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.Affi~uuit ®f 1fxrrutnr ®r .Abmittiatrutnr
~tatt nf;~ruusyluauia } Q!n~itty nf llas4ingtnu sn:
P II b f th d · d th •t Notary Public · d f 'd ersona y e ore me, e un ers1gne au on y, a ............................................ m an or Sal
County and State, appeared .......... !?.!.>:~--~-~---~!?-~.!-~.1.-~-~--------------------------------------.. who, being duly
sworn according to law, deposes and says that he is the executor or administrator of the es-
tate of .... He.le.n .. E.liz.ab.e.th .. Ha.ll ....... deceased, that the foregoing schedules constitute a
complete inventory and appraisement of the real and personal estate of ............................................ ,
deceased, except real estate outside the Commonwealth of Pennsylvania; that the figures opposite
each item of real and personal estate in the foregoing schedules are determined and stated by the
undersigned to be the fair value of said items as of the date of the decedent's death, based upon a
just appraisement of each item made by the above named Executor Administrator.
day Os1worn~and subscribed be
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.&:. )( (.) UJ ADDITIONAL INSTR ·U § = ·en i _!jl ·iJ. i. i
1. An inventory must be filed within three months after appointment of personal representative.
2. A supplemental inventory must be filed within thirty days of discovery of additional assets.
3. 1 Original and 2 Copies and 2 RCRI-34, Under $10,000; 1 Original and 2 Copies and 2 RCRI-33,
Over $10,000, including Copy of Will; 1 Original and 3 Copies and 2 RCRI-33, Over $50,000, in-
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
lluurutnry aub !\pprai!itmtnt of the goods and chattels, rights and credits -which
were of .......... ~~-~-~-~---g·~-~~~~~-~-~ .... Ji.~.~-~ .............. late of .......... f.~~-~~-~-~-~-~-~.4 ... !9.~~:?.~.~-P ............. .
Washington County, Pa., taken and made in conformity with the ab~e affidavit.
DOLLARS CENTS
Savings Acct"' #64-20064, Charleroi Office, Mellon
National Bank and Trust Company
Savings Acct. #9209, First National Bank of Washington
Charleroi, Pa. Office
Checking Account, First National Bank of Washington
Charleroi, Pa. Office
Issue Date October 14, 1955, #Ql237612178E
II II II II II #Ql237612179E
II II December·· 21, 1955 #Ql247612039E
II II II II II #Ql247612040E
II II EM~XX19, 1955 #Ql232477156E
September
848(!) 20
45J 27
5' 72
159; 10
Medicare Reimbursement 3 07
11300 00 Real estate situate in the Borough of North Charleroi,
washington County, Pennsylvania, located at 623 7th St ,
being a one and one half story frame dwelling house. ore
particularly bounded and described as follows:
ALL that certain piece or parcel of land lying in
-~he Borough cr North Charleroi, Washington County,
State of Penna., and described as follows: Lots no.
(6) and seven (7) in Block No. six (6), beginning at
a point on the North side of seventh (7th) st. at the
corner of Seventh (7th) St. and a twenty (20) foot
wide alley, thence along the North side of Seventh (7t· )
st. N 83° 33' W Eighty four (84) feet no inches, to a
paht on the line of Lot. No. eight (8) thence along
said line between lots numbered seven (7) and eight
(8) N 11° 18' One Hundred Nineteen and 60/100 (119.60)
feet to a point on the Southside cr Orange St., thence
along the South side of O~ange St. the dista¥cetp~ Eighty je~~ (80) feet no ~ncnes to tne carne o TOTAL 24,731 36
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INVENTORY AND APPRAISEMENT
TWenty (20~ foot wide alley, thence along the West side o£ said
Alley S 11 18 1 Ee One Hundred Forty-five and 22/100 (145.22)
feet to the place of beginning, and being lot numbered six (6)
and seven (7) in Block Six (6) as shown in the Lock View Plan
o£ Lots ~d out by the North Charleroi Land Company, and recorded
in the Recorder's Office £or washington County, Pennsylvania,
in Plot Book Volume 2, Page 132$
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LJ -7 J-32t-~.
LAST WILL AND TESTAME.NT
I, HEL.EN ELIZABETH HALL, a widow, of the Borough of
North Charleroi, Wa~hington County, Pennsylvania, being of sound
and disposing mind and memory, do on this 2nd. day of April, 1968,
hereby make,· p:.1blish and declare the following to be my Last Will
and Testament.
1 •. I hereby revoke any and all Wills, Testaments and
Codl.cils by me at any time heretofore made.
2. !.nominate and appoint my Attorney, JOHN E. COSTELLO,
ESQ., to be the Executor of this, my Last \'Jill and Testament, and
r·direct that he be permitted to serve without bond.
3. I direct that my Executor promptly pay from out of
the proceeds of my est~te, all ~f my just debts including the
expense of my funeral and the costs of administration.
4. I give, devise and bequeath all of my p~operty,
whether the same be real, personal or mixed unto my Executor and
I direct that he sell the same for the best obtainable price, at
either private ox public sale and divide the proceeds as follows:
Unto my three ( 3) children l\1ARY HALL BAYLEY, VIRGINIA J. HALL
BROWN and ELIZABETH ANN HALL MESSER equally except that having
advanced $3,000.00 in my lifetime to my daughter, MARY HALL BAYLEY,
I direct that her share be reduced by $3,~00.00. That is, my
daughter VIRGINIA and my daughter ELIZABETH ANN shall receive
$3,000.00 each more.than my daughter MARY for the reason that Mary
has received $3,000.00 during my lifetime.
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s. In the event that any of my daughters should have
predeceased me, then I give, devise and bequeath her interest to
her· surviving children, if any, and should the children of MARY.HA
BAYLEY take they sQ.a11 take under the exact conditions as their
mother •.
6. In the event that any person taking under this Will
should be a minor then I nominate and appoint my Atto~ney, JOHN E.
COSTELLO, ESQ., to be the guardian of their estate or estates
during the period of their minority. He ~hall have all powers
given to fiduciaries under the law of Pennsylvania.
IN \'JITNESS ~VHEREOF, I have hereunto set my hand and seal.
this 2nd. day of April, 1968.
Helen Elizabeth/Hall
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. 111 FalloNfield Avenue
P.O. Box 11 BASSI &·A~SQCIATES, P.C. Sutte 209, Plaza B'dg.J
15o'w. Beau Street
Washington, Pennsylvania 15301-4425 Charleroi, Pennsylvania 15022-0011 ATTORNEYS AT LAW
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IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY, PENNSYLVANIA -.· .,_,. -
INRE:
ESTATE OF HELEN ELIZABETH
HALL, Deceased
ORPHANS' COURT DIVISION
No. 63-71-326
PETITION FOR PAYMENT OF
FUNDS REMAINING IN ESTATE
Filed on behalf of
LUCILLE E. COSTELLO,
Executrix, ,
Estate of John E. Costello
Counsel of Record for
this party:
MELVIN B. BASSI, ESQUIRE
Pa. I.D. No. 05326
BASSI & ASSOCIATES, P.C.
Firm No. 25-1347135
P.O. Box 11
111 Fallowfield A venue
Charleroi, PA 15022-0011
(412) 483-5502
·,
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IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
INRE:
ESTATE OF HELEN ELIZABETH
HALL, Deceased
No. 63-71-326
PETITION FOR PAYMENT OF FUNDS REMAINING IN ESTATE
Your Petitioner, Lucille E. Costello, Executrix of the Estate of John E. Costello,
Deceased, through her attorney, Bassi & Associates, represents and sets forth as follows:
1. That your Petitioner, Lucille E. Costello, is the Executrix of the
Estate of John E. Costello, Deceased, who died on April 7, 1985, and Letters Testamentary
were granted to your Petitioner by Washington County at No. 63-85-0441.
2. John E. Costello was formerly a member of the bar of Washington
County, Pennsylvania, and was the counsel and duly appointed Executor of the Estate of Helen
Elizabeth Hall, the above-named Decedent.
3. That as the Executor of the Estate of Helen Elizabeth Hall, John
E. Costello undertook the administration of the Estate of Helen Elizabeth Hall and completed
the administration by filing an Inventory and Appraisement and an Inheritance Tax Return, and
by arranging for the payment of all obligations of the Decedent, Helen Elizabeth Hall. The
' '· . ' ' (
Executor, John E. Costello, made distribution of the remainder of the assets pursuant to the
terms of the Will of the Decedent.
4. That John E. Costello maintained an estate account with Mellon
Bank N.A. at its Pittsburgh office, being Account No. 150-7006, in which there remains a sum
of $1,903.53, all of which your Petitioner alleges and prays is due to the Decedent, John E.
Costello, for accountant's commission, costs advanced and attorney's fees.
WHEREFORE, your Petitioner requests that an Order be made authorizing and
directing Mellon Bank to pay unto Lucille E. Costello, Executrix of the Estate of John E.
Costello, the sum of $1,903.53, together with interest, closing out such account and the
Executrix of John E. Costello to file a receipt at the above number and term indicating payment
thereof.
AND FURTHER Petitioner prayeth not.
RESPECTFULLY SUBMITTED,
By~>~/
/ MclVill(B:Bassi
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VERIFICATION
I verify that the statements made in this Petition are true and correct. I
understand that false statements herein are made subject to the penalties of 18 Pa. C.S.A. §4904
relating to unsworn falsification to authorities.
Dated: ~t:~La
. LUCILLE E. COSTELLO,
Executrix of Estate of John E.
Costello
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IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
INRE:
ESTATE OF HELEN ELIZABETH No. 63-71-326
HALL, Deceased
ORDER
AND NOW, the pO day of November, 1991, upon consideration of the
foregoing Petition and upon motion of Melvin B. Bassi of the firm of Bassi & Associates, P.C.,
Mellon Bank NA is authorized and directed to pay to Lucille E. Costello, Executrix of the Estate
of John E. Costello, the sum of $1,903.53, together with such interest as may have accrued, in
termination of all estate accounts of the Decedent, Helen Elizabeth Hall.
BY THE COURT,
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OFFICE OF
, THE REGISTER OF WILLS
AND
CLERR OF THE ORPHAN'S COURT
WASHINGTON COUNTY
WASHINGTON, PENNSYLVANIA 15~}
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MISCO 15.00 ·
6 TOTL 15.00
~~~2Z10:47NOV.21'91E CHECK 15.00
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MISCO 1.00
6 TOTL 1.00
f~~~10:49NOV.21'9H CHECK 1.00
LINE 08
RECEIVED OF ·/ )~ .. .! U 'i-U.j. .. ./ I t ; ,t .6 J
/ tfi_fu. J! / / . . '. ·-. I BY ,1') {1. L ' .-,U. L( l;i ,._)Lt' .-.. <_
Kathleen Flynn Reda J
No. 24791 , ... -:·
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Form RCC-33
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
J 1
RESIDENT DECEDENT HELEN ELIZABETH HALL COUNTY OF ············.WASHINGTON·································· ..
IMPORTANT: This return must be completed in detail and filed in duplicate, with wiU. attached, with the
Register of Wills of the County where decedent resided; Return is due within one year after
date of death, unless an extension is granted by the Secretary of Revenue. (Section 703 of
. _the_Inh~ritance_ an!! Estate ':{'ax J\ct of 1961.)
IN THE MATTER OF THE ESTATE OF } AFFiDAVIT OF
................................................... ~-~~;~~~r-~;;;~-~~~~~ ...... J.iA~k.................................. EXECUTOR
Late of ..... .Nor .. th .... .Char .. le.r . .o;L ... B.or.ou.gb. ................ County ~
State of.............. ~~~~=x.~.Y.-~.~-~ ................................ :.}ss:
County of ......... Washing.t.on. .......................................... .
JOHN E. COSTELLO ESQ. ....................................................................................................................................................... 1... ................................................................................................................................... .. . ..... Executor
of the estate of the above-named decedent being duly sworn, depose S and sat'
Decedent ·dJed .......... MatGh J9.,
(Month)
........ , 19 ........... .7..1,.) testate leaving a last will, copy of which is hereto attached. }
(!lay) (Year) L em p
Name and address of attorney or}
other authorized representative to
whom all correspondence should be_
mailed.
JOHN E. COSTELLO ESQ • .......... ... ········· .... ·········· ............ ... ··········'··"······················· ..................... .
That as such .... .J~~!?..9..~.:t..9..; ................ deponent is familiar with the affairs of said estate and the property con-
< l•:x.,cutor-Administrator)
stituting the assets thereof and their fair market value.
That at the time of death there was no safe deposit box registered in decedent's individual name, or jointly
with, or as agent or deputy of another, or in decedent's individual name, with right of access by another as agent
or deputy, with the exception of the following:-
NAME AND ADDRESS OF BANK OR OTHER INSTITUTION THIS SAFE DEPOSIT BOX RENTED RELATIONSHIP OF JOINT
--~I~N~WH~I~C~H~D~EC~E~D~E~N~T_R=E~N~T~E~D~A~S=A~F~E~DE=P~O=S~I~T-=BO=X~----f----=IN~N~A~M~E_O=R~N~AM=E~S~O=F ____ -+~H~OLDERS TO DECEDENT
NONE
That the contents of said safe deposit box or boxes are itemized under Schedules _____ of this
return, with the exception of the following, for the reasons hereinafter set forth:
That Sc.hedule A attached hereto and made part hereof sets forth full v and in· detail all the
real property in the Commonwealth of Pennsylvania of which decedent died having an interest therein. It
also sets forth the mortgage encumbrances upon each parcel of real property at the date of death, giving
the amount still due at death, name of mortgagee, date, rate of interest, and book and page of record
thereof. It also sets forth in the columns provided therefore the assessed valuation of each of said
parcels, the estimated market value thereof as of date of death of decedent.
That Schedule B attached hereto and made part hereof sets forth fully and in detail all personal
property wheresover situated owned by the decedent at the time of death; all moneys left by the decedent
at the time of death, whether in decedent's immediate possession, standing to decedent's credit in banks
of deposit, savings banks, trust companies, or other institutions, whether individually, or in trust for
any other person or persons giving also separately the accrued interest thereon, if any, down to the last
intere~t daY. p_r~or_ to decedent's death in the case of savings banks, and ·to· the date of decedent's death
in all other cases; all bonds, postal savings, treasury certificates or notes and other evidence of in-
debtedness-of the United States to the decedent; all obligations, whether by statute or agreement they
are designated as tax free, of the United States, or any state, or political subdivision thereof, or of
any foreign count~y, which are-owned at the time of death; all wearing apparel, jewelry, silverware, pic-
tures, books, works of art, household furniture, horses, carriages, automobiles, boats, and any and all
other personal chattels of whatsoever kind or nature, left by decedent, together with the fairly estimated
market value thereof; all bonds and mortga~tes held by decedent and of all claims due and owing decedent
at the time of death, and all promissory notes or other instruments in writing for the payment of money
of which decedent died possessed, of whatsoever nature, with interest thereon, if any, giving the face
value and estimated fair market value thereof, and if such estimated fair market value be less than the
face value, it sets forth briefly the reasons for such depreciation-as ~o each item; all moneys payable
to the estate from life insurance policles carried by decedent; all annuity and endowment contracts the
proceeds of which were payable upon the death of the decedent; and all the corporate stocks and dividends
due thereon and unpaid as of the date of death, bonds and accrued interest thereon to the date of dece-
dent's death and other investment securities owned by the decedent at the time of death, with the market
value thereof at such time.
...
In the case of securities of close or family corporations, the values reported are as far as
possible substantiated by financial statements of the corporations, showing· the assets and liabilities
thereof as of the· date of death. The schedule also sets forth the interest of decedent at 'the time of
death in any co-partnership or business, and in support of the value of such interest there is annexed to
said schedule, financial statements showing the assets and liabili.ties of said co-partnership or business.
A copy of the co-partnership agreement, (if oral, a statement setting forth the nature of the agreement)
together with a statement setting forth the character of the business, its location, and such other facts
pertaining to the business as may be pertinent to a fair and just appraisal of the decedent's interest
therein must be submitted.· It should also set forth in itemized form, together with the fair market value
thereof, any other property owned or bequeathed by the decedent at the time of death.
The Schedule C attached hereto and made part hereof sets forth a true answer to each inquiry
contained therein and in the case of transfers ofproperty, real or personal, within two years of decedent's
death, in contemplation of decedent's death, or intended to take effect in possession or enjoyment at or
after death, said schedule sets forth the nature and value of such property, to whom transferred, the
relationship of the transferees to the decedent, the proportionate share received by each transferee and
all other facts of a pertinent nature regarding said transfers •• In the case of transfers intended to
take effect in possession or enjoyment at or after death, there is also attached to the schedule a co~y
of the deed, trust agreement or other instrument creating the trust. TherA is also set forth in said
schedule a list of all property, real and p_~r§.qnal, 'with its value, which 'passes at decedent's death by
virtue of the exercise by decedent, either individually, or jointly with another, or any power of appoint-
ment vested in decedent, either individually or jointly, by.the will, deed, or other instrument of another,
with a copy of the instrument creating such power attached to the schedule.
* ~ : "
That Schedule D attached hereto and made part hereof sets forth the names and addresses of all
persons beneficially interested in this estate at the time of decedent's death, the nature of their res-
pective interests, their relationship, if any, to the decedent, together with the ages at the time of
decedent's death of all minors, annuitants and beneficiaries for life under decedent's Will. It also
contains a statement showing which of the beneficiaries named in the decedent's will, if any, died prior
to decedent, the dates of their death, their issue, andthe relationship of such issue to the beneficiary.
That Schedule E attached hereto .and made a part hereof sets forth all property, real and per-
sonal, owned by the decedent jointly with another or others, including intangible, standing in the name
of the decedent and others, plus· the·date and place of record of--instruments effecting the vestiture of
real estate and the date of acquisition of personalty, plus the name, address and relationship, if any,
of co-oWners to the decedent.
That Schedule F attached hereto and made a part hereof sets forth fully and in detail all debts
and deductions claimed for and on behalf of this decedent's estate, including funeral expenses paid;
family exemption, where applicable; costs of administration of this estate; counsel fees and fudiciary's
commissions paid or to be paid; cost expended for burial trusts, tombstones or gravemarkers, and reli-
gious services, in consequence of the death of the decedent; debts and claims owing and unpaid at time of
death; taxes accru~d charge.able for period prior to decedent's death (except. those allowed under Section
651 of the Inheritance and Estate Tax Act); together with a statement of collateral pledged for obliga-
tions, if any. It is agreed that the fiduciary will present proof of said claimed obligations upon re-
quest, that if the amount actually paid in settlement of any fee, commission or debt is less than the
estimated amount claiming and allowed; that the same will be reported to the Register of Wills, and that
the amount of tax assessed can be reassessed in accordance therewith.
That the totals of the appropriate columns in Schedules "A", "B", "C", "E", and "F" as directed therein,.
have been carried forward and properly registered in the Summary.
Subscribed and sworn to before me this {..fS ................. .
.... day of.~ ......... :~ ... ~ ............. 19 ....... 7.,:1,
... .J~-~ ................... .. ................ ~ •............................ . ............. ?. ... ~ .... ~ .. ~ .......... ~.?. ..... ~-~ .......... .?. ..... ~.~.9.~ .......................... -.. .
(Executor~
.. ....... ~ .. ~-~ .... W~.?..h~.n91:.9n .... A:vg .. !L ......................... -............. .
(Street Number) ~
...... Gh~;.;:J.~.~.Q.~.J. ..... P..a ......... l.S.Q.G..2 ..................................... .
(City or Town and State)
. '. '.'lashington c~ ~o'laTY Pub\ic. 19711 ta · ~ . . h. ~> ~~ uecemj)~r. 31! ·~o ry Publrc. Charleroi Washr'n t · •. m·~rn!SSIOn-.. llill'.n• j . -' g on Co. NOTE: "''fefo're signing affidavi ~ s~'lDJxM.Dbdemllit 31Pii:J7Js in the affidavit and schedules annexed are
filled in with details or the word "None", and in case the assets include rare and unlisted securities,
securities of close or family corporations or an interest in any co-partnership or business, that the
data and statements required under the paragraph above relating to Schedule "B" are attached. Also make
certain that column #1 in the "Summary" has been properly completed as above-directed.
I •cc-M u-.. > • •
I COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF.COUNT)' COLLECTIONS
TRANSFER INHERITANCE TAX
RESIDENT DECEpENT
SCHEDULE 11 A11
t'EAL PROPERTY *-
Real property in Pennsylvania, with statement of mortgage encumbrances upon each parcel at death of dece-
dent. Where property held as joint tenant or tenancy by entireties, report on Schedule "E". Property held by
the de.cedent as tenant in common with another or others, should be identified as to quantum of interest and
the estimated value should be that of.the. decedent's interest only.
(1) The real property located In the Commo!'lwealth of Pennsylvania should be
described by lot and block number, street and street number, together wl th
a general description of the property, with a reference to the record of the
conveyance by which the decedent took title; if a farm· state number of a-
cres; also statement of mortgage encumbrances upon each parcel at death
of decedent. Taxes, assessments, acc~ued Interest on mortgages, etc.,are
to be listed on Schedule" F" and must not be deducted from this schedule.
ASSESSED VALUE
FOR YEAR OF
Real oastate situate-'"in the Borough of N0 rtt
Charleroi, Washington County, Pennsylvania,
located at 623 7th Street, being a one and
one half story frame dwelling house. More
particularly bounded and described as follov.~:
ALL that certain piece or parcel of land
lying in the Borough of North Charleroi,
Washington County, State of Penna., and
described as follows: Lots No. six (6) and
seven (7) in Block No. six (6), beginning
at a point on the North side of seventh (7th)
Street and at the corner of Seventh (7) Strelat
N 83° 33' wEighty four (84) feet no inches,
to a point on the line of Lot No$ eight (8)
DECEDENT'S
DEATH
(2)
ESTIMATED
MARKET VALUE
e,f(.x.t
$li1., (~00
thence along said line between lots numbered seven (7) alnd
eight (8} N 11° 18' One Hundred Nineteen
and 60100 (119.60) feet to a point on the
Southside of Orange Street, thence along the
South side of said Orange Street the distanc~
of Eighty (80) feet no inches to the corner
of a Twenty (20) foot wide alley~ thnce alon~
the West side of said Alley S 11 18' E.
One Hundred Forty-five and 22/100 (145.22) f~et to
the place of beginning, and being lot numberPd
six (6) and seven (7) in Block Six (6) as
shown in the Lock View Plan of Lots laid out
by the North Charleroi Land company, and
recorded in the Recorder's Office for
Washington County, Pennsylvania, in Plot
Book Volume 2, page 132. ·
,..·.· '
Insert this total opposite "real property", Schedule "A" in the X X X X X
"As Reported" column on the last page of this return.
(3)
DEPARTMENT
VALUATION
CAUTION
(Do not write
In this space)
;/SOO I
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RCC-35
COMMONWEALTH OF PENNSYLVANIA
TRANSFER I~HERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "B"
PERSONAL PROPERTY
INSTRUCTIONS: This Schedule must disclose all tangible and intangible personal property owned individually
by the decedent, at the time of his death. Property owned by the decedent jointly with another or others
must be listed under Schedule "E", Intangible personal property, titled in the name of the decedent, but
payable at death to another or others, including but not limited to P.O.D. u. S. Savings Bonds and tenta-
tive trust accounts, must be listed, despite the fact that they are not of the administered estate.
Tangible personal property should be listed first (e.g. jewelry, wearing apparel, household
goods, and furnishings, books, paintings, automobiles, boats, etc.)
Intangible personal property, such as bonds, treasury certificates, cash on hand and in bank, . . stocks, ·mortgages, notes, together with accrued interest or dividends, salaries or wages, insurance pay-
able to the estate or fiduciary in said capacity, partnership interests, interest in anyundistributed
estate of or income from any property held in trust under the will or agreement of another, even though
located outside of the State, at the time of death, should be listed in this schedule.
Item
No.
ITEM
List and describe fully
Savings Acct. #64-20064, Charleroi O££ice
Mellon National Bank and Trust co.
Savings Accte #9209, First National Bank
o£ Washington, Charleroi, Pa. O££ice
Checking Acct. First National Bank of
Washington, Charleroi, Pa. Office
Issue Date October 14, 1955, #Ql237612178E
" " II II II #Ql237612179E
II " December 21, 1955 #Ql247612039E
II II II II II #Ql247612040E
tt tt September 19,1955 #Ql232477156E
Medicare Reimbursement
TOTAL
UNIT
VALUE
Insert this total opposite "Personal Property", Schedule "B" in X X
the "As Reported" column on the last page of this return.
ESTIMATED
MARKEr VALUE
(J. k .;7i. t
$8480.20
(!)J~. t
$45~6.27
{)t/( 1;~72 .
~/~
(J 159.10
3.07
$13231.36
DEPARTMENT VALUATION
(Do not write in
this space)
g---1 ro. :<. o
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RCC-30
COM\fONI.\'EALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
~~SIDENT DECEDENT
SCHEDULE "C"
TRANSFERS
(1) Did decedent, within two years of death, make any transfer of any material part of his estate, without
receiving a valuable and adequate consideration therefor? (Answer yes or no)_n __ o ____ _
(2) Did decedent, within two years of death, transfer property from himself to himself and another or
others (including a spouse) in joint ownership? (Answer yes or no) no
(3) If the answer to (1) or (2) above is in the affirmative state:
(a) Age of decedent at time of transfer -----------
(b) State of decedent 1 s health at time of making the transfer. (Note 1),
(c) Cause of decedent's death. (Note 1).
(4) Did decedent, in his lifetime, make any transfer of property without receiving a valuable or adequate
consideration therefor which was to take effect in possession or enjoyment at or after his death?
(Answer yes or no) no
(a) Was there any possibility that the property transferred might return to transferer or his
estate or be subject to his power of disposition? (Answer yes or no) no
(b) What was the transferee's age at time of decedent's death?-=n~o=------
(5) Did decedent in his lifetime make any transfer without receiving a valuable and adequate consideration
therefor under which transferor expressly or impliedly reserves for his life or any period which does
not in fact end before his death:
(a) The possession or enjoyment of or the right to income from the property transferred?
(Answer yes or no) ___ n __ o ______ _
(b) The right to designate the persons who shall possess or enjoy the property transferred or
income therefrom? (Answer yes or no) __ ~n~o ____ __
(6) If the answer to (5) (b) above is in the affirmative, state whether the right was reserved in decedent
alone or others ____________________________________________________________________________________ __
(7) Did decedent in his lifetime make a transfer, the consideration for which was transferee's promise to
pay income to or for the benefit of care of transferor? (Answer yes or no) no
(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) no
(9) If the answer to (8) above is in the affirmative, was the power to alter, amend, or revoke the inter-
est of the beneficiarnJeserved in the decedent alone or the decedent and others?
(Answer yes or no) __________ __
NOTE 1: The answers to these questions should be supported by affidavit by the attending physician as
well as a copy of the death certificate.
NOTE 2: If answer to any of the above questions is yes, set forth below a description of the property
transferred, it's fair market value at date of death, dates of transfers and to whom transferred, with
relationship of transferees to decedent, if any. Submit copy of any trust deed or instrument, if trans-
fers are claimed to be non-taxable, also submit detailed statement o~ ~acts on which said claim is based.
NOTE 3: List applicable property below in manner in which provided in Schedules A, B, or E.
ITEM DESCRIPTION
NONE
Insert this total opposite "Trans~ers", Schedule "C" in the
"As Reported" column on the last page of this return.
MAIUillT VALUE
(Estimated)
DEPT. VALUATION
(Dept. Only)
. '
CCM\l1JN'NFALTH OF PENNSYLVANIA
CHI\.~~H:lt TNHl~lllTANCE TAX
H.F.SinENT DECEDENT
SCHEDULE "E"
JOINTLY OWNED PROPERTY
BSTRrCTIO~S: This scherlule must disclose all property, real and personal, owned by the rlecedent jointly
with another or others, including intangibles, standing in the name of the decedent and others. List
real estate first, as entireties, or joint tenants, giving brief description, as indicated tmder Schedule
"A", plus the date and place of record of instrument effecting vestiture, but do not include entireties
or out of state real estate value in estate valuation column. Personal property should be listed as in
Schedule "B", plus date of acquisition, and the name, address and relationship (if any) of co-o:wners to
the decedent.
====================================================~1======~==~~~==-r=========~=====================-----Description of Property, Date of Acquisition, Name Unit percentage Estate DEPART~tENT VALUATION
Address and Relationship of Co-Owners, and Place 1 Value Share Valuation CAUTION-Do not Write
of Record of Instrument, where Real Estate. ! In This Space. xv~~--------------~---
NONE
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1
I NONE
Insert this total opposite "Jointly Owned Property", Schedule "E"
in the "As Reported" colWlB'l on the last page of this return.
Value of
Entire
Property
J
Value of
Decedent's
Interest
\ I
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RCC-37 {12-63) .. ,
......-' I II
C'Ol\1!\ION\\"EALTH OF PENNSYYLANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
.
BENEFICIARIES AND ADDRESSES
State full names and addresses of all who
ave an interest, vested, contingent or other·
wise, in estate)
Mary Hall Bayley
R. D. #2, Box 102
Monongahela, Pa.
Virginia J. Hall Brown
2734 Woodall st.
Camarillo, Calif .. 93010
Rli7.::\hPth Ann R Messer
1858 Sorrell St
Camarillo. Calif. 93010
n
. .
SCHEDULE "D"
BENEFICIARIES
RELATIONSHIP SURVIVED (If step-children or DATE INTEREST OF
illegitimate children DECEDENT OF BENEFICIARY
are involved, set STATE YES IN ESTATE
forth this fact.) OR NO BIRTH
Daughter yes 5-24-1922 one third
Daughter yes 4-2-1928 one third
n::\ualmr ves 9-19-193$ one third
..
n
Deponent further says that all the above-named beneficiaries are living at this time except below:
NAME DATE OF DEATH RESIDENCE
\
Will
Administration ( No. Year ....
P.l< THE
:\lATTER OF THE APPRAISEMENT
OF THE
ESTATE OF
Helen Elizabeth Hall
Deceased
Late of l'i., Charleroi, Pa • . . . . . . . . . . . . . . . . . . -. . . . . . . .
County of Washington
Commonwealth of Pennsylvania
REPORT AND APPRAISAL
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John E. Costello, ":Es'q·:
418 washingt(';~ ·.Ave.· .' '-.f ~t • .
Charleroi, Pa$~15022
. '
(Executor-Administrator
must complete "As'
Reported" column #1.)
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Form RC C ·10 ~ ._; A.. DEDUCTIONS ALLOWED IN
OFFICE OF THE
REGISTER OF WILLS STATEMENT OF DEBTS
AND DEDUCTIONS
THE SUM OF &f.~?~.~.~.?. $ %:(t~ 't.?. ...
oF Washingtm COUNTY
.-rf-7tf
1h~ AND AGENT OF THE COMMONWEALTH
Register of Wills, Age"t
ESTATE oF Helen Elizabeth Hall LATE oF North Charleroi Bo;tough
DATE OF FILING APPRAISEMENT ----------DATE OF DEATH _ ___,M=a..::r:..::C~h~..:::l:...:9:....:tt:.!h~l~l:..9._7"'-'=l----
DATE NO. OF NAME OF PAYEE REMARKS AMOUNT VOUCH lOIII -~';"1 ·•, ,. ~ .
H. F .. Mcc.ro.xy funeral services 1770 70
Charleroi-Monessen Hosoital I hosoi tal . care l..a.s± ill_no~~ 150 00
Dr. Charles Wilson. M.,D., medical _c_ar_e l.~st i 11 nor:::r::: /?.7 '00
IReaister of Wills Probate of Will 43 50
Reoister of Wills lfi"ilinn TnvPntnr'!.L And~,....,....,....,..; c J, 3 00
ment.~
The Authority of the Borough. Water and Sewage Bill 20 50
West ~~3r~ompany Electric Service 6 19
Bell Telephone co. Phone Service 4 14
wa.shi-~ton countv Reoorts AduA~t:Sina letj:er_s_ 14 00
Daily Helfald " rr 12 50
John. E. Costello Accountant's Commission 1200 00
John E. Costello Attorney • s Fees 1200 00
RPll Tc:>l .... Ca _o:f Pa Tel ·" .bi11 ..4 17
Columbia Gas o£ Penna. Gas bill 54 77
TOTAL 4,510 ~7
COMMONWEALTH OF PENNSYLVANIA }
COUNTY OF Washington SS:
I, -----------~J~O~H.!;N~=E~.!...._;C::::.:;:OS~T:!E~L=LO~,L.-:E~S~Q'-!"L----HE.REBY cERTIFY. THAT. TO THE BEeT OF
. '
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RCC-81 (2-64)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
INHERITANCE TAX DIVISION
NOTICE OF FILING OF APPRAISEMENT
.IOHN E • COSTELLO
(Executor ~~)
IN YOUR REPLY PLEASE
RIFlER TO
In Re: Estate of ____ ~HE~J~Eu•N~~~~~~l~·IuZ~~~B~F~~~H~HwA~I~J·~-----------
_____ --'!liW.~:~>AS~'H~IuNGnuT..!.iOWJN.__ ____ County -File No. 63-71--326
Dear Atty. Costello,
You are hereby notified that the arig:i nal.
appraisement in the estate of l:liU:~! lil.IU:aEl'l:l BALI,
has been filed in the office of the Register of Wills qf l"LfiSIUNG'CON
County on .Tune 10 , 19.21. Said appraisement reflects the
following valuations:
Real Estate __ ~--~11~~,5~00~·~00~--------
Personal Property __ ~J~J~,~2~Jl~.J~6U---------Transfers ______________________ ~----
Total ----------42/~+,J ,....,7F.;;3~l..;,.i~3Q.6----
As to such tax that is paid within three months from date of
death, a five (5%) percent discount is allowable. As to any tax that
remains unpaid after one year from date of death, interest at the rate
of six (6%) percent per annum is charged.
Any party in interest who is aggrieved by an appraisement may
appeal therefrom as provided by law.
Date ____ ~J~w~~~e~l~O~,~l·97~l~.----------Signed
Title liitUTCES LFO, CHIEF APPRHSVH
DA'l'E OF DEATH: Harch 19, 1971
Note: This is not a bill.
J
--·
RCC·39 (5-68l
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SUMMARY
Estate of_HA_LL _____ HE_LEN_· ____ E..::...~•-------DATE OF DEATH 3-19-71 FILE NO. 63-71-326
(Last Name) (First Name) (Initial)
REPORT OF INHERITANCE TAX APPRAISER
I, the undersigned duly appointed Inheritance Tax Appraiser in and for the County of _ __,!!Wi~ac!:!s~hing::!::'~..!!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 i tern in the last column to the right in Schedules "A", "B", "C", and "E".
Dated: ---=Jc..::un=e_1=.0.::...,il......,.;:1~97,~,='1~---~ ~'-L4 llb.~-INHERITANCE TAX APPRAI~ER
REPORT OF THE REGISTER OF WILLS
I, the undersigned duly elected Register of Wills in and for County, Pennsylvania, do respect-
fully report that I have allowed deductions in the amounts claimed by deponent, except as to those items where a greater or
lesser amount is set forth in the last column to the right in Schedule "F", which greater or lesser amount represents the sum
allowed as a deduction.
Dated:-------------REGISTER OF WILLS
INVENTORY VALUE AS APPRAISED
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
24 731 36
annuities . . . . . . . . . . . . . . . . . . . $ -------+--
ESTATE TAX ASSESSMENTS $ _____ .J..__
$ ll 'iOO 00
1~ ?~1 -~r:
-
24.731 36
FOR USE OF REGISTER ONLY COMPUTATION OF TAX
Tax on$ 2% $ _______ -4--
Tax on $ -----------+---~ $ __________ -4---
Tax on$ 5% $-------------4----
nxoo$ 1~ $ ___________ -4----
Tuoo$ 1~ $ ________ ~_
VALUE AS REAPPRAISED
$ _______ ~_
Exemptions *
Total Estate --------1---
TOTAL TAX $---------~---
(*) 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 $============
Add interest at rate of 6% from
------to --------
AMOUNT OF ESTATE TAX ASSESSED $------+---
Estate tax paid $--------'--
BALANCE DUE
Add interest at rate of 6% from
----------~10------
$ _________ ---I __ _
$-------------4----
TOTAL TAX BALANCE $ --------+--
PAID $ ------L--
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
HELEN ELIZABETH HALL
Deceased
Late of. F ALLOWFIELD TWP. . .............. .
County of WASHINGTON
Commonwealth of Pennsylvania
REPORT AND APPRAISAL
I I
Fonn RCC-2
COMMONWEALTH OF PENNSYLVANIA
RESIDENT INHERITANCE TAX
APPRAISEMENT
DATE ........ ~1ID.~ .... .J.Q., ..... l.97l. ...................................... .
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS COUNTY ... ~.~.~.~~.4 ..... ~ ........................................ .
FILE NO. . .. §?..:-:7J::J..?..2 ............................. -................... .
.. -,
HARRISBURG, 'PENNA. 77 12 7
Whereas, .................................. .HELEN .... E.LI.ZABETH. ... HA..LL ............................................ late of ..................... f.~QWf..~ .... 'r.WP.~ ................................ .
in the County of ................................................. W.~~UU;NG'r.QN ..................................................... Commonwealth of Pennsylvania, having died on
the .................................... l9t.h .............................................. day of ............... ~.gb. ............................................. 19 .. 7.l ... , seized and possessed of an estate
subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania;
Therefore, I, ............................. f.M:NQ~ .... ~9 .................................................................. , 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 Purposes
$
RELATY:
See copy of schedule "A" attached to appraisement ll,500 00
PER3)NAL:
See copy of schedule ttBU attached to appraiseement 13.231 36
total 2L...711 16
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Having been duly sworn according to law, I do hereby certify: that the above appraisement is made in con-
fonnity with law on this ~ day of -~..,t;iY'~~ ~·
ppraiser
.................... ....... . ..................................... . . . ... . ... ······· . ................
(!'lumber and Street)
................................................. !&!.~········ .. ······ Penna.
(Post Oflle
I
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H. • •••••• WASHINGTON County
RESIDENT INHERITANCE TAX APPRAISEMENT
Estate of
HELEN ELIZABETH HALL. ··································
Deceased.
Late of
F ALLOWFIELD TWP.
Date_ of Death, ............. ,.3..~l..9~7l ...................... : .................. .
Appraisemel!t Docket Vol., ......... ?.~ .................................... .
Page, ........ .l.56.~4 .................. No ........... .§:3.~7;L.~ . .:3.?..?. ... .
Filed in Register's Office, ...... June .... ~0 .......... 197.l ... .
A1n0unt of tax due, $ .................................................................. .
DEPARTMENT OF REVENUE
Received,
E.x-a.mined and Approved,
Wrote abo.ut Appra.isement,
Appeal j1'om Appraisement,
Entered and charged, ,•
/
---------------~------------------
LAST WILL A:~O TESTAMENT
I, HELEN ELIZABETH HALL, a ~iciow, of 1th!2 Borpugh of
North Char~eroi, Washingl~n County, P.e~msy,lvania, being of sound
and disposing mincf and memory, do on ~.pj.s 2nd. day of April, 196~ ~
hereby make, pJblish and declare the following to be my Last Wi~l
and testament.
1 •. I hefeby revoke C).ny and a.H. Wil).s, Tes1;aments W1d
Co,dici ls ;by me at any time heretofore made.
' f'
2. I nomirJaJ:e and appoi~,t my Attorney, JOHN E. COSTI;LLO,
' E~Q.,•, to be the Executor of this, my Last vJil}-
1
anq Testamen1;, and
I di;re~t that he be pe,r·mi;tted to s,e~ve w~ thout bond.
3, I 1di1rec1: that my Executor promptly pay f:J,"om out of
the proceeds of my estate, all of my just debts inclJding the
expense of my furteral an-d the cos;t.s of c;~.dminist,ration.
4/. /I give, devise .and ,b.equeath aJl of my :property,
f
whether the same be 5eal, personal or mixed unto my Executor and
I direct that he sel,l the same for the best obtainable price, at
either private ox public sale and divide the proceeds as !ollqws:
Unto ·my three ( 3) children J'.·lARY HALL BAYLEY, VIRGINIA J. HALL
SROWN and ELIZABETH ANN HALL MESSER equally except that having
advanced $3,000.00 in my lifetime to my daughter, MARY HALl,. BAYLEY,
f
I direct that her share be reduced by $3,000.00. That is, my
. '
daughter VIRGINIA and my daughter ELIZAHETH ANN shall ,:-eceive
$.3, 000,00 each more than my daughter MARY for the reasor;t th/a:t Mar:y
has r~ceived $3,000.00 during my lifetime.
i
s. In the event that any of my daJg~ters should have
predeceased me, then I give, devise and bequeath he~ interest to
her surviving children, if any, and should the childr~n of MARY HI\
BAYLEY take they shall take under ~he exact conditions as their
mother.
6. In the event that any per~on taking under this Will
should be a minor then I nominate and <1ppoint my Attorney, JOHN E.
COSTELLO, E.SQ., to be the guardian of their estate or estate~
during the period of their minority. He shall have all powers
given to fid~ciaries under the law of Pennsylvania.
IN WITNESS WHEREOF, I have hereunto set my hand ~nd seal
this 2nd. day of April, 1968.
_}_..__./ __ ,:__j
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. 7. :.
Helen Elizabeth Hall
I.
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