HomeMy WebLinkAbout09-21-12J REV 1500 ~ 1505610143
PA Department of Revenue Pennsylvania
Bureau of Individual Taxes aeraaraee.oF aeyewr
PO 80X.280601 INHERITANCE TAX I
Harrisburg, PA 17128.0601 RESInFMT nerd
01=FICIAL USE ONLY
County Coda Year File Number
N 21 11 1289
=..=vcrv i irvrultmATION BELOW -
Social Security Number Date of Death
Date of Birth
O1 19 1921
Decedent's Last Name
Suffix Decedent's First Name
BRUNDZO
D.
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name
Suffix Spouse's First Name
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIAT
MI
E
MI
E OVALS BELOW
1. Original Return ~
2
Su
l
t
.
pp
emen
al Return
3. Remaintler Retum (date of death
r~
L1 4. Limited Es[ate ~
qa FuWra Interest Compromise
(date of death eker 12
12
~ prior to 12-13-a2)
5
F
d
-
-82) .
e
eral Estate Tax Return Required
g, Decedent Dietl Testate ^
(Adach Copy of Wi10 T Decadappt Mainra~ned aLiving Trust
(AkaGt Gopy of irusp
d
. Total Number of Safe Deposit Boxes
r j 9, Litigation Proceeds Received ~ 1p Spousal Pov n Cretlit dot of death
between 121 ~1 end t<-1-~5)
~
Elec[ion to t
11
d
.
ax un
er Sec. 9113(A)
(Attach Sch. O)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFID
Nam ENTI
e AL TAX INFORMATION SHOULD BE DIREC TED TO:
JERRY A T^1EIGLE ESQUIRE Daiftime Telephone Number
7717 532 7388r~,
"'
-n
~n
REGISTE ~, /ILLSU~ONLT,~
First line of address ~i r'? ~D ~'~~ C:7
126 EAST KING STREET ~D~~~ ~ ~,
~~
'
; ~
~
{
~
Second line of address C~~"~% ~
~
c'~G"` _
~ ~
SS~
Q y f
City or Post Office
~ ~..
SHIPPENSBURG
State ZIP Code DA
FILED r
PA 17257
Correspondent's a-mail address:
I.. JIOe 7
1505610143 15105610143 1
rt
1505610243
REV-1500 EX
Decetlanfs Name: i3~UndZO, D. Evelyn Decedent's Social Security Number
RECAPITULATION
1 . Real Estate(Schedule A) ........................
........................................................... .... 1. 58,000.00
2 . Stocks and Bonds (Schedule B) ....................
..................................................... .... 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)..... .... 3.
4. Mortgages & Notes Receivable (Schedule D) .............
........................................ ... 4,
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ............ ... 5.
24,292.63
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested
7. ..........
Inter-Vivos Transfers & Miscellaneous f~{oq-probate Property
(Schedule G) .. 6.
a Separate Billing Requested.......... ..
7.
8. Total Gross Assets (total Lines 1-7)
..................
.................................................
.. 8.
82,292.63
9.
Funeral Expenses & Administrative Costs (Schedule H) . .
..................................... . g.
25,450.69
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............... 10
.............. .
,
2,344.92
11. Total Deductions (total Lines 9 & 10) ..........................
........................................ .
11.
27 , 795.61,
12. Net Value of Estate (Line 8 minus Line 11) ................
13. ................ .
Charitable and Governmental Bequests/Sec 9113 Trusts for which
1z.
54,497.02
an election to tax has not been made (Schedule J)
............................................... 13.
14. Net Value Subject to Tax (Line 12 minus Line 13
)
............................................. .. ta. 54 , 497.02 .
TA X 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 .00 15. 0
00
16. Amount of Line 14 taxable .
at lineal rateX .045 54,497.02 1s. 2
452
37
17. Amount of Line 14 taxable ,
.
at sibling rate X .12 0 - 00 17. 0
00
18. Amount of Line 14 taxable .
at collateral rate X 15 0.00 18. 0.00
19. Tax Due ..............
................................................................................................... . 19. 2 , 452.37
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ^
Side 2
1505610243
1505610243
REV-1500 EX Page 3
Decedent's Complete Address:
DECEDENT'S NAME
Brundzo, D. Evelyn
STREETADDRESS
Elmcroft
CITY
129 Walnut Bottom Road
~ STATE ZIP
_JI_ PA 17257
(1) 2,452.37
Total Credits (A + g) (2) 0.00
(3)
(4)
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19)
2. Credits/Payments
A. Prior Payments
B. Discount
3. Interest
0.00
File Number 21-11-1289
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 2 Line 20 to request a refund
1. Did decedent make a transfer and:
a. retain the use or income of the property transferred :................................................................................ Yes No
b. retain the right to designate who shall use the property transferred or its income :..................................
c. retain a reversionary interest; or ...............................................................................................................
d. receive the promise for life of either payments, benefits or care? ...................... . x
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without ^
receiving adequate consideration? ....................... ^ ^
...........................................................
id decedent own an "in trust for" or payable upon death bank account or security at his or her death?.......
4. Did decedent own an Intlividual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation?.... .
^ 0
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G ~4ND FILE IT AS PART OF THE RETURN.
~Ya a.u,~.kr z ,..~
For dates of death on or after July 1, 1994 and before Jan. i, 1995, the tax rate imposed on the net value of tnansfers 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 January 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.
For 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 dea~dh 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 1.2) [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 ['!2 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-0502 EX+(11-081
copyngnt (c) 2009 form software only The Lackner Group, Inc. ~~ _ y' ~~~
Form pA-1500 Schedule A (Rev. 11-08)
REV-1151 EX~ (ia-06)
COMMONEEWpp E4LTk1 OFgqXxp NEENTT VLVANIA
IN RESIIDEN DECEDEN~RN
ESTATE OF
Brundzo,D.
SCHEDULE H
FUNERAL EXPENSES &
1DMINISTRATNF rnsTc
Debts of decedent must be reported on Schedule I.
ITEM
NUMBF~R DESCRIPTION
A. FUNERAL EXPENSES:
FILE NUMBER
21-11-1289
AMOUNT
See continuation schedule(s) attached
5,410.48
B. ADMINISTRATIVE COSTS:
t. Personal Representative's Commissions
Name of Personal Representative(s)
Mathew Brundzo
Street Address 30 Briarcliff Drive
City Shippensbur State PA
Year(sl Commission paid 2012
2. Attorney's Fees Weigle & Associates, P.C.
17257
4,115.00
4,865.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State
Zio
Relationship of Claimant to Decedent
a. I Probate Fees Register of Wills, Cumberland County
5.
6.
7
Copyright (c) 2009 form software only The Lackner Group, Inc.
Accountant's Fees
Tax Return Preparer's Fees
Other Administrative Costs
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation)
261.50
9,795.71
( LD,40U.69
Form Pq-1500 Schedule H (Rev. 10-06)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
I
ESTATE OF
Brundzo, D. Evel n FILE NUMBER
21-11-1289
ITEM
NUMBER DESCRIPTION
AMOUNT
Funeral Exo -sent
1 Dugan Funeral Home
5, 985.48
2 Greencastle Bronze & Granite
425.00
H-A
OtherAdministrativ rate 6,410.48
3 Carl Brandt, Jr. -lawn mowing
50.00
4 Central Penn Gas
132.76
5 Central Penn Gas
132.76
6 Central Penn Gas
119.10
7 Central Penn Gas
43.87
S Central Penn Gas
40.34
9 Central Penn Gas
24.35
10 Central Penn Gas
21.88
11 Central Penn Gas
10.66
12 Chambersburg Rental Service, Inc. -tent rental for public sale
302.10
13 Charles Martin -appraisal of personal property
65.00
14 Cumberland Law Journal -advertising Letters Testamentary
75.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H (Rev. 6-98)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF
D.
:NUMBER
-11-1289
ITEM
NUMBER DESCRIPTION
15
Expenses of public sale of personal property AMOUNT
1,161.15
76 John O'Donnell -snow removal and painting
85.00
17 Linda K. Klein -notary fee
22.00
18 News Chronicle -advertising Letters Testamentary
104.75
19 Orrstown Bank -estate checks fee
11.25
20 Orrstown Bank -estate checks fee
11.50
21 Penelec
30.78
22 Penelec
51.30
23 Penelec
8.22
24 Penelec
10.86
25 Penelec
23.55
26 Penelec
37.27
27 Real Estate Settlement Expenses -including realtor commission ($3,480.00); deed
r
i
p
eparat
on ($95,00); realty transfer tax ($580.00); 2012-13 school taxes ($1
308
04)
a
d fi
t 5,557.71
,
.
;
n
wa
nal
er, sewer billing ($94.67)
28 Register of Wills, Cumberland County -filing PA Inheritance Tax Return
15.00
29 Register of Wills, Cumberland County -filing Family Settlement Agreement
75.00
30 ShippensburgBorough-dumpsterfee
99.40
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form Pq-1500 Schedule H (Rev. 6-98)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF
:NUMBER
-11-1289
ITEM
NUMBER DESCRIPTION
31
Shippensburg Borough -water, sewer, refuse AMOUNT
134.19
32 Shippensburg Borough -water, sewer, refuse
125.40
33 Shippensburg Borough -dumpster rental
25.00
34 Shippensburg Borough -dumpster rental
63.20
35 Shippensburg Borough -water, sewer, refuse
131.79
36 Shippensburg Borough -water, sewer, refuse
131.75
37 Shippensburg Borough Tax Office - 2011 county real estate tax
594.52
38 Shippensburg Little League - 2011 tax preparation
50.00
39 Spraying for bugs at sale
21.19
40 Wal Mart -supplies
74.61
41 Weigle 8 Associates, P.C. -reimbursement for postage
xerox
i
,
cop
es, and long distance
telephone calls
45.00
42 Whitter's Septic & Sanitation -ports-a-potty for public sale
79.50
H!-B7 9,798.71
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form Pq-1500 Schedule H (Rev. 6-98)
Rev-151] EX. 112-09)
COMMONWEALTH OF PENNSYLVANIq
INHERITANCE TTX RETORN
RESIpENT OECEOENT
SCHEDULE 1
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF
:NUMBER
-11-1289
Report tlabts incumetl by the decadent prlorlo death that remained unpaid at the date or death, including unreimb
ITEM ursatl metlical expen ses.
NUMBER
DESCRIPTION _
VALUE AT DATE
1
Care First Pharmacy Services OF DEATH
281.78
2 Central Penn Gas
164.04
3 Citizens Bank Checking Account 00199 -checks clearing after date of d
th
ea
and debits and
transfers from account after date of death
1,639.85
4 Commercial Acceptance Company -ambulance fee
131.17
5 Hershey Care
48.67
6 Penelec
79.41
TOTAL (Also enter on Line 10, Recapitulation) I 2,344.92
(If more space is needed, additional pages of the same size)
Copyright (c) 2009 form software only The Lackner Group, Inc.
Form Pq-1500 Schedule I (Rev. 12-08)
REV-7573 EXi (77-OBI I{ E
COM INDHEWp TANCE TgXP RNENTg(~RN ANIA
RESIDENT DECEDENT
ESTATE OF
Brundzo, D. Evel n
NUMBER MAME AND ADDRESS OF
PERSON(S) RECEIVING PROPERTY
I TAXABLE DISTRIBUTIONS [include outright spc
distributions, and tr:
under Sec. 9116 a I
1 Mathew J. Brundzo
30 Briarcliff Drive
Shippensburg, PA 17257
2 Debra C. Rotr
111 South Washington Street
Shippensburg, PA 17257
3 Victoria A. Smith
37 Violets Path
Elizabethtown, PA 17022
SCHEDULE J
BENEFICIARIES
FILE NUMBER
21-11-1289
ATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
DECEDENT
Son One-Third 18,165.68
Daughter One-Third 18,165.67
Daughter One-Third 18,165.67
Enter dollar amoun s for distributions shown above on lines 15 throw h 18 on Rev 1500 oO~ashe
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO T4X IS
CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
Copyright (c) 2009 form software only The Lackner Group, Inc.
54,497.02
I
COVER SHEET
Form PA-1500 Schedule J (Rev. 11-08)
Page 1 of 1
linda klein
From: linda klein
Sent: Tuesday, June 26, 2012 3:40 PM
To: 'RA-InheritanceTaxExt@state.pa.us'
Subject: Estate of D. Evelyn Brundzo
Attachments: Extension request to file inh. tax return 6-26-12.doc
Dear Sir or Madam:
Please see the attached request for extension of time to file a PA Inheritance Tax Return for
the above-captioned estate.
Jerry A. Weigle, Esquire
Weigle & Associates, P.C.
126 East King Street
Shippensburg, PA 17257
717-532-7388
jweigle@weigleassociates com
6/26/2012
JERRY A. WEIGLE
Associates
JOSEPH P. RUANE
RICHARD L. WEBBER JR.
Of Counsel
THOMAS L. BRIGHT
WEIGLE & ASSOCIATES, P.C.
Attorneys••at--Law
126 EAST KING STREET
SHH'PENSBURG, PENNSYLVANIA 17257-1397
TELEPHONE (717) 532-'7358 or (717) 776-4295
FAX (717) li32-5289
June 26, :2012
Department of Revenue
Bureau of Individual Taxes
Inheritance Tax Division
Department 280601
Harrisburg, PA 17128-0601
Attention: Extension Request
Deaz Sir or Madam:
In Re: Estate of D. Evelyn Bnmdzo
SS # 204-03-9122
Cumberland County File #21-11-1289
Please consider this a formal request fora 6-month extension of time to file a
Pennsylvania Inheritance Tax Return for the above-captioned estate. The estate's real
estate is presently being mazketed but has yet to be sold. In addition, until the real estate
proceeds aze realized, the estate has insufficient funds for the payment of the inheritance
tax.
We understand that an extension will not extend the time for the payment of the
inheritance tax, but only the time for the filing of the inheritance tax return.
Sincerely,
WEIGLE & ASSOCIATES, P.C.
Jeny A. Weigle
JAWak
Copy: Mathew Brundzo, Executor
LAST WILL l~ND TESTAMENT
I, D. EVELYN BRDNDZO, being of sound mind, memory and understanding, do
make, publish and declare this my Last Will and Testament, hereby revoking
all prior wills and codicils made at any time before by me.
FIRST. I direct that all my funeral expenses be paid as soon as practicable
after my death.
SECOND. I give, devise, and bequeath all my property, be it real, mixed or
personal in equal shares to my children, per stirpe:s, with the provision that they
may take in kind, according to value. ~
THIRD. I nominate and appoint my son, MATTHEW' BRUNDZO, as the executor of
this, my Last Will and Testament, and as such to serve without bond of any
nature or kind.
IN WITNESS WHEREOF, I, D. EVELYN BRUNDZO, to this, my Last Will and Testament
set my hand and seal this J~~ day of ~t~i~~ 1980.
Sworn to and subscribed,
declared and published by
D. EVELYN BRUNDZO, as her
Last Will and Testament,
and so done in the presence
of we the witnesses, who sign at
her request, and in her presence
and in the presence of each other.
_, ,~
o ~ f r'1'1 a i J ,^ ,~
~~ _ C j
f~
~..~,. Wvm Y. ae.YY.
A., SPff»~ent Statement
B. 7YPa of Loen
rmm Nuo-t IS'361.Y MYYCmi, 43as z
U.S. Depanrrtent of Hauaing and Urban Devebpmemt
OMB royal No. 25ox-0255 FINAL
1. pFHA 2. pFmHA :I. OConv. Unins. fi. File Number 7. Loan Number ~. 9. Mangage Insurance Cam: Number
/. VA 5. Cpnv. Ins. 122356'WHITE
C.Note: r.,,.m.~,uyPV~p,W P~Ye;Y,wv„m,;,s;v.,•oYbni:,.m.wamYb, P,.P=,...,,e..,w sr~uaaaahwveY,. TitleExpress SeUlement System
~muxnY.iae:rrYb~maaau.Pam"araYF~n:nXU'i'us~cae"Fa~i~PtotlwaYSam~'to~~~P`" Printed 07(1312012 at 10:57 RLH
D. NAME OF BUYER: Jamie W. Whke arM Lisa M. Whke
ADDRESS: 300 East Oranpe Street, Shiopenshurd PA 17257
E. NAME of SELLER: Estate of Evelyn Bnrndzo _
ADDRESS:
F. NAME OF LENDER
ADDRESS
G. PROPERTY ADDRESS: 30 South Washington Street, Shlppenaburg, PA 17257
Baroueh of ShI00enebur0
H. SETTLEMENT AGENT: South Central Home Seklementa, Inc., Telephone: 717.532-7387 Fax: 717.532.6552
PLACE OF SETTEMENT: 126 East KInO Street, Shippensbum PA 17257
I. SETTLEMENT GATE: 0712a2012
J. SUMMARY OF BUYER'S TRANSACTION: K. SUMMARY OF SELLER'S TRANSACTION:
100. GROSS AMOUNT DUE FROM BUYER 400. GROSS AMOUNT DUE TO SELLER
101. Contract sales Price 58 000.00 401. Canoact sales rbe 5fi 000.00
102. Personal 402. Personal
103. Settlement ch s tp BUYER fine 1400 1 017.00 403.
104. 404.
105. 405.
Ad"u3imanb for Name aid SELLE
10T. Caum taxes O7Ra12ta 12Td1112
'~ 106. School Taxes 0712a121o06130113 R in advance
266.85
1225.61 Ad'ustmenls for Nerrb aM h SELLE
407. Cpunt taxes 0712a12 to12131H2
406. School Taxes 07Y2a12 to0fi130H3 R in eMenm
2fifi.fi5
1225.61
109. 409.
110. 410.
111. 411.
112. 412.
120. GROSS AMOUNT DUE FROM BUYER fi0 509.4fi 420. GROSS AMOUNT DUE TO SELLER 59 49246
200. AMOUNTS PAID BY OR ON BEHALF OF BUY ER 500. REDUCTIONS IN AMOUNT DUE TO SELLER
201. weamest 1000.00 W1. FxcessD see lnsWCtlons
202. PdM amount d new loans 502. SelOenienl ch s to SELIER Ilne 1400 5557.71
203. Er3s8n b s taken b 503. EusO loan s bken suh ed tP
204. 501. Pa dFlrst eLpan
205. 505.
206. 506.
207. 507.
208. 506.
209. 509.
Ad uatmerda for items un aid b SELLER Ad ustmems fw kerns un aid b SELLEFI
213. 513.
214. 511.
215. 515.
216. _ 516.
217. 517.
218. _ 518.
219.
220. TOTAL PAID BYIFOR BUYER
f 000.00 519.
520. TOTAL REDUCTION AMOUNT DUE SELLER
5 557.71
300. CASH AT SETTLEMENT FROM OR TO Bl7YER 600. CASH AT SETTLEMENT TO OR FROM SELLE R
301. Grass mnpnt due fmrn SUYER Me 120 60 509.46 fi01. Gmss amount due to SELLER fine 420 59 492.46
302. Less amounts Ifa BUYER line 220 1000.00 602. Less redud'wn amount due SELLER fine 520 5 557.71
303. CASH FROM BUYER 59 509.Ifi 603. CASH TO SELLER 53 931.75
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SEl1FR18) XEW MN11q MPRE93:
9ELLERISI PHPNE Nlkr3ER3:
,VT OF HOUSING AND URBAN DEVELOPMENT
.NT STATEMENT
rmm HUar ryasl nxllaaeooxxmez
File NUmber.122756WH1TE FINAL PAGE2
TitleExaess Settlement Svslem PdnlRd 07I73I201] al 11P5i RI H
• AT CHARGES PAID FROM PAID FROM
ALE583ROKER'S COMMISSION hasatl on 'ca E58 000.00 6.000' 3480.00 BUYER'S :TELLER'S
.0(Laan1591al INne 700 as lMlOxs: FUNDS AT FUNDS AT
3.480.00 to Sailhamer Real Estate SETTLEMENT SETTLEMENT
to
COnurdssim at Settlement 3 480.00
!. REMS PAYABLE IN CONNECTION WITH LOAN
d01. ~ Coal 9ridnetlm Fee %
802. Loan Discount %
803. AoadsN Fee
B0/. GedN ReoOn
BOS.
806.
807.
BOB.
809.
810.
811.
900. fTEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE
901. Inlaed Fmm to Ida
902. Man Inwrzrke Premium for 0 moot to
903. Hazard Inwrence Premium fm 0 moot to
901.
905.
1000. RESERVES DEPOSRED WRH LENDER FOR
1001. Hazard Insurance m . hn0
1002. Mat Inwmnce m . Imo
1003. Tax m . Imo
1004. Coup Pr Tax mo. Ano
1005. Shcod Taxes mo. hn0
1009. a Mal A invent
1100. TITLE CHARGES
1101. Settlements Gosh Fee to South Ce al Home SettlemeMS Inc. 375.00
1102.
1103.
1104.
1105.
1106.
1107. Mom sfees to Wei Ia BAssociates 95,00
uNdtWes above items No: Deed Pre areGon
1108. Title Inwrmce
suludes above Nems No:
1109. Lendels
1110. Owlays
1111.
1112.
1113.
1200. GOVERNMENT RECORDING AND TRAN6FER CHARGES
1201. Fees Deed 62.00 ~ Mort ~ Release 82.00
1202. ICOUn taxlsl Deed 580.0 ~ Mat a 580.00
1203. Stale Taxhtam Geed 580.00 Mat a 580.00
1204. Geed 'M e
1205. Deed ~MM a ~Releas~
1300. ADDRIONAL SETTLEMENT CHARGES
1301. Surve
1302. 2012113 Schad Taxes m Borou h Shi ensbur 1308.04
1303. Fmd Wala and Sevyer BNls to Borou h fShi ensbur 94.67
1304.
1305.
130fi.
1307.
1308.
1400. TOTAL SETTLEMENT CHARGES tg m Nnes 103 Sedian J and 502 Sectlon 1 017.00 5 557.71
XUL CERTIFICATION OF &IYER,VN SELIER
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FINAL SETTLEMENT DATE 6/28/2012
SELLER --Estate of D. Evelyn Brundzo, Mathew J. Brundzo Executor
ADDRESS - BriarcliffDrive, Shippensburg, PA
DATE OF SALE 6/28/12 SALE LOCATION --Same As Above
AUCTIONEER -- Dean Alleman (AU-2666L) & C.H. (Whitey) Martin (AU-1466L)
CLERK -- Dale Heberlie CASHIER -- Cheryl Runshaw
SALE TOTALS
PERSONAL ITEMS $ ~ 2 3 `i .7
REAL ESTATE $ - '-
OTHER $
$ 3 2 ~ . 7 " TOTAI.OF SALE
TOTAL EXPENSES
TOTAL SALE $ .~J 'c'. 3! 7S
LESS EXPENSES $ ~~ „~ ~S-
TOTAL TO SELLER $ ~ U "a 3 ~ (~ U
I, (or we), the seller of goods, merchandise, and/or property sold at public auction on above date and location,
acknowledge and accept this settlement of proceeds of sale. I (or we) agree to accept alfl responsibility for
providing merchantable title of all goods, merchandise, and/or property sold, and for delivery of title to the
purchaser. ,
Date ' ~ ~ ~ ~ Z ~ Se er's Sign re
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Auctippneer ~~
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Cashier °
Seller's Signature
Seller's Signature
AUCTIONEER FEE °/a .~C/ a -~- 3 ~ 3;~,) S $ L; <~ 7. C)
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Amount Debited ~~ -G 1---CG ~ 7~
For:
s anrount has been charged to your account. Please adjust your records.
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Citizens Bank 0360
~ December 15, 2011
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1 ORDER OF ~
' MEMO. >;rawer: Citizens Hank of Pennsylvania
8 .~-
R® SIGNATURE
n'S00469573~i' ~:036076i5D~:
600000640 Iii'
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December 13, 2011
WEIGLE & ASSOCIATES, P.C.
ATTORNEYS-AT-LAW
126 EAST KING. STREET
SHIPPENSBURG PA 17257-1397
Estate of D Evelyn Brundzo
Date of Death: Oat 15, 2011
SSN: 204-03-9122
One Citizens Drive
ROP112
Riverside, RI 02915
Dear Sir/Madam:
In accordance with your request, the attached information sheets have been provided in the above
decedent's name as of his/her date of death.
For Installment Loans or Line of Credit accounts, contact our Loan Department at 1-800-708-6680. For
all other inquiries, please ca11877-579-2667 option 2.
Sincerely,
Kristen B. Correia
Decedent Account Processing
REF#: 523237
" Citizens an~~
Account Number 61008001'99
Account Title D EVELYN BRLTNDZO
Date ened 3/29/1980
Account T e Checkin
Princi al Balance as of DOD $3203.1 h
Interest from Last Postin to DOD $ .00
Account Balanc$ as of DOD $3203.14
YTD Interest to DOD $ .00
Citizens an~C
Account Number 6140233968
Account Title D EVELI'N BR.UNDZO
Date O ened 1/6/2001)
Account T e Savin s
Princi al Balance as of DOD $12589.26
Interest from Last Postin to DOD $ .16
Account Balan as of DOD $12589.42
YTD Interest to DOD $3.02