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HomeMy WebLinkAbout12-11-07 -.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 OFFICIAL USE ONLY County Code Year File Number INHERITANCE TAX RETURN RESIDENT DECEDENT 21 05 00819 Date of Birth 161-21-0888 09/07/2005 06/25/1927 Decedent's Last Name Suffix Decedent's First Name MI Murren Jeune M (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 Return . 2. Supplemental Return 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 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 See, 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 4. Limited Estate 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received 8. Total Number of Safe Deposit Boxes Kathleen B. Murren, Esq Firm Name (If Applicable) (717) 780-2629 206 Willow Ave. REGISTER OF WILLS USE OHI$ o g S9 --J J=B ~ +0 n ;..r- c.:..~m 2rs~ First line of address Second line of address Camp Hill PA 17011 (:)0 ..) ::~,;J~l (J C': DATEElED --i :-a ::r,. --0 ::if: '2} C) rn City or Post Office State ZIP Code l_" N Correspondent's e-mail address: kbmurren@hacc.edu 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. D TE tz- L 2fJ((l I~D~l2tV] PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056051058 15056051058 -.J 4\lV\. -.J 15056052059 REV-1500 EX Decedent's Name: Jeune M Murren RECAPITULATION 1. Real estate (Schedule A). ............. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1. 2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . . . . 4. Mortgages & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . . . 6. Jointly Owned Property (Schedule F) Separate Billing Requested . . . . . . . 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) Separate Billing Requested.. . . . . . . 8. Total Gross Assets (total Lines 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. Funeral Expenses & Administrative Costs (Schedule H). . . . . . . . . . . . . . . . . . . . . 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 Govemmental Bequests/Sec 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 45 172,092.36 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 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 161-21-0888 219,000.00 2. 3. 4. 5. 6. 7. 8. 219,000.00 9. 46,907.64 46,907.64 172,092.36 172,092.36 15. 16. 7,744.16 17. 18. 7,744.16 . 15056052059 -.J REV-1500 EX Page 3 Decedent's Complete Address: DECEDENT'S NAME Jeune M Murren STREET ADDRESS 440 W. Main St. File Number 21 05 00819 DECEDENT'S SOCIAL SECURITY NUMBER 161-21-0888 CITY Mechanicsburg i STATE PA ZIP 17055 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 7,744.16 9,906.63 Total Credits (A + B + C ) (2) 9,906.63 3. Interest/Penalty if applicable D. Interest E. Penalty 0.00 2,162.47 Total Interest/Penalty ( 0 + 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) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5) (5A) (5B) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. 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;.......................................................................................... 0 [i] b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 [i] c. retain a reversionary interest; or.......................................................................................................................... 0 [i] d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 [i] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. 0 [i] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. 0 [i] 4. Did decedent own an Individual 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 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 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 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 ofthe decedent's siblings is twelve (12) percent [72 P.S. 99116(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-1502 EX+ (6-9. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF Jeune M. Murren FILE NUMBER 21-05-0819 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 1. DESCRIPTION Family residence: 440 West Main Street, Borough of Mechanicsburg, Cumberland County, PA VALUE AT DATE OF DEATH 219,000.00 Tax parcel No. 19-23-0567-009 TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 219,000.00 ,-' Tax Parcel # 19-23-0567-009 THIS DEED Made the 14th day of November, in the year Two Thousand Seven (2007) BETWEEN PHILIP J. MURREN, Executor of the ESTATE OF JEUNE M. MURREN, Deceased, late of the Borough of Mechanicsburg, County of Cumberland, Commonwealth of Pennsylvania, party of the first part, GRANTOR A N D JOHN W. SELFE and KATHLEEN M. CAVANAUGH, husband and wife, of Mechanicsburg, Pennsylvania, parties of the second part, GRANTEES. WHEREAS, the said JEUNE M. MURREN, upon the death of her husband, JOSEPH E. MURREN, on October 8, 1990, became in her lifetime seized in fee of and in that parcel of land situate in the Borough of Mechanicsburg, County of Cumberland, Commonwealth of Pennsylvania, being more particularly bounded and described hereinafter; and she being so thereof seized, died on September 7, 2005, having first made her Last Will and Testament in writing consisting of a document bearing date of June 30, 1999 and duly probated and registered in the Office of the Register of Wills of Cumberland County on September 14, 2005, wherein and whereby he was appointed as Executor thereof, the said PHILIP J. MURREN, to whom Letters Testamentary were duly issued by said Register of Wills on September 14, 2005, and wherein and whereby, said premises, hereinafter described, were designated as part of the residue of the estate, as in and by said Will and the records of the said Register of Wills, recourse thereunto being had appears; NOW THIS INDENTURE WITNESSETH, That the said PHILIP J. MURREN, Executor, for and in consideration of the sum of Two Hundred Twenty-Eight Thousand ($228,000.00) Dollars, lawful money of the United States, to him paid by the said GRANTEES at and before the sealing and delivery hereof, the receipt whereof is hereby acknowledged, and by these presents does grant, and convey unto the said GRANTEES, their heirs and assigns as part of the administration of the ESTATE OF JEUNE M. MURREN. ALL THAT CERTAIN lot or tract ofland situate on the north side of West Main Street, in the Fourth Ward of the Borough of Mechanicsburg, County of Cumberland and State of Pennsylvania, bounded and described as follows, to wit: 1 .. BEGINNING at the curb line on West Main Street, at the comer of the lot formerly of D.H. Gleim; thence northward along the line of the lot formerly of D.H. Gleim a distance of 222 feet to the center of a 15 foot private alley; thence along said alley eastward 54 feet to a point in the center of said alley; thence southward along the lot formerly of Jacob A. Shelley Heirs 222 feet to the aforesaid curb line on West Main Street; thence along said curb line west 54 feet to the place of BEGINNING. Having thereon erected a two-story brick dwelling house known and numbered as 440 West Main Street. Being the same premises which Paul L. Walter and Eva C. Walter, his wife, by deed dated August 2,1965, recorded in Deed Book S 21, Page 19, granted and conveyed to Joseph E. Murren and Jeune M. Murren, husband and wife. TOGETHER with all and singular rights, liberties, privileges, hereditaments and appurtenances thereunto belonging, or in any way appertaining, and the reversions and remainders thereof; and also, all the estate, right, title, interest, use, trust, property, possession, claim and demand whatsoever, of the said JEUNE M. MURREN at and immediately before the time of her decease, in law, equity, or otherwise howsoever, of, in, to, or out of the same: TO HA VE AND TO HOLD the said above-described parcel of land, the hereditaments and premises hereby granted, and, or mentioned and intended so to be, with the appurtenances, unto the said GRANTEES, their heirs and assigns forever. AND the said PHILIP J. MURREN, Executor of the ESTATE OF JEUNE M. MURREN, covenants, promises and agrees, to and with the said GRANTEES and their heirs that the said PHILIP J. MURREN, Executor of the ESTATE OF JEUNE M. MURREN, has not done, committed, or knowingly or willingly suffered to be done or committed, any act, matter or thing whatsoever, whereby the premises hereby granted, or any part of it, is, are, shall, or may be impeached, charged or incumbered, in title, charge, estate, or otherwise. IN WITNESS WHEREOF, the said PHILIP J. MURREN, Executor of the ESTATE OF JEUNE M. MURREN, Deceased, has executed this deed the day and year first above written. Signed, Sealed and Delivered In the Presence of: By PHILIP J. MURREN, Executor ESTATE OF JEUNE M. MURREN 2 .. COMMONWEALTH OF PENNSYL VANIA SS: COUNTY OF On this, the day of ,2007, before me a Notary Public the undersigned officer, personally appeared PHILIP J. MURREN, Executor of the ESTATE OF JEUNE M. MURREN, Deceased, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that he executed the same for the purpose therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and notarial seal. Notary Public I HEREB Y CER TIFY that the precise address of the grantees herein is: COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND Recorded on this day of Office of said County in Deed Book , Vol. under my hand and seal of the said office the date above written. ,2007, in the Recorder's , Page . Given Recorder 3 REV-1511 EX+ (12-99)W COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Jeune M. Murren FILE NUMBER 21-05-0819 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. FUNERAL EXPENSES: 1. DESCRIPTION AMOUNT B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions 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 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 5. Accountant's Fees 1,325.00 6. Tax Return Preparer's Fees 8. Income taxes paid Costs related to the maintenance, repair, and sale of real property listed in Sch. A (appendix attached) 257.00 45,325.64 7. TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 46,907.64 ESTATE OF JEUNE M. MURREN SSN 161-21-0888 ESTATE # 21-05-00819 DOD 09/07/2005 APPENDIX TO SCHEDULE H: COSTS RELATING TO MAINTENANCE, REPAIR, AND SALE OF REAL PROPERTY LOCATED AT 440 WEST MAIN STREET, BOROUGH OF MECHANICSBURG, CUMBERLAND COUNTY , PENNSYLVANIA COSTS RELATING TO REAL PROPERTY 1. Ad valorem property taxes City/county 2007 (LESS PRORA nON) School District 2006-07 School District 2007-08 (LESS PRORATION) 2. Utilities (since 5/20/2006) UGI PPL United Water (LESS PRORA nON) Boro of Mechanicsburg (trash/sewer) (LESS PRORA nON) 3. Insurance premiums F ire/liabit ity (LESS PRO-RATED REFUND) Liability insurance (cleaning/construction crew) 4. Costs for replacement of appliances that broke down COSTS FOR MAINTENANCE / REPAIRS TO REAL PROPERTY 1. Lawn/yard care Lawn mowing; removal of dead tree; removal of overgrowth/weeds 2. Radon remediation 3. Structural repairs Costs for engineer and contractor 4. Electrical repairs Costs to replace / repair old circuit breakers and wiring (LESS PRORATION) 5. Termite treatment 6. Rep1astering/painting/cleaning 7. Plumbing Costs to replace broken toilets / fixtures Costs to repair frozen pipes COSTS RELATING TO SALE OF REAL PROPERTY 1. Realtor commission 2. Transfer taxes TOTAL: 681.52 ( -90.71) 1,862.37 1,924.79 (-1,411.55) 3,285.39 1,045.78 288.85 ( -244.64) 595.02 ( -55.46) 2,676.00 ( -945.00) 876.00 1,086.50 1,060.00 865.00 5,995.00 2,365.00 ( -448.50) 265.00 6,886.78 208.00 1,134.00 13,140.00 2,280.00 45,325.64 form HUD.l (3/88) ref Handbook u.s, Department of Housing and Urban Development , Oval No. 2502-0265 ex Ires 11/30/2009 I 8. Vlortgage Insurance Case Number form HUD-1 (3/86) rer Handbook 4305.2 St;tllenjent Statement U.S. Department of Housing and Urban Development . OMS Aooroval No. 2502-0265 (expires 11/3012009) TYDe of Loan DFHA 2. O):niHA 3. DCony. Unins. I G. File Number I 7. Loan Number I a. Mortgage Insurance Case Number OVA 5. DCony. Ins. CS07012 Note: .1. nlS form IS r~~ls,-,a,u. 0 give you a s a,tamam 0 a.Clua salllamen, cos s. "moun s palo, 0 ano oy If e se~ueman~ ~gen ere Inown. I TltleExpress Settlement System lIems marked "(p.o.c.)" were paid outllde tha closing; they ere shown here for Information purposes and are not Included In the totals. WARNING: It Is e cr1me to knowingly make false stetementlto the United Slelel on this or enb other slmller form. Penalties upon Printed 11/1412007 at 12:50 VS conviellon can Include a flne and Imorllonmenl. For details lee: TIUe 18 U. S. Code Seellon 1 01 end Section 1010. NAME OF BORROWER: John W. Selfe, Jr. and Kathleen M. Cavanaugh ADDRESS: NAME OF SELLER: Philip J. Murren, Executor of the Estate of Jeune M. Murren ADDRESS: NAME OF LENDER: Americholce Federal Credit Union ADDRESS: 2175 Bumble Bee Hollow Road Mechanlcsbura. Pa.17055 PROPERTY ADDRESS: 440 W. Main Street, Mechanicsburg, PA 17055 Mechanicsbura Borouah SETTLEMENT AGENT: Charter Settlement Services, LLC, Phone: 717.975.2117 Fax: 717.730.9665 'LACE OF SETTLEMENT: iETTLEMENT DATE: K. SUMMARY OF SELLER'S TRANSACTION: J. SUMMARY OF BORROWER'S TRANSACTION: O. GROSS AMOUNT DUE FROM BORROWER 400. GROSS AMOUNT DUE TO SELLER 1. Contract sales price 228 000.00 401. Contract sales orice 228 000.00 2. Personal Property 402. Personal Property 3. Settlement charaes to borrower (line 140m 11.714.61 403. 4. 404. 5. Utility ororations 11/14-11/30 244.64 405. Utilitv prorations 11/14-11/30 244.64 Adiustments for items paid by seller in advance Adlustments for items paid by seller in advance 6. City/town taxes 406. City/town taxes 7. County taxes 407. County taxes 8. School taxes 40a. School taxes 9. Sewer/Refuse 11/14-12/31 55.46 409. Sewer/Refuse 11114-12/31 55.46 D. CountyfTwo 11/14-12/31/07 90.71 410. CountvfTwp 11/14-12/31/07 90.71 1. School 11/14-G/30/0a 1.411.55 411. School 11/14-G/30/0a 1411.55 2. electrical repairs 448.50 412. electrical repairs 448.50 O. GROSS AMOUNT DUE FROM BORROWER 241 965.47 420. GROSS AMOUNT DUE TO SELLER 230.250.86 O. AMOUNTS PAID BY OR ON BEHALF OF BORROWER 500. REDUCTIONS IN AMOUNT DUE TO SELLER 1. Deoosit or eamest money 5 000.00 501. Excess Deposit (see instructionsl 2. Principal amount of new loans 221 000.00 502. Settlement charaes to seller (line 1400) 15 420.00 3. Existina loan(sl taken subiect to 503. Exlstina loan(sl taken sublect to I. 504. Payoff of First Mortaaae Loan ). 505. ,. 50G. , 507. I. 50a. l. 509. Adjustments for items unpaid bv seller Adiustments for items unpaid by seller 1. City/town taxes 510. Citvltown taxes I. County taxes 511. Countv taxes 1. School taxes 512. School taxes , I. 513. seller concession 9 000.00 514. seller concession 9.000.00 I. 515. I. 51G. 517. '. 51a. I, 519. ). TOTAL PAID BY/FOR BORROWER 235.000.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 24.420.00 ). CASH AT SETTLEMENT FROM OR TO BORROWER 600. CASH AT SETTLEMENT TO OR FROM SELLER Gross amount due from borrower (line 120) 241.965.47 601. Gross amount due to seller !line 420) 230,250.86 , Less amounts paid byltor borrower IIine 220\ 235.000.00 602. Less reduction amount due seller (line 520) 24.420.00 .. I. CASH FROM BORROWER 6.965.47 603. CASH TO SELLER 205.830.86 STITUTE FORM 1099 SELLER STATEMENT: The Information contained herein Is Important tex Information and Is being fumllhed to the Intamal Revenue Service. If you are required to file B retum, gllgenca penally or other lanellon will be 1m pOled on you If thll Item II required to be reported end the IRS determine. th.t It hel nol been reported. The Contrect Sele. Price deocr1bed on 101 ebove conlUlutellhe Groll Procaed. of thll trenlectlon. ere required by lew 10 provide the .ettlement egent (Fed. Tax 10 No: 251751821) with your correcttexpeyer IdentlflceNon number. If you do not provide your correct taxpeyer Identification 'er, you mey be .ubject to civil or cr1mlnel peneltles Impoled by lew. Under peneltles of pe~ury. I cartlfy that the number Ihown on thll stetement II my correct taxpayer IdentlflcaUon number. - - 1_ _ SELLER(S) SIGNATURE(S): .ER(S) NEW MAILING ADDRESS: .ER(S) PHONE NUMeERS: (H) CNl U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT ,File Number: CS07012 SETTLEMENT STATEMENT TitleExoress Settlement Svs em SEl1LEMEm CHARGES I. TOTAL SALES/BROKER'S COMMISSION based on price $219 000.00 @l6.000 = 13140.00 Division of commission (line 700\ as follows: $ to M,C. Walker Real Estate . $ 13140.00 to M.C. Walker Real Estate . Commission paid at Settlement ,ITEMS PAYABLE IN CONNECTION WITH LOAN Loan Oriaination Fee % Loan Discount % Aapraisal Fee to Advanced Residential Mortaaae CorD Credit Report to Advanced Residential Mortaaae CorD Lender's Inspection Fee Mortaaae Application Fee Assumption Fee Broker fee to Advanced Residential Mortaaae CorD Processina fee to Advanced Residential Mortaaae CorD Underwritina fee to Americholce Federal Credit Union Flood cert to Americhoice Federal Credit Union ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE Interest From to @$ 42.9722 Idav Davs Mortaaae Insurance Premium for to Hazard Insurance Premium for to lonn HUD.1 (3/66) ror Handbook 4305.2 PAGE 2 Printed 11/1412007 at 12 50 VS PAID FROM PAID FROM BORROWER'S SELLER'S FUNDS AT FUNDS AT SETTLEMENT SETTLEMENT 13140.00 350.00 16.33 5 525.00 330.00 550.00 25.00 730.53 ). RESERVES DEPOSITED WITH LENDER FOR . Hazard Insurance mo. @ $ ~. Mortaaae Insurance mo. @ $ ;. City PropertY Tax mo. @ $ . County Property Tax mo. @ $ '. School taxes mo. @ $ I. Aaareaate Analysis Adiustment J. TITLE CHARGES . Settlement or c10sina fee . Abstract or title search , Title examination , Title insurance binder . Document Preoaration . Notary Fees . Attorney's fees (includes above items No: , Title Insurance (includes above items No: . Lender's Policy . Owner's Policy , 100 No Viol 300 Survey, 710 V Imo Imo Imo 57.95 Imo 163.67 Imo 0.00 0.00 to Notarv Public 25.00 ) to Charter Settlement Svcs. acent for ORNTIC 1,498.75 ) 221.000.00 . 228.000.00 .1 498.75 to Charter Settlement Svcs. acent for ORNTIC 200.00 . ClosinaSvcUr to Charter Settlement Svcs. acent for ORNTIC ,. GOVERNMENT RECORDING AND TRANSFER CHARGES , Recordina Fees Deed $ 38.50 . Mortaaae $ 70.50 . Release $ . CitylCounty tax/stamps Deed $2 280.00 . MortQaQe $ . State Tax/stamps Deed $2.280.00 . Mortgage $ 35.00 109.00 2 280.00 2 280.00 J. ADDITIONAL SETTLEMENT CHARGES . Survey . Pest Insoection . e-doc . Courier to Charter Settlement Services LLC to Charter Settlement Services LLC 25.00 15.00 ,. TOTAL SETTLEMENT CHARGES (enter on lines 103 Section J and 502 Section K\ 11714.61 iT l r/;; ;r;~UD CERTIFICATION OF BUYER AND SELLER corefully r !newe he HUD-1 Settlen nl I ',";::!:.l 0 the best 01 my knoWledge end bellel. It Is e true and accurata statamanl of all racelpts and dlsbursaments mada on my account TIe In this t nsa on. Ilurthar certify t:1 a:::.:;(~y 01 the HUD.1 Sattlamant Stalemant. 1/\ /- A t:'~ ~ . /fjj ~ ~ ~ / ~ t ~.,,'". eo".... / ~ ~VJIJ . Murran. ",xecu\o '\Yu'V,a e 0 aune M. Murren 15 420.00 liNG: IT IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE ,0 STATES ON THIS OR ANY SIMILAR FORM. PENALTIES UPON CONVICTION NCLUDE A FINE AND IMPRISONMENT. FOR DETAILS SEE TITLE 18: :ODE SECTION 1001 AND SECTION 1010. The HUD-1 SetIJamant Stelemanl which I have prepared Is a trua and accurate account of this transacUon. I have caused or WIll cause the lunda 10 be dlabursed In accordance WIth this statement. SETTLEMENT AGENT: DATE: REV-1513 EX+ (9-00) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF Jeune M. Murren FILE NUMBER 21-05-0819 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 [include outright spousal distributions, and transfers under Sec. 9116 (al (1.2)] 1. Philip J. Murren, 206 Willow Ave., Camp Hill, PA 17011 son 1/4 of res. estate 2. Kathleen A. Murren, 918 Brandt Ave., New Cumberland, PA 17070 daughter 1/4 of res. estate 3. Daniel J. Murren, 30 E. Coover St., Mechanicsburg, PA 17055 son 1/4 of res. estate 4. Maureen A. Murren, 1195 W. Trindle Rd., Mechanicsburg, PA 17055 daughter 1/4 of res. estate 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 TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size)