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Home My WebLink AboutOC1971-0983 - ESTATE OF MALYUK. (.• ·• .~ FORM 67 REV. 1-60 REG. WILLS 1\pplirattnn fnr 1Jl:rtt:rr.a nf A~mitti.atratintt nn t4:r Estate of ................................................ ~.Y..?. .... ~.?..!Y.~.~ ............................................................................. ~ ........... ; .......................... ; .................. . .................................................................................................................................................................................................................................................. late of .................... JJ.n.!9..n .... 1'.9.W.tH?.h.;hP. .. : .................................................................. , Deceased. Before the R~gister of Wills of Washington County personally a p pea re d ............................ ~~.;:Y. ... Jt~!-~9 .................................. : ........................................................................................... .. who, being duly sworn deposes and says that ......................... E.v.a ... .Mi;\.lY,.Uk ........................................................................... .. age ... .?..?. ....... , having-h.§:.;' ........ last family or principal residence at ......... R.~ ..... :O..~ ..... #.~ ................................................... .. (Street and Number) .F.inley.:v..ill.e ....... Unio.n ... ~p.,. ........................................... , Washington County, Pennsylvania, died intestate (City, Borough, Township) . at.. ................ N~:W. .... ~.~gl.~., ..... ~~t~ .......................... ;., on thel.6.:tlulay of ................ Aug.us.t ........................................ : ... .. A. D., 19 ...... :n ...... , at.. .............................. ~l.j.~Q .... A~., possessed of personal estate. to the estimated _value $ ... ~ •. QQO. .•. !'-.O. .... , and of real estate in the Commonwealth of Pennsylvania to the estimated value of $ ... ~I..QQQ.~.9..Q .... , situate i n ..... V.:!?:~.~:!?: .... ~.<?..~:!?:~.~.!PI ..... W:~.~-~-~~8.~.~-~ .... 9..~~~.11. .... ?~~~.1.~.!.~.~-!.~ • The names and addresses of the decedent's surviving spouse (if any) and other heirs (including heirs by a~option) are as follows. RELATIONSIDP RESIDENCE .... ~.~.9-P.-.~.§:.! .... ~~.!Y.~.~ .......................................................... S.9..n ................. R ....... o ........ #.2., ..... F..in.le.Y,M.i.ll~ ...... P.a ........ . .... ~.~-~Y..~ .... ~~-~.¥..~~ ................................................................ $..9.!?: ................. R ...... D ....... #.2.,. .... F.in.le.y.:v.i.ll:6l-r.P.a ........... . .... ~~-~~ .... ~~-~~~-~ ............................................................ P.~~.9.E.~.§:E. ...... R.~ ..... :O. ........ #.~.~ ..... F.inley~.ille ...... .P.a ........ . .... ~.~-:~::¥. .... ~~-~-~-~ .................................... : ........................... P.~.~gh.t:.~J;" ....... 6.13 .... Mo.und .... S.t .... , ..... Monongab.ela .•... P a • .............................................................. ; .......................................................................... ·····················································································:················· ... ' ' ······································································································· ·································· ······································································································· ................................................................................................................................................................................................................................................. ....................................................................................................... ·································· ······································································································· That deponent is over 21 years of age, resides · at... ....... §J.~ .... M9..'!~m'L .. S..t..;r;:~.§.t.~ .......................................... ~ ........ : ..... ~9.~.?.~.~-~~-~.!.~.!. ..... ~·-~~-~-~.Y..!.Y.~.~-~-~ ............................................................................ : .......................................................... .. is a citizen of the United States and a resident of Pennsylvania, and respectfully applies for Letters of Administration upon the Estate of said decedent, no letters having been previously issued thereon. Sworn and subscribed before me this ....... ?};-9. ......... ~-~ ....................................................... ~LI. .............................. -....... .. REGISTER COMMONWEALTH OF PENNSYLVANIA } SS: WASHINGTON COUNTY, And now .. ~~P..t.~~!?.§.r. .... :?..J ...................... , 19 .. :Z.l ... , comes ......................... :M9.~Y. ... Jl~l.;h9 ........................................ . who being duly sworn qoth depose and say that.. .... .§.b.e .............. will well and truly administer the goods and chattels, rights and credits of ...................... EY..iil ... .Maly,.uk ........................................................................................... , 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 ..... f}.;r;:9 .......... .. day of.. ....... ~.§:l?.t.§~.~.f. ............... , A. D., 19.7.1 .......... . ........ ~ ... ~ ......................... . .. ............................... ~.J;".Y. .... ~.~-~.;h.9. ..................................... . ~f' ' .. ~ ... , .. --- ··~ -· /; ~· ;:!"{ ·. ~ ;-... / 4t~ t:1-1!-f y_;7 ,_, ::)APPLICATION FOR ~ ~ . . Letters of Administration c c . c c c c ESTATE OF EVA MALYUK Deceased . ' () 0---o . I\ $ .. ,. ... ;;4tJ. ......... -L __. > ..• etters ............. :;:.; ............................. ..-.. .~-. .. ·}· '-l '-l ·Y ..ll-. ::0 -n .r ~ '-~ ·"" 'D'l$ .......... (fl . c:: f-ri .... ; ...................... : .. (fl ""':J Extra Alias ::C ' n <fl . ._.,.,~, :::::~ ~ ·$~'· -. ~ -:::1 f'· •..•. ,;y ............. ; ............... . c . c: ,_., 1_::-~ ·..J-) rJ. Certifica,tes . 1-"' ~. : __ ;. .. ·: .. _J ..... £t(::.-:::::.:, .... -::, .... ·-~ Renuncia,dons "· . ,;, .'::::;;. =.· ••• -=::$ It ~ '· ol .: ; ~ •. · · .. \"'-'··········· .. ••••••••••••••••• s:::-::::.:~::::~~~:::::::::t:i.::::;:~ 8 ' ~ :;: ···:;.; . ~ . ... ~' ........ J;~AUL ... M ....... l?.;l.';.l'RQ ....... t:.S.Q ..... • ..................... ; .. ·· Attorney ~· ,, •, ·.t ;t·· 1· .:. I, ! : ·' ~ i \· .' ~- I.;, ! • ! ) .t .: . ' . '' ~ ';, I, I. 'i ·: d. I I . {.' .. Q> :'' ESTATE OF ........................................................................ ~YA ... MA.~XP.:K.! .... ~J.g.Q~ . .t ....................................................................................... DECEASED The undersigned ....... MJ.9.h~.§!J ... M~.J:y~~.t. ..... $..t.~.Y.~ .... M9..!Y~~ .... ~ .... b..D.P:9. .... HQJ~.~P: ................................ and heirs · 1 of ...... EY.A .... MALY.o:K~ .... ytJ9,9..W..a .............................. _ .................... .late of ... llN.IQ.N .... T.QWN.S.HI.P.~ .... W.A.S..H.J.N.GTQ.N .... Q.QV.NTY, PA ., deceased, hereby renou~ces .. :th~.ir..... right to administer on ............ t.h.~ ..... S .. ~i..4. ... : .................... , ............................... es~ate and respectfully asks that Letters of Administration be issued to ...... M.~~.Y. .. J·~-~.!!.~ ..... !?.:!:' ..... ~.!~ .... M?..~~ .... ~~~~.e t , ¥."?..~.~-~~~-~-~ .. ~-~-~ ..... ?.~.~.~.Y..~Y.~!?:~.~ .... ~.~Q~~ ............................................................................................................................................. . Signed ·in ·the presence ·of: ........................................................................................... :·~·············· ...... . •ooooooooooooooooooooooooooooooooooo ... ooooooouoooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooo .................................................................................................................. . ~, 1 1 C t I· IQ ::HI') ",l''l ·., ''ttd '·oo NOl~~ N! H St; Iff S77/f.~ _it) ~J1S!D3U oN 1 tn· t.v · n .7 s s n 1:1 0£ 21 Ud U dlS 1 L, e (f ::l '7 .. / -{ '• ..;] '""" ::0 ITI z c .Z 0 -.. )> -{: -0 z •. . : I ·--~ . r-:· -• (':. 0 ' '· / Estate of .......... ~.Y!:3. .... M!:i.lY.~¥ ...................................... . late of ... V.~J.()I.l. .. T.~P.~ ............................... , Deceased } No .................... of 19 ........ . KNOW ALL MEN BY THESE PRESENTS, That we, .M.E?..r.Y ... ~~).J_q ___ ~_f3 ... ~r.~.nQJ.P~} ... ~.~~ .Y~~-~-~-~---~~-a,-~-~.f3 ... ~~~~~-~-~-~-!. ... ~!l?. ... ~.~-~-~~n ty Co. Baltimore, Md. Suretycn. ································································································································································································· Jll of Washington County, Pennsylvania, are held and firmly bound unto the Commonwealth of Pennsyl- vania, for the use of those interested in the estate, in the_ sum of --~~g_:P.t!. .. ~hC>.~.~~J19: .............. Dollars, to be paid to the said Commonwealth, to which payment, well and truly to be made, we do bind ourselves, jointly and severally; for and in the whole, our· heirs; ·executors, administrators, successors and assigns, and each and every of them, firmly by these presents. Sealed with our seals and dated the .2~r.d . .c .... day of ···········-~-~P:t.~mP.~.r. ................... A. D., one thousand nine hundred and .:~f3.:V:~m.t.Y. .. :9~~---···· ........... . THE CONDITION OF THIS OBLIGATION IS, That if the above bounden ............................ . · · · · · · · · · · · · · ·ii tr :r:x-· · · · · · · · · · · · · -~~-r.Y · · ·13-~ J~-9-· ··· ·· ··· · ···· · ··· ··· ··· · ··· · · · ·· ··· · · · · · · ·· · · · · · ·· · · · · ·· · ·· · ·· · · · · · · · ·· · ·· · · · · · · · · ·· ··· · ·· ·· · ·· · ·· · · · · ·· · · ·· · · ·· · · · · · · · Administr;ocor . . . . . . . . . . . . . . . . . . .. . . .. . .. . . . . .. . .. .. . . . . ... .. . .. . . . . . .. . ... ... .... ... . . . . . . . or any of them, shall well and truly administer the estate according to law, this obligation shall be void as to th~se who shall so administer the estate; but otherwise, it shall remain in force. Sealed and delivered in thC. presence of: ---~~-~~--- Attorney l.n ································ .................................... (SEAL) @ltatement nf @lurety I, ------------------------------------------------------------------·-·······-------·-···• surety in the sum of $ ..... ____________________ on the administration bond in the estate of -----------------------------------------------·--···· say that I reside at ------. -.-----------------------------· Washington County, Pennsylvania; that I am the owner of real estate, the title to whlch is in my own name. an? duly recorded, situated in .................................................................................................... , Washington County, Pennsylvania, wor.th above all encumbrances $ .... __________________________ : ___________ ; and that I am worth the amount expressed in said bond, over and above my just debts and liabilities . .'~., ·-------------------·------------------------------------------------------ -------------------------------------------------------------------Street P.O. &tatement nf ~urety I, ------------------------·---·----------------------------·---·----~------· surety in the sum of $--·-------------···---------on the administration bond in the estate Qf -------------------·------·-----------·--·----------·'--·-···----------------------------------------------······ say that I reside at -·-----------------------------------------------------~----------· Washington County, 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 amoun~ expressed in. said bond, over and above my just debts and liabilities. ························································································································· --------------------------------------·---- Street P.O. COMMONWEALTH OF PENNSYLVANIA, } ~s-. WASHINGTON COUNTY, " . And now ·········'······························ 19 ............ , comes ...............•............................................................................................................. · .......... . who being dillY s~orn, 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 that 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 _____ _ ·····-····------------------------------------------------------------------------- Co. &3~71-983 No ....... l453 ....... . 1\bmtutstrutinu 1Bnub IN THE ESTATE. OF ______________ Ev.a __ Mgly~J~-------------------------------·-·· --.. '·" And now ..... S.e.P.~-~~9.~-~---g-3._ ___ , 19 . ..I! ... Bond approved and Letters issued to __ : ___________ Ma.ry ___ :s_~l;tc._____ . ---------------------------- .... 1ID.Q ... w.~-~-'='_g~~Y.-@alilled. :X::: ;:;:;_ :;:o---------·~------------------ (f) c::> c (./') r.......,. -,---(f) r..-, ' ::: -rf:Jf> (f) -o. • ----------------~-.au~e.ll.MarJJ:Jil~-----------------"·-~ r-q r-· ~' Register ~ ~ ,-V"' 0 z -,~ -r• .... -q ;._ -...:! 0 --:r.>-.....,. 0 •.0:: ;::J .c I-,- ""U ,-0 ·l> (/) C) :, 61. -Bond BooR ------f+--------------------Page _?37 ---------- BADZIK PRINTING ~9 DONORA . ~ [ .1 .( ',\'"' .. 'i A' -, .., 1 ~- /' ,. 1" . .. --~ 6,3-7/-98$ Affibauit ®f fxrrutnr ®r A~ministratnr ~tau of Jrnnayluania, t DB: C!!ounty of Jllaa~ingtnn \ Personally before me, the undersigned authority, a. .............. ~~.~~::.~ .... ~~.~.~.~ ...................... in and for said MARY BELIC . County and State, appeared ......................................................................................................................................... who, be1ng duly sworn accordinfJo law, deposes and says that She is the~~~ administrator of the estate of ..................... ~Y.~ ........... ~~~ ...................................................................... deceased, that the foregoing schedules constitute a complete inventory and appraisement of the real and personal estate of.. .. ; ......... ~Y.-8-.... M81.X!JK ............................ , 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 E:K.e;ClX.t:lmc Administrator. . Sworn ,~nd ~ubsfribed -~efore _ m.e this .... J.~.th..... l ~A .../1 /) , _ ' day af. .. S.e~:"l!:emb.e.r.-... :f:8.,.: ... 19 .. ]~iJ.:.~~ .. /././...~·····~~~t;~t·~;·· ........ .. . ": ............. ) ...... 2t2 .. ~6.d. ... d.. ........ , ........ ......................... u ' MARTHA 0. LICHT, Notary Pulj ic T _,_ MY: Commission Expires February z!t.\.UDITIONAL INSTRUCTIONS 1. An inve.nt-11Q®t;Jfutgt§ii&(u~t1Hn 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 RCRic33, 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 _; llnti.rntory an!l .P.pprai.srm.rnt of the goods and chattels, rights and credits which were of ......... : .. :.. .... ~.Y.A ... MA..~XV~ .............................................. Jate of .................. V.n.?.s!.n .... ~.Q~.n.~.h.;!:P.., ............................. .. Washington County, Pa., taken and made in conformity with the above affidavit. I REALTY: All that certain tract of land situate in Union Township, Washington County, Pennsylvania, bounded and des- cribed as follows, to-wit: · BEGINNING at a point marked by a Surveyor's pin, formed by the intersection of the boundary lines of lands o A. E. Hackney, John Zipay and land herein conveyed; thence North 41° 5' East by land of A. E. Hackney, a distance of 189.32 feet to a stake; thence South 71° 25' East by land o L. C. Isler, a distance of 152 feet to a stake; thence South 83° 7' East by land of L. c. Isler, a distance of 149.4 feet to a stake; thence South 33° 23' East by land of John Zipay,-a distance of 1154.24 feet to a stake; thence North 81° 26' West by land of Rapper Estate, a distance of 524.4 feet to a fence post·;' thence North 33° 23' West by land of John Zipay, a dist~nce of 966.18 feet to·the place DOLLARS CENTS of beginning. Containing 10 Acres, more or less, $9500 00 PERSONALTY: Savings Account: 1. No. 27491, Western Pennsylvania National Bank Monongahela, Pennsylvania, 4250 47 2. No. 592, Western Pennsylvania National Bank, Finleyville, Pennsylvania, 4132 54 TOTAL - - -17,883 01 '1 I :_'. L #~1{~4 ' \\'' ~\. \ "' " ;;{ ?f £./I " \j ~ '" ";'' ,.;)i, ~..-; . ""· .c:.--;...-./'~ ·:::~ _;.., ~ >t-. ~!! ~u "': ln"i;entory and Appraisement '" ' ,j/ IN THE EST ATE OF ,.;. ·EVA MALYUK, DECEASED, ....................................................................................................... Filed ............... ?...~.t.~ .. ~9:! .... ~.~., 1973-·· . ........... ~-::::0 l>fTJ:::O cno.c: .,.,._(/) = (/) (/) z -1 rq r;-~ .fTl ,-. -! ;1.J ~-0 . ..,._. 0 <--,, 3:. 0 :::)'-o::E:;u ; ;::= z "r-!>cnO ~ .,...,~ w -------·· . ~· U') f"'''-1 -o. !"..) 0") ·-o ::::r .Jt '-0 r·~ tTi 0·· .. Paul M. Petro ·Attorney at Law 215 7th Street- Donora, Pennsylvania ,, .--, ·' Form RCC-33 RESIDENT DECEDENT -~3-7!-~83 . -~}f ' . . COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF R~VENUE · BUREAU OF COUNTY COLLECTIONS COUNTY OF WASHINGTQN IMPORTANT: This return must be completed ih detail and filed in duplicate, ·with will 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 _ _I_htleritllnce __ lil1!i.E.~t~~e .T~ A.ct of lQ~l.) IN THE MATTER OF THE·ESTATE OF } . EVA MALYUK AFFIDAVIT OF ................................................................................................................................................................................................... ~. (State full name of decedent) . WASHINGTON ADMINISTRATOR Late of .......................................................... ........................................................................................ County · State of ............................ :P..E.N.N.S.XLVAN.I.A. ................................. :.} WASHINGTON ss: County of .................................................................................................................. -. MARY BELIC ................................................................................................................................................................................................................. , ..................... :···: ............................................ _., ........................................... . Administrator of the estate of the above-named decedent being dUly sworn, depose and say (Month) 16 ..... , 19.?.~ ....... ,{· testate .leaving a last will, copy of which is hereto attached. } (Jiay) (Yr:ar) intestate . August Decedent died ........................................................................ : ........ . N~me and address of attorney or} tither authorized representative to .. whom all correspondence should be. . mailed. .. 1?.?:~~-r.1.~ .. ;E.>~~!.~'--.... ~-~-q\1:~!.~........... . ............................................................................ . . .. ?15 .. 7.t.h. .. S.tx.~-~t., .... D.on.oxa, .. P..~Pn9..Y.lv.a.n.i..a. .... J.50.33. ................ .. Th t h Administratrix d · t · f ·1· 'th th ff -· f 'd t t d th a as sue ...................................................... eponen Is ami Iar WI e a airs o sa1 es a e an e property con-(:€~~~-. stituting the assets thereof and their fair market value. That at the time of death there was no safe deposit box registered in decedent'~ 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:- . . ;, INSTITUTION THIS SAFE DEPOSiT BOX RENTED RELATIONSHIP OF JOINT NAME AND ADDRESS OF BANK OR OTHER IN WHICH DECEDENT RENTED A SAFE. DEPOSIT BOX IN NAME OR _NAMES OF HOLDERS TO_D~C~DENT . NONE. - _./ . . .. That the contents of ~aid saf.e deposit box or boxes are itemized under Schedules ___ of this return, with the exception of t~e following, for the reasons hereinafter set forth: That Sc.hedule A attached J1ereto and made part hereof sets forth full v and in'·detail all the real property in the Commonweal tn of Pennsylvani{l. of which decedent died having an interest therein. It also sets forth the mortgage enc~brances upon each parcel of real property at th~.date of death, giving the amount still due at death, n{l.me of mortgagee, date,_ rate of interest, and book and page of record thereof. It also sets forth in the columns prQvided therefore the assessed valuation of each of said parcels, the estimated market value thereof as of date of death of decedent. · That Schedule 8 attached hereto and made part hereof sets forth fully and in detail all personal property wheresover situated owned by the decedent at the time of death; all moneys left by the 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 trpst for any oth~r person or persons giving also separately the accrued ~nterest thereon, if any, down_ t6" ~e;tJ.'ast> interest day prior to decedent's death in the case of savings banks, and to thet date, of decedent's death ., . . . .. . " in all other cases; all bonds, postal savings, treasury certificates or notes and other ev!'dence-of in-· ' ~ ( ... . debtedness of the United States to the decedent; {l.ll obligations, whether by s~atute or agreement they a:re designated as tax free, of. the United States, or any state, or political. subdivision thereof, or"'gf' ·any foreign counotry, which are owned-at the time Qf death; all wearing apparei; jewelry, ,s-:t.lverware, r-Pic-,. . • l tures, books, works ·of art, household furniture, horses, carriages, automobiles, boats, and any and inl other personal chattels of whatsoever kind or nature, left by decedent, together •with "'the fairly estimated market value thereof; all bonds and mortga,e;es helci by decedent and of ali claims due and owing decedent,• . ... a-t the· time of death, and all promissory notes or other instruments in W~iting f9r· the payment of money 0 f 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 ~a:rket value be less than the face value, it sets forth briefly the reasons for such depreciation· as to each !·tern; all moneys payable to the estate from life insurance polici-es carried by decedent; all annuity and endowment contracts the proceeds of which were payable upon the death of the decedent; and all t~e1 c;:or.po.rate stocks and dividends due thereon and unpaid as of the d'ate of death, bonds and a·ccrued interest thereon to the date of dece- dent's death and other investment securities owned by the decedent ~t the time of death, with the market value thereof at such time. ' l_ . ·~ 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 liabilities of said co-partnership or business. A copy of the co-partnership agreement, (if oral, a statement setting forth the nature of the agreement) together with a statement setting forth the character of the business, its location, and such other facts pertaining to the business as may be pertinent to a fair and just appraisal of the decede~t'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 transfe~ee and a11· <;>ther 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. Ther~~ is also set forth in said schedule a list of all property, real and personal, 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 jointl;x-, 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, togeth.er with the ages at the time of decedent's death of all minors, annuitants and beneficiaries for life under decedent's Will. I·t 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 her·eto .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 cons.equence of the death of the decedent; debts and· claims owing and tmpaid at time of ' . death; taxes accrued. 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 statemen:t of coilater.ai 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 ;mount 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 ................................ . .... :: .......... ~ ...... JJ;?.t.h ................... day of ........ S .. ~.P.t.emb .. er .. , .......... 19 ..... 73 .. . ·;n~-d~J ~. ~~-c ........................ ······················:····················································t;;j. ... ~ ................................................. . MARTHA D. LICHT, NotarY Public· My ·commission Expires February 29, 1976 Donora, Wa~hington County, Pa. . ..... %..~~'1!~ ......................... : ..... -.. . (~Administrator) ........... 9J3 ...... M9. .... P.:9: ..... S..tr..~.~t. ............................................ -·-·· (Street Number) ........... IYI.~.~g~g.~h.~-~~ .. ~ ....... ~.~ .. ! .......... ~5..9.2? ....................... .. (City or Town and State) NOTE: Before signing affidavit make sure all blank spaces in the affidavit and schedules annexed are filled in with details or the word "None", and in case the assets include rare and unlisted securities, securities of close or family corporations or an interest in any co-partnership or business, that the data and statements required under the paragraph above relating to Schedule "B" are attached._ Also make certain that column #1 in the "Summary" has been properly completed as above-directed. RCC-34 (1-64) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE 'BUREAU OF COUNTY COLLECTIONS TRANSFER INHERITANCE TAX RESIDENT DECEDENT . ! t~ " • • .. tl . ..; :;,: .~ \ ~ ~., .... ·-. ,..... . ,. '· _;., .. •' SCHEDULE "A" REAL 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 decedent as tenant in common with another or others, should be identified as to quantum of interest and the estimated value should be that of the decedent's interest only. The real property located In the Commonwealth of Pennsylvania should be described by lot and block number, street and street number, together wl th a general description of the property, with a reference to the record of the conveyance by which the decedent took title; If a farm state number of a- cres; also statement of mortgage encumbrances upon each parcel at death of decedent. Taxes, assessments, accrued Interest on mortgages, etc.,are to be listed on Schedule "F" and must not be deducted from this schedule. ALL that certain tract of land situate in Union Township, Washington County, Pennsylvania, bounded and described as follows, to-wit: 'BEGINNING at a point marked by a Surveyor's pin, formed by the intersection of the boundary lines of lands of A.E. Hackney,·John Zipay and land herein conveyed; thence North 41° 51 East by land of A.E. Hackney, a distance of 189.32 feet to a stake; thence South 71° 25' East by land of L.c. Isler, a distance of 152 feet to a stake; thence South 83° 7' East by land of L.c. Isler, a distance of 149.4 feet to a stake; thence South 33° 23 1 East by land of John Zipay, a distance of 1154.24 feet to a stake; thence North 81° 26' West by land of Happer Estate, a distance of 524.4 feet to a fence post; thence North 33° 23 1 West by land of John Zipay, a distance of 966.18 feet to the place of beginning. .Containing Ten { 10) Acres, more or less, ( 1) ASSESSED VALUE FOR YEAR OF DECEDENT'S DEATH Insert this total opposite "real property", Schedule "A" in the X X X X X "As Reported" column on the last page of this return. (2) ESTIMATED MARKET VALUE $ 7500.00 (3\ DEPARTMENT VALUATION CAUTION (Do not write In this space) RCC-35 COMMONWEALTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT ' ' --:! ' •• ',.:..1. 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 or 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 ITEM UNIT ESTIMATED . DEPARTMENT VALUATION NO• List and describe fully VALUE MARKEl' VALUE (Do not write in this space) SAVINGS ACCOUNTS: 1. No. 27491 -Western Pennsylvania itj National Bank, Monongahela, ' . o; Pennsylvania, $ 4250.47 I tf~o(t) . 4 7 2. No. 592 -Western Pennsylvania National Bank, Finleyville, ": r/t. .II JfJJ ~· t>'f Pennsylvania, $ 4132.54 TOTAL --$ 8383.01 •tt (313. 0 1 •· ' I ' Insert this total opposite "Personal Property", Schedule "B" in X X the "As Reported" column on the last page of this return. •. -------------------------------------------------------------------------------------------------~ 'T'CC-~16 ·comtOI\'1\'EALTH OF PENNSYLVANIA TlUNSFER INHEIUTANrs TAX RESIDENT DECEDENT SCHEDULE 11 C11 TRA.NSFEilS (1) Did decedent, within two years of death, make any transfer of any material part o:C..his estate; without receiving a val¥able and adequate consideration therefor? (Answer yes or no) ~0 (2) Did decedent, w,ithin two years of death, transfer property from hi1Jl$elf to himself and another or others (including a spouse) in joint ownership? (Answer yes or no) l'IJO (3) If the answer to (1). or (2) above is in the affirmative state: (a) Age·of decedent at time of transfer----------- (b) State of decedent's health at time of making the transfer. (Note 1). (c) Cause of decedent's death. (Note 1), (4) Did decedent, in his lifetime, make any transfer of· property without receiving a valuable or adequate consideration t~erefor~~hich was to take effect in possession or enjoyment at or after his death? (Answer yes or no) ~0 (a) Was there any possibility that -the property transferred might return to transferer o'r his estate or be subject to his power of disposition? (Answer yes or no) ________ _ (b) What·was the transferee's age at time of decedent's death? ________ __ (5) Did decedent in his lifetime make any transfer without receiving a valuable and adequate consideration therefor under which transferor expressly or impliedly reserves for his life or any period which does not in fact end before his death: (a.) The possession or enjoyment of or the right to income from the property tr:ansferred? (Answer yes or no) No (b) The right to designate the persons who shall possess or enjoy the property transferred or income therefrom? (Answer yes or no) ~!0 (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 t~;,~nsferee' s promise to pay income to or for the benefit of care of transferor? (Answer yes or no) ~O (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 beneficiary reserved in th~ decedent alone or the decedent and others? (Answer yes or Ao) __ ~N~o ______ _ NOlE 1: The answer.s to these questions should be supported_ by affidavit by the attending physician as well as a copy of tQe death certificate. NOTE 2: If answer ,to any of the above questions is yes, set forth below a description of the property transferred, it's fair market value at date of death, dates of transfers and to whom transferred, with relationship of transferees to decedent, if any. Submit copy of any trust deed or instrument, if trans- fers are claimed to~be non-taxable, also submit detailed statement of facts on which said claim is based. NOTE 3: List applicable property l:!elow in manner in which provided in Schedules A, B, or E. ITEM DESCRIPTION l' , .. f l· Insert this tot(J.l opposite "Transfers", Schedule "C" in the "As Reporter!." column on the last page of this return. MARKET VALUE (Estimated) DEPT. VALUATION (Dept. Only) CCMMONWEt\LTH OF PENNSYLVANIA THAN:::;FEH INHElUTt\NCE TAX RF.SIDENT DECEDENT ' . -::~-· ... · .. ·~. SCHEDULE "E" JOINTLY OWNED PROPERTY HiSTRrCTIOKS: This schedule must disclose all property, real and personal, owned by the decedent jointly with another or others, including intangibles, standing in the name of the decedent and others. List real estate first, as entireties, or joint tenants, giving brief description, as indicated tmder Schedule "A", plus the date and place of record of instrument effecting vesti ture, but do not include entireties or out of state real. estate value i.n 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. Description of Property, Date of Acquisition, Name I Address and Relationship of Co-Owners, and Place ( of Record of Instrument, where Real Estate. 1 N 0 N E Unit Value percentage Share Estate Valuation Insert this total opposite "Jointly Owned Property", Schedule ."E" in the "As Reported" column on the last page of this return. DEPARTMENT VALUATION CAUTION~Do not Write In This Space. Value of Entire Property Value of Decedent's Interest \ h ' . COJ\1-!\ION\\"EALTII OF f'ENNSYYLANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT BENEFICIARIES AND ADDRESSES · State full names and addresses of all who ave an interest, vested, contingeht or. other wise, in estate) Michael Malvuk R.D. #2, Finleyville, Pa. Steve Malyuk R.D. #2, Finleyville, Pa Anna Holman R.D. #2, Finleyville, Pa. - Marv _B_elic 6i3_ Mound Street~ Monongahela~ Pa. ~~ Md..; ~, .. e.~ ,..., . , .,. w· ;.e_.:>.IJ ..U~.-c~::: .. _ Cl u c; iV ~ -I -~ u u~ c;.;>_. '. ·L··' 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 Son Yes One-fourth (1/4) Son Yes One-fourth (1/4) Daughter Yes One-fourth (1/4) Daughter Yes One-fourth (1/4) .. .~ "' Deponent fUrther says that all the above-named beneficiaries are living at this time except below: NAME DATE OF DEATH RESIDENCE : ... ,. . ~ ~ ~~======================~ . ~ Will Administration ( No. P.ll THE Year ........... . MATTER OF THE APPRAISE:MENT OF THE ESTATE OF ... :I!: VA . IVIA:r.iXlJ.l{:, .. Deceased · Late of UNION TOWNSHIP .... ··········· ......................... J ... . . County of WASHTNGT8N,. Commonwealth of Pennsylvania REPORT AND APPRAJSAL Paul M. Petro Attorney At Law '215 Seventh Street Donora, Pa. .15033 ;}j ,, I ~ (Executor-Administrator must complete "As Reported" column #1.) 0 ..., 0 til til ,...., II> X II> C"' (b l 1:%1 "' ..... II> Cb .r: ...., '"d' ..., (1) II> ..., :::3 til "' o· ..... :::3 (1) e. ..., "' '"d ..., 0 '0 (1) ..., ..... '< !:0 (1) e. '"d ..., 0 '0 (1) ..., ~ CJ) c ~ ~ > !:0 ,............ ~····-' ~ W W W· ::r'.::r''::r'" d ~r ~~-; :: :::.. :: ------------ -(,19~~-oo~-oo :1-J . \11. --:: • .. ~ \,.t.) .•.• • 0 :1-J -(,19~ :o:)~ ~ \J..>''\n :CP :o ~~ \J.) :o '0 ,_ :• ':• 0-:o:o:::!. :~ :q 8.. -<F>-E/9-(F.o-(,19 ~-- > ;r. t:i rt~ (;N 3------ ::::l r. c... .. '. l-•~ ~ ' Form . RC C ·10 t, ~-71:_~ 183 . "'""c""' moww '" ~I OFFICE OF THE REGISTER OF WILLS THE SUM OF ............ $ .... 4 .. (?..~.~ .. . OF _w..:..:...::,a:..;;:S_h_i_n_.g.._t_O_n __ COUNTY STATEMENT OF DEBTS AND DEDUCTIONS DAT~ClRJvl 197~ !USSELL MM.lllQ ·····•·• ................ rr .. r···:-· ....... ::~···· ~. ,,U(~· ~~"Agent AND AGENT OF THE COMMONW5ALTH ESTATE OF EVA MALYUK LATE OF Union Towns hiE DATE OF FILING APPRAISEMENT OATS OP DEATH August 16.! 1271 DATE NO. OF NAM&: OF PAYEE REMARKS AMOUNT VOUCHEit 1971 ~iring cook, purchase of Aug. 16 Post Funeral Luncheon ~ood, and refreshments 188 13 II 25 Kurtz Monument Co. 16 00 II 28 N. Merle Vanderslice, ~inggold School Taxes 64 41 Twp. Treasurer Sept. 1 Monongahela Publishing Co. !Advertising 3 00 It 2 Rev. David Smoley 7r5 00 II 23 Russell Marino, Reg. ~etters 20 00 II 24 Rocco's Flower Shop 174 90 II 24 Frye's Funeral Home 1706 00 " 27 Dr. Norman G. Golcomb 4o 00 II 28 Washington County Reports !Advertising 14 00 1972 Web. 7 iMerico S. Lignelli IA:oPraisal of Real tv 50 00 II 7 Andrews Agency Appraisal of Realty 50 00 i I ' " 7 F. J .-Buckley Insurance Administratrix Bond . 50 00 . j It 7 Walter L. Kennedy Ambulance 15 00 lunreimbursed I " 7 Memorial Hospital hospital 109 ' IAxnAn1=1A 00 " 16 Daily Herald !Advertising 12 50 I I June 26 1~a~~~lm~. Morgan, : nu ~v •easurer !Realty Taxes 20 ih3 " 28 IM~nMe~le Vanderslice, 1. reasurer !Realty Taxes 8 .36 A.u!Z. 28 John T. McClure Survey of property 115 00 Oct. 6 ~~· Merle Vanderslice, wn. Treasurer · School Taxes 70 27 Dec. 30 F.J. Buckley Insurance !Administratrix Bond 50 00 1973 Malcolm L. Morgan, TI$.~ - ?A IRealtv Taxes ~ -.. L.1 rnl"l~ lr.nnnt"'r IJ1resH~urera 20 v Sept. 4 Paul M. Petro IA.ttorney's Fee 895 00 II 7 N. Merle Vanderslice, lrrwn l'f'IT>~A 1=11l'Y'A'Y' School Taxes '\)·~ ~ I)-78 L.6 4 ~dmil)is-tratrix' ..,., II Mary Belie 895 00 p.,;omm~ss~on $4,740 89 COMMONWEALTH OF PENNSYLVANIA }ss: -110~Y COUNTY OF Washington ~ 9l.P4L.~ I, MARY BELIC, Administratrix, HEREBY CERTIFY, THAT. TO THE BE8T OF NY KNOWLI!:DGE AND BELIEF, THI!: FOREGOING IS A JUST AND TRUE fHATEMENT OF DEBTS, FUNERAL EXPENSES AND EXPENS!!l OP' ADMINISTRATION SUBMITTED TO TH~ ESTATE OF RllA MAI;v"TIK ---DECIEA8ED. AS DEDUCTIONS f'OR INHERITANCE TAX PURPOSES. ......,. __ ·-··--- -922~ ~be4a'.._, .... , 18th SWORN AND SUBSCRIBED BEFORE ME THIS ~ember fi{1, , __n__ cAY OP' ar Bel:c, ~lrlnf&t~atrix w,A, d:& . Notary Pu lie • MARTHA D. LICHT, NotarY Public :My I:.ommiss:on Expir~s February 29; 1976 · Dp_n.Qr!l. Washington County • Pa. (' ~ , .I .r.: ! . fr' t . ; ' I·- ' I !" - ("'I'\ ( -r ... ( ..... - -(. (I I -. ,. •" l '-..1 ' ~ --.{ ... ··": ~~ .- * ... , .. '~ •• / .00 T 188.13 16.0 0 6 4.41 3.00 15.0 0 2 0.00 1 1 4 .9 0 1,? 0 6 .0 0 40.00 14 .0 0 50.00 50.00 50.00 15.00 1 0 9.0 0 12.5 0 2 0.43 8 ;36 115.00 10 2? 50.0 0 2 0.4 3 8 9 5 .0 0 1 8.46 8 9 5 .0 0 4,1 4 0 .8 9 T I I .00 i '.0 0 i 1,5 0 0.0 0 8,3 8 3 .01 1 Sl8 8 3 .01 S ~,l 4 0 .89 - 1Ll42.121 ' ~-' .· - ! .t t '.'; .,'~ ' RCC-81 (6-71) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS HARRISBURG 17127 NOTICE OF FILING OF APPRAISEMENT MARY BELIC (Executor or Administrator) IN YOUR REPLY PLEASE REFER TO Inheritance Tax Division In Re: Estate of ___ E_V_A_MAL_· _:YUK _______________ _ vlASHINGTON County -File No. ___ 6_~_-_71_-_9_83_!5 __ _ Dear MADAM: ORIGINAL· You are hereby notified that the--_,.,E""VA..,.--,MAL......,....,....,:Y,.,OK....,...------------ appraisement in the estate of ___________ ~;::;;-;;;===...--------- has been filed in the office of the Register of Wills of WASHINGTON! County on OCTOBER. n. I 19 73 I Said appraisement reflects the following valuations: Rea I Estate _______ 771::...::5=-0::-::0=-=o-=00-=--__ _ Persona I P roperty _____ 8=-,~,3~8===3~o::...:O:..::l=-----....;_; Transfers ______________ _ Jointly Owned------------- T ota I __ !:.__ ____ ~1~5j,L.:.8=-=8~J~'•-=.:01=----- As to such tax that is paid within. three mo~ths 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 De.cember 22, 1965 to June 16, 1971, inclusive; and twelve months when death ~ccurred prior to December 22; 1965) from date of death, interest at the rate of six (6%) percent per annum is charged. . Any party in interest who is aggrieved by qn appraisement may appeal therefrom as provided by law. Oat.({)~' J~ /97.3 S;gned~JJ~· THie ~~ ·/, DATE. OF DEATH: AUGUS'D.' 16, 197]. Note: This is not a bill. ,• I RCC•39 (~68) CCjOO)NWEAL TH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDENT DECEDENT ·SUMMARY . ·'· . . . Estate of __ MAL __ Y_UK__:_:,:_E_VA_· ------_;__ _______ ·DATE. OF DEATH 8-16-71 FILE NO. 63-71-983> (Last Name) (First Name) (Initial) REPORT OF INHERITANCE TAX APPRAISER WASHINGTON. I, the undersigned duly appointed Inheritance Tax Appraiser in and for the County of _______ ___!_ ____ _ Pennsylvania, do respectfuliy repor~ that I have appraised the real and personal property as reported in t~e foregoing return at the values !!et forth opposite each item in the last c·olumn to the right in Schedules "..\", "B", "C", and "E". Dated: OCTOBER 11, 19'73 -FREE TOSI INHERITANCE TAX APPRAISER REPORT OF THE REGISTER OF WILLS I, the undersigned duly elected Register of Wills in and f~r . WASHINGTON. · . County, ennsylvania, do respect- fully report that I have allowed deductions in the amounts claimed by deponent, 9:;?ei;t as to those itejlls where a greater or lesser amount is se~ forth in the last column to the right ~ri Schedule "F", whiyfi greafifter or lesse ... anrount represents the sum allowed as a deduction. · , · · . \. · ~ Dated: .OC.T 11197J~Fl MAi~INO . . . . · . ·LY1r<c.t.l ILL~ R INVENTORY Real Property (Schedule A) Personal Property (Schedule B) Transfers (Schedule C) VALUE AS REPORTED $ _ _;_,.-------1~_.;.... Joint-Held Property (Schedule E) TOTAL GROSS ASSETS Less Debts and Deductions (SCHEDULE F) CLEAR VALUE OF ESTATE FOR USE OF REGISTER ONLY Tax on·$ ________ +-~ 2% Taxon$ @ Tax on$ 5% Tuoo$ lK Tax on$ 15% 11,1.42. 12 COMPUTATION OF TAX $ __________ -4--- $ ____________ -4--- $------------4~----- $ ___ ~-----~--- $~---------~--- VALUE AS REAPPRAISED $---------+--- Exemptions • Total Estate------~~--- TOTAL TAX $--------~--- (*) As evidenced by Charitable Exemption Certificates issued by the Secretary of Revenue. Less tax previously paid $======+-==- BALANCE $~----~-4--- Less 5% of tax if paid within 3 months after death $=::::;::::======= BALANCE OF INHERITANCE TAX DUE Add interest at rate of 6% from _______ to~------ AMOUNT OF ESTATE TAX ASSESSED $-· -------+--- Estate tax paid $----...,.,---'--- $ -,-,-------+,-,.---1 $-------~-~~ BALANCE DUE $ ---'---..,....,..-'--- Add interest at rate of 6% from -------110 $·-"""----~~-- TOTAL TAX.BALANCE $ -------+-- PAID $ ~----------.....1: L.-. __ FOR USE OF REGISTER ONLY AOJUSTMENTS 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 ~xplanation! ,.. -:~. I /· Will Administration t No ......... . IN THE . Year ........... . MATTER OF THE APPRAISEMENT OF THE ESTATE OF. EVA MALYUK Deceased Late of . . . . . . . UNION TWP. .... ..... . ......... ············ County of 1/IJASHINGTON Commonwealth of Pennsylvania REPORT AND APPRAISAL I-' ,.. ,., ,.. ;. ; ... -•: ~; __ ... ·..:.· ., ·, " ,. -. ... .... ; ';.: ;; I; .. ,. . : ...... 'l;-i• ( .. -·-!" .,,.. ,_,. l r , . . . ' DATE ........ Q.Q1:.Q~ ...... J,J,,_ .... J.9.7).l. ....... DEr_AP..'!'l':!E~:T OF REVENUIE Bplt'EAU OF COUNTY COLLECTIONS HARRISBURG, PENNA. 1 7 12 7 COMMONWEALTH OF PENNSYLVM.JIA RESIDENT INHERITANCE TAX APPRAISEMENT :u::. 6;=~i~~;~ ---I ................................................................................................ :! Whereas, ........................... ~Y~ .. ~~~: ...................................................................................... late of ....... ~.+.9..~ .. --~~ .................................................................... . in the County of ........................ ~~~~~~-~9.~! ..................................................................... : ...... Commonwealth of Pennsylvania, having died on the .......................... , ......................... .+.9th ............................ day of ........... AVQ.t!.~~ ............................................. 19 .. 7:D,.; .. , seized and possessed of an estate subject to Inheritance Tax under the laws of the Commonwealth of Pennsylvania; Therefore, I, ............................... .X~:· .. ~ .. Q§.~ ...................................................................... , 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. _/ Appraisement Unit Description of Asset Values Made for Inheritance Tax Purposes REALTY $ ' SEE COPY OF APPRAISEMENT 11SCHEDULE An ?,,500. 00 EE_RSONAL -. SEE SCHEDULE liB II OF APPRAISEMENT S:,383. 01 .. ' TOTAL 15 ,883 •. 01 ; ~ .. ' > ·.· .. ' .. .. . ' ................................................................................................................ ·················································· Appraiser ................................................................................... : ..................... . (Number and Street) ........................................................................................................................................ , Penna. (Post Offiee) I ·- - County RESIDENT· INHERITANCE TAX APPRAISEMENT Estate of Late of Date of Death, Appraiseme1!f Docket Vol., Page, ................... No. Deceased: Filed in Register's Office, .......... , .............................. .19 .......... . Amount of tax due, $ .................................................................... . DEPARTMENT OF REVENUE Received, Exa.mined and Approved, Wrote. abo.ut Appraisement·, Appeal f1'om Appraisement, Entered and charged, 1-, " '• t h ,... "\ !" J . ~· :~ 1 .;_ .. r ;." ... ,. ,'~ 1 r :· "' . ; .· ..