HomeMy WebLinkAbout10-21-11 1505611185
FI
11
02
X
)
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-
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REV-1500 E
OFFICIAL USE ONLY
PA Department of Revenue County Code Year File Number
Bureau oflndividualTaxes INHERITANCE TAX RETURN 21 11 00131
PO BOX 280601
Harrisburg, PA 17128-0601
RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYW Date of Birth MMDDYYYY
162-22-1579 01272011 09071928
Decedent's Last Name Suffix Decedent's First Name M I
WAGNER ROBERT E
(if Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name M I
Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
EGISTER OF WILLS
- - R
FILL IN APPROPRUITE BOXES BELOW
® 1. Original Return ^ 2. Supplemental Return ^ 3. Remainder Return (Date of Death
Prior to 12-13-82)
^ 4. Limited Estate ^ 4a. Future Interest Compromise (date of ^ 5. Federal Estate Tax Return Required
death after 12-12-82)
® 6. Decedent Died Testate ^ 7. Decedent Maintained a Living Trust ~ 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will)
^ (Attach Copy of Trust.)
A
9113
d
S
^
^ 9. Litigation Proceeds Received 10. Spousal Poverty Credit (Date of Death
Between 12-31-91 and 1-1-95) )
(
er
ec.
11. Election to Tax un
(Attach Schedule O)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SINOULD BE DIRECTED TO:
Name Daytime Telephone Number
BRIDGET M• WHITLEY 717-233-1000 r.__,
First Line of Address
SKARLATOSZONARICH LLC
Second Line of Address
17 S 2ND ST FL 6
City or Post Office State ZIP Code
HARRISBURG PA 17101
REGISTER O 11.LS USE ONL~G Jr .~
Efi-~' n -"I
~
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~„. ~ ~. ~i
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.
....
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DATE FILED L
Correspondent'se-maiiaddress: BMWaSKARLATOSZONARICH • COM
Under pe tie of per' at i have examined this return, inGuding accompanying schedules and statements, and to the best of my knowledge and belief,
it is tru correct and corn eclaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
17 S 2ND 'S.~ 6
SIGNATUI~Q OF PREPARER OTH
TIVE
HARRISBURG, PA 17101
~ ~~
17 S 2ND ST FL 6 HARRISBURG, PA 17101
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505611185 OM46473.000 1505611185
1505611285
REV-1500 EX (FI)
Decedent's Social Security Number
162-22-1579
Decedents Name WAGNER ROBE RT E
RECAPITULATION
1. Real Estate (Schedule A) 1• 8 0, 7 8 6. 0 0
2. Stocks and Bonds (Schedule B) . 2. 0 • 0 0
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) , 3. 0 • 0 0
4. Mortgages and Notes Receivable (Schedule D) 4. 0 • 00
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E) 5. 10 8 , 0 8 7.0 0
6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested g. 0 • 0 0
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
arate Billing Requested
~ Se
7.
0 • 0 0
p
(Schedule G)
8. Total Gross Assets (total Lines 1 through 7) g. 18 8 , 8 7 3.0 0
9. Funeral Expenses and Administrative Costs (Schedule H). g. 3 0 , 816.0 D
10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) 10. 16 , 6 6 2.0 0
11. Total Deductions (total Lines 9 and 10) , . 11. 4 7 , 4 7 8.0 0
12. Net Value of Estate (Line 8 minus Line 11) . 12. 141, 3 9 5.0 0
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) , . 13. 0 • 0 0
14. Net Value Subject to Tax (Line 12 minus Line 13) . 14. 141 , 3 9 5.0 0
TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers un~er Sec. 9116
0 0
0
(a)(1.2) x .o - 0.0 0 15. .
16. Amount of Line 14 xable
4~
00
0
at linealratex.o
96,009.00 1s. 4,32
.
17. Amount of Line 14 taxable
at sibling rate X .12 0. 0 0 17. 0' 0 0
18. Amount of Line 14 taxable
at collateral rate x .15 2 8, 4 4 4. 0 0
1 s.
4, 2 6 7. 0 0
19. TAX DUE 19. 8, 587 • 00
20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
1505611285 1505611285
OM4648 3.000
a
REV-1500 EX (FI) Page 3 File Number
ueceaenrs wm ~~ur r-~w C~~. - - - - -
DECEDENTS NAME
STREET ADDRESS
CITY STATE ZIP
A P PA 7 -
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19)
2. Credits/Payments
A. Prior Payments 9, 5 0 0 •0 0
B. Discount 4 2 9.0 0
(1) 8,587.00
Total Credits (A + B) (2) 9 , 9 2 9.0 0
3. Interest
(3) 0.00
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in boz on Page 2, Line 20 to request a refund. (4) 1, 3 4 2 • O O
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0 • 0 0
Make check payable to: REGISTER OF WILLS, AGENT.
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 Vansferred ~ X
b. retain the right to designate who shall use the property transferred or its income ^
c. retain a reversionary interest .. .. .. .. .. ... ^
d. receive the promise for life of either payments, benefits or care?
2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? . .. .. .. .. .. .. .. .. .. . ^
or her death?
t hi
it
"
" ^
y a
s
or payable-upon-death bank account or secur
in trust for
3. Did decedent own an
4. Did decedent own an individual retirement account, annuity, or other non-probate property, which ^
contains a beneficiary designation? .. .. .. .. .. .. .. .
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 Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse
is 3 percent [72 P.S. §9116 (a) (1.1) (i)].
For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt 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.
Far dates of death on or after July 1, 2000:
• The tax rate imposed on the net value of transfers from a deceased child 21 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 percent [72 P.S. §9116(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 4.5 percent, except as noted in [72 P.S. §9116(a)(1)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116(a)(1.3)]. Asibling is defined,
under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
OM4671 2.000
REV-1502 EX+ (01-10)
Pennsylvania
DEPARTbENT OF REVENUE
INFERfTANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
ESTATE OF: FILE NUMBER:
R bert E . W er 21 11 00131
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 fads.
Real properly that is jointlyowned with right of survivorehlp must be disclosed on Schedule F.
swasas 2.000 If more space is needed, use additional sheets of paper of the same size.
REV-7508 EX+ (11-10)
Pennsylvania
DEPARibENiOF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, 8r, MISC.
PERSONAL PROPERTY
ESTATE OF: FILE NUMBER:
Robert E. Wa er 21 it 00131
Include the proceeds of litigation and the date the proceeds were received by the estate.
etl nrenPrty jointly owned with right of survivorship must t1e disclosed on Schedule F.
ITEM I VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. PNC Bank Checking Account No. 5140125801
Interest accrued to 1/27/2011
2 PNC Bank Savings Account No. 5080592888
Interest accrued to 1/27/2011
3 Cash in Wallet
4 Erie Insurance Group - Premium Refund
5 PNC Bank IRA Account No. 65001007233 (payable to estate
at DOD)
Interest accrued to 1/27/2011
6 2001 Ford Van
7 2008 Ford Explorer
8 Cash in House
9 Cash in Van
10 The Patriot News - refund
11 Proceeds from sale of generator
12 Proceeds from sale of compressor
13 Proceeds from sale of orange plane
14 Proceeds from the sale of pressure washer
15 Proceeds from sale of remote tow truck, two monster
trucks and safe
16 Erie Insurance Group - Refund
17 Proceeds from sale of snowblower
18 Erie Insurance Group - Refund
19 Proceeds from gun sale
20 PA Department of Revenue - uncashed checks
OW46AD 2.000
Total from continuation schedules .
TOTAL (Also enter on line 5, Recap
If more space is needed, use addRional sheets of paper of the same size.
17,680
0
21,028
1
390
353
11,862
5
4,450
14,000
4,500
300
37
325
.200
150
250
1,200
28
600
53
1,500
2,410
26,765
S 108,087
Estate of: Robert E. Wagner
Schedule E (Page 2)
Item
No. Description
21 Metro Bank
Balance after deducting outstanding checks on date of
death.
22 Metro Bank IRA - payable to estate as beneficiary
23 Cash in House
21 11 00131
Value at Date
of Death
2,972
23,752
41
Total (Carry forward to main schedule) 26,765
REV-1511 EX+(10-09) SCHEDULE H
Pennsylvania
oEPARTNENrOF REVENUE FUNERAL EXPENSES AND
IN~iERITANCETAXRETURN ADMINISTRATIVE COSTS
RESDENrDECEDENT
ESTATE OF FILE NUMBER
Robert E Wagner 21 it 00131
Decedent's debts must be reported on Schedule 1.
ITEM AMOUNT
NUMBER DESCRIPTION
A. FUNERAL EXPENSES:
~ Hetrick-Bitner Funeral Home 3,340
B.
1
ADMINISTRATIVE COSTS:
Personal Representative Commissions:
Name(s) of Personal Representative(s)
Street Address
2.
3.
City State ZIP
Year(s) Commission Paid:
Attorney Fees:
Family Exemption: (If decedent's address is not the same as Gaimant's, attach explanation.)
Claimant
Street Address
City State ZIP
Relationship of Claimant to Decedent
4. Probate Fees:
5. Accountant Fees:
6. Tax Return Preparer Fees:
7.
1 Register of Wills -Non-subscribing witness fee
2 Cumberland Law Journal -Estate Advertising
Total from continuation schedules .
TOTAL (Also enter on Line 9, Recapil
awasnc z.ooa If more space is needed, use additional sheets of paper of the same size.
17,815
344
900
20
75
8,322
30,816
Estate of: Robert E. Wagner 21 11 00131
Schedule H Part 7 (Page 2)
3 Expenses relating to the sale of 319 N. 19th Street,
Camp Hill, PA 6,000
4 Ian Spitzer - Appraisal of real estate 800
5 Janet L. Miller, Tax Collector - 2011 Co/Boro RE
Taxes 763
6 The Sentinel - Estate Advertising 161
7 Janet L. Miller - Fee for Tax Certification 10
8 Schultz Landscaping - Lawn Care 102
9 Skaraltos ~ Zonarich LLC - Costs 464
10 Gregory Chelap
Reimbursement for out of pocket expenses 22
Total (Carry forward to main schedule) 8,322
REV-1512EX•(12-oe)
Pennsylvania SCHEDULE
DEPPRi1rENr0F REVENUE DEBTS OF DECEDENT,
NRiERITANCETAxRETURN MORTGAGE LIABILITIES ~ LIENS
RES~ENrDECEDENT
ESTATE OF FILE NUMBER
Robert E Wagner 21 11 00131
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
~• Borough of Camp Hill - Sewer 150
2 Schultz Landscaping - Snow Removal 325
3 Verizon 320
4 Comcast Cable 28
5 Chase 172
6 UGI 433
7 Pennsylvania American Water 90
8 PPL Electric 221
9 Penn Waste Trash Service 25
10 Pennsylvania Municipal Retirement System - Return of
pension 161
11 US Treasury - Repayment 1,110
12 Daniel and Teresa Haberkamp 2,023
13 Santander Consumer USA car loan 11,604
8W46AH 2.000 If more space is needed, insert additional sheets of the same size.
REV-1513 EX+(01-10)
Pennsylvania
DEPARTNENi OF REVENUE
INHERfTANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
OF:
FILE NUMBER:
Robert E. Wa er 21 11 00131
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
TAXABLE DISTRIBUTIONS [InGude outright spousal distributions and transfers under
Sec. 9116 (a) (1.2).]
1. Gregory S. Chelap
106 N. 25th Street
Camp Hill, PA 17011
General Bequests: 28,444 None 28,444
2 Debra L. Schulz (Sanderson)
555 Matmor Road
Woodland, CA 95776
85~ of Residue: 96,009 Daughter 96,009
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APP ROPRIATE.
I[ NONTAXABLE DISTRIBUTIONS
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. 3 0
9W46AI 2.000 It more space is neeaea, use aaaitional sneers Ot paper or the same size.
~~.~~ ~.1 ~xt.~ ~.e~~~x~t.e~t~
OF
ROBERT E. WAGNER
I, ROBERT E. WAGNER, of the Borough of Camp Hill,
Cumberland County, Pennsylvania, declare this to be my last Will,
hereby revoking all prior wills and codicils.
F R The expenses of my last illness
and funeral shall be paid from my estate.
SECOND; I hereby give and bequeath all
my property, real and personal, to my spouse, SHIRLEY M. WAGNER,
if my said spouse survives me by thirty (30) days.
THIRD: In the event my spouse
predeceases me or does not survive me by thirty (30) days, I give
and devise said property as follows:
(a) FIFTEEN (15x) PERCENT of my gross estate shall be
paid to my close friend and financial advisor, GREGORY S. CHELAP,
if living. This fifteen (15%) percent bequest shall be paid free
and clear of all Pennsylvania inheritance taxes.
(b) All the residue of my estate, from which payment of
all ta.Yes, debts and administrative expenses shall be made, sY:a).l
be paid to my daughter, DEBRA L. SANDERSON, if living, otherwise
to her issue, per stirpes.
Page 1
tld "0~ Gt~~dlti~YV(1'J
id(1Q~ S.i~'~'I-'~0
30 ~13~
r. t 11 1 1_ (:7 J t l r7
_ _ _ _ ,
FOIIRTH: I appoint my Executor as
Guardian to hold for minors (issue of my daughter) all property
payable by law to a guardian appointed by my Will and use the same
for the minors maintenance and education, either directly or by
payment to any person selected to disburse it, whose receipt shall
be a complete acquittance therefor. All unexpended income and
principal shall be paid to the minor at majority. For purposes of
this Will, majority shall be construed to be when the individual
attains the age of twenty-one (21) years.
FIFTH; All taxes, interest and
penalties thereon payable by reason of my death with respect to
property comprising my gross estate, whether or not passing under
this Will, shall be paid from the principal of my residuary
estate.
SIXTH; No interest of any beneficiary
under this Will or any codicil hereto shall be subject to
anticipation or voluntary or involuntary alienation, and the
personal receipt of such beneficiary shall be the sufficient and
only discharge of my Executor and Trustee unless otherwise
provided herein.
SEVENTH: In addition to powers given by
law, my Executor and his successors and any guardian acting
hereunder shall have the following discretionary powers applicable
to all real and personal property held by them, effective ;.rithout
court order and until actual distribution:
(a) To retain all property received by them including
the stock of any corporate fiduciary acting hereunder, provided
such property remains productive;
Page 2 -y~1?~R
(b) To compromise controversies;
(c) To exchange or sell for cash, property or credit,
publicly or privately, or to lease, even for a term exceeding five
(5) years or the duration of the trusts hereunder, without
liability on the purchasers or lessees to see to application of
the consideration, and to give options for these purposes without
obligation to repudiate them in favor of a higher offer;
(d) To distribute in cash or kind or both at such
valuations as they may fix;
(e) To hold investments in the name of a nominee;
<f) To distribute in cash or kind or partly in each at
valuations fixed by them; and
(g) To undertake any and all acts deemed necessary and
proper by them for the proper and advantageous management of any
trust and the settlement of my estate.
EIGHTH Any person who shall have died
within thirty <30) days of my death, shall be deemed to have
predeceased me. Any person (other than myself) who shall have
died at the same time as any then recipient of income or in a
common disaster with such beneficiary, or under such circumstances
that it is difficult or impossible to determine who died first,
shall be deemed to have predeceased such beneficiary.
NINTH; I appoint my friend and
financial advisor, GREGORY S. CHELAP, of 1841 Creekview Drive, New
Cumberland, Pennsylvania, as Executor of this my Will. No
Page 3 -~~~/~~'
fiduciary acting hereunder shall be required to post bond or enter
security in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal
this l~ ~ day of ~~~~ 19rJa to this and the
preceding three <3) pages, and I have also placed my initials on
each preceding page for better identification and greater
security.
SEAL)
BERT E. WA NER
SIGNED, SEALED, PUBLISHED and DECLARED by the above-
named Testator, ROBERT E. WAGNER, as and for his Last Will and
Testament, in the presence of us, who at his request, in his
presence and in the presence of each other, have hereunto
subscribed our names as witnesses:
G[~
Residing ate [u . 4Q.~-~~+- La--
Residing at / N• ~`1~'
_ _ _ _ _ _ _.
OIeB NO. 2Sb2-0265
A '_ N:
.
HOUSING b URBAN DEVELOPMENT 1• FHA 2. FmHA 3. X CONV..,NINS. 4. VA 5. CONY. INS.
U.S. DEPARTMENT OF 6. F NUMB R: 7. LOAN NUMBER:
SETTLEMENT STATEMENT 8. RTGAG INS E NUMBER:
C. NOTE: This liD-m fs famished ro phb you a statemerd of atlas/ setNemerrt costs. AmourNs pabd to and by the sattlemanr spent are shown.
crams marked ?POCr were >~ outside rte ~~• rney ane shown here for r'nfwrrrertonar pwposes arxf are norlnclrrded n a-e:ora/s.
,.o ~s tLEMOrwEa,awr~r aFauaro»r~rwa.~*wr~
D. NAME AND ADDRESS OF 90RROWER:
Lemoyne Lend Carp., Inc.
319 S. Third Street, PO Box 31
Lemoyne, PA 77043 E. NAME AND ADDRESS OF SELLER:
The Estate of Robert E. Wegner
by Gregory S. Chdap, Executor F. NAME AND ADDRESS OF LENDER:
Centric Bank
4320 Linglestown Road
Harrisburg, PA 17112
G. PROPERTY LOCATION:
319 N. 19th Street
Camp F#N, PA 17011 H. SETTLEMENT AGENT: 23-2083639
Kerwin 8 KerwM, LLP I. SETTLEMENT DATE:
May 17
2011
Cumberland County, Pennsylvania
Tax Paroel No. 01-21-0289-047 PLACE OF SETTLEMENT
27 North Front Street
Harrisburg, PA 17101 ,
101. Contract Sates Prioe 60.000.00 401. Contract Sales Price 80,000.00
102. Personal 402. Personal
103. Setllenrent to Borrower Line 1400 ~ 2,680.25 403.
104. 404.
105. 405. '
106. Sewer 8i1 05N8111 to 07/01!11 72.53 40B. Sewer Bitl 05118H 1 to 07!01!11 72.53
107. Taxes 05118/11 to 01!01/12 466.48 407. C Taxes D5/18111 to 01/01/12 486.48
108. Scholl Taxes 0~181t 1 to 07101!11 226.97 408. Sctrool Taxes 05!18111 to 07/01/11 226.97
109. 409.
110. 410.
111. 411.
112.
120. GROSS AMOUNT DUE FROM BORROWER 83,44fi.23
PAt N LF F R R: 412.
420. GROSS AMOUNT DUE 710 SELLER 80,785.98
500. E UE E E
Z01. ' or earnest ~ 5,OD0.00 501. Excess ostl Irrstruc~ions
202. Prl Amours of New Loans 64 000.00 502. Settlement Cha es to Seger Une 1400 6 000.00
203. Exists s taken sub to 503. Exlstl loan a taken su to
204. 504. P of first Mortgage
205. 505. ff of second Mori
206. 506.
207. 507.
208. 508.
209.
u
210. Sewer Bitl to 509.
e or ms
510. Sewer Bill to
211. Taxes to 511. C Taxes to
212. School Taxes to 512. Scholl Taxes to
213. 513.
214. 514.
215. 515.
218. 516.
217. 517.
218. 518.
219-
220. TOTAL PAfD 8Y/FOR BORROWER 69,000.00
C T F MlTO B R: 519.
520. TOTAL REDUCTION AMOUNT DUE SELLS g,D00.00
600. SH T T R ELLER:
301. Gross Amourrt Due From Borrower 'ne 12 83,44823
302. Less Amount Paid or eorrawer (Line 220 '( 69.000.00 601. Gross Amount Due To Seller Line 42D 80 785.98
602. Less Reductions Due Seller (Una 520 q 6,000.00
303 X FROM) ( 70) SORRON4<R 14446.23 603• CASH (X 7D) ( OM) SELLER _ 74,785.98
~ "~ ~ do agp w~+ ~ ~ a+P aw nm~euya ~ eiCO GOPy O7 pages l d,"L OT mrs sut'enrem a any O herein.
~ ~~ Seller
-~" Executor of The Estate of Robert E.
Micha ~ nt Wa
r+ua, iaes~ aesa~ rre.3oss
L OC 1 I ~.Gwncn . v..r...v..~ - - -
% 4 500 ~ PAID FROM PAID FRDM
• S ~ OOQ ~ ® B ~~
7 T eoRROweR~s sr~Rs
DlVfSlOA 0/L`OfI1Rljs,S~Or1 700 85 FO/bWS: FUNDS AT FUNDS AT
701. 2, .00 P al HDn1e88ie n/it...a coup SE"TLFJ+IENr SETiLBiA'cNT
.OD to H age Real Estate Group 5,025.00
703. Corrrrrssbn Palo at Seitlen~ent
704 to
Note: Line 701 Includes gd)ushnent of 225.00 For Broker Fee
I
802. Loan Discaud °~ tD 250.00
~ to Centric Bank 19.00
Fae to Centnc Bank
804
to ntnc nk
~
806. Ins. .Fee to
to
807
itl
t
e
r;a
808. Cert
809.
810.
811
.
t) N ADV C
I
901. Interett From 05H7/11 to 06/01111 ® S !clay ( 15 days ~)
(nom fOr S 1D
903. Hazand Irntrance Premium for 1.0 to
904.
905.
WITH LENDER
Ftazard krsurance months S month
1001
.
1002. a Insurance months S month
monU-s S month
1003. Sewer Brl
1t>04• Taxes months S month
months ~ S per month
1005. School Taxes
1 months S month
1007. morphs ® S f~ ~~
1008. mordhs S r mordh
11
1101. Settlertlent or Fee to
1102. Atretract a Title Search to
1103. Title Exenination to
00
25
1104. t11Are Transfer Fee to Mid Penn Bank .
1105. Doairrrent ion to
~
~
1108. Fees to Kerwin 8 Kerwin, LLP •
1107. Attorney's Fees to
rrrdudes above Xem numbers:
738
75
1108. Title I to Stewart Title Guaro C a .
ncAdes show Aern nrarrbers:
1109. tend e s 6a,ooo.oo
S 80.~•~ 738.75
1 10
.
100. .900 710 to Guaranty ompany
11 200.00
.
ro ee to n Kerwin,
1 2 0.00
.
1113. C Service L.eUer to Stewart Title G Comps 75.00
C RDI D F R CHARGE
ReoDrdng Fees: Deed S 65.00; Mortgage S 81.00; Releases S
1201 1~•~
.
1202 Taw - p~ 800.00• Mo a e ~•~
00
500
1203. Slate T Deed 800.00: Mo a .
1204.
1205. of Rents to Recorder of Deeds
~•~
EITLEM C
1301. t°
1302. Pest I to
0
20
1~3, F Fees to U.S. Postmaster . 150
00
1304• Sewer Btll to Boro hot Ca HIN Sewer .
1305.
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By signing Page 1 of this statement, the signatories adrnowledge receipt of a completed copy of page 2 of this two pag~ nt-
Certified to be a true copy erwin d.
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(LFJAOYNE318-N~ 16rN / LEIAOVN637FN•19TH J 15 )
Feb. 24. 2011 12:19PM PNC BANK 412-705-2747
P1~~
LEAE?~IGT~iE WAY
February 24, 2011
Gregory S Chelap Esq.
Skarlatos Zonarich LLP
17 S Second St 6~' Fl
Harrisburg, PA 17101-2039
RE: Robert E Wagner
SSN: 162-22-1579
DOD: Ol -27-2011
Dear Mr. Chelap:
No.~ ~' 60 P. 1/2
In response to your request for Date of Death (DOD) balances for the customer noted above, our
records show the following:
CLccking Account
Account # 5140125801 Established: 12-21-1990
ROBERT E WAGNER
DOD balance: $ 17,680.33 + 0.43 accrued interest
Interest paid 01-01-2011 thru 01-27-2011 $ 0.80 YTD
Savings Account
Account # 5080592888 Established: 09-19-1996
ROBERT E WAGNER
DOD balance: $ 21,028.27 + 0,98 accrued interest
Interest paid 01-01-2011 thru 01-27-2011 $ 3.37 YTD
IRA Account
Account # 65001007233 Established: 02-15-1994
ROBERT E WAGNER
DOD balance: $11,862.01 + 5.25 accrued interest
Interest paid O l -01-2011 thre Ol -27-20 ] 1 $ 0.00 YTD
For beneficiary information, please call 1-888-762-4727.
Page 1 of 2
Received Time Feb. 24. 2011 12:25PM No. 4433
_ _ __ _
Feb. 24. 2011 12:19PM PNC BANK 412-705-2747
No: 0160 P. 2/2
Please note that this office provides date of death balances for deposit accounts (TItAs, CDs, Checking and
Savings). We do not process any 5naoclal transactions or provide ststementa. If you need assistance with
any of these items, please call 1-888-PNC-BANK (1-888-762-2265) or stop by your local PIVC Hank bzanch
office.
Sincerely,
National Financial Services Center
PNC Bank, N.A.
Member FDIC
This message is intended for the use of the individual or entity to which it is addressed and may
contain information that is privileged confidential and exempt from disclosure under applicable law.
If the reader of this message is not the intended recipient or the employee or agent responsible for
delivering this message to the intended recipient, you are hereby notified that any dissemination,
distribution or copying of this communications is strictly prohibited. !f you have received this
communication in error, please notify me immediately by reply or by telephone at 800-762-1775 and
immediately destroy this faxed document.
Page 2 of 2
Received Time Feb. 24. 2011 12:25PM No. 4433