Henry Schein Dental 135 Duryea Road Melville, NY 11747-3824
Wachovia Bank P. O. Box 3000 Winterville, NC
Welcome Wagon- P. O. Box 9101 Plainview, NY 11803
Allegheny Energy 800 Cabin Hill Road Greensburg, PA 15601
AT&T Wireless P. O. Box 6463 Carol Stream, IL 60197
Bank of America 4161 Piedmont Parkway Greensboro, NC 27410 8110
Bio-Haz Solutions, Inc. P. O. Box 420 531 Seneca Rd., Suite 2 Lehighton, PA 18235
Brown Rudnick One Financial Center Boston, MA 02109-1803
Bureau of Employer Tax Operations Labor & Industry Building P. O. Box 68568 Harrisburg, PA 17106-8568 Capital One P. O. Box 30281 Salt Lake City, UT 84130
Capital One P. O. Box 30281 Salt Lake City, UT 84130 0281
Carlile Patchen & Murphy LLP 366 East Broad Street Columbus, OH 43215
Chase Bank 800 Brooksedge Blvd. Columbus, OH 43081
Citi Cards CBSD NA P. O. Box 182654 Columbus, OH 43218
Citizens Bank 1 Citizens Plaza Providence, RI 02903
City of Washington 55 West Maiden Washington, PA 15305
Clear Channel Communications 200 Fleet Street Pittsburgh, PA 15220
Comcast c/o Credit Management Company 2121 Noblestown Road Pittsburgh, PA 15242 Dentrix Dental Systems, Inc. Dept. CH 14200 Palatine, IL 60055-4200
Direct Capital 155 Commerce Way, Suite B Portsmouth, NH 03801
Direct Capital Corp.. P. O. Box 643451 Cincinnati, OH 45264-3451
Equitable Gas P. O. Box 6766 Pittsburgh, PA 15212
ESBCO Reception Room Subscriptions P. O. Box 830460 Birmingham, AL 35283
ESPN Visa P. O. Box 660487 Dallas, TX 75266-0487
EZ to Use Big Book P. O. Box 1433 Altoon, PA 16603-1433
FMC-Omaha Service Center P. O. Box 54200 Omaha, NE 66154 8000
FMC-Omaha Service Center P. O. Box 54200 Omaha, NE 68154 8000 Ford Motor Credit P.O.Box 535150 Pittsburgh, PA 15235
Froggy Radio 100 Ryan Court, Suite 898 Pittsburgh, P
GE Health Care Financial Services P. O. Box 414418 Boston, MA 02241-4418
General Electric Capital Corporatio P. O. Box 414418 Boston, MA 02241-4418
Glidewell Labs 4141 MacArthur Blvd. Newport Beach, CA 92660
General Electric Capital Corporatio One Beacon St., 2nd Floor Boston, MA 02109-1803
Henry Schein Dental 135 Duryea Road Melville, NY 11747-3824
Henry Schein Dental 135 Duryea Road Melville, NY 1174703824
Henry Schein Practice Solutions Dept . CH 14200 Palatine, IL 60055-4200 Hitachi Capital America Corporation 21925 Network Place Chicago, IL 60673-1219
HMI c/o RMS Collection 55 Shuman Road, P. O. Box 3099 Naperville, IL 60566
Internal Revenue Service Philadelphia, PA 19154
Internal Revenue Service P. O. Box 804521 Cincinnai, OH
Internal Revenue Service P. O. Box 804521 Cincinnati, OH 45280-4521
Internal Revenue Service P. O. Box 804521 Cincinnati, OH 45280-4521
Keller Laboratories c/o Laurence K. Richmond & Assoc. Greenleaf Building 1419 Hancock Street Quincy, MA 02169-5203
Keystone Dental 144 Middlesex Turnpike Burlington, MA 01803
Kinol Sharie Leyh & Associates 3740 Mt. Royal Blvd. Allison Park, PA 15101 Lorigan, Bridgette L, DMD 920 center Avenue Pittsburgh, PA 15215
Macy's P. O. Box 689194 Des Moines, IA 50368-9194
Malin Bergquist & Company 206 Clay Avenue Jeanette, PA 15644
Medical Arts Press c/o RMS Collection 4836 Brecksville Road Richfield, OH 44286
N.C.Sanitation, Inc. P. O. Box 501, Gas Valley Road New Manchester, WV 26056
PA Department of Revenue Department 280903 Harrisburg, PA 17128-0903
PA Department of Revenue P. O. Box 281041 Harrisburg, PA 17128-1041
Portnoff Law Associates, LTD 1000 Sandy Hill Road, Suite 150 Norristown, PA 19401
Quantum Products File 50676 Los Angeles, CA 90074 Renda Broadcasting 900 Parish Street, 3rd Floor Pittsburgh, PA 15220-3407
Target National Bank c/o Target Credit Services P. O. Box 673 Minneapolis, MN 55440-0673
Twp. of Upper St. Clair 1820 McLaughlin Run Road Upper St. Clair, PA 15241
United Bank, Inc. 109 Three Springs Drive Weirton, WV 26062
Verscharen, William 523 Valleyview Road Eighty Four, PA 15330
Verscharen, William A. c/o Roy E. Powell, Esquire Jones Day 31st Fl, One Mellon Bank Center Pittsburgh, PA 15219
Visa/DSNB 9111 Duke Blvd. Mason, OH 45040 8999
Ford Motor Credit PO Box 535150 Pittsburgh, PA 15253-5150
Washington Federal Savings Bank c/o Consumer Loan Center 2730 Liberty Avenue Pittsburgh, PA. 15222-4746 Washington Federal Savings Bank 77 South Main Street Washington, PA 15301
Weltman, Weinbert & Reis Co., LPA 436 Seventh Avenue 1400 Koppers Building Pittsburgh, PA 15219
WesBanco Bank Washington Trust Building 6 South Main Street Washington, PA 15501
WesBanco Bank Washington Trust Building 6 South Main Street Washington, PA 15301
WestBanco Bank Trinity Point Office 1003 Trinity Circle Washington, PA 15301
World's Foremost Bank P. O. Box 82608 Lincoln, NE 68521
Wrigley, Mark, DMD 133 S. 20th Street Pittsburgh, PA 15203
Zila/Pro-Dentec P. O. Box 41460 Batesville, AR 72501 UNITED STATES BANKRUPTCY COURT WESTERN DISTRICT OF PENNSYLVANIA
In re: Barry F Bartusiak Kristi E. Bartusiak Case No. Debtors Chapter 11
VERIFICATION OF CREDITOR MATRIX The above named debtor(s), or debtor’s attorney if applicable, do hereby certify under penalty of perjury that the attached Master Mailing List of creditors, consisting of 8 sheet(s) is complete, correct and consistent with the debtor’s schedules pursuant to Local Bankruptcy Rules and I/we assume all responsibility for errors and omissions.
Dated: 04/17/09 Signed: s/Kris A. Vanderman Barry F Bartusiak Barry F Bartusiak
Dated: 04/17/09 Signed: s/Kris A. Vanderman Kristi E. Bartusiak Kristi E. Bartusiak
Signed: /s/ Kris A. Vanderman KRIS A. VANDERMAN Attorney for Debtor(s) Bar no.: 26054 KRIS A. VANDERMAN 142 FALLOWFIELD AVENUE CHARLEROI, PA 15022 Telephone No.: (724) 489-9578 Fax No.: (724) 489-0399 E-mail address: [email protected] B 1 (Official Form 1) (1/08) United States Bankruptcy Court Western District of Pennsylvania Voluntary Petition
Name of Debtor (if individual, enter Last, First, Middle): Name of Joint Debtor (Spouse) (Last, First, Middle): Bartusiak, Barry, F Bartusiak, Kristi, E. All Other Names used by the Debtor in the last 8 years All Other Names used by the Joint Debtor in the last 8 years (include married, maiden, and trade names): (include married, maiden, and trade names): d/b/a Barry F. Bartusiak - Washington, PLCC d/b/a Kuzy, LLC Last four digits of Soc. Sec. or Indvidual-Taxpayer I.D. (ITIN) No./Complete EIN(if Last four digits of Soc. Sec. or Indvidual-Taxpayer I.D. (ITIN) No./Complete EIN(if more more than one, state all): 9598, 26-2744386; than one, state all): 9769 20-4640528 Street Address of Debtor (No. & Street, City, and State): Street Address of Joint Debtor (No. & Street, City, and State): 2615 Rossmoor Drive 2615 Rossmoor Drive Upper St. Clair, PA Upper St. Clair, PA ZIP CODE 15241ZIP CODE 15241 County of Residence or of the Principal Place of Business: County of Residence or of the Principal Place of Business: Allegheny` Allegheny Mailing Address of Debtor (if different from street address): Mailing Address of Joint Debtor (if different from street address):
ZIP CODE ZIP CODE Location of Principal Assets of Business Debtor (if different from street address above): 3901 Washington Road ZIP CODE 51314 McMurry, PA 1 Type of Debtor Nature of Business Chapter of Bankruptcy Code Under Which (Form of Organization) (Check one box) the Petition is Filed (Check one box) (Check one box.) Health Care Business Chapter 7 Chapter 15 Petition for Single Asset Real Estate as defined in 11 Individual (includes Joint Debtors) Chapter 9 Recognition of a Foreign See Exhibit D on page 2 of this form. U.S.C. § 101(51B) Main Proceeding Railroad Chapter 11 Corporation (includes LLC and LLP) Chapter 15 Petition for Partnership Stockbroker Chapter 12 Recognition of a Foreign Other (If debtor is not one of the above entities, Commodity Broker Nonmain Proceeding Chapter 13 check this box and state type of entity below.) Clearing Bank ______ Other Nature of Debts (Check one box) Tax-Exempt Entity Debts are primarily consumer Debts are primarily (Check box, if applicable) debts, defined in 11 U.S.C. business debts. § 101(8) as “incurred by an Debtor is a tax-exempt organization individual primarily for a under Title 26 of the United States personal, family, or house- Code (the Internal Revenue Code.) hold purpose.” Filing Fee (Check one box) Chapter 11 Debtors Check one box: Full Filing Fee attached Debtor is a small business debtor as defined in 11 U.S.C. § 101(51D). Filing Fee to be paid in installments (applicable to individuals only). Must attach Debtor is not a small business debtor as defined in 11 U.S.C. § 101(51D). signed application for the court's consideration certifying that the debtor is Check if: unable to pay fee except in installments. Rule 1006(b) See Official Form 3A. Debtor's aggregate noncontingent liquidated debts (excluding debts owed to insiders or affiliates) are less than $2,190,000. Filing Fee waiver requested (applicable to chapter 7 individuals only). Must attach signed application for the court's consideration. See Official Form 3B. Check all applicable boxes A plan is being filed with this petition Acceptances of the plan were solicited prepetition from one or more classes of creditors, in accordance with 11 U.S.C. § 1126(b). Statistical/Administrative Information THIS SPACE IS FOR Debtor estimates that funds will be available for distribution to unsecured creditors. COURT USE ONLY Debtor estimates that, after any exempt property is excluded and administrative expenses paid, there will be no funds available for distribution to unsecured creditors. Estimated Number of Creditors 1- 50- 100- 200- 1,000- 5,001- 10,001- 25,001- 50,001- Over 49 99 199 999 5,000 10,000 25,000 50,000 100,000 100,000 Estimated Assets $0 to $50,001 to $100,001 to $500,001 to $1,000,001 $10,000,001 $50,000,001 $100,000,001 $500,000,001 More than $1 $50,000 $100,000 $500,000 $1 to $10 to $50 to $100 to $500 to $1 billion billion million million million million million Estimated Liabilities $500,001 to $1,000,001 $10,000,001 $50,000,001 $100,000,001 $0 to $50,001 to $100,001 to $500,000,001 More than $1 $1 to $10 to $50 to $100 to $500 $50,000 $100,000 $500,000 to $1 billion billion million million million million million B 1 (Official Form 1) (1/08) FORM B1, Page 2
Voluntary Petition Name of Debtor(s): (This page must be completed and filed in every case) Barry F Bartusiak, Kristi E. Bartusiak All Prior Bankruptcy Cases Filed Within Last 8 Years (If more than two, attach additional sheet.) Location Case Number: Date Filed: Where Filed: NONE Location Case Number: Date Filed: Where Filed: Pending Bankruptcy Case Filed by any Spouse, Partner or Affiliate of this Debtor (If more than one, attach additional sheet) Name of Debtor: Case Number: Date Filed: NONE District: Relationship: Judge:
Exhibit A Exhibit B (To be completed if debtor is required to file periodic reports (e.g., forms 10K and (To be completed if debtor is an individual 10Q) with the Securities and Exchange Commission pursuant to Section 13 or 15(d) whose debts are primarily consumer debts) of the Securities Exchange Act of 1934 and is requesting relief under chapter 11.) I, the attorney for the petitioner named in the foregoing petition, declare that I have informed the petitioner that [he or she] may proceed under chapter 7, 11, 12, or 13 of title 11, United States Code, and have explained the relief available under each such chapter. I further certify that I have delivered to the debtor the notice required by 11 U.S.C. § 342(b). Exhibit A is attached and made a part of this petition. X Not Applicable Signature of Attorney for Debtor(s) Date
Exhibit C
Does the debtor own or have possession of any property that poses or is alleged to pose a threat of imminent and identifiable harm to public health or safety? Yes, and Exhibit C is attached and made a part of this petition. No
Exhibit D
(To be completed by every individual debtor. If a joint petition is filed, each spouse must complete and attach a separate Exhibit D.)