HomeMy WebLinkAbout02-08-08 (2)
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15056041125
REV-1500 EX (06-05)
PA Department of Revenue '*
Bureau of Individual Taxes INHERITANCE TAX RETURN
PO BOX 280601
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
OFFICIAL USE ONLY
County Code Year
2 1 0 7
File Number
090 4
Date of Birth
201186160
090 5 2 0 0 7
050 6 1 9 2 4
BAUER
BET T Y
MI
J
Decedent's Last Name
Suffix
Decedent's First Name
(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
00 1. Original Return
o 4. Limited Estate
00 6. Decedent Died Testate
(Attach Copy of Will)
o 9. Litigation Proceeds Received
D 3. Remainder Return (date of death
prior to 12-13-82)
4a. Future Interest Compromise (date of 0 5. Federal Estate Tax Return Required
death after 12-12-82)
7. Decedent Maintained a Living Trust
(Attach Copy of Trust)
10. Spousal Poverty Credit (date of death 0 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch. O)
CORRESPONDENT - THIS SECTION MUST BE COMPlETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
D
o
D
o
8. Total Number of Safe Deposit Boxes
2. Supplemental Return
S U S A N J . H A R T MAN
Firm Name (If Applicable)
D U N C A N & H A R T MAN ,
First line of address
1 I R V I N E R 0 W
Second line of address
71724 9 7 780
REGISTER QF,WtLLS USE ~y
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City or Pest Office
.3tate
ZIP Code
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'-__~~rLED
CAR LIS L E
P A
17013
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Correspondent's e-mail address:susanhartman@planetcable.net
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, coned and complete. DecJaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNA T1JRE OF PER RESP N OR FlUNG RETURN DA E
~
ADDRESS
4551 SEQUOIA DRIVE, APT. B 271
OF PREPARER OT
HARRISBURG
PA 17109
PLEASE USE ORIGINAL FORM ONLY
Side 1
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15056041125
15056041125
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15056042126
REV-1500 EX
Deoedenrs Social Security Number
201186160
Decedenfs Name: BETTY J. BAUER
RECAPITULATION
1. Real estate (Schedule A)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1.
1 2 2 7 5 9.3 9
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.
O. 0 0
3 5 6 4.6 6
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ....... 5.
6. Jointly Owned Property (Schedule F) D Separate Billing Requested . . . . . .. 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) D Separate Billing Requested . . . . . .. 7.
11. T olal Deductions (total Lines 9 & 10)
. . . . . . . . . . . . . . . . . . . . . . . . . . . 11.
1 2 6 3 2 4. 0 5
2 2 2 8 5. 3 6
9 2 9 0 O. 6 0
1 1 5 1 8 5. 9 6
1 1 1 3 8. 0 9
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.
12. Net Value of Estate (Line 8 minus Une 11) . . . . . . . . . . . . . . . . . . . . . . . . . 12.
13. Charitable and Governmental BequestslSec 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. 1 1 1 3 8 . 0 9
TAX COMPUTATION - SEE INSTRUCTIONS FOR APPUCABlE RATES
15. Amount of line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2) X.O _ o . 0 0 15. O. 0 0
16. Amount of line 14 taxable 1 1 1 3 8 . 0 9
at lineal rate X .00L 16. 5 0 1 . 2 1
17. Amount of line 14 taxable o . 0 0 O. 0
at sibling rate X .12 17. 0
18. Amount of Line 14 taxable o . 0 0 O. 0 0
at collateral rate X .15 18.
19. Tax Due . ... ., . ............................ . ..... . .. ....19. 5 0 1. 2 1
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
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Side 2
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15056042126
15056042126
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REV-15~O EX Page 3
. Decedent's Complete Address:
File Number
21 07 0904
DECEDENT'S NAME
BETTY J. BAUER --
STREET ADDRESS
119 FARM ROAD
CITY I STATE I ZIP
NEWVILLE PA 17241
Tax Payments and Credits:
1. Tax Due (Page 2 Une 19)
2. CreditslPayments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
501.21
600.00
25.06
Total Credits ( A + B + C ) (2)
625.06
3. InterestlPenalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty ( D + E) (3)
4. If Line 2 is greater than Une 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
123.85
0.00
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(5A)
(5B)
A. Enter the interest on the tax due.
0.00
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 00
b. retain the right to designate who shall use the property transferred or its income; ............................... 0 [&J
c. retain a reversionary interest; or .............................. ...... ............................................................ 0 [&J
d. receive the promise for life of either payments, benefits or care? ....................................................... 0 [&J
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ....................................................................................... 0 ~
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ......... 0 ~
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? .................................................................................................. 0 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. ~116 (a) (1.1) (ii)). The statute does not exernot 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 decedenfs lineal beneficiaries is four and ~aIf (4.5) percent, except as noted in
72 P.S. ~9116(1.2) [72 P.S. ~9116(aX1)J.
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. ~9116(a)(1.3)]. A sibling is defined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-1502 EX + (6-98)
'*
SCHEDULE A
REAL ESTATE
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
BETTY J. BAUER 21 07 0904
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 Drooertv which is jointly-owned with right of survivorshiD must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
122,759.39
119 FARM ROAD
NEWVILLE, PA 17241
[SEE HUD SHEET ATTACHED]
TOTAL (Also enter on line 1, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
122759.39
REV-1508 EX + (6-98)
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SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
BETTY J. BAUER
FILE NUMBER
21 07 0904
Include the proceeds of litigation and the date the proceeds were received by the estate.
AU property jointIy-owned willi right of survivorship must be cIiscIoIed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
BANKNORTH CHECKING ACCOUNT # 307000040
2.
M&T BANK ACCOUNT # 2188
3.
ESCROW REFUND FROM REAL ESTATE CLOSING
4.
CHASE REFUND
VALUE AT DATE
OF DEATH
2,402.96
100.00
780.00
281.70
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
3 564.66
REV-1511 EX + (12-99)
Ow
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
BETTYJ.BAUER
FILE NUMBER
21 07 0904
ITEM
NUMBER
A.
1.
2.
B.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Debts of decedent must be reported on Schedule I.
DESCRIPTION
AMOUNT
FUNERAL EXPENSES:
HOFFMAN ROTH FUNERAL HOME & CREMATORY
CARLISLE MEMORIAL SERVICE, INC. - HEADSTONE FOR GRAVE
8,133.30
1,005.00
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Represen1ative (s) CAROLYN JO TELEGA
Social Security Numbef(s)/EIN Number of Personal Represen1ative(s) 208-42 -3658
StreetAddress 4552 SEQUOIA DRIVE. APT. B 271
City HARRISBURG S1ate PA Zip 17109
Year(s) Commission Paid: 2008
Attorney Fees DUNCAN & HARTMAN, PC
Family Exemption: (If decedenfs address is not the same as c1aimanfs, attach explanation)
Claimant
Street Address
6,311.20
6,311.20
City
Relationship of Claimant to Decedent
S1ate
Zip
Probate Fees REGISTER OF WILLS
192.00
Accoun1anfs Fees
Tax Return Preparer's Fees
THE SENTINEL - LEGAL AD
CUMBERLAND LAW JOURNAL - LEGAL AD
FILING FEE INHERITANCE TAX RETURN
HELD IN RESERVE
142.66
75.00
15.00
100.00
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional shee1s of the same size)
22,285.36
REV-1'512 EX + (12-03)
*'
SCHEDULE.
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
BETTYJ.BAUER
FILE NUMBER
21 07 0904
Report debts incurred by the decedent prior to death which remained unpaid as of the date of deaIh, including unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1. CITIZENS AUTOMOBilE FINANCE, INC - CAR PAYMENT
VALUE AT DATE
OF DEATH
231.29
2. MABEL G. STOTT - TAX COLLECTOR
11.00
3. CHURCH OF GOD HOME
194.54
4. KUHN COMMUNICATIONS
37.07
5. KINETIC IMAGING, INC.
37.07
6. STEVENS BUSINESS SERVICES
50.95
7. CARLISLE REGIONAL MEDICAL CENTER
46.07
8. INTERNISTS OF CENTRAL PA
127.08
9. HEALTHSOUTH REHABILITATION HOSPITAL
23.00
10. MCI
42.55
11. AT&T CONSUMER LEASE SERVICE
47.93
12. BRONSTEIN JEFFRIES PA
11.34
13. CARLISLE HMA PHYSICIAN MARGEN
11.17
14. PHYSICIANS OF REHAB, INDIVIDUAL & SPINE
96.58
15. DARREN BAR BACC I , DPM
14.41
TOTAL (Also enter on line 10, Recapitulation) S
(If more space is needed, insert additional sheets of the same size)
92900.60
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
BETTYJ.BAUER
Decedent's Name
Page 1
21 07 0904
File Number
Schedule I - Debts of Decedent, Mortgage Liabilities, & Liens
ITEM
NUMBER DESCRIPTION AMOUNT
16. CARDIOVASCULAR SURG. INST. 6.49
17. WEST SHORE EMERGENCY SERVICES 87.22
18. EMBARQ 88.95
19. NCO FINANCIAL SERVICES 431.24
20. KINETIC IMAGING, INC. 30.43
21. KINETIC IMAGING, INC. 1.68
22. PPL 84.55
23. INTERSTATE WASTE SERVICES 268.36
24. HOUSEHOLD FINANCE COMPANY 158.02
25. DCM SERVICES LLC 5,946.58
26. LVNV FUNDING - SEARS 4,200.00
27. TSYS 900.00
28. HEAL THSOUTH REHAB 992.00
29. GUISTWITE FAMILY PRACTICE 70.39
30. KINETIC IMAGING, INC. 11.53
SUBTOTAL SCHEDULE I
13,'J77.44
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
BETTY J. BAUER
Decedenfs Name
Page 2
21 07 0904
File Number
Schedule I - Debts of Decedent, Mortgage Liabilities, & Liens
ITEM
NUMBER DESCRIPTION AMOUNT
31. CARLISLE REGIONAL MEDICAL CENTER 100.96
32. REAL ESTATE SETTLEMENT COST - COMMISSION 7,320.00
[SEE ATTACHED HUD SHEET]
33. REAL ESTATE SETTLEMENT COST - NOTARY FEE 10.00
[SEE ATTACHED HUD SHEET]
34. REAL ESTATE SETTLEMENT COST - ATTORNEY FEE 250.00
[SEE ATTACHED HUD SHEET]
35. REAL EST ATE SETTLEMENT COST - TAX CERT 10.00
[SEE ATTACHED HUD SHEET]
36. REAL ESTATE SETTLEMENT COST - OVERNIGHT MAIL FEE 50.00
[SEE ATTACHED HUD SHEET]
37. REAL ESTATE SETTLEMENT COST - DEED TAX 1,220.00
[SEE ATTACHED HUD SHEET]
38. REAL ESTATE SETTLEMENT COST - SEPTIC SERVICE 582.00
[SEE ATTACHED HUD SHEET]
39. REAL ESTATE SETTLEMENT COST - PLUMBING 154.74
[SEE ATTACHED HUD SHEET]
40. REAL ESTATE SETTLEMENT COST - ELECTRICAL 1,135.04
[SEE ATTACHED HUD SHEET]
41. REAL ESTATE SETTLEMENT COST - ESCROW FOR ROOF 2,340.00
[SEE ATTACHED HUD SHEET]
42. CHASE HOME FINANCE PAYOFF FIRST MORTGAGE 44,625.20
[SEE ATTACHED HUD SHEET]
43. HOUSEHOLD FINANCE CORP. PAYOFF SECOND MORTGAGE 20,843.17
[SEE ATTACHED HUD SHEET]
SUBTOTAL SCHEDULE I 78,641.11
GRAND TOTAL SCHEDULE I $ 92,900.60
REV-15~3EX+(*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
BETTY J. BAUER
SCHEDULE J
BENEFICIARIES
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Ust Trustee(s) OF ESTATE
1. TAXABLE DISTRIBUTIONS pnclude outright spousal dis1ributions, and transfers under
Sec. 9116 (a) (1.2)]
1. BARBARA ANN SHOFF Lineal
1873 WALNUT BOTTOM ROAD 1/4 SHARE
NEWVILLE, PA 17241
2. TYRONE JAMES WATKINS Lineal
6890 FARRAGUT STREET 1/4 SHARE
HOll YWOOD, Fl 33024
3. NANCY BIERBOWER Lineal
P.O. BOX 324 1/4 SHARE
GRANTHAM, PA 17027
4. CAROL YN JO TELEGA Lineal
4552 SEQUOIA DRIVE, B 271 1/4 SHARE
HARRISBURG, PA 17109
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 TAXIS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART n - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
FILE NUMBER
21 07 0904
(If more space is needed, insert additional sheets of the same size)
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. I, BETTY JAHB BAUER, now residing at 735 Anderson Avenue,
ih ,the' Borouqh of CllffSiae Park,' County of Be~. and. .S'tate of,'
Jlew J.ersey. bein~t of-- 'lawfW. age and' of' sound' and disPosing 1ll1nd.
..emory atKl' im4ers1:an4iDg~' c!o .alee. pub1ish and declare "1:h1s"
instrument as and to be DIY Last Wi1.1 and TestalDent ~ hereby
revoking' and annU1.1il'l<J any and all Wills and Codicils by me made
heretoforeo. .
"t; ~
": PX'Rft:- 'x diree..:. 'tha1i, -ail' my'- ju'st:" debts': 'funeral" and
.t~t:aii.erd:ax". ~8e&' be' 'paid out:~ of my' ~.rl:.t:e' as . soon after": my ~ ;::: ':.~
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in his .or her sole and. absolute cJiacr.~ioft, 4... ~or 'the ~R
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"".: XII WI'T'JIBSS ~BOP, X Jaave hereunto subseribed. .y n_e
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II and ROBERT W. DEMPSEY I the testaX~K/trix and the
witnesses, respectively, whose names are signed to the attached
II instrument, being first duly sworn, do hereby declare to the under-
~Si9ned authority that the testa~.x/trix signed and executed the
I instrument as ~t>>/her Last Will and Testament and that K<</she had
I signed willingly and that HH/she executed it as KlK/her free and'
IVOluntar! act for the purposes therein expressed; and that each
witness states that he or she signed the Will as w1tness in the
presence and hearing of the testaitil/trixJ and that to the best
of his or her knowledge the testaX~X/trix was at that time 18 or
more years of age, of sound mind and under no constraint or undue.
influence.
11.,~'\.
ISUbscribed, swor~"to
BAUER
~~~
ROBERT. W. DEMPS 1. tner
and acknowledged before me by BET~Y JANE
-
, .the testaUK/trix, and 'subscribed and swor
to before me by
KATHIiEEA."; DE SIMONE
ana ROBERT W. DEMPSEY
witnes$es, this
24,
'.
day of
February 1982
(!p~ -(~.~.
. . ..-- LtY'IOt DA.tIY
. " ~ Notarr Public of N...- ~ '
IJft l".a-lJl'.tar. ~ires Mar.. ~98.J
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A. !'3ettlement Statement
U.S. Department of Housing
and Urban Development
OIVlS Approval No. 2502-02
B Type of Loan
1.[ ] FHA
4. [X] VA
2. [ ] FmHA 3. [ ] Cony. Un ins. 6. File Number:
5. [ ] Cony. Ins. 400701832-CH
7. Loan Number:
8. Mortgage Insurance Case Number
0045916418
'101060594947
NOTE: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the setUemen\ agent are shown. Items
marked "(p.o.c.)" were paid outside of the closing: they are shown here for informational purposes and are not included in the totals.
D. Name and Address of Borrower E. Name and Address of Seller F. Name and Address of Lender
JOSHUA YALE CAROL YN JO TELEGA, ADMINISTRATRIX ERA HOME LOANS
OF ESTATE OF BETTY JANE BAUER 3000 LEADEN HALL ROAD,
MOUNT LAUREL, NJ 08054
C.
11971 BUCHANAN TRAIL WEST
MERCERSBURG. PA 17236
. PA
G. Property Location
119 FARM ROAD.
NEWVILLE, PA 17241
COUNTY: CUMBERLAND
PARCEL 10: 31-11-0300-053
TOWNSHIP: PENN TOWNSHIP
ptace of Settlement
1068 HARRISBURG PIKE
CARLISLE, PA
H. Settlement Agent
ECURED LAND TRANSFERS - MECHANICSBURG
I. Settlement Date 11/21/2007
Disbursement Date 11/21/2007
J. SUMMARY OF BORROWER'S TRANSACTIONS K. SUMMARY OF SELLER'S TRANSACTIONS
100. Gross Amount Due From Borrower 400. Gross Amount Due To Seller
101. Contract Sales Price $122,000.00 401. Contract Sales Price l $122.0000
102. Personal Property 402. Personal Property
$5.949.37 -
103. Settlement Charges to Borrower 403.
Adjustments For Items Paid By Seller In Advance Adjustments For Items Paid By Seller in Advance
113 CitylTown Taxes 413. CitylTown Taxes
114. County Taxes 214.7600/yr for 11/21/07 thru 01/01/08 $24.12 414. County Taxes 214.7600/yr for 11/21/07 thru 01/01/08 $24.1
115. School Taxes 1206.7700/yr for 11/21/07 thru 07/01/08 $735.27 415. School Taxes 1206.nOO/yr for 11/21/07 thru 07/01/08 $735.2
118. Assessments 418. Assessments
119. I 419.
120. Gross Amount Due From Borrower I $128,708.76 420. Gross Amount Due To Seller L $122.75939
200. Amounts Paid By Or In Behalf Of Borrower 500. Reductions In Amount Due To Seller
201. Deposit or Earnest Money $2,000.00 501. Excess Deposits
202. Principal Loan Amount from ERA Home Loans $124,600.00 502. Settlement Charges to Seller $13.236.71
203. Existing Loan(s) Taken Subject to 503. Existing Loan(s} Taken Subject to
204. 504. Payoff First Mortgage to Chase Home Finance, LLC $44,625.2C
205. 505. Payoff Second Mortgage to Household Finance Corp. $20,843.1 :
Adjustments For Items Unpaid By Seller Adjustments For Itums Unpaid By Seller
210. 510.
211. 511.
212. 512.
213. CityfTown Taxes 513. CityfTown Taxes
214. County Taxes 514. County Taxes
218 Assessments 518. Assessments
219. 519.
220. Buyer's Total Credits
300. Cash At Settlement FromlTo Borrower
301. Gross Amount Due From Borrower (line 120)
302. Less Amounts Paid By/For Borrower (line 220)
$126.600.001520. Seller's Total Charges
600. Cash At Settlement To/From Seller
$128,708.76 601. Gross Amount Due To Seller (line 420)
$126.600.00 602. Less Deductions In AmI. Due To Seller (line 520)
L
$78.705.1 ;
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$122,7S9.3'
$78,705.1:
303. Cash [ X ] From [ ] To Borrower
$2,108.761603. Cash [X] To [ ] From Seller
$44,054.2-
400701832 - CH
l Settlement Statement
Page L
700. Total Sale Commission 122000.00 @ 6 % = 7320.00
Division of Commission (line 700) As Follows: Paid From Borrower's Paid From Seller's
701. $7320.00 to ERA-NRT, Inc. Funds At Settlement Funds At Settlement
702. Commission Selling
703. Commission paid at settlement $7,320.00
708. Broker Administrative Fee to ERA-NRT, Inc. $165.00
800. Items Payable In Connection With Loan
801 Loan Origination FHe
802. Loan Discount
803. Appraisal Fee to Stars (POC 300.00 by Lender)
804. Credit Report to FNMA CBC Innavis, Inc. (POC 24.95 by Buyer)
805. Lender Inspection Fee
810. Document Preparation to ERA Home Loans (POC 85.00 by Buyer)
8'12. Flood Cert. Fee to Stars (POC 19.50 by Lender)
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8'15. Application Fee to ERA Home loans (pOC 395.00 by Buyer)
816. VA Funding Fee to Secretary of VA $2.623.00
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900. Items Required By Lender To Be Paid In Advance
901 . Interest from 11/21/07 to 12/01/07 @23.47 1 day
902 . Mortgage Insurance Premium
903. Hazard Ins. Premium State Farm (POC 313.00 by Buyer)
904 . Flood Ins. Premium
1000. Reserves Deposited With Lender
j
$234701
1001. Hazard Ins. Reserve 3 mo @ 26.08 / mo ERA Home Loans $78.24
1002. Mortgage Ins. Reserve
1003. City Property Taxes
1004. County Property Taxes 10 mo @ 17.901 mo ER.A Home loans $179.00
1005. School Taxes 6 mo @ 100.56/ mo ERA Home Loans $603.36
1010. Aggregate Accounting Adjustment from ERA Home Loans -$306.31
1100. Title Charges
1101. SettlemenUClosing Fee
'1102. Abstract or Title Search
'1103. Title examination
1104. Title Insurance Binder
-
1105. Document preparation
1106. Notary fee to Christina L. Hershey, Notary Public $10.00
1107. Attorney Fee to Duncan & Hartman. P.C. $250.00
1108. Title Ins. Total to Secured Land Transfers - Mechanicsburl} $885.38
1109. lender's Coverage $124600.00 ($)
'11'10. Owner's Coverage $122000.00 ($885.38)(RI)
1111. Endorsements-100/300/900 ($150.00) to Secured land Transfers - Mechanicsburg $150.00
1138. Processing/Tax Cert. to Secured land Transfers - Mechanicsburg $10.00
1140. Overnight Mail (B - POC by Lender) to Secured Land Transfers - Mechanicsburg $50.00
1200. Government Recording And Transfer Charges
1201. Hecording Fees for Deed 38.50; Recording Fees for Mortgage 68.50 $107.00
1202. City/County Tax/Stamps 1220.00 $1,220.00
1203. State Deed Tax 1220.00 $1,220.00
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1300. Additional Settlement Charges
1302. Pest inspection to South Central PA Horne Inspection Co., Inc. (POC-B)
1305. Horne Inspection to South Central PA Home Inspection Co., Inc. (POC-B)
1306 Well Inspection to South Central PA Home Inspection Co., Inc. (POC-B)
1307. Septic Inspection to DEW & Sons Septic Service $175.00 $582.00
1308. Plumbing to T & T Construction & Plumbing $1 54.7 4
1309. Electrical to Mr. Electric $1.135.04
1310. Escrow for Roof to Jack Gaughen REAL TOR ERA $2,340.00
1400. Total Settlement Charges $5.949.37 $13,236.78
I have carefully reviewed the HUD-1 Settlement Statement and to the best of my knowledge and belief it is true and accurate statement of all receipts and disbursements
made on my account or by me in this transaction. I further certify that I have received a copy of the HUD-1 Settlement Statement.
SELLERS
ared is a true and accurate a
d21/k/
,.,--
Date
11/21/2007
SECURED LAND TRANSFERS - MECHANICSBURG