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HomeMy WebLinkAbout10-01-0815056051058 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue Bureau of Individual Taxes ~ ~r County Code Year File Number PO BOX 280601 INHERITANCE TAX RETURN Harrisburg, PA 17128-0601 '- RESIDENT DECEDENT 21 08 0131 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 198-36-2269 01/19/2008 12!08/1906 Decedent's Last Name Suffix Decedent's First Name MI GREEN ELINOR C (1f 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) 4. Limited Estate 4a. Future Interest Compromise (date of 5. Federal Estate Tax Return Required death after 12-12-82) • 6. Decedent Died Testate 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. litigation Proceeds Received 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 CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number Jane F. Burke, VP (717) 240-4504 Firm Name (If Applicable) M&T Bank, Executor First line of address One West High Street Second line of address City or Post Office Carlisle Correspondent's e-mail address: jburke@IT1tb.COnl REC=lSTEF; OF Wtt.Lh tfSE L)NL.Y C) r~ -- 0 = _ ~ ~ T ~ -~ t. f BATE F?LEf'3.; _~ .- :~ -- -^n ,? i7 ti~ Z= (V ~,. Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and [o the best of my knowledge and belie(, 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. SIGNATURE OF~PERSON RF+.I7JSP~~,'Q"}~y)Si IBLF~ FOR FILIiN~'i RETAUR+N ., a DATE ~ ~~ ~ _ ~~ t/ `` ~ dr"~-._ .~,d ~ ~t ~' l,l-Y~ ~ VI ~~I )) ~:I t~Y- I ~Y^ ' ``+ ' \ 3 ADDRESS LYNN I,~t'~.~ ~~Cta 5~1:~e~ I Lfl ~,~tS~L, ~~ ~~~~ ~~~1 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIG{NAL FORM ONLY Side 1 15056051058 15056051058 State ZIP Code PA 17013 1C ~~ 15056052059 REV-1500 EX ELINOR C GREEN Decedent's Name: RECAPITULATION 1. Real estate (Schedule A) . .......................................... .. 1. 2. Stocks and Bonds (Schedule B) ..................................... .. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ... .. 3. 4. Mortgages & Notes Receivable (Schedule D) ........................... .. 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ...... .. 5. 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) .................................. .. 8. 9. Funeral Expenses & Administrative Costs (Schedule H) ................... .. 9. Decedent's Social Security Number 198-36-2269 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule 1) .............. .. 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/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~ 15. 16. Amount of Line 14 taxable at lineal rate X .0 45 1,057,198.79 16. 17. Amount of Line 14 taxable at sibling rate X .12 17. 18. Amount of Line 14 taxable 1 000 00 , . at collateral rate X .15 18. 19. TAX DUE ......................................................... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 15056052059 Side 2 240,000.00 797,064.89 0.00 0.00 112,074.40 0.00 0.00 1,149,139.29 69,559.56 21,380.94 90,940.50 1,058,198.79 0.00 1,058,19$.79 0.00 47,573.95 0.00 150.00 47,723.95 15056052059 REV-1500 EX Page 3 File Number Decedent's Complete Address: 21 os o131 DECEDENT'S NAME DECEDENT'S SOCIAL SECURITY NUMBER ELINOR C GREEN 198-36-2269 STREET ADDRESS 240 Glendale Street CITY STATE ZIP Carlisle PA 17013 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) 47,723.95 2. CreditslPayments 0.00 A. Spousai Poverty Credit B. Prior Payments 43,500.00 C. Discount 2,289.47 Total Credits (A+ B + C) (2) 45,789.47 3. InterestlPenalty if applicable 0 00 D. Interest E. Penalty 0.00 Total Interest/Penalfy (D + E) (3) 0.00 4. If Line 2 is greater than Line t + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the 7AX DUE. (5) 1,934.48 A. Enter the interest on the tax due. (5A) 0.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 1,934.48 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 :.................................................................................... ...... ^ 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. Dld decedent own an "in trust for" or payable upon death bank account or security at his or her death? ........ ...... ^ 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 1T 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)j. 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 of the decedent's 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. REV-1502 EX+(6-98) Y ~.M1:~. ~` SCHEDULE A COMMONWEALTH OF PENNSYLVANIA REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER ELINOR C. GREEN 21-08-0131 All real property owned solely or as a tenant in common must 6e reported at fair market value. Fair market value is defined as the price at which properly would be (If more space is needed, insert additional sheets of the same size) REQ.'-M1503EX+(6-98) ~~. `~ SCHEDULE B COMMGNVJEALTN OF PENNSYLVANIA STOCKS & BONDS INHERfTANGE TAX RETURN RES1pENT DECEDENT ESTATE OF FILE NUMBER EI.INOR C. GREEN 21-08-0131 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH ~ 1546 shs. Bank America Corp. 55,930.42 2 645 shs. Gencorp, Inc. 6.401.63 3 964 shs. Hancock Fabrics 650.70 4 186 shs. Monsanto Co. 18,860.40 5 Dividend Monsanto Co. ex-dividend 1/2108 32.55 6 621 shs. Norfolk Southern Corp. 27,379.89 7 645 shs. Omnova Solutions, Inc. 2;297.81 8 2233 shs. PNC Financial Services Group, Inc. 126,644.60 9 Dividend PNC Financial Services Group, Inc. ex-dividend 119/08 1,406.79 10 1200 shs. PPG Industries, Inc. 73,860.00 11 3653 shs. Pepsico, Inc. 257,061.61 12 770 shs. Pfizer, Inc. 17,353.88 13 1757 shs. Wachovia Corp. 55,046.81 14 4320 shs. Yum! Brands, Inc. 142,624.80 15 Dividend Yum! Brands, Inc. ex-dividend 1/9/08 648.00 16 1000 shs. Nuveen Pfd. & Cvrt. Income Fund 10,865.00 TQTAL (Also enter on line 2, Recapitulation) I $ 797,064.89 (If more space is needed, insert additional sheets of the same size) REV-1548 EX+r6-98) ~~ v SCHEDULE E '~~ CASH, BANK DEPOSITS & MISC. COMMaN4VEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER ELINOR C- GREEN 21-08-0131 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE A7 DATE NUMBER DESCRIPTION OF DEATH 1 M&T Bank Checking Account 1197746 1,950.06 2 M&T Bank Checking Account 415464 80,889.75 3 Refund, Family Home Health Care Products, Inc. 160.92 4 Refund, New York Times 51.20 5 Refund, Highmark, insurance premium 154.35 6 Refund, Embarq, telephone service 24.33 7 Refund, Ewing Brothers Funeral Home, Inc. 60.00 8 Citi/Smith Barney, money market balance 4,267.49 9 Lititz Mutual Insurance, premium refund homeowners policy 502.00 10 Refund, Natural History, subscription 5.00 11 Refund, 2007 Federal Income Tax 1040 6,515.04 12 Refund, 2007 PA Income lax PA40 492.00 13 2008 Economic Stimulus payment 179.35 14 Personal Property, as appraised (appraisal attached) 14,835.00 15 Pro rated Real Estate Taxes, 240 Glendale Street, Carlisle, PA 1,987.95 TOTAL (Also enter on line 5, Recapitulation) $ ' 112,074.40 (If more space is needed, insert additional sheets of the same size) EV-1511 EX+ (12-99) r ~~, SCNEDIJLE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER ELINOR C. GREEN 21-08-0131 Oebts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: ~' Ewing Brothers Funeral Home,lnc. 10,363.16 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) M&T Bank Social Security Number(s)fEIN Number of Personas Representative(s) Street Address One West High Street City Carlisle ,State PA Z;p 17013 Year(s) Commission Paid: 2009 2. Attorney Fees Salzmann Hughes P.C°. 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees z. The Sentinel, advertising Letters Testamentary a Cumberland Law Journal, advertising Letters Testamentary s Rowes Auction Service, personal property appraisal ~ o Closing and Filing Costs Zip 37,482.78 19,000.00 830.00 158.62 75.00 150.00 1,500.00 TOTAL (Also enter on line 9, Recapitulation) I $ 69,559.56 (If more space is needed, insert additional sheets of the same size) REV-1512 EX+(12-03) ~, - SCNEDt~LE 1 DEBTS OF DECEDENT, COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN & LIENS MORTGAGE IIABIlIT1ES RESIDENT DECEDENT , ESTATE OF FILE NUMBER ELINOR C. GREEN 21-08-0131 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Betra In Home, balance due care 1,477.96 2 PPL, electric service 284.38 3 UGI, gas service 1,001.43 4 Borough of Carlisle, water and sewer service 159.16 5 Embarq, telephone service 36.56 6 AT&T, telephone service 280.52 7 Hilton's Lock Service 189.01 8 Quality Care Pharmacy, balance due 132.83 9 Jack Nace, check dtd 1(10(08 M&T Checking acct. 1197746 50.00 10 Joann Gardners, Check #3864 dtd 1/13!08 M&T Checking acct. 415464 270.00 11 Ellen Tyree, Check #3854 dtd 12/19/07 M&T Checking acct. 415464 1,000.00 12 Family Home Medical, Check #3865 dtd 1/16108 M&T Checking acct. 415464 640.00 13 Family Home Medical, Check #3866 dtd 1/16!08 M&T Checking acct. 415464 94.82 14 Lauren Crooke, Check #3851 dtd 12119/07 M&T Checking acct. 415464 1,000.00 15 Tim Green, Check #3832 dtd 12/6107 M&T Checking acct. 415464 500.00 16 Tim Green, Check #3834 dtd 1216!07 M&T Checking acct. 415464 500.00 17 Westminster Cemetery, Check #3912 dtd 1 /18/08 M&T Checking acct. 415464 1,270.00 18 Jesse Ruth, lawn care 240 Glendale Street, Carlisle, PA 140.00 19 Comcast Cable, balance due 18.45 20 Carlisle Digestive Disease Assoc., balance due 135.00 21 Jack Nace, tax preparation fee 2007 individual tax returns 365.00 22 Carlisle Borough Tax Account, real estate taxes 240 Glendale Street, Carlisle, PA 846.91 23 SES Insurance Service, homeowner premium 1,320.00 24 Terry Lindsey, trash removal 365.00 25 Susan L. Hope, cleaning service 157.50 TOTAL (Also enter on line 10, Recapitulation) $ 12,234.53 (If more space is needed, insert additional sheets of the same size) REV-1512 EX+ (12-03) a SCHEDULE 1 COMMONWEALTH OFPENNSYIVANIA DEBTS OF DECEDENT, '""ERiTANCE Tnx RETURN MORTGAGE LIABILITIES, 8c DENS RESIDENT DECEDENT ESTATE OF FILE NUMBER ELINOR C. GREEN 21-08-0131 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 BALANCE FORWARD 12,234.53 26 Danny Raudabaugh, repiace sidewalk and curb, 240 Glendale Street, Carlisle, PA 4,430.00 27 Tom Oiler, shrubbery maintenance 240 Glendale Street, Carlisle, PA 212.00 28 Stephen Hietsch, Tax Collector, school real estate taxes 240 Glendale Street, Carlisle, PA 2,083.66 29 1% Real Estate Transfer Tax 240 Glendale Street, Carlisle, PA 2,400.00 30 Borough of Carlisle, final water and sewer service 20.75 TOTAL (Also enter on line 10, Recapitulation) ~ I 21, 380.94 {If more space is needed, insert additional sheets of the same size) ~ RFV-t513EX+f9-00) p,:. ~ '`~ '~: ~~` SCHEDULE J COR4MONIh'EALTH OF PEtJNSYLVANIA BENEFICIARIES WHER,ITANCE TAX RETURN RESIDENT DECE[?ENT ESTATE OF FILE NUMBER ELINOR C. GREEN 21-08-0131 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 (a) (12)] 1 Elinor C. Peterson, 8734 Donnybrook Rd., Boise, ID 83709 Niece 1,000.00 2 Joseph E. Green, III, 963 Walnut Lane, Carlisle, PA 17013 Son 10% of Residue 3 Nora G. Whalen, 2419 Military Road, Arlington, VA 22207 Daughter 10% of Residue 4 Michael T. Green, 72144 Foley Road, Burns, OR 97720 Son 10% of Residue 5 Kristin A. Green, 411 Ellerslie Avenue, Ambler, PA 19002 Granddaughter 3.125% of Residue 6 Lauren C.G. Crooke, 10615 Kinloch Rd, Silver Spring, MD 20903 Granddaughter 3.125% of Residue 7 A. Tanya W. Gobel, 4132 Whispering Lane, Annandale, VA 22003 Granddaughter 3.125% of Residue 8 Donald Curtis Whalen, 4082 Albatross, Apt. 11, San Diego, CA 92103 Grandson 3.125% of Residue 9 David C. Whalen, 1451 Marin Avenue, Albany, CA 94706 Grandson 3.125% of Residue 10 Megan Whalen Turner, 3122 Woodbury Rd. Shaker Heights, OH 44120 Granddaughter 3.125°l0 of Residue ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THRO UGH 18, AS APPROPRIATE, ON RE V-1500 COVER SHEET fl NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAt_ OF PART II - FNTFR TCITAI N(1N_TAXARI F r11STRIRt ITI(lNS r1N 11NF 13 ClF RFV-15M CnVFR SHFFT I ~ (If more space is needed, insert additional sheets of the same size) P,F.V-1513 EX*!9-00) /„i r ),r ~~~ S~NEDULE J C00..1tvI0NWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAx RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER ELINOR C. GREEN 21-08-0131 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE 1 TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)j 11 Patricia A. Montgomery, 904 Colfax St., Evanstown, IL 60201 Granddaughter 5.625% of Residue 12 Ellen G. Tyree, 516 Kendall Road, Knoxville, TN 37919 Granddaughter 5.625% of Residue 13 Michele S. Green, 1706 Westchester Dr., Knoxville, TN 37918 Granddaughter 5.625% of Residue 14 Todd A. Green, 1409 Faxon Street, Memphis, TN 38104 Grandson 5.625% of Residue 15 Teresa Dilys Green, 3254 Findlay St., Vancouver, BC Canada V5N 4E7 Granddaughter 6.458% of Residue 16 Timothy M. Green, 3254 Findlay St., Vancouver, BC Canada V5N 4E7 Grandson 6.459% of Residue ~ ~ Valerie E. Green, 811 Gleams Rd. Kitchener, Ontario Canada N2E 3X4 Granddaughter 6.458% of Residue 18 Heather Green, 247 Norgren Road, Fraser, CO 80442 Granddaughter 3.125% of Residue 19 Michael 0. Green, 13608 Ellendale Dr., Chantilly, VA 20151 Grandson 3.125% of Residue 20 Salene Green, 575 N. Birch, Burns, OR 97720 Granddaughter 3.125°l0 of Residue ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROU GH 18, AS APPROPRIATE, ON RE V-1500 COVER SHEET If NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRI8UT10NS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I $ (If more space is needed, insert additional sheets of the same size) .~ LAW OFFICES KNI GHT IR WIN ~ M A Settlement Statement U S. Department of Housing and Urban Development OMB No 2502-0265 ex fires 11/30/2009 c B. TYPE OF LOAN WEST POMFRET PROFESSIONAL BUiLDlNG 1. FHA 2. ~FmHA 3. OConv. Unins. ~ 4. VA 5. Conv. Ins. 60 WEST POMFRET STREET CARLISLE, PENNSYLVANIA 17013-3222 6. FILE NUMBER HOFFMANJL9.OS 7. LOAN NUMBER {717) 249-2353 I a ortn a r a a o p w you s a a •msn o a ua q •msn col a. un s pa o n C. Note: Rama m,r«.a •(0.o.c.l^ w.r. paw omaa• m. doanp: m•y ,r• anown n.r. ror marmatwn parp WARNING: It If a crlm• to anowlnyN mak• fits. statamenn to tM llnlESE slabs on tnla or anY o convic+bn can incwo• a M• anE fm AaonrtNnt. For tl•tails •••: Titl• 1a U. 9. Coda SMlon 100 8. MORTGAGE INSURANCE CASE NUMBER y• a• •m•n span ar• a own. o.a. ana ar. not tid.a•a In m• wtala. TilleExpress Settlement System lh•r simigr 5ortn. Panalti•a upon 1 end s•ctlon +o,o. Printed 09/0412008 at 08:42 JMR i D. NAME OF BORROWER: J. LYNN HOFFMAN and NANCY K. HOFFMAN ADDRESS: 846 WEST SOUTH STREET CARLISLE PA 17013 E. NAME OF SELLER: ELINOR C. GREEN ADDRESS: F. NAME OF LENDER: ADDRESS: G. PROPERTY ADDRESS. 240 GLENDALE STREET, Carlisle, PA 17013 Carlisle Borou h H. SETTLEMENT AGENT: I&M REAL ESTATE SERVICES, LLC, Telephone: 717-249.2353 Fax: 717.249.6354 PLACE OF SETTLEMENT: West Pomfret Professional Bld 60 West Pomfret Street Carlisle PA 17013 I. SETTLEMENT DATE: 0 910 412 0 0 8 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 rice 240 000.00 401. Contract sales rice 240 000.00 102. Personal Pro ert 402. Personal Pro en 103. Settlement char es to borrower line 1400 3195.50 403. 104. 404. 105. 405. AdLslments for items aid b seller in advance Ad~ustmenis for items ald b seller i n advance 107. Count taxes 09104/08to12/31108 275.36 407. Count taxes 09104108to12131106 275.36 i 108. School Tax 09/04108 to 06130109 1 712.59 408. School Tax 09/04108 to 06!30109 1 712.59 ' 109. A69. 110. 410. 111. 411. 112. 412. 120. GROSS AMOUNT DUE FROM BORROWER 245183.45 420. GROSS AMOUNT OUE TO SELLER 241 987,95 20D. AMOUNTS PAID BY OR ON BEHALF OF BOR ROWER 500. REDUCTIONS IN AMOUNT DUE TO SELLER 201. De sit or earnest mone 162 000.00 501. Excess De sit see Instructions 2 000.00 202. Princi al amount of new loans 502. Settlement char es to seller line 1400 2 420.75 203. Existin loans taken sub ect l0 503. Existin loan s taken sub'ect to 204. 504. Pa off of First Mort a e Loan 205. 505. 206. 506. 207. 507. 208, 508. 209. 509. Ad'ustments for items un aid b seller Ad'ustments for items un aid b seller 213. 513. 214. 514. 215. 515. 216. 516. 217. 517. 218. 518. 219. 519. 220. TOTAL PAID BYIFOR BORROWER 162 000.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 4 420.75 300. CASH AT SETTLEMENT FROM OR TO BORR OWER 600. CASH AT SETTLEMENT TO OR FROM SELLER 301. Gross amount due from borrower line 120 245163.45 601. Goss amount due to seller line 420 241 987.95 302. Less amounts aid b Hor borrower line 220 162 000.00 602. Le ion amount due seller tine 520 4 420.75 303. CASH FROM BORROWER 83 183.45 603. CASH TO SELLER 237 567.20 U.S. ~EPARTMEiCT OF HOUSING AND URBAN DEVELOPMENT File Number: HOFFMANJL9.08 PAGE 2 SFTTI FMFNT STATEMENT rmoc„nra~~ ceHlnmenf c~~tam or~n,on~4tnal~nna at nR a~ .IMa L. SETTLEMENT CHARGES PAID FROM PAID FROM 7pp. TOTAL SALES/BROKER'S COMMISSVON based on rice 5240 000.00 = BORROWER'S SELLER'S ~ Division of commission line 700 as follows FUNDS AT FUNDS AT i 701. to SETTLEMENT SETTLEMENT 702. S to 703. Commission aid at Settlement 800. ITEMS PAYABLE IN CONNECTION WITH LOAN ~ 801. Loan Ori ination Fee 802. Loan Discount 803. A raisal Fee 804. Credit Re rt 805. Lender's Ins coon Fee 806. Mort a e A lication Fee 807. Assum lion Fee 8G8 ' 809, 810. 811. 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest From to Ida 902. Mort a e Insurance Premium for to 903. Hazard Insurance Premium for to 904. 905. 1000. RESERVES DEPOSITED WITH LENDER FOR 1001. Hazard Insurance mo. /mo 1002. Mort a elnsurance mo. Imo 1003. Cit Pro ert Tax mo. Imo 1004. Count Pro ert Tax mo. 70.58 Imo 1005. Scnool Tax mo. 173.64 Imo tU09 A re afe Anal sis Ad'ustment 0.00 0.00 1100. TITLE CHARGES 1701. Settlement or closin fee 1102_ Abstract or title search 1103. Title examination 1704. Title insurance binder 1105. Document Pre aration 1106. Nola Fees 7.00 t 1G7. Attome 's fees to IRWIN 8: MGKNIGHT 750.00 includes above items No: 1108. Title Insurance includes above items No'. 1109. Lender's Covera e 1110. Owner's Covera a 240 000.00 - 1111, 1112. 1113. ' 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recordin Fees Deed 38.50 Mort a e 'Release 38.50 1202. Cit (Count tax/stam s Deed 2 400.00 Mort a e 2 400.00 1203. State Tax/stam s Deed 2400.04 Mort a e 2 400.00 1204. 1205. 1300. ADDITIONAL SETTLEMENT CHARGES 1301. Surve 1302. Pesllns edion 1303. 1304. Final WtrlSwr #06362 to CARLISLE BOROUGH 20.75 1305. 1306. 1307 1308. 1400. TOTAL SETTLEMENT CHARGES (enter on lines 103, Section J and_502 Section K 3195.50 2 420.75 I HUD CERTIFICATION OF BUYER AND SELLER I have carelyNy nvMwed the NUO 5• re~nf Striement and b tM best of my Mnowledge end DNlet M 4 a Wa and eccurata elaUment or all ncNpta and tlLLbunemenU made on my account or D In this vanea~on. Irlunner nrt 6 e.receNed a copy of Ne HUO-7 SetOement 51aUnrnt. (-~ /:~ I, I2. ~~(~ Lt, ~. ~. (/~ ~` mwCVICRaFFpDaO--'~~ n~~~~ ELINOq C. GREEN -~.Lll-Ltl L -~j r WARNING: R IS A CRIME Tr0 KNOWINGLY MAKE FALSE STATEMENTS TO 1HE The NUO-7 Se ment SNIe nl hkh I MN prepared is • trw and accrrate account or Nis transacUo UNITED STATES ON THIS OR ANY SIWLAR FORM. PENALTfES UPON CONYfCTION I have oue r will uus nM to De dl read In accordanu with Mla suument CAN INCLUDE A FINE AND IMpgISONMENT. FOq DETAILS SEE TITLE 78: U.S. CODE SECTION 7007 AND SECTK)N 1010. ~ / ~( l7 art 8y. ~` 7 ~~Va 02-13-'08 1:51 FROM- ©M&TBank Memorandum Fax # 717-240-4554 T-836 P001l001 F-031 499 Mitchell Road, Milltihoru, UI 19961> Mail Cole I)L;-M13-12 1-88K-51)2113A9 'I'o: Personal "1'nrst, M&T Bank, Jane F Burke From: Nancy Clagett /Records Management /Dale of Death Unil Date: February 13, 2008 Subject: llate of Death Values for the Estate of: Estate of: Minor C Green Social Security Number: 198-3G-2269 Date of Death: January 19, 2008 Pcr• your inquiry dated February 11, 2008, please be advised that at the time of death, the above-named decedent had on deposit with this bank the followi++g: 1. Type of account Checkin~,> Accoturt Accoturt Nrun6er• 415464 C><vners•hip (Names o~J Openin~;~ Date 6alcnrce un Dntc n~ Death Accrued Intcrert 7'ntal 2. Type ojAccount ACCOtIn[ Numher Ownership (Names o~ Opening Datc i3alnrrcc Litt Dulc> of Death h~linor C Green U9/UI/67 CYaserl02/11/US ,~8U,889.2U ,~ O.SS x'80, 589.75 Checking ~iccnurrt 1197746 F;linor C Crec>n l2/77/J3 Closed 02/l 1/U8 ,b 1, 95D. U6 ~cc:rued Interest $ U.00 Total ~' 1, 95(J. U6 F If upon reviewing the information above, you believe there are additional accounts not referenced, please provide us with an account number and/or name of any possible joint account holder, you feel that any additional accounts should exist, please provide us with an account number and/or the name of any possible joint accow+t holder. For any additional information on the above accounts, including ownership and any changes, closures and/or reimbursement of funds, etc., please contact our High Street Carlisle Branch at 1 West High Sl--eet, Carlisle, PA ]7013, or # 717-240-4536. Sirnc~ejrely, ~/ c Nancy Clagcu: Records Management ROWE'S AUCT{ON SERVICE 211 N. OLD STONE HOUSE ROAD CARLISLE, PA 17015 717-249-1978 To: Jane F. Burke, Vice President Market Manager M 8 T Investment Group One West High Street Carlisle, PA 17013 From: William G. Rowe, Appriaser Rowe's Auction Service 211 N. Old Stone House Road Carlisle, PA 17015 Re: Personal Property Appraisal Estate of Elinor C. Green 240 Glendale Street Carlisle, PA 17013 Date of Death -January 19, 2008 Date: January 31, 2008 LIVING ROOM Mahogany bookcase $850.00 Books $10.00 Collection of bird knick knacks $110.00 Stoneware pitcher $20.00 Clown bookends $50.00 Bird bookends - as is $20.00 Lamp $15.00 Bride's basket -Victorian $45.00 Wa{nut candlestand $55.00 .Prints (3) $60.00 Oriental rug -small (3) $315.00 Oriental rug -medium (2) $295.00 2-tier stand $125.00 Victorian sofa $500.00 Footstool $30.00 Pedestal tea table $135.00 Footstool $30.00 Selection of cane-seat chairs -throughout the house $75.00 Watercolor, seascape -wharf $125.00 Large credenza table (or desk) - as is $500.00 Lamps $15.00 Watercolor, ship -Brann $100.00 Vases $65.00 Linens $30.00 Cherry chest of drawers - 2 over 4 $950.00 Wing chair, blue $40.00 Watercolor, street scene - Kastner $150.00 Fireplace fender, brass $75.00 Banquet lamp -electrified $95.00 Watercolor, landscape -Brann $100.00 Corner whatnot $115.00 Green Appraisal 1 01/31!2008 Vases $20.00 HALLWAY Rugs, contemporary (2) $50.00 Hall table $215.00 Lamp $15.00 Stand, marble top $125.00 Victorian mirror $150.00 Miscellaneous household (closet) $25.00 OFFICE Photo -Civil War soldier $150.00 Painting, child -unsigned $110.00 Love seat $100.00 Pair wing chairs $120.00 Oriental rug $350.00 Oriental rug $200.00 Contemporary rug $30.00 Drop-leaf table $200.00 Wall hangings $30.00 Candle stand $75.00 Lamps /floor lamps $30.00 Nest of stands $85.00 Office desk /chair $115.00 Books $215,00 Vases $20.00 Watercolor, floral (3) -Spencer $225.00 Empire stand $150.00 Charcoal, bird -Anna Lefft Siok $50.00 ~ V $30.00 Wood box $20.00 Stool $10.00 Chest of drawers, Empire $150.00 Office arm chair $40.00 Small Arts 8 Crafts table $125.00 Brass pot $30.00 Windsor mahogany chair $35.00 Rocker $30.00 Mahogany stand $30.00 SITTING AREA Chest of drawers, cherry $175.00 Rug $85.00 Rug $75.00 Rug $20.00 Cedar chest $50.00 Windsor mahogany chair $35.00 Bed $50.00 Stand $5.00 Lamps $10.00 Spinet desk /chair $100.00 Books $15.00 Arm chair $10.00 Housewares (closet) $10.00 Mahogany dresser - as is $75.00 Green Appraisal 2 01/31/2008 OUTSIDE Patio decoraters BEDROOM Stand - 2-drawer Bed Rug Chair Fold-up table -long Wing chair Small round table Clothes tree Folding screens (2) Cylinder roll secretary -oak Books T.V. - no value Blanket chest Knick knacks Mirror, O.G. Chest of drawers with mirror Chest of drawers, 4-drawer Clock Lamp Floor lamp Soft goods (hall closet) KITCHEN Table /chair Pine cupboard Stand Country collectibles Kitchen wares Bowls Small appliances DINING ROOM Drop-leaf table Ladder-back chairs (4) Plant stand Pitcher Brass sconces, pair Painting, stream /house - G.Gibney Stand, rectangular Sideboard, mahogany Watercolors (3) Prints Miscellaneous dishes Glassware Cups /saucers Tankard, California pottery Set dishes Linens Flatware Oriental rug Jelly cupboard, walnut Stemware $85.00 $85.00 $100.00 $30.00 $10.00 $20.00 $85.00 $100.00 $10.00 $50.00 $650.00 $50.00 $0.00 $275.00 $50.00 $35.00 $100.00 $315.00 $65.00 $30.00 $10.00 $20.00 $15.00 $115.00 $5.00 $30.00 $25.00 $10.00 $10.00 $100.00 $200.00 $80.00 $50.00 $150.00 $50.00 $75.00 $115.00 $180.00 $70.00 $50.00 $90.00 $50.00 $30.00 $50.00 $30.00 $20.00 $235.00 $500.00 $25.00 Green Appraisal 3 01/31/2008 BASEMENT Wood potty Frames Baskets Brass /glass tea cart Housewares Corner shelf -bamboo Freezer - no value Refrigerator -older High chair Office scales Seasonal decorations Wood chest Storage chest Work table Country collectibles /basket Miscellaneous tools Rug Housewares Book shelf Books Bookcase w! doors Fan Folding cots (2) - no value Mattress - no value Chairs - no value Redware bottle - as is GARAGE Ladders Mattress - no value Plastic chairs T.V. - no value Piano stool Lawn mower Garden tools Hand cart Washstand ATTIC Trunk Chairs /rocker Blanket rack Old canes Tool box Frames !prints Basket ITEMS REMOVED BY JOHN GREEN Nightstand Sewing stand $20.00 $30.00 $20.00 $30.00 $15.00 $135.00 $0.00 $20.00 $10.00 $25.00 $10.00 $10.00 $10.00 $10.00 $40.00 $10.00 $25.00 $10.00 $10.00 $25.00 $110.00 $5.00 $0.00 $0.00 $0.00 $25.00 $20.00 $0.00 $5.00 $0.00 $20.00 $30.00 $50.00 $10.00 $45.00 $30.00 $20.00 $10.00 $45.00 $10.00 $60.00 $10.00 $85.00 $75.00 Total $14, 835.00 William G. Rowe Green Appraisal 4 01/31/2008