The URL can be used to link to this page

Home My WebLink About11-29-07 o '. --.J 15056041147 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 County Code Yeer INHERITANCE TAX RETURN 21 07 RESIDENT DECEDENT OFFICIAL USE ONL V File Number 0768 186341116 08092007 Date of Birth 10081942 Decedent's Last Name Suffix BADMAN Decedent's First Name SUE MI A (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW I X" 1. Original Return THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 2. Supplemental Return 3. Remainder Retum (date of death prior to 12-13-82) 5. Federal Estate Tax Retum Required ~__.....J 4. Limited Estate 4a. Future Interest Compromise (date of death after 12-12-82) iX 6. Decedent Died Testate (Attach Copy of Will) 7 Decedent Maintained a Living Trust . (Attach Copy of Trust) 8. Total Number of Safe Deposit Boxes 9. Litigation Proceeds Received 10 Spousal Poverty Credit (date of death . between 12-31-91 and 1-1-95) 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 Telephone Number STEPHEN M. GREECHER JR. 71723~fl121 s;~ ~..~~ ~-.-) :;-j r-......' Firm Name (If Applicable) TUCKER ARENSBERG, 111 N. FRONT STREET P . C . , ~"'} .,--....., " REGISTEFd?ri~LS uW ONt.;V . ,}~" en ~ First line of address Second line of address V ......'!!',... N City or Post Office HARRISBURG w .. State PA ZIP COde 17108-0889 DATE FILED Correspondent's e.mail address: 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. SIC:; E 0 PERS RESP ISLE FOR FILING RETURN Fred S. Badman DATE r iO!2Ct/OJ 17036 Stephen M. Greecher Jr. DATE /6~k- 111 N. Front Street, Harrisburg, PA 17108-0889 L Side 1 15056041147 15056041147 --.J . ~ --' 1S0Sb042148 REV-1500 EX RECAPITULATION Decedent's Social Security Number 186341116 Decedent's Name: Sue A. Badman --~----~---- 1. Real Estate (Schedule A)...................................................................................... 1. 130,000.00 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. 10,656.85 6. Jointly Owned Property (Schedule F) Separate Billing Requested............. 6. 7. Inter-Vivos Transfers & Miscellaneous N~I}-Probate Property (Schedule G) . . Separate Billing Requested............. 7, 8. Total Gross Assets (total Lines 1-7)..............................._.................................. 8. ".__._._---'~.._-"~---_._---_._--_._--_._----_._-~-~--~-----------------------------~,_._- 140,656.85 22,973.34 9. Funeral Expenses & Administrative Costs (Schedule H)...................................... 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)................................ 10. 77,386.49 11. Total Deductions (total Lines 9 & 10)................................................................. 11. 100,359.83 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. 40,297.02 14. Net Value Subject to Tax (Line 12 minus Line 13).............................................. 14. -----------~~-_.._~._---~_._,~----_._~--- 40,297.02 TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, of transfers under Sec. 9116 (a)(1.2) X~ 16. Amount of Line 14 taxable at lineal rate X .045 17. Amount of Line 14"tai<able at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 0.00 15. o .00 16. o . 00 17. o . 00 18. 6,044.55 19. 6,044.55 o . 00 40,297.02 19. Tax Due................................,......................... .................... ....... .......................... 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. D L Side 2 1S0Sb042148 1S0Sb042148 --' .J REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-07 -0768 DECEDENT'S NAME Sue A. Badman --'._-"-~~'--' STREET ADDRESS 46 Erford Road ----'-- ------ -_.._---.,.,----'~~--~---~-----~-~--.- Camp Hill --,._-----~-------._---------- ---"--_._--,._----..._._-------~--- I STATE [ZIP CITY Camp Hill I PA 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1 ) 6,044.55 302.23 3. Interest/Penalty if applicable D. Interest E. Penalty Total Credits (A + 8 + C) (2) 302.23 Total Interest/Penalty (0 + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is thEOVERPA YMENt Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE A. Enter the interest on the tax due. 8. Enter the total of Line 5 + 5A. This is theBALANCE DUE (3) (4) (5) (5A) (58) 5,742.32 5,742.32 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;............................................................................. [xl ~==r b. retain the right to designate who shall use the property transferred or its income;................................ x' M c. retain a reversionary interest; or............................................................................................................ L~ 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?.................... ....... ....... ............................................. ......... ........................ I J(l 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?........ L)(.J 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?............................................................................................................... x' 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 statutedoes 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. S9116 (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 P.S. S9116 (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. .... 't Rev-1502 EX+ (6.981 . SCHEDULE A REAL ESTATE COMMONIIVEAL TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Badman, Sue A. FILE NUMBER 21-07-0768 All real property owned solely or.. a tenent In common must be reported et fair marlcet 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 Jolntly-owned with right of survivorship must be disclosed on schedule F, ITEM NUMBER DESCRIPTION 1 23 Fairfax Village, Lower Paxton Township, Harrisburg, PA 17112 VALUE AT DATE OF DEATH 130.000.00 TOTAL (Also enter on Line 1, Recapitulation) 130.000.00 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule A (Rev. 6-98) , . Rev-1508 EX+ (6-98) . SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEAlTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Badman, Sue A. FILE NUMBER 21-07 -0768 Include the proceeds of lijigation and the date the proceeds were received by the estate. All property jolntly-owned with the right of survivorship must be disclosed on schedule F. TOTAL (Also enter on Line 5, Recapitulation) 10.656.85 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) . ., ~. REV.1151 EX+ (12.99) . SCHEDULE H FUNERAL EXPENSES & ADMINISTRA TIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Badman, Sue A. Debts of decedent must be reported on Schedule I. FILE NUMBER 21-07-0768 ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s) attached 5,698.19 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Social Security Number(s) I EIN Number of Personal Representative(s): Street Address City State Zip - Year(s) Commission paid 2. Attorney's Fees 2,500.00 See continuation schedule(s) attached 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 298.00 See continuation schedule(s) attached 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 14,477.15 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 22,973.34 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 ScheduleH (Rev. 6-98) .J I > c. ReY-1502 EX+ (6-98) *' SCHEDULE H-A FUNERAL EXPENSES continued COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Badman, Sue A. FILE NUMBER 21-07-0768 ITEM NUMBER DESCRIPTION AMOUNT 1 Gilbert Dailey Funeral Home - funeral 3.533.19 2 Holiday Inn - funeral dinner 300.00 3 Woodlawn Memorial - tombstone payment 1.865.00 Subtotal 5.698.19 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 ScheduleH-A (Rev. 6-98) I, t. Rev-1502 EX+ (6-98) . SCHEDULE H.82 A TTORNEY'S FEES continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Badman, Sue A. FILE NUMBER 21-07-0768 ITEM NUMBER DESCRIPTION AMOUNT 1 Tucker Arensberg, P.C. - attorney fees 2.500.00 Subtotal 2.500.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 ScheduleH-B2 (Rev. 6-98) I ~ : it Rev-1502 EX+ (6-98) . SCHEDULE H-B4 PROBA TE FEES continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Badman, Sue A. FILE NUMBER 21-07-0768 ITEM NUMBER DESCRIPTION AMOUNT 1 Register of Wills - probate fees 298.00 Subtotal 298.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B4 (Rev. 6-98) .' , ~ .t 41 Rev.1502 EX+ (6-98) . SCHEDULE H-B7 OTHER ADMINISTRA TIVE COSTS continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Badman, Sue A. FILE NUMBER 21-07-0768 ITEM NUMBER DESCRIPTION AMOUNT 1 23 Fairfax Village, Lower Paxton Township, Harrisburg, PA 17112 _ settlement charges to seller 12.063.48 2 Allstate Insurance - automobile insurance 278.20 3 Chambers Hill Fire Swatara EMS - ambulance service 1.000.35 4 Cumberland Law Journal - proof of publication 75.00 5 Jamie Eisennacher - deposit to electrician for property repairs 300.00 6 Joe Gusherowski - moving expense 50.00 7 Register of Wills - short certificate 4.00 8 Susquehanna Township Ambulance - ambulance service 405.00 9 The Sentinel - Legal - proof of publication 158.62 10 Townhouse Assocation - fee for re-sale certificate 30.00 11 U-Haul - remove household items 10.60 12 U-Haul- remove household items 88.19 13 United Water of PA - final water bill for property 13.71 Subtotal 14.477.15 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) . . f I '. Rev-1512 EX+ (6-98) *' SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Badman, Sue A. FILE NUMBER 21-07-0768 Include unrelmbursed medIcal expenses. ITEM NUMBER DESCRIPTION 1 23 Fairfax Village, Lower Paxton Township, Harrisburg, PA 17112 _ payoff offirst mortgage loan VALUE AT DATE OF DEATH 62.274.54 2 Cardiology Diagnostics - medical expense 35.00 3 OJ Ortho - Acct. No. 752308N - orthopedic equipment 162.00 4 ERI Financial Services - payoff Bon Ton credit card 476.70 5 GM Cardmember Services - payoff of credit card 4.456.52 6 GM Cardmember Services - final credit card payment 4.456.52 7 GMAC - payoff of balance of car loan 2.265.02 8 Pinnacle Health Services - Acct. No. 469370 - medical expense 0.00 9 Q-Card - payoff QVC credit card balance 2.183.31 10 Quantum Imaging & Therapeutic Associates - medical expense 396.00 11 Sears Credit Card - credit card balance 486.88 12 SR Goldman & Associates - payment for ambulance 194.00 TOTAL (Also enter on Line 10, Recapitulation) 77,386.49 (If more space is needed. additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98) .' " .. REV-1513 EX+ (9-00) . SCHEDULE ,J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF NUMBER Badman, Sue A. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(a)(1.2)] RELATIONSHIP TO DECEDENT Do Not List Truste8/s) FILE NUMBER 21-07 -0768 SHARE OF ESTATE AMOUNT OF ESTATE (Words) ($$$) I. 1 Claire Badman 251 Grandview Road Hummelstown, PA 17036 Niece 1 year tuition at PSU; 1/4 residue of estate one-fourth residue of estate 2 Fred B. Badman 6300 Culbreth Court Moseley, VA 23120 Nephew 3 Helen S. Badman 1249 B East Caracas Ave. Hershey, PA 17033 Niece one-fourth residue of estate 4 Luke Badman 8230 3rd Street Boiling Springs, SC 29316 Nephew one-fourth residue of estate Total 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 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS Copyright (c) 2002 form software only The Lackner Group, Inc. TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00 Form PA-1500 ScheduleJ (Rev. 6-98) I ., . WILL I, SUE A. BADMAN, of Lower Paxton Township, Dauphin County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. ITEM I. I give to my niece, CLAIRE BADMAN, a sum of money equal to one (1) year (2 fulltime semesters) of tuition at the Pennsylvania State University as of the date of my death. ITEM II. I give all the rest, residue and remainder of my estate, real and personal, in equal shares to my following nieces and nephews, per stirpes, who survive me by thirty (30) days: 1. FRED BLAISE BADMAN; 2. LUKE BADMAN; 3. HELEN SELlNE; 4. CLAIRE BADMAN ITEM III. My executor may, without further responsibility, distribute property passing to a minor under this Will to the guardian of the minor to hold for the minor. ITEM IV. No interest in income or principal shall be assignable by, or available to anyone having a claim against, a beneficiary before actual payment to the beneficiary. ITEM V. All of my just debts and expenses owing at the time of my death and any debts arising from my death and burial shall be paid out of the principal of my residuary estate. ITEM VI. All federal, state, and other death taxes payable on the property forming my gross estate for tax purposes, whether or not it passes under this will, shall be paid out of the principal of my residuary estate just as if they were my debts, and none of those taxes shall be charged against any beneficiary. ITEM VII. J authorize my executor: Page 1 of 3 Pages. FILE I . l . A. to retain and to invest in all forms of real and personal property, regardless of (i) any limitations imposed by law on investments by executors or trustees, (ii) any principle of law concerning delegation of investment responsibility by executors or trustees, or (iii) any principle of law concerning investment diversification; B. to compromise claims and to abandon any property which, in my executor's opinion, is of little or no value; to borrow from, and to sell property to others, and to pledge property as security for repayment of any funds borrowed; C. to sell at public or private sale, to exchange or to lease for any period of time any real or personal property, and to give options for sales or leases; D. to join in any merger, reorganization. voting-trust plan or other concerted action of security holders, and to delegate discretionary duties with respect thereto; E. to use administrative or other expenses of my estate as income tax or estate tax deductions and to value my estate for tax purposes by any optional method permitted by the law in force when I die, without requiring adjustments between income and principal for any resulting effect on income or estate taxes; and F. to distribute IN KIND and to allocate specific assets among the beneficiaries in such proportions as my executor may think best, so long as the total market value of any beneficiary's share is not affected by such allocation. These authorities shall extend to all real and personal property at any time held by my executor and shall continue in full force until the actual distribution of all such property. All powers, authorities, and discretion granted by this will shall be in addition to those granted by law and shall be exercisable without leave of court. ITEM VIII. I appoint my brother, FRED S. BADMAN, Executor under this Will. Should my brother, FRED S. BADMAN, fail to qualify or cease to act as executor, I appoint my nephew, Page 2 of 3 Pages. ) . I . LUKE BADMAN, Executor under this will. No personal representative appointed hereunder shall be required to give bond or furnish sureties in any jurisdiction. ITEM IX. The term "executor" and "trustee" or any pronoun used to indicate the executor, trustee, any other fiduciary or any beneficiary shall be deemed to apply to one or more than one person or corporation and to the masculine, feminine or neuter gender as the case may be. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my last will, this If: day of JULY, 2007. Js"'( Su- U_ ~a~~ SUE A. BADMAN (SEAL) SIGNED, SEALED, PUBLISHED, and DECLARED by the above testatrix, as and for her last will, in the presence of us, who thereupon at her request, in her presence and in the presence of each other, have hereunto subscribed our names as witnesses. ~Wi/lJ.., {j S' i 95130.1 ~s:a~ n ~~ cy Page 3 of 3 Pages. . . I . COMMONWEALTH OF PENNSYLVANIA) ( ss: COUNTY OF DAUPHIN ) (];zJ,e,SUEA.T' ~ H~h(2and -€-J.'YIJ L r J e testatrix and witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn do hereby declare to the undersigned authority that the testatrix signed and executed the instrument as her last will and that she had signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the testatrix, signed the will as witness and that to the best of our knowledge, the testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. ISI ~ fL R~~ SUE A. BADMAN ~ ..'-1>12:&~fl Witne ,- ~ (1JLti~/~ t!s I Witness SUBSCRIBED, sworn to or affirmed, and acknowledged before me by the above-named testatrix and by the witnesses whose names appear above on JULY !! ,0(2007. 95130.1 ~~-Ca,V6 No ry Public · . ~ Settlement Statement -... ...- . ,-...... -.-.---.. .---.... B. T"~ of Loan OMB Approval No. 2502-0265 lexoires 11130120091 1. OFHA 2. DFmHA 3. KlConv. Unins. I 6. File Number I 7. loan Number r 8. Mortgage Insurance Case Number 4. OVA 5. DCanv. Ins. 07-01.6.03031 12365011 C. Note: n~;=-8di~~tw'=~=';::~";"'U;==;:';'.,or~;~~':"'.:.d=::=:"~1 I TitleExpress SetUement System ~~G~~d~:~~=='F==~:~I~~S~~~~,%'1:,I~:":''''ml~en._upon Printed 08I23l2OO7 a/11:17LM D. NAME OF BORROWER: Jared L. Ford ADDRESS: 20 Ramblewood Drive Etters PA 17319 E. NAME OF SElleR: Estate of Sue A. Badman ADDRESS: 23 Fairfax Villaoe. Harrisbura. PA 17112 F. NAME OF LENDER M & T Bank, Mortgage Division ADDRESS: One Fountain Plaza. Floor 6 Buffalo. NY 14140 G. PROPERTY ADDRESS: 23 Fairfax Village, Harrisburg, PA 17112 Lower Paxton TownshiD H. SEITLEMENT AGENT: Barristers Land Abstract Company. Telephone: 717.761-6190 Fax: 717.761-4072 PLACE OF SETTLEMENT: 3310 Market Street CamD Hill PA 17011 I. SffiLEMENT DATE: 08/2312007 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 orice 130000.00 401. Contract sales Drice 130000.00 102. Personal Prooertv 402. PersonaH'raDertv 103. Settlement chames 10 borrower Iline 14001 4 598.31 403. 104. 404. 105. 405. Adiuslmenls for items oaid bv seller in advance Adlustments for items paid bv seHer in advance 106. Cilvllown taxes 406. Cilvllown taxes 107. County taxes 08/23/071012/31/07 232.12 407. Counlv taxes 08/23/0710 12/31107 232.12 108. Schoollaxes 08/23/071006130108 917.48 408. Schoollaxes 08/2310710 06l3OI08 917.48 109. Sewer 08/23/07 to 09130/07 40.69 409. Sewer 08/23107 to 09I30I07 40.69 110. Assn. Dues 08/23/07 to 08/31/07 19.45 410. Assn. Dues 08/231071008131/07 19.45 111. 411. 112. 412. 120. GROSS AMOUNT DUE FROM BORROWER 135808.05 420. GROSS AMOUNT DUE TO SELLER 131209.74 200. AMOUNTS PAID BY OR ON BEHALF OF BORROWER 500. REDUCTIONS IN AMOUNT DUE TO SELLER 201 . Oeon..it 0( earnest money 1,000.00 S01. Excess DlDOSit (see instructions1 202. Principal amount of new loans 133.900.00 502. Settfement charaes 10 seller (Une 14001 12.063.48 203. Existina Ioan(s) taken subiect 10 S03. Existina loan(sllaken subiect to 204. 504. Pavo/f of FIrst Motta""e loan 62.274.54 Wells Farao Home Mortaaae 205. S05. 206. 506. 207. S07. 208. SOS. 209. 509. Adjustments for items unpaid bv seller Adjustments for items unpaid bv seller 210. Citvllown taxes 510. Citvllown taxes 211. County taxes 511. Counlv taxes 212. School taxes 512. School taxes 213. 513. 214. 514. 215. 515. 216. 516. 217. 517. 218. 518. 219. 519. 220. TOTAL PAID BYIFOR BORROWER 134900.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 74 338.02 300. CASH AT SmLEMENT FROM OR TO BORROWER 600. CASH AT SmLEMENT TO OR FROM SELLER 301. Gross amount due from borrower nine 1201 135.808.05 601. Grass amount due to seller nine 4201 . 131.209)4 302. less amounts oaid bvlfor borrower lIine 2201 134 900.00 602. Less r~ amount due seHer lline 5201 74 338.02 303. CASH FROM BORROWER 908.05 603. CASH TO SELLER 56 871.72 U.S. Department of Housing and Urban Development (W) . . . TitleExnress Settlemenl System Prinled 0812312007 al11 :17 LM L SETTLEMENT CHARGES PAID FROM PAID FflOM 700. TOTAL SALESIBROKER'S COMMISSION based on nrice $130 000.00 = 7 800.00 BORROWER'S SELLER'S Division of commission (line 700) as follows: FUNDS AT FUNDS AT 701. $ 3 875.00 to HOWARD HANNA REAL ESTATE SEmEMENT SEmEMENT 702. $ 3 925.00 to ReMax Realtv Associates 703. Commission oaid at Settlement 7800.0 704. Administratin Fee to Howard Hanna Real Estate Services 185.00 800. ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan Oriaination Fee % 802. Loan Discount 0.500 %M & T Bank. Mortaaae Division LR 669.50 803. Aooraisal Fee to Kirchmever & Associates IP.O.C.1350.00 Buver 804. Credil Reoort to CBC $6.25 POC bv Lender 805. 806. 807. 808. Processino Fee 10 M & T Bank:" Mortaaae Division LR 195.00 809. Document Preoaration Fee 10 M & T BanlL Mortoaoe Division LR 400.00 810. Tax Service/Rood Cert. 10 First American RETSlFirst American FDS LR 80.00 811. Annlication Fee to M & T Bank. Mortoaoe Division iP.O.C:J 100.00 Buver 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interesl From 0812312007 to 08130/2007 illS 25.6795 Idav 7 Davs LR 179.76 902. Martnane Insurance Premium tor to 903. Hazard Insurance Premium for 10 Erie Insurance Exchanae TP.O.C.l279.00 Buver 904. 905. 1000. RESERVES DEPOSITED WITH LENDER FOR 1001. Hazard Insurance 2 mo:@"$ 23.25 lmo LR 46.50 1002. Mortnaae Insurance mo. tiS lmo 1003. Cily Prooertv Tax mo.ill-$ lmo 1004. County Prooertv Tax 8 mo. illS 52.82 lmo LR 422.56 I 1005. School taxes 2 mo. illS 87.62/mo LR 175.24 : 1009. Aaareoale Analysis Adiustment to M & T Bank Mortaaae Division LR -424.13 0.00 1100. TITLE CHARGES 1101. Electronic Doc T ransmillal Fee to Barristers Land Abstract General. Hba 35.00 ! 1102. Overnioht Fee to Barristers Land Abstract Postaae . Hba 13.00 13.00 1103. Wire Fee to Barristers Land Abstract Wire. Hba - 11.00 1104. Tille insurance binder 1105. Document PrMaralion to RelMax RealtY Associates Inc. 125.00 1106. Notarv Fees 10 Lisa Rowe 15.00 10.00 1107. Attornev's fees !includes above items No: l 1108. Tille Insurance 10 Barristers .Land.Abstract Premium. HbII 925.88 !includes above items No: Reissue Rate I 1109. Lender's PO/iev 133.900.00 .925.88 1110. Owner's PoliCY 130000.00 . 1111. End 100 End 300 End 900 10 Barristers Land Abstract Premium. Hba 150.00 1112. End 820 Loan to Barristers Land Abstract Premium. Hba 50.00 1113. ClosinaSvcLlr 10 Barristers Land Abstract Premium. Hba 35.00 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recordina Fees DeedS.41.50 . Martaa;;s 77.50 . Release S 119.00 1202. Cilv/Caunlv tax/stamas Deed S1 300.00 . MortaaneS 1.300.00 1203. State T axlstamas Deed S1 300.00 . MartaaaP. S 1 300.00 1204. 1205. 1300. ADDITIONAL SETTLEMENT CHARGES 1301. Horne Insoection 10 Home 'nsDflcl IP.O.C.l275.00 Buver 1302. Pesllnsaedion 10 Interstate Termite IP.O.CJ 45.00 Buver 1303. T ransaclion Fee 10 RelMax RealtY Associates Inc. 295.00 1304. Tax Certification to RelMax Realty Associates 12.00 1305. Tax CertifICation to Barristers Land Abstract General. Hba 10.00 1306. Sewer Manaaement Fee to Lower Paxton TownshiD Authoritv- 15.00 1307. Sewer 711107-9130107 to Lower Paxton TownshiD Authoritv 96.00 1308. Other Disbursements /15201 2 402.48 1400. TOTAL SETTLEMENT CHARGES (enter an lines 103 Section J and 502 Section Kl 4 598.31 12 063.48 SETTLEMENT STATEMENT , "- . .-......-. .. .... ... ...-....... ""M~i" .r ".-? -_"'7 .." Jareo ~oR{ - ~ ,- ~-v* HUO CERnFreA TIDN OF BUYER ANn seLLER I h... """",,,y re.._ the HUO-l Set_ Sial..... and 10 the bat 0/ my _go and behI. . is "rue Bnd .<am'18 _ 0/" _'nd -......... made... my lICCOUn' or by me in this lransadion. I further certify "II have received " copy of Ihe HUO.1 SetUemeN S18tement. <~".3:~ ~ E,\-~(.l.)T~r WARNING, IT IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE UNITEO STATES ON THIS OR ANY SIMILAR FORM. PENAlTIES UPON CONl/ICnoN CAN INCLUOE A FINE ANn IMPRISONMENT. FOR OET AILS SEE nTLE IS, u.s. CODe SECTION 1001 AND SECTION 1010. u.s. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT , · . · SETTLEMENT STATEMENT File Number: 07-01.6.03031 PAGE 3 TitleExpress Settlement System Prinled 0812312007 at 11 :17 UM I ITEMIZATION OF HUD LINE 1308 1500. SCHEDULE OF DISBURSEMENTS BUYER SELLER 1501. Association Dues 7/1-8/31107 to Fairfax Villaae Homeowners Assn. 134.00 1502. 2007108 School Taxes to Diane K. Bair Tax Collector 1.051.38 1503. Misc. Reoair Services 10 Jamie Eisenacher 825.00 1504. Home Warranty 10 American Home Shield 392.10 1505. 1506. 1507. 1508. 1509. 1510. 1511. 1512. 1513. 1514. 1515. 1516. 1517. 1518. 1519. 1520. TOTAL HUD LINE 1308 EXPENSE: 2,402.48 ~ l=8 ;LtQ.O "DO '"d)\}j. ()& 0 ' (JD jJAP D