HomeMy WebLinkAbout01-0433
PETITION FOR PROBATE and GRANT OF LETTERS
d\- 0\- 433
Zdenka F. Hoza
No.
To:
Estate of
also kno wn as
Register of veIls ~or ~e d
8 61 Deceased. County of um er an in the
Social Security No. Ub~-l.L- ':} Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the execur or
in the last will of the above decedent, dated November 30.
and codicil(s) dated
n~ed
, 192-
(state ~e!evam circllmstancc=s. e.g. renunciation, death of executor. etc.)
Oecendent was domiciled at death in Cumberland County, Pennsylvania, with
h er last family or principal residence at 28 South Pitt Street, Carlisle, PA 17013
(list street. number and muneipality)
Oecendent, then 90 vears of age, died March 14,
at Praha 10. Czech Republic
Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent:
~ 2001
, .
Oecendent at death owned property with estimated values as follows:
(If domiciled in Pil.) All personal property
(If not domiciled in Pa.) Personal property in Pennsylvania
(If not domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania
situated as follows:
$ 650,000.00
$
$
$
WHEREFORE, petitioner(s) respectfully ie~uest(s) the _probate of the last will and codiciI(s)
presented herewith and the grant of letters e tamentary
(testamentary; administration C.La.; administration d.b.n.e.t.a.)
theron.
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~~nufacturers & Traders Trust Company ~
Successor to Farmers Trust company. ~ (! ~
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OATH OF PERSONAL REPRESENTATIVE
CO~f~fONWEA.LTH OF PE~NSYLVANIA I ss
COCNTY OF Cumberland J
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
true and -:orrec: to the best of the knowledge and belief of petitioner(s) and that as personal represen-
tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law.
Sworn to or affirmed f~d
before me this 26
AP IL
~o. 21 - 01 - 433
Estate of
Zdenka F. Hoza
, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW MA Y 1, Xf~2001 . in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated November 30, 1994
described therein be admitted to probate and fIled of record as the last will of
Zdenka F. Hoza
and Letters Testamentary
are hereby granted to Manufacturers & Traders Trust Company
Successor to Farmers Trust Company
~/>O{}!/2ff~fV'.a/Jzo ~/{
Register of Wills
MARY CLEWIS
FEES
Probate, Letters, Etc. .........
Shon Certificates( 1 p . . . . . . . . . .
Renunciation ................
X-Pages
llCP
$ 410.00
$ 30.00
$
I/.UU
$ ~ . 00
TOTAL _ $ 457.00
. . .~~ Y. .1.,. . ? 9.Q ~ . . . . . . . . . . . . . . . . . . .
ATTORNEY (Sup. Ct. 1.0. No.)
ADDRESS
Filed
PHONE
Call Bank on 5-2-01
OF-180 (Rev _ 03-19981 In accordance with 5 CFR 1320 5(b). persons are not required to respond to the collection OMB APPROV Al NO. 1406~096
of this information unless this fonn displays a currently valid OMB control number. EXPIRES: 03-31-2001
REPORT OF THE DEATH OF AN AMERICAN CITIZEN ABROAl)TEOBUROEN:2HOURS
Americal1EmlJ~Y _~~~~,_ _~~~~ _~~P~l>l!~,_ _~~1_0-~~1 _
(Post & date of issue)
068-22-8961
SSA No. __ u__ _ __ _ _ _ __ _ __ _ u _ _ _ _ _ ___
Name in full _ _ _ _ _ _ __ _ _ _ _ _ Zde_~~_ _~~~ntis.k~ .1:1 OZA
Date (mm-dd-yyyy) and Place of Birth _~~-_~~_~ ~~1 0 _ _ ~~_~~,_ _~_~~_ _~~_p~~_~~ _ _ _ _ __
Evidence of U.S. CitiT,ftldlip US p~_~~._~7209563 ~. ~_?ra~~_~~__~~~~:-:~~3
Addr~ in U.S.A. u______ _ _~~~~t_~_~~~t~eet,Car~I~,__}>~__I?~~_~___u_______
Permanent or Temporal)' Ad~ Abroad __ ViI.1~~I"~~~n~~/~~~_~, }2~ _~ _ ~~~}?__ ~~~~l}~~~~_l>lic
March 14 2001
Age
90
Date of death
Place of death
(Month) (Day) (Hour) (Minute)
___________n____ _____ _______u_u n__ Praha 10 ~zech Republic
(Number and stred) or (Hospital or hotel) (City) - - - - - - - - - - - - - (Coontry) - - - -
~~~_~~~~~~~C?_~~ _ -: _~~~~~~~g_ _t~_ ~11~_ ~~~~~~~ _ ~~~ _ ~~~~~ certificate
(lncJud.in3 authority for statement ~ if physician, include rull"-~~ -and ;;ftk~ titie~ - if ~yj - - - --
(Year)
Cause of death
~~.~.I~~~~~~~___~~~<:I~Y_'r~~_I:I~llinJ!r~gtIe _10 on 03-04-2001
- . - - - - - - - - - - - - - - - - - - - - ~ . - - - - - - - - -. - - - - ~ - - - - - - - - - - ~ -
cremated in Melnik on 03-18-2001
Disposition of the remains
Local law governing cmintennent of remains provides that
n/a
Disposition of the effects
. ~~~ _ ~~p~eW', Mr .1?~...~.n:~11<l_~1l~~1"
Person or official responsible for custody of effects and accounting therefore
n~p~e~_,_ ~. Fer~inan<l ~uller
Traveling/residing abroad with rdatives or friends as follows:
NAME
ADDRESS
None.
Informed by telegram or telephone
NAME
ADDRESS
DATE NO'ID'IED
(mm-dd-Y)')Y)
None.
Copy of this report sent to:
NAME
Mr. Ferdinand Muller
ADDRE.~
DATE SE'IT
(mm-dd-yyyy)
Y'yz_l()vsl~~ ~!~~~~ _..
1_()()OO Prague 10 .
~~ech Repll~li~
~__.!..~.YA _____-.-CSC
04-11-2001
Notif"lcation or copy sent to Federal Agencies: SSA
Other
(State Agency)
The original copy of ~ doCument and information concerning the effects are being placed in the permanent files of the Department
of State, Washington, D.C. 20520
Remarks:
US passport was canceled and returned to the next of kin.
[SEAL)
~... 7~ __ ,~ntinue on reve~ .!!!-'ecessary_ .)
---....--- . .... .G ill A/f c;iL ________
/ (Signature on aD copies)
Elizabeth. B~r!lett, Consul General. of the United States of America.
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"21~OI_1~33
LAST WILL AND TESTAMENT
OF
ZDENKA F _ HOZA
I , Z DENKA F _ HOZA, of the Borough of Carlisle,
Cumberland County, Pennsylvania, make publish and declare this
to be my Last Wills and Testament, hereby revoking any and all
former Wills by me at any time heretofore made.
1. I direct the payment of my just debts and funeral
expenses as soon after my death as will be convenient to my
Executor hereinafter named.
2. I make the following additional specific requests:
a. I give and bequeath to ST _ PATRICK'S
ROMAN CATHOLIC CHUR.CH of Carlisle,
Pennsylvania, the sum of Five Hundred Dollars ($ 500.00):
b. I give and bequeath to the AMERICAN
HEART ASSOCIATION, the sum of Five Hundred
Dollars ($ 500.00);
c. I give and bequeath to the AMERICAN
CANCER. ASSOCIATION, the sum of Five Hundred
Dollars ($ 500.00);
d. I give and bequeath to THE CAR.LISLE
GARDEN CLUB for its Student Scholarship Fund, the
sum of Five Hundred Dollars ($ 500.00);
e. I give and bequeath to the CIVIC CLUB OF
CARLISLE for its Student Scholarship Fund, the sum of
Five Hundred Dollars ($ 500.00):
1
~--
...
f'. I give and bequeath to HANNA HOZA, Pi'ikra
3499, 760 00 Zlin, Czech republic, the sum of One Thousand
Dollars ($ 1,000.00);
g. I give and begueath to SVATOS HOZA jr.,
prikra 3499, 760 00 Zlin, Czech republic, the sum of One
Thousand Dollars ($ 1,000.00);
h. I give and bequeath to JAROSLAV HOZA,
Pi'ikra 3499, 760 00 Zlin, Czech republic, the sum of One
Thousand Dollars ($ 1,000.00);
i. I give and bequeath to DANIELA
RUZ ICKOVA., Kollarova 7, 351 01 Frantiskovy Lazne,
Czech republik, the sum of One Thousand Dollars ($ 1,000.00);
j. I give and bequeath to IVA BREZINOvA,
Kuttelwascherova 922, 198 00 Praha 9, Czech republic, the sum
of Two Thousand Dollars ($ 2,000.00);
k. I give and bequeath to PATRICK
SCHIRMER., Vyzlovska. 34/2242, 100 00 Praha 10, Czech
republik, the sum of Five Thousand Dollars ($ 5,000.00);
1. I give and bequeath to SANDY GORITY,
261 West Pomfret str., Carlisle,PA.,USA, the sum of Five
Thousand Dollars ($ 5,000.00);
m. I give and bequeath to ANNE GOR.ITY, 261
West Pomfret str., Carlisle,PA.,USA, the sum of Five Thousand
Dollars ($ 5,000.00);
2
~ --~
-- .~---..
3. Following the distribution of all specific legacies
mentioned above and the payment of death duties all the rest,
residue and remainder of my estate whatsoever nature and kind
I give and bequeath to my nephew FERDINAND
MULLER, Vyzlovska 34/2242, 100 00 Praha 10, Czech
republic, who shall be free to dispose of the said rest,
residue and remainder of my estate entirely at his own
discretion. The executor of my will shall be obliged to
proceed in accordance with the instruction given to him by
said residuary legatee.
In the event the residuary legatee named above should
not survive me or should he fail to take possession of the
residue of the estate for whatever reason I hereby appoint his
heirs as substitute residuary legatees who shall take
possession of the rest of the estate subject to same
conditions set down by me in the preceding paragraph.
4. I nominate, constitute and appoint
TRUST COMPANY and its
Carlisle ,Pennsylvania ,USA, to the Executor of
Will and Testament.
successors
FAR.MER.S
of
I
Last
this my
3
L
...
,
In WITNESS WHER.EOF , I have hereunto set my
hand and seal this .3C77J day of Nove h be-A. , 1994.
;lIJAAhr; 1. .~~)
Zdenka F.Hoza
SIGNED,SEALED,PUBLISHED~d
DECLAR.ED in the presence of:
PI;, Oil/A/IR 'r!)I' E)<
f{ i A'l} T If- J i~ C I-i () fA
I,ZDENKA F.HOZA,Testatrix,whose name is
signed to the attached or foregoing instrument,having been
duly qualified according to law, do hereby acknowledge that I
signed and executed the instrument as my Last Willi that I
signed it willinglYi and that I signed it as my free and
voluntary act for the purposes therein expressed.
Sworn or
Z DENKA
NO~' t.hbe,p-
affirmed to and acknowledged
F . HOZA, Testatrix, this
,1994.
before
JC>7}j
me, by
day' of
I';
!J
)
:Jf::/1<f 1-, /frA
denka F.Hoza,Testatrix
. ,,'...;'\:',,"
;) i~~
>>
D
Robert \v. ~,1ustain Jr.
American Consul'
Notary Public
4
-.
r.., ~ ~h Repubr!c )
LY ';;l.: of' Pr2.gue )
C:;tv of Praque ) tiS
r- r,,:sy o( the United )
L __ .__ (.It Arnenca )
We, f)'<, V r I/- K If ^
-T IJ A 15 1<
and /~ j3/r1TIi-
J If: c Ij () t~ If
the witnesses whose names are signed to the attached or
foregoing instrument, being duly qualified according to law,
do depose and say that we were present and saw Testatrix sign
and execute the instrument as her Last Will; that Z DENKA
F _ HOZA signed willingly and that she executed it as her
free and voluntary act for the purposes therein experessed;
that each of us in the hearing and sight of the Testatrix
signed the Will as witnesses; and that to the best of our
knowledge the Testatrix was at that time 18 or more years of
age, of sound mind and under no constraint or undue influence.
Sworn or affirmed to and subcribed to before me
and
dav of I/()//t! 11t3€,<t
.M.
by
this J47J1
,1994
.~
/ftt/ttt
witnJss
;2 e(;~~'
/
--1 j
-;/ C--??~~
~t~7~L~-
Notary PublicRoben V~ t..h~~_~t:1in Jr.
Amerk~~fi CGh.;ui
5
nt.XJune 30, 1992/17858
AUG ~~ 1 ZOO;?
Estate No.: 21-01-433
ORPHANS' COURT DIVISION
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY
PENNSYLVANIA
In Re: Estate of Zdenka F. Hoza
Late of Carlisle Borough
NO.
NOTICE OF FAILURE TO FILE CERTIFICATION AND REQUEST TO CONDUCT A
HEARING PURSUANT TO RULE 5.6(e), SUPREME COURT
ORPHANS' COURT RULE
Personal Representative: Manufacturers & Traders Trust Co
Counsel for Personal Representative:
Date of Grant of Original Letters: May 1, 2001
Date of Delinquency Notice: August 11, 2001
The undersigned, Mary C. Lewis, Register of Wills, in accordance with Rule 5.6,
Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of
Common Pleas of Cumberland County, that neither the above named personal representative nor
the above named counsel for the personal representative have filed with the Register of Wills or
Clerk of the Orphans' Court his, her or its certification required by Rule 5.6(e), Supreme Court
Orphans' Court Rule and that the requisite notice, pursuant to Rule 5.6(e), Supreme Court
Orphans' Court Rules, was given by the Register of Wills on August 6, 2001, and that the ten
(10) day notice to file the certification has expired. Accordingly, in accordance with Rule 5.6(e)
the Court is hereby notified of such delinquency and the undersigned requests that a Court
conduct a hearing to determine whether sanctions should be imposed upon the delinquent
personal representative or counsel for the delinquent personal representative.
Date: September 4 2001
Distribution:
Personal Representative
Counsel for Personal Representative
Estate File
A hearing is scheduled for acAj:/V.A. If ,.k,/ at 9, .Jt,i In Courtroom No.3. If the
Certification of Notice is filed prior to the hearing date, the hearing will automatically be
cancelled.
Georgel~U4rj
D~ ~ ~-~~-O\
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
M- & T INVESTMENT GROUP
C/O RONALD S KEARNS
804 WAYNE AVENUE
~L1SE, rA 17013 _ _
.. /~~/ /4- //,;20/
Wpk
-------- fold
ESTATE INFORMATION: SSN: 068-22-8961
FILE NUMBER: 21 - 2001 - 0433
DECEDENT NAME: HOZA ZDENKA F
DATE OF PAYMENT: 12/12/2001
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 03/14/2001
NO. CD 000631
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
1 ,:. 'i I
101 I $2, 182.05
I
I
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TOTAL AMOUNT PAID:
$2,182.05
REMARKS: M & T INVESTMENT GROUP
C/O RONALD S KEARNS
CHECK# 754588
SEAL
INITIALS: DO
RECEIVED BY:
REGISTER OF WILLS
MARY C. LEWIS
REGISTER OF WILLS
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BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
RONALD S KEARNS
SMITH ETAL
804 WAYNE AVE
CHAMBERSBURG PA 17201
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF DETERMINATION AND
ASSESSMENT OF PENNSYLVANIA
ESTATE TAX BASED ON FEDERAL
CLOSING LETTER
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
*
REV-736 EX AFP (01-02l
03-31-2003
HOZA
03-14-2001
21 01-0433
CUMBERLAND
202
ZDENKA F
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR FILES ~
Rifv=736--EX--AFP--[oi~-02)-----.-.-No-ffcE--oF--nETE-RMIN-ATIO-N-AN-n-As-sESS-MENT-----------------------------
OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL CLOSING LETTER ..
ESTATE OF HOZA
ZDENKA
F FILE NO.21 01-0433
ACN 202
DATE 03-31-2003
ESTATE TAX DETERMINATION
1. Credit For State Death Taxes as Verified
13,084.00
2. Pennsylvania Inheritance Tax Assessed
(Excluding Discount and/or Interest)
97,182.05
3. Inheritance Tax Assessed by Other States
or Territories of the United States
(Excluding Discount and/or Interest)
.00
4. Total Inheritance Tax Assessed
97,182.05
5. Pennsylvania Estate Tax Due
.00
6. Amount of Pennsylvania Estate Tax Previously Assessed
Based on Federal Estate Tax Return
.00
7. Additional Pennsylvania Estate Tax Due
.00
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
-IF PAID AFTER THIS DATE, SEE REVERSE SIDE (IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED
FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE
DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
/6 -;Jo17-/L/
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF DETERMINATION AND
ASSESSMENT OF PENNSYLVANIA
ESTATE TAX BASED ON FEDERAL
ESTATE TAX RETURN
REV-48~ EX AFP (Ol-O~)
RONALD S KEARNS
SMITH ETAL
804 WAYNE AVE
CHAMBERSBURG
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
03-24-2003
HOZA
03-14-2001
21 01-0433
CUMBERLAND
201
ZDENKA
F
Amount Remitted
PA 17201
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR FILES ~
----------------------------------------------------------------------------------------------------------------
REV-483 EX AFP (01-03) ~~ NOTICE OF DETERMINATION AND ASSESSMENT
OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN ~~
ESTATE OF HOZA
ZDENKA
F FILE NO.21 01-0433
ACN 201
DATE 03-24-2003
ESTATE TAX DETERMINATION
1. Credit For State Death Taxes as Verified
13,084.00
2. Pennsylvania Inheritance Tax Assessed
(Excluding Discount and/or Interest)
97,182.05
3. Inheritance Tax Assessed by Other States
or Territories of the United States
(Excluding Discount and/or Interest)
.00
4. Total Inheritance Tax Assessed
97,182.05
5. Pennsylvania Estate Tax Due
.00
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
*IF PAID AFTER THIS DATE, SEE REVERSE SIDE (IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED
FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE
DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
. --7-/Y
DUAL TAXES
ISION
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
128-0601
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
'02 r:IAf~ i 8
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
P :7 :"1 6 COUNTY
ACN
03-11-2002
HOZA
03-14-2001
21 01-0433
CUMBERLAND
101
RONALD S KEARNS
SMITH ETAL
804 WAYNE AVE
CHAMBERSBURG
*
REV-1547 EX AFP (01-02)
ZDENKA
F
l~c..;
PA 17ZaOll.rl-183-
Allount Rellitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
Ri-Y-=is4j-ix-AFP--(fff:02-f-NOY-ici--OF-.rtiHiifiTANCi-;--AX-APPRjrisiiiENT~--ALLowAirci-crR-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF HOZA ZDENKA F FILE NO. 21 01-0433 ACN 101 DATE 03-11-2002
TAX RETURN WAS: (X) ACCEPTED AS FILED
) CHANGED
NOTE: I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
re~lect ~igures that include the total o~ ~ returns assessed to date.
ASSESSMENT OF TAX:
lS. Allount of Line 14 at Spousal rate (lS)
16. Allount of Line 14 taxable at Lineal/Class A rate (16)
17. Allount of Line 14 at Sibling rate (17)
18. Allount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
TAX CREDITS:
.00 X 00 = .00
.00 X 045 = .00
.00 X 12 = .00
681,213.68 X 15 = 102,182.05
(19)= 102,182.05
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Receivable (Schedule D)
S. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
(1)
(2)
(3)
(4)
(S)
(6)
(7)
.00
638.444.27
.00
.00
90.031.97
.00
.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
(10)
35,067.56
9.695.00
(11)
(12)
(13)
(14)
NOTE: To insure proper
credit to your account,
subllit the upper portion
of this forll with your
tax paYllent.
728,476.24
44.762 56
683,713.68
2,500.00
681,213.68
. ft II ....... . rn:l,;c~r I (+J AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
06-13-2001 AA496719 5,000.00 95,000.00
12-12-2001 CDOO0631 .00 2,182.05
TOTAL TAX CREDIT 102,182.05
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
STATUS REPORT UNDER RULE 6.12
Name of Decedent: Zdenka F. Hoza
Date of Death: 3/14/01
Will No.
21-01 00433
Admin. No. 21-01 00433
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the
following with respect to completion of the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes X No
--
2. If the answer is No, state when the personal representative reasonably
believes that the administration will be
complete:
3. If the answer to No.1 is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes X No
b. The separate Orphans' Court No. (if any) for the personal
representative's account is:
c. Did the personal representative state an account informally to the
parties in interest? Yes No
d. Copies of receipts, releases, joinders and approvals of formal or
informal accounts may be filed with the Clerk of the Orphans' Court and
may be attached to this report.
Date: January 10, 2003
Ik~ 0/;
~gnature
David C. Gority, Trust Officer
M & T Investment Group
1415 Ritner Highway
Carlisle, PAl 7013
(717) 240-4505
~1
~\~J
\)~
Capacity:
Personal Representative
/
OaK
COURT OF COMMON PLEAS OF CUMBERLAND COUNTY
PENNSYLVANIA ORPHANS' COURT DIVISION
No. 21-01-0433
Estate of ZDENKA F. HOZA, Deceased
FIRST AND FINAL ACCOUNT OF
MANUFACTURERS AND TRADERS TRUST COMPANY
SUCCESSORTOFARMERSTRUSTCOMPAN~EXECUTOR
Date of Death:
Letters Granted:
First Complete Advertisement of Grant of Letters:
Account Stated to:
March 14, 2001
May 1, 2001
September 19, 2001
July 20, 2002
Income Balance Remaining
SUMMARY & INDEX
Paaes
2 $ 732,856.47
3 2,059.04
734,915.51
3 149,525.58
585,389.93
3-4 33,291.21
$ 552,098.72
4 $ 22,900.14
4 1,574.03
21,326.11
4 20,416.33
909.78
$ 553,008.50
PRINCIPAL
Receipts
Net Gain on Conversions
Less Disbursements
Less Distributions to Beneficiaries
Principal Balance Remaining
INCOME
Receipts
Less Disbursements
Less Distributions to Beneficiaries
COMBINED BALANCE REMAINING
Cash
Inventory Filed
COMPOSITION OF NET BALANCES
Principal
50,000 par U.S. Treasury Note 5.75% due 4-30-03
50,000 par FHLB 6.25% due 8-13-04
750 shares AT&T Corp.
241 shares AT&T Wireless
1000 shares Bell South Corp.
2000 shares Exxon Mobil Corp.
1000 shares PPL Corp.
1000 shares SBC Communication Inc.
1000 shares Sprint Corporation
500 shares Sprint Corporation PCS Group
1000 shares Wells Fargo Company
5405.405 shares Vision Intermediate Term Inc. Fund
Cash
Income
PRINCIPAL RECEIPTS
Per copy of Inventory Filed
Subsequent Receipts
9/11/01
10/23/01
5/29/02
Refund IRS
Final Balance TUA Zdenka Hoza
IRS - Refund 2001 Form 1040
Total Principal Receipts
5/14/01
5/14/01
5/14/01
PRINCIPAL CONVERSIONS INTO CASH
1000 shs. Bell South Corporation
Proceeds
I nventoried at
40,938.63
40,170.00
500 shs. Exxon Mobil Corp.
Proceeds
Inventoried at
44,618.51
41,237.50
800 shs. Lucent Technologies
Proceeds
Inventoried at
8,439.71
8,868.00
-2-
Gain
768.63
3,381.01
$
51,359.38
51,789.05
13,207.05
3,793.69
40,170.00
82,475.00
44,230.00
42,475.00
20,845.00
9,645.00
47,235.00
51,837.83
93,036.72
$ 552,098.72
$
909.78
$
728,476.24
300.00
1,040.23
3,040.00
$
732,856.47
Loss
428.29
5/14/01
7/23/01
9/28/01
PRINCIPAL CONVERSIONS INTO CASH (continued)
1300 shs. Wells Fargo Company
Proceeds
Inventoried at
59,992.99
61,405.50
Fractional Shares AT&T Wireless
Proceeds
Invertoried at
5.70
5.51
25,000 par U.S. Treasury Note Due 9-30-01
Proceeds 25,000.00
Inventoried at 25,249.99
0.19
4,149.83
TOTAL
Net Gain on Conversions
4/30/01
4/30/01
5/1/01
5/8/01
5/24/01
6/13/01
9/13/01
9/17/01
10/10/01
12/12/01
12/12/01
12/18/01
12/28/01
1/4/02
4/15/02
5/8/02
5/8/02
PRINCIPAL DISBURSEMENTS
U.S. Treasury - 2000 Federal Income tax
PA Dept. of Revenue - 2000 PA State Income Tax
Register of Wills, Letters Testamentary
Darlene Moyer - Cumberland County Personal Tax
Parente-Randolph - Preparation Personal Income Tax
Register of Wills - Estimated PA Inheritance
Cumberland Law Journal - Advertising Letters
Dr. Otakar Turek - Legal Services
The Sentinel - Advertising Letters
Register of Wills - Balance PA Inheritance Tax
Register of Wills - Filing Fee
Register of Wills - Additional Probate Fee
U.S. Treasury - 2001 Estimated Tax 2001 Form 1040
Smith, Elliott, Kearns & Company
Preparation IRS Form 706 and PA Inheritance Tax
PA Dept. of Revenue - 2001 PA State Income Tax
U.S. Treasury - 2001 Fiduciary Income Tax
PA Dept. of Revenue - 2001 PA Fiduciary Income Tax
Reserved:
Manufacturers and Traders Trust Company, executor fee
Dr. Otakar Turek, Final Attorney Fee
Miscellaneous Filing and Closing Costs
Total Principal Disbursements
5/14/01
5/14/01
5/24/01
5/24/01
5/24/01
5/24/01
PRINCIPAL DISTRIBUTIONS TO BENEFICIARIES
Ferdinand Muller - Zivnostenska Banka
Account #3483-29860 @ 000 Value
Ferdinand Muller - Personal Property
S1. Patrick Church - Specific Bequest
American Heart Association - Specific Bequest
American Cancer Association - Specific Bequest
Carlisle Garden Club - Specific Bequest -3-
1,412.51
249.99
2,090.79
$
2,059.04
$
3,706.00
539.00
457.00
10.00
240.00
95,000.00
60.00
2,123.90
77.63
2,182.05
15.00
35.00
5,200.00
2,500.00
859.00
7,877.00
144.00
26,000.00
1,500.00
1,000.00
$
149,525.58
$
7,716.21
2,075.00
500.00
500.00
500.00
500.00
5/24/01
6/1 /01
6/1/01
6/1 /01
6/1 /01
6/6/01
8/9/01
PRINCIPAL DISTRIBUTIONS TO BENEFICIARIES (continued)
Carlisle Divic Club - Specific Bequest
Iva Brezinova - Specific Bequest
Daniela Ruzickova - Specific Bequest
Svatos Hoza, Jr. - Specific Bequest
Hanna Hoza - Specific Bequest
Jaromir Hoza - Specific Bequest
Renata Schirmerova as Guardian for Patrick Schirmer - Specific Bequest
Reserved:
Sandy Gority, Specific Bequest
Anne Gority, Specific Bequest
Total Distributions to Beneficiaries
INCOME RECEIPTS
Dividends - BellSouth Corp 5-3-01 to 7-20-02
Dividends, SBC Communication 5-31-01 to 7-20-02
Dividends - Wells Fargo Company 6-1-01 to 7-20-02
Dividends - Exxon Mobil Corp 6-12-01 to 7-20-02
Dividends - Sprint Corporation 6-29-01 to 7-20-02
Dividends - PPL Corporation 7-2-01 to 7-20-02
Dividends - AT&T Corporation 8-1-01 to 7-20-02
Interest - U.S. Treasury Note due 10-1-01
Interest - U.S. Treasury Note due 4-30-03
Interest - FHLB due 8-13-04
Dividends - Vision Funds 5-1-01 to 7-20-02
Total Income Receipts
INCOME DISBURSEMENTS
Manufacturers and Traders Trust Company, income commission
Smith, Elliott, Kearns & Company, Preparation 2001 Federal and State
Income Tax
Total Income Disbursements
INCOME DISTRIBUTIONS TO BENEFICIARIES
Ferdinand Muller 6-29-01 to 7-20-01
Total Income Distributions to Beneficiaries
500.00
2,000.00
1,000.00
1,000.00
1,000.00
1,000.00
5,000.00
5,000.00
5,000.00
$
33,291.21
$
1 ,140.00
1,295.00
1,612.00
2,300.00
625.00
1,515.00
112.52
796.88
2,875.00
3,125.00
7,503.74
$
22,900.14
$
1,374.03
200.00
$
1,574.03
$
$
20,416.33
20,416.33
~
-4-
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
Jane F. Burke, Vice President, Manufacturers and Traders Trust Company, Executor being
duly sworn, depose and says that the foregoing Account, both as to the items of charge and discharge,
are just and true to the best of her knowledge and belief.
Ja
Sworn t011nd Subscribed before me
this ~~ . day o~ Iy, 2002.
'/J I
;'
Notarial Seal
'"' ~athy_ J. Lear, Notary Public
\",ariis:e .::'~o.ro, CUlT)berland County
, My Cornr.1:','<;(ji" I=J(Dlres ,}uiy 26, ':?004
~....._--_. -_...~-_.
,;;, ;"'~;-rtil'n r,f f\!r~''t :~r~r-~.~.
-5-
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY
PENNSYLVANIA ORPHANS' COURT DIVISION
IN THE ESTATE OF ZDENKA F. HOZA, LATE OF CUMBERLAND COUNTY
SCHEDULE OF PROPOSED DISTRIBUTION
Balance for distribution as per First and Final Account
filed July 26, 2002
Distribution
FERDINAND MULLER
50,000 par U.S. Treasury Note 5.75% due 4-30-03
50,000 par FHLB 6.25% due 8-13-04
750 shares AT&T Corp.
241 shares AT&T Wireless
1000 shares Bell South Corp.
2000 shares Exxon Mobil Corp.
1000 shares PPL Corp.
1000 shares SBC Communication Inc.
1000 shares Sprint Corporation
500 shares Sprint Corporation PCS Group
1000 shares Wells Fargo Company
5405.405 shares Vision Intermediate Term Inc. Fund
Principal Cash
Income Cash
5'1,359.38
51,789.05
13,207.05
3,793.69
40,170.00
82,475.00
44,230.00
42,475.00
20,845.00
9,645.00
47,235.00
51,837.83
93,036.72
909.78
STATEMENT OF THE REASONS FOR THE PROPOSED DISTRIBUTION
$553,008.50
$553,008.50
DL
The above distribution is proposed in accordance with the terms of the Last Will and Testament of
Zdenka F. Hoza, Late of Cumberland County, Pennsylvania.
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
Jane F. Burke, being duly sworn according to law, deposes and says that she is Vice President
of Manufacturers and Traders Trust Company, the Account in the Estate above named, and that the facts set
forth in the Statement of the Reasons for the Proposed Distribution are true and correct.
Notarial Seal "
Kathy J. Lear, Notary PLDiiC
'''c'',:~, "."r:,.,','''~oro Cumberland county., "\
'l....,Ju, 1 ',,,h ' ,~ , ,")~" ,,~ ,
My C;:>,... ," C;;f)1") Expires 2f:, i ,I 'j.;- .
L.." ...--
.", 'S\i!Vtl"'8 AssOclaticj', ':i '
-6-
,"
Estate of Zdenka F. Hoza
C!..
.....- REV-1500 &:, OFFICIAL USijONLY
COMMONWEALTH OF I ~),~1- }
PENNSYLVANIA
DEPARTMENT OF REVENUE INHERITANCE TAX RETURN FILE NUMBER
DEPT. 280601 RESIDENT DECEDENT 21 - 01 0433
HARRISBURG, PA 17128-0601 -- -- -----
COIJIITY CODE YEAR i'lJMBER
DECEDENTS NAME (LAST, FIRST, AND MIDDLE INrTl'\L) SCCl'\L SECURrTY NUMBER
I-
Z Hoza, Zdenka F_ 068-22-8961
W DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD- YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
C
W 03/14/01 02/18/10 REGISTER OF WILLS
(.)
W (IF APPLICABLE) SURVMNG SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITl'\L) SCCl'\L SECURrTY NUMBER
C
w ~ 1. Original Return 0 2 Supplemental Return 0 3. Remainder Return (date of death prorto 12-13>82)
~~(/) 0 4. Limited Estate 0 4a. Future Interest Compromise (date of death after 12-12-82) 0 5. Federal Estate Tax Return Required
uo:>:
wa.u ~ ~
IOO 6. Decedent Died Testate (Attach copy of Wi!) 7. Decedent Maintained a Living Trust (Attach copy 01 Trust) 8. Tolal Number of Safe Deposit Boxes
uo:~ -
a."'
a. 0 9. Lnigation Proceeds Received 010. Spousal Poverty Credit (dale of death between 12-31-91 arK! 1-1-95) 011. Election to tax under Sec. 9113(A) (Attach Sch 0)
'"
l- THIll.SI&TION MUST BE C~IlD. ALL ~RESPONDENCE ~Al;:J!)NI'Ii:JJ:NTIAL m:lJi!RMga1:IIilN)ll.~ BE EilRECTeMjlk.
z NAME COMPLETE MAILING ADDRESS
w
0 Ronald S_ Kearns, CPA 804 Wayne Avenue
z
0
a. FIRM NAME (If App~cab.1 Chambersburg, PA 17201
"' Smith Elliott Kearns & Co. 1 LLC
w
0:
0: TELEPHONE NUMBER
0
u (717) 263-3910
1. Real Estate (Scl'edule A) (1) Ot" OFFICIAL USE ONLY
2. Slocks and Bonds (Scl'edule B) (2) 638,444.3a~ 9 ::0::0
ro~
u. {::':' 0
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 0:; l::J ,....'-.:
". ~(4 ()
Mortgages & Notes Receivable (Schedule 0) (4) CJ ';,i,,' (2
4. .", ,,-..,'
-
5. Cash, Bank Deposits & Miscellaneous Personal Property (5) 90,031.97 N
Z (Schedule E) :::g
0 6. Jointly CNined Property (Scl'edule F) (6) N
""t)'".
< o Separate Billing Requesled ,J."",,,.' b:-
0
...J 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
::::l
I- (Schedule G or L)
it 8. Total Gross Assets (total Lines 1 - 7) (8) 728,476.24
c(
(.) 9 Funeral Expenses & Administrative Costs (Schedule H) (9) 35,067_56
W
0:: 10 Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 9,695.00
11. Total Deductions (total Lines 9 & 10) (11) 44,762.56
12. Net Value of Estate (line 8 minus line 11) (12) 683,713.68
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been (13) 2,500.00
made (Scl'edule J)
14. Net Value Subject to Tax (Une 12 minus line 13) (14) 681,213.68
SEE INSTRUCTIONS FOR APPLICABLE RATES
Z
Q 15. Amount of Line 14 taxable at the spousal tax
!;( rate, or lransfers under Sec. 9116 (.)(1.2) XO_ (15)
I-' 16. Amount of Line 14 taxable al lineal rate X.O_ (16)
::::l
Q. 17. Amoont of Line 14 taxable at sibling rate X .12 (17)
:!:
0 18 Amount of Line 14 taxable at collateral rate 681,213.68 X .15 (18) 102,182.05
(.)
~ 19. Tax Due (19) 102,182.05
20. D Ic;:HEl;:K HERE IF YOU_RS.lUESTltIG A REFUND OF AN ~~M1SNT I
STFPA42021F.1
> > alE liIlIRE TO ANSWER ALL QUESTIONS ON REVERSE sllll: AND RECHECK MATH < <
l)eced~nt's Complete Address:
STREET ADDRESS 28 South pitt Street
Estate of Zdenka F. Hoza
CITY Carlisle
I STATE PA
I ZIP 17013
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Pnor Payments
C. Discount
(1)
102,182.05
95.00D.00
5.000.00
3. InteresVPenalty if applicable
D. Interest
E. Penalty
Total Credits (A + B + C) (2)
100,000.00
Total Interest/Penalty (D + E) (3)
4. If Line 2 is 9reater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
0.00
2,182.05
A. Enter the interest on the tax due.
(5A)
8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58)
Make Check Payable to: REGISTER OF WILLS, AGENT
2,182.05
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes
a. retain the use or income of the property transferred; .. ............................... D
b. retain the right to designate who shail use the property transferred or its income; . . . . . . . . . . . . .. D
c. retain a reversionary interest; or ...........,........................................... 0
d. receive the promise for life of either payments, benefits or care? ............. . . . . . . . . . .. D
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ................... . . . . . . . , . . . . . . . . . . . . . . . . . 0
3. Did decedent own an "in trust fo( or payable upon death bank account or secunty at his or her death? . D
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? . . . .. .. .. .. .. . . . . . . . . . . . . .. .. .. .. .. D IXI
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of pe~ury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my koowledge and belief, it is true, correct
and complete.
Declaration reparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNAT OF PERS~ R ONSI8LE FOR FILING RETURN
't:laUI G ~. jJ.--)fA! 5T
ADD ESS /J . /)
. I'll)' 10TA/.';<I. !llbf.ll1J~ 'I, C/lrZ/.../5L-1C) /-,</ / 7iJ/ J
SIGNATU REPA R THER T~ SENTATIVE, ~
~A ~ C/'4
No
[XI
[XI
[XI
[XI
[XI
IXI
AD
DATE
if:ll \' 2mn
DATE
..;;t -~ -.:::; ./
LV'/P.YN"'e ..4?ve;t.J~e ~"~4/.R~ d:>/?..:z...O/
- "
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the survivin9 spouse is 3%
[72 P.S. ~9116 (a) (1.1) (ilJ.
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. 99116 (a) (1.1) (ii)J.
The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even
if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive
parent, or a stepparent of the child is 0% [72 P.S. 99116(a)(1.2)J.
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 99116(1.2) [72 P.S. 99116(a)(1)J.
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 99116(a)(1.3)]. A sibling is defined, under Section 9102, as an
individual who has at least one parent in common with the decedent, whether by blood or adoption.
STFPA42021F.2
\.REV-1503'\:X+ (1-97)(1)
Estate of Zdenka F. Hoza
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
Zdenka F. Hoza
FILE NUMBER
21-01-0433
All property jointly-owned with the right of sUlVtvorship must be disclosed on Schedule F.
ITEM
NUMBER DESCRIPTION
1.
2.
3 .
4.
5.
6.
7.
8.
9.
10.
11.
12.
13 .
750 shs AT&T Corp CUSIP #001957109
2,000 shs Bellsouth Corp CUSIP #079860102
1,500 shs Exxon Mobil Corp CUSIP #30231G102
$50,000 Federal Home Ln Bks Con BD 6.25%CUSIP #3133M9ER9
Accrued Interest on Item Number 4
800 shs Lucent Technologies Inc CUSIP #54963107
1,000 shs PPL Corp CUSIP #69351T106
Accrued Dividends on Item Number 6
1,000 shs SBC Communications Inc CUSIP #78387G103
500 shs Sprint Corp CUSIP #852061506
1,000 shs Sprint Corp CUSIP #852061100
Accrued Dividends on Item Number 9
$50,000 United States Treas Nts 5.75% 4/30/01 CUSIP #9128274D1
Accrued Interest on Item Number 10
$25,000 United States Treas Nts 6.375% 9/30/01 CUSIP #912827Z54
Accrued Interest on Item Number 11
5,405.4050 shs Vision Group Fds Ine CUSIP #92830F752
2,300 shs Wells Fargo & Co CUSIP #949746101
VALUE AT DATE
OF DEATH
17,006.25
80,340.00
123,712.50
51,789.05
269.10
8,868.00
44,230.00
265.00
42,475.00
9,645.00
20,845.00
125.00
51,359.38
1,064.23
25,249.99
722.44
5J.,837.83
108,640.50
STFPA42021FA
TOTAL (Also enter on line 2, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
638,444.27
i' REV-1508~X.;. (1-97) (I)
Estate of Zdenka F. Hoza
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Zdenka F. Hoza
FILE NUMBER
21-01-0433
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the rtght of sUlVivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
2 .
3 .
4.
5 .
Cash Acct, Zivnostenska Banka, Czech Republic
Acct No. 3483-29860
Miscellaneous Household Items
Miscellaneous Jewelry
Captial Blue Cross/PA Blue Shield Refund
Zdenka F. Hoza T/U/A Manufacturers & Traders Trust
Company Acct No. 41-3797-60-9
7,716.21
1,000.00
1,075.00
162.76
1.
80,078.00
STFPA42021F.9
TOTAL (Also enter on line 5, Recapitulation) $
(If more space IS needed, insert additional sheets of the same size)
90,031. 97
~ REV-1511 ~X + (1-97) (1)
Estate of Zdenka F. Hoza
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Zdenka F. Hoza
FILE NUMBER
21-01-0433
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Funeral Expenses 222.57
2 . Burial Urn Handle 75.68
3 . Confer a Burial Ground 47.50
4. Services; burial, church, transport 142.50
5 . Ten years lease of burial ground 62.50
6 . Stone sculptural works 212.50
7 . Final set up of the grave 412.50
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative( s) Manufacturers & Traders Trust Co.
Social Security Number(s) I EIN Number of Personal Representative(s)
Street Address 14 15 Ritner Highway
City Carlisle StatePA Zip 17013
Year(s) Commission Paid: 2001 26,000.00
2. Attorney Fees 3,624.90
3. Family Exemption: (If decedent's address is oot the same as daimant's, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees
5. Accountant's Fees 2,500.00
6. Tax Return Preparer's Fees
7. Death Certificates Fees 22.75
8. Apartment Expenses 186.60
9. Telephone Fees 112.93
10. Legal Advertising Fees 77.63
11. Register of Wills - Letters Testamentary 457.00
12. Cumberland Law Journal - Legal Advertising Fee 60.00
13 . Miscellaneous Household Expenses 850.00
TOTAL (Also enter on line 9, Recapitulation) $ 35 067.56
(If more space is neeced, insert additional sheets of the same size)
STFPA42021F.12
lREV.1512 ~x + (1-97) (I)
Estate of Zdenka F. Hoza
COMMONWEALTH OF PENNSYlVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF
Zdenka F. Hoza
FILE NUMBER
21-01-0433
Include unrelmbursed medical expenses.
ITEM
NUMBER
DESCRIPTION
AMOUNT
3,706.00
539.00
10.00
240.00
5,200.00
1.
2.
3.
4.
5.
US Treasury - 2000 Federal Income Tax
PA Dept of Revenue - 2000 PA Personal Income Tax
Darlene L. Moyer - 2001 Personal Tax
Parente Randolph, PC - 2000 Tax Preparation
Estimated 2001 Federal Income Taxes
STFPA42021F.13
TOTAL (Also enter on line 10, Recapitulation) $
(If more space IS neeced, Insert additional sheets of the same size)
9,695.00
,REV-1513 to*!<. + (9-00)
Estate of Zdenka F. Hoza
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
Zdenka F Hoza
FILE NUMBER
21-01-0433
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee{s) OF ESTATE
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers
under Sec. 9116 (a) (1.2)]
Hanna Hoza
prikra 3499
7600 00 Zlin, Czech Republic 1,000.00
Svatos Hoza
prikra 3499
7600 00 Zlin, Czech Repulbic 1,000.00
Jaroslav Hoza
prikra 3499
7600 00 Zlin, Czech Republic 1,000.00
Daniela Ruzickova
Kollarova 7
351 01 Frantiskovy Lazne, Czech Rep 1,000.00
Iva Brezinova
Kuttlewascherova 922
198 00 Praha 9, Czech Republic 2,000.00
Patrick Schirmer
Vyzlovska 34/2242
100 00 Praha 10, Czech Republic Grand-Nephew 5,000.00
Sandy Gority
261 West Pomfret Street
Carlisle, PA 17013 None 5,000.00
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
NUMBER
I
1.
2.
3.
4.
5.
6.
7.
STFPA42021F.14
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1. St. Patrick's Church
140 E. Pomfret Street
Carlisle, PA 17013
2. American Heart Association
1019 Mumma Road
Harrisburg, PA
3. American Cancer Society
500.00
500.00
Carlisle, PA 17013
500.00
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
1 500.00
\REV-1513 \3X + (9-00)
Estate of Zdenka F_ Hoza
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
Zdenka F Hoza
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers
under Sec. 9116 (a) (1.2))
ijl Anne Gority f
261 West Porn ret Street
Carlisle, PA 17013
9. Ferdinand Muller
Vyzlovska 34/2242
100 00 Praha 10, Czech Republic
FILE NUMBER
21-01-0433
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
AMOUNT OR SHARE
OF ESTATE
None
5,000.00
Nephew
535,144.09
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
t. The Carlisle Garden Club
Carlisle, PA 17013
5. Civic Club of Carlisle
264 Pomfret Street
Carlisle, PA 17013
500.00
500.00
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
1 000.00
STFPA42021F.14
I '
(0:'0
I
I
I
,
LAST WILL AND TESTAMENT
OF
ZDENKA F _ HOZA
I, Z DENKA F _ HOZA, of the Borough of Carlisle,
Cumberland County, Pennsylvania, make publish and declare this
to be my Last Wills and Testament, hereby revoking any and all
former Wills by me at any time heretofore made.
1. I direct the payment of my just debts and funeral
expenses as soon after my death as will be convenient to my
Executor hereinafter named.
2. I make the following additional specific requests:
a. I give and bequeath to ST _ PATR.ICK' S
ROMAN CATHOLIC CHURCH of Carlisle,
Pennsylvania, the sum of Five Hundred Dollars ($ 500.00);
b. I give and bequeath to the AMERICAN
HEART ASSOCIATION, the sum of Five Hundred
Dollars ($ 500.00);
c. I give and bequeath to the AMERICAN
CANCER ASSOCIATION, the sum of Five Hundred
Dollars ($ 500.00);
d. I give and bequeath to THE CARLI SLE
GARDEN CLUB for its Student Scholarship Fund, the
sum of Five Hundred Dollars ($ 500.00);
e. I give and bequeath to the CIVIC CLUB OF
CARL ISLE for its Student SCholarship Fund, the sum of
Five Hundred Dollars ($ 500.00);
1
f. I give and bequeath to HANNA HDZA, Pi'ikrGi
3499, 760 00 Zlin, Czech republic, the sum of One Thousand
Dollars ($ 1,000.00);
g. I give and begueath to
Pi'ikra 3499, 760 00 Zlin, Czech
Thousand Dollars ($ 1,000.00);
h. I give and bequeath to
Pi'ikra 3499, 760 00 Zlin, Czech
Thousand Dollars ($ 1,000.00);
i. I give and bequeath to DANIELA
RUZ ICKDVA, Kollarova 7, 351 01 Frantiskovy Lazne,
Czech republik, the sum of One Thousand Dollars ($ 1,000.00);
j. I give and bequeath to IVA BRE Z INDVA,
Kuttelwascherova 922, 198 00 Praha 9, Czech republic, the sum
of Two Thousand Dollars ($ 2,000.00);
k. I give and bequeath to PATRICK
SCHIRMER, VyZlovska 34/2242, 100 00 Praha 10, Czech
republik, the sum of Five Thousand Dollars ($ 5,000.00);
1. I give and bequeath to SANDY GDRITY,
261 West Pomfret str., Carlisle,PA.,USA, the sum of Five
Thousand Dollars ($ 5,000.00);
m. I give and bequeath to ANNE GDRITY, 261
West Pomfret str., Carlisle,PA.,USA, the sum of Five Thousand
Dollars ($ 5,000.00);
SVATDS HDZA jr.,
republic, the sum of One
JARDSLAV HDZA,
republic, the sum of One
,
2
,.
3. Following the distribution of all specific legacies
mentioned above and the payment of death duties all the rest,
residue and remainder of my estate whatsoever nature and kind
I give and bequeath to my nephew FERDINAND
~~~~ER, Vyzlovska 34/2242, 100 00 praha 10, Czech
republic, who shall be free to dispose of the said rest,
residue and remainder of my estate entirely at his own
discretion. The executor of my will shall be obliged to
proceed in accordance with the instruction given to him by
said residuary legatee.
In the event the residuary legatee named above should
not survive me or should he fail to take possession of the
residue of the estate for whatever reason I hereby appoint his
heirs as substitute residuary legatees who shall take
possession of the rest of the estate subject to same
conditions set down by me in the preceding paragraph.
4. I nominate, constitute and
TR~ST CO~PANY and
carlisle,Pennsylvania,USA, to the
Will and Testament.
appoint F A~ERS
its successors of
Executor of this my Last
3
In WITNESS WHEREOF, I have hereunto set my
hand and seal this ,3on; day of !V()Vc h bY.. , 1994.
1~1.rAh'f 1. ,~~)
Zdenka F.Hoza
SIGNED, SEALED, PUBLISHED and
DECLARED in the presence of:
jJ~. O/'IfJ<I}/1, '/Vi{E;<
f?EA'4-Ttf- JECHOrfl
I,ZDENKA F.HOZA,Testatrix,whose name is
signed to the attached or foregoing instrument,having been
duly qualified according to law, do hereby acknowledge that I
signed and executed the instrument as my Last Will; that I
signed it willingly; and that I signed it as my free and
voluntary act for the purposes therein expressed.
Sworn or
ZDENKA
NOV t. /11) ep.
affirmed to and acknowledged
F _ HOZA, Testatrix, this
,1994.
before
J&7JJ
me, by
day' of
ro. -:;'"'; ~z:Jt;::':c
[.ciet of ,0,-";"8
>>
}
)ss
)
)
eil<f?' t~.
denka F.Hoza,Testatr~x
;.0 C ;'J 0f p(,J_:.~~
-:?-y )( 1:-.') U~'~!~3.j
_ _' uf Ar:le.:c..i
Robert W. MU3tllin Jr.
American Consul
Notary Public
4
C-~,:h Republfc )
Oi-'~rict of' Prague )
C'tv of Prague ) S9
[-.'~~3SY of the United )
L__.__ uf "menca )
We, pl.. 0 T.1K Iff,..
T IJ /'1 13 )(
and /~ l31YtJ.T+
J~Cf/Oj/1f
the witnesses whose names are signed to the attached or
foregoing instrument, being duly qualified according to law,
do depose and say that we were present and saw Testatrix sign
and execute the instrument as her Last Will; that Z DENK.A.
F _ HOZA signed willingly and that she executed it as her
free and voluntary act for the purposes therein experessed;
that each of us in the hearing and sight of the Testatrix
signed the Will as witnesses; and that to the best of our
knowledge the Testatrix was at that time 18 or more years of
age, of sound mind and under no constraint or undue influence.
Sworn or affirmed to and subcribed to before me
and
day of A/t)fffi 11~€.t<.
by
this JIJ71f
,1994
----
/1t~
witn~ss
/
~ t:.vJ.../ .;:-7 ':-"~-.....c.-
C--~~L~_
>
Notary PublicRobcn W. Mu3tain Jr.
Americ:!n Ccn;;ui
5
THU, '.2'Hif1H! ~'J
.,:e;,
.'-"1
~I/!LLEF
C.j. 8/l001
Ihe' deetl;:. ceI'"~.fi'c4te
I
i
I
i
Ct::::f1'\A "~""UCH..'r\.""
OMATN( LIST
V I<nlzo umrti (Ilmltni malrico) matnllnlho ollvOdu
Praha 10
64 2001 6" "196
svazek,.",..",........ ~/k.,_.,..........,. 5tl'!1tl......,......,...~ pol. ~ ..,._.......... )eSl l.8jlsano:
14.3.2001
OOtl. mffk, ... ttrnacty b~ezen dve tislce jedna
..m<ato.:.nru PraMa 10 fourteen of ii.arc h. t.wo
.
"~""'" 1<. tho ul>.an <1 and one
_.pIfjtnod Zdenka Haza r-oz. ~ikoloVa
.
MaY! ~enske f'o",~l ~
- rozvedena d~orce<i
-.. v dOnlacnosti nous.e.wi fa
;
~.. Praha 2,Vinohradska J3/H20
Con. _!Ok 18.2.1910 Praha
._-
-""~ Antonin Sikola
'oc:teO~1'lo Emi lie roz. Potakovll ."
P_1IlII1I Atherosclerosis vniverllilis I 70.9
- I.... M~lnik 18.3.2001 kremace
llClh/bIIl-l -
PGZll*""!'
.'
/::..>> ~'o.:.;;~
Praze 10/:.....:\ .). Blstrikafka
v ...'''''.............''.qfS:''f:.Z'ii'{L;~f('\ '\ & A-L~
n \ . ,'J'
... .. . _ ". -," . .
!) &,y ,.m,C n th, year
and.. pI ace 0 f death
,
Ctmis ti an and family!
name!prev;,ou6 name/ .
Sex
Marl tal ~atu.a
Occup.ation
Place of :-esi:lence
iJay, man th, ye ar
and place of birth
Christi&n r,!Ilr.e and
family name of parents
. J
C SLlS e of clast!: .
PlaCE! ar.d daLe
I) f b~ial/kJrem~ld.oIV
One ........... .... ........... ...........~...~
"\ ~4.
'03 ClOI I). Omrtnflll)Olo (IZfny \
Oncft Republ!o ;" ~"";' "":"'....~
D1.tr!clt 01 Ptegv. )
CIIy of Pragu_ ,. ) .
timtlM.y of th. UrlitId )
~",.~... .
I, the und.raign.d c~1Sf'\Jl.r ()mc::or of tbo OJl';'~.i E:t.;t.I.er. :~:
".m.ri~". dw:y (o"""I..loMd .,,<1 quw;{\.d, do l;.~,.lly.<~'tdY th".
ti" (o....(oinl i. . true .lId (lIlth(ul copy of the or';I,oo:l/....." l;';'
da, .xbibned to tile, ~h. .aase havintt b~J') elltarnH~ '.::)'nil';llt~d by ;'1::1;.
and COM'P.,ed "it' the laid ori,+n...J! ~ ,IHd! ;".I',~BJ. t.a i.!;t'~le
th.rewith word (Dr wor<l and fi.{(1U"o(Il r"'lt, '" .I~ '.: r'I~.
UI WITNESS WHEREOI' I haVI '0' ..,1>.,.1 #'" ":;".'.; t/;" ...;i 0; "".
Am..ricfI~ E'm~uy I1t Vr~'UA. CI6Ch Ri:iH\L~.ic.
(i>i. ..L-l..rL_ doy "r._!{@._..... ,.-;:;:~:(,_~~}
c~::.;i..~rlf;~lf;.~;~"._~.,t ~. "':'~'."
""
'..' ,..I.........J.....,~..........,...'........h...
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I
OF.lao IRO!.... OJ. 19961 In ollccorQance with 6 CFR 1320 5Ib). pel'1lOns .re riot required to respond to the collection OMS APP'lO'J AL NO. 1 <\06..0096
of this infomVItton unless this fo,," disp"y. . cunentfy v.lid OMB contl'Dl number. eXPIRES: 03.31-"2001
REPORT OF THE DEATII OF AN AMERICAN CITIZEN ABROmEDBuR.E.2HDuR.
American Embassy Prague, Czech Republic, 04-10-2001
. .~~~~~~.................... ..........
068-22-8961
SSA No. .....................
Name in full Zdenka Frantiska HOZA
Dale (mm-dd-yyw!and Place or Birth 02-1~~~~10 . Praha,..<::zechRepublic .
Evidence or u.s. C.b~""p..U~..Jlptl'io.Z7209563 iss~inPragtJe on02-05~199~.
Addre<s in u.S.A_~..So\Jt~_~tt Street, Carlisle, PA 17013
Pennanent 0< Tempor3l)' Addre<s Abroad Vinohradska 3~/1420, 120 00 Prague 2, Czech Republic
March 14 2001
Age
90
Date of death
----. ......--..-....
(Mooth) (Day) (!l...., (Mln....)
.... _.. Praha 10 . ..Czech~epl1blic
(Number md street) or (Hospital or botd) (City) -. (c'ountry)
Atherosclerosis - according to the official Czech death certificate
....... .... ..,....... ..-(fud~hl&'~;;~iiY'i~.~~t~. ii Pby.~: .tOcl~de. run. ~.~.; .~~i onk~i iiti~~.ii~1j.'
......-...-.
(Y....)
Place of death
Cause of death
No.64/2001 ~/l~~. .~ecl.by.'J:'()_\Vl:I_lIa~_~llgtJl!.lO on 03-:O't~2_()()I..
cremated in Melnik on 03-18-2001
DlspositJon of the remams
LocaJ law governing dbintCl1Dent or .-.... provtd<s that
nla
Disposition of the effeds
~tl1lll!P~e\\" 1\1r ~Ferdinand Muller
PersoD or offldal responsible for custody of effects aud accounting therefore
.. ._Ill!JlI1_ew?_ ~ ~.J?erdil1lln~Muller
TraveUaglredding abroad 1ritb relatives or Iiimds as loUows:
NAME
ADDRESS
None.
IDronoed by ldegnm or Idepbooe
NAME
ADDRF.BS
DAm NOTIF1EIl
(_.JJ..yyyy)
None.
Copy of this report smt to:
NAME
Mr. Ferdinand Muller
ADDRESS
DATE SENT
(__dd_yyyy)
yrzlovs~~/2~~2
~OO OOPra~elO.
<;zecl1 Republic.
04-11-2001
Notification or copy sent to Federal Agencies: SSA
x VA
cSt""
Other
(State Agency)
The original copy of tbi; dotumeut and. information CODCembJg the effects are being placed In the permanent rues of the Departmeo.t
of State. Wasbingtou. D.C. 20520
Remarks:
US passport was canceled and returned to the next of kin.
[SEAL I
Elizabeth Barnett, Consul
or the United States of America.
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WHEREAS, on the 1st
dated November 30th 1994
was admitted to probate as the last will of HOZA ZDENKA F
(LAbl, rlKbl, M1UUL~)
late of CARLISLE BOROUGH CUMBERLAND County, who died on the
14th day of March 2001 and,
WHEREAS, a true copy of the will as probated is annexed hereto.
THEREFORE, I, MARY C. LEWIS , Register of Wills in and for
the County of CUMBERLAND in the Commonwealth of Pennsylvania, hereby certify
that I have this day granted Letters TESTAMENTARY
to MANUFACTURERS & TRADERS TRUST and CO SUCC TO FARMERS TRUST CO
who have duly qualified as Executor (rix)
and have agreed to administer the estate according to law, all of which fully
appears of record in my Office at CUMBERLAND COUNTY COURT HOUSE,
CARLISLE, PENNSYLVANIA.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal
of my Office the 1st day of May 2001.
......,... '''-..
..... ~.' ,) 'J. I,/~ .
.... -....._ ~ f"'~
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.,.............r~y
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Register of Wills of CUMBERLAND County, Pennsylvania
Certificate of Grant of Letters
No. 2001-00433
PA No. 21-01-0433
ESTATE OF HOZA ZDENKA F
(LAbl, rlKbl, M1UUL~)
Late of
CARLISLE BOROUGH
LUM~~K~U CUUN1Y/
Deceased
Social
day
Security
of May
2001 an instrument
No. 068-22-8961
* * NOTE * * ALL NAMES ABOVE APPEAR (LAST, FIRST, MIDDLE)
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MULLLH IEROINnNO
FAX TRANSMISSION
M U L L E R FERDINAND
VV!LOVSKA 34/2242
100 00 PRAHA 10
CZBCH REPUBLIC
TEL. 1 FAX: ... 420 2 7811974
To
ll..avid C..Oorlty
AU and T Bank
Date: May 10,2001
Fax: 001 717 240 4518
Pages: 6.including this
cover sheet
From: Ferdinand l4\lller
Subjects: ElLtate o:f Zdenka F..HOZA
COMMENTS:
Dear .L.l8v1 d: Thank you for ,your Fax transmission d.ated lakay J .01.
Accordingly,fullowing ere tne informations you are required..
I am sorry it has taken so ~ong,but 1 heve been very busy.
Sending you~elso ~tQtement from the Bank etc~
As to Zendas property here:8s you know Zenda 8 ~urnlture and
car was sold. in t;arlisle.Many t.hinga were ief't t.here or g~ven
to her f'riends aa a gif't;,i.She t.ook three trunks o:f personal
efrects with her when she moved f'rom ~ar1i;:,le to Praglle../aee
general. description !'rom ASTON INTL.. ,1NC../These things/esp_
clothing,shoes, underwear.. ./haa not ~pprecillted fin vQ1ue I
over the 1aat eight years..So that they ere worn out and haa
very ~ow value or are completely valueless now.
Other personel property in the apartement which belonged to
ZenQ:ll:
- 5 ema1l china figurines of various person
1 tabl e pendul urn cluck
- J p.in~inb piotu~es
- 1. glass figurines of a laay
- 1 porcelain figure or playing bagpiper
- 1 porcelain candle. tick
Total value of these things is QPproximatel.y S 1,000..00 lone
thousand,! ..
Several piece-a or ZU*I1ka Hoz.a'a jewelleI'Y having a value ot'
appro xlmatel,y:
- 1. gold necklace
- 1 silver necklace
- 1 ,gol (1 hracele to.
- ~ gold bracelet
- I"silver bI'liicelet
15
IS
IS
$
"
150.00
75.00
200.00
175.00
100.00
- 1
- 1
- 1
1
- 1
pair of gold earings
pair of ell Val' earings
ladies Omega watch
ladies blue zircon ring
silver cigarette box
total value
f, 75.00
IS 25.00
t 125.00
t. 100.00
A__2Q.:QQ
$1,075.00
/one thousand and
seventy f1 ve /.
Accordlr.g to facta listed above
at Zdenka Hoze as of the Jate Of~::~ It~: total property I
$ 2,500.00 I two thoU8an~ and f' . des mated to be
As fa th ~ve nun red /
. r e apartment:I have had t' . ,
81nce 1991.Zenda lived there and ~: ~artment 1n my nllllle alone
payments le.lectricit e uaer paye~ for every
:;iince her .Death 1 P.~' ~~;' ~:ntr~~. heating, water 8lld 80 on I.
to hold the apartment in thee~y 1ng a1l.alen~ and 1 am going
to be out of the Esta,ta. uture.l th~nk tnis matter ought
Ll$t of the estate beneficiaries who re~~de
H.na Hoz~va
Slezak' 4767
760 05 Zlin
Czech republic
in tile Czech rep..:
Jaroslav llo2a
PI-ikr4 3499
"60 00 Zlin
Czech republic
Svatos Hoza.Jr..
Prikr.l J499
760 00 ZHn
Czech republic
~a~~~la R~zi~kova
T".c> 0:;<' _.. ~ .. ,....,J"
P.01
.
~~~'~:;.'::.;'
f' . - '''':~.~,~~::::s~~,;:~}~~:~~~~~~~.~-r
i
I
j.
Liat of expenaeli death.
aft.er ~.r8.Zd.enka Hoza s
"!
I till_ Subject Totlll U:?"- ~-h-
;
1\l.arch 23?B,- } It I
1. A.part..ent.. expense-a
A.pril ~49 3.- 7464,- Ig~ .CQU/
May .:643,-
41... Trle,hone. March 1~67, 401 If 2 . 9'), ~
April 1749,60 4517,20 ;
I
May-bill still .
r.aa no t come-roug~y aeoutl:,OO,- J r
). Fun er III 6902,80 '2--22, S~,/ I
e.x p enaeil
4. Fe.. for 800,- 1 Z2..,::rS;
Of!Rt.h ~",rt:lfi~atl!'e 50,. 910,. , ,
60,-
-
5 . Burial urn handl. e 6.3,. } ::;-5,0'7<;;> v
2964, - .3027,- .
I
6. Confer Il burilll ground 1900,- 'if .5D ./
7. Service.G ,
buriQl, church, traneport JIOO,- ) /tf2.,SO/ i.
600,- 5700,-
O. Tt';11 .16..."... ~".,,'" (02.60/
of a burial ground l500,-
9. Stone ecul~tural work.. 8500,- 2/2,'50/
10. Final set up 1r2.5O/
of the grave 16500,-
TOTAL 59921,- - 1498,025
-
Local .bit. US Am t.
1 local Czech crown = 0,0250 US Dollar
1 US Dollar = 40.00 ~Qo~ ~D.oh crown
I!lll. bill froll. US ElrlblIDay Prague in item 4/
I
,.
l,:,
Bill.. ...,u 111Volcetl are senl11ng C':ont....mporary by mail
- 2. -
~J. @~
" /_I._~'..-""
ROZPIS BEZHOTOVOSTNi PLATBY SIPO
~J 1020742307 I Plal.mi:5ic Brezen 2001 T Jll\drihk.i 14 IPIlSlald.<I. 62
Sptljovacitfslo KlInt'lklnimi.,t.. n~ ,h ,
~.... Mu 11 er Ferdinand K6d az: c
Vinohradska 1420 / 33
;ESKA PO~TA Vinohrady (Praha 2) ,
4]749/01 120 00 Praha 2
lIdpolpl. Ca"Cka ,,":in,, ~tail KOdpopl. Caslka ~:ize" Delllil
8 15 _00 Plyn 10481 )))12
13 2313. 00 N.lJem eo ZlZkov
- on _
Celkem Kc 2118.00
-- ..un .._. .....;. -.--.... -. .-.. -- >-~'-',~ --- -.
- _. ___u_ .,-"....-..- n.u... ___n. ---~---
ROZPIS BEZHOTOVOSTNi PLATBY SIPO
~J 1020742307 IPllll.me.ic Duben 2001 I Jjndj'lllska 14 I P"sta/d.lI, 62
SfI'Ijovadtfslu Kunl:lklni mi~tu n. ~..
Pllike Mull er Ferdinand K6d az:
Vinohradska 1420 / 33
;ESKA PO~TA Vi nohrady (Praha 2) f_
43145/01 120 00 Praha 2
uldpllpl. Cj.'lCkll NlUev Detail K.K1pupl. (::i.lb Na7.ev U~I:Jil
1 165.00 Ehktl'ltna PRE 0011098953
8 15.00 Plyn 10481 JJ31Z
13 231].00 NaJlm BD Z1lkov
Celkem Kc 2493.00
c
...~_.... ... ,.- .~. . .,-... ~,,,_"'....~..~,,..,_.,", ....~.",..-. ....--.. "'''''''''''''''''''''l..",,'H' ..............l_~...._
ROZPIS BEZHOTOVOSTNI PLATBY SIPO
\OJ SDOJOTIId~lsIo 1020742307 I Pf;ILnM:slc Kveten 2001 J 1 Jil\di'Hslca 14 I P""r..J<l.o. 62
Konlllklnimlsln 0 ...~ '
~.... Mfi 11 er Ferdi nand K6d az: r
:ESKA PO~TA Vinohradska 1420 / 33
Vinohrady (Praha 2) E
43885/01 120 00 Praha 2
<lpopl. Coblka Nbev ~iJ KOdpopl. C.tslk:J Nazev ~L3il
1 315.00 E1elcti'1na PRE 0011098853
8 15.00 Plyn 10481]3312
13 2313.00 Niijllm 80 ZizIcOl/
CelkemKc 264.1.00
---
TE LE COM
120 34 prana J
OU=:: Q03..Q0193336 IC: 60193336
Cislo uttu: 19-140905110100
Zapsana., obchodrim reJ$ltlku vlldenem MeslKYm
so'ldemv Pra;r:8. ~ ~na.:ka: odd. 6. vlotJca ZlZ2
VYUCTovANi ZA TELEKOMUNIKACNi SLUZBY
NEPLATTE!
RefefenCnf'::lslO
278678
DlCplatce
Sldlo'
BanKoyn! spo,enll SIPO
08000000002111624018
Utl:ovacl obdoCl Datum vystavenl doktadu Datum U&kutetnenf zc1anrte4neho
0312001 13.04.2001 plnenl 31.03.2001
Variabdnl symbol (pof,~.) Konstantni symbol Datumsplalnostl
4004165332 14.04.2001
NEPLA fTE - Castka 'Celkem k platbe' bude inkasovana II beznem meslci
z Vaseho Lictu nebo zahmuta do SIPO v nasledujlcim meslci.
Ceny uctovane za poskytnute sluzby:
I l)TQ ISlldby
: Ueastnick~6,
I Datum od~u
2 T eleto"nl stanice
7811974 04I2001SIandardnicenovyplan
Mlstnl hoYOfY
Mlstni!,1ovotY
Mezrmestske hovory
Mezmarodni hovory
Mezinarodnl hovory
Pold:lvanf HTS
pronaJem stand teC pi do 04197
30.04.2001
"
.Upozocflujeme, .te cislo ohldovny poruch je 13129'.
'-'....."",' , '~'-C""''''''IYI c:I ~
\ ' ..
Zakaznic:~ centrum CENTRUM
Politickych vezfuJ 911/8 Tel: 08001123456
11000 PflAHA 1
0203001
OO/OOST.
0127179 9
Pardubice 02
18.04.2001
MULER FERDINAND
Vinohradska 33/
120 00 Praha
P= I Uetovana delka DPH Cenaslutby C"kem una
HH:MM.SS " Kt Kt
silny 08:06:00 S 704.70
slabY 04:53:00 5 234.40
sdny 00:04:30 5 16.65
sllny 00:05:52 5 58.66
slaby 00:08:02 5 70.69
5 175.00
22 7.30 1267.40
Cena bez OPH 5.. 1200.12
OPH 5% 59.98
Celkem cena s OPH 5.. 1260.10
Cena bez OPH 22 % 5.98
OPH 22 % 1.32
Celkem cena s OPH 22 % 7.30
Celkem cena s OPH 1267.4<1
Celkem k platbe K6 1267.40 I
Z.t. 0106255
Strana 111
TELECOM
_._.._..~ --"-
130 34 Praha 3
ole: 003-00193336 C: 60193336
Cislo uttu: 19-140905110100
Z..ps4nayotx:hodnimrlll$lflkuvedenojm~m
!iOUdem v Pnize. Sl*OYa .l;naClul: odcl. 8. viatica n22
VYUCTovANi ZA TELEKOMUNIKACNi SLUZBY
NEPLATTE!
RefefenCtlI'::Jslo
278678
I OlCplatce
I BankoYnl sporenil SIPQ
08000000002111624018
Sldla:
! UO:CMlCJ obdobJ Datum vystavenl dokladu Datum uskuteCn~nl zdanltelneho
, 0412001 14.05.2001 pln,anl 30.04.2001
i V3nabllnlsymbol(pot.o:..} Koostantnl symbol Datum splatnosll
9004684485 14.05.2001
--
NEPLA tT~ ~ Castka 'Celkem k platb~. bude inkasovana v be.tnem mesici
z Vaseho uCtu nebo zahmuta do SIPQ V nasleduJicim mesici.
Cel'!Y uctovane za.po5~ytnUte sluzt?y:
V 10 I 51utby
utastnlCke~,
Dah.Jm odeCtu
2 Telefanni stanice
7811914 0312001 Standardni cenovY plan
Mistni hovory
31.03.2001 Mistni hovory
MeZlmestske hovory
Mezlrnestske hovory
MeZlnarodni hovory
Mezmarodni hovory
Xcall
Ostalni
Pouiivani HTS
Promljem stand tel pf do 04197
Vyldijte nejyYoodm1ijsi. cenu mezimestskeho volimi. KaZdY den od 22.00
do 5.00 hod!il jen 1 ~min.(u HOME MINI 2 KC'mln.).
UPOZORNENI:Pflpominame, 18 ~islo informaci 120 bylo zmanana na 1180
Upc:!Zorflujeme, 18 Od 1.1.2001 se zmenlly pol;Iminkv ~ro teleQrafni
sJidbu ~ lnformace z[skclte na specialni IInee 0800 f27000JPOUZE TElEGRAF/.
CESKY TELECOM, a.s.
Zakaznicke centrum CENTRUM
PolitickYch vezJ'iU 911/8 Tel: 08001123456
11000 PRAHA 1
0204001
OO/OOST'
0127081 1
Pardubice 02
16.052001
MULER FERDINAND
Vinohradska JJI
12000 Praha
P<o><oz I Uetovana delka I DPH I Cef1aslutoy C.lkemc;ellil
HH:MM:SS % KO Kt
silny 10:44:00 5 933.80
slaby 07:18:00 5 350.40
sllny 00:32:30 5 120.25
slaby 00:21:00 5 35.70
sllny 00:02:25 5 24.17
slaby 00:05:42 5 50.16
00:07:26 5 47.22
00:01 :08 5 5.89
5 175.00
22 7.30 1749.69
Gena bez OPH 5% 1659.65
DPH 5% 82.94
Celkem cana s OPH 5% 1742.59
Cena bez OPH 22 % 5.98
OPH 22 % 1.32
Celkem cena s OPH 22 % 7.30
Celkem cena s OPH 1749.80
Celkem k platbi ~ 1748.80
Z.t. 0106302
Strana 1/1
LJJ-'.l'lUV T UUI'\L..J-'.U CISlO:
, //[/ 'i~ 7'
Den zdanilelneho plneni:
Den vyslaveni dokladu:
-it/. :; C1 f
,11. .J t'1
Den odes/ani dokladu: ~V J (J I Place no
Den splatnosti dokladu: i~, t /'
DODAVATEL
Jaroslav Sikula
OBJEDNATEL
"
iedilelslvi: Kaleilnska 13, 12000 Praha 2
ICO: 66451604 DIC 005-480423055
Bank, spoj,: KB, a,S, pobocka Praha 2
Cislo uclu: 19-4135470227/0100
TeL/fax: 02124942046
nonstop: 0602387735,0602257713
Jmeno, piijmeni:
Piibuzensky vzlah:
Rodne cislo:
Bytem:
Telefonicke spojeni:
ZESNULY/A
Jmeno a piijmeni: j;}~,ij,{p Itl"); ;1 Slav: ~(J},C0-;;){[ /J,:J
Rodne cislo: 1Cf:e/!I/,fJ3 Mislo obradu: 2 t"Z- !?J/?/'cjl/
Dalum narozenl: 1't: :? /11/0 Den a hodina obiadu:
Dalum umrtl: 4'1. ) :?e1[1/ Uloienl do hrobu:
MislO umrti: '} a l~'1::i7J,(Jfe,4 7./// Den a hodina uloieni:
Plevoz zesnuhillo: 'J I
Zpopelneni v kremaloriu: hn.1!k Pilva: jJ{f'
Na zaklade rozpoclu sluieb, ktery je nedilou souc~sti loholo da~oveho dokladu, V~m uctujeme:
Ole rozpoclu sluieb cislo:
OPH 5%
Celkem k ullrade
.... ".7ft',f",,< "
"""tf...!.~"lf
Ye~ ~
/11/*-"/ to
Cena bez DPH
Cena vcelne obchodni marie 10%
= .f tl?lrJ '
Zalolla: ...."".:."."."1""."..
/,:.\ :;CI!.- 10
Doplatek: "."""".""-/""",,.
uhrazena dne: .ltl.:..tt. C. PPD: ..!.L~."
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uhrazen dne: .""":,."".;"",,,,,. C. PPO. """....c......,
Faklura. uhrazena v pine vysi dne: "",,,,,,.,,,,,.....,,..,..,,,,,,,,,,,,,,..
::::,::,,",,1. .......
C. PPO: ".........."....
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:s I Vh__..KA serie Da/1999
cisla * 035190
Oznaceni sEravce dane
l
Dnesniho dlle pii!aJ podepsany spnivce dane od vyse uvedenfJho danOlleho
SUUtektuv hololloshcaSlku
~
;
Af.""
PRAGUE Il)
1~r-MAR-~(u)1 09:08 CASHIER: csr-
I LOCAL' '),02,0000 US DOLLAR
1 IJS DOLLAR' 40,00 LOCAL
RECEIPT; 01001253
o
OllSk(Jrcdnlhorazitka
800.00 }I),OO
1000.00
21)1).1)1)
CONSULAR OFFICER:
....FEE COLLECTION
LAST NAME: MULLER
FI<ST MAME:
Qt~ Ser Ctr~ Visa Lo(al Alt. US Alt.
1 333 81)1),1)1) 21),1)1)
CERTIFY TRUE COPY
6 336
NO FEE TRUE COPIES
BALANCE:
CASH TENDERED:
CHANGE:
1),1)1)
0,(11)
A-----
4662(J2Mf";n6202.vlQf'::.1
Dodavalel (flrma)
STVRZENKA
ole:
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uE',ac.i pr~vo k proo~ice(\t!l'lu poh;bivaci.u ..istu konci uplynuti. sil?dnafle do by prop~i:enl. POI:U'J nen.i :en,l dl;:o t(to ::>ilIl;Ju~'.'
lJf'riianJ a u~i'liltel ~'!'l flli p."oJiti JIl~ty upo,ornen1 u~i'laci pr~vo ,anHa. UU'Iil:tel ie ~o...inf"n 0" 6 t.;.dfl~ il\Ji' \1::f ,.ir.\~'.
~o~oto ~(a'la o~klidit hrobo'le o;i~Ju~enstvi. Jinak hUGe adkli:eno na ~&klaor a nebezoe:i utivatele. Ne~;iIlJAsi-l: ~e "Jasrnit
h~oooyeno flrIS;4~pns~'1i a "epro;e'li~ll ~rJ~azateln1 :aie! 0 ne a 0 jeho vy,vednut~ : Jscho~r Jo I~dfiuno "'o~u 01 .enL
Joklizl?ni. ~ripnda dIll' obc~nskiho t1kona nrobove p;isJ~~l?nstv~ do vlastnict'li ooce,
Tis "Sd~ neni dotc:eM orho proo~jCitele lloiddo'lat na uhvatl?li ilhradu naUild~ sp,Jjen./ch s odk!iten~iI, :i11Btl!n:" a :l~~JeJnoll
~s'nayou nro&ov~~o prisIusenstYi.
~livilt~1 :e pO'lir.f'n ne~ro.jlene nahlasit kJidou tllhlU bydlgt~ prlJp~,:,itelJ; PD~U~ uHlfatl?l ne0;:n.jJl ;1oI~nl. uy~l~~te lIruc:,l
:tte:i, nl!~E' ve~~ere, ~ohlJ Hni~1f nasledly sail. V pripade l;.,ti uH'IatE'lE' p;echj;:llJ~i','ac. prdVo ~ OJhr~. :lbSt\J;101 .:e~c
ae:tic~. :Jh101~1?1 aohfeb. tista odpovlda Zd ':'Jdnou udr:bu tohoto lista a hroboY~!l(j ~r1:sltJSt!nstv.i. Ostatnl f1.l~eZltC'jt; (I
ilir:"~ni CO,lreilnlh:1 lista S~ riai 'Jlatnyllti i1rJ'IniJi prt:dpisy a hibitovni. radel. r(lJO~_:dtel je pO'ii.nl!,1 J'~cdlit ufiv-Hi.'ll
':rGD~jCf!n~ Dohf. tistu a ullo~oH jeho uti'ran. v provczni dob~ pohrebBt~. lajisti uH'latE'.i odbJr v::Jdy Z l!'lstalo'.aneo1J .;r:J~e
~a ponre~l~ti Doale t~chnlCky~h loinosti Bohrehi~te S vyjilkou zi.nlhe obdobi. Ufl~a~l crave l.e na iaJost uiiv~crl~
erooloutit l pied uplynutil sjednar.~ doby prop~j,enl. d to fta~!ialne 6 lesic~ ~ied u~j~nutim t~tQ coby.
~?H ne~dpo~ida za skodv zp~soQene Yanrialisll?l.
~ UflvateJ .~ povinnost fla ra. hroboviho pfislulenstvi nechat vysekat cislo hrobu.
Tato sml:>uYd J!! '1Vililto'/ena 'fe 2 'iyti5c~chl I nieht katd~ Sir. serana obddi DO 1 :;,teJrlooise.
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KAMENICTVf s.r.o.
ZAKAZKOVY LIST c.
Objednatel:
40601
..w.. ~'''''c:",Ck.. "'''c....c~
Pan
Mu"lIer Ferdinand
I~';p .11'0 1,,01 1~'10.1I6
Botanovska 1581
193 00 Praha 9 -Horni Poeernice
ICO: 25 701827, DIC: 009-25701827
e-mait:olsany@telecom.cz
kancelilf Olhny teUfax' 727 303 16 90055519
Vyilavska 34/2242
10000 Praha 10
tel. 74811974
Bankovn! spojeni Datum abiednani: 4.6.2001
C.s. a.s. pob. Homi Pocernice Dadacf Ihuta: do 10.7.2001
t. litlu: 0244377349/0800 Mfsto dodani: Ols 2ob-31 a-247uh
R. Mu"lIerava
Papis zakazky :
Ols 9-2-134
Mratek
Na miste 9-2-134
Stavajici pomnik odstranit, nechat spodni saki
Celkova oprava . zvednout, leva postranice u pomniku prasklci . zasilikonovat
Krycl deska umilla 2 dily 100x175
Skllpek pod desku u nohou f1 0 urenf
Volat Vaska k praci
Pi'evoz pomniku z mista 2ob-31a-247uh
a osadit na misto 9-2-134
Urny z mlsta 2ab . prenest do naveha skllpku na 9
Predbezna cena: 16.500,- vc DPH
Zhatavene dila je ai do liplneha zaplaceni vyuctavane castky rnajetkem firrny
Kamenlctvi Obelisk sra. ':.."H
.oo:~ ~ _. -"~r
Hoza Estate Executor Fee
rage: L Vi t
j f)~ I ~ i 'f!l I ~ I 'e I X I ... ... i ?
..
From: David Garity [SMTP:dgority@mandtbankcomJ
To: Skaufman@sek.com
Cc:
Subject: Hoza Estate Executor Fee
Sent: 11/7/014:14 PM
Importance:
Normal
Steve: The banks Executor Fee will be $26,000.00. Thanks, DAVE
.. ./read.asp?conunand=open&obj=00000000E96F13A223ACD5119BE200508B 1 04 7DB070011/19/200 1