
County File No._
Bureau File No._
We have received notice that,XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
on November 17 197JL,you came into ownership ~f certain property through~lX~~
H!X~n~~transfer from,.JOHN GALLIK ,SR.deceased.
RCC-134 (1-69)"
COMMONWEALTH OF.PENNSYLVANIA
I5EPARTMENT OF REVENUE
BUREAU OP--":OUNTY COLLECTIONS
INHERITANCE TAX DIVISION-
Under the Inheritance and Estate Tax Laws of the Commonwealth of Pennsylvania such transfers are taxable
and the liability for the payment of the inheritance tax due is imposed upon you,as transferee.
The property on which tax is hereby assessed consists of:Jt.Sayin~s Account #5215.held in
the WESTERN PENNSYLVANIA NATIONAL BANK,CALIFORNIA OFFICE,CALIFORNAI,
PE~~SYLVANIA.In the names of JOHN GALLIK SR.or LEONARD GALLIK.Opened,
July 15,1966.Balance as of date of death,$358.84.
appraised by the Commonwealth,as of the date of death,at $358.84
50 %of this amount is taxable at the rate of 6 %
ORIGINAL ASSESSMENT AMENDED ASSESSMENT
DATE OF ASSESSMENT
TAXABLE AMOUNT
LESS:ALLOWED DEBTS
NET TAXABLE AMOUNT
$---.;1:::...;7!..:9~.4~2=--__$-
AMOUNT OF TAX DUE 10.77
o If you pa'y the above amClunt within three (3)months
of the date of death of the decedent,or on or
before Feb.17.19 71'you'may deduct a
"disco'unt of 5%of the amount of tax due!or ..54
o This tax became delinquent,fifteen (15)months
after the date of death C1nd,in addition to the
tax,statutory interest at,the rate of 6%of the
tax per annum is also due as of *__~_
19__in the amount of -----------_...
ASSESSED BY:_
(Agent for the Commonwealth)
*1£the tax is not paid by the above date additio'nal
interest is due at the rClte of 6%per annum until
paid
TOTAL AMOUNT DUE
/
APPRAISED BY:~,,;(~
,,(.eritance Tax Appraiser)
$10.77
$-==================
INSTRUCTIONS TO TAXPAYERS
Make checks or money orders payable to:
~<)/'/O·~3
J--e--?-/;7"/y ;J/'
;(?e.L('#/.2Y7~~d/~
To insure proper credit to your account
this Official Notice must accompany
your payment.Mai I or bring it to:
'R~IINA~
FOR THE CO\l,nMm~\llitAd Ii
AGENT COURT HOUSE~l.IA 15301WASHINGTON,,PEl'!l't •
ve already paid this tax to an executor,administrator,attorney or other personal represe.ptative of the
for forwarding to the Commonwealth,list below the date paicf,name'and address of'the person to whom
payment,their official title and the amount.~
~"'
d Name and Address of Payee Official Title Amount Paid
rtain circumstances,if,after the date of death of the decedent,you personally paid funeral expenses
just debts of the decedent,with funds derived from the property herein taxed,such amounts expended
ay qualify as deductions against the gross value of the property in the computation of tax due.If any
enditures meet all of the three following tests,it is recommended that you itemize the payments below,
the affidavit,and return this notice.The Register of Wills will examine the debts claimed and allow
ich he determines to be proper.The tax will then be recomputed and you will receive an amended
ent of tax.
REE TESTS WHICH MUST BE MET ARE THAT:
ere personally legally responsible for these debts,and
ctually paid these debts out of the account or property described above and can furnish proof
ch payment,if required,and
e same debts are not also claimed,for tax purposes,by an executor,administrator or other
nal representative of the decedent handling the administration of the general~state of the
ent or any other transferee.
SCHEDULE OF DEBTS
id Name of Payee Description of Obligation Amount Paid
TOTAL $
(attach separate sheet if requ ired)
WEALTH OF PENNSYLVANIA)
SS:
Y OF:)
hereby certify that the foregoing is a just and true statement of
expenses and other debts of the decedent,,for which I
ally responsible and which I did payout of the property herein taxed.I further certify,that to the
my knowledge and belief,these same debts will not be claimed by any other person,for inheritance
oses.
AND SUBSCRIBED BEFORE ME THIS DAY OF
19_.
Signature of Taxpayer
REPORT OF REGISTER OF WILLS
ndersigned,duly elected Register of Wills in and for the above county,do respectfully report that II,the u
have allowed deductions listed above in the total amount of $"
SWORN
1,_-
funeral
was leg
best of
tax purp
COMMON
COUNT
Date Pa
3 -Thes
perso
deced
Date Pai
1 -You w
THE TH
2-You a
of su
Under ce
or other
by you m
such exp
execute
those wh
assessm
If you ha
decedent
you made
Date of Approval:_
Register of Wi lis
.--
Form RCC-2 ....COMMONWEALTH OF PENNSYLVANIA DATE ............1ff3..p.r..JJ9<r.y....??"......+..97.+................
D'EPART.MENT OF REVENUE RESIDENT INHERITANCE TAX ............~{.~::>..h?:!.Jg.~.~~..........................COUNTYBUREAUOFCOUNTYCOLLECTIONS ...............
I HARRISBURG.PENNA.17127 APPRAISEMENT FILE NO.........§?:?.?.:.~~§4............................................
I ................................................y..9.00....G.~;u..~....P..r..!L...............................................late of ................................~.~~?.~~.~~............................................Whereas,
in the County of ............................................~~~.~0.~!:lg~~.~.........................................................Commonwealth of Pennsylvania,having died on
the ...............................l.7t..n .................................................day of ..............NQ.Y~gtp.~~....................................19.....7.9,seized and possessed of an estate
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore,I,ALFRED TOSI 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 annuitie:s 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 AppraisementDescriptionofAssetValuesMadeforInheritance
Tax Purpoles
$
Jt.Savings Account #5215.held in the WESTERN PENNSYLVANIA NATIO ~AL
BANK,CALIFORNIA CALIFORNIA.PENNSYLVANIA.In the(W]"·;~names
of JOHN GALLIK SR.OR LEANARD GALLIK.Opened 7-15-66.lil
Balance as of dati::>of rlp.Rt.h £i'iR .RI,358 84
-
form~~v:fhbl:e:::I~~W~..~~~~~~~~.~~~:.~:;o~~~~~.~..~~~~.~.~.~~.~~..~~....~.~~e 1~~2;~
..............··................~....·\lr'~·..·..·~F
App 'Ber
.......,......................................................................................................................................................'''ZJ.(Number and Street)
............................................~..........................,Penna.(Post eel
..............Was~?:?~~?Il COUtlty
RESIDENT INHERITANCE TAX APPRAISEMENT
Estate of
JOHN GALLIK SR.
Deceased.
Late of
..................................CALIFORN.IA ,..
Date of Death,..·11.-17-70 .
Appraisemel!t Docket Vol.,3..~.
Page,~?;L.~.~No ??:?.9.:~?.4.
Filed in Register's Office,F.ep ~.~19 .7l
Amount of tax due,$..
DEPARTMENT OF REVENUE
Received,
Examined and Approved,.
Wrote abo.ut Appmisement,..
Appeal f,.om Appraisement,..
Entered and charged,..
"
.~
•.
•
REAL PROPERTY
REAL PROPERTY IN PENNSYLVANIA.WITH STATEMENT OF MORTGAGE ENCUMBRANCES UPON EACH PARCEL AT DEATH OF DECEDENT.
WHERE PROPERTY HELD AS JOINT TE:NANT OR TENANCY BY ENTIRETIES.GIVE NAMES.ADDRESSES A~m RELATIONSHIP OF OTHER OWNERS.
Real Estate Estimated
Value
Lots N'>s.~and 6 in the Underwood Plan,in the Borough of
California,(formerly East Pike Run Township),Washington.---County,Penna.upon which there is erected a four-room
frame bungalow.For chain of title see Deed Book Volume 19i1.:t-:1
(}f ..'V:J ~>I
764.Page k477'5,000.00
•H2.o.-'"\.-,.A
~)117~.d.~,,
.•~J,n'"
•
Personal Property
.,L
"A/t'1{q2.08NationalSlovakSociety,death benefits,
"
Social Security death benefits '---u.6 2'55-0{}':"-,-~-'-;'
,.-.-
5,917.08
,
<
"..
<•
70-110
NOTE:You may expedite the processing of this return by filing with it,and as a part of the return,
letters from financial institutions or mortgage holders,certifying to amounts on deposit or owed by the
decedent as of the date of death.Such letters must be signed by a responsible officer of the financial
institution or mortgage holder and indicate clearly amounts of principal and interest in the decedent's
account at the date of death and the type of account,account number and the exact name or names in
which the account is registered.
Jointly Held Property
1.Western Pa.
1 I
2.Wester:n Pa.NC!.tional Bank,,Savings Account No.5215,JohnGallilc,Sr
or Leonard Gallik,son;'$353..55,one-half taxable
176.77
3.Western Pa.National Bank,Savings account No.00 0009910,J~~lik,~t7i84::..
Sr.,or Albert Gallik,son,$357.69,one-half taxaple ./
Transfel's 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
BENEFICIARIES AND ADDRESSES
RELATIONSHIP SURVIVED AGE OF LIFE
(If step-children or DECEDENT TENANTS OR INTEREST OF
(State full names of all and their addresses who have illegitimate children STATE YES ANNUITANTS BENEFICIARY
an interest;vested,contingent or otherwise,in estate.)are involved,set OR NO AT DEATH OF IN ESTATE
forth this fact.)DECEDENT
Leonard Gallik,337 Irene Street son yes 1/6th
Deer Park,Texas
John M.Gallik,1930 Stanhope Roc d son yes 1/6th
Dundalk,Md.
-
Josephine Zavachin,Box 313 daughter yes 1/6th
Richeyville,Penna.
Albert Gallilc,1385 E.Lafayette D y,.son yes 1/6th
Lee Hall Va.
William Gallik,1073 ro-:a~a]:r:rrcJ.,e son yes 1/6th
J oppatowne,Md.
Elizabeth Gallik Palgutta daughter yes 1/6th
llj Lanmer Ave.Bobtown,Pa.
~I
J
,".
RESWENT DECED"ENT DEBTS AND DEDUCTIONS CLAIMED
NOTE'"isHi.~tfive items in the spacps so provided observe notations thereon and instructions.-,,
DEBT OR CLAIM NATURE OF SAME AMOUNT THIS COLUMN
~EGISTERONLY
Funeral expenses paid $$
"
Family exemption (will not be allowed unless
decedent died residing with a spouse or children.)
"Administration Expenses *
ICounselfees*
Fiduciary commission *
I
OTHER DEBTS AND CLAIMS
(*)See Note below
,
I
.-.,.-'".
Total
(City or Town and State)
...,(St~~~i N~~b~;i .
RicheyvilleJ Penna
.~.
Box 313
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.
,\,1.1-\\\\'-
.~~,.,'i ,'.1)."'..J.;0 -e:vSubscnbed.an<rswol'mto before me titus,..,.t , .
"'::':"1 ...,.":..
"''\'';1 ."""{Il.~.....',.>:<.t~'.".:;..?,..\d~~~f . , .~~,19 ..7.1~';:.2 1 ~j(;A.~,*~~;u{:~~~$:'DiA~~'~"""""
'I,,:"',,.."',~Notary Public,Cali/orn;;],,:..>:'tnn Co.'
'"~My tYlllmlsslon EXpires 'u '1975"\'.1\\\,,\'\',....l.,,"•
, .~~~:~~.~~~~~~~l.'~I.n.gd:~:::~'..1.~~.~~~b:~~r~l.f~~.h~:.~~~.~~~~~.~~~:'~:~e.~~~:9i.S.7~in conformity with law on this
··O~~·,···~·0"~······~·~p·r~i~~r·····
In the event that any future interest in this estate is transfened in possession 01'enjoyment to collateral heirs of the decedent after the
expiration of any estate for life 01'for years,the Commonwealth hereby expressly reserves the right to appraise and assess transfer"inheri-
tance taxes at the lawful collateral rate on any such future interest.
"REPORT OF THE REGISTER OF WILLS
I,the undersigned duly elected Register of Wills in and for,, , , . . . . . . . . . . . . . ...County,Pennsylvania,do respectfully
report that I have allowed debts and deductions in the amounts claimed by deponent,except as to those items where a greater or lesser amount
is set forth in the last column to the right in said schedule above,which greater or lesser amount represents the sum allowed as a deduction.
Dated:,.
Register of Wills
.4
I,
"
Form No.RCC-62(7-69)
WillAdministration INo Year .
IN THE
MATTER OF THE APPRAISEMENT
OF THE
ESTATE OF
JOHN GALLIK a/k/a
JOHN GALIK
Deceased
Late of .~alifornia.........................................................
County of Washington..........................................................
Commonwealth of Pennsylvania
REPORT AND APPRAISAL
'Iid "r"~j'I "·l/II('VJ.\_.J "U."",,,j,,)m
S'TIl!;',I n ',!j 1SI f)3tJ
oU:",;:',,:')r~H
sc ',.:.l t;irl ""'JHORMELL,TEMPEST,SiMMONS"-,.I i .II.
BIGI &MELENYZERvi f ""
Attorneys at Lau.:.J 1J -;
423 Third Street •,
California,Pa.15419
~
\,Itl I,f'IJ_J ,.\.,
\.'Q ./"'>':~.'*'"f...."""~-.
I 1,-..".
,~I ".......\.t."r'·'f t
:\...I ~..~...~\..~J t l",........
.",0.:+...~:••••$.....-f \---.....
/,L.l ['';:4 ....
l I
r----
R C C-B 1 (6-71)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
HARRISBURG
17127
NOTICE OF FILING OF APPRAISEMENT
JOSEPHINE ZAVACHIN
(Executo~
IN YOUR REPLY PLEASE
REFER TO
Inheritance Tax Division
38-121-6
J
In Re:Estate of __J.::....O=-=HN=..:.....--=-G=-=ALL=I:::.:K:.-.a=:!/c...::k:::L/-=a ~_
WASHIIDTON County -Fi Ie No.63-70-1l64
Dear ~1rs.Za"ITachin,
You are hereby notified that the __----Io.loJ..:,rJ..!.<·gt!>-ll..l'nJ..Sal _
apprai sement in the estate of ~II~Ou:JHu..uT\.J_GI..U:l..ATUlJ......,IwK.l...__
has been filed in the office of the Register of Wills of vJASHINGTON
County on January 6 ,19R,Said appraisement reflects the following
valuations:
Real Estate 5.000.00
PersonaI PropertY_-06L0642-.J.O..u.8::>-_
Transfers _
Jointly Owned _
Total 5,662.08
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 mte 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 Januar;,r 6,1972
DATE OF DEATH:November 17,1970
Note:This is not a bi II.
Signed __A_l_FRED_'_TO_S_I _
Title APPRAISER I
i.
RCC-39 (5-68)
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SUMMARY
Estate of GALLIK
(Last Name)
JOHN
(First Name)
a/k/a
(Initial)
DATE OF DEATH 11-17-70 FILE NO.63-70-1164
REPORT OF INHERITANCE TAX APPRAISER
I,the undersigned duly appointed Inheritance Tax Appraiser in and for the County of __W:..-A:..-S_H_I_N_G_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 itl~m in the last column to the right in Schedules "A","B","C",and "E".
Dated:_---""J-"'an!..:.ua=-yr~....:::6'J-,.....:1=-CJ7L...L.::.2"--_
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 dedul:tions in the amounts claimed by deponent,except as to those items where a greater or
lesser amount is set forth in the last column to the right in Schedule "F",which greater or lesser amount represents the sum
allowed as a deduction.
Dated:.
REGISTER OF WILLS
VALUE AS REAPPRAISED
$-------+--e:;r)()()FIn
"t.t.0 (\0
5,662 C8
NONE
5,662 b8
VALUE AS APPRAISED
$
5,662
NONE
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
FOR USE OF REGISTER ONLY
Tax on $----------1-.-2%
Tax on $C§i)
Tax on $5%
Tax on $10%
Tax on $15%
Exemptions *
Total Estate --I-_
TOTAL TAX
COMPUTATION OF TAX
$---------4--
$---------4--
$--------+---
$-------+--
$---------4--
$-----_--1._-
(*)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 ::::::::::::t====
BALANCE OF INHERITANCE TAX DUE $t=
Add interest at rate of 6%from_____to $---..J
AMOUNT OF ESTATE TAX ASSESSED $--~----lL-
Estate tax paid $----'L-
BALANCE DUE $----JI_
Add interest at rate of 6%from t=
-------(to-----$-----~
TOTAL TAX BALANCE $-----~
PAID $....J
FOR USE OF REGISTER ONLY ADJUSTMENTS
NOTE:Where subsequent adjustments are made to the above computation of tax by the Register of Wills,for proper reason,
same should be noted below,with short explanation.
Will
Administration t No .
IN THE
year .
MATTER OF THE APPRAISEMENT
OF THE
ESTATE OF
JOImGAIJ.]:K .....
Deceased
Late of ..CALIFORNIA...
County of .WP..SH:r:1'P'l'QN...
I
Commonwealth of Pennsylvania
REPORT AND APPRAISAL
,
)
'"
...,'~.,..
}"'unn RCC-2 I ,,,'"."••"
~COMMONWEALTH OF PENNSYLVANIA DATE ........January.....6.,.....1.972.............••-............
DU'ARTME'l'JT OF REVENUE RESIDENT INHERITANCE TAX .......WA'SHINGTON.........................BUREAU OF COUNTY COLLECTIONS COUNTY ..............
HARRISBURG.PENNA.17127 APPRAISEMENT FILE NO.........63.::::7Jbll64........................................
Whereas,....................................~9..mt.QAg~~...~./~/~.....................................................late of .................9.A~.~.9.~P~:..........................................................
in the County of .................................".....WA$.H.+..NG.TQN.............................................................Commonwealth of Pennsylvania,having died on
the ....................~7.~.~..............................................................day of .................~9.~~.................................70 seized and possessed of an estate19............,
subject to Inheritance Tax Illnder the laws of the Commonwealth of Pennsylvania;
Therefore,I,ALFRED T08I 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 futur,e interest in this estate is transferred in possession or enjoyment to collateral heirs of the decedent after
the expiration of any estate for llfe 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 AppraisementDescriptionofAssetValuesMadeforInheritanceTaxPurpo.es
$
REALTY:
SEE COPy OF DESCRIPTIClN A'T''T'A~~n '1'0 IJ.PPRII .....5.000 00
PERSONAL:
SEE COpy OF BESCRIPrION ATTACHED TO APPRA ISElvIENT 662 08
total 5,662 08
>
'.
.
.....................,Penna.
.WAS.HINGTON County
RESIDENT INHERITANCE TAX APPRAISEMENT ,..,
Estate of
~·1·.....
Received,
~
~
~pW~
\~~
f
I
........~6"-
"
r -..__A A ~\'-\~,
'\
..
-~.~1_~l~~
""....
..
Deceased.
Late of
JOHNGALLIK"a/k/a .
~.9.¥.P.!9.~:J:A .
DEPARTMENT OF REVENUE
Examined and Approved,..
Wrote abo,ut Appra.isement,.
Date of Death,1l~l7~.70 .
Appraiscmel!t Docket Vol.,3.8 :.
Page,..l4.1~Q No 63.~7~.ll64 ·
Filed in Register's OfJice,...J.C3:p.~Q 19..72...
Amount of tax due,$.
Appeal from Appraisement,..
Entered and charged,..,
t
"
(L.6.)
COUNTY OF }
I.JOSEpHINE ZAVACHIN HEREBY CERTIFY.THAT.TO THE BEaT OF
MY I<NOWLEDG.E AND BELIEF,THE ,fOREGOING IS-JI -IUST,zitNQ T~UE ~fAlEME,NT OF ..QEB.T-St,FUNERAL EXPENSE8 AND EXPENSES OF
AI',)M 'R'A"'.~.J onn \QYalhK,a I K a Jolin liallKINlln11....N.SUBMITTED TO THE ESTATE OF .DECEASED.AS DEDUCTIONS FOR
.\.-.
INHERITANCE ·fAlt;PUlIlP08ES.~~,"""\'.<)'.',,,.",-')"-'..-'"28th .,
•SWO.~N AND "'~l!IS~~.'!BED BEFORE ME THIS DAY 01"=:zzi;ak~:4;~':6.~.~~J!r .
..---I\'';·..1 ......:.\JANNA .DZAVAN
..,\'I.N?~.ry_Public.California,Washington Co.
:~\,MY:Commission'Expir,es Jurra 16,1975
h rli\ln"'r'l;"\\'~\Y"'.
Form RC ColO
(;,3--7 CJ ,-/I b if
o,"uono"mow,""1j..".t9 oZ,,3,
'OFFICE OF TME STATEMENT OF DEBTS THE SUM OF ............$................................
REGISTER OF WILL:I$·
7C:;;:i~I;JA';~~f~=t~t AND DEDUCTIONS
!OF Washington COUNTY
AND AGENT OF THE COMMONWEALTH I'V V'V -.....U
Register of Wills,Ag~,,
ESTATE OF.John Gallik LATE OF California
November 1,1971 Nov.17,1970DATEOFFILINGAPPRAISEMI.NT DATE OF DEATH
DATE NO.OF NAME OF PAYEE REMARKS AMOUNT
~-VOUCH"'1Il
.L v I v Probate of will and one short
Nov.~4 !Russell Marino,Reg.of Wills certificate 14 00
!Washington County Reports estate advertising 14 00
tBrownsville Telegraph estate advertising 9.00
1971 Reimbursement to Josephine Zav chin for:
.V'AltOrlO liuneral tiome -Iunera expense 1,lOU.UU
Quinet Monument Co.-headstone engraving 20.00
&~~cr:lle(itor -Cali,forni~liorou:Rh taxes 36:~gIC0sFowers-unera owe
Groceries:-for funeral dInner 4:U.tlb
California.Water Co.-water service 9.14
~Ee:itrllnn Power Co.-el:t,ctric eryice 7.44eleephoneCo.-telep one s rVIce 8.63
Columbia Ga.Co.-gas service 17.57
A.ne-elo Cole &Sons -gas repair 7.50
1,327.68 1,327 68
Oct.9 Borough of California sewage 7 35
Oct.~7 Julia McDonald,tax collector 1971 school tax l7 6 25)
Nov.1 Rlssell Marino balance on letters 4.00
filing inventory 3.00
filing renunciation 1.00
8.00 8 00
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Dec.2C West Penn Power Co.electric servtce''-5.21)
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61 Borough of California 7.35Jan.sewage
:West Penn Power Co.electric service o.15
Feb.23 lWest Penn Power Co.electric service 9.73
Mar.21 Iwest Penn Power Co.electric service 1.76 -
Marc 27 bliver N.Hormell .attorney fee 791 38
Josephine Zavachin executrix fee 474.82
Wash.Co.Bar Assn.Bar Assn.fee 10 00
C 4"!r'~tR£/9s\>rJ ~a~4,l,l '~JJx.~J,~~./"A~~~760.68.J
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COMMONWEALTH OF PENNUYLVANIA'I C'A.-I ';'t.f/-f.A AJ<0....c c.>f t6~Ci{),-"CJ ._-v . _
.Washington 8.:
70-110
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~Recorder of Deeds
RECORDER1S OFFICE
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Washington,Pa.,_~L..?.19 2~
PRESENT.RECEU'T WHEN LIFTING INSTRUMENT
7210N~
State Realty Tax $-:=:__.
Registration Fee ....$........._
RECEIVED o:.....t.?~.....~.~T"..&'!,;..o:i-":1v.:.'L...
paped~.I2~No f/::.!:..'l../.to be recorded
in the Recorder's Office of Washingt;n-County,Penna.Parties named below.
Fees $~~.~
.50
State Tax $ .
1.00
Certificate and Seal $ .
Satisfaction $--..
Total $7.!.:rP.
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