HomeMy WebLinkAbout09-30-08 (2)15056041125
REV-1500 EX (06-05)
PA Department of Revenue
Bureau of Individual Taxes INHERITANCE TAX RETURN County Code Year File Number
PO BOX 280601 2 1 0 8 0 3 3 4
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
0 3 1 4 2 0 0 8 0 7 1 2 1 9 3 0
Decedent's Last Name
G E O R G E
Suffix Decedent's First Name
G R A C E
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix
Spouse's Social Security Number
FILL IN APPROPRIATE OVALS BELOW
Q 1. Original Return
4. Limited Estate
OX 6. Decedent Died Testate
(Attach Copy of Will)
9. Litigation Proceeds Received
Spouse's First Name
MI
M
MI
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
2. Supplemental Retum ~ 3. Remainder Return (date of death
prior to 12-13-82)
4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Retum Required
death after 12-12-82)
7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
(Attach Copy of Trust)
10. Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch. O)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRE
Name
W I L L I A M A D U N C A N
Firm Name (If Applicable)
D U N C A N & H A R T M A N,
First line of address
1 I R V I N E R O W
Second line of address
City or Post Office
C A R L I S L E
Correspondents a-mail address: billduncan@planetcable.net
AND CONFtDENTU4L TAX INFORMATION SHOULD BE DIRECTED T0:
Daytime Telephone Number
7 1 7 2 4 9 7 7 8 0
i REGISTER OF WILLS U~NLY
P C n
~~~
cn
~ ~`= <? ! ~
~-
_, _ ~-? ~
I ~ -
~__ ' ~ ~ -_
State ZIP Code ~ D'A~ FILED
P A 1 7 0 1 3 ~ =1--^ q '
Under penalties of perjury, I dedare that I have examined this return, including aooompanying sd>edules and statements, and to the best of my age and belief,
it is true, correct and complete. Dedaration of preparer other than the personal representative ~s t infonnaticxr of which preparer has any knowledge.
SI TURF OF PERSON NSIBLE FOR FILING RETURN DATE
ADDRES QQ ^ 3O _ U~
519 BURGNERS ROAD CARLISLE PA 1701~i
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY
Side 1
L 15056041125
15056041125
J ~
15056042126
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: GRACE M. GEORGE
RECAPITULATION
1. Real estate (Schedule A) 1 1 1 0 8 2 0, 0 0
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 8 Miscellaneous Personal Property (Schedule E) ....... 5. 6 0 6 4 6 , 4 8
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) ~ Separate Billing Requested ....... 7.
8. Total Gross Assets (total Lines 1-7) . .... . .. . . ...... g_ 1 7 1 4 6 6 , 4 8
9. Funeral Expenses & Administrative Costs (Schedule H) ......... ..... . . 9. 1 7 9 0 1 , 3 0
10. Debts of Decedent, Mortgage Liabilfies, & Liens (Schedule I) ..... ....... 10. 1 4 0 9 1 , 6 4
11. Total Deductions (total Lines 9 8 10) .................... ....... 11. 3 1 9 9 2, 9 4
12. Net Value of Estate (Line 8 minus Line 11) .................. ....... 12. 1 3 9 4 7 3 , 5 4
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13) ........
....... . . ........
.. . . . . . .. 13.
.. 14,
1 3 9 4 7 3 ,
5
4
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 .o _ 0 0 0 15. 0, 0 0
16. Amount of Line 14 taxable
at lineal rate X .045 1 3 9 4 7 3. 5 4 16 6 2 7 6. 3 1
17. Amount of Line 14 taxable
at sibling rate X .12 0. 0 0 17 0. 0 0
18. Amount of Line 14 taxable
at collateral rate X .15 0 0 0
18.
0 .
0
0
19. Tax Due ............................ ........... ... .... ..19. 6 2 7 6, 3 1
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF A
ide 2
15056042126 15056042126 J
REV-1500 EX Page 3 File Number
Decedent's Complete Address: 21 os o334
GRACE M. GEORGE _
STREET ADDRESS
611 CONDOGUINET AVENUE
CITY STATE
CARLISLE I'A
Tax Payments and Credits:
~ • Tax Due (Page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
3. Interest/Penalty if applicable
D. Interest
E. Penalty
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.
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.
(4) 0 00
(5) 6,276.31
(5A)
B. Enter the total of Line 5 +5A. This is the BALANCE DUE. (56) 6,276.3'1
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:
a. retain the use or income of the property transferred : .................
............................... Yes No
......................
b. retain the right to designate who shall use the property transferred or its income; ............................... ^ a
c. retain a reversionary interest; or ................
................................................................................
d. receive the promise for life of either payments, benefits or care? .................
...............................
^
^
a
a
.......
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 "intrust for" or payable upon death bank account or security at his or her death? ......... ^ Q
4. Did decedent own an Individual Retirement Acxount, annuity, or other non-probate property which
contains a beneficiary designation? ...........................................
.......................................................
^
a
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 spause
is three (3) percent [72 P.S. §9116 (a) (1.1) (i)].
For dates of death on or after January 1,1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent
[72 P.S. §9116 (a) (1.1) (ii)). The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disdosure 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-0ne 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 onefialf (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 decedents siblings is twelve (12) percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
ZIP
17015
(1) 6,276.31
Total Credits (A + g + C) (2) 0 00
Total Interest/Penalty (D + E) (3) 0 00
REV-1502 EX + (6-98)
SCHEDULE A
COMMONWEALTH OF PENNSYLVANIA REAL ESTATE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
yr
:M.GEORGE
FILE NUMBER
A11 real ro ~ 21 08 0334
p party owned solely or as a tenant in common must be re rted 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 ro which is 'oirrt -owned with ' ht of survivorshi must be disclosed on Schedule F.
ITEM
NUMBER DESCRIPTION VALUE AT DATE
1 • 611 CONDOGUINET AVENUE OF DEATH
CARLISLE, PA 17015 110,820.00
[SEE ATTACHED HUD SHEET]
TOTAL (Also enter on line 1
(If more space is needed, insert addfional sheets of the same size)
110, 820.00
REV-1508 EX + (6-98)
SCHEDULE E
COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
GRACE M. GEORGE 21 08 0334
Indude the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-0wned with riyh4 of survivorship must be discbsed on Schedule F.
fTEM
NUMBER DESCRIPTION VALUE AT DATE
1. M&T CHECKING ACCOUNT # 9839436525 OF DEATH
[SEE ATTACHED D.O.D. LETTER] 1,894.72
2. M&T SAVINGS ACCOUNT # 15004214278928
[SEE ATTACHED D.O.D. LETTER) 58,351.70
3. UNITED HEALTHCARE SERVICES, INC. REFUND
54.80
4. COUNTY TAXES SELLER CREDIT
[SEE ATTACHED HUD SHEET] 213.04
5. SCHOOL TAXES SELLER CREDIT
[SEE ATTACHED HUD SHEET] 46.94
6. PPL REFUND CHECKS (69.76 + 15.52)
85.28
TO~~„ (Altio enter on line 5 Recapitulation) 13 60
(If more space ~s needed, msert additional sheei,~ f ~bti Same srze)
~± fh
REV-1511 EX + (12-99)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
FILE NUMBER
GRACE M. GEORGE 21 08 0334
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION
A• FUNERAL EXPENSES:
1.
B• ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s) DOUGLAS A. GEORGE
Soaal Security Number(suEIN Number of Personal Representative(s) 198-56-5528
Street Address 519 BURGNERS ROAD
City CARLISLE state PA
zip 17015
Year(s) Commission Paid: 2008
8,573.32
2. Attorney Fees DUNCAN & HARTMAN, PC 8,573.32
3. Family Exemption: (If decedents address is not the same as claimants, attach explanation)
Claimant
Street Address
Cdy State zip
Relationship of Claimant to Decedent
4• Probate Fees REGISTER OF WILLS
322.00
5 Accountants Fees
6• Tax Return Preparer's Fees
7• CUMBERLAND LAW JOURNAL LEGAL AD
8• SENTINEL LEGAL AD 75.00
9. FILING FEE 142.66
10 HELD IN RESERVE 15.00
200.00
TOTAL (Also enter on line 9, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
AMOUNT
17
REV-1512 EX + (12-03)
SCHEDULEI
COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT
,
IN RES DENTEDECEDENTRN MORTGAGE LIABILITIES
~ LIENS
,
ESTATE OF
FILE NUMBER
GRACE M. GEORGE
21 08 0334
Report debts incurred by the decedent prior to death which remained unpaid as of the date of dead, including unreimbursed
di
me
cal expenses.
ITEM
NUMBER DESCRIPTION VALUE AT DATE
1.
GRAHAM MEDICAL CLINIC OF DEATH
22.38
2. CARLISLE PETROLEUM, INC.
578.85
3. CARLISLE REGIONAL MEDICAL CENTER
849.00
4. MOFFITT HEART & VASCULAR GROUP
68.94
5. YORK WASTE DISPOSAL
43.35
6. CARDIOLOGY DIAGNOSTIC, LLC
1.63
7• WEST SHORE EMS -CARLISLE
77.93
8. ERIE INSURANCE GROUP HOMEOWNERS POLICY
538.00
9. PPL
39.61
10. FOREST PARK HEALTH CENTER
3,026.50
11. CUMBERLAND-GOODWILL FIRE RESCUE
106.97
12. REIMBURSEMENT FOR DEATH CERTIFICATES
82.00
13. PPL
76.94
14. WEST SHORE EMS -CARLISLE
76.00
15. FOREST PARK HEALTH CENTER
TOTAL (Also enter on line 10 Recapitulation) I $
(If mae space ~ needed, insert additional sheets of the same size) 14 091 64
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
GRACE M . GEORGE
Decedent's Name 21
Page 1 08 0334
File Number
Schedule 1-Debts of Decedent, Mortgage Liabilities
& Liens
,
ITEM
NUMBER DESCRIPTION
16. CUMBERLAND-GOODWILL FIRE RE AMOUNT
SCUE
106.97
17. MISC. (EXTRA DEATH CERTIFICATES & OTHER MISC.ITEMS)
82.00
18. PPL
76.94
19. WEST SHORE EMS -CARLISLE
76.00
20. FOREST PARK HEALTH CENTER
8.00
21. CARDIOLOGY DIAGNOSTIC, LLC
1.63
22. WALNUT BOTTOM RADIOLOGY
42.32
23. PPL
8.22
24. VASCULAR ASSOCIATES
7.09
25. CARLISLE HMA PHYSICIAN MANAGMENT
31.97
26. REALTOR COMMISSION
[SEE ATTACHED HUD SHEET] 6,649.20
27. NOTARY FEE
[SEE ATTACHED HUD SHEET] 10.00
28. ATTORNEY FEE TO DUNCAN & HARTMAN, PC
[SEE ATTACHED HUD SHEET] 250.00
29. PROCESSING/TAX CERTIFICATION
[SEE ATTACHED HUD SHEET] 10.00
30. STATE DEED TAX
[SEE ATTACHED HUD SHEET) 1,108.20
SUBTOTAL SCHEDULE I I 8,468.54
Continuation of REV-1500 inheritance Tax Return Resident Decedent
GRACE M. GEORGE
Decedent's Name 21 08 0334
Page 2
File Number
Schedule I -Debts of Decedent, Mortgage Liabilities, & Liens
ITEM
NUMBER DESCRIPTION
31. MORTGAGE SATISFACTION FEE
[SEE ATTACHED HUD SHEET]
AMOUNT
27.00
SUBTOTAL SCHEDULE I
GRAND TOTAL SCHEDULE I
27.00
14,091.64
REV-1513 EX + (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERfTANCE TAX RETURN
RESIDENT DECEDENT
t5 SATE OF
GRACE M.
NUMBER
I.
1.
2.
3.
4.
5.
6.
II.
1
SCHEDULE J
BENEFICIARIES
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [nclude outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2))
DOUGLAS A. GEORGE
519 BURGNERS ROAD
CARLISLE, PA 17015
BARRY L. GEORGE
930 BOWER ROAD
SHERMANSDALE, PA 17090
DEBRA J.SHANABROUGH
6 WILLIAM PENN DRIVE
CAMP HILL, PA 17011
JACQUELINE F. LAUGHMAN
13 PEIPERS COURT
CARLISLE, PA 17015
RANCE BROWNAWELL, JR. -SON -CINDY BROWNAWELL
231 MT. ZION ROAD
CARLISLE, PA 17015
BRIAN BROWNAWELL -SON -CINDY BROWNAWELL
225 MT. ZION ROAD
CARLISLE, PA 17015
FILE NUMBER
21 08 033
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
Lineal
Lineal
Lineal
Lineal
Lineal
Lineal
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIA
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 II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ONLINE 13 OF REV-1500 COVER SHEET
(If more space is needed, Insert additional sheets of the same size)
AMOUNT OR SHARE
OF ESTATE
1/5 SHARE
1/5 SHARE
1/5 SHARE
1/5 SHARE
1/10 SHARE
1/10 SHARE
ON REV-1500 COVER SHEET
E
LAST WILL
TESTAMENT OF
I, GRACE M. GEORGE, of Carlisle, North Middleton Township, Cumberland County,
Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make,
publish and declare this as and for my Last Will and Testament, hereby revoking any and all
other wills and codicils heretofore made by me.
FIRST. I direct that all my just debts and funeral expenses be paid from my estate as
soon after my death as practically and conveniently may be done.
SECOND. I direct that my remains be cremated and disposed of in accord with my
expressed wishes.
THIRD. I authorize my personal representative to expend funds from my estate, in such
amounts as my personal representative shall consider necessary and desirable for the purchase,
erection and inscription of a suitable marker for my grave.
FOURTH. I give, devise and bequeath any and all tangible personal property owned by
me at the time of my death unto my children, Cindy L. Brownawell, Barry L. George, Douglas
A. George, Debra J. Shanabrough, and Jacqueline F. Laughman, in equal shares, per stirpes.
FIFTH. I give, devise and bequeath any and all real estate owned by me at the time of
my death, unto my children, Cindy L. Brownawell, Barry L. George, Douglas A. George,
Debra J. Shanabrough, and Jacqueline F. Laughman, in equal shares, per stirpes.
SIXTH. I give, devise and bequeath all the rest, residue and remainder of my estate
unto my children, Cindy L. Brownawell, Barry L. George, Douglas A. George, Debra J.
Shanabrough, and Jacqueline F. Laughman, in equal shares, per stirpes.
SEVENTH. I direct that any and all Inheritance, Estate and Transfer taxes imposed
upon my estate passing under my will or otherwise, shall be paid out of the principal of my
residuary estate.
EIGHTH. I hereby nominate, constitute and appoint my daughter, Cindy L.
Brownawell as Executrix of this my Last Will and Testament. In the event of renunciation,
death, resignation or inability to act for any reason whatsoever of Cindy L. Brownawell, I
nominate, constitute and appoint my son, Douglas A. George as Executor of this my Last Will
and Testament. I hereby relieve my Executrix from the necessity of posting security in
connection with her duties, as such, in any jurisdiction in which she may be called upon to act
insofar as I am able by law to do so. In addition to the powers conferred by law, I authorize
my Executrix, in her absolute discretion, to retain in the form received, and to sell either at
public or private sale any real or personal property owned by me at the time of my death.
NINTH. I have made, or may from time to time make, a written memorandum expressing.
my desire to give certain items of personal property to specific persons. I urge my Executrix.
and beneficiaries to respect these wishes. Such a memorandum, if made, shall be stored in
conjunction with this Will.
IN WITNESS WHEREOF, I have hereunto set y h d and eal tot 's, my Last Will
and Testament, consisting of two typewritten pages thi~~y of. ~ 2002.
GRACE M. GEORGE /~
Signed, sealed, published and declared by the above named Testatrix Grace M. George as
and for her Last Will and Testament, in the presence of us, who, at her request, in her sight and
presence and in the sight and presence of each other, have hereunto subscribed our names as
witnesses.
~~~~~~ ~~
COMMONWEALTH OF PENNSYL VANIA ,
COUNTY OF CUMBERLAND SS.
I, Grace M. George, Testatrix whose name is signed to the attached or foregoing
instrument, having been duly qualified according to law, do hereby acknowledge that I signed
and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as
my free and voluntary act for the purposes therein expressed.
~~~~~~~ .
GRACE M. GEORGE -'
Sworn or affirmed to and
acknowledged before me,
Gra M. Geo ge, this~~
of , 2gt~Z
--___~.,H.,~,~._.~.
NOTARIAL SEAL
Cynth'sa L. Darr, Notary Public
South Middleton Twp., County of Cumberland
My Cammissiar~ Expires Aught 4, 2004
COMMONWEALTH OF PENNSYL VANIA
COUNTY OF CUMBERLAND
SS.
We, ~,t~ t (~ L~.h'1 ~ - ~ ~'1C'Q ~~ and "' /`~'~c~ ~ ~Lfl/1~C000J-~~.
witnesses whose names are signed to the attached or foregoing instrument, bein dul the
according to law, do depose and say that we were present and saw Grace M. George sggn andd
execute the instrument as her Last Will; that she signed willingly and that she executed as her
free and voluntary act for the purposes therein expressed; that each of us in the hearing and
sight of the Testatrix signed the will as witnesses; and that to the best of our knowledge, the
Testatrix was at that time eighteen (18) or more years of age, of sound mind and under no
constraint or undue influence.
C---~
~.
Sworn or affirmed to and
subscribed before me by /
i /l ~ ~~ ~~(~Ir?C'~9~'and
f~:'~~ J~~/J1,~~laG~/~'~ witnesses,
tlu~~ dray of~~ 02.
o ~~:=~G
~ra~~r~~~~-~~~~ ~1=AL
Cynthia, !.. 's:, 3;:': !~~atar,~ Public
;south Middleton Tsv:~p..:~'>~,rsay of Cumberland
~.`IV ~s~ ~?..t~lhlt~~-~~ i~' ~'~' ,.,~t1C~. ~I A 9~AFl.r1.
Public
0~
499 Mitchell Street, Millsboro, DE 19966
April 15, 2008
Duncan 8s Hartman, P.C.
Attorneys at Law
One Irvine Row
Carlisle, PA 17013
RE: Estate of Crrace George
Date of Death: March 14, 2008
Social Security l~iu:nber: 172-24-8705
Dear Mr. Duncan:
In response to your request, please be advised that at the time of death, the above-
named decedent had on deposit with this bank the following accounts.
1. Account Type ........................... Checlflng Account
Account Number ....................... 9839436525
Ownership (Names ofJ .............. Grace George
Opening Date ...........................11/13/0'7 (account closed 03/25/08)
Balance on Date of Death .........$1,894.72
Accrued Interest $ 0 00
Total ....................................... $1,894.72
2. Account Type ........................... Savings Account
Account Number ....................... 15004214278928
Ownership (Names o. fl .............. Grace George
Opening Date ...........................09/22/06 (account closed 03/25/08)
Balance on Date of Death.........$58,351.70
Accrued Interest $ 72 85
Total ....................................... $58,424.55
• Page 2
The above named decedent did not have a safe deposit box.
April 15, 2008
* If upon reviewing the information above, you believe there are additional accounts not
referenced, please provide us with an account number and/or the name of any possible
joint account holder. For any additional information on the above accounts, including
ownership and any changes, closures and/or reimbursement of funds, please contact
our North Middleton Branch at 1958 Spring Road, Carlisle, PA 17013, or # 717-240-
4521.
Sincerely,
P ~ 1
~' ~ ,' • ~ // ' r /1
11 i `'/:
1
Charlene Warrington, Records-Management
1-888-502-4349
A. Settlement Statement
B. Type of Loan
1. [ ]FHA 2. [ ] FmHA
4. [ ] VA 5. [ X ]Conv. Ins.
r
U.S. Department of Housing
and Urban Development
OMB Approval No. 2502-0265
3. [ ]Conv. Unins. I o. nee rvumoer: 7. Loan Number:
18. Mortgage Insurance Case Number:
400800747-CB 0096201459
~•~ ~ _. ~ ills rorm is furnished to give you a statement of actual settlement casts. Amounts paid to and by the settlement 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 totaN
D. Name and Address of Borrower
JENNIFER L. SWOPE E. Name and Address of Seller F. Name and Address of Lender
DOUGLAS A. GEORGE, EXECUTOR OF
THE ESTATE OF GRACE M. GEORGE SOVEREIGN BANK
403 WEST PINE STREET 601 PENN STREET, MAIL STOP: 10-6438-SA3
MOUNT HOLLY SPRINGS, PA 17065 READING, PA 19601
611 CONODOGUINET AVENUE
CARLISLE, PA 17013
G. Property Location
i11 CONODOGUINET AVENUE,
CARLISLE, PA 17013
BOUNTY: CUMBERLAND
'ARCEL ID: 29-18-1384-010
TOWNSHIP: NORTH MIDDLETON TOWNSHIP
J. SUMMARY OF BORROWER'S TRANSACTIONS
100. Gross Amount Due From Borrower
101. Contract Sales Price
102. Personal Property
103. Settlement Charges to Borrower
4djustments For Items Paid By Seller In Advance
113. City/Town Taxes
114. County Taxes 399.8600/yr for 06/20/08 thru 01/01/09
115. School Taxes 1561.7800/yr for 06/20!08 thru 07/01/08
118. Assessments
119.
120. Gross Amount Due From Borrower
!00. Amounts Paid By Or In Behalf Of Borrower
!01. Deposit or Earnest Money
!02. Principal Loan Amount from Sovereign Bank
:03. Existing Loan(s) Taken Subject to
\djustments For Items Unpaid By Seller
:10.
'11.
'12.
'13. CityfTown Taxes
'.14. County Taxes
:18. Assessments
19.
21. Seller Paid Closing Costs
20. Buyer's Total Credits
00. Cash At Settlement From/To Borrower
01. Gross Amount Due From Borrower (line 120)
02. Less Amounts Paid By/For Borrower (line 220)
03. Cash [ X ]From [ ] To Borrower
H. Settlement Agent !-'
SECURED LAND TRANSFERS - MECHANICSBURG
Place of Settlement I. Settlement Date 06/20/2008
1068 HARRISBURG PIKE
CARLISLE, PA Disbursement Date 06/20/2008
K. SUMMARY OF SELLER'S TRANSACTIONS ~-
400. Gross Amount Due To Seller
$110,820.00 401. Contract Sales Price ----------
402. Personal Prooertv $110,820.00
$4,418.30 403.
Adjustments For Items Paid By Seller in Advance
413. City/Town Taxes
$213.04 414. County Taxes 399.8600lyr for 06/20/08 thru 01/01/09
$46.94 415. School Taxes 1561.7800lyr for 06!20/08 thru 07/01/08
418. Assessments
419.
$115,498.28 420. Gross Amount Due To Seller
500. Reductions In Amount Due To Seller
$1,000.00 501. Excess Deposits
$107,476.00 502. Settlement Charges to Seller
503. Existing Loan(s) Taken Subject to
Adjustments For Items Unpaid By Seller
510.
511.
512.
513. City/Town Taxes
514. County Taxes
518. Assessments
519.
$3,320.00 521. Seller Paid Closing Costs
$111,796.00 520. Seller's Total Charges
600. Cash At Settlement To/From Seller
$115,498.28 601. Gross Amount Due To Seller (line 420)
$111,796.00 602. Less Deductions In Amt. Due To Seller (line 520)
$3,702.28 603. Cash [ X ] To [ ]From Seller
$213.04
$46.94
$111,079.98
$8,054.40
$3,320.00
$11,374.40
~~~
$111,079.98
$11,374.40
$99,705.58
700. Total Sale Commission 110820.00 @ 6 % = 6649.20
Division of Commission (line 700) As Follows:
701. $3349.60 to George L. Ebener & Associates
702. $3299.60 to ERA-NRT, Inc.
703. Commission paid at settlement
709. Broker Administrative Fee to ERA-NRT, Inc.
800. Items Payable In Connection With Loan
801. Loan Origination Fee
802. Loan Discount
803. Appraisal Fee to Central Penn Appraisals (POC 299.00 t
804. Credit Report to CBC Companies
805. Lender Inspection Fee
812. Flood Cert. Fee to FIS Flood Services
813. Tax Service to LSI Tax Services s
816. Document Delivery Fee to Sovereign Bank
826. Mers Registration Fee to Mers
900. Items Required By Lender To Be Paid In Advance
901 . Interest from 6/20/2008 to 7/1/2008 @17.9127/day
902 . Mortgage Insurance Premium
903 . Hazard Ins. Premium State Farm (POC 283.00 by Buyer)
904 . Flood Ins. Premium
1000. Reserves Deposited With Lender
1001. Hazard Ins. Reserve 3 mo @ 23.58 ! mo Sovereign Bank
1002. Mortgage Ins. Reserve
1003. City Property Taxes
1004. County Property Taxes 5 mo @ 33.32 / mo Sovereign Bank
1005. School Taxes 13 mo @ 130.15 / mo Sovereign Bank
1010. Aggregate Accounting Adjustment from Sovereign Bank
1100. Title Charges
1101. Settlement/Closing Fee
1102. Abstract or Title Search
1103. Title examination
1104. Title Insurance Binder
1105. Document preparation ,
1106. Notary fee to Colleen Blume, Notary Public
1107. Attorney Fee to Duncan & Hartman, P.C.
1108. Title Ins. Total to Secured Land Transfers -Mechanicsburg
1109. Lender's Coverage $107476.00 ($)
1110. Owner's Coverage $110820.00 ($616.78)(CR)
1111. Endorsements-100/300/900 ($150.00) to Secured Land Transfers -Mechanicsburg
1116. Insured Closing Protection Letter to TRGC
1119. Wire Transfer Fee to Secured Land Transfers -Mechanicsburg
1127. Electronic Delivery & Handling Fee to Secured Land Transfers -Mechanicsburg
1138. Processing/Tax Cert. to Secured Land Transfers -Mechanicsburg
1140. Overnight Mail to Secured Land Transfers -Mechanicsburg
Paid From Borrower's
Funds At Settlement
$165.00
$51.00
$19.00
$7.50
$69.00
$3.50
$4.95
$197.04
$70.74
$166.60
$1,691.95
-$180.46
$20.
$616.78
$150.00
$35.00
$35.00
$50.00
Page 2
Paid From Seller's
Funds At Settlement
$6,649.20
1200. Government Recording And Transfer Charges $25.00
1201. Recording Fees for Deed 46.00; Recording Fees for Mortgage 66.50 _
1202. City/County Tax/Stamps 1108.20 $112.50
1203. State Deed Tax 1108.20 $1,108.20
1223. Other Recording Fee Mortgage Sat
1300. Additional Settlement Charges
1302. Pest inspection to South Central PA Home Inspection Co., Inc. (POC 85.00 by Buyer)
1305. Water Test to South Central PA Home Inspection Co., Inc. (POC 155.00 by Buyer)
1400. Total Settlement Charges
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 a~ receOpts and disburse
made on my account or by a in this transaction. I further certify that I have received a copy of the HUD-1 Settlement Statement.
BUYERS
S LLERS
Jennifer L wo 4 G ~ { C.
The HUD-1 Settlement Statement which I have prepared is a true and accurate accounDt of 9his transact on~•Ehavetcausedeor will causerthe fundsetorbe disbursed in
accordance with this statement.
Settlement Agent
Date
SECURED LAND TRANSFERS - MECHANICSBURG 06/20/2008
$10.00
$250.00
$10.00
$1,108.20
$27.00
$8,054.40