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Home My WebLink About09-20-07 (2) -.J 15056051058 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 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY County Code Year File Number 21 07 0072 Date of Birth 195-28-0954 01/06/2007 04/25/1936 Decedent's Last Name Suffix Decedent's First Name MI Weigle Elinor R (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW (.) 1. Original Retum 2. Supplemental Retum 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 4. Limited Estate 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 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number :a; 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received o 8. Total Number of Safe Deposit Boxes James D. Flower Jr. Esq Firm Name (If Applicable) Saidis Flower & Lindsay (717) 243-6222 REGISTER OF WILLS USE ONL~., (}:J . -~:> First line of address 26 West High Street r. , c..-:.J P -t} , .> Second line of address ---: City or Post Office State ZIP Code DATEF!t:.1iD Carlisle PA 17013 r.._'1 C', Correspondent's e-mail address:jflowerjr@sfI-law.com Under penalties of perjury, I declare that I have examined this return, inciuding 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 pre parer has any knowledge. :'L~~SO I :SPONSfBLE FOR FILING RETURN u. q~S...107. ADDRESS 147 Oak Flat Road, Newville, PA 17241 ~ ---- ~. ---- - ---- - ----- f N URE OF PRE PARER OTHER THAN EPRESENT AD RESS .OJ.. l West High Street, Carlisle, PA 17013 PLEASE USE ORIGINAL FORM ONLY DATE .9-. t~CFl Side 1 L 15056051058 15056051058 -I J .....J 15056052059 REV-1500 EX Decedent's Name: Elinor R Weigle RECAPITULATION 1. Real estate (Schedule A). ................ . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1. 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. 6. Jointly Owned Property (Schedule F) Separate Billing Requested . . . . . .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) Separate Billing Requested.. . . . . .. 7. 8. Total Gross Assets (total Lines 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 8. 9. Funeral Expenses & Administrative Costs (Schedule H). . . . . . . . . . . . . . . . . . . .. 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) . . . . . . . . . . . . . . . . 10. 11. Total Deductions (total Lines 9 & 10)................................... 11. 12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . . . . . . . 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . . . . . . . 14. 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 .0_ 16. Amount of Line 14 taxable at lineal rate X.O_ 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 137,507.71 15. 16. 17. 18. 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT L 15056052059 Side 2 Decedent's Social Security Number 195-28-0954 139,900.00 0.00 0.00 0.00 4,122.63 9,028.28 0.00 153,050.91 14,195.89 1,347.31 15,543.20 137,406.99 0.00 137,507.71 20,626.13 20,626.13 15056052059 --.J REV-1500 EX Page 3 File Number Decedent's Complete Address: DECEDENTS NAME Elinor ---~--~--- STREET ADDRESS 221 Easy Road ----_._.._-~-------------- 0072 R Weigle DECEDENTS SOCIAL SECURITY NUMBER 195-28-0954 n ~_..---_..- CITY Carlisle - UjSTATE- PA iZ!p I 17013 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. CreditS/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 20,626.13 5,860.00 - -.---.----...--..- 308.41 Total Credits (A + B + C ) (2) 3. Interest/Penalty if applicable D. Interest E. Penalty 6,168.41 Total Interest/Penalty ( D + E ) (3) 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. (4) 0.00 0.00 B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (SA) (5B) 14,457.72 0.00 14,457.72 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. 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 transferred;.......................................................................................... D 00 b. retain the right to designate who shall use the property transferred or its income; ............................................ D 00 c. retain a reversionary interest; or.......................................................................................................................... D [iJ d. receive the promise for life of either payments, benefits or care? ...................................................................... D [iJ 2. If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. D 00 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. D 00 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate. property which contains a beneficiary designation? ........................................................................................................................ D 00 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 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 zero (0) percent [72 P.S. ~9116 (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. ~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 four and one-half (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 twelve (12) percent [72 PS. ~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. c:I"}JS 1 Iwills\weigle. wi! LAST WILL AND TESTAMENT OF OF ELINOR R. WEIGLE I, ELINOR R. WEIGLE, of 221 Easy Road, Carlisle, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void any and all former Wills, Codicils, or writings in the nature thereof, by me at any time heretofore made. FIRST: I hereby order and direct my Executrix or Executor, hereinafter named, to pay all. my just debts, funeral expenses, testamentary expenses and all Inheritance, Estate, Transfer and Succession Taxes, as soon as may be conveniently done after my death, out of my residuary estate. SECOND: I hereby make the following specific bequests: A. To my nephew, JOSHUA LEE STOUFFER, of 1957 Waggoner's Gap Road, Carlisle, Pennsylvania 17013, the sum of Five Hundred ($500.00) Dollars; B. To my niece, SHIANN STOUFFER, of 1957 Waggoner's Gap Road, Carlisle, Pennsylvania 17013, the sum of Five Hundred ($500.00) Dollars; C. To my niece, KATHIE JUMPER, of 37 "G" Street, Carlisle, Pennsylvania 17013, the sum of Five Hundred ($500.00) Dollars; D. To my nephew, DUSTIN BITTINGER, of 147 Oak Flat Road, Newville, Pennsylvania 17241, the sum of One Thousand ($1,000.00) Dollars; 1 c:\wp51 \wills\weigle. wil E. To my niece, PATTY ADAMS, of 445 Pisgah Road, Shermansdale, Pennsylvania 17090, the sum of One Thousand ($1,000.00) Dollars; F. To my niece, CHRIS WEIGLE, of 123 Porter Avenue, Carlisle, Pennsylvania 17013, the sum of One Thousand ($1,000.00) Dollars; G. To my nephew, KENNY BLOSSER, of P. O. Box 256, Plainfield, Pennsylvania 17081, the sum of Three Thousand ($3,000.00) Dollars; H. To my nephew, WILLIAM STUM, of 702 Bloserville Road, Newville, Pennsylvania 17241, the sum of One Thousand ($1,000.00) Dollars; I. To my brother, DEAN BLOSSER, of 94 Cherry Lane, Carlisle, Pennsylvania 17013, the sum of One Thousand ($1,000.00) Dollars; and J. To my brother, BEN BLOSSER, of 24 North Hanover Street, Carlisle, Pennsylvania 17013, the sum of Five Hundred ($500.00) Dollars. THIRD: My house located at 221 Easy Road, Carlisle, Pennsylvania, shall be sold and the proceeds therefrom shall be added to my residuary estate. FOURTH: All the rest, residue and remainder of my estate, I hereby give, devise and bequeath to my niece, WANDA BITTINGER, of 147 Oak Flat Road, Newville, Pennsylvania 17241; LASTLY: I nominate, constitute and appoint my niece, WANDA BITTINGER, to be the Executrix of this my Last Will and Testament. In the event that WANDA BITTINGER shall be unable to serve as Executrix for any reason, I appoint my nephew, KENNY BLOSSER, as Executor. No Executrix or Executor shall be required to file bond in this or any other jurisdiction. 2 c:lwp51 Iwillslweigle. wi! IN WITNESS WHEREOF, I have hereunto set my hand and seal this day of /J r ' 2006. 7~/.- ,). ~ 1 L:~ 11 .~ Elinor R. we~ SIGNED, SEALED, PUBLISHED and DECLARED in the presence of: ~~2~ \ II I \ f k= ,~ ~. .-U;a 0 , 3 c:lwp51Iwillslweigle.wil COMMONWEALTH OF PENNSYLVANIA ss COUNTY OF CUMBERLAND I, ELINOR R. WEIGLE, Testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. WEIGLE, the Testatrix, this Sworn or affirmed to and acknowledged before me, by ELINOR R. ~,(4L / t"'- day of ,2006. ~~MJ1Jd tary Public . '. NOTARIAl SEAl MERLENE J. MARHEVKA. NOTARY PUBLIC CARLISLE. CUMBERLAND COUNTY. PA :. MY COMMISSION EXPIRES JUNE 8, 2008 4 c:lwp51 Iwillslweigle. wil COMMONWEALTH OF PENNSYLVANIA ss COUNTY OF CUMBERLAND We , the witnes oregoing instrument, being duly qualiti according to law, do de se and say that we were present and saw Testatrix sign and execute the instrument as her Last Will; that ELINOR R. WEIGLE signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the Will as witnesses; and that to the best of our knowledge the Testatrix was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn or affirmed to and subscribed to before me bY/~"'~~>t...LJ 0. 4.e~'-<lc ~ . an~ cl? U )o..u this 0 7-t.A. day of ~~'t ,2006. cr~u ~j== Witn~~s ( ~~~- U VVitness . ~hdL~~)i;f;)~~ Notary Public .... . . NOTARIAL SEAl MERLENE J. MARHEVKA. NOTARY PUBLIC CARLISLE, CUMBERLAND COUNTY. PA , MY COMMISSION EXPIRES JUNE 8, 2008 5 REV-1502 EX+ (6-9* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF Elinor R. Weigle FILE NUMBER 21-07 -0072 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. All that certain tract of land situate in North Middleton Township, Cumberland County, PA. Being known and numbered as 221 Easy Road, Carlisle, PA. Actual sale price. See attached HUD-1 139,900.00 TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 139,900.00 REV-1508 EX+ (6-98) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Elinor R. Weigle FILE NUMBER 21-07 -0072 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. Miscellaneous household goods and furnishings sold at public sale 1,911.50 2. 1990 Buick Skylark. Actual Sale Price 500.00 3. 2006 Federal Income Tax Refund 130.00 4. Savings deposit to open estate account 25.00 5. Kinetic Imaging, refund 23.02 6. 2007 County/Township Real Estate Tax Proration 8/16/07 -12/31/07 7. 2007 School Real Estate Tax Proration 07/01/07 - 08/16/07 113.50 147.36 8. Capital Blue Cross, Refund 227.80 9. The Sentinel, Subscription Refund 96.82 39.83 10. Comcast, Refund 11. Erie Insurance Group, Automobile Insurance Refund 232.00 12. United Healthcare Service, Inc., Refund 45.80 13. Income Tax Refund 130.00 14. Department of Revenue, Property Tax Rebate 500.00 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 4,122.63 REV-1509 EX+ (6-98* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF Elinor R. Weigle FILE NUMBER 21-07-0072 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Wanda Bittinger 147 Oak Flat Road, Newville, PA 17241 Niece B. C. JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTL V-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. 09/01/04 Checking Account #61 00732622, Citizen's Bank. See attached sheet 18,056.56 50% 9,028.28 TOTAL (Also enter on line 6, Recapitulation) $ 9,028.28 (If more space is needed. insert additional sheets of the same size) REV-1511 EX+ (12-99>. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21-07-0072 ESTATE OF Elinor R. Weigle Debts of decedent must be reported on Schedule I. ITEM NUMBER A. DESCRIPTION AMOUNT 1. FUNERAL EXPENSES: Hoffman-Roth Funeral Home, Funeral Pastor for Funeral Service 6,893.10 200.00 2. B. ADMINISTRATIVE COSTS: 1 . Personal Representative's Commissions 10. 11. 12. Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees 4,592.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 310.00 5. Accountant's Fees 6. Tax Retum Preparer's Fees 7. Cumberland Law Journal, Advertise Estate Notice The Sentinel, Advertise Estate Notice Morrison's Auto Sales, Transfer Automobile Recorder of Deeds, 1 % T ransfer Tax on Sale of Real Estate Register of Wills, Filing Fee for Inheritance Tax Return Roy Gottshall, Auctioneer's Fee, Sale Clerks and Advertising Public Sale 75.00 144.29 153.50 1,399.00 15.00 414.00 8. 9. 14,195.89 TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) REV-1512 EX+ (12-03) '* SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Elinor R. Weigle FILE NUMBER 21-07-0072 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. P. P. & L., Account, February-August 2007 177.73 2. Embarq, Account, February-August 2007 54.98 3. Robin Sollenberber, Tax Collector, 2007 County/Township Real Estate Taxes 300.20 4. Stott & Stott, Preparation of 2006 Income Tax Returns 170.00 5. Jones Plumbing, Repairs 105.50 6. Shipley Energy, Furnace Repairs 348.00 7. Shipley Energy, Air Conditioner Repairs 190.90 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 1,347.31 REV-1513 EX+ (9-00) '* SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Elinor R. Weigle FILE NUMBER 21-07 -0072 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS Dnclude outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. Joshua Lee Stouffer, 1957 Waggoner's Gap Road, Carlisle, PA 17013 Nephew 500.00 2. Shiann Stouffer, 31 East Main Street, Newville, PA 17241 Niece 500.00 3. Kathie Jumper, 37 "G" Street, Carlisle, PA 17013 Niece 500.00 4. Dustin Bittinger, 147 Oak Flat Road, Newville, PA 17241 Nephew 1,000.00 5. Patty Adams, 445 Pisgah Road, Shermansdale, PA 17090 Niece 1,000.00 6. Chris Weigle, 123 Porter Avenue, Apt. #3, Carlisle, PA 17013 Niece 1,000.00 7. Kenny Blosser, P. O. Box 256, Plainfield, PA 17081 Nephew 3,000.00 8. William Stum, 134 CME, Newville, PA 17241 Nephew 1,000.00 9. Dean Blosser, 94 Cherry Lane, Carlisle, PA 17013 Brother 1,000.00 10. Ben Blosser, 24 North Hanover Street, Apt. Rear, Carlisle, PA 17013 Brother 500.00 ENTER DOLLAR AMOUNTS FOR DiSTRIBUTiONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE TAXABLE DISTRIBUTIONS CONTINUED FROM ABOVE: 11. Wanda Bittinger, 147 Oak Flat Road, Newville, PA 17241 Niece 106,881.58 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS NONE TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 0.00 (if more space is needed, insert additional sheets of the same size) A, Settlem€nt Statement U.S. Department of Housing and Urban Development S. Tvee of Loan OMS Aeeroval No. 2502-0265 (expires 1113012009\ 1. OFHA 2. OFmHA 3. K1Conv. Unins. I 6. File Number 7. Loan Number 18. Mortgage Insurance Case Number 4. [lVA 5. DGonv. Ins. 2007 -221SHERMANMAS C. Note: IS onn IS ,,!!,llIoneo 10 give you e Slal8rnen 0 e",ue~. sell,ernen COSIS. Amoun s palo. 10 ano DY e se~lIemen~ agent are Snown. I TilleExpress Setllement System Items marked "(p.o.c.)" were paid outside the closing; they are shown here for Information purposes and are not Included In the totals. WARNING: It Is a crime to knowingly make false statements to the United States on this or any other similar fonn. Penalties upon conviction can Include a fine and Imorisonment. For details see: Tille 18 U. S, Code Section 1001 and Section 1010. D. NAME OF BORROWER: David S. Sherman ADDRESS: 59 Partridae Circle Carlisle PA 17013 E. NAME OF SELLER: Estate of Elinor Weigle ADDRESS: 221 Easv Road Carlisle, PA 17013 F. NAME OF LENDER: Orrstown Bank ADDRESS: 77 East Kina Street P.O. Box 250. Shippensbura. PA 17257 G. PROPERTY ADDRESS: 221 Easy Road, Carlisle, PA 17013 North Middleton TownshiD H. SETTLEMENT AGENT: O'Brien, Baric & Scherer, Telephone: 717-249-6873 Fax: 717-249-5755 PLACE OF SETTLEMENT: 19 West South Street. Carlisle. PA 17013 I. SETTLEMENT DATE: 08/16/2007 J. SUMMARY OF BORROWER'S TRANSACTION: K. SUMMARY OF SELLER'S TRANSACTION: 100. GROSS AMOUNT DUE FROM BORROWER 400. GROSS AMOUNT DUE TO SELLER 101. Contract sales price 139 900.00 401. Contract sales mice 139 900.00 102. Personal Property 402. Personal Property 103. Settlement charQes to borrower (line 1400) 7 846.90 403. 104. 404. 105. 405. Adjustments for items paid by seller in advance Adjustments for items paid by seller in advance 106. City/town laxes 406. City/town taxes 107. County taxes 08/16/07 to 12/31/07 113.50 407. County laxes 08/16/071012/31/07 113.50 108. School Tax 408. School Tax 109. 409. 110. 410. 111. 411. 112. 412. 120. GROSS AMOUNT DUE FROM BORROWER 147860.40 420. GROSS AMOUNT DUE TO SELLER 140013.50 200. AMOUNTS PAID BY OR ON BEHALF OF BORROWER 500. REDUCTIONS IN AMOUNT DUE TO SELLER 201. Deposit or earnest money 500.00 501. Excess Deposit (see instructions) 500.00 202. Princioal amount of new loans 111 920.00 502. Settlemenl charoes to seller (line 1400) 1 399.00 203. ExislinQ loan(s) taken subiect to 503. ExistinQ loan(s) laken subiect to 204. 504. Payoff of First Mortaaoe Loan , 205. 505. 206. 506. 207. 507. 208. 508. 209. 509. Adjustments for items unpaid by seller Adjustments for items unDaid bv seller 210. Cilvllown taxes 510. Cily/town laxes 211. County laxes 511. County laxes 212. School Tax 07/01/071008/16/07 147.36 512. School Tax 07/01/071008/16/07 147.36 213. 513. 214. 514. 215. 515. 216. 516. 217. 517. 218. 518. 219. 519. 220. TOTAL PAID BY/FOR BORROWER 112.567.36 520. TOTAL REDUCTION AMOUNT DUE SELLER 2.046.36 300. CASH AT SETTLEMENT FROM OR TO BORROWER 600. CASH AT SETTLEMENT TO OR FROM SELLER 301. Gross amount due from borrower Wne 120) 147.860.40 601. Gross amounl due to seller (ljne 420) 140013.50 302. Less amounls paid bv/for borrower (line 220) 112.567.36 602. Less reduction amounl due seller (line 520) 2.046.36 303. CASH FROM BORROWER 35.293.04 603. CASH TO SELLER 137.967.14 U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT C:ETTLEMENT 5T A TEMENT File Number: 2007.221SHERMAN T't1 E S Itl t S PAGE 2 oJ I e xoress e emen :ivstem L. SETTLEMENT CHARGES PAID FROM PAID FROM 700. TOTAL SALES/BROKER'S COMMISSION based on price $139 900.00 = BORROWER'S SELLER'S Division of commission lline 700\ as follows: FUNDS AT FUNDS AT 701. $ to SETTLEMENT SETTLEMENT 702. $ to 703. Commission oaid at Settlement 800. ITEMS PAYABLE IN CONNECTION WITH lOAN 801. loan Oriaination Fee 2.000 %Orrstown Bank 2.238.40 802. loan Discount % 803. Aooraisal Fee to Orrstown Bank 325.00 804. Credit Reoort to Orrstown Bank 14.00 805. Aoolication Fee to Orrstown Bank 86.00 806. Tax Service Fee to Orrstown Bank 75.00 807. Document Preoaration Fee to Orrstown Bank 200.00 BOB. Underwriting Fee to Orrstown Bank 195.00 B09. Flood Hazard CertifICation 10 Orrstown Bank 30.00 810. 811. 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest From 08/16/2007 to 09/01/2007 (Q)$ 20.2075 Iday 16 Davs 323.32 902. Mortaaae Insurance Premium for to 903. Hazard Insurance Premium for 10 Erie Insurance (P.O.C.) 299.00 Buver 904. 905. 1000. RESERVES DEPOSITED WITH LENDER FOR 1001. Hazard Insurance 4 mo. liD. $ 24.92 Imo 99.68 1002. MortaaQe Insurance mo. liD. $ Imo 1003. City Prooerty Tax mo. liD. $ Imo 1004. Countv Prooerty Tax 9 mo. ~ $ 25.02 Imo 225.18 1005. School Tax 5 mo. liD. $ 97.71 Imo 488.55 1009. Aaareaate Analysis Adiustment .370.47 0.00 1100. TITLE CHARGES 1101. Settlement or c10sina fee 1102. Abstract or title search 1103. Title examination 1104. Title insurance binder 1105. Document Preoaration I 1106. Notary Fees to Cash 15.00 1107. Attorney's fees /includes above items No: \ 1108. Title Insurance to O'Brien. Baric & Scherer 1.058.75 (includes above items No: \ 1109. lender's Policv 111 920.00 . 1110. Owner's Policy 139.900.00 .1 058.75 1111. End 100 End 300 End 900 10 O'Brien. Baric & Scherer 150.00 1112. ClosinaSvcltr 10 O'Brien. Baric & Scherer 35.00 1113. 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. RecordinQ Fees Deed $ 38.50 . MortQaoe $ 48.50 ' Release $ 87.00 1202. CitylCounty tax/stamos Deed $1 399.00 . Mortoaoe $ 1.399.00 1203. State Tax/stamos Deed $1 399.00 . Mortoaoe $ 1,399.00 1204. 1205. 1300. ADDITIONAL SETTLEMENT CHARGES 1301. 2007 School Real Estate Taxes to Robin Sollenberaer 1,172.49 1400. TOTAL SETTLEMENT CHARGES (enter on lines 103 Section J and 502 Section K\ 7.846.90 1,399.00 HUD CERTIFICATION OF BUYER AND SELLER I have carefully reviewed the HUD.1 Selllement Statement and to the best of my knowledge and belief, It is a true and accurate statement of all receipts and disbursements made on my account or by me In this nsactlon. I further ce 'fy that I have received a copy of the HUD-1 Settlement Statement. Estate of Elinor Weigle 6/.Lk~ ~taff~ WARNING: IT IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE UNITED STATES ON THIS OR ANY SIMILAR FORM. PENAL TIES UPON CONVICTION CAN INCLUDE A FINE AND IMPRISONMENT. FOR DETAILS SEE TITLE 18: U.S. CODE SECTION 1001 AND SECTION 1010. The HUD-1 Selllement Statement Which I have prepared is e true and accurata account of this transaction. I have ca~sed or ~ ~; 7d~ b: disbursed In accordance with this sta~e;~;d .0' SETTLEMENT AGENT: ~:!:..! DATE: ~ I' 4i:_-t~C1n-;:; FINAL SETTLEMENT Esrn'F Or h5AIC-( U}nGfk Date 401j/01- OWNER Address Date of Sale Sale Location Auctioneer Clerk Cashier Other PROCEEDS OF SALE: Cash . _ u_ _ _ ____u __n_ ___ u ___ ___ u _ ___ _ ___u __n__ $ rf(J. YJ~ I J4/.{X)I- , Checks n __ ___ n __n_ ____ _u___ __n_n___ ________n Othe r _ __ _ _ __ _ __ _ _ _ __ _ __ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _n _ _ u__ _ _ __ _ _ __ ____ __ __ u _nnn_ n_ __ _ _n_ ______u__. Miscellaneous (see attached list) TOTAL PROCEEDS OF SALE ____n_______________. $ 1f. ~ / /,5 () LESS SELLER'S SALE EXPENSE: Auctioneer's Fee _ ..5.-1d _ __ _ _ m_______ _____n___ u_u_____ _____ _____ __________ $ qs. OcJ+ Other Seller's Expenses Advanced by Auction~r: (')/ CJ CL rJ:: ~5;'[fe -3.70 - 317 - f "'--Wf5tft:>-.6% - ~8 ilitftt{; S/!2i _. ~ ~/O:jr/ -~5 14nnec5D/Q:: JJ:?S It, tZ) =f-- J c;~()()~ , jOI {)a~ Miscellaneous (see attached list) _________n__________________n_______________ TOTAL NET PROCEEDS TO SELLER _m___________________________ $ t;1.20()~ I, 'i ~~~6 ~. DEDUCT TOTAL SELLER'S SALE EXPENSE ________n_____________________ $ 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 all responsibility for providing merchantable title to all goods, merchandise, and/or property sold, and for delivery of title to the purchaser. (Date) (Seller's Signature) Auctioneer or Cashier's Signature (Seller's Signature) Form No. FS Reorder lrom: MISSOURI AUCTION SCHOOL Phone 1-800-835.1955 . JACK KAL TEN BAUGH . Sales Manager '. ~~, ~ MORRISONS AUTO SALES ~LES (717) 249-6262 1560 Holly Pike Carlisle, PA 17013 Toll Free (800) 795-6264 Fax (717) 249-0097 :TAL k;e- A -K/i'/l-e,J bA-"J f -5 ~ ) e .:;, IY1 t\"" Aj e;t..- -r )q ~v B v- ~ c- Ie 5 kflA~k I -5 V,4-/v ~ ~Of DD.~, 'C~ 0+ t' 500 ----- -rn , <:: t.e \.l Q rJ /', I IIORRISONS AUTO SALES NAME _JiA"'~' J f i-\ I~ ".; d ~:~. (> il,J C.,r J ,j:) -€ e L ;A .,) -' 1510 Holly PIke ADDRESS 77 1<- '<2. CARLISLE, M 11018 /-~ ,:. }\ ~) y' r".~, Phone; (111j 2. I2tJ2 CITY 1'_14 'f;"" \ -10 1 3 DATE I CUST. ORDER NO. I WHEN PROMISED I PH~E ~ ;2- ,);c ,-># )' ,') 6 >7 r ' PART NO. NAME OF PART SALE I; <,' I lAMT. AMT. YEAR & MAKiO OF CAR- T)'PE OR MODEL SERIAL NO.NIN# J c.::. i/ IJ (S '/ [,I' ? i /lei - \-......1' e) 0 8 ..~\I / ?i) p' ,/ MOTOR NO. .f,/(j(. I /t.... L1CE~E NO. e) MILEAGE i,./ '-' '7 f?" :;: I WRITTEN,~i~ / 6- )? If .,;,. &" / ,,- I "-" _____ '-~\ DESCRIPTION OF WORK AMOUNT - Sf; k' '. /I'i ./ 0 {J J ..... 1:. __" ..::0 ~ -~'" ,2;;2 S.J J/ ./ _/ (~~r' ,r- \ X u \\ ~,::b , -/ .;;:;, it) --- ~O /.4<..;j.:5' ~ ~'--'- n i "\ \~ \V ....j:;c::. ,. /" --' ....'? 6 ~ I-e "t;,__'. f\V \"i J l!\ /1/ I. ,~.> '''5rM :s ~( /. .:J Y ;)...,',./.-/ .//0 ( " "~-~ . .. ? \J 'It, / .' ~ - .' \.)j '.. . - , " .' ~ " I ! ( J ) i.- '. t .) .f " ^ '. ~., \ (1 '--..J '1: (j GAS, OIL & GREASE eHECK BELOW LABOR ONLY t WBRICATE GALS. GAS CHANGE PARTS .._,n...... " ENGINE' OIL i ) OTS. OIL TRANSMISSION ACCESSORIES '",---/ SEE BACK FOR TOTAL PARTS ~ LBS. GREASE DIffERENTIAL I GAS, OIL ADDITIONALf>ARTS & GREASE ACCESSORIES-TIRES AND TUBES WASH MISC. I MERCHANOISE / ~- , IlOLlSH SUBLET " ~ r ; REPAIRS '-/ I HAZAROOUS WASTE IlISP. TOTAL GAS, ~ TOTAL ~ TAX OIL & GREASE SERVICE ~ AUTHORIZED BY ~ TOTAL ACCESSORIES TOTAL 15805 esTIMATES ME FORPAR~ i HEREBY AUTHORIZE THE ABOVE REPAIR WORK TO BE DONE ALONG I;VITfF\JECESSARY MATERIALS_ YOU AND YOUR EM.PL 0 YE..E S MAY OPERATE ABOVE V.EHICLEFOR PUR.P.OSES OF TESTING. INSPEC~.... OR DELIVERY AT MY, RISK.. A. N EXPRESS ME~C!SUEN'IS~lEDGI3J ON:ABQlIEAA;HIClE TOSoCURE THo AMOUOP REPAIRS THORETO.lT'IEl.UNDERSTOOD THAT THIS 'CoMPANY ASSUMES NO RESPONSIBILITY' FOR LOSS OR DAMAGE BY oPT OR FIRE TO llEHICLES P!:ACED wn H THEM FOR STORAGE. SALE. RoPAIR OR WHIL!' ROAD TESTING. -" " .__._... "..__,., ,... _.----L....___ PAY THIS AMOUNT t --~~~--, ~ Page 1 of 1 IMII 02/15/07 ELINOR R WEIGLE WANDA J BITTINGER 221 EASY RD BEGINNING BALANCE 17561.11 DATE 01/05 01/09 01/12 01/29 02/05 CHECK# 1103 1105 LAST PAGE DDA STATEMENT HISTORY 08.48.46 PAGE 2 ACCT NO. 060-000-0000-6100732622 DATE LAST STATEMENT 02/05/07 DATE THIS STATEMENT 02/15/07 *****DDA TRANSACTIONS***** CHECKS/OTHER DEBITS DEPOSITS/OTHER CREDITS ENDING NO. TOTAL AMOUNT NO. TOTAL AMOUNT BALANCE 13 20105.92 4 2544.81 0.00 AMOUNT TYPE 53.66 40.16 1407.00 1407.00 18016.40 PF2 - PAGE BKWD TRANSACTION DESCRIPTION CHECK CHECK DEBIT MEMO CREDIT MEMO CLOSING WITHDRAWAL BALANCE 18056.56 18016.40 16609.40 18016.40 0.00 ~ ::t C::> )~ J.-::S: (: ~, '""\ La b .b-....~ ... - DJ>..l... P--"'- D z... A:::::> D r-- DA... -'\ :f- - ' 'I' lo ,3.DD', Dr- O~.A \ K MAR 1 2 2007 ~ j ODO'~ - D'~\ ~AuD-( L.0-L-~ - - D"'- - 0 S u)),.""'- t:- 00 :t.~ Jared L. Keiter Asst Mgr/Certified BBB/BAW Specialist Carlisle-Sharon Office S~ ):~ Citizens Bank 665 N. East Street 18B-0419 Carlisle, PA 17013 7172435311 tel 717245.0972 fax 717798.7407 cell ~RBS , 1ILn_'L__~_+/':!'1"7()I".,.....nl1.,)7{) htm 2/1512007