HomeMy WebLinkAbout01-07-08 (2)
CHARLES E. SHIELDS, III
A1TORNEY-AT-LAW
(, CLOU~:ER ROAD
Corner o(Trindle and Clollser Roads
MECHANICSBURG, PA 17055
GEORGE M. HOUCK
0912-1991 )
TELEPHONE (717) 766-0209
FAX (717) 795-7473
January 2, 2008
Register of Wills
Cumberland County Court House
1 Court Square
Carlisle, P A 17013
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Re: Charles P. Pisano, Jr.
No. 21-07-0161
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Dear Register of Wills:
Please find enclosed for filing 2 copies of the Inheritance Tax Return for the Charles P.
Pisano, Jr. Estate as well as Check No. in the amount of $2.103.51 for Inheritance Tax due,
Check No. 145 in the amount of$200.00 for additional probate and Check No. 146 in the amount
of $15.00 for the filing fee. I am also attaching an additional copy to be date stamped.
Thank you for your kind attention to this n1atter.
Very truly yours,
~ l.Pc;
Charles E. Shields, III
Attorney-At-Law
CES/mjj
Enclosures
15056051047
REV-1500 EX (06-05)
PA Department of Revenue
Bureau of Individual Taxes
PO BOX 280601
Harrisburg, PA 17128-0601
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
OFFICIAL USE ONLY
County Code Year
File Number
INHERITANCE TAX RETURN
RESIDENT DECEDENT
~I
o 7
o 0 / 6/
Date of Birth
I " f St{. / J 0 if
() 2 / 0 ~O 0 7
I :L 0 g /9 (p I
Decedent's Last Name Suffix
Decedent's First Name
MI
PISANO /J1t..
CHIJ.RtES
1:
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix
Spouse's First Name
MI
viII
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
_ 1. Original Return c:::>
2. Supplemental Return
c::>
c:::> 4. Limited Estate c:::>
c::> 6 Decedent Died Testate c::>
(Attach Copy of Will)
c::> 9. Litigation Proceeds Received C)
4a. Future Interest Compromise (date of
death after 12-12-82)
7. Decedent Maintained a Living Trust
(Attach Copy of Trust)
10. Spousal Poverty Credit (date of death
between 12-31-91 and 1-1-95)
c:::>
o
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
C)
11. Election to tax under Sec. 9113(A)
(Attach Sch. 0)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE-DIRECTED TO:
Name Daytime Telephbne Number',
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7 I 7" 7r~n~ (;J20 ~ CJ'~
7 l *) .. :':,~~.-:= F..F'-," t'}
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REGISTEROf' WILLS ~~J ONLY
CHAIlLcS
t;
SII/E"LDS
, I
I
Firm Name (If Applicable)
Mitt
First line of address
to
CLOt/SElf..
/l.tJA-D
Second line of address
o
N/ It
City or Post Office
State
ZIP Code
DATE FILED
m €'C IIA- III C s 6 tJ Ie c;.. f'A-
Correspondent's e-mail address: be dMerc s (fJ-ep ix .11ei
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief,
it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
170S~173S-
S~GNATU~~~IBC'9~~TURN
ADDRESS C HA-IlL~S ~ fJ/SAKO
IS' f,{)Er~€1t8tU!.AI 1f!.P#~ cNI'/~A~ ",II{.. /7D;lS
SIGNATU" 91fRE~E~TH~AN~EPRESENTATIVE
;( ~Q(/!/P~ ~/d'd r-
ADDRESS ellA-illeS F. Sfll~:m: EStj.
, CLtJQJE7C ~.D.J mEt!#AAlicset{~6j /lA /7()S~
PLEASE USE ORIGINAL FORM ONLY
DATE.
/1 L 10 ~
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DA~
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Side 1
L
15056051047
15056051047
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15056052048
REV-1500 EX
Decedent's N~~_fJSA-AlO, CHII-IlL6 P.
RECAPITULATION
1. Real estate (Schedule A).
2. Stocks and Bonds (Schedule B) . .
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)
4. Mortgages & Notes Receivable (Schedule D) .
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) .
6. Jointly Owned Property (Schedule F) <=) Separate Billing Requested . . . . .
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) c::) Separate Billing Requested. . .
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Sctledule H). .
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .
11. Total Deductions (total Lines 9 & 10), . . '
12. Net Value of Estate (Line 8 minus Line 11) . . . . . , . . . .
13. Charitable and Governmental Bequests/See 9113 Trusts for which
an election to tax has not been made (Schedule J) .
14. Net Value Subject to Tax (Line 12 minus Line 13) . .
..~,._."",--."....o.oc'''' ^".~ _-"''-''''.''__. ,c ,__,~"._,,,,... ."'_..--._-""
TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2) X .OD- . 0 0
16. Amount of Line 14 taxable
at lineal rate X.O 'is
17. Amount of Line 14 taxable
at sibling rate X .12
18. Amount of Line 14 taxable
at collateral rate X .15
Lt' 1~9 07
. () 0
. () 0
Decedent's Social Security Number
/6 t.flf //ol{
1 .
30 000.00
.00
2.
00
. t) 0
~CfJ315,70
.00
.00
I I Cf J '1 S, 7 0
~ ,._,~--",-,<.,-,---~,--_._.-_...~~............._~_._,...__-.._---.,_..
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if? '9 7. J~
j 3 ~~(ol~~
If ~ ;( II 9 ..P?
. () 0
3.
4.
5.
6.
7.
8
9
, . . . 10.
11 .
. . . . . . . 12.
. . . . 13.
. . . . . 14.
If' 1'-9 ~ Z
15.
.00
16.
:~ 0 7 7 . h I
. () 0
.00
2-077,61
17.
19. TAX DUE.
. . . . . . . . . 19.
18.
\.....
'1 \./
._..... J
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20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
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Side 2
L
15056052048
15056052048
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~~-_:': ~omPlete Address:
DECEDENT'S NAME
C H/fIlL/:'S ,J. ;21S,tf/fJO
STREET ADDRESS
d.8 S" ~AJl) S~
File Number :2-1-07- /'1
CITY
tv~/l.MLEYJ8tl~G
STATE P/f
ZIP
/ 7 0 ~3
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
~
(1) ~ ~/o11. I.'
o
o
o
Total Credits (A + B + C ) (2)
o
3. Interest/Penalty if applicable
D. Interest
E. Penalty
()
o
B. Enter the total of Line 5 + SA. This is the BALANCE DUE.
(3) 0
(4) 0
;t " :J..~ () 77# U;/
(5)
(5A) 'J 5. 5l.f
(58) '1~ / Q 8 ' 5"1
Total Interest/Penalty ( D + E )
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2, Line 20 to request a refund.
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
Make Check Payable to: REGISTER OF WILLS, A GENT
PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred;........................................................................................ 0 !
b. retain the right to designate who shall use the property transferred or its income: ............................................ 0 ~
c. retain a reversionary interest; or............... ............. ............. ......................... ................... ................................... 0 rg]
d. receive the promise for life of either payments, benefits or care? .................................................................. 0 ~
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 for" or payable upon death bank account or security at his or her death? ............. 0 ~
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ..................... ................................ ...................................... ...... ..................... lXl 0
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
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 surviving spouse
is three (3) percent [72 PS. S9116 (a) (1.1) (i)].
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 zero (0) percent
[72 PS. 89116 (a) (1.1) (ii)]. 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 zero (0) percent [72 P.S. 99116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in
72 P.S. 99116(1.2) [72 P.S. s9116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. ~9116(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.
, REV-1502 EX+ (6-98) .
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
ESTATE OF
il/ J I!-IJ}O / {!/I/fI&.E:5 ~
FILE NUMBER
;l!-/J7-/6/'
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be
exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts.
Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F,
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
1, DeCE/JENT DWtvE"D DIIIG~HA-t.F 01=' ;If J)OU.I6LI: HottS~
illS ~A'E /{,r}{.,F fI/lJ/lN~ If./f/ ~:b!J1l6~ t'Jr ;l. e s.. Sr:&;NJ.~
S-r., tt)tI/l.A1LEYs8t(R~ ~~~1l61-/, eU 1J18E"RL4-A/J) tptt/Ji7Y.
{SEE (!P)py t)~ l/€t:'b Fdf;/11 ~Ji/lV;e, ,cA-U~T
HA-/JttJltl(;1'I7 E'XE""etlT/lIY pF TN€" J!::'ST/!-7'E" OF
I
7H1)/J'//rS E: NA-/J//J,€/6#T; LJ~Cc7f:fe-t.)) ~Z ,TULY 1'1'1"1..,
D€ED ;jt:r:'k ;lL) s:: J'2/16€ 6 Lf :z /I T77t1- (!N et:>).
-P//S P/Zp,t!E,lt.ry kA-S r5E7/EnEZy ./,)/I-/J//H!J&-t)
6y A71/ /l-t!L!/~e AJrl"!-L PI,eE.. (See /hSSo~rEi)
" r#6P rSC!H GtJ nLOS j=i::>'cz A-iJi) ITI ~/J}.IIL .i:)E /;11-1 LS)
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5/!-/,t.) F//le:- LG1J 70 L)EeEflCNTs t/A/?/mELY
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(oSEe ~py aF A6/lEc/JIE/'IT /l-7"T~en'~).
(A-LSD S€€ C!J!;PY 01= bElfD /fFFllJAv/T t:JF f/'/l-llJE" f
J ~
5E 71LB/Z1eIt/T 5f.-IEET /l-774-t?.NEZ>)
TOTAL IAI I' 1 R' t":::?;-' I"J /'1/'"\ 0 0
, SG enter on me ,lecapitulation) ljI ~ v" ...-V't....-'.
(liIIJUlt, Sp8CH it> IltJtJclHU, ins81i ctdcJitiullai slleets ui tile ::iClr1l8 size)
A-Gfl€E/HElVT ,Lb,f S/f{.,~ IJ/= ~ BTA--Tb
/N'.() ~EJVT, ~ ~ ,;21-11 7' If ~ :? EJO~ ~ 7- ~
~ (!JlA-/CLeS;? ,a5-?-AI'~ 44 ~ f ~ ~ -/
AM ~/ tYI,f-/2LB I! /;?/.s4-N~ 71(, M / lie ~ 7" 4~f-
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V-l8;:' t
y r~,;96: RECORDER'S USE ONL Y ---,
~,&A)
~~S;J' StOle T ox Paid
REALTY TRANSfER TAX
booY. Number
COMt.'\ON\VEALTH OF PENNSYLVANIA STATEMENT OF VALUE
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES Poge Numbec ~
DEPT 280603 Dole Recorded
HARRISBURG, PA 17128-0603 See Reverse for Instructions
I
, ,.
::>~plete each sectIOn and nle ,n.dupl1cate with Recorder of Deeds when (l) the full value/consideration is not set forth in the deed, (2) when the deed
without co~s~der.ahon, o.r by ~Ift/ or (3) ~ t?X e.~emption is claimed. A Statement of Value is not required if the transfer is wholly exempt from tax
1sed on: (1) tamlly relononshlP or (2) pUDllc utdfty easement. If more space is needed, attach additional sheet(s).
~ CORRESPONDENT.. All inquiries may be directed to the following person:
!ome Telephone Number:
MURREL R. WALTERS III, ESQ d ( 717
Area Co e
State
697-4650
reeT Address
54 East Main
Street
CiTY
Mechanicsburg,
Zip Code
PA
17055
TRANSFER DATA
Date of Acceptance of Document
~
~
rontor(s)/Lessor(s) C h a r 1 e s P. Pis a no,
f the Estate of Charles P.
~eet Address
Adminis " I Grantee (s)JLessee(s)
Pisano Jr Donald T.
Street Address
Orris
II
Tj
15 Wetherburn Road
State
1 Beaver Road
Enola
PA
Zip Code
17025
Ciiy
Stote
Zip Code
17033
Hershey
FA
PROPERlY LOCATION
ee-t-Address
28 s.
I City, Township, Borou9h
Borough
of Wormleysburg
Second Street
luorV
'Cumber 1 and
I School D;,"d
T ax Parcel Number
47-20-1858-068
~
VALUATION DATA
Actual Cash ConsideraTion
I' 2. Other Consideration
+ 0.00
15. Common Levei Ratio Fodor
X 1.14
13. T oial Consideration
= 30,000.00
16__. Fair Market Value
83,368.20
30,000.00
County Assessed Value
73,130,00
EXEMPTION DATA
Amount of Exemption Claimed
o
, 1 b. Percentage of Interest Conveyed
100%
:heck Appropriate Box Below for Exemption Claimed
"] Will or intestate succession
]
J
(Nome of Decedent)
(Estate file Number)
Transfer to Industrial Development Agency.
Transfer to 0 trust. (Atiach complete copy of trust agreement identifying all beneficiaries.)
Transfer between principal and agent. (Attach complete copy of agencylstraw party agreement.)
Transfers to the Commonwealth, the United States and Instrumentalities by gift dedication, condemnation or in lieu of condemnation.
(If condemnation or in lieu of condemnation, attach copy of resolution.)
Transfer from mortgagor to a holder of Q mortgage in default. Mortgage Book Number
, Page Number
Corrective or confirmatory deed. (Attach complete copy of the prior deed being corrected or confirmed.)
Statutory corporate consolidation, merger or division. (Attach copy of articles.)
)ther (Please explain exemption claimed, if other than listed above.)
needs extensive repair.
The ~roperty is fire damaged and
,/
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alties of law I : d&clare that I have examined this State 'ent I inel/ding acCompanying information, and to the best of my know-ledge
, it is true I correct and complete. 1 / / /'"
//f{ ~/ (;/Ll.-
!
.f Correspondent or Responsible Party
Date
~rel
R.
Walters
III
5/11/07
) CON'.PLETE iHIS FORM PROPERLY 01': ATT ACH APPLICABLE DOCUMENTATION MA '( ~ESUL 11N lHE- RECORDER'S REfUSAL
) THE DEED,
Tax Parcel No.
47--20-1858-068
THIS DEED
Made the / / ~ day of
and seven (2007).
~
in the year two thousand
Between CHARLES P. PISANO, as Administrator of the ESTATE OF
CHARLES P. PISANO, JR., a.k.a. CHARLES P. PISANO, a.k.a. CHARLES
PATRICK PISANO, a.k.a. CHUCK PISANO, a single n1an, deceased, late of
Wormleysburg, Cumberland County, Pennsylvania, Grantor,
to
DONALD T. ORRIS, II, currently of Hershey, Dauphin County, Pennsylvania,
Grantee.
WHEREAS, the said Charles P. Pisano, Jr., a.k.a. Charles P. Pisano, a.k.a. Charles
Patrick Pisano, a.k.a. Chuck Pisano was vested in his lifetime with title to the prelnises
hereinafter described in Wormleysburg, Cumberland County, Comn10nwealth of Pennsylvania;
and
WHEREAS, the said Charles P. Pisano, Jr., a.k.a. Charles P. Pisano, a.k.a. Charles
Patrick Pisano, a.k.a. Chuck Pisano, departed this earthly life, intestate, on the 10th day of
February, 2007, and Letters of Adn1inistration were duly issued on the 20th day of February,
2007 by the Register of Wills of Cumberland County, Pennsylvania to the aforesaid
Adn1inistrator and docketed to No. 21-07-0161; and
NOW, THEREFORE, THIS INDENTUIlE WITNESSETH, that the said CHARLES
P. PISANO, as Adn1inistrator, as aforesaid, for and in consideration of the sun1 of THIRTY
THOUSAND and No/IOOths ($30,000.00) DOLLARS, and other good and valuable
considerations, to hiln in hand paid by the said Grantee, at and before the ensealing and delivery
hereof, the receipt whereof is hereby acknowledged, has granted bargained, sold, aliened,
released and confirmed, and by these presents, by virtue of the power and authority in hilll vested
by the Fiduciaries Act of the Commonwealth of Pennsylvania, does grant, bargain, sell, alien,
release, and confinn unto the said Grantee, his heirs and assigns, the prelnises more fully herein
described below:
ALL TI-IA T CERTAIN lot or tract of land and buildings situate in the Borough of
W orn11eysburg, County of Cumberland, and State of Pennsylvania, more particularly bounded
and described as follows:
BEGINNING at a point on the westerly line of South Second Street, said
point being at a distance of 84.14 feet n1easured in a northerly direction from
Locust Street; thence along a line running through the partition wall of a double
fran1e dwelling house, South 50 degrees West, a distance of 46.7 feet to a point;
thence along the line of premises No. 30 South Second Street, South 47 degrees
49 minutes West, a distance of 81.86 feet to a point; thence North 44 degrees 6
n1inutes West, a distance of 21.05 feet to a point; thence along lands now or
fonnerly of Bertha Sadler, No. 26 South Second Street, North 50 degrees East, a
distance of 129.83 feet to a stake on the westerly line of South Second Street;
thence along South Second Street, South 40 degrees 35 n1inutes East, a distance
of 17.86 feet to the point or place of BEGINNING.
HAVING TIIEREON erected the northerly half of a double frame dwelling
house, No. 28 South Second Street, Wormleysburg, Pennsylvania.
1
BEING THE SAME PREMISES which the Estate of Thomas E. Halllbright, deceased,
by his Executrix, Robin R. Faust Hambright, by deed dated July 23, 1999 and recorded August 9,
1999 in the Office of the Recorder of Deeds in and for Cumberland County, in Deed Book 205,
Page 642, granted and conveyed to Charles P. Pisano, a single man. The said Charles P. Pisano,
Jr., a.k.a. Charles P. Pisano, a.k.a. Charles Patrick Pisano, a.k.a. Chuck Pisano departed this
earthly life on February 10, 2007. His Estate is the Grantor herein.
TO HAVE AND TO HOLD the said 11lessuage or tenement and tract of land,
hereditanlents and premises hereby granted and released, or lllentioned and intended so to be,
with the appurtenances, unto the said Grantee, his heirs and assigns, to and for the only proper
use and behoof of the said Grantee, his heirs and assigns, forever.
AND THE SAID GRANTOR, Administrator as aforesaid, his heirs, executors and
adnlinistrators, do covenant, promise and agree to and with the said Grantee, his heirs and
assigns, by these presents, that the Grantor has not done, committed any act, 111atter or thing
whatsoever whereby the preluises hereby granted, or any part thereof, is, are, shall or may be
impeached, charged or enculubered in title, or otherwise howsoever.
IN WITNESS WHEREOF, the said Administrator of the Estate of Charles P. Pisano,
Jr., a.k.a. Charles P. Pisano, a.k.a. Charles Patrick Pisano, a.k.a. Chuck Pisano, deceased, Grantor
herein, has hereunto set his hand and seal the day ,md year first above written.
Signed, sealed and delivered
in the presence of:
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CHARLES P. FIISANO, Administrator
of the Estate of Charles P. Pisano, Jr.,
a.k.a. Charles P. Pisano, a.k.a. Charles Patrick
Pisano, a.k.a. Chuck Pisano, Deceased
2
COMMONWEAL TH OF PENNSYL VANIA
: SS.
COUNTY OF CUMBERLAND
On this, the / / J-/, day of (ll'!;;t , A.D. 2007,
before lTIe the undersigned officer, personally app. red CHARLES P. PISANO, as
Administrator of the Estate of Charles P. Pisano, Jr., a.k.a. Charles P. Pisano, a.k.a.
Charles Patrick Pisano, a.k.a. Chuck Pisano, known to nle, (or satisfactorily proven) to
be the person whose name is subscribed to the within instrument, and acknowledged
that he executed the same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set nlY hand and official seaL
,().. '/ /) (J ~/
(; I ,ttJ-(n.a /f\- ()t,. '/j ~
I Notary Ptr ic
Ce' I 'ltlm. _
NOTARI,I~L SEAL .
DEBORAH L. FtYAN, Notary Public
Mechanicsburg Baro.. County of Cumberl~nd
M Commission Expires June 11, 20 10
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CERTIFICATE OF RESIDENC:E~
I HEREBY CERTIFY that the precise residence of the Grantee is:
Attorney for Grantee
3
A.' Settlement Statement
U.S. Department of Housing
and Urban DevE~lopment
~
,r
OMS Approval No. 2502-0265
8. Type of Loan
1 0 FHA 2. 0 FmHA 3. 0 Conv.. Unins. 6. File Number
4 0 VA 5. 0 Cony. Ins.
7. Loan Number
8. Mortgage Insurance Case Number
C. Note: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are
shown. Items marked "(p.o.c.)" were paid outside closing; they are shown here for informational purposes and not
included in the totals.
1
H
Name and Address of Borrower E. Name and Address of Seller F. Name afld Address of Leflder
IONALD T. ORRIS II CHARLES P. PISANO, ADMINISTRATOR
BEAVER ROAD ESTATE OF CHARLES P. PISANO, JR.
ERSHEY PA 17033
G. Property Location H. Settlement Agent
'AX PARCEL NO. 47.20.1858.068 MURREL R. WALTERS III, ESQUIRE
8 S. SECOND STREET Place of Settlement I. Settlement Date
ORMLEYSBURG PA 17043 54 EAST MAII~ STREET 5/11/2007
MECHANICSEJURG PA 17055 Disbursement Date
Lot: Block: 5/11/2007
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1
2
W
J. Summary of Borrower's Transaction
100. Gross Amount Due From Borrower
1 D1. Contract sales price 30,000.00 401. Contract sales price 30,000.00
102. Personal property 402. Personal property
103. Settlement charges to borrower (line 1400) 1,114.50 403.
104. TAX CREDIT. 311107 -5/11/07 OF $121.32 29.17 404. TAX CREDIT. 3/1/07.5/11/07 OF $121.32 29.17
10S. 405.
Adjustments for items paid by seller in advance Adjustments for items paid by seller in advance
106. City/town taxes to 406. City/town taxes to
107 County taxes 5/11/2007 to 12131/2007 232.08 407. County taxes 5/11/2007 to 12/31/2007 232.08
108. Assessments to 408. Assessments to
109. SCHOOL 5/11/2007 to 6/30/2007 97.19 409. SCHOOL 5/11/2007 to 6/30/2007 97.19
110. to 410. to
111. SEWERl 5/11/2007 to 6/30/2007 63.19 411. SEWER! 5/11/2007 to 6/30/2007 63.19
112. REFUSE to 412. REFUSE to
113. to 413. to
114. to 414. to
115. to 415. to
120. Gross Amount Due From Borrower 31,536.13 420. Gross Amount Due To Seller 30,421.63
K. Summary of SE~lIer's Transaction
400 Gross Amount Due To Seller
200. Amounts Paid By Or In Behalf Of Borrower
500. Reductions In Amount Due To Seller
201. Deposit or earnest money 1,000.00 501. Excess deposit (see instructions) 1,000.00
202. Principal amount of new loan(s) 502. Settlement charges to seller (line 1400) 351.90
203. Existing loan(s) taken subject to 503. ExistinQ loan(s) taken subject to
204 504. Payoff of first mortgage loan
205. 505. Payoff of second mortgage loan
206 506. I
207. 507.
2013. 508.
209 509.
Adjustments for items unpaid by seller Adjustments for items unpaid by seller
210. City/town taxes to 510. City/town taxl;s to
21'1. County taxes to 511. County taxes to
212. Assessments to 512. Assessments to
213- to 513, to
214. to 514. to
215. to 515, to
216. to 516. to
217', to 517. to
218. to 518. to
21S. to 519. to
220. Total Paid By/For Borrower 1,000.00 520. Total Reduction Amount Due Seller 1,351.90
I
300. Cash At Settlement From/To Borrower
301. Gross Amount due from borrower (line 120) 31,536.13 601. Gross amount due to seller (line 420) 30,421.63
302. Less amount paid by/for borrower (line 220) ( 1,000.00) 602. Less reductions in amt. due seller (line 520) ( 1,351.90
303. Cash [RJ From o To Borrower 30,536.13 603. Cash [g] To o From Seller 29,069.73
600. Cash At Settlement To/From Seller
SUBSTITUTE FORM 1099 SELLER STATEMENT
he information contained in Blocks E, G, H, and I and on line 401 (or, line 403 and 404) is important tax inf,xmation and is being furnished to the Internal Revenue
ervice. If you are required to file a return, a negligence penalty or other sanction will be imposed on you if this item is required to be reported and the IRS determines
lat It has not been reported. If this real estate is your principal residence, file Form 2119, Sale or Exchange of Principal Residence, for any gain, with your income tax
'turn: for other transactions, complete the applicable parts of Form 4797, Form 6232 and/or Schedule D, Form 1040). You are required to provide the Settlement Agent
amed above) with your correct taxpayer identification number. If you do not provide the Settlement Agent with your correct taxpayer identification number, you may be
IbJect to civil or criminal penalties imposed by law. Under penalties of perjury, I certify that the number shown on this statement is my correct taxpayer identification number.
(Seller's Signature)
L. Settlement Charges
700. Total Sales/Broker's Commission based on price $ 30,000.00 @ %= 0.00 Paid From Paid From
Division of Commission (line 700) as follows: Borrower's Seller's
701. $ to Funds At Funds At
Settlement Settlement
702. $ to
703. Commission paid at Settlement
704.
800. Items Payable In Connection With Loan
801. Loan Origination Fee %
802. Loan Discount %
803. Appraisal Fee to
S04. Credit Report to
805. Lender's Inspection Fee
806. Mortgage Insurance Application Fee to
807. Assumption Fee
808.
809.
810.
811.
812.
S'13.
900. Items Required By Lender To Be Paid In Advance
Exclude last day in cales -line 901
901. Interest from to @$ f day
902. Mortgage Insurance Premium for months to
903. Hazard Insurance Premium for years to
904. years to
905
1000 Reserves Deposited With lender
1001. Hazard Insurance months@$ per month
1002. Mortgage insurance months@$ per month
1003 City property taxes months@$ per month
1004. County property taxes months@$ per month
1005. Annual assessments months@$ per month
1006 months@$ per month
1007. months@$ per month
1008. Aggregate Accounting Adjustment
1100. Title Charges
1101. Settlement or closing fee to
1102. Abstract or title search to
1103. Title examination to
1104. Title insurance binder to
1105. Document preparation to
1106. Notary fees to CASH 15.00
1107 Attorney's fees to
(Includes above items numbers: )
110S. Title insurance to MURREL R. WALTERS III, ESQUlltE 760.00
(Includes above items numbers: 1101-1104, 1108 PENN ATTORNEYS TITLE INS. CO. )
1109. Lender's coverage $
1110. Owner's coverage $ 84,000.00
111,.
1112.
1113.
1200. Government Recording and Transfer Charges
1201. Recording fees: Deed $ 39.50 ; Mortgage $ ; ReleasEis $ 39.50
1202. City/county tax/stamps: Deed $ 300.00 ; Mortgage $ 300.00
1203. State tax/stamps: Deed $ 300.00 ; Mortgage $ 300.00
1204.
1205.
1300. Additional Settlement Charges
1301. Survey to
1302. Pest inspection to
1303.
1304.
1305. TAX CERTIFICATION 10.00
1306 CLERK OF COURTS- CUMBERLAND COUNTY - #CP-21-CR-0002906-200!i 41.90
1307.
1308.
1400. Total Settlement Charges (enter on lines 103, Section J and 502, Section K) 1,114.50 351.90
CERTIFICATION ~ .'
h"e OO'e'ully ,e"ewed the HUD-1 SeUlemeot Statemeot aod to the best of my koowledge Bod be",.. t~1e and accqrate statement of a~1 r c ~ ipts a.nd. disbur.sements
)n my account or b in thO ransaction. I further certify that I have received a copy of the HUD-1 Settle t;lit S_~ateme I 6(; ~
? t-/;" '--~
, Seller 11' / [/....... ~- Borrower
CHARLES P. PISANO, ADMINISTRATOR DONA D T. ORRIS II
Seller Borrower
"he beo.4 ky~;~:~~.e Hl)liJ-1 s.ettlement Statement which I have prepared is a true and accurate account of t'J.e"iu~ndS wnich were received and have been or will
= dlsbUrr;2~)t~ n11ft'}?s t.:.:f the settlement of this transaction. / /'1{ t:1
I Settlement Agent ? f-( l 7 . Date
~URREL R. WALTERS III, ESQUIRE
ARNING: It is a crime to knowingly make false statements to the United States on this or any other similar form. Penalties upon conviction can include a fine and
prisonment. For details see: Title 18 U.S. Code Section 1001 and Section 1010.
,/'
U.S. GOVERNMENT PRINTING OFFICE: 19890.944-245
RE'V.1?JB EX + (197t
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATEOF P IslflJlCj CHIfI2LE,S f!
FILE NUMBER
OLI-tJ7- /b/
ITEM
NUMBER
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly.owned with the right of survivorship must be disclosed on Schedule F.
I VALUE AT DATE
OF DEATH
DESCRIPTION
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CHARLES PISANO
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Payment for DWELLING Coverage for FIRE
'Loss of 02/10/'2007
DATE 03./29/2001
TIN
PMCO 5130
Bank ofAmerica,.NA
Atlanta, Dekalb County, Georgia
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EMPL DFJ2
Forty-Nine Thousand Five Hundred
Sixty-Nine & 22/100 USD
$
49,569.22
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CHARLES PISANO JR. and
REGIONS BANK DBA REGIONS MORTGAGE
Allstate
Insurance Company
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inCludec
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28 S. 2ND STREET
WORMLEYSBURG, PA 17043
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VOID IF NOT PRESENTED WITHIN THREE HUNDRED SIXTY-FIVE DAYS OF THE DATE OFIS5UE. , , AUTHOFl!1EtD SIGNATURES
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THE ORIGINAL DOCUMENT HAS REFLECTIVE WATERMARK ON THE.BACK.. DO NOT CASH IF WATERMARK IS NOT VISIBLE.
PI M&fBank
499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12
Phone (888)502-4349
Fax (302) 934-2955
March 19,2007
Charles E Shields III
Attorney At Law
6 Clouser Road
Mechanicsburg, Pennsylvania 17055
Re: Estate of Charles P Pisano
Social Security: 168-54-1] 04
Date of Death: February 10.2007
Dear Sir or Madam:
Per YOlrr inquiry dated March 14, 2007, please be advised that at the time of death, the above-named decedent had on
deposit with this bank the following;
1. Type of Account Checking Account
Account Number 9834528714
Ownership (Names oj) Charles P Pisano *
Opening Date 07/21/03 Closed 03/05/07
Balance on Date of Death $],748.52
Accrued interest $ 0.]0
Total $1,748.62
2. Type of Account Savings Account
Account Number 015004204083361
Ownership (Names of) Charles P Pisano *
Opening Date 07/21/03 Closed 03/05/07
Balance on Date of Death $1,132.49
Accrued Interest $ 0.29
Total $1, 78
3. Type of Account Certificate of Deposit
Account Number 031003914966494
Ownership (Names oj) Charles P Pisano *
Opening Date 07/05/05 Closed 03/05/07
Balance on Date of Death $15,873.12
Accrued Interest $ 82.34
Total $15,955.46
4. Type of Account Certificate of Deposit
Account Number 031003914967814
Ownership (Names oj) Charles P Pisano *
Opening Date 03/28/06 Closed 03/05/07
Balance on Date of Death $ 7,000.00
Accrued Interest $ 306.93
Total $7,306.93
Please be advised, there was no safe deposit box found for the above decedent.
* For further account information, regarding ownership, closures and/or reimbursement of funds, etc., please call
the Trindle Road Office # 717-737-2308.
Sincerely,
Nancy Clagett
Records Management
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CHARLES PISANO ADM
CHARLES PISANO DEeD
15 WETHERBURN RD
ENOLA PA 17025-1844
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CHUCK P PISANO
28 S 2ND ST
WORMLEYSBURG P A 17043-1310
Important Information
As you requested, we have terminated your policy effective February 10, 2007. Attached is your refund check.
We th8nk you for the opportunity to serve you and hope we can provide your insurance protection In the tuture,
If you have any questions, please contact your agent or producer of record.
Policy Number:
628 853 599
Agency:
Issued To:
JAN VAJDA AGENCY (717) 731-1300
CHUCK P PISANO
28 S 2ND ST
WORMLEYSBURG PA 17043-1310
Description:
94 PROBE
99 VOLKSWAGEN JETI A
Please detach the check below before depositing.
( OVER)
:$;j~
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MVI
-----------------------------~----------------------
ALLSTATE INDEMNITY COMPANY
10815 DAVID TAYLOR DRIVE CHARLOTTENC 28262
Check Number: 0068421228
Date of Issue: Apr 17,2007
66-156
531
Policy Number:
PAY
628853599
07
~ A[ [stafe~
FIFTEEN AND 45/100 _u____ DOLLARS
You're in good hands,
TO THE
ORDER OF
Check Amount: $15.45
CHUCK P PISANO
28 S 2ND 5T
WORMLEYSBURG PA 17043-1310
ATLANTIC DATA CENTER
PREMIUM REFUND ACCQUf\rr
WachQvia Bank. National Association
Chapel Hill. NC 27514
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AI/state Insurance Comoany - Claims Payment Processinq
P. O. Box 487840, Charlotte, NC 28269
~Allstater",
You'n; In goorl hands
111.11111.11111. .1..111111 111111111. .111111.11 111.11111. 1111. I
ESTATE OF CHARLE PISANO II
15 WETHERBURN RD
ENOLA PA 17025
06/19/2007
EST ATE OF CHARLE PISANO 11,
ENCLOSED PLEASE FIND PAYMENT IN THE AMOUNT OF $9,156.54 FOR YOUR FOR YOUR FIRE LOSS TO
UNSCHEDULED PERSONAL PROPERTY ON 2110/2007
PLEASE REFERENCE CLAIM DETAILS BELOW.
CLAIM NUMBER: 0100856953
DA TE OF LOSS: 02/13/2007
INSURED: CHARLES P PISANO
ALLSTATE INSURANCE COMPANY
MCO Hours :
MCO Phone Number:
Adjuster Name :
Adjuster Phone :
B.2055SW
E.....~
. ~i:"'~
. oJ, :
00000200706190011 02ZCT0300 1 001001147
03
Item Id 2007/04/30-0060957-919-016-00
CERT# 4020430 MP# 241-0181-000
LL# 090037250
Borrower PISANO, CHARLES P
Policy cancelled per Lender's request. No
further premium due.
9.68
: CHFCKNO.
NOT N EGO T I A B L E - Attac~check is in full payment of the items listed above. Please detach this statement before depositing chock.
1,_lun1t~c,ilfaranty .
I United. Guaranty. Corporlltign
f P~O.Box 21567
I Greensboro, NC27420
i.PAYEXACTLY
i
I
I
I
t
t TO THE
[?ORDER
I
IOF
i
!
N{A8iIDVik~B.ANK;;N,A.\
:::~9~lnIlLL;Ng:'..
66-15.8
,.:......5.31
. CHECK NO. 01594348!
17025
DATE: '5/0.2/07
VOID AFI'ER6MONTHS
_.. c. . ..' " ~.'___ ." .,', __ _' . - ..........,.._.
;~- - " . ". . - . . -,'. _ ...... '." :-'c', >,"':';':>' . . '"
* *** *.**** *.*'*9~ . .':D.QPLAiRS.;~ND: .. *'*'6 8**
REGIONS BANK D/B/AREGIONS
OR PISANO, CHARLES 'p
ATTN:
15 WETHERBURN ROAD
ENOLA
PA
.~tJt1b-u rc~
AUTHORIZED SIGNATURE
III 0 . 5 9 L. ?a L. B III I: 0 5 3 . 0 . 5 b . I: 2 0 7 9 9 0 0 0 0 0 9 3 5 III
~
- . . &. Regions Mortgage
>H P.O. Box 1860
REGIONS Memphis, TN 38101-1860
MORTGAGE 1(800) 986-2462
REGIONS MORTGAGE
REGIONS BANK
DISBURSEMENT CLEARING
HA2 R10 0090037250
0090037250
~
0620
MO/DAY/yR
04/27/2007
FOR PAYMENT OF RESTRICTED ESCROW
AMOUNT
***'*'*'*'***'$1 ,945.39
VOID IF NOT CASHED WITHIN 180 DAYS
One Thousand Nine Hundred Forty Five and 39!100 Dollars
PAY TO
THE ORDER
OF
ESTATEOF CHARLES P PISANO
CHARLES P PISANO, SR., ADMIN.
15 WETHERBURN ROAD
ENOLA PA 17025
Security features
Included.
Details on back
III 2 . ~ 8 0 j III I: 0 b 2 0 0 5 b g 0 I: III 0 2 0 0 b b ~ 7 . 5 III
Disbursement Check Voucher
BATCH: HA2
CHECK NUMBER: 214803
CHECK DATE: 04/27/2007
PAYEE CODE: 0090037250
PAGE 1 OF 1
PAYEE NAME
& ADDRESS
EST A TEOF CHARLES P PISANO
CHARLES P PISANO, SR, ADMIN.
15 WETHERBURN ROAD
ENOLA PA 17025
SHORT NAME!
INIT NAME!
LOAN NUMBEFI PROPERTY ADDRESS
DESCRIPTION
TRAN
CODE DATE
AMOUNT
DUE
0090037250 EC PISANO LN PD IN FULL 304 l,945.39
Chpr+ Tnt81S'
1 Itp,m
$1,945,39
REV 1510 EX + (1-97) ,
._~-
~
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF fJ/sI!-AitJ) f!#/fI?LEJ /!
FILE NUMBER
;2/-07- /4,- /
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes,
ITEM
JUMBER
1 ,
DESCRIPTION OF PROPERTY
INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATlONSHlf' TO DECEDENT AND THE DATE OF TRANSFER
ATTACH A COpy OF THE DEED FOR REAL ESTATE.
DATE OF DEATH
VALUE OF ASSET
%OF
DECO'S
INTEREST
EXCLUSION
(IF APPLICABLE)
TAXABLE VALUE
C OYl e Sl-O~A -r: Ie f-rof;t S'no..rl~ Pla.n No.
\ % S- ~ 02 0\5 Ad IVI ~ 1\\51-v-ed by 't< EL/AJJU-
"""DeS ',~noJed PCVfte was d~ce.det'\t5 SlsteA)
t<.r~5t; t\~o.Ylo.
Note: '"DeCe.dent was tons,de.ro.-\Jly Jess-MLUt
59 y~ YWJ "are uui had pI? unkle.red
r' fhf!. pf. Jt g. Dr N,Mdr4/Vpl. ,/Mte-h,/<e,
~ fov~IJ;//1i 4M/JtlJ1t is /Jet zerO.
~
&; I ~ 17. Jlt!
III 04
/tJolo
I'd- zero
._ .....____________J_
TOTAL (AlSO erne: un iim~ 7, Re:;apiiulaikm) $
;.(.;7: Zt:.A-C
. REV-l~11.EX+ (12-99)
· . . (,. ~ ,W
'f';~''\.~
.~}~~;..,
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF fJ /511-1f~ eHII/tLES' f?
FILE NUMBER
2/-/}7-/~/
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A FUNERAL EXPENSES:
B.
D,
9,
It),
ff.
DESCRIPTION
1.
lJ1A-lPE-ZZ/ FUNElVIi. HOME- I/P /J1et!H/MJ/(!Sf3Ule6-
J.
Gi!jfJ/ES/IJtE 5E7J.1;1c,E ,fT AfT: O{.,(VET Cl:IJ1E7b--XY, jJITT-STt:JAJ, PA-
I}. f/o/V'ORJI-/<./u m Id FHTN€1i!. ~A-tlL
8. FL~ wE72.$
~ . F tlA;'F /tAL IU C7J-L /for C.OL U R u s S 0 ~ I2t::-STrI-t{ 2.n-AJ 7; A-~(!'A
CSt:lF f(E{!~IIJT 1/ TTACHEP)
n 5E:/11/A-AJ /Jf/)IIUIJ1ENT Co. of T/1-Yc /)/C1 PA- (oSe&;:" /2Er!E1PT
A-'7rMket>) E. COS 7" of Lor, ET~. /YJT OLIVIFT CEm~72!;e/y" fJF
ADMINISTRATIVE COSTS: W"/ontl/Vc., JOA. rsccRt&G"/pr)
1. Personal Representative's Commissions
Name of Personal Representative(s) CI-III-IlL.ES (J.. jJIS/}#tJ
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address /:r IVI: T~ ~,(3 tt,e/IJ J€P..
City EIV~t.~ State fJA _ Zip /7 LJ ;{ 5"
Year(s) Commission Paid:
2.
Attorney Fees CJ.ltf-/2LE~ e. SI1/ ez.OS 1iE, E:5~,
3 Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
AJ~IJE
Street Address
City
State _ Zip
Relationship of Claimant to Decedent
4.
Probate Fees fJMI1 ~rt cerf; ~'cates
5.
Accountant's Fees 1 C
'7 e to r y & Ie..
Tax Return Preparer's Fees R. t L. .J" neJ A eeCnts
p~. c.IDSl. -out l'tJ.fOI Pit lfo
t04/, Pit L(f,r:tZ"
6.
AMOUNT
~
9~ 54/.. tJL{
l' ~-O, ()/)
" OS" DO
~
5 70. DO
~I.fl / q s: 00
Jl I, I fj 7. "D
W A/lit: D
</
6; 975",t;O
A)/)A/G
?
f(o"oo
Y3~S: tJt)
1 c:2/s; t10
~
j S. DO
~
I :z 2.. 5 I
"7S'1 ~o
1f.J1i'I;~h4! proud/!- fee
r//j~ Fee ~ ~~;sfer ~~ UJ///s
/fdye,.rf;s/n; i" & Cd.r/,'s!t. Senf/nd NeW.5fo/JU"
Adrift/sin! //1 fAL {'UHfb~kJ1" LpW>>UI"J14/
<<ellt:bt:,"~CA/~l1t ~~r:f~:t~1 .ma!/,ltf~ .~~" c!,J:~e {"a//~
, v ! '/.
(JP5faf't,l j1/U;m~,P/~s.. (e.sh~) , 11 I '3!,!:J7)
( t!J;Jt flllu~ If; .
_____________.____._.___------1_______________._..__________
I .-".... ~'. a '7 C
TOTAL 1L\,i~(' pnt7"- nn in,p ~I P,Pr'3[Jitlll;ltI0!1: i S .~ -"~ __, r;:I. I,.. .I:-..J
. e
7.
(!t .......,0...(''',n;:~(' 1'"' r:0;-10ri 'r;~0"'+ ~('i~!t!'"'.-.,,':! f'~r~~" :;~ +"i" :,"",:""""'i"" ,'"',:....(' ~
t5tll E/) ~ H'I r!.Dn t 'd.
Es 7: OF ;:J/Slflf/t), {W,1tU.t::-3 ~
.~~ _, .." ~ ... ~ I"", ,
/~ , -r,'t-It cKArtlt - /,,/- ~ItA f,46sln:u/JcrI/'c.e
13. (!6a"f~ OJ1~#k/MdI ~~~fCJH S:zJ of ~~Bk~ .r:r~
i.Sdtet/u1e A...r>>ui d~c4h1l1hf .#lert!41)
I
!.A.) SMrc of rUl/fy ~dHSfer ~
IJ.) k: Cer/t f,ca ~ '0 "1
c) /J'1Jflent of balaJ1ceda ~sf,'-fu:l-/OJ1 Drde~1 ClerK 61 e,lIr~
- C u-Mherl0A14 &~ - #(!.f1 -2./-:C{- 0002.7 /)~ - zoo S-
Ii. S~,.)//ce CIJt/~e/lt;Se<;~ by /lifT /.3ChtA:.utt/f~r cI,{),e!.
15". if /k-tnRJ; J:=/ot /sf <<-. Itledvucs-Iu rj ~ sr;'t c ere/Julny
(~t'L t-tC~J{Jt al!ru:h.d).
lb. }.Jdd: ~ ~ JemifHI /Jj(JIZUmed r;-
F/LE;=".l//tJ. ;l/-o7...16/
,..
, I 3 S- · 00
t:
300. /)D
.r
It:) , ~t)
~511, 9.?
00 r 00
.L
58,30.
9'
3..30, tyrO
GLENDA M. \VETHINGTON
TRI-COUNTY ABSTRACT SERVICE
3414 CHESTNUT ST.
CAMP HILL, P A 17011
Date
3/9/2007
Bill To
SHIELDS. CHARLES E. Ill, ESQ.
() CLOUSEI< ROAD
MECIIANICSBURG. PA 17055
P.O. No.
Terms
Net 30
Quantity
Description
Rate
1 CUMBERLAND COUNTY SIXTY YEAR SEARCH: PISANO: 28 S. SECOND
STREET BOROUGH OF WORMLEYSBURG
135.00
p;.:~ __.........,...., _ __-"" ~~",,=-<.~t'i ~-"-J-.n-...ir""""--'<';"~~.- _>- .
"",,,,,~~_. ~,w..,,~.~,=<o.~~-"''''''mH''''''' _.~...H"V""=~
1830
c--",-
<.;:D.
CHARLES E. SHIELDS III
6 CLOUSER RD.
MECHANICSBURG, PA 17055-9735
Date
3-7615/360
292
Pay to the ~
order of /ru '-
~~
4/;~
.~
~~~
~
DalLa rs
Citizens Circle Account
:r~ J;=S;~ 01~37/~_!:~
I : 0 ~ b 0 7 b ~ 50 I: b" 0 0 7 0 ~ 7 ~ a II- .. a ~ 0
i9C/arj<c ,"j",e'HWl
Total
Invoice
Invoice #
07 -3 71
Project
Amount
135.00
S i ~5.()(i
Michael J. Malpe:.zi, Owner · Jeremy J. Shartzer, Funeral Director
8 Marker Plaza Way · Mechanicsburg, 1~4. 17055 · Plume: (717) 697-4lJ96
March 20. 2007
Mr. Charles P. Pisano
15 Wetherburn Road
Enola. P A 17025
The Funeral Ser,;ice for Charles Patrick Pisano
V\/e sincerely appreciate the confidence you have placed in us and will continue to assist YOLl in every way we can. Please
feel free to contact us if YOll have any questions in regard to this statement.
THE FOLLOWING IS AN ITEMIZED STATEMENT OF THE SERV1CES, FACILITIES. AUTOMOTIVE EQUIPMENT.
AND MERCHANDISE THAT YOU SELECTED WHEN MAKING THE FUNERAL ARRA.NGEMENTS.
1. PROFESSION"AL SERVICES
Services of Funeral Director/Staff
3. AUTOMOTIVE EQUIPMENT
Out ofwwn transportation
FUNERAL HOME SERVICE CHARGES
SELECTED MERCHANDISE:
Steel Protective Casket
Sentinel Burial Vault
50 additional acks.
Register. folders. Acks.
Suit. Shirt. Tie. Underclothing
Memory Portrait
THE COST OF OUR SERVICES, EQUIPMENT, AND MERCHANDISE THA T YOU HAVE SELECTED
AT THE TIME FUNERAL ARRANGEMENTS WERE MADE. WE ADVANCED CERTAIN PAYMENTS TO OTHERS AS AN
ACCOMMODATJON. THE FOLLO\VING IS AN ACCOUNTfNG FOR THOSE CHARGES.
CASH ADVANCES
Opening Grave
Certified Death Cenificates
Newspaper Notices - PatriOl
Newspaper Notices - Out of Town
Deacon Parusn
Flowers
TOTAL CASH ADVANCES AND SPECIAL CHARGES
SUB-TOTAL
JNITIAL PA YMENT I DISCOUNT; CREDITS
TOTAL AMOUNT DUE
l_ C .11/:/.' .:-'J/".//.;~-r-7c
).:.:<.' ~//1/-:T)
, / /)
------------: '/ -" /~:--
;../1".A.
~:'\."\',.l.'i(l[/)('~'_~.~/Li/l'l /~I;l/il-/j'll.\ (Jiil
$3865.00
$185.00
$4050.00
$2675.00
$1095.00
$14.00
$78.00
$205.93
$100.00
$8217.93
$700,00
$60.00
$387.01
5;] 70.00
$50.00
$]96.]0
51563.11
S978 J .04
$9781.04
/_ 0)' ~00
--;-:-.--;--;;
f!;'7)r,(J/
/" f .
GUEST CHECK
I' Date Table' Guests Server '
6:"Q"'~ 4::
.. ..0 U ..L ..L V
i
I
+=
ACR-G6000SCC
Flight Schedules
-- - f"'" ) . ';::]' . ~ - - - . : - -- , ... .. -} - ... -. . ... . ..~....- . . - - -. . - -
FRX NO. : 5705621419
Aug. 02 2007 11:40AM I
=-ROI'1 : SEM I RN FUI-..jERAL D I RECTORS
;'..... .~...
.... '~.
'. "1;. ',." ,
~~9
-'~
C?;.. ·
e/fftlU/n
~
Semian Monument Company
Statement
August 1 ~ 2007
Mr. Charles PisuY.>
15 Wetherburn Road
Enola, P A 17025
RE: Pisano Monument
Select Barre Gray Die & Base, Pol. Front, Back. Top. BRP
Die: 3-6 X 0-8 X 24
Base: 4-6 X 1-2 X 0-8
PISA...~O Family Name! Front & Back
Two/Standard Shaped Carvings
All individual names as requested
Delivery and sitting: Mount Olivet Cemetery , Carverto~ P A
TOTAL COST
(previously FW'Iished liemizatiorz)
$ 4,195.00
John A. Souter Tamara Semian-Souter
704 Union Street # Taylor, PA '# 18527-1316 ~ (S70) 562-3530
:;+.~ c.~:~~.~..:!. ~ 1 c- :; :'".:-:::
Page 2 of 2
S/2/2()(: -:
!'I h~Bank
.
ACCOUNT NO. ACCOUNT TYPE
15004204083361 M&T MARKET ADVANTAGE
STATEHENT PERIOD
PAGE
JAN.20-APR.20,2007
1 OF 1
00 0 04350H NH 017
51840
CHARLES P PISANO
15 WETHERBURN RD
ENOLA PA 17025-1844
INTEREST EARNeD FOR STATEMENT PEHIOD
INTEREST PAID YEAR TO DATE 1.12
0.6'1
TRINDLE ROAD OFFICE
ACCOUNT SUMMARY
BEGINNING DEPOSITS & WITHDRAWALS & OTHER CURRENT ENDING
BALANCE OTHER ADDITIONS SUBTRACTIONS INTEREST PAID BALANCE
NO. 1 AMOUNT NO. I AHOUNT
1,141. 99 01 0.00 31 1,143.11 1.12 0.00
ACCOUNT ACTIVITY
POSTING . DEPOSITS~INTEREST W/DRAWALS & OTHER DAILY
DATE TRANSACTION DESCRIPTION & OTHER ADDITIONS SUBTRACTIONS BALANCE
01-20-07 BEGINNING BALANCE $1,141. 99
01-23-07 INTEREST PA YHENT 0.50 .
01-23-07 SERVICE CHARGE 10.00 1,132.49
02-23-07 INTEREST PA YHENT 0.48
02-23-07 SERVICE CHARGE 10.00 1,122.97
03-05-07 INTEREST PA YHENT 0.14
03- 05 - 07 CLOSEOUT 1,123.11 0.00
ENDING BALANCE $0.00
ANNUAL PERCENTAGE YIELD EARNED
0.50 %
A $1,000 FOR YOUR THOUGHTS?
VISIT AN M&T BANK BRANCH BETWEEN APRIL 2 AND MAY 4 TO RECEIVE AN INVITATION TO
PARTICIPATE IN OUR CUSTOMER SERVICE SATISFACTION SURVEY. COMPLETE THE SURVEY
FOR A CHANCE TO WIN A GRAND PRIZE OF $1,000.
NO PURCHASE OR TRANSACTION NECESSARY. FOR COMPLETE SWEEPSTAKES RULES VISIT:
WWW.MANDTBANKSURVEY.COH.
MAIN OFFICE
CATHOLIC CEMETERIES
1708 ORAM S1 . SCRANTON, PA 18504
PHONE 207-2209
R~C~IPT
f\J~ 29853
Date I tJ ~ 9 -cJ 1
Mt. Olivet Cemetery
(612 Mt. Olivet Road, Carverton, PA)
P.O. Box 257, Wyoming PA 18644-0257
Received Fro~ {!jnr /~51?s~o yCA!;S#;e-/itM> (J ftVJ.,fJ
LS" We. th /3,1;(,1 1 c( _
&0 [.,11/ . t~ / () (:;20
THE SUM olJe ~eW. h lAtlP(e.d fiJl/J e +; -::5.e.u.~
LOT / ~ ~?()JU 0
CRYPT
NICHE
BRONZE MEM.
INT/ENT FEE
OVERTIME
PRE-NEED INT/ENT
SET GOVT. MKR.
Lot No. 19: 6\k, I Y: )eL Y-
Orig. Lot O.Lner-S'A m'~
Int/Ent. of
Balance $7J Pu \, l
,
. . . . . ! I uu Ll()LLARS
SET GRAN. MKR.
FDN.
LETTERING
VASE
BC/BS
A.c.
PERM. CARE
J) I S( () ,,1, ^t)
TOTAL i
'fA U~ ....'.3,
- &3. CI~
$ 119 7,ClO
I
By RG
--
Cash 0 Check ~oney Order 0
" ro rTl S'
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r11 <J. :; 0 ~ :;"0
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ro ~ S' g b
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................ ................................................................................................
ADDRESS
.....................................................................................u..........................................................
DELIVERY DATE
CITY ZIP
STATE .............. ....................................................................................... CODE .......... ........... ..... .............
CUSTOMERr- ORDERED
PHONE NO. BY ............................................................................
MC V DC CARD NO.
CODE
DESCRIPTIVE INFO
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RELAY CHG.
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FIRST NAME
LAST NAME
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PHONE
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STATE
VD0159 3 pI
REV-I5'12 EX+ (12-03)
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SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF fJ /.sA- NO I eN//- teL es fJ.
FILE NUMBER
2/-07- /6/
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, inclu~ing unreimbursed medical expenses.
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NUMBER
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REV-ft13 EX+ (9-00) .
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF fJ/S,4A1~ M/fR1.ES /?
FILE NUMBER
:z,/-/J 7- /6/
RELATIONSHIP TO DECEDENT
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s)
] TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
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AMOUNT OR SHARE
OF ESTATE
/ (JO/o
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
1.
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