HomeMy WebLinkAboutOC1971-1207 - ESTATE OF DZIAKQlnmmnUtUtllltl1 nf JtnUaYIUllnia,}l1.li...IhUl~ington Qlountg,
KNOW ALL MEN BY THESE PRESENTS:Whereas,at Washington,III the County aforesaid
the last Will and Testament of
Letters of Administration in and for the County of Washington,in the Commonwealth of Pennsylvania,
Russell Marino
on the 7th.day of December A.D.19 71 ,before me,
,Register for the Probate of Wills and Granting
I[
Mike DZiak,A/K/A Michael Dziak
Iat'e of Somerset Township in the County aforesaid,deceased,
(a true copy whereof is to these presents annexed),was duly admitted to probate;and
Michael Megles
the Executor III said Will and Testament named,havinS.a.ppeared before mc arid taken and subscribed
the oath of office prescribed by law;
?'-JOW,THEREFORE,I,Russell Marino ,Register as aforesaid,do
gram these LETTERS TESTAMENTARY,unto the said
Michael Megles'
committing unto Him the a<:lministration of all and singular the goods and
chattels,rights and crcdits,which were of said deceased;and requiring Him
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to exhibit a true .and perfect inventory thereof,into the Register's Office,at Washington,within ninety
days from thc date hereof,and to render a just and true account of said administration at the expiration
of six months from the date hereof,and to regard and comply with the provisions of the laws of this
Commonwealth relating to inheritance taxes.
I?'-J TESTIIvIONY WHEREOF,I have'hereunto set my hand and the seal
of said Office at Washington,this 7 th.·
day of December III the year of our Lord one thousand
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nine hundred and
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Seventy One
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"LAST WILL AND TESTAMENT
OF
MIKE DZIAK,WIDOWER
I,MIKE DZIAK,Widower,a resident of Somerset Township,Washington
of One Thousand ($1,000.00)Dollars.
of One Thousand ($1,000.00)Dollars.
of One Thousand ($1,000.00)Dollars.
and Testament in manner and form following:
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i,:II!do hereby make,publish and declare this to be my Last Hill
I hereby give and bequeath unto my daughter,HELEN DZIAK,
I hereby give and devise unto my son,FRANK DZIAK,one grave
I hereby give and bequeath unto my daughter,MILDRED DZIAK,
I hereby give and bequeath unto my son,JOSEPH DZIAK,the sum
I direct tha~hll my just debts,funeral and testamentary
I,hereby give and bequeath unto my son,FRANK DZIAK,the sum
I hereby give and bequeath unto my son,GEORGE DZIAK,the sum
I hereby give and bequeath unto my daughter,PAULINE DZIAK,
SEVENTH:
SIXTH:
SECOND:
EIGHTH:
FOURTH:
THIRD :
FIRST:
FIFTH:
the sum of One Th~usand (~l,OOO.OO)Dollars.
the sum of One Thousand ($1,000.00)Dollars.
made by me,and
expenses shall be paid as soon as possible may be after my death.
the sum of One Thousand ($1,000.00)Dollars.
County,Pennsylvania,being ot sound mind and memory,hereby revoke all wills
II and codicils,as "ell as all instruments of a testamentary nature heretofore
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lot in the Sacred Heart Cemetery.
Page 1.
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IN WITNESS ~~EREOF,I have set my hand and seal to this my Last Will
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______A'-,/')_"y_~_/~_·....-.:.~~"¥_~_,----.:d?---<SEAL)
I herGby nominate,constitute and appoint'MICHAEL MEGLES,
I hereby give and devise unto my three daughters,MILDRED DZIAK,
All the rest,residue and remainder of my estate,real,personal,
Signed,sealed,published and declared by MIKE DZIAK;the above named
ELEVENTH:
TENTH:
NINTH:
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'IIIIi PAULINE DZIAK and HELEN DZIAK,all of my household goods,furniture,clothing,nIiI,and other items of household use and personal matter,in equal proportions,
HIIII share and share alike,
i'IIIIiIIi
'II!and mixed,of whatever nature and wheresoever situate,which I may mm or have
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:1:,the right to dispose of at the time of my death,I hereby give,devise and
'I;1!I bequeath unto the following,MARY SCHWARTZ,~ZAMISKA,MICHAEL DZIAK,
"a![JOSEPH DZIAK,GEORGE DZIAK,FRANK DZIAK,PAULINE DZIAK,HELEN DZIAK and
iIIi MILDRED DZIAK,in equal proportions,share and share alike.
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!i Executor of this my Last Will and Testament.
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HIi and Testament,which consists of two pages,to each of which I have affixed.I
I'l!my signature,this 2!'r;{day of__..:..A-"o/,--/J;-,-~_C...:.,..II,--__,1969,
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"i!.."Tes.tator,as and for his Last Hill and Testament,in the presence of us,who,
"H,i!at his request,and in his presence,and in the presence of each other,have
ilh hereunto subscribed our names as Hitnesses.
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i\ffibautt ®f 1£Xfnitnr ®r i\bmtutlitratnr
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~tutr nf Jruunyluuniu }
<!tnuuty nf lIunqiugtnu nn:
Personally before me,the undersigned authority,a .~9.~.a.!'X ~.\ll:>~.~<::in and for said
County and State,appeared .__Mis;:hael__Megles ____who,being duly
sworn according to law,deposes and says that he is the executor or administrator of the es-
tate of ~.~.~.~..,J:).:I:~.Cl~~__.~!]<;!Cl ...~.t;.s:.~....__deceased,that the foregoing schedules conatitute a
complete inventory and appraisement of the real and personal estate of .M.i,J5~__.;Qg:J~~.,~/~J.~etc.
deceased,except real estate outside the Commonwealt of Pennsylvania;that the figures opposite
each item of real and personal €state in the foregoing chedules are det rmined and stated by the
undersigned to be the fair value of said items as of th date of the dece ent's death,based upon a
just.appra~~.~m~lt..~feach item made by the above ed Execu~or /Administrat r.
Sworn aFd sl,bsc~lbed before me thIS 9?/~"'L .'hfLtU .~"~0~~~9~y/-Exe t roAd
~~..~....~'",-.~
M'"'.""''''''';<1 ,T"D••"_•.•-_."",o,ADDITIONAL INSTRUCTIONS~1y f'..'""_,,,1-'-I _.,>-:•."!--,,.~1973LAninventorymust'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 R€turn.
REFERENCE FOR ADDITIONAL COPY
Act of 1947 P.L.513 Sec.5.2,72 P.S.4844.2
IJluurutnryUtUli\ppruinrmrut .of the goods and chattels,;ights and credits which
were of ..M.~~l?p<!:i~k!.Cl/~/Clet.c=,..._.late of .~ClIlle.:I:~e.:t ~Cl.~s.I:l~);>.........
Washington Connty,Pa.,taken and made in conformity with the above affidavit,
DOLLARS
PERSONAL BROPERTY
CENTS
Livestock ...............................................5,375.77
Farm Equipment &Miscellaneous Items •.•...•••...•••.•••.•5,589.55
Milk,.Inc".....•..................•....................••
Straw,corn,oats and hay•.•...•..•...•....•..••..•..••••
827 '113
588(2
united Mine Workers,death benefit.......................350.00
Atlantic Breeders corp.,Stock Refund....................IJ35::~:::::i:::e::::r::::·~c::::::·;~~;~·~~;~~:::::::::::::J::
Burial Lot,Sacred Heart cemetery•....•......•..•••••..••T.-__~5~0~J~0~0
TOTAL PERSONAL PROPERTy •.•.•.••......••..•.•..•••.•.•...•12,849.98
REAL PROPERTY
ALL that certain tract of land situate in Somerset
Township,Washington county,Pennsylvania,bounded and
described as follows:
BEGINNING at a corner on land now or formerly of M.
Tombaugh;thence South 15~?'East,72.16 perches.:to a
stone on land now or formerly of John Freeman;thence
South 38°East,34.32 perches to a walnut;thence
++continued on rider attached hereto.
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'Vd "0:.1 NOl~)NIHS\fIi\
Slll/~:10 H31SI~3U
ONltIVI'/T13SSntl
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INVENTORY &APPRAISEMENT -CONTINUED -ESTATE OF MIKE'DZIAK,A/KIA ETC.
South 20~0 East,48 perches to a stone;South 47~0
East,131.3 perches'to a post;North l4J;,0 West,15.76
perches;North 1 3/40 East,7.48 perches;North ll~o
East,24.8 perches;North 30~0 East,19.44 perches;
North 29J;,°East,25.36 perches;North 5~0 West,8.32
perches;North 12 1/80 west,75.24 perches;North 5~0
West,9.6 perches;North l2~0 East,17.68 perches;
North 41 0 West,8 perches;,North 16 3/4 0 west,7.72
perches;North 8l~0 West,28.2 perches;North 35~0 West,
76.2 perches on land now or formerly of M.Mankey;South
','
66l-,°west,98.8 perches to the place of beginning.
CONTAINING 156 acres,118 perches.
EXCEPTING and RESERVING hereout and herefrom,the
.following parcels heretofore conveyed:(1)2.66 acres
described in Deed Book 402,page 590;(2)15 acres,more or
less,described in Deed Book 480,page 677;(3)12 acres,
more or less,described in Deed Book 487,page 442;
(4)10 acres,more or less,described in Deed Book 492,
page 58;(5)19.472 acres,described in Deed Book 702,
page 254;(6)0.380 acres,described in Deed Book 911.
page 630;and (7)1.366 acres,described in Deed Book
1023,page 507.
UPON which is erected a frame dwelling and barn,
and other out buildings.having a value of••.•••..•..•••.••.$35.200.00
TOTAL REAL PROPERTy ••.•...••.•••..•..•••..•.•.............~.$35,200.00
TOTAL PERSONAL PROPERTY AND REAL PROPERTY ••••.•••.•..•••..~.$48,049.98
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STATE OF PENNSYLVANIA,
WASHINGTON COUNTY,
The within named Accauntant being duly swarn according to law,deposes and say sthat the above account
a~stated is true and correct as J1.l;L,,,,.,verily believe.
Sworn and subscribed before me thiso,Z'~....
day of ,..,~E3E!;,~~E!:r ,19 !.?.
d~"'"_~../...__..Z.~__H •••••~••••L/~__.._.
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;:-:-T~c:;rSA MUTOI\:~":"'~~··~7J.;.3nt'1 fWp,.Wl'ls~ir'!t'1;1Co.
MYJ,m:f~r.;#n upi,,,~SeptembN 3,1973
Wa'shingtan County,'~s:I do certify that I have given legal notice to all persons
concerned of the filing of the within account in the manner
prescribed by Statute and Rule of Court,as evidenced by proofs
thereof filed to No.....~..3..~.7.,7..:::_...7&,:z__
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Witness my hand and official 'seal this..,;?..7 ..
day OL..",..,.,/Vf1.,1/~,.....197~,
......................................,on,../.22.4.;fvT~':?:"''tif
,Register of y!1{2').cl~J"
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L_t.-'"~-'72 OCT 10 PH =2 09 ~
00~MCo-=RUSSELL ~
MI\RINO 000
REGISTU{OF WILLS •=IVASHINGTGN CO.•PA..J ~,;
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The Court is respectfully reCjtle£ted to determine
proper distribution in this estote.
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NO.63-71-120'7
THE FIRST AND FINAL ACCOUNT OF
MICHAEL MEGLES.Executor of the Estate of MIKE DZIAK.also
Iknown as MICHAEL DZIAK.deceased.late of Somerset Township.
II Washington County.Pennsylvania.
I Th,Aooount'nt io oh"g,d '0 followo,
ITO Inventory and Appraisement of Property filed
as of September 21.1972 $48.049.98
IDifference Between:
Proceeds of Sale of real estate .••.$35.200.00
Inventory Value 35.200.00 -0-
TOTAL ASSETS OF ESTATE •............•••....•..•...•..•$48.049.98
RECAPITULATION OF ACCOUNT:
TOTAL ASSETS OF ESTATE •.......•...••..$48.049.98
TOTAL AMOUNT OF CREDITS
CLAIMED BY ACCOUNT •....•......•.......14.972.44
BALANCE DUE ••.•....••...••...••••..•..$33.077.54
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AMOUN'r:
$155.00
25.00
1,018.71
1,283.16
50.53
36.50
394.00
5.00
23.25
11.30
390.22
20.00
4.91
34.75
15.95
12.25
37.20
205.00
205.00
167.96
11.50
14.00
14.00
15.00
2,400.00
2,400.00
5.25
17.00
1,000.00
1,000.00
1,000.00
'1,000.00
1,000.00
1,000.00
Burial Expense
Labor
Executors Commission
Burial Services
Breeding
Lettering on Monument
Services
State Income Tax
Labor
Insurance Premium
Supplies
Feed
Ad
1972 Road Tax
1972 School Tax
Cows
Ad
Probate of will
Filing Inventory
Ad
Advertising Letters
Advertising Letters
county Tax
,Grinding'
:Feed
Attorney Fee
Notary Fee
...Filing Account
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"';if'
Legacy
Legacy
Legacy
Legacy
Legacy
LegacyMildredDziak
\:THE ACCOUN'rANT CLAmS CREDI'rs Ou'!'OF 'rEE ASSE.TS OF SAID ESTATE
iI TO-WIT:
II"=~:;-;"","--;:::~=----------'-;:=;;;-;:;-;:;;:;-:-----------;;-;:;;:;:;:-;;::;;;;-:-;Ii NAME OF PAYEE:REMA RKS :',------------------------------------;
Ii John N.Dugan
IiIi Rev.M.Gubanich
Ii Kenneth V.Thompson
!Mon valley Eqpt.Co.
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lMalcOlm Morgan,Co.Treas.
~Atlantic Breeders Corp.
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'I'd',jPatsy DeBerar ~n~s
jlIi Charles R.wood,Vet.
II Edwin Smell
!Kefauver Hardware
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!Edgar Feed &Supply
!
IQuinet Monument co.
IPa.Dept.of Revenue
IArleigh Cale,Tax ColI.i .
iObserver Publishing Co.
II Valley Independent
I
IPittsburgh Press
Ipauline Dziak
I .IGeorge Dz~ak
iArleigh Cale,Tax ColI.
I
'II Reg ister of Wills
lwashington Co.Reports
II
IObserver Publishing Co.
IIRegister of Wills
IMichael Megles
I
iJ.D.Costa,Esq.
I'II Notary Publ ic
1'1 .'.Reg~ster of w~lls
IJosePh Dziak
IGeorge Dziak
!!Frank Dziak
II Pauline Dziak
IHelen Dziak
Total ..••.......••.......$14,972.44
•Observer Reporter
WASHINGTON,PENNSYLVANIA
PROOF OF PUBLICATION,·
In compliance with the Newspaper Advertising Act o.f 16 May.1929,
P.L.1784,as amended.
Commonwealth of Pennsylvania,County of Washington,SS:.
Personally appeared before file,a Notary Public in and for said County
an~State Ri.c:.I:l.<lJ:4 $...,CQW?,.n.who heing duly &worn
~ccordiDg to law,deposes and says that he is the Yic..e.;'Pr.e.s.id.e.n.t
of the Observer Publishing Company.a Pennsylvania corporation,and its
agent in this behalf;that the said Com.pany is the"owner and publisher of
the Observer-Reporter,successor to The Wash~ngton Observer,established
September 18,1871,and The Washington Reporter,'established August 15.
1808,a daily newB,pap'er of"general circulation,printed and published and ,,-
having its place ofbusineS's at Washington,Washington County,Pennsyl-
vania,where it'or'its predecessors have pee;n established and publish'6d
~tinuous'ly for more than six months prior to the publIcation of the notice
hereto at:tached;that the printed notice or advertisement hereto attached-
is a copy of an official advertisement.official notice,'legal noUce or legal
advertisement,exactly as printed or publislJ,ed in th~Ob~'erver-Report€!rin
its regular editions on the following date or dates;.
.........................P..e.~.!:.m.bex ...1Q.,...JZ....il:I.!.4.....?4..•....19.T,1,
that neither th'e affiant nor the Observer Publishing Company is interested
in the subject matter of said notice or advertising and that all of the allega-
tions'of this affidavit as to the Ume,Pla~endcharacter,of pUblication
are true.','I''._e .
.........................................,.......~
Sworn to and .uh.cr9tid;;~:;~M;:~,~..1971
MARGARET M.BRADLEY,NOTARY PUeliO
WASHINGTON,WASHINGTON COUNTY
MY COMMISSION EXPIRES MAY 6,1972
--,-~---------,------------------
Testate Form
PETITION SUR AUDIT
IN THE ORPHANS'COURT OF WASHINGTON COUNTY J
Estate of....~~.~...l?~.~~!....?:~.S.9...~~.9.~.~..ii_S._
...................~.~~~;r;:.~_.p.~_¥.1~!.._..__. . .
Deceased
No _~~.::~_~::_~?~.._.A.A.
Fiduciary _Mi,~h~~J,..M~9.J,~.S..,___. _
Executor
Date of Date of
Decedent's death ~~ye.~~~.;:_..~.~.~~_9}.~.._.._...Grant of Letters_.._..!?_e.C:::!'!.~e.!:...?L_:l.':J:rh.....__...._
This is the !!'.~!:.~~~!1:~~~!1:~.~.__.account filed in this estate
If there have been former accounts filed in this estate,list file number or number and term _..~9~.~_.. .
Election to take
Under or Against will.(cross out one)
Date Election Place of;
Filed ..__~9P:~.. ..Record _N9X!~.
Pauline Dziak,Daughter
Helen Dziak,Daughter
Mildred Dziak,Daughter
Name of surviving spouse JllQ!J-.~_.._ _..__._.__...___.._.._._.._._
List issue,where material:
Mary Schwartz,Daughter
Anna Zamiska,Daughter
Michael Dziak,Son
Joseph Dziak,Son
George Dziak,Son
Frank Dziak,Son
Did decedent marry after execution of will?(indicate)~No.Any children born after execution of will?(indicate)
~No_If answer yes,name them...___.__..._._._..__.
Legatees Relationship Interest Fiduciary,if deceased or not sui juris
Mary Schwartz Daughter 1/9 None required
Anna Zamiska Daughter 1/9 None required
Michael Dziak Son 1/9 None required
Joseph Dziak Son 1/9 +legacy None required
George Dziak Son 1/9 +legacy None required
Frank Dziak Son 1/9 +legacy
+lot None requiredQaUlineDziakDaughter1/9 +legacy None required
Helen Dziak Daughter 1/9 +legacy None required
Mildred Dziak Daughter 1/9 +legacy None required
"
List,if exceptions to above:Adeemed:Revoked:Lapsed:Abated:Give Cause:
If partial intestacy,give facts:
No Exceptions-----------------------------
No Partial rntestacy----------------------
Notice to interested porties.Have all parties,having either vested or contingent interests and all crediors entitled
to notice (Court Rule No.9 paragraph C:Section 6:Subdivision c)received written notice of the filing of the account
and of call of audit?Yes.~.
If any exception give cause:JllQ l!;;lj:.9.!'!p.j;.:j..Q!J-.~.
File copy of Notice
and date of mailing W!;.~tt;:.~~!)..9.!::.~.s:~g.i,~~.~..p.y r,:?:S~~.~:t:.9.L ,•...
'\
.,
Is estate subject to the filing of a Federal Estate Tax Return?~?_._..__..._,..__.._.._.~.~_,~
Actual payment made on Pennsylvania Transfer Inheritance Tax.Amount $ .__N.o.n.~..
If the Will makes any portion of estate subject to a life·estate,give name and birth date of life tenant ..~K.~.
No Life Estate
Give Nomes and addresses of all unpaid creditors who are legally entitled to notice,together with the amounts
of such claims;state whether they are admitted to be correct;and whether the claim is denied.
None.
Give reference to such ports of the will as require interpretation by the Court;a reference to all questions re-
quiring adjudication,and a statement of any other facts deemed necessary for the preparation of the adjudication:
None.
Balance for distribution per account,
Itemize any additional debits not shown by account:$..}.3.!.~.??:.?.~__.
'-:...
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$.__::-.Q~_.
not shown by account:
(,
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(A~d)
credits.',
,r.
Balance far distributian
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Total .additional de~its
ItemiZE!anyc:;additional
Helen D~iak -·Advancement $I,OOO.OO
Pauline Dziak -Advancement $I,OOO.OO
Frank Dziak -Advancement $l,OOO.OO
~~".,..
yt-,.~.?.?..:.?.~._.
If balance for distribution is not in cash,list each item held in kind,giving appraised Value (or distribution Value);
Total additional credits (Subtract)
One grave in the Sacred Heart Cemetery,inventory value of $50.00,distributed
to Frank Dziak in kind.Balance of $30,027.54 in cash.
"-.:...~.....-'"",..~
/.-•
JESS D.COSTA
ATTORNEY AT LAW
107 MAIN STREET
BENTLEYVILLE,PENNA.
15314
PHONE
ARgA CODE 412
OFFICE 239_4321
HOME 239.4514
January 8,1973
President Judge P.V.Marino
Orphans'court of washington County
Court House
Washington,Penna.15301
Attention:John Hana
Re:Estate of Mike Dziak,alk/a
Michael Dziak
No.63-71-1201
Dear Mr.Hana:
In the matter of the above Estate,the Audit
Petition fails to reflect the following debits and credits:
Additional debits not shown in Audit Petition -
John N.Dugan Agency
Nore DiNardo
Insurance Refund
Pro-rated share of
1972 taxes
$19.00
84.42
Total ••..•..•.•..•..••..••.$103.42
Additional credits not shown in Audit Petition -
Recorder of Deeds ~Realty Transfer Tax $352.00
I trust that this letter will be sufficient to make
the above additions or corrections.
Very truly yours,
1~~
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~'.Oc.t.o.ber 14,~g..JL
./Michael Megles,Executor 0#the'1tcfl~et¥on1/.Estate of Mike Dziak,Deceased'
aNE THOUSAND and noLIOO - - - - - - - -q)lJllwf1l
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.('£Michael Megles,Executor of the I
/JC8tlJett:j4'01JVJ.s.t.a.te of Mike D.z1.ak.,..De aeased I
ONE THOUSAND and noLIOO - - - -fl)tIIo1J:1I 'II
Advancement on distributive share
1 1 ,000.00
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IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY,PENNSYLVANIA,
ORPHANS'COURT DIVISION
ESTATE OF MIKE DZIAK,
IN RE:
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NO.63-71-120
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ECER
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also known as
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I,H_E_L_E_N D_Z_IA__K ,do hereby acknowledge to have
received from Michael Megles,Executor of the Estate of MIKE
DZIAK,also known as MICHAEL DZIAK,Deceased,'the sum of ONE
THOUSAND ($1,000.90)DOLLARS in full satisfaction of my legacy
under the will of Mike Dziak,Widower,deceased,dated March
28,1969.and of record in will Book 113,page 79.
I hereby authorize and direct the Clerk of the Court of
Common Pleas of Washington county,Pennsylvania,Orphans'Court
Division,to mark said legacy satisfied of record.
Datedthis ~L~&~',day of September,1972.
_~-f-~;J_-f.t:--')1_,_,,_0'__(SEAL)
HELE;];ZIAK ~
Check NO.__~~~',~~_
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IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY,PENNSYLVANIA,
ORPHANS'COURT DIVISION
.IN RE:
I.ESTATE OF MIKE DZIAK,
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also known as NO.63-71-120
MICHAEL DZIAK,
,I Deceased.
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I,PA__U_L_I_N_E__D_Z_I_A_K ,do hereby acknowledge to have
received from Michael Meg1es,Executor of the Estate of MIKE
DZIAK,also-known as MIC}ffiEL DZIAK,Deceased,the sum of ONE
THOUSAND ($1,000.00)DOLLARS in full satisfaction of my legacy
under the will of Mike Dziak,Widower,deceased,dated March
28,1969,and of record in will Book 113,page 79.
I hereby authorize and direct the Clerk of the Court of
Common Pleas of Washington County,pennsylvania,Orphans'Court
Division,to mark said legacy satisfied of record.
Dated this ~-~~~·day of September,1972.
Check No.,,-:2_._~_._
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(SEAL)
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IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY,PENNSYLVANIA,
ESTATE OF MIKE DZIAK,.
also known as
MICHAEL DZIAK,
NO.63-71-120
ORPHANS'COURT DIVISIONII~Ii IN RE:~.
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Deceased.
I,F_RA_NK__D_Z_IA_K ,do hereby acknowledge to have
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received from Michael Megles,Executor of the Estate of MIKE
DZIAK,also·known as MICHAEL DZIAK,Deceased,the sum of ONE
THOUSAND ($1,000.00)DOLLARS in full satisfaction of my legacy
under the will of Mike Dziak.Widower,deceased.dated March
28,1969.and of record in Will Book 113,page 79.
I hereby authorize and direct the Clerk of the court of
Common Pleas of Washington County,pennsylvania,Orphans'Court
Division.to mark said legacy satisfied of record.
Dated this ~~·_71~11 day of September,1972.
Check No.gJ./-
IN THE COURT OF COM-MON PLEAS OF WASHINGTON COUNTY,PENNSYLVANIA,
R E C E IP T
ORPHANS'COURT DIVISION
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IN RE':.
ESTATE OE IHKEDZIAK,
also known as
MICHAEL DZIAK,
Dece,ased;.,
NO.63-71-120
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I,J_O_S_E_P_H__D__Z_IA__K ,do hereby acknowledge to have
received from Michael Megles,Executor of the Estate of MIKE
DZIAK,also known as MICHAEL DZIAK,Deceased,the sum of ONE
THOUSAND ($1,000.90)DOLLARS in full satisfaction of my legacy
under the will of Mike Dziak.Widower.deceased,dated March
28,1969 •.and of record in "rill Book 113,page 79.
I hereby authorize and direct the Clerk of the Court of
Common Pleas of Washington County,Pennsylvania.Orphans'Court
Division.to mark said legacy satisfied of record.
Dated this,__~~~71~I1 day of September,1972.
CheeR No.~S-
DZIAK,also known as MICHAEL DZIAK,Deceased,the sum of ONE
received from Michael Megles,Executor of the Estate of MIKE
IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY,PENNSYLVANIA,
p.T
NO.63-71-120
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ORPa~NS'COURT DIVISION
R
I,G_E_O_R_G_E_D_Z_I_A_K ,do hereby acknowledge to have
ESTATE OF MIKE DZIAK,
also known as
IN RE:
Deceased.
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THOUSAND ($1,000.00)DOLLARS in full satisfaction of my legacy
under the will of Mike Dziak,widower,deceased,dated March
28,1969.and of record in Will Book 113.page 79.
I hereby authorize and direct the Clerk of the Court of
Common Pleas of Washington County,Pennsylvania,Orphans'Court
Division.to mark said legacy satisfied of record.
Dated this b-;H 'day of September,1972.
="~,,-,,,-."""Pa?-J"'-,.IA1J'fY'R"""/~:1J"-~"¥"A4~·rk::u..J...!__(SEA L)
GEORGE DZIAK
;210CheckNO._
DZIAK,also known as MICHAEL DZIAK,Deceased,the sum of ONE
received from Michael Megles,Executor of the Estate of MIKE
IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY,PENNSYLVANIA,
I,M_I_LD_RE_D_D_Z_I_A_K ,do hereby acknowledge to have
TP
NO.63-71-120
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ECE
ORPa~NS'COURT DIVISION
R
ESTATE OF MIKE DZIAK,
also known as
IN RE:
Deceased.
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THOUSAND ($1,000.00)DOLLARS in full satisfaction of my legacy
under the Will of Mike Dziak,Widower,deceased,dated March
28,1969,and of record in will Book 113,page 79.
I hereby authorize and direct the Clerk of the Court of
Common Pleas of Washington County,Pennsylvania,Orphans'Court
Division,to mark said legacy satisfied of record.
Dated this ~!#7~day of September,1972.
--:.-:....C};£=~~f)~"LJ:.---(SEAL)
MILDR13D DZIAK ~
Check No ._rf_--'le-_
----~-----------------------
NoneIfFamilyExemptianclaimedbyPetitian,give place af Record:.
If Family Exemption is claimed at audit,give name,relationship and basis for Claim:~~.!]:~.
List any advancement ar di~tribution on account that has been made,and nature and amount af same:
Joseph Dziak,$1,000.00 -legacy Pauline Dziak,$1,000.00 -Advancement
George Dziak,$1,000.00 -legacy Helen Dziak,$1,000.00 -Advancement
Frank Dziak,$1,000.00 -le~cy Frank Dziak,$1,000.00 -Advancement
Pauline Dziak,$1,000.00 -legacy
Helen Dziak,$1,000.00 -legacy
Mildred Dziak,$1,000.00 -legacy
Suggested distribution of balance shown,both as to principal and income,attaching signed and itemized elections
to take in kind if balance is not in cosh:residuary shares being stated in proportions:
Mary Schwartz,daughter,1/9th interest
Anna zamiska,daughter,1/9th interest
Michael Dziak,Son,1/9th interest
Joseph Dziak,Son,1/9th interest +legacy
George Dziak,Son,1/9th interest +legacy
Fra~K Dziak,Son,1/9th interest +legacy and lot
Pauline Dziak,daughter,1/9th interest +legacy
Helen Dziak,daughter,1/9th interest +legacy
Mildred Dziak,daughter,1/9th interest +legacy
COUNTY OF WASHINGTON,SS:
COMMONWEALTH OF PENNSYLVANIA.
The above named Fiduciary or representative thereof,
being duly ~.\Y().r.I1 doth depase and say
that the facts set forth in the foregoing petition are true
to the best of JloA-.!;;knowledge and belief.
..........I?W9.~~to and subscribed before j
me thiS..n.$.j;:da~~.P.~.~~~E~..19..J~j
Signature of Offlc~"'-6.,.~.
..THF~rs!\MUTOTItIeofOfficer"'•............~'."""l~"••••••tkt:Jr,;"""I·'~,....;;l».,·c,-·.-i~,.."<...'"•
.My Commission Expires se~tember 3!.1913Officeexplres .
An.your petitioner will ever pray,etc.
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Estate of.....~.~~...p..?!~!5.!...~.~~~..~~9~
as MICHAEL DZIAK,
Deceased
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-Fiduciary !:!:~.~HAEL MEGLES,._._--_...._._...__..._.--_..__.-----_....
EXECUTOR
PETITION SUR AUDIT
FROM WHER'E DECEDENT LEFT A WILL
Counsel of Fiduciary will submit herewith the
following,inconformity with Court Rules
adopted effective December 3,1951,being
rule No,9:paragraph b-c;and divisions
thereof:shown on pages 23-24.
1.Written praecipes of all Counsel in the
case.
2.Copy of order appointing Guardian ad
litem,if pertinent.
3.Copy of Order appointing Trustee ad
litem,if pertinent.
4.Proof of service of above.
5.Letters Testamentary or Administration
C.T.A.or a~attest copy of Will.
6.Copy of inve!"ttory and appraisement.
7.Proof of adv~rtisementof grant of letters
if not filed with account..,
8.Certificate of liens in case ony of the
funds for distribution are from judicial
sale of real estdte.
9.Signed and itemized elections if any
distribution in kind.
10.Copy of Federal Estate Tax return if es-
tate is subject thereto.
JESS D.COSTA
Attorney
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RUS;~ELL i;:l"~':~'~':J
REG\STEH Of Wll.L.:j
~'IASH\HGTON CO ..P.\.
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IN THE COURT OF C01~10N PLEAS OF WASHINGTON COu~TY,PENNSYLVANIA
ORPHANS'COURT DIVISION
ESTATE OF__M_i_k_e_D_Z_i_a_k.-;'e-a",,/k....-:/_a,-_e_t..;:c..;:._
NO.63-71...,120
Deceased.
NOTICE OF FILING ACCOUNT AtID AUDIT
To the Heirs,Creditors and other persons interested in said Estate:
Please take notice that the First and Final Account of
Michael Megles,Executor
of the above estate,was filed in the Office of the Register of Wills
of Washington County,Pennsylvania,on,O_c__t_o_b_e_r_l~0__,__1_9_7_2 _
and is docketed to the above number and term.
Also,please take notice that the Orphans'Court of washington
1 " h f"d Friday,December 22,1972County,Pennsy van~a,as .1.xe . _
at 10:00 o'clock,A.M.,E.s.'r.,in its courtroom on the Third
Floor of the courthouse,Washington,Pennsylvania,as the time and
place for the audit of said account.
Respectfully submitted,
TO:
November 13th,19 72
Michael Megles
Cokeburg,Pa.15324
IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY,PENNSYLVANIA
ORPHANS'COURT DIVISION
ESTATE OF Mike Dziak,a/k/a etc.
NO.63-71-120
Deceased.
NOTICE OF FILING ACCOUNT AND AUDIT
To the Heirs,Creditors and other persons interested in said Estate:
Please take notice that the First and Final Account of
Michael Megles,Executor
of the above estate,was filed in the Office of the Register of Wills
of washington County,Pennsylvania,on O_c_t__o_b_e_r__l_0_t_h~,__1_9_7_2 __
and is docketed to the above number and term.
Also,please take notice that the Orphans'Court of Washington
County,Pennsylvania,has fixed ~F~r~id__a~y~,~D~e_c~e~m~b~e~r~2~2~,_=1~9~7~2~.__
at 10:00 o·clock,__~A~.~M.,E.S.T.,in its courtroom on the Third
Floor of the courthouse,Washington,Pennsylvania,as the time and
place for the audit of said account.
Respectfully submitted,
November 13th 19 72---------,.
TO:Mary Schwartz
c/o Sylvia Schwartz
1251~Arliss Ave.
Lakewood 7,Ohio
IN THE COURT OF CO~MON PLEAS OF WASHINGTON COUNTY,PENNSYLVANIA
ORPfffiNS'COURT DIVISION
ESTATE OF Mike Dziak,a/k/a etc.
NO.63-71-120
Deceased.
NOTICE OF FILING ACCOUNT AND AUDIT
To the Heirs,creditors and other persons interested in said Estate:
Please take notice that the First and Final Account of
Michael Megles,Executor
of the above estate,was fi~ed in the Office of the Register of Wills
of Washington county,Pennsylvania,on__-=O~c~t~o~b~e~r~=1~0~t~h~,~1~9~7~2 ,
and is docketed to the above number and term.
Also;please take notice that the Orphans'court of Washington
county,Pennsylvania,has fixed Friday,December 22,1972
at 10:00 o'clock,A.M.,E.S.T.,in its courtroom on the Third
Floor of the Courthouse,Washington,pennsylvania,as the time and
place for the audit of said account.
Respectfully submitted,
II
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November 13th ,19 72
TO:Anna Zamiska
Cokeburg,Pa.15324
IN THE COURT OF CO~~10N PLEAS OF WASHINGTON COUNTY,PENNSYLVANIA
ORPHANS'COURT DIVISION
ESTATE OF__M...,...ik_e_D_Z_i_a_k_,_a_/_k_/_a_e_t_c_._
NO.63-71-.120
Deceased.
NOTICE OF FILING ACCOUNT AND AUDI~
To the Heirs,Creditors and other persons interested in said Estate:
Please take notice that the First and Final Account of
Michael Megles,Executor .
of the above estate,was filed in the Office of the Register of Wills
of Washington County,Pennsylvania,on__O_c_t_o_b_e_r_l_0~,__1_9_7_2 ,
and is docketed to the above number and term.
Also,please take notice that the Orphans'Court of Washington
county,Pennsylvania,has fixed,_~_F_r_i_d_a~y_,_D_e_c_e_m_b_e_r_2_2~,_1~9~7~2 _
at 10:00 o'clock,A.M.,E.S.T.,in its courtroom on the Third
Floor of the courthouse,Washington,Pennsylvania,as the time and
place for the audit of said account.
Respectfully submitted,
I
I
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TO:
November 13 ,19 72
Michael Dziak
R.D.#1
Scenery Hill,Pa.15360
IN THE COURT .OF COMJII0N PLEAS OF WASHINGTON COUN'ry,PENNSYLVANIA
ORPHANS'COURT DIVISION
ESTATE OF Mike Dziak,a(k(a etc.
NO.63-71-120
Deceased.
NOTICE OF FILING ACCOUNT AND AUDIT
To the Heirs,Creditors and other persons interested in said Estate:
Please take notice that the First and Final Account of
Michael Megles,Executor
of the above estate,was filed in the Office of the Register of Wills
of Washington County,Pennsylvania,on O_c_t__o_b_e_r__l_0_t_h__,__1_9_7_2 _
and is docketed to the above number and term.
Also,please take notice that the Orphans'Court of washington
County,Pennsylvania,has f ixed F_r_id_a_y_,_D_e_c_e_mb__e_r_2_2_,_1_9_7_2 _
at 10:00 o·clock,~A~.M.,E.S.T.,in its courtroom on the Third
Floor of the courthouse,''iashington,Pennsylvania,as the time and
place for the audit of said account.
Respectfully submitted,
.November 13th ,19 72 •
TO:Joseph Dziak
R.D.#1
Scenery Hill,Fa.15360
(
IN THE COURT OF COMMON PLEAS OF ,vASHINGTON COUNTY,PENNSYLVANIA
ORPHANS'COURT DIVISION
ESTATE OF Mike Dziak,a/k/a etc.
NO.63-71-120
Deceased.
NOTICE OF FILING ACCOUNT AND AUDIT
To the Heirs,creditors and other persons interested in said Estate:
Please take notice that the First and Final Account of
Michael Megles,Executor
of the above estate,was fi~ed in the Office of the Register of Wills
of Washington county,Pennsylvania,on.O_c_t_o_b_e__r __l_0~,__1_9_7__2 __
and is docketed to the above n~~be~and term.
Also.please take notice that the Orphans'Court of Washington
County,Pennsylvania,has fixed ~F~r_~_·d~a~y~,~D~e~c~e~m~b~·~e~r~2~2~,~=1~9~7~2~__
at 10:00 o'clock,A.M.,E.S.T.,in its courtroom on the Third
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Floor of the Courthouse,Washington,Pennsylvania,as the time and
place for the audit of s.aid account.
Respect~ully submitted,
November 13th 19 72-------------------,
TO:
George Dziak
R.D.#1
scenery Hill,Pa.15360
IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY,PENNSYLVANIA
ORPfffiNS'COURT DIVISION
ESTATE OF Mike Dziak,a/k/a etc.
NO.63-71-120
Deceased.
NOTICE OF FILING ACCOUNT AND AUDIT
To the Heirs,Creditors and other persons interested in said Estate:
Please take notice that the First and Final Account of
Michael Megles,Executor.
of the above estate,was filed in the Office of the Register of Wills
October lOth,1972ofWashingtonCounty,Pennsylvania,on ~___
and is docketed to the above number and term.
Also,please take notice that the Orphans'Court of Washington
County,Pennsylvania,has fixed F_r_i_d_a~y~,~D__e_c_e_m_b_e_r 2_2~,__1_9_7_2__.___
at 10:00 o'clock,~__~a~.M.,E.S.T.,in its courtroom on the Third
Floor of the courthouse,Washington,Pennsylvania,as the time and
place for the audit of said account.
Respectfully submitted,
November 13th,19 7_2_.
TO:Frank Dziak
R.D.#1
Scenery Hill,Pa.15360
IN THE COURT OF COMl''10N PL&,S OF WASHINGTON COUNTY,PENNSYLVANIA
ORPHANS'COURT DIVISION
ESTATE OF_--.:Mc:;J.:::"kc:;e::...;D=z.::i.::a::.;kC"'-,.....:;a:<./..:.k:<./...:a:o.....:e:.:t:.:c::..:..._
O 63-71-120N •_
Deceased.
NOTICE OF FILING ACCOUNT AND AUDIT
To the Heirs,Creditors and other persons interested in said Estate:
Please take notice that the First and Final Account of
Michael Megles,Executor
of the above estate,was filed in,the Office of the Register of wills
of Washington County,Pennsylvania,on__O_c_t_o_b_e__r_1_0_,__1_9__7_2 ,
and is docketed to the above number and term.
Also,please take notice that the Orphans'Court of Washington
county,Pennsylvania,has fixed,F_r_id_a~y_,_D_e~c_e_m_b_e_r_2_2_,_1_g_7_2_~._
at 10:00 o'clock,A.M.,E.S.T.,in its courtroom on the Third
Floor of the Courthouse,Washington,Pennsylvania,as the time and
place for the audit of said account.
Respectfully submitted,
TO:
November 13th,19 72
Pauline Dziak
R.D.#1
Scedery Hill,Pa.15360
=
,
IN THE COURT OF COr~~ON PLEAS OF WASHINGTON COUNTY,PENNSYLVANIA
ORPHANS'COURT DIVISION
ESTATE OF__M_i_k..;.e---:;:D..;:z..;.i..;:a..;.k=.:,~a",/...;k",/..;.a=-e=t",c..:.._
NO.63-71-120
Deceased.
NOTICE OF FILING ACCOUNT AND AUDIT
To the Heirs,Creditors and other persons interested in said Estate:
Please take no·tice that the First and Final Account of
Michael Megles,Executor
of the above estate,was fi~ed in the Office of the Register of wills
of washington County,pennsylvania,on October 10,1972
and is docketed to the above number and term.
Also.please take notice that the Orphans'Court of Washington
County,Pennsylvania,has fixed F_r_~_·d_a~y~,__D_e_c_e..;.m..;.b..;.e~r__"2..;:2~,~1~9~7;2_'____
at 10:00 o'clock,A.M.,E.S.T.,in its courtroom on the Third
Floor of the Courthouse,Washington,Pennsylvania,as the time and
place for the audit of said account.
Respectfully submitted,
___N_o_v_e_m_b_e_r_l_3_t_h:.:-_,19 72
TO:Helen Dziak
R.D.#1
Scenery Hill,Pa.15360
IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY,PENNSYLVANIA
ORPHANS'COURT DIVISION
ESTATE OF Mike Dziak,a/k/a etc.
NO.63-71-120
Deceased.
NOTICE OF FILING ACCOUNT AND AUDIT
To the Heirs,Creditors and other persons interested in said Estate:
Please take notice that the First and Final Account of
Michael Megles,Executor
of the above estate,was filed in the Office of the Register of Wills
of Washington county,Pennsylvania,on.O~c__t_o_b_e_r__l_0~,t_h~,__1_9_7_2 __
and is docketed to the above number and term.
Also ,please 'take notice that the Orphans'Court of washington
County,Pennsylvania,has fixed__~F~r~i~d.~a~y~,~D~e~c~e~m~b~e~r~2~2~,~1~9~7~2~__
at l__O_:_O_O o'clock,A__·~M.,E.S.T.,in its courtroom on the Tnird
Floor of the courthouse,Washington,Pennsylvania,as the time and
place for the audit of said account.
Respectfully submitted,
--'N"'o"-v!!:e""mb=::::e.::r-=1c;:3c::t~h:..__,19 72
I,
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TO:Mildred Dziak
R.D.#1
scenery Hill,Pa.15360
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ESTATE OF
Mike Dziak a/k/a
Michael Dziak,
deceased.
63,,71-1207No.__-.::..:::..-.:....:=----===--'--_
In the matter af the First and Final
Account of Michael Megles
Executor·
ADJUDICATION AND DECREE
And now January 9 ,19...13.-,this matter came on for hearing,
audit and distribution at this session and testimany taken;and thereupon,upan due consideration
ther3af a:f.jb.e §Qlance for distribution in the hands of the Accountant is determined to be
$:2 ,l:l2l:l.t)and the account is accordingly confirmed;and it is ordered,
adjudged and decreed that the said balance be paid out by the Accountant in accordance with the
schedule of disribution hereto attached and made part hereof,unless exceptions hereto be filed
sec.reg.or an appeal be taken herefrom sec.leg.
__~-"-.:L--"--"~~~.......a>-~
SCHEDULE OF DISTRIBUTION
Balance per accountr _
Additional debit asked at a udit
Additional credit asked at audit
Balance'_
inheritance
$23~4:[~
Deduct Clerk's Costs &Receipt's.s -
Attorney Jess D.Costa
Russell Marino,Agent,transfer
tax,
Interest from 8-29-72 to 1-19-73
Redebit -Legacies advanced prior to distribu~
tion by the Court,
Mildred Dziak,daughter,legacy under Paragraph
Second of the will,.credit to be taken by the
sccountant for funds in the amount of $1000.00
advanced prior to distribution by the Court,
54.50
2388.06
6000.,00
1000.00
Pauline Dziak,daughter,legacy,under Paragrap~
Third of the Will,credit to be taken by the
accountant for funds in the amount of $1000.00 .
advanced prior to distribution by the Court,.1000.00
Joseph Dziak,son,legacy under Paragraph Fourt~
of the will,credj,t to be taken by the account-
ant for funds in the amount of $1000.00 advance
prior to distribution by the Court,1000.00
$33,386.40
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George Dziak,son,1egacy.under Paragraph Fifth
of the will,,credit to .be ,ta,ken by the account-
ant for funds in the amount·,··of $1000,00 ad-
vanced prior ,to d~striqution by t~e Court,
, i..1000.00
Frank Dziak,son,legacy;,under Paragraph Sixth
of the will,credit·to~be taken by,the accoun-
ant for funds in the amount of $1000.00 advance~
prior to distribution·by the qourt,1000.00
Helen Dziak,daughter,legacy under Paragraph
Seventh of.the will;credit to be taken by the
accountanttfor funds in the amount 'of $1000,00
advanced pr1orto distribution 'by the Court,,.,
,"
Frank Dziak,son,bequest of grave plot in the
Sacred Heart Cemetery,held in kind and distri-
buted as such at the appra.ised ~a1ue,
Mary Schwartz,daughter,1/9 r~sidue,
Anna Zamiska,daughter,1/9 residue,'.....~
Michael Dziak,son,1/9 resldue;
Joseph Dziak,son,1/9 residue,
George Dziak,son,1/9 residue,
3370.72
3370..71
3370.71
3370.71
3370.71
Mildred Dziak,daughter,i/9 residue,3370.71
Pauline Dziak,daughter,1/9 residue,credit to
be taken by the accountant for funds in the
amount of ~1000.00 advanced prior to distribu-
tion by the Court,3370,71
Helen Dziak,daughter,1/9 residue,credit to b
taken by the accountant for funds in the amount
of $1000,00 advanced prior to distribution by
the Court,3370.71
Frank Dziak,son,1/9r!"sidue,credit to be
taken by the accountant for funds in the amount
of $1000.00 advanced prior to distribution by .
the Court,3370.71
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NO.63-71-1207
:
ORPHANS'COURT DIVISION
ESTATE.OF
MIKE DZIAK,also known
as MICHAEL DZIAK,
I
IN 'rHE COURT DE'COMMON PLEAS OF'vlASHING1.'ON COUN'rY,PENNSYLVANIA I
III
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Deceased ,.
IN RE:
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R E C E I P T
._H~E=L=E=N~D=Z~I=A~K ~,do hereby acknowledge toI,
making a total of Three Thousand Three hundred Seventy and
share in the above captioned Estate as per Adjudicaticn and
Dollars heretofore advanced and the balance of Two Thousand,
Michael Dziak,deceased,the sum of One Thousand ($1,000.00)
dated January 9,1973,at the above number and term;and I
Three hundred Seventy and 71/100 Dollars ($2,370.71)in cash,
71/100 Dollars ($3,370.71)in full satisfaction of my distributi~e
"
Decree of the Orphans'Court of washington County,Pennsylvania.
I
have received from the Estate of Hike DziaJc,also known as
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authorize and direct the Clerk of the Orphans'Court to mark
said award satisfied of record.
Dated this II...,1973 .
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H-·-E~--;P"D'-Z';;'I-A-K-=-=:.:/Jd~~·c---·----(SEAL)
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IN THE COURT OF Cm1MON PLEAS OF WASHINGTON COUNTY,PENNSYLVANIA,
ORPHANS'COURT bIVISION
IN RE:ESTATE OF
MIKE DZIAK,also known
NO.63-71-1207
as MICHAEL DZIAK,
Deceased.
R E eEl P T
I ,,M_I_LD_R_E_D_D_Z_IA_K ,do hereby acknowledge to
have received from the Estate of Mike Dziak,also known as
Michael Dziak,deceased,the sum of Three Thousand Three Hundred
Seventy and 71/100 Dollars ($3,370.71)in full satisfaction of
my distributive sha"re in the above'cap.tioned Estate as per
Adjudication and Decree of the Orp~ans'Court of Washington
county;Pennsylvania,dated January 9,1973,at the above
number and term;and I authorize and direct the Clerk of the
Orphans'Court to mark said award satisfied of record.
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Da ted this /...;
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_'chLLIZJ~'4'.i4..£4f~'--...L4=~101i:::.~~='_'_(SEAL)
MILDRED DZIAK
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IN THE COURI'OF COMMON PLEAS OF NASH ING'rOW COUN'l'Y ,PENNSYLVANIA,
ORPF~NS'COURT DIVISION
IN RE:ESTATE OF
.frUKE DZIAK,also known
NO.63-71-1207
as MICHF.EL DZIAK,
Deceased.
R E C EI P--!
I ,,__--:MA=R:::Y=-:::S.::C.=HWA:.:.;;:;:.:R::T:.:Z=-,do hereby acknowledge to
have received from the Estate of Mike Dziak,also known as
Michael Dziak,deceased,the sum of Three Thousand Three Hundred'
Seventy and 71/100 Dollars ($3,370.71)in full satisfaction of
my distributive share in the above cap~tioned Estate as per
Adjudication aud Decree of the Orp~ans'court of Washington
.County,Pennsylvania,dated January 9,1973,at the above
nurr~er and term;and I authorize and direct the Clerk of the
Orphans'Court to mark said award satisfied of record.
,
III
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Dated this /'I day -'1973.
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county,Pennsylvania,dated January 9,1973,at the above
have receiv(~d from the Estate of Hike Dziak,also known as
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I,1973.
Thousand Three Hundred i
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NO.63-71-1207
EC
Of!~
~/)~~.~!J~4~/~~:....e...-'_{SEAL}(JOSPff DZIAK/-
R . E
ESTATE OF
Dated this_L(~!~'__~day
I "J_O_S_E_P_H_D_Z_I_A_K ,do hereby acknowledge to
IN RE:
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IN THE COURT OF COl'olMON PLEAS OF WASHINGTON COUNTY,PENNSYLVANIA,I
ORPHANS'COURT DIVISION j I
I
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number and ter~m;and I authorize and direct the Clerk of the
Orphans'Court to mark said award satisfied of record.
my distributive share in the above captioned Estate as per
Adjudication and Decree of the Orphans'Court of Washi.ngton
as MICa~EL DZIAK,
Michael Dziak,deceased,the sum of Three
seventy and 71'/100'Dollars {$3,370.71}in full satisfaction of
MIKE DZIAK,also known
Deceased.
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NO.63-71-1207
R E C E I P T
as MICHAEL DZIAK,
Deceased.
COMMON PLEAS OF WASHINGTON COUNTY,PENNSYLVANIA,.I
ORPHANS'COUR'l'DIVISION .
I,A_NNA ZA_M_I_S_KA ,do hereby acknowledge to
Seventy and 71/100'Dollars ($3,370.71)in full satisfaction of
Michael Dziak,deceased.the sum of Three Thousand Three Hundred
MIKE DZIAK,also known
have received from the Estate of Hike Dziak,also known as
IN RE:ESTA'l'E OF
IN '£HE COURT OFIj
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my distributive share in the above captioned Estate as per
Adjudication and Decree of the Orphans'Court of washington
County,Pennsylvania.dated January 9,1973.at the above
number and term;and I authorize and direct the Clerk of the
Orphans'Court ·to mark said award satisfied of record.
Dated this ,1973.
---",L==~a./!=<:....d~·~=·.:::::........:..L_:::'::~~_(SEAL)
ANNA ZAMIS~
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NO.63-71-1207
R E C E I P T
said award satisfied of record.
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day 0 f-;;:>".2;~:::=::::::::~::::::¥-'1973.Dated this 1/);
ORPHANS'COUR'I'DIVISION
Ii
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making a total of Three Thousand Three hundred Seventy and
I,F-'-RA'-'-N_K-"D..;;Z;;..:IA:.;.c.K ,do hereby acknowledge to
Three hundred Seventy and 71/100 Dollars ($2,370.71)in cash,
o
MIKE DZIAK,also known
as MICHAEL DZIAK,
IN RE:ESTATE OF
Michael Dziak,deceased,the sum of One Thousand ($l,OOO.OO)
dated January 9,1973,at the above number and term;and I
Deceased.
authorize and direct the Clerk of the Orphans'Court to mark
IN THE COURT OF COMMON PLEAS OF WASHINGTON COUNTY,PENNSYLVANIA
have received from the Estate of Mike Dziak,also known as
I71/100 Dollars ($3,370.71)in full satisfaction of my distributive"I
share in the above captioned Estate as per Ad"iudication and I
Decree of the Orphans'Court of Washington co~nty,Pennsylvania ..I
Dollars heretofore advanced and the balance of Two Thousand,
I
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!'IN THE ~OURT OF COMMON PLEAS OF WASHINGTON COUNTY.PENNSYI~ANIA I
ORPHANS'COURT DIVISION
AULINE DZIAK
dated January 9.1973.at the above number and term;and I
said award satisfied of record.
I
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TPI
NO.63-71-1207
ECER
ESTATE OF
PAULINE DZIAK1.•do hereby acknowledge to
71/100 Dollars ($3.370.71)in full satisfaction of my distributive
Michael Dziak.deceased.the sum of One Thousand ($1,000.00)
as MICHAEL DZIAK.
MIKE DZIAK.also known
share in the above captioned Estate as per Adjudication and
Deceased.
IN RE:
have received from the Estate of Mike Dziak.also kno~n as
Decree of the Orphans'Court of washington county.Pennsylvania.
Dated this.~,~;1~/day
authorize and direct the Clerk of the Orphans'Court to mark
I
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!IIiIi'Dollars hereto,fore advanced and the balance of 'l'wO 'rJlOusand
II Three hundred Seventy and 71/100 Dollars ($2.370.71)in cash.I .
,making a total of Three Thousand Three hundred Seventy and
I
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IN THE COURT OF CO~~10N PLF~S OF WASHINGrON COUNTY,PENNSYLVANIA,'II
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II
"II IN HE:ESTATE OFI,
ORPHANS'COURT DIVISION
11,'.
MIKE D7.IAK,also known
NO.63-71-1207
as MICHAEL DZIAK,
Deceased.
II
R E C E I P T
nillnber and term;and I authorize and direct the Clerk of the
I
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IThousandThreeHundredI....
..,
full satisfaction of
tij.....·t?f"",.~t:=:==::>.>t----'1973.
MICHAEL DZIAK.,do hereby acknowledge toI,
Dated this--L~day of
Orphans'Court to mark said award satisfied of record.
Seventy and 71/100 Dollars ($3.370.71)in
Michael Dziak,deceased,the sum of Three
Adjudication and Decree of the Orphans'Court of I'lashington
my distributive share in the above captioned Estate as per
have received from the Estate of Mike Dziak,also known.as
County,Pennsylvania,dated January.9,1973,at the above
II
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(,
as MICHAEL DZIAK,
Deceased.
MIKE DZIAK,also known
I
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II
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_,do hereby acknowledge to
NO.63-71··1207
:
R E C E I P T
ORPI:Ll\.NS'COURT DIVISION
GEORGE DZIAK1,,_
IN RE:ESTATE OF
have received from the Estate of Mike Dziak,also kno\vn as
Michael Dziak,deceased,the n\l.'U of Three Tho"usand Three Hundred
Seventy and 71/100 Dollars ($3,370.71)in full satisfaction of
IN THE COURT OF COI'!L"!ON PLEAS OF itJ.l\.SHINGTON COUNTY,PENNSYLVANIA,
'.J:,
my distributive share in the above captioned Estate as per
I!Adjudication and Decree of the Orphans'Court of \\fashington
'I county,Pennsylvania,dated January.9,1973,at the above
number and term;and I authorize and direct the Clerk of the
Orphans'Court to mark said award satisfied of record.'.
Dated this /ItA ,day of ~__,1973.
1
I
IIiI
f!I!
---------------------
j
WASHINGTON
bs-7/-/rJ 67
~.".~COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
COUNTY OFRESIDENTDECEDENT
Form RCC-33
IMPORTANT:This return must be completed in 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 hy the Secretary of Revenue.(Section 703 of
the Inheritance and Estate Tax Act of 1961.)
_tors:
..........}ss:
._.
of the estate of ·the above-named decedent being duly sworn,depose S and say
\'iFi'l~h:i,!lg1:C:>Il.
Michae1 ~E:l.g!~~.
County of
Administrator
IN THE MATTER OF THE ESTATE OF }MIKE DZIAK,also known as AFFIDAVIT OF
MLCHAEL..D.ZIAK....EXECUTOR
(State full name of decedent)
Late of .SQro.g.r..~.~j::.TqWJ:!~h:i,p<.washing~<munty ADMINISTRATOR
Stole of .I'ennsy:J,.yan:i,g,
Decedent dJed ~9.Y~~~\~29th··{i·~~·)··········,19,.(Z!";i ..,{~~:::::t~eaVing a last will,copy of which is hereto attached.}
Name and address of attorney or}
other authorized representative to .
whom all correspondence should be
mailed.
J.D.Cq51:i'lL ];:~q,............
107 Main Street,Bentleyville,Pa.15314
That as such EXg~~j;.Ql::deponent is familiar with the affairs of said estate and the property con-
(fo;::u~~tor·AdmjnislraLorI
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 rightof 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 JOINTINWHICHDECEDENTRENTEDASAFEDEPOSITBOXINNAMEORNAMESOFHOLDERSTODECEDENT
~--------
That the contents of said saf'e deposit box or boxes are i temtzed tmder Schedules o:r this
return,with the exception o:r the f'ollowing,:ror the reasons hereina:rter set :rorth:
That Sc.hedule A attached hereto and made part hereof'sets forth :fully and in detail all the
real property in the Commonwealth ,of'Pennsylvania of'which decedent died having an interest therein.It
also sets f'orth the mortgage encumbrances upon each parcel o:r real property at the date o:r 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 there:rore the assessed valuation of each of'said
-parcels,the estimated market value thereof as of'date o:r death of decedent.
That Schedule B attached hereto and made part hereof sets :rorth :fully ~nd 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".cdo·~··to 'the last
interest-day prior to decedene 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 othe:r·oevidence.of'in-
debtedness of the United States to the decedent;all obligations,whether by stat~t~!~r agreement they
are designated as tax free,of the United States,or any state,or political SUbdivis~on:thereof,or of
any foreign country,-which are owned at the time of'death;all wearing apparel,jew~lry;silverware,pic-
tures,lJooks,works of'art,household :furniture,horses,carriages,automobiles,bo~-t,~~<a~d any and all
other personal chattels of'whatsoever kind or nature,left bydecedent,together with \h~'fairly estimated
market value thereof';all bonds and mortga,fles held by decedent and of all claims due ~and owing decedent..
,l t the time of'death,and all promissory notes or,other instruments in writing for tJ:1e payment of'money
of which decedent died possessed,of whatsoever nature,wi th 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 to each item;all moneys payable
t.o the estate from life insurance polici'es carried by decedent;all annuity and endowment contracts the
vroceeds of which were payable upon the death of the decedent;and all the corporate stocks and dividends
rille t~ereon 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
va.lue Ulereof'at such time.
"
.i.
In the case of securities of close or famil,)'corporations,the values reported are as far as
posSiible substantiated by financial statements'of the corporations,showing the assets and I,labilities
~pe~eof,as of t~e date of death.The ~chedule also sets forth the interest of decedent at the time of
deatn in-any co-partnership or business,and 1n support of th~vsaue of such interest'there is annexed to
said schedlile,financial statements shoWing the assets and liabilities of-said co-partnership or business.
A copy'jof the co-partnership ag"reemen't,(if oral;a sta.tement setthi.g f'orth the nature of toe·agreement)
together.with a statement setting forth the charact~r of the .business,its location,'and ~uc.h other facts
pertaining to the l;msiness as may be pertinent to a fair and .lust'appraisal of the aecedent's interest
therein mllst 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 attache~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,wtthin 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 decerlent,the proportionate share received by each transferee and
all,other facts of a pertinent nature regarding sain transfers.In the case of transfers intended to
take effect in possession or enjoyment at or after death,there is also attached ~o the scherlule a coRY
of the deed,trust agreement or ~ther instrument creating the trust.The~,~is also set forth in said
schedule a list of all property,real and personal,with its value,Which pa€ses 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 jo,intly,by the Will..,deed,or otper ,instrument of another,
with a copy of the instrument creating such power p-ttached to ~he schedule.
That Schedule 0 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.~ature of their res-
pective interests,their relationship,if any,to the decedent,together with t~e ages at the time of
decedent's death of all minors,annuitants and beneficiaries for life under decedent's ·Will.It also
coritai.ns a statemen't showing which of the beneficiaries named'in.the decedent's ,will,,If any,-died prior
to'decedent,the dates of ·their death,thefr issue,and the -relationship of"·such ,is~ue t()the-beneficiary•
.."That S{/'Iedule E attached her'eto and made a part hereof sets forth all property,real and per-
sonal,o~ned by the decedent jointly with another or others,including 'intangi?ie~st'anding in the 'name
of the·decedent and others,plus the date and place of record of i~struments,ef,fecting the .vestiture of
real estate and the date of acquisition of pers'onalty,plus the name,.address and_relationship,if any,
of'co-owners to the decedent.
That Sc/'ledule F attached hereto and made a part hereof sets forth 'fully ~nd in detail all debts
and deductions claimed for and on behalf of this decedent's estate,inclurling f'uneral expenses paid;
family exemption,where applicable;cos'ts of administration of this ~state;counsel fees and fudiciary's
co~issions 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 unpairl at time of
death;texes accrued chargeable for period prior to decedent's death (except those allowed under Section
651"or"the Inheritance and Estate Tax Act);together with a state"ment of collateral pledged for obliga-
tions,.'if any.It is agreed that the fiduciary will present 'proof of said claimed obligatio."s upon re-
qu:est,that if the amount actually paid 'in settlement of any fee',commission or :debt is less than the
es'timated 'amount claiming and allowed,that the same will be reported to the Regtster of WillS,and that
the ~ount'of tax assessed can be reassessed in accordance therewith.·
...i~.m m.m ~•••••,••••••••_•••••••••_••
(Executor-dmin')
.~.~.~~~.:'.J::1.~.r.':'3.::':..<:>.~~~~~__.__.
(Street Number).
C0l<f;.I.:>?J:~.~.....I'f;~.rl~~....~..?3.24
(City or Town and State)
Subscribed and sworn to before me thi~~
"'../2f ;/-,72:.dayo~~19 .
.~~m ••~••'M .
.......:?-Tiilp~SA '.nin
N,;it;~!tC·ntnniwp."':·~:,h,..·;:t"~~n.
~h ~i:i,~..~:pt 'f'IN!r 3..1.973
.~NOTE:Before Sig_~.lng affidavit make sure all blank spaces 1n 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 Rttached.Also make
certain th~t column #1 in the "Summary"has been properly completed as above-directerl.
That t~e tQtals of the appropriate columns in SchedUles "A","B","C","E",and "F"as directed therein,
have ~een carried.forward and properly registered in the Summary.
RCC-34 (Hi4",.
COMMON\VEA~TH OF PENNSYLVANIA
OEPARTMEIH OF REVENUE
BUREAU OF COUNTY COLLECTIONS
TRAN'SFER INHERITANCE TAX
RESIOENT OECEpENT
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 tenoncy by entireties,report on Schedule "E".Property held by
the decedent as tenant in cammon 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 with
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·
eras;also statement of mortgage encumbrances upon each parcel at death
of decedent.Taxes,ossessments,accrued interest on mortgages,etc.,are
to be listed on Schedule llF"and must not be deducted from this schedule.
ALL that certain tract of land
situate in Somerset Township,Washington
County,pennsylvania,bounded and described
as follows:
(1 )
ASSESSED VALUE
FOR VEAR OF
DECEOENT'S
DEATH
(2)
ESTIMATEa
MARKET VALUE
(31
DEPARTMENT
VALUATlON
CAUTION
(Do not write
in this space)
BEGINNING at a corner on land now or
formerly of M.Tombaugh;thence South l5~0
East,72.16 perches to a stone on land now
or formerly of John Freeman;thence South
38 0 East,34.32 perches to a walnut;thence
South 20~0 East,48 perches to a stone;
South 47~0 East,131.3 perches to a post;
North l4~0 West,15.76 perches;North 1
3/40 East,7.48 perches;North ll~o East,
24.8 perches;North 30~0 East,19.44 perche ;
North 29~0 East,25.36 perches;North 5~0
West,8.32 perches;North 12 1/80 West,
75.24 perches;North 5~0 West,9.6 perches;
North l2~0 East,17.68 perches;North 41 0
West,8 perches;North 16 3/40 West,7.72
perches;North 8l~o west,28.2 perches;
Notth 35~o West.76.2 perches on land now
or formerly of M.Mankey;South 66~o
West,98.8 perches to the place of
beginning.
CONTAINING 156 acres,118 perches.
EXCEPTING and RESERVING hereout and
herefrom.the following described
parcels heretofore conveyed:(1)2.66
acres,described in Deed Book 402,page
590;(2)15 acres,more or less,described
in Deed Book 480,page 677;(3)12 acres,
more or less,described in Deed Book 487,
page 442;(4)10 acres,more or less,
described in Deed Book 492,page 58;
(5)19.472 acres,described ,in Deed Book
702,page 254;(6)0.380 acres,described
in Deed Book 911,page 630;and (7)1.366
acres,described in Deed Book 1023,page 50n.
UPON which is erected a frame
dwelling and barn,and other out buildings,
having a value of .•.....••.•.•••...••.•.••.••...•••....$35,200.00
tf--I(»J..,(l-
Insert this total apposite "real property".Schedule "A"in the
"As Reported"column an the last page of this return.
XXXXX $35,200.00
~cI/lf
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE 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 wi~h .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.D.D."U.S.Savings":B{:mdS and tenta-
tive trust accounts,must be listed,despite the fact that they are not of the administer~d ~state.
Tangible personal property should be listed first (e.g.jewelry,wearing app,ar.e1,household
goods,and furnishings,books,paintings,automobiles,boats,etc.)."
Intangible personal property,such as bonds,treasury certificates,cash o~',ha!14 ,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,any~n~istributed
es tate of or income from any property held in trust under the will or agreement of anoth~~,'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
UNIT
VALUE
ESTIMATED
llARKET VALUE
DEPARTMENT VALUATION
(Do not write in
this space)
#...507.5.77/
..5>.5tff.S os-
?..<>7,/3
..j~?rf,/~
S.5tJ.&tJ
/ ..J'~
/Ie?b£/
015."/01
Sc!?CJ(!J
1.35
25.42
50.00
42.64
588.12
827.13
350.00
.~~~L~vestock ......................•.••.•••••PI'-;.:.I?5,375.77
Farm Equipment &Miscellaneous Items •••••~!'?~5,589.55
Milk,Inc•••..••...••....•.........•......tY.f:'/f!..J..
straw,corn,oats and hay.•.•..•.•....•...~~fC
united Mine Workers,death benefit •....••~~
Atlantic Breeders Corp.,stock refund •...~J.1~
Atlantic Breeders Corp.,Stock•.•....•.••~~
Harleysville Insurance Co.,Premium refun~~~
Burial Lot,Sacred Heart cemetery•....••~~~~.
~
Insert this total opposite npersonal Property",Schedule "Bn 1n
the nAs Reported"colWlDl on the last page of this return.
x X 12,849.98
~jJJ.j'.-
,RCC-3.b
COMM0NWEALTH OF PENNSYLVANIA
TMNSFEFl INHERITANCE TAX
RESIDE:-lT DECEDENT
SCHEDULE "c"
TRANSFERS
(1)Dirt decedent,within two years of de11th,make any transfer of any material part of his estate,without
receiving a valuable and adequate consideration therefor?(Answer yes or no)no
(2)Did rlecedent,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 or transfer -,-_
(b)State of decedent's health at time of making the transfer.(Note 1).
(c)Cause of decedentls 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)__
(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:no
(a)The possession or enjoyment of or the right to income from thE.'property transferred?
(Answer yes or no)__~~~__
(b)The right to designate the persons who shall possess or enjoy the property transferred or
income therefrom?(Answer yes or 00)_
(6)If the answer to (5)(b)above is in the affirmative,state whether the right was reserved in decedent
alone or others-,-~--,--,--,-~~-~~-~--=---~~-----,-:----,-----=--~:-c--,------,---=-----;-----~-(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 c01l1d revert to decedent under terms
of transfer or by operation of law?(Answer yes or no)~--=-n,-o,----_-:--_
(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 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 of facts on which said claim is based.
NOTE 3:List applicable property below in manner in which provided 1n Schedules A,B,or E.
ITEM
None.
DESCRIPTION MARKET VALUE
(Es timated)
DEPT.VALUATION
(Dept.Only)
Insert this total opposite "Transfers",Schedule "C"in the
"As Reported"colwrm on the last page of this return.
K.CC-::iH
COMMONWEALTH OF PENNSYLVANIA
TnA~SF1,1\INHElU TANCE TAX
RF:SIllENT DECEDENT
SCHEDULE "E"
JOINTLY OWNED PROPERTY
I~STRrCTIO~S:This schedule must disclose all property,real and personal,ownerl by the decedent jointly
wi th 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 instrwnent 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 acquisi tion,and the name,address and relationship (if any)of co-owners to
the decedent.
Description of Property,Date of Acquisition,Name 1 unit
Address and Relationship of Co-Owners,and Place I Value
of Record of Instrument,where Real Estate.1
None.
percentage
Share
Estate
Valuation
DEPARTMENT VALUAT10N
CAUTION-Do not Write
In This Space.
Value of Value of
Entire Decedent's
Property Interest
Insert this total opposite "Jointly Owned Property",Schedule ·"E"
in the"As Reported"coltUlDl on the last page of this return.
RCli-37 \12-63).
CO~l~lON\\:EALTH OF PENNSYYLANIA
TRANSfER INHERITANCE TAX
RESIQENT DECEDENT
•<•
SCHEDULE "0"
BENEFICIARIES
BENEFICIARIES AND ADDRESSES RELATIONSHIP SURVIVED(If step-children or DATE INTEREST OFStatefullnamesandaddressesofallwhoillegitimatechildrenDECEDENTOFBENEFICIARY
ave an interest,vested,contingent or other are involved,set STATE YES IN ESTATE
wise,in estate)forth this fact.)OR NO BIRTH
Mary Schwartz Daughter Yes 1/9th
Cleveland,Ohio
Anna Zamiska Daughter Yes l/9th
Cokeburg,Pa.
Michael Dziak Son Yes l/9th
R.D.#1,scenery Hill,Pa.
Joseph Dziak Son Yes l/9th
R.D.,jj,l Scenerv Hill,Pa.
~nzi"k Son Yes l/9th
R.D.#1,Scenery Hill,Pa.
Frank Dziak Son Yes 1/9th
R n ,jj,l C:~onorv U;11 o~
Pauline Dziak Dauqhter Yes 1/9th
R.D.n Scenerv Hill,Pa.
Helen Dziak Daughter Yes l/9th
R.D.#1,scenery Hill,Pa.
Mildred Dzaak Daughter Yes 1/9th
R.D.#1,scenery Hill,Pa.
\
h
Deponent further says that all the above-named beneficiaries are living at this time except below:
NAME DATE OF DEATH RESIDENCE
-.,
OF THE
ESTATE OF
\IATTER OF THE APPRAISEl\mNT
(Executor-Administrator
must complete "As
Reported"column #1.)
•....,."::02~co
::I C e:...~::s ."'"'"~~-0~'0
."'"~~o ~'0 '<
!!?~
o~o~~....,
'"x~'"M~""
Year
Dl"THE
~No.
Will
Administration
MIKE DZIAK,also known as
..MI.C:aAEI,..DZIl'>K..
Deceased
Late of SOllle:r$et'l'OWTI$hip
County of Washington.
Common\H";.l!th of Pennsylvania
REPORT AND APPRAISAL
,
enc:~
~;.-
::0
en Vl cn-.....c::
r'>r'>r'>?"?"?"
rl t>i ;;
::~;:
•
-.
'lid '"00 NO,LON/HSlfll\
Slllh\.dO U3J.S/:)31I
ONIlJlli'l insSOd
'"'"'"'"'".01:>'f-O 'W,co :f\.):V1 ..-.•;...;..-;.-
'0 :(X):1\)VI
'01:>,01:>,0 ::0
\":\0 :0 til::::.:.:..~-,'"\0 :0::;,co :00 :0 [._.
~I II ~IV ".d35 u.
'03"IJ I..:rJessD.costa,Esq.
-oo~.oo-w
'-C::..
~""".'C),-,'".-;-C:\
~
<li'ffi
~(..>~~Gt;
-.e:.jl...>&~-:~:(':tv.':..,-,3-t;>.<:::l ::'
'"<:;j coc.
"
RCC-81 (6-71)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
HARRISBURG
17127
NOTICE OF FILING OF APPRAISEMENT
MICHAEL MEGLES
(Executo~
IN YOUR REPLY PLEASE
REFER TO
Inheritance Tax Division
3S-229-2
JI
I
I
In Re:Estate of MIKE DZIAK a/k/a
WASHINGTON County _File No.__6_3.:...-_7_1-_1_20_7 _
Dear Mro Meg1es,
You are hereby notified that the_-"o""r",i."a",l.",·n"-a"""1 _
appraisement in the estate of -"M"'I"'K"'E!:--"'D"'Z"'I"'AK""-_
has been filed in the office af the Register of Wills of WASHINGTON
Cauntyon October 3 ,19-22,Said appraisement reflects the fallowing
valuations:
Real Estate 3_S--=,_2_0_0_00_0 _
Pe rsanaI P raperty 1L 2,,-,-,QS-'l4c:l9~0c.:9ZJ;S2..-_
Transfers _
Jointly Owned _
T otaI --=4".,S"-','-"0'-"4'-'9:...0-"'9"'S'-----_
As to such tax that is paid within three months fram date of death,a five (5%)
percent discount is allowable.As ta any tax that remains unpaid after nine (9)manths
(fifteen manths when death occurred from December 22,1965 to June 16,1971,inclusive;
and twelve manths when death occurred prior to December 22,1965)from date of death,
interest at the rate of six (6%)percent per annum is charged.
Any party in interest who is aggrieved by an appraisement may appeal therefrom
as provided by law.
Date __O,,-c::.t.=o.=b=e.=r---=3C!,--=1:.:9:...:7c.:2,,-__Signed~J~•
Titl~,Ly-~",,<eJ
DATE OF DEATH:Novemper 29,1971
Nate:This is not a bill.
.-;.
RCC-39 (&-68)
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SUMMARY
"';.';'.-.'_''._~--.r..~5(Y76
Estate of DZIAK
(Last Name)
MIKE
(First Name)
a/k/a
(Initial)
DATE OF DEATH 11-29-71 FILE NO.63-71-1207
REPORT OF INijERITANCE TAX APPRAISER
Dated:----'=O'-'c""'t""o<-"b""a...r'----'3'-','---'1"-'9"-'7'-'2'----~-
I,the undersigned duly appointed Inheritance Tax Appraiser in and for the County of__W.;..AS--=-=-H.;..I.:.N.;..G=-T_O=-N _
Pennsylvania,do respectfully report that I have appraised the rea!and personal property as reported in the foregoing return at
the values set forth opposite each item in the last column to the right in Schedules "A","B","e",and "E".
~~~
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 elF",which greater or lesser amount represents the sum
allowed as a deduction.
Dated:~
REGISTER OF WILLS
$'I'i 70r or
12 849 98
48,049 98
NONE
48,049 98
$'I'i 7[J[)
17 84q Iq8
.48.049 98
NONE
48,049 98
VALUE AS REPORTED VALUE AS APPRAISED VALUE AS REAPPRAISED
$~------1f----
INVENTORY
Real Property (Schedule A)
Personal Property (Schedule B)
Transfers (Schedule C)
Joint-Held Property (Schedule E)
TOTAL GROSS ASSETS
Le.s Debts and Deductions
(SCHEDULE F)
CLEAR VALUE OF ESTATE
Valuation of life estates or
annuities.. . . . . . • • . . . . . . • . . .$-1
ESTATE TAX ASSESSMENTS $----'
(0)As evidenced by Charitable
Exemption Certificates issued
by the Secretary of Revenue.$
1=
$
$
C
$
COMPUTATION OF TAX
$------+--
$------+--
$------+--
$-------4--
$------+--
___1-
TOTAL TAX BALANCE :------1-.PAID $C
Less tax previoilsIy paid $,======BALANCE $__
Less 5%of tax if paid within
3 months after death $'=========
TOTAL TAX
BALANCE OF INHERITANCE TAX DUE
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
-------Ito-----
Tax on $-+_-\-"6~%y'
Tax on $-+__5%
Tax on $10%
Tax on $15%
&e~tions *
Total Estate -'--__
FOR USE OF REGISTER ONLY
Tax on$2%
FOR USE OF REGISTER ONLY ADJUSTMENTS
NOTE:Where subsequent adjustments are made to the above computation of tax by the Register of Wills,for proper reason,
same should be noted below,with short explanation.
Will
Administration t No.
IN THE
Year
MATTER OF THE APPRAISEMENT
OF THE
ESTATE OF
.MII(EDZIJlJ(..a/kla
Deceased
Late of SOMERSET TWP.
County of WASHINGTON
Commonwealth of Pennsylvani·a
.REPORT.AND APPRAISAL
..'
..
;.
~';
.'
•
.:<
,,~
"
Funn RCC-2
DEPAI!TMEl':T OF REVENUE
-;.~\'..
BURllAU OF COmiTY COLLECTIONS
HARRISBURG.PENNA.17127
COMMONWEALTJI OF PENNSYLVANIA
RESIDENT INHERITANCE TAX
APPRAISEMENT
DATE QctQber3.•..19.7.2.....
COUNTY WASHIN~':r.9.~.
FILE NO...§}:::?~::::I,~q?.
Whereas.~:P9i:p~:J::M ..~g,.m..late Of.m ..QQM;!i;Rs.j!:T~.TWP,.
in the County of ...WASHIN.GTON ..Commonwealth of Pennsylvania.having died on
the...2.9..th day of N.Qvemb.er......19 .7.1.seized and possessed of an estate
subject to Inheritance under the laws of the Commonwealth of Pennsylvania;
Therefore.I..v.~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 alI annuities and life estates growing out of said estate.hereby file the folIowing 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 Appralsemant
Description of Auet Values Made for Inheritance
Tax PurpOlfll
$..
REALTY:..
'\<;.'00 00SEECOpyATTACHEDTOAPPRAISEL
PERSONAL:
SEE COpy ATTACHED TO APPRAISEL 12.849 98
total 48,049 98
.
..
,
..
,
f,=::;:~bl:~::rb~:""m g
to."::,~.reb'::,.t../:;l'iy~....;",....""'K<..."'h..,~.~,..{.~~~.
~~~'('J.....................::~.~~~~~..~.,..,',Penna.
..".f
WASHINGTON County
RESIDENT INHERITANCE TAX APPRAISEMENT
Estate of
MIKEIXz;J:AJ<a/V"".
Deceased.
Late of
SOMERSET NRTWP.
Datc of Dcath,11-29-71
Ii
Appraiselllc"t Docket Vol.,3.8 .
Page,.~~2~.~No.§3~7J~:J,~Q7.
Filed ill Register's Office,Oct.3 19 72
A"wunl of tax due,$..
DEPARTMENT OF REVENUE
Received,
Examined and Approved,....
Wrote abo.llt Appraisement,...
Appeal f~oHI Appraisement,....
Entered and charged,..
."\"0",,(,\,~"\\.\S'J~~va ...1 1'11....,_....\"1
Sll
'"r ',j'J \C;\~3\l ..l rtJ,-'\.J C -l ..l.....Cl\\\L','~\~y\3';S\\'b
~hi.I,-\c\.II ~Wl'tL.
'n '3 ~\\,:l ..
-1---I-LE!tl:'I!!::.~L--L---L..LLC~U!LL---(L.5.)
DAY OP'
STATEMENT OF DEBTS
AND DEDUCTIONS
R!'.M'JTH~C-o<-".;!.'.0 __,-
COUNTY
TW'lFSi 'IIUTO
I,
.,
COUNTY OF Washington
Michael Me les--~===='-"===:----------_J~-----HEREaYCERTIFY,TH.....T.TO THE BEaT OF
FUNE AL
Mike Dziak,alk/a etc.Somerset TownshipESTATEOF_~_---:=-~=-=-:...:...--.:..~---=---::....LATE OF ---='-_
MY KNOWL~DGE AND BELIEF,TH~FOREGOING IS A JUST AND TRU E BTA EMENT OF DEBTS,
ADMINISTRATION SUBMITTED TO THE ESTATE OF Mike Dziak k a etc.
INHERITANCE TAX PURPOSES.
AND AGENT OF THB COMMONWS.....LTH
•
OFFice OF TME
I,RATER OF WILLS
OF Wa h~n ton
"Form RC(:·lO
DATE OF FILING APPRAISEMENT OATS OF DEATH
DATE NO.0 .../II .Yo ~M~P~".~•Jm/.!All.j"J~1itI.AAIAq:,w ~.I8lNTA/lVOUCHIi'"~.H.
W 1 'T ,V!;I/};-'IV""/if.VI .I ",.~,.'/
John N.Dugan Insurance Prem~um 155 00
Rev.M.Gubanich Burial Services 25 00
Kenneth V.Thompson Burial expense 1.018 71
Mon Valley Eqpt.Co.Supplies 1,283 16
Malcolm Morgan,Co.Tl!!eas.Co.Tax 50 53
Atlantic Breeders Corp.Breeding 36 50
,
Patsy DeBerardinis Cows 394 00
Charles R.Wood,Vet.Services 5 00
Edwin Smell Gringing 23 25
Kefauver Hardware Feed 11 30
Edgar Feed &Supply Feed 390 22
Quinet Monument Co.Lettering on Monument 20 00
Pa.Dept.of Revenue State Income Tax 4 91
Arleigh Cale.Tax Collector 1972 Road Tax ~4~13)
Observer Reoorter Ad 15 .95
valley Independent Ad 12 .25
Pittsburgh Press Ad 37 .20
Pauline Dziak Labor 205 00
George Dziak Labor 205 .00
Arleigh Cale,Tax Collector 1972 School Tax CJ.67 .%)
Register of Wills Probate of will 11.50
Washinoton Co.Reoorts Advertisina Letters 14.00
Observer Publishing Co.Advertising Letters 14 .00
:}r~t~~~rM~~l:~l1S t'~.L~ng .Lnvent:0:!Cy .2.456 .ggExecutorsComm~ss~on
~(Drvcost!.Attorne~s fee L.,q,u~:~~otar Pub ~c Notary ees
Register of Wills Filing Account H .~OIs....;;~"'~..~,...4
COMMONWEAL.TH OF PENNSYLVANIA fA .t.."All:-'''''
.':'
"\,'I·.-
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DEDUCTIONS ALLOWED IN
OFFICE OF n~E
REGI9Tt:R OF Wlt-L.G
OF Vic 511 in-r{ton,COUNTY
STATEMENT OF DEBTS
AND DEDUCTIONS
THE SUM OF $.
DATE APPROVED ......••
AND AGENT orr THE COMMONWEALTIi
Aegllt~r of Wills.Agr.llt
Hike Dziak,a/k/a etc.Somerset 'l'o"mshipESTATEOF....:.....:.....:.....:.CATE OF ~-::_
OATS:,OF DEATH _DATE OF FILING APPRAISEMENT
I OA.Tl!NO.OF'NAME OF PAYEE .REMARKS AMOUNT
I VOUCH!=1it
,
John N.Dugan Insurance Premium S 155 00
Rev.H.Gubanich Burial Services 25 00
Kenneth V.Thompson Burial expense 1,018 71
Mon valley EQpt.Co.Supplies 1,283 16
Malcolm Morgan,Co.TilCeas.Co.Tax 50 53
Atlantic Breeders Corp.Breeding 36 50
.Patsy DeBerardinis Cows 394 00
Charles R.VJood,Vet.Services.5 00
Edwin Smell Grinc~ing 23 25
•Kefauver Hardware Feed 11 30
Edgar Feed &Supply Feed 390 22
!
Quinet Monument Co.Lettering on Monument 20 .00
Pa.Dept.of Revenue State Income Tax .4 91
Arleigh Cale,Tax collector 1972 Road 'fax 34 .75
Observer Reporter Ad 15 .'15
Valley Independent Ad 12 .25
Pittsburgh Press Ad 37 .20
Pauline Dziak Labor 205 00
.George Dziak Labor 205 .00
Arleigh Cale,'Tax Collector 1972 School Tax 167 .96
Register of Wills Probate of will 11 .50 -
Washinaton co.Reoorts Advertisinq Letters 14 .00
Observer Publishing Co.Advertising Letters 14 .00
~T~~;~~rM~~l:~l..lS FlJ.lng Inventory "2,460 .ggExecutorsCOffiffilsslon
~k D."costa Attorne¥s fee ",,4U~:~~otar'Public Notary ees
Register of Wills Filing Account 17.00
'T'-~~'4 •4 ••Is 8.97~.44
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COMMONWEAL.TH OF PENNSYLVANIA
COUNTY OF Washington
Michael Me les--~====~.o.'::.:::t='=':::"""---;f-IHEt:lEBY CERTIFY.THAT.TO THE BtaT OF
NY KNOWLEDGE AND BELIEF,THl!FOREGOING IS A JUST AND TRU E SfA EMENT OF DEBTS FUNE~AL EXPEN6ES AND EXPENSt:S OP'
ADMINISTRATION !SUBMITTED TO THE ESTATE OF Mike Dziak Ak 'a etc4'r
INHERITANCE"TAX PURPOSES./JI{.f}/1 /;L#J"".<%_/-I--+-L..!..t~L-J:Jr;~<-r-~L.~'--L!...JL::~,iI...L __
6WORN!-N6 SUBSCRIBED eEF~RE ME THf5~~e-<-DAY Of"
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DZIAK,Michael
DZIAK,Mike,a/k/a
.';'.~..,...--":
IN THE ORPHANS'COURT OF WASHINGTON COUNTY,PENNA.
.)Date of deat.b t 1-t,'1-..':7/.
In tbe matter of .bhe Audit of Account filed in the Estate of
\No.lZQ7~~,Term,19~"_'AA
Deceased )DOCket~L77-···'--'::':,.~'~=:-
TO THE AUDITING JUDGE:
Enter my 'appearance for the Commonwealth of PennsyIVlawa,c1aiming transfer inheritaiI1ce tax in lfueabove estate,'as follows:
DR
To appraised Vlalue of Estate:Realty __.._$
.,S\.Z-~"l~
/z..$v9,"tt.f
Personalty__~_.._~.__$~----~-_~-
Additional Assets per Account,Subject to Tax ____~___$-"-----
GROSS VALUE __$
CR.
Debts and Expenses per Account;see Note
Addltiona<!Assets per Audit,Subject to '!1ax "$--c--c------:=;c:~:l_---~&0 C(?,fl,:'l"
$~~'1s:tfll;1~gA ..
Additional Debts and Expenses per Audit
$------
$-----
$----,----
$----'-.•_'---
$$---------_.
$~.
TOTAL DEDUCTIONS,$_-,-_,---~_
..
.NOTE:The following credits claimed in the Account are
held not deductible.as against the tax:
I~-
::I-~--··_--
at .
15%)--'-_
$
TAX PAID ON ACCOUNT
$------
Total Tax;..................._.........................2 ?-,.'3,".l......l~"'1'."$--'-'-'~/_.~~!!!-:""._~--.............,'..--,.,-
--------•......--_.$Less amount,·previously paid.__.. ........_
Balance _......$,1,,:;3·~,,·§.,,
>','V ~~.,S-U,.IL,Interest__yrs.----f--mos._~_·_.days@_'_%$-l\"(.
TOTAL TAX AND INTEREST DUE _$;Z.i}~llfr~i ()r;'
.-."~~~l~
Ckn I 07 1113__.'Z;'13'S-
(f p4 ~d.3 ~:t,.~(3.)
~~i~~_,~
$--_._-~
$----~-
$-----~
$--------'
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•
No•.Term,19 •A.A.
FIL.E.D,
'13 J~H Lf PM 7.46
.",;
ESTATE OF
Deceased
RUSStJ.L HARINO
l\EGISTEH OF WILLS
WASHINC;TON GO ..PA.
PRAECIPE FOR APPEARANCE
FO R
COMMONWEALTH OF PENNSYLVANIA
~5
Rcc-n (9-68)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
APPLICATION FOR AND CONSENT
TO TRANSFER SECURITIES
REGISTERED IN THE NAME
OF A RESIDENT DECEDENT
JI
DATE March 28.1972
APPLICATION (MUST BE FILED IN TRIPLICATE)
TO THE PENNSYLVANIA DEPARTMENT OF REVENUE:
Applicatian is hereby made for coosent to the transfer of the following securities of a Pennsylvania
Carporation or a Natianal Banking Assaciatian located in Pennsylvania:SEE REVERSE SIDE
(a)(b)(c)-"----'__
(NOTE:In describing securities enter in (a),ab Ole,either the number af shares of stock or the face amount of
registered bands,in (b),the name of the issuing company and in (c)the class of stock or the stated interest rate
and maturity date of registered bonds.)
(Name of Decedent)
who,was late of_R::.:..::.-._D=--.:.-._#=1-=-.--=-S__ceft__._ry~H i_1_1__,_wa__sh_i_ft.::.g_to_ft_C_O_Wl__ty=-,_Pe_M_a.:cy_1_v_a_ft_i_a _
(Street and Number)(Post Office)(County)(State)
The securi ties are registered as follows:__-=-M_i_c_ha_e_1_D_z_i_a_k _
(Name or names in which certificates are registered)
ADMINISTRATOR)__~M~i~c~h~a~e~l_,_:Me=g!!.:l~.::.=_____=C=ok:.:::e=b=ur=.!9~,--=Pe-=ft:.:::n•.::.:y~1=v=_.:a:.:::n:..::i:.:::a_,__--
EXECUTOR)(Name)(Add,ess)
NAME OF APPLICANT _----'Mi=-i~=h:.::a=e=l--'Me:.:=1!g'-=l:.::.c::.s _
COUNTY FILE NUMBER 63-71-1207 ADDRESS OF APPLICANT~~~~LL-¥!J~'..!..-+--+__
BUREAU FILE NUMBER 6 3-71-l207 SIGNATURE OF APPLICANT,Il"'4Ji'..ITl:~~/...L!-I--l4)AJ...d'Jl.L __
NOTICE:IF YOU FAIL TO PROPERLY FILL IN ANY PORTION OF THIS PLICATION,IT WILL NOT.
CONSIDERED COMPLETE AND WILL BE RETURNED TO YOU FOR COMPLETION.
COMMONWEALTH OF PENNSYLVANIA -DEPARTMENT OF REVENUE
CONSENT TO TRANSFER SECURITIES
DATE March 30 1972
I hereby consent to the transfer of the above securities now registered in the name of the aforesaid
•
Decedent and waive the filing of a certificate certifying to the'payment of the transfer inheritance tax to which
the property of said Decedent is made subject pursuant to the provisions of the Act of June 20,1919,P.L.521,
as amended and the Act of June 15,1961,P.L.373,as amended.This is also in accordance with the provisions
of the Act of April 9,1929,P.L.343.
This Consent to Transfer the herein described property operates only in reference to the estate of the
above.named Decedent.
(Signature)
Register of Wille Washington
(Title)(County)
(a)One
(b)Atlantic Breeders cooperative
(c)Common Stock -value $5.00 ••••.••.•••.••.•.•..•••.••••.$5.00
seri••M-face value $10.92 diecounted at 24%••••••••••••••.•8.30
Seriee N -face value 7.97 di.counted at 30%.....................
Series a -face value 4.59 ('liecounted at 36".....".................
Series r -face value 7.75 discounted at ·42%.........................
Sedee Q -face value 17.54 discounted at 4lEl~.• • • " " •.... ..•..•...."
seri••a-face value 10.94 c51acountea at 54%.............................
Sede.S -
face value 5.42 discounted at 60%.............""....."...."
5.58
2.94
4.50
9.12
5.03
TQt.l•••..••••••.•••••$42.64
S'I r r Li'){•
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I am the attorney of record for the ",,~=-F{
tate or the transferee shovm on the
front of this form.I do hereby pArSODc i
ally guarantee the payment.within the i
'hme prescribed by law.of any Pennsyl-::
vania inheritance tax-which may be due
on the transfer of the securities 1ist,,;]
hereon for which a consent to transfer
is granted.,,rr-./';/~(J/.7..:k /.,~~,
('-.'-'(Date)',Signature)._.. ._._j
~-1"'\
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vJ -
c.-.r-'P'.
~r'f1
I'.3.3 3 o~"
~.,...-'.',-
,
3 3 3 o 0
'.'.1 5 5 0 0
2 5 0 0
1 0 1 8 7 1
1 2 8 3 1 6
5 0 5 3
'3 ,6 5 0
3 9 4.0 0 ,.
5 0 0
2'3 2 5
1 1 3 0i·
3 9 0 2 2
2 0 0 0
49.1
I,1 5 9 5
1 ,2 2·5
I·i '3 7 2,0..2 0 005
2 0 5 0 0
1 1 5 0..e,
1 4 0 0
1 4 0 0
1 5 0 0..4 02 0 o 0
2 4 0 0 '0 0-;.5 2 5i170,0
..~.5 4 c;0.J
9 1 5 7.2 3 -"'.'
';M t·•••·.··.'.2 ~*•..•.••..';'.....__...---.........."'-............
"'--.\)V I
•.00 T
3 5;2 :.J .C '.'•
3 5,2 ').\(~
5,375.77
5,58955
827.13
583.12
350 .G 0
1 J 5
4Z .64
25.4 Z
50.C 0
11("9535
~S.C·i 9 S 3 '
.00 T
-.,/..,.~.
.~tutl'of Pl'lIlHi !JlllllUitt }55:Q!ollnty of Ulu511ington
P II b f th d · d tl·t Notary Public .d f 'dersonayeoreme,e un erslgne au'lon y,a III an or sal
County and State,appeared .Mic.b.ae.l...Me.g.les who,being duly
sworn according to law,deposes and says that he is the executor or administrator of the es-
tate of :M..~.~.e:...P..~~.~1I:.'...~.!.~!<i ~.t:~deceased,that the foregoing schedules constitute a
complete inventory ·and appraisement of the real and personal estate of }:ti..1s~...Pg:J.9,J~.,....Cl./J5.J.'i'-etc.
deceased,except real estate outside the Commonwealt .of Pennsylvania;that the figll1'es opposite
each item of real and personal estate in the foregoing chedules are deter lined and stated by the
undersigned to be the fair value of said items as of th ate of the deced 1t's death,based upon a
just appraisement of each item made by the above d Executor dmini rator.?w:j{;:j;}'Cr;~db:forc 111e tbiso?M.}/A P .n)oJ
day oi~;;q,~~19 ?~.r ~~~:Ad .
.....;?'~.~'-1n:~....."t'.j,-,!.
I'•",':-;;,."",..T",O.,',.,'X.ADDITIONAL INSTRUCTIONS
j .f"_''';•--,,,.'_"..~.I.",~,1113 "1.'An inventory must be filed within three months after appointment of personal repTesentative.
2.A suppJ.emental 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~
eluding 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
31nul'nh1ry unIt Apprni!il'ntl'nt of tbe goods a"d cbattels,rigbts a"d credits whicb
were of ..M-.~1:'EOl J:)z i~k.~Cl/1</Cl.ei:.c;~.late of ?()11lE!:r:s.E!:t :r.()'1.Jls.J:1.~~..
Wasbingto"Cou"ty,Pa"tnken a"d mnde in confor111ity witb tbe above affidavit.
DOLLARS CENTS
PERSONAL PROPERTY
Livestock ••..••...••.....•.••........••.•.•......•...•••$5.375.77
Farm Equipment &Miscellaneous Items •.•...•••....••••.•••'5.589.55
,
Mi"lk,"Inc_;""p.,
United Mine workers.death benefit...•.....•...•..••.••."1
Atlantic Breeders corp..Stock Refund •.....••••..•.•.....IiI!L,
Straw.corn,oats and hay !
Ii
827.13
588.12
I
350.00
i
1.35
I
Atlaritic Breeders corp••Stock........•..•••••...••••...•i:42.64
25.42
I
Harleysville Insurance company.Premium refund·•.•.......;.II
Bur ial Lot.Sacred Heart Cemetery•....•..•.•.•••••••••..._1__-,5::;0=.:::,0-",-0
TOTAL PERSONAL PROPERTY •...•.••..•...••....•..•••••••...•$12.849.98.
REAL PROPERTY
ALL that certain tract of land situate in Somerset
Township.Washington County.Pennsylvania.bounded and
described as follows:
BEGINNING at a corner on land now or formerly of M.
Tombaugh;thence South 15J.,0 East.72.16 perches·to a
stone on land now or formerly of John Freeman;thence
South 38 0 East.34.32 perches to a walnut;thence
++Continued on rider attached hereto.
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INVENTORY &APPRAISEMENT -CONTINUED -ESTATE OF MIKE DZIAK,A/KIA ETC.
South 20~0 East,48 perches to a stone;South 47~o
East,131.3 perches to a post;North.14~o west,15.76
perches;North 1 3/40 East,7.48 perches;North 11~0
.East,24.8 perches;North 30~0 East,19.44 perches;
North 29~0 East,25.36 perches;North 5~0 west,8.32
perches;North 12 1/80 west,75.24 perches;North5~0
west,9.6 perches;North 12\0 East,17.68 perches;
North 41 0 west,8 perches;North 16 3/40 west,7.72
perches;North 81~0 west,28.2 perches;North 35~0 west,
76.2 perches on land now or formerly of M.Mankey;South
66~0 West,98.8'perches to the place of beginning.
CONTAINING 156 acres,118 perches.
EXCEPTING and RESERVING hereout and here from,the
following parcels heretofore conveyed:(1)2.66 acres
described in Deed Book 402,p~ge 590;(2)15 acres,more or
less,described in Deed Book 480,page 677;(3)12 acres,
more or less,described in Deed Book 487,page 442;
(4),10 acres,more or less,described in Deed Book 492,
page 58;(5)19.472 acres,described in Deed Book 702,
page 254;(6)0.380 acres,described in Deed Book 911,
page 630;and (7)1.366 acres,described in Deed Book
1023,page 507.
J
UPON which is erected a frame dwelling and barn,
and other out buildings,having a value of $35,200.00
TOTAL REAL PROPERTy ••••...•••••••.••••.••.••"....•.........$35,200.00
TOTAL PERSONAL PROPERTY AND.REAL PROPERTY •••••••••••••••...•$48,049.98
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