HomeMy WebLinkAbout04-02-08 (2)
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15IJ5bIJ41147
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 2 1 0 7
1110
Date of Birth
210402560
11132007
12061915
Decedent's Last Name
Suffix
Decedent's First Name
MOHLER
PEARL
MI
V
(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
'X 1. Original Return
2. Supplemental Return
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)
xi
6. Decedent Died Testate
(Attach Copy of Will)
7 Decedent Maintained a Living Trust
. (Attach Copy of Trust)
o
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)
i"1
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
JERRY A. WEIGLE ESQUIRE 7175327388
Firm Name (If Applicable)
WEIGLE & ASSOCIATES P.C.
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SHIPPENSBURG
State
PA
ZIP Code
17257
REGISTER ~~LS US~LY 'i
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First line of address
126 EAST KING STREET
Second line of address
City or Post Office
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 0,1 my knowledge and belief,
is true. correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge,
IGN TURE OF PEflSON RESPONSIBLE FO FILING RETURN DATE
X ',) . (\') . Vickie R. Dunn ~S .~J.( - u Ssl
ADDRESS
977
lADDRE
Jerry A. Weigle Esquire
DATE
.-7- '-/ - 0 r
126 East King Street, Shippensburg
!
Side 1
L
15IJ56IJ41147
15IJ56IJ41147
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15IJ56IJ42148
REV-1500 EX
Decedent's Name Pearl V. Mohler
RECAPITULATION
1. Real Estate (Schedule A).......................................................................................... 1.
2. Stocks and Bonds (Schedule B)......................
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)................
6. Jointly Owned Property (Schedule F) Separate Billing Requested............. 6.
7. Inter-Vivos Transfers & Miscellaneous NOD-Probate Property
(Schedule G) IJ Separate Billing Requested............. 7.
8. Total Gross Assets (total Lines 1-7).......................................................................
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, of
transfers under Sec. 9116
(a)(1.2)X.00 0 00 15.
16. Amount of Line 14 taxable
at lineal rate X .045 0 00
17. Amount of Line 14 taxable
at sibling rate X .12 178 662 66
18. Amount of Line 14 taxable
at collateral rate X .15 75 465 04
16.
17.
18.
19. Tax Due..
19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
Side 2
L
15IJ5bIJ42148
Decedent's Socic:i1 Security Number
210402560
161,000.00
2.
5.
148,245.78
8.
309 245 78
~52 871 47
2 246 61
~55 118 08
2~54 127 70
2!54,127.70
0 00
0 00
21 439 52
11 319 76
32 759 28
D
15IJ5bIJ42:~48
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REV-1500 EX Page 3
Decedent's Complete Address:
DECEDENT'S NAME
Pearl V. Mohler
STREET ADDRESS
975 Ridge Road
File Number 21-07 -1110
CITY
Shippensburg
I STATE
PA
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
29,000.00
-----------.------_.._-
1,526.32
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Credits (A + B + C)
Total Interest/Penalty (0 + E)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 2 Line 20 to request a refund
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.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
Make Check Payable to: REGISTER OF WILLS, AGENT
.
ZIP
17257
(1 )
32,759.28
(2)
30,526.32
(3)
(4)
(5)
(5A)
(58)
2,232.96
2,232.96
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and:
a. retain the use or income of the property transferred;............................... ..................................................
b. retain the right to designate who shall use the property transferred or its income;...................................
c. retain a reversionary interest; or.. .......... ... ............. ........... ........ ............................ .................... ...... .... .........
d. receive the promise for life of either payments, benefits or care?..............................................................
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?.................. ......... ........................ .............. ............... ......................................
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?.. I x
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.
Yes No
x
x
I x
x
I x
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 survivin9 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 PS. ~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. ~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 ~X+ (6-98)
SCHEDULE A
REAL ESTATE
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Mohler, Pearl V.
IFILE NUMBER
21-07-1'110
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 ".,;lIing 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
975 Ridge Road, Shippensburg, Hopewell Township, PA - gross proceeds of sale
1-15-08
161.000.00
TOTAL (Also enter on Line 1, Recapitulation)
161,000.00
(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
Mohler, Pearl V.
IFILE NUMBER
21-07-1110
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with the right of survivorship must be disclosed on schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Fogelanger-Bricker Funeral Home - refund of prepaid funeral 498.76
2 School tax proration at real estate settlement 539.18
3 Adams Electric Patronage Capital Retirement 37.14
4 Citizens Bank Checking Account #6100792285 107,192.44
5 Citizens Bank Checking Account #6100794156 7,638.99
6 Embarq - refund of final credit 8.81
7 Harleysville Insurance - homeowner's premium refund 309.00
8 PSERS - final refund 184.71
9 Gross proceeds of public sale of personal property 2-18-08 31.836.75
TOTAL (Also enter on Line 5, Recapitulation)
148.245.78
(If more space is needed, additiDnal 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 &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Mohler, Pearl V.
FILE NUMBER
21-07-1110
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A. FUNERAL EXPENSES:
DESCRIPTION
AMOUNT
See continuation schedule(s) attached
250.00
B.
1.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Vickie R. Dunn
Social Security Number(s) I EIN Number of Personal Representative(s):
181-42-9848
Street Address 977 Ridge Road
City Shippensburg
Year(s) Commission paid 2008
State PA Zip 17257
15,462.28
2.
Attorney's Fees
Weigle & Associates, P.C.
15,462.28
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City
Relationship of Claimant to Decedent
State
Zip
4.
Probate Fees
Register of Wills, Cumberland County
352.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
Other Administrative Costs
21,344.91
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation)
52,871.47
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H (Rev. 6-98)
Rev-1502 ~X+ (6-98)
.
SCHEDULE H-A
FUNERAL EXPENSES
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Mohler, Pearl V.
IFILE NUMBER
21-07-1110
ESTATE OF
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
Ridge Church Women's Fellowship - funeral reception
250.00
Subtotal
250.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-A (Rev. 6-98)
Rev-1502.EX+ (6-98)
.
SCHEDULE H-B7
OTHER
ADMINISTRATIVE COSTS
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Mohler, Pearl V.
IFILE NUMBER
21-07-1'110
ITEM
NUMBER
AMOUNT
DESCRIPTION
1
Citizens Bank - balance owed for estate checks
1.80
2
Cumberland Law Journal - advertising Letters Testamentary
75.00
3
Expenses of public sale
7.824.19
4
Linda K. Klein - notary fee
26.00
5
News Chronicle - advertising Letters Testamentary
96.50
6
Real Estate Settlement Expenses - including county tax proration ($8.68); realtor
commission ($9,660.00); document preparation ($85.00); realty transfer tax
($1,610.00); septic cleaning ($205.00); carpet cleaning ($154.23); repairs prior to salle
($1,167.58)
12.890.49
7
Register of Wills, Cumberland County - filing PA Inheritance Tax Return
15.00
8
Register of Wills, Cumberland County - filing Family Settlement Agreement
125.00
9
Tom Dunn - reimbursement for supplies for estate
224.53
10
U. S. Postal Service - stamps
16.40
11
Weigle & Associates, P.C. - reimbursement for postage, xerox copies, and long
distance telephone calls
50.00
Subtotal
21.344.91
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-B7 (Rev. 6-98)
Rev-1512 EX+ (6-98)
.
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Mohler, Pearl V.
IFILE NUMBER
21-07-1110
Include un reimbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1 Adams Electric
VALUE AT DATE
OF DEATH
111.04
2 Adams Electric
130.05
3 Adams Electric
66.45
4 COC Repair - car inspection
55.12
5 Citizens Bank Checking Account #6100794156 - checks clearing after date of death
153.72
6 Continuing Care Rx
104.11
7 Green Ridge Village
41.70
8 Green Ridge Village - final balance
1.002.27
9 Hoover's Plumbing
147.40
10 Larry Weaver - house cleaning
210.00
11 Tye Schwartz - garbage removal
100.00
12 West Shore EMS
124.75
TOTAL (Also enter on Line 10, Recapitulation)
2,246.61
(If more space is needed. additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-150'O Schedule I (Rev. 6-98)
REV-1513.EX+ (9-00)
ESTATE OF
NUMBER
I.
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Mohler, Pearl V.
NAME AND ADDRESS OF
PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal
distributions, and transfers
under Sec. 9116(a)(1.2)]
FILE NUMBER
21-07-1110
RELATIONSHIP TO
DECEDENT
00 Not List Trustee(s)
SHARE OF ESTATE AMOUNT OF ESTATE
(Words) ($$$)
1
Esther Dunlap
Main Street
Newburg, PA 17240
Sister
1/7 share of
residuary
35,732.53
2
Vickie R. Dunn
977 Ridge Road
Shippensburg, PA 17257
Friend
$2,000 plus 1/7
share of
residuary
37,732.52
3
Ethel Henry
16384 Cumberland Highway
Newburg, PA 17240
Sister
1/7 share of
residuary
35,732.53
4
Iso bel Hockersmith
226 Mohawk Road
Newville, PA 17241
Sister
1/7 share of
residuary
35,732.53
5
Sarah Misner
19 Hollar Avenue
Shippensburg, PA 17257
Sister
1/7 share of
residuary
35,732.53
See continuation schedule attached Continuation 73,465.06
Total 254,127.70
Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT
BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
0.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule J (Rev. 6-98)
SCHEDULE J
BENEFICIARIES
(Part I, Taxable Distributions)
ESTATE OF:
Pearl V. Mohler 210-40-2560 11/13/2007
Item Name and Address of Person(s) Share of Estate Amount of Estate
Number Receiving Property Relationship (Words) ($$$)
6 Kathy Sue Myers Niece $2,000 plus 1/7 share 37,732.52
29 Brandy Run Road of residuary
Newville, PA 17241
7 Charlotte Vaughn Sister 1/7 share of residuary 35,732.54
2379 Greene Street
Chambersburg, PA 17201
Total 73,465.06
1
LAST WILL AND TESTAMENT
I, PEARL V. MOHLER, presently residing at 975 Ridge Road, Shippensburg, Hopewell
Township, Cumberland County, Pennsylvania, 17257 being of sound mind, memory and
disposition, do hereby make, publish and declare this my Last Will and Testament, hereby
revoking and making void all Wills by me at any time heretofore made.
FIRST.,~ I order and direct the payment of all my legally enforceable debts and
funeral expenses as soon as may be convenient after my decease.
SECOND.
names parties:
I hereby give and bequeath the following sums of money to the following
A. Two thousand dollars ($2000.00) to Kathy Sue Myers.
B. Two thousand dollars ($2000.00) to Vickie R. Dunn
THIRD. I give, devise and bequeath all the rest, residue and remainder of my estate,
real, personal and mixed, whatsoever and wheresoever situate, in equal shares, as follows:
A. One share to Kathy Sue Myers, granddaughter of my sister, Fredith
Showbaker.
B. One share to my friend and neighbor to Vickie R. Dunn.
C. One share to my sister, Ethel Henry.
D. One share to my sister, Esther Dunlap.
E. One share to my sister, Isobel Hockersmith.
F. One share to my sister, Charlotte Vaughn.
G. One share to my sister, Sarah Misner
FOUR TH. I direct that all taxes 1:..."'1.at may be assessed in consequence of my death of
whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a
part of the expense of the administration of my estate.
FIFTH, I nominate, constitute and appoint my neighbor and friend, Vickie R.
Dunn to be the Executrix of this my Last Will and Testament. In the event that she unable to
fulfill the duties of Executrix then nominate, constitute and appoint Jerry A. Weigle to be the
Execuor of this my Last Will and Testament.
SIXTH. I direct that neither my personal representative(s) nor Guardians shall not be
required to give bond for the faithful performance of their duties in any jurisdiction.
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(SEAL)
WEIGLE & ASSOCIATES. Pc. - ATTORNEYS AT LAW - 126 EAST KING STREET - 5HIPPENSBURG. PA 17257-1397
IN \VITNESS \VHEREOF, I, Pearl V. Mohler, have hereunto set my hand and seal to this
my Last Will and Testament, 'Yritten,on two (2) pages, the first page signed for identification only,
th' ~/ d f . i/. r (-1 ~ ")006
IS A ay 0 ,..JOO'/.<;'" .) ,I, (f ,(r .
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WEIGLE .5< ASSOCIATES. P.c. - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPEN~BURG. PA 17257.1397
This instrument was by the Testatrix, on the date hereof, signed, published and declared by Pearl
V. Mohler to be her Last Will and Testament, in our presence, who at her request and in the
presence of each other, we believing her to be of sound and disposing mind and memory, have
hereunto subscribed our names as witnesses.
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COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF CUMBERLAND
I, Pearl V. Mohler, the person whose name is signed to the 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.
j;YJ L~c, 1- V, \) 1 rI,jc-/(~'( j
Sworn or affirmed to and acknowledged before
m. ~ b~rl V. Mo r, t T .
tlJs/, . }Jdayof
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NOTARIAL SEAL
Jerry A. Weigle, NotarY Public
ShlppensburQ, PI\ Cumbeiland Q:u1ty
OQmrnlssion Bpifes OctOber 1. 2006
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(SEAL)
WEIGLE & ASSOCIATES. Pc. - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG. PA 17257-1397
COMMOl\'\VEAL TH OF PENNSYLVANIA
SS
COUNTY OF CUMBERLAND
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and
, the witnesses whose names are signed to the
foregoing instrument, being duly qualified according to law, do depose and say that we were
present and saw Pearl V. Mohler, the Testatrix, sign and execute the instrument as her Last Will;
that she 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 the time eighteen (18) or
more years of age and of sound mind and under no constraint or undue influen.ce. . ,/
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Sworn or affirmed to and subscribed before me
did
by f; L ~.t' r J L l p.A b&~ ,r .) ). _ ,
~
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and f!.J r J c! ",1 ("..AJ
~ses, thi~y of
l__ [/^-' 0 /
NOTARIAL SEAL '\
Jerry A. Weigle, Notary Public
Shlppensburg, PA Cumberland County\
Commission Expires October 7,
WEIGLE & ASSOCIATES. Pc. - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG. PA 17257-1397
dre obsolele
form HUD-1 (3/86) ref Handbook 4305.2
Itt1 ement. Statement
U.S. Department of Housing and Urban Development
)e of Loan OMS Approval No. 2502-0265 (expires 9/30/2006)
JFHA 2. OFmHA 3. OConv. Unins. I 6. File Number I 7. Loan Number , 8. Mortgage Insurance Case Number
OVA 5. OConv. Ins. 081935BRANDT
C. Note: IS torm '5 turnlsnea.!o give you a statement or actua,. settlement COSIS. Amounts palo. 10 ana cy tne settlement ~gent are SnOwn. I TitleExpress Settlement System
Ilems marked "(p.o.c.)" were paid oulsidelhe closing; lhey are shown here for informalion 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 form. Penalties upon Printed 01/15/2008 at 13:42 RLH
conviction can include a fine and imprisonment. For details see: Title 18 U. S, Code Section 1001 and Section 1010.
D. NAME OF BORROWER: Sharon M. Brandt
AiJiJRE3S: 950 Ridae Road Shiooensbura. PA 17257
E. NAME OF SELLER: Pearl V. Mohler Estate
ADDRESS:
F. NAME OF LENDER:
ADDRESS:
G. PROPERTYADDRESS: 975 Ridge Road, Shippensburg, PA 17257
Hooewell Townshio
H. SETTLEMENT AGENT: South Central Home Settlements, Inc., Telephone: 717.532.7387 Fax: 717.532.6552
PLACE OF SETTLEMENT: 126 East Kina Street Shiooensbura. PA 17257
I. SETTLEMENT DATE: 0111512008
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 161,000.00 401. Contract sales price 161 000.00
102. Personal Prooertv 402. Personal Prooertv
103. Settlement charoes to borrower (line 1400) 2 048.50 403.
104. 404.
105. 405.
Adiustments for items oaid by seller in advance Adjustments for items paid b~' seller in advance
108. School Taxes 01115108 to 06130108 539.18 408. School Taxes 01115108 to 0613010:8 539.18
109. 409.
110. 410.
111. 411.
112. 412.
120. GROSS AMOUNT DUE FROM BORROWER 163,587.68 420. GROSS AMOUNT DUE TO SELLER 161.539.18
200. AMOUNTS PAID BY OR ON BEHALF OF BORROWER 500. REDUCTIONS IN AMOUNT DUE TO SELLER
201. Deposit or earnest money 1,000.00 501. Excess Deposit (see instructions)
202. Princioai amount of new loans 502. Settlement charaes to seller (line 1400) 12881.81
203. Existino loan(s) taken subiect to 503. Existino loan(s) taken subiect to
204. 504. Payoff of First Mortaaae Loan
205. 505. ~-
206. 506.
207. 507.
208. 508.
209. 509.
Adjustments for items unoaid bv seller Adjustments for items unpClid bv seller
211. County taxes 01101108 to 01115108 8.68 511. County taxes 01101108 to 0111510a: 8.68
nAn I "An I
are obsolete form HUD-1 (3/86) ref Handbook 4305.2
, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT File Number: 081935BRANDT PAGE 2
t:TTLEMENT Sf A TEMENT TitleExoress Settlement System Printed 01115/2008 at 13:42 RLH
.lETTLEMENT CHARGES PAID FROM PAID FROM
/. TOTAL SALES/BROKER'S COMMISSION based on price $161.000.00 lW 6.000 = 9 660.00 BORROWER'S SELLER'S
Division of commission (line 7001 as follows: FUNDS AT FUNDS AT
101. $ 9,660.00 to SETTLEMENT SETTLEMENT
702. $ to
703. Commission naid at Settlement 9.660.00
800. ITEMS PAYABLE IN CONNECTION WITH LOAN
801. Loan Oriaination Fee %
802. Loan Discount %
803. Aooraisal Fee
804. Credit Reoort .-
805. Lender's Insoection Fee
806. Mortaaae Aoolication Fee
807. Assumbtion Fee ~-- -
808.
809.
810.
811.
900. iTEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE
901. Interest From to (a)$ Idav
902. Mortnane Insurance Premium for ta
903. Hazard Insurance Premium for to
904.
905.
1000. RESERVES DEPOSITED WITH LENDER FOR
1001. Hazard Insurance mo. (a) $ Imo
1002. Mortnaae Insurance mo. Iii> $ Imo
1003. City Prooertv Tax mo. Iii) $ Imo
1004. County Prooertv Tax mo. (a) $ Imo
1005. School Taxes mo, Iii> $ Imo
1009. Aoareoate Analvsis Adiustment
1100. TITLE CHARGES
1101. Settlement or c10sina fee to South Central Home Settlements. Inc. 325.00
1102. Abstract or title search
1103. Title examination
1104. Title insurance binder
1105. Document Preoaration to South Central Home Settlements, Inc. 85.00
1106. Notarv Fees
1107. Attornev's fees
lincludes above items No: )
1108. Title Insurance
linr.llJdes above items No: )
'~~Citizens Bank"
525 William Penn Place
Suite 153-2618
Pittsburgh, P A 15219
January 19,2008
JERRY A WEIGLE Esq
126 E KING ST
SHIPPENSBURG PA 17257-1397
Estate of PEARL V MOHLER
Date of Death: November 13,2007
SSN: 210-40-2560
Dear Sir/Madam:
In accordance with your request, the attached information sheet has been provided in the above decedent's
name as of her date of death.
The decedent had 2 active accounts at the time of her death and she had no Safe Deposit Box.
For IL or LC accounts, contact our Loan Department at 1-800-708-6680. For all other inquiries, please
call 1-888-999-6884
Sincerely,
Phillip Lynch
Operations Services
t:~ Citizens Bank'"
Account Number
Account Title
Date Opened
Account Type
Principal Balance as of DOD
Interest from Last Posting to DOD
Account Balance as of DOD
YTD Interest to DOD
6100792285
PEARL V MOHLER
4/4/1983
Checking
$107,192.44
$.00
$107,192.44
$217.61
>>'C c"t.-.. '. .'.','.. B.............. . k
,.<<I.lzensan
Account Number
Account Title
Date Opened
Account Type
Princip~l Balance as ofDOD
Interest from Last Posting to DOD
Account Balance as of DaD
YTD Interest to DaD
6100794156
PEARL V MOHLER
3/29/1980
. Checking
$7,638.99
$.00
$7,638.99
$19.36
t,,~,
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John F. Kohler, Jr. - Auctioneer
Final Settlement
Owner
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Date
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Address
Date of Sale
'},77
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Sale Location CJ-\-"{\::- i.i.r-~" (.J~\.d::7q I. C (\
Auctioneer
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Clerk
Cashier
Other
PROCEEDS OF SALE: Cash. . . . . . . . . . . . . . . . . .. $
Checks . . . . . . . . . . . . . . . . .
Other . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
)) J C .,-;~) \(.
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Miscellaneous (see attached list) . . . . . . . . . . . . . . .
Total Proceeds of Sale. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
LESS SELLER'S SALE EXPENSE.:, r{'j/ "7 ,".' I q
" ,.~ S- ? u' C z e- 3 os k . --- t):) 1 ~ .-
AuctIoneer s Fee. . . . . . . . (.....-. . . . . . . . . . . \ . . . . . . . . $ I'
Other Seller's expenses advanced by auctioneer:
_\ C.,i~~ i~\jr~ 1~'I\j~SI Ct" l'); 0(\ ,~~" j
e t-\-t,?,. i i\( (, - (7~ C) t~-iL ')
'7-
$ ]
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$') \ I t. i 2 >))j
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, ,
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.
Miscellaneous (see attached list) . . . . . . - . . . . . . . .
Deduct Total Seller's Sale Expense. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total Net Proceeds to Seller .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
..j
. .)
\-" \:.,
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1/ . !
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(Seller's Signature)
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(Seller's Signatul'e)