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Home My WebLink AboutOC1971-0651 - ESTATE OF JURIK;1 J, " '--.--.,,- ,J IN THE COURT"OF COMMON PLEAS OF .. WASHINGTON COUNTY,PENNSYLVANIA .ORPHANS·COURT DIVISION NO.63-71-651 -, iI C'.lo I 00 ~~I ,.' ;. • I~ j' ~c,.z tr.l-f_>r"ro-f""~~~d 00 ~'3::lll=~:~.l:fJ"1 :to 0(- "11-£)~>~,:ll -fIIIr III > UI ~')::E ,~ bo ~~ ". t ~, (..) / IN RE: ESTATE OF ANTHONY C.JVR,IK, also known as ANTHONY JURIK,Deceased. Petition for Settl~ment of Small Estate 'U~~~. ...,., .;:::0 -...J rn::O r..> ",cnG")C: --- ~=.U;.cn C/) rT"r ~~'74g::-0 ~..,)fTl •--r..~I'~ .-i::O' t i ........CD r i'"'V ,:z:0 C ~0 '" :0-... ~~;:;:::;: ".;=.-.-e Z c::;) ~~~~C>r"".J c::::> JESS D.COSTA ATTORNEY AT LAW 107 MAIN STREET I B;L~~~L~P~15~ \ ""; r --......../- I' FORM 67 REG.WILLSREV.1-50 .Application for iGrttrrs of .Allministration un tbr Estate of..~~~9.~~.~':!.~~.~.~~~.~.~.~~.:>:?~.:>::~.~~~~9.~~~~~.!. ......................................................................................;.. late of ~.~~!:.!.~Y.Y.:~.!!.~.~;, Deceased. Before the Register of Wills of Washington County personally appeared ~~.~.~~.~~Y.-E..~.~:.. who,being duly sworn deposes and says that....~.t>:~.h.Qn..Y.~..~l!..~.gj)~.,~!~1.?l,8.P.j;.b.QD.Y.!1.l.lJ:'Jk age §.?,havingh!.§last family or principal residence at..?~.J,M?.l,.i.n S.t..:r.~.~t .. (Street and Number) .............~~.~~.!.~¥..'Y..~!.~.~,Washington County,Pennsvlvania,died intestate (City,Borough,Township).• at.~~.~.~.~.~.'i!..~.?~~.~~.f.?.~.~.~.~:,,on the ~day of..~.~~.~. A D 71 7·00 PM'd f 1 1'"d al.".19 ,at..:':,::':.........,possesse 0 persona estate to t le estlmate V ue $..Y.:~~.~.!:~.;:~.;.~.~gnd of real estate.in the Commonwealt~of Pennsylvania to the estimated value of $~.~?:~,situate in .. The names and addresses of the decedent's surviving spouse (if any )and other heirs including heirs by adoption)are as follows. R~LATIoNsmp I RESIDENCE .....!}.~.t>:~!!.~g,~.;:.!.~w.!.f..~;??.!..J1~.!.n §.t..~..A ~~nt.l!?.yy.!,J,.!.!?..f.."Pa. Richard Jurik Son Mt.Lebanon,'Pa .............................................................................................................................................. Louise Smith Daughter .R.D.#1,Bentleyville,Pa .......................................................................................................~. ...................................................................................................................................................................................................................................................' ........................................................................................................· · ·..··· I · ·..· ·..·~..·:.. J That deponent is over 21 years of age,reside3 at....??.!M~.~n ~.t.;:.~!?..t..,. ..~~.~~.~~¥..'Y..~.~.~~..~~.~.~~.~¥.!y.~.~.~.~!.?.~.!.~. i~a citizen of the United States and'a resident of Pennsylvania,and respectfully applies for Letters of Ad~~:::r::n s~::::::::::::::s~.e.:::::.~o letre;a:'.~;~"~l~;ssued tirereon June 71dayo~,A,D.,)9 . .........................:~~. REGISTER COMMONWEALTH OF PENNSYLVANIA}SS: WASHINGTON COUNTY, And now ~~~~!§.~~: ,19 ?.!.,comes ~.~.~~~.~'!.~E.~.~. who being duly sworn doth depose and say that...J?h!?will·well and truly admini~ter the goods and chattels,rights and credits of ~.:>:~E:?~.¥.~.~~~!..~~.!~!~(~~.:>:~.~?~.¥.~~!.~~,deceased, to the best of..he.r..skill and judgment in strict compliance with the laws of this Commonwealth,mind-.. / ful of the laws relating to inheritance taxes. Sworn and subscribed before me this J.§.!=.h. day Of..M...~~D:~.....:.;.....~%.D.,19.).J.........................v...~~<.(.Q.. REGISTER .~~:..:. ~3 -71-~5J /-.\t .~. APPLICATION FOR .Letters of Administration ESTATE 'Of-. ANTHONY C.JURIK,a/k/a ANTHONY JURIK .j';Deceased R $.. .Letters ::.....'0 II! P $........·..7 ......·......·.. Extra Alias . . . . . . .$. Certificates ..J:-.~.~$.J:::..!.P. Renunciations $. ..................................................................$. -~;JJ .~.,~Total...........:....3;;...c:r.o...::n..............'-,.I'7)~J G)c::L~l..;.. ;y " " ":- e..v .e..v (4;) Jess D.Costa =en ~..=Z-jen ~1 G":)fT',''"'1 ';o"~f1-;-.r-'-a j.'0"'-"-en . :;;::0 ,1"-;-1"1 ~~"...~';.:-0.~~::;;~ I:J.,-2::~enO Attorney ~2 ~_>:-0_ Estate of }\~r,rn:.9;r;r.x.:.G.,.....;r.g~:;r~.f....~/1~/.~...~:t9..·} No of 19 . late of Bent.leyvill.e ,Deceased KNQW ALL MEN BY.THESE PRESENTS; .Anna L.Jurik as Principal,and United Sta tes Fide Iity and.That ·we,5 .. Guaranty Company,Baltimore,Md.urety......:.. all of Washington County,Pennsylvania,are held and firmly bound UIilo the Commonwealth of Pennsyl- vania,for the use of those interested in the estate,in the sum ofO'n..~'rh9.W:?~.p..g Dollars,to be paid to the said Commonweal'th,to which paymen t,well and truly to be made,we do bind ourselves, jointly arid~severally,for and in the .JV4.ol~,~Qur~heirs,~_execu.tors,administrators,successors·and.assigns,and ..hi'.'16theachandeveryofthem,firmly by t~ese presents.Sealed Wit our sea s and dated the day of .......................J.~n.~.<A.D.,one thousand rune hundred and ~.~.Y.E!.I1.~¥.~~~~. THE CONDITION'OF THIS OBLIGATION IS,That if the above bounden .. ..................................................................................................................................................;. Administrator ,:or any of them,shall well and truly administer the estate according to law,this obligation shall be void as to those who shall so administer the es~atej but otherwise,it shall remain in force. Sealed aml delivered ht the presence 01:~Q' Ba1t.imor.e.."... , I ~tatrmrttt of ~urdt! I,------~:----_._--------------.----------_'--------------------.-.-..---•surety in the sum of $_.-._.on the administration bond in the estate of --------:------..._,say ~hat I reside at ----------.Washington Cpunty,Pennsylvania;that I am the-owner of real estate.the title to which is in my own name and duly recorded,situated in .__.._____.__ _ _ ____ ___ ___.__..__ __.:___.., Washington County.Pennsylvania,worth above all encumbrances ~----_~_._:..._--.----.;and that I am worth the amount expressed in said bond.over and above my just debts and liabilities. ._------;---------_.-------------------_._-----._------------ .-.-.-------------------------.-.....------.-"7"'-..-- Street ~tatrmrttt of ~urdt1 P.O. 1,....__._____--+--------------.surety in the sum of $ . ...on the administration bond in the estate,of -----------------------•say that I reside at _..•Washington County,Pennsylvapia;that I am the owner of real estate,the titie to which is in my own name and duly recorded.situated in ___ _ ____ _..______ _ ____ . Washington County.Pennsylvania.worth above all encumbrances $------.-----.,... ;a~d that I am worth the amount expressed in said bond,over and above my just debts and liabilities.. ......................................................................................................................... -------.-_..----._-_._-----_.---.._--------------------.-------- COMMONWEALTH OF PENNSYLVANIA,}SS:WASHINGTON COUNTY.. Street P.O. And now _._..__19.___..,comes _ _ _..___.__.___------ -..-.-_:_.__ __. who being duly sworn,says that he is acquainted with the financial standing of the securities to the within bond;that the said obligors have each executed the said bond and ,th.3t the sureties thereto are the owners of real estate in their own right of value more than the penal sum of said bond over and above all incumbrances and exemptions. Sworn and subscribed before me this ---------------------- day of .._.._......_.~_____A.D.19 _ -'-------_.-_.._--_.._.__.-._------_._---.._--._.-----.-.-----__----_._---------_.---_._------. ._._.__.._----------._-----;.._------------------_..--..----_._-----------.:------ <-v u-t -!'-' Yi r ':'-()--'--'~~- ~J-7/-b5J No .39.6 . !\bmiuistrntinu IBnub IN!THE ESTATE OF ...............AJ::ltho.n.y···g·i·..·J-ur.lk.;····,..·.....·· a/k/a Anthon'y Jurik' And now :.J.une.l6.,19 .'H:. Bond approved and Letters issued to' -;:-.:;11.......Ann~···~~iW13.fik =-~:,;;: . ~\.-,c::c-!;n=-.=-> ..--L -((.)I::::1Z:1);..':?:2;;:...,."".....Who...wa.S,..a:u'1~··-€i\NlJ.:1·£1.~e;d ..··:···--·..".-:~~!:.-=~~.. <0 I ifF""'1 '..<:a _. .~R\}..s.S.e.;J;~..M~. O•~::;~-'-.Register.-.::-.........,.r-:;:-0 r-_. ?><n 0 Bond Book ..6.4 __Page 19-4 . MOYONGAHELA PUBLlSHIYG co.~-5 I:I!i , )",,'v ,-< ~' \~ ."1' I IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY,PENNSYLVANIA ORPHANS'COURT DIVISION IN RE: ESTATE OF ANTHONY C.JURIK, also known as ANTHONY JURIK,Deceased NO.63-71-651 I I> i I I PETITION FOR SETTLEMENT OF SMALL ESTATE TO THE HONORABLE P.V.MARINO,JUDGE OF SAID COURT: The Petition of ANNA L.JURIK respectfully represents: 1.That she is the Administratrix of the Estate of Anthony C.Jurik,also known as Anthony Jurik,deceased,who died intesta e, on June 3,1971,Letters of Administration having been granted on June 16,1971_by the Register of Wills/,of Washington County, pennsylvanfa,which are attached'hereto and marked Exhibit "A". 2.That the decedent,hnthony C.Jurik,also known as Anthony Jurik,died,intestate,on June 3,1971,a resident of the Borough of Bentleyville',Washington County,Pennsylvania, leaving to survive him as his only heirs at law,his wife, Anna L.Jurik,the Petitioner herein,and a son,Richard Jurik, and a daughter,Louise Smith. 3.That the property of the decedent consisted of: Real Property:None. Personal Property:Cash contributions from Anna L. Jurik,to pay the balance due and owing in the Estate, in the amount of $4,411.96. 4.That all of the claims of creditors of the decedent of which your petitioner has knowledge or notice,are listed in the Statement of Debts and Deductions,attached hereto and marked Exhibit "B",amounting to $4,411.96. -1- 5.That there is no Inheritance Tax du~the Commonwealth of Pennsylvania. 6.That Letters of Administration granted by the Register of Wills of Washington County,Pennsylvania,were advertised in the washington County Reports and the Observer Publishing company,proof of the same are attached hereto and marked Exhibit "c"and Exhibit "0",respectively. 7.Assignment of the interest of Richard Jurik of all of his interest in the Estate of Anthony C.Jurik,also known as Anthony Jurik,deceased,unto Ann Jurik,his mother,is attached hereto and marked Exhibit "E". 8.Assignment of the interest of Louise Smith of all of her interest in the Estate of Anthony c.Jurik,also known as Anthony Jurik,deceased,unto Ann Jurik,her mother,is attached hereto and marked Exhibit "F". WHEREFORE,your petitioner prays your Honorable Court, under the ~rovi~ion of Section 731 of the Fiduciaries Act of 1949,to confirm said account and to discharge her from the duties of her appointment. -2- I· COMMONWEALTH OF PENNSYLVANIA COUNTY OF WASHINGTON ,./ SS: 'Ii, Personally appeared,before me,the undersigned authority, ANNA L.JURIK,who,being duly sworn according to law,deposes and says that the facts set forth in the foregoing Petition are true and correct to the best of her knowledge,information and belief. Sworn to and subscribed before me,this 8th day of September,1972. -TH:::~'~~I',M!)TO ,i.·,'t";",'l"V',J',.''I".ol..!";io.y,.·,.i"A''~~J'lol",~>;l'..:;tJ}m1Co. 'My'CN;:~.;:).:,;~;)t2'"1)€r 3.1973 " ., O1nmmnuUtra1t4 nf 'rnu.aylnuuia, 1IlIht.a4tugtnu C!tnuuty. I,Russe 11 Marino ,Register for the Probate of Wills and Granting Letters of Administration in and for the County of Washington,in :the Commonwealth of Pennsylvania, to Anna L.J urik administr a trix Cl'edits,which were of of all and singular ,the goods and chattels,rights,and·~thony Jurik Anthony G.Jurik,A/E/A /late of Washington County,deceased, GREETING: WHEREAS,the said Anthony C.Jurik,A/K/A Anthony Jurik late of Bent1eyvi11e in the county aforesa~d,lately died intestate (as is affirmed),possessed of divers goods and chattels,rights and credits,within the said County, Russell Marino by reason whereof the power of granting administration thereof doth belong ,to me;I therefore,confiding in.your fidelity,do by these presents gl'ant unto you these LETTERS OF ADMINISTRATION,here- bycommitcing unto you full power to administer the'goods and chattels,rights and credits,which were of said deceased within this Commonwealth,you having taken ,and subscribed the oath of office pre- scribed by law;requiring you to well and truly administer the goods ~nd chattels,rights and credits, .which wer·e of s'i:dd deceased,and to exhibit a true and perfect inventory thereof into the Register's office,at Washington,within ninety days,,and to render a just and true account of your administration at the expiration of six months from the elate hereof,and to regard and comply with the provisions of the laws relating to inheritance taxes. IN TESTIMONY WHEREOF,I have hereunto set my hand and caused the seal of said Office to be 'affixed this 16th. / I , / day of June in the year of our Lord one thousand ........ nine hundred and Seventy One ~~~~~......... .RUSSELL MARINO,Register. EXHIBIT "All r .Form RCe ·10 DEDUCTIONS ALLOWED IN OFFICE OF THE REG'STER OF WILLS ~WashingtonOF COUNTY AND AGENT OF THE COMMONW&ALTH STATEMENT OF DEBTS AND DED'UCTt'ONS THE SUM OF'.'.'$:. DATE APPROVED ...•...• Regl,'er 01 Wills,Ag,n' ESTATE OF Anthony C.Jurik,a/k/a L~T~CO~B_e_n_t_l_e_y_V_l_'_l_l_e _ DATE OF FILIN:;APPRAISEMENT DAT&OF DEATH June 3,1971 ,r,, I DATE ·NO.OF NAM&:OF PAYEE REMARKS AMOUNTVOUCHE" Greenlee Funeral Home Funeral expenses ;>1,359 00 Dr.Quetch Professional Services 550 00 Washington Hospital Services 984 02 I Dr.Gerald Ruben Professional Services 217 00 Dr.Bress Professional Services 75 00 Dr.Graham Professional Services .20 00 Caldwell's Drug Store 1"lerchandise 94 44 Gordon's Ambulance Svc.Ambulance service .15 00 Dr.Walters Professional Services 16 00 Sacred Heart Cemetery Burial Lot 380 00 ~acred Heart Cemetery Memorial 332 00 Commonwealth of Penna.Certification 38 00 Register of Wills Letters of Administration 11 00 Observer Publishing Co.Advert~sing 14 00 Washington County Reports Advertising 14 00 F.J.Buckley,Ins.Co.Bond 20 00 ..Reaister of wills Certification 14 00 J.D.Costa,Esq.Attorney Fee 250 00 Reqister of Wills Filinq this Petition 8 50 Total .....................$4,41,1 96 - . Ir II ! COMMONWEALTH OF PENNSYLVANIA Anna L.DAY 01' COUNTY OF washington Anna L.Jurik,"'--~~~~~~~~~---------~H£REBY CERTI~,THA~TO THE BEGT OF ....Y KNOWLE:DGE AND BELIEF.THE:FOREGOING 18 A JUST AND TRU E 8rATE~NT OF/DE~T8,FUNERAL EXPENSE8 AND EXPENSES O~. ADMINISTRATION SUBMITTED TO THE ESTATE OF Anthony C..Jur1 ,a k;a etc.0ECEA ,AS DEDUCTI $POR INH.ERITANCE TAX ,P,URPOSES.~ SWORN AND IilUSSC~:8't:OBEFORE ME THIS J1'ft; ____s-::e,...Pn~.r..f'r"Cf'.....~ ...THE;'1:~SI"MUTO .JIlrt~ri Pvblj-:,~'1nJ;~Twp.•Washineton Co. My comrr.i~sl~,E;;PiICS September 3.1973 .....'EXHIBIT "B" "'to..."l -~ 1Vas~on County Reporis Washington,Pennsylvania (PUBLISHED BY WASHINGTON COUNTY BAR ASSOCIATION) PROOF OF PUBLICATION' In compliance with the Newspaper Advertising Act of May 16,1929, P.L.1784 Sec.3,paragraphs (3)and (25).• COUNTY OF WASHINCTON}88. STATE OF PENNSYLVANIA Personally appeared before me,a Notary Public in and for said County and Commonwealth,CHARLES C.KELLER,who,being duly sworn,deposes _ and says:that he is the Editor of the WASHINGTON COUNTY REPORTS, the officiaJI legal periodical for said Washington County,published weekly hav,ing its place of business at Washington,Washington County,Pennsylvania,- and is acting as its agent in this behalf;that the said WASHINGTON COUNTY REPORTS.was established on March 31,1920,and was designated as the official legal publication for Washington County,Pennsylvania,by order of the several courts of said County,dated November 11,1920;that the printed notice or advertisement attached hereto is a copy of a notice or advertisement, exactly ,as printed or published,which appeared in the said legal periodical in its regular issues on the following dates: June 24 1971..····..··c·..·..·..······..·..· ·,······..····..····..·. Estate Notices The Register of WiHs has granted letters,testamentary or of administration, in the following estates.Notice is hereby given to all persons indebted thereto to' make payment without delay and to those having claims or demands to present them for settlement to the Executors or Administrators or their Attorneys. •• •• •• •••• • • ••• •• iURIK,'ANT H 0 NYC.,'a/k/a ~ANTHONY ·JURIK.-Dec'd. Late of Bentleyville,Washington .County,Penna..'.IAdministratrix:Anna L.Jurlk,721MainStreet,Bentleyville,Penna. 15314 ..:.Attorney:.J.D.Costa,107 MamStreet,Bentleyville,Penna.15314 ..................J.uJ.:y .l.,.8.,..:..l.9l.l .. that the affiant or the corpora'tion in behalf of whioh he is acting is not interested in the subject matter of said notice or advertising and that all of the ::~~,of"'"""ida""M to ~:"~:~L2:_~~~ ~l~orr:;'Vr'(-''--~r.....d"~ Sworn to and subscribed before e _~:, 8h ,...,1 --(-·r .......~t .J 1 ,<.(-r .I .',..-,.........................day Of ~1.1 :..,19 1..1........<!:;~J'"'r~: ..~J --.;-..i7'~il''''.~:¥..,~"""'~,.-.'- JOSEPHINE T.SCIAMANNA Notary Public,Washington,Washington Co. My Commission Expires July 1,1974 EXHIBIT Vc II .. ---\1 Observer .Repo,rter WASHINGTON,PENNSYLVANIA PROOF OF PUBLICATION In compliance with the Newspaper Advertising Act of .16 May.1929,:, P.L.1784,as amended. Commonwealth of Pennsylvania,County'of Washington,S8:. Personally appear,ed before me,a Notary Public in and for said County and State,Ri.~h.~.r.q S..~C9.W.~,;L who being duly sworn according to law.deposes and Says tha;t he is the ..vic.e~.P.t:.e.sident of the Observer Publishing Company.a Ptennsylvania corporation.and its agent in this behalf;that the said Company is,the owner and publisher of the 'Observer-Reporter.succ'essor to The Washington Obs'erver.established September 18.1871.and The Washington Reporter.'established August 15. 1808,a daily news,pape,r of general circulation,printed and published and having its place of busines's at Washington,Washington County,Pennsyl- vania.where it or its predecessors have been established and published contlnuous'ly for more than six months'prior to the publication of the notice hereto attached;th8Jt the pr.inted notice or advertisement hereto attached is a copy of an official advertisement,official notice,legal notice or legal advertisement,exactly as printed or published in the Obs'erver-Reporter,in its regular editions on -the following date or dates;.. ..............................J.une 24.,.J.ul.y l and .8.,1.9.7.1 :. that neither tIre affiant nor the Observer Publishing Company is interested in the subject matter of s'aid notice or advertising and that all of the all-ega- ~~~n~r~~.this affidavit as to th~..~i~.e,...~.I7&:~d:~4:::~ ....~...4.'l:Es~~M~r~ATaix 'NOTICE .. alkla"ANTHO HONY...C.JURIK. ,late of BenNY -!UR~dec~l\sed,County l"eYVllle.""WashIngtonLettei-~e~~;t~·'\,,~,if'h., above -estate ha~~~a,tliupon thetotheunderslgd.'.een granted given,to those nfncie~~t:f~thiS hereby.make 'imniediat e ereto to ,•those having C!<ie~'!Yment.and to j Present.them tor set8r demands to\ ...."'.,.",,-"~,AnQa TL.~~~n:.t ,,••';Administratrix'.~i~721 Main,.Street,. J...,.,..~..qosta :t~~:~:;ilI.<o.:e.-.p..a.153141~,1..10~,MaIn Street·•I:a~.l},t;l!!yvilIe,Pa.153140" ,-• •7114S:ThU.rS..3t -, Sworn to and sUbsce~re me this..JL.;day ~lY···)V_·9.·7.1...7~~;?!:~~~m WASHINGTON,WASHINGTON COUNT EXHIBIT MY ~OMMISSION EXPIRES MAY 6,19(2 "D". ............-- IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY,PENNSYLVANIA ORPHANS'COURT DIVISION IN RE: ESTATE OF NO.63-71-651 ANTHONY C.JURIK, Deceased. ASSIGNMENT OF INTEREST IN ESTATE KNOW ALL MEN by these presents,that I,RICHARD JURIK, residing at Mt.Lebanon,Pennsylvania,herein called the "Assignor",in consideration of the sum of One ($1.00)Dollar, paid to me by ANN JURIK,residing at 721 Main Street,Bentleyville Pennsylvania,herein called the "Assignee",the receipt of which is hereby acknowledged,do hereby sell,assign,grant and convey, transfer,and set-over to ANN JURIK,Assignee,all of my right, title and interest,both legal and equitable,in and to all of the Estate of Anthony C.Jurik,deceased,whether real,personal or mixed,whereof the said Anthony C.Jurik died seized or possesseq,'that I now,or hereafter,may claim,demand,own or be, or become,~st'ed with,9r entitled t'?';under~·6r.by virtue of the'"-...~,' Intestate Laws of the Commonwealth of Pennsylvania,and which estate is being administered.under-thejurisdiction of the Court ,',...·f of Common Pleas of washingtodcounty,Pennsylvania,Orphans' court Division. And I,the said Assignor,hereby appoint the said Assignee to be my true and lawful attorney,irrevocable,for me,and in my name and stead,but for such Assignee's own benefit,and at said Assignee's own cost and expense,to execute and deliver'any deeds,conveyances and assurances,to demand,sue for,attach, -1- EXHIBIT "E" ,F '.'.40_'.,,"" " ~ levy,recover,receive,receipt,and release',':any;:aq.d all,"swns of t '._.1.',t .~~..:.£,":l*~-v'"".;:~,.·i ','.,;~, -;y', money or other valuables that ,now are,or hereafter shall become due,owing and payable under:or py..;y~rt9.eof the foregoing Assignment. -'-j,~ IN WITNESS WHEREOF,I have hereunto set my hand and seal, this_....o-o-.Il--__day of_.L..R:-u-::>,q+--=-:.~..::;.::;..t__"1972.o In the presence of: -2- day of August,1972,before me, ·- COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF WASHINGTON On this,the 21st _____J_o_h_n__P__._R__e_b_8_r_i_c_k ,the undersigned officer, personally appeared RICHARD JURIK known to me (or satisfactorily proven)to be the person whose name is subscribed to the within instrument,and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF,I hereunto set my hand and official seal. lith DlmiiftLeI.~£,Mater M1 Commiuion &rp!r_JMluery G.r97& ·i IN.THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY,PENNSYLVANIA ORPHANS'COURT DIVISION IN RE: ESTATE OF NO.63-71-651 ANTHONY C.JURIK, Deceased. ASSIGNMENT OF INTEREST IN ESTATE KNOW ALL MEN by these presents,that I,LOUISE SMITH, residing at R.D.#1,Bentleyville,Pennsylvania,herein called the "Assignor",in consideration of the sum of One ($1.00)Dollar, paid to me by ANN JURIK,residing at 721 Main Street,Bentleyville II Pennsylvania,herein called the "Assignee",the receipt of which is hereby acknowledged,do hereby sell,assign,grant and convey, transfer,and set-over to ANN JURIK,Assignee,all of my right, title and interest,both legal and equitable,in and to all of the Estate of ANTHONY C.JURIK,deceased,whether real,personal or mixed,whereof the said ANTHONY C.JURIK died seized or possessed,that I now,or hereafter,may claim,demand,own or be, or become,vested with,or entitled to,under,or by virtue of the Intestate Laws of the Commonwealth of Pennsylvania,and which estate is being administered under the jurisdiction of the Court of Common Pleas of Washington County,Pennsylvania,Orphans' Court Division•. And I,the said Assignor,hereby appoint the said Assignee to be my true and lawful attorney,irrevocable,for me,and in my name and stead,but for such Assignee's 'own benefit,and at said Assignee's own cost and expense,to execute and deliver any deeds,conveyances and assurances,to demand,sue for,attach, -1- "EXHIBIT F" levy,recover,receive,receipt and release,any and all sums of money or other valuables that now are,or hereafter shall become due,pwing and payable under,or by virtue of the·foregoing Assignment. this IN WITNESS WHEREOF,I have hereunto set my hand and seal, ;)I ~.day of._~fl"!'-""-(J+-~-.:.-i:;;...,1972. In the presence of: ff~(j?OC~X (SEAL) ~.'. ,~,.~ -2- {(~, J COMMONWEALTH OF PENNSYLVANIA ) COUNTY OF WASHINGTON ) , ,~\ SS: ;.'" On this,the 21st day of August,1972,before me, Johti p.Rebarick ,the undersigned officer, personally appeared LOUISE SMITH,' known <to me (or satisfa"ctori1y proye~)to~be the person whose '.,'"-,I >."~:":',~l /''-.."'~',,:,:1...-~;,-".,.~1,,':l.',;L (;:'" name,~s subscribed'>..t,o'!the within ~instrUment,:'and acknowledged that she executed the s~e for the pu~poses therein contained. ,,J~,',~.~ :{ IN WITNESS WHEREOF:/'i'heieunto set my hand and official seal. ;'11".:.-.: er .~, ----_._------- ".IN THE COURT .oF COMMON PL~,S OF WASHINGTON:·COUNTY ,PENNSYLVANIA ORPHAN.S·'COURT~,DIVIS ION'· ,;,,-i.-",...', J.,. IN RE: ESTATE OF ANTHONY C.JURIK, also known as ANTHONYJURIK,deceased. NO i-63':;11-651 upon DEC R E E AND NOW.this (let:day Of~.1972. consideration of the annexed p~,~ntof Anna L.Jurik,as Administratrix of the Estate of Anthony C. Jurik,also known as Anthony Jurik,is confirmed,and the said Anna L.Jurik is discharged as Administratrix and she and her sureties released from future liability on the bond given by them on her appointment. By the Court, <, Form No,RCC-62 (4-71)THIS FORM REQUIRED IN ALL ESTATES WITH GROSS ASSETS UNDER '10,000,UNDER SECTION 701 OF ACT OF JUNE 16.18411, EFFECTIVE .JANUARY I,1982.(FILE.IN DUPUCATE WITH COP",OF WILL ATTACHED) I~ OFFICE OF THE REGISTER OF WILLS County of ~.~lJ;r~<?~lf .....,..... ..........~~~.~•..~~~'of .?~~.~~~..~~.~~~~~~.~~~.e:~.~~~~'"?~~' (Name)(Addreee) being duly .._.__~_._._.~~~.~__._.according to law,deposes and says that he is the _.~~.~.~!.~~~~~~~~.._..__.__(Exec,.Adm.•Lega_.EIC.) of the estate of.AntbQnY C.1!JU;.'i~~_._a~LlL~t8b6e last residence was..1.21...Ma.in...st.ree.t __. (N0.).(Str~etl . -..-~~~~!-~~~~-~~..~.....-.__._.._...deceased,and that the whole of the estate of said decedent,who die~~~._}.L.!-.?.7.!~ (CitY,Borough or Township)(Dale) consisted of: REAL PROPERTY REAL PROPERTY IN PENNSYLVANIA.WITH STATEMENT OF MORTGAGE ENCUMBRANCES UPON EACH PARCEL AT DEATH OF DECEDENT, WHERE PROPERTY HELD AS JOINT TENANT OR TENANCY BY ENTIREnES,GIVE NAMES,ADDRESSES AND RELATIONSHIP OF OTHER OWNERS. Real Estate Estimated Value NOne. ~ ~a~'-IJI:.J~7YL~-4"'7':.z . .~.. I"-'..-c./1 "--£e.. / 0 Personal Property None., , " j"-' --- 0 I I Ii. I ..................--.. 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 Estimated,-,_Value None.~O - ,r J \\ l. ... ...._........-- - Transfers within TWO YEARS Prior to Death None.0 I I 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 RELATIONSHIP SURVIVED AGE OF LIFE BENEFICIARIES AND ADDRESSES (If step-children or TENANTS OR INTEREST OF (State full names of all and their addresses who have illegitimate children DECEDENT ANNUITANTS BENEFICIARYSTATEYESaninterest,vested,contingent or otherwise,in estate.)are involved,set OR NO AT DEATH OF IN ESTATE forth this fact.)DECEDENT Anna L.Jurik Wife Yes 1/3 Louise Smith Daughter Yes 1/3 Richard JliJ:ik son Yes 1/3 .,~.. , , .. NOTE.;List'"grst five 'items in 'the spaces so provided,ob~erve notations thereon,and instructions. Funeral expenses paida' DEBT OR CLAIM NATURE OF SAME AMOUNT THIS COLUMN.------"'------''-'''-----'------..-----~-=--------''-----------r------'--r---+nKEGISTERONLY $ Family exemption (will not be allowed unless decedent died residing with a spouse or children.) Administration Expenses • Counsel fees • FiduciafY commission • OTHER DEBTS AND CLAIMS (.)See Note below see statement of Debts and Deductions attached hereto. Total (City or Town and State) i Note:The estate agrees t.oadvise the Register of Wills if the amount actually paid in settlement of any fee,commission 01'debt .is grea 01'less than the estimated amount claimed and allowed.'"SUbSCr;be~)and~::~:.riito before ~e this ,F~............~.'~('E";ec'U'to'r·.·:d'm~~n':o a't'or)'r_~'~t"/<,r~.lff .I v.\......,g ,"".>"';;_(\,;;.f~ ........~..~:~.:<i:(d;y ot".~.~p'~~~~: ,19.~~.721 Main street~I~~('')1,.I •••••0 ••0 ••0 •••••0 •••0 •••••••••••••'0'.0 ••0.'0',••• ......'..$~~..~...'.....:..........Bentleyvi11(Setr,eetpNaU.mb1erS)314 .?~::..;.i,''''"'?1:HERESA MUTO'' '-<"~~-<: .NQtaiyf"~Il'ic.Canton Twp.,Washington Co~i My \;O(lltnlsslon txpltCS :;eptemoer :5,1971 ; .. H..a.v.i.n.g..b.e.e.n..d.U.I.Y.\.S.~."o.I..n.la.~...'#--.'~i;.n.g.datOy olafw.,..1.d.o..h.e..Ii,e.~y.cert'y that the above appraisement is made in conformity with law on this.N~I ~,19..~·,'7 ()······················~····r~;···· In the event that any future intel'est in this estate is 'transferred in possession 01'enjoyment to collateral heirs of the decedent after the expiration of any estate for life 01'for years,the Commonwealth hel'eby expressly reserves the right to appraise'and assess transfer'inheri- tance taxes at the lawful collatel'al 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 del?ent,except as to those items where a greater or lesser amount is set fortil in the lastcolumn to the right in said schedule above,which greate or lesser amount representsih~llowedas a deduction. Dated:~~~..~.~..1.~?~.~~~.q1.~A~!~9......~.i••••~•••••••••••,•••••••••••••••••••••:. ...I ~Register:of Wills . --:.,)~ Form No.RCC-62 (4-71) ~ J /' WillAdministration }No Year ." }····t~r.r·i/~ .:-..,-,,'..::14-; IN THE MATTER OF THE APPRAISEMENT OF THE "'.~. "S :.1/Q f \.,t')/f';.,~"0 "''''\~.~.~";.1.,-0..."~,........""L'"...',_,~,../,-•••.•f\y,"-"c,'J'-\.1 __\'"~;e t,'\'\1-\_\\ """'"IHI+-ll\11 , ESTATE OF ANTHONY C.JURIK,a/k/a etc ...... Deceased Late of ....~.~t:l~.l:~¥~~~.l.e............. County of washington..... ...................~..... ~. .....-f: 1:..;' :..0' Commonwealth of PennsYlvan~~ :E :;:0 r"'oJ---,,_,»rn :;:0 ,' (f)C <.....,....--.REPORTIA~~APPR~S~~_ Z -!n-I Ii,·· C)rt'1 r..!=" -l :?:',-f~c),.,-", z·o ~-a-a--rr -d~o _:;>o ~::~ r--~....-or:C;,,»en Jess D.costa,Esq. STATEMENT OF DEBTS AND DEDUCTIONS OFFICE OF THE REGISTER OF 'W~LL6 WashingtonOF COUNTY Form RCC·lO 'H''"M ,:'""''''':A".'~~~IJ,~--(. ,...AP[",)'J~C-M=l tJ'L' AND AGENT OF THE COMMONW£ALTH I (~A Ll-~, ,tt •A.olller of Will.,AOP.O' -'~:'"'7',--'--1--_ .~'k / /etc ,Bentleyville1ESTATEOFAnthonyC.Jur1 ,a k a LATE O~_ DATE OF FILING APPRAISEMENT _ DATE NO.OF VOUCHE""NAM&:OF PAYEE Greenlee'Funeral Horne Dr.Quetch Washington Hospital Dr.Gerald Ruben Dr.Bress Dr.Graham Caldwell's Drug'Store Gordon's Ambulance Svc. Dr.walters Sacred Heart Cemeter acred Heart Cemetery Commonwealth of Penna. Register of Wills Observer Publishing Co. Washington County Reports F.J.Buckley,Ins.Co. ister of "fills J.D.costa,Es . Re ister of Wills OATS OF DEATH June 3,1971 REMARKS AMOUNT i Funeral expenses 1,359 00 II Professional Services 550 00 tII Services 984 02 Professional Services 217 00 Professional Services 75 00 Professional Services 20 00 lvlerchandise 94 44 Ambulance service 15 00 Professional Services 16 00 Burial Lot 380 00 Memorial 332 00 certification 38 00 Letters of Administration 11 00 Advert~sing 14 00 Advertising 14 00 Bond 20 00 Certification Attorne Fee 250 00 Filin this Petition 8 50 Total .....................$4,411 96 I-I II COMMONWEALTH OF PENNSYLVANIA DAY Of" I. COUNTY OF washington Anna L.Jurik, SWO<lH AUD 61J8SCRIB'f:D BEFORE ME THIS .p~.'S~IlIfL----.:~:::;..?':.-(~7Z!U%' .,.,THEReSA MUTO N,tary Pu1ic.C.nt '0 TWp"Washington ceo My Comrrr •'A....:3 3eptember 3.1973 NvkNOWLEOGE AND BELIEF,THE:FOREGOING IS A JUST AND TRU E STATEMENT ';AD"'INIST.RAT~ON 6UfJMITTED TO THE E5T"TE OF Anthon C.Jur ik,, INHERITANCE ,AX PURPOSES.' EXHIBIT "B" ...' RCC-Bl (6-71) .. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS HARRISBURG 17127 IN YOUR REPLY PLEASE REFER TO Inheritance Tax Divisian NOTICE OF FILING OF APPRAISEMENT ANNA L.JURIK (Executor or Administrator) In Re:Estate of AN_TH_O_N_Y_C_._JU_R_I_K_a.:.-/k/--=-_a _ __W_AS_H_I_N_G_TO_N County _Fi Ie No.__6_3_-_7_1_-_6_5_1 _ Dear Mrs.Jurik, You are hereby noti fi ed that the--'o~r:.Li~gf.li'-J:nJ.ca;i.,1.L------------- appraisement in the estate of ANTHONY C.JURIK a/k/a has been filed in the office of the Register of Wills of WASHINGTON County on September 15 ,19.....1.2,Said appraisement reflects the following va Iuations: Real Estate __--=-....ou.-~----- Personal Property~-.u;O"""-'--_ Transfers -o- J ointly Owned _--=-:..!.O!..:-=--_ Total -0- As to such tax that is paid within three months from date of death,a five (5%) percent discount is allowable.As to any tax that remains unpaid after nine (9)months (fifteen months when death occurred from December 22,1965 to June 16,1971,inclusive; and twelve months when death occurred prior to December 22,1965)from date of death, interest at the rate of six (6%)percent per annum is charged. Date _--=S~e::::Jp~t~ern~b~e~r!o._~1~5.L,---.:!:1~9....!.7~2,-Si9ned~V~Titl~J7~ ESTATE INSOLVENT Any party in interest who is aggrieved by an appraisement may appeal therefrom .as provided by law. DATE OF DEmTH:June 3,1971 Note:This is not a bi II. COMMONWEALTH OF PENNSYLVANIA TRANSfER INHERITANCE TAX RESIDENT DECEDENT ~"~.~,':.':~':;:~~~:~..~,:.:~~..,}..-.·':-;/;.·.·r_~"-:>.)':',:::/:.~~'~:'.•.:........~..:.; l ,,SUMMARY ,I· ......1 Estate of JURIK (Last Name) ANTHONY C.a/k/a' (First Name)(Initial) DATE OF PEATH 6-3-71 FILE NO.63-71-651 REPORT OF INHeRITANCE TAX ApPRAI~ER h d . d d I . d I h ."T 'A".,d f 'h C f WASHINGTONI,t e un erslgne u y appolOte,nentance ax ppralser 10 an or t e ounty 0 _ Pennsylvania,do respectfully report that I.have appraised the reaJand personal property as reported in the foregoing return at the values set forth opposite each item in the last colum'n'to the right in Schedules"A","B", "C",and "E", Dated:September 15,1972 ~EPORT OF THE REGISTER OF WILLS I,the undersigned dl,lly elected Register of Wills in arid for WASHIN;GTQN County,Pennsylvania,do respect- fully report that I have allowed de~uctions in the amounts claimed by dep~>nent,exce'pra's~o those items where a greater or lesser amount is set forth in the last cohi~n to the right in Schedule "F",)",ffil~gr2ater011 lesser amount represents the sum allowed as a deduction,' ( Dated,SEP 18 197~RUSSm MARINO ........~.t~{~\..t.i~ ",'R'€GISTER OF ILLS _0- _'0_ .0,,-0- -0- 4,411 96 TE INSOLVEN~,TA $'_0_ _o- n -0-' -0- 411 '964,, ES VALUE AS REPORTED VALUE AS APPRAISED VALUE AS REAPPRAISED $$-------+-- INVENTORY Real Property (Schedule A) Personal Property (Schedule B) Transfers (Schedule C) Joint -Held Property (~chedule E) TOTAL GROSS ASSETS Less Debts and Deductions' 'ISCHEDULE F) CLEAR VALUE OF ESTATE Valuation of life estates or FOR USE OF REGISTER ONLY,,Tax on'$~__+-_2 Tax on $---------+--t'6% Tax on $5% Tax on $10% Tax on $15% b~ptioos * Total Estate -_-_ TOTAL TAX COMPUTATION OF TAX$----4_- $__,_---4-- $-.-------+-- $-'--------+--$-----4-_ $--__..1-...,.- (*)As evidenced by Charitable Exemption Certificates is~~ed by the Secretary of Revenue" Less tax previously paid BALANCE Less 5%of tax if paid within 3 months after death BALANCE OF INHERITANCE TAX DUE $$"..,.,-.1''C,''Add interest at rate of 6%from'_____to .... AMOUNT OF ESTATE TAX ASSESSED $-.......,.-~-.-ll-" Estate tax paid $_-'--,...Jl-- BALANCE DUE'$--,..--~--..,lJ~ Add interest at rate of 6%from ------tt'o-----$-----,-It=",'TOTAL TAX BALANCE $_---~, PAID $__-_-....J FOR USE OF REGISTER ONLY ADJUSTMENTS NOTE:Where subsequent adjustments are made to the above'co'mputation of tax t>y the Register of Wills,for proper reason, same should be noted below,with short explanation', AWdill ...l No ..mImstration ~ IN THE .Year . MATTER OF THE APPRAISEMENT OF THE ESTATE OF ..~.r:raO~X ..G..-._.J.VIq:~q./~I.Ci . Deceased Late of '"B~'I'LEYVI~E . County of ..~l\SHINGTON.......'..... Commonwealth of Pennsylvania REPO~T ,.\NO APPRAISAL .; .~." ""..• C.- }'onn :\Cc-2 ,DEp·AR.TME~~T OF REVEl\lUE•BtmEAU OF CO'UNTY COLLECTIONS M HARRISBURG.PENNA.17127 COMMONWEALTH OF PENNSYLVANIA,- RESIDENT INHERITANCE TAX APPRAISEMENT ~ DATE S.ep.tember.l.5."19.7.2 . COUNTY WMH.I.N.G.T.QN.,.. FILE NO•....§.~.::.~::..?!.::..~.?...!. Whereas,~AN.mQ.NY C.~Y.VRl..K a/kl.a late of B.ENTL,EYVI.LIE .. ,I,.'., in the County of WASHINGTON :"""..""""""Commonwealth of Pennsylvania,having died on the t.h~.~.g "day of :.I,~19 .7.],seized and possessed of an estate SUbj:e:::~~~~~~~=e~~~.o::::::::;i:~IYappointed 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 Made for InheritanceValuesTaxPurpo.es $ THERE XX ARE NO ASSETS AS EVERTTHING IS HELD BY HUSBANm &WIFE ESTATE INSOLVENT.. '" , • -..i ,1 ;,..,i } ".., , ,."i .'.,.~t .' " ;... rform~;V~~hbl::~:IfJ,~worIl~Cc;?.u:I~~:~:;o~e~~:~~~?~~~l~~~~ ..~~~'"~?~. ..........................~,Penna.- ·zJ..(Post Offiee) WASHINGTON CoulIty .,...,. :;- RESIDENT INHERITANCE TAX APPRAISEMENT Estate of ............A.N.T.a.QNX....G..~..;r.vRJ;.K.. Deceased. Late of BENTLEYVILLE Datc of Dcatll,9..~.3..~..1..:L.. Appraisemel!t Docket Vol 38. J •••••••••••••••••••••••••••••••••••••••••• Page,:t..f3..~.~~No..§.~.~.?:l.:::::.~.?.:l.: Filed in Register's Office,§.~p.1;...~.:L..?J9:...7.~ Amouni of tax dtte,$.. DEPARlMENT OF REVENUE .ReceJved, .Examined·and Approved,,,. ..Wroteab~lIt Appra.isement, APPtltil /,.OHZ Appraisement;,. Entered and charged,.. ,. ,.~...• z· ~. -..Ii> .i .: