HomeMy WebLinkAbout08-13-0915056051047
REV-1500 EX (Oii-05) t?FFfa;t&t~ t7~E ONtY.
PA Department of Revenue ----~-M -----~-----~-----------------
Bureau of Individual Taxes CouN:y Code Year File Number
Po Box 2aosol INHERITANCE TAX RETURN
Harrisburg, PA 17128-OS01 RESIDENT DECEDENT 2 1 0 _9 0 _0_ 4_ 9 8
ENTER DECEDENT INFORMATION BELOW ~- ~ _ ~-
Social Security Number Date of Death Date of Birth
162 22 2978 0520,,20Q'9 0,50319.29
Decedent's Last Name Suffix Decedent's First Name MI
O C K E R _ D O R R I S M
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
t~aX 1. Original Return .;;.„"D 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 =„Z„"~ 7. Decedent Maintained a Living Trust ~ 2. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
v'e~ 7 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 T0:
Name Daytime Telephone Number
KEITH 0. BRENNEMAN 71 7 6.97 85,28
Firm Name (If Applicable) -
_._ _G y
_.
~~~ ~ ~ r. ~
S N E L B A K E R & B R E N N E M A_ N ,- ~` ~~ ~' ~_>
,, ~ _,
First line of address I ~ ~ t"7 ~ <-' =
I 7 >r- , .
44 WEST MAIN STREET ! =`-' w ~-"'`'
- ~ -,
-, .-_
Second line of address ~-.a' ;-,~ ~_ ~ _:..:~
.~. - ~~
- :o p r r_t-1
--t ; - -
City or Post Office State ZIP Code --- _-- -- ~ y S,+J _ r - "?
tv
M E C H A N L C S B U R G p A 1 7 0 5 5
Correspondent's a-mail address:
er pena ies o penury, ec are a ave examined this return, including accompanying schedules and statements. and to the best of my knowledge and belief,
it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSO RESPONSIBLE FO FILIN RETURN ~ ~- ~~~~~~-"--~-~-~"~~~"--~~~-~~~ DATE ~~~~~~~-_~~~~
~~.~ ,_~ _~ Fonda 0. Taylor, Executrix ~~~3~`'`~
ADDRESS _._ ..-„-_....~__.__~.__ __._._.____m_ ~___..M. e_...__._.. .. w _-_..___...:,.-._ _...___~_-
__ _2200 West Coventr Lane~~~ -~~~~~~~ ~~~
SIGNATU F PREPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS ~-.,...M_-____.-..______"_"'" `..'
44 West Main Street, Mechanicsburg, PA 17055
PLEASE USE ORIGINAL FORM ONLY
Side 1
15056051047 15056051047
1~5D56D52D48
REV-1500 EX
Decedent's Social Se curity Number
Decedent's Name: 1 6 2 2 2 2 9 7 $
RECAPITULATION
1. Real estate (Schedule A) ........................................... .. 1. 8 6 , ~ Q Q '• Q
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. 4 6 3 . 1 Q
6. Jointly Owned Property (Schedule F} C Separate Billing Requested ..... .. 6. 1 6 ~ ,. 3 6
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) f Separate Billing Requested...... .. 7.
8. Total Gross Assets (total Lines 1-7) .................................. .. 8. $ 6 , ~ 3 Q !k 6
9. Funeral Expenses & Administrative Costs (Schedule H) ................... .. 9. 6 , 3 6 3 1 7
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I} .............. .. 10. 5 2 , 9 ~ 2 6 5
11. Total Deductions (total Lines 9 & 10) ................................. .. 11. 5 9 , 3 3 ,5 $ 2
12. Net Value of Estate (Line 8 minus Line 11 j ............................ .. 12. 2 ~', 3 ' 9 4 6 4
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. 2 ~ , 3 9 4 6 4
TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
16. Amount of Line 14 taxable
at lineal rate x .015 2 7, 3 '9 4 6 4
17. Amount of Line 14 taxable
at sibling rate X .12
18. Amount of Line 14 taxable
at collateral rate X .15
15.
1s. 1,232.76
17.
18.
19. TAX DUE ......................................................... 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
15056D52D48
Side 2
1,2 3 2 . 7 6
15D56D52D48 J
REV-1500 EX Page 3
Decedent's Complete Address:
File Number
21-09-00498
DECEDENT'S NAME
Dorris M. Ocker
STREET ADDRESS
513 West Louther Street
CITY STATE
Carlisle F'A ZIP
17013
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19) (1) 1, 232.76
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount 61.63
Total Credits (A + g + C) (2) 61.63
3. InteresUPenalty if applicable
D. Interest
E. Penalty
Total InterestlPenalty (D + E) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2, Line 20 to request a refund. (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 1 , 171.13
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5g) 1 , 171.13
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? ............................................................................................
................ ^
.. ~f
3. Did 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? .......................................................................................................
...............
..
^ [~
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEQULE (s 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 t~ansfers to or for the use of the surviving spouse
is three (3) percent (72 P.S. §9116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent
[72 P.S. §9116 (a) (1.1) (ii)j. 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-?502 EX+ (1;-08?
~ij pennsylvania
!~- DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
ESTATE OF FILE NUMBER
Dorris M. Ocker 21-09-00498
All real property owned solely or as a tenant in common must be reported at fair market value, Fair market value is defined as the price at which property
would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts.
Real property that is jointly-owned with right of survivorship must be disclosed on Schedule F.
Attach a copy of the settlement sheet if the property has been sold.
ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE
NUMBER OF DEATH
DESCRIPTION
1. All that certain parcel of land improved with a
residential dwelling commonly known as 513 West Louther
Street, Borough of Carlisle, Cumberland County,
Pennsylvania, Fair Market Value (settlement statement
attached): $86,100.00
TOTAL (Also enter on Line 1, Recapitulation.) ~ $ 86 , 100.00
If more space is needed, insert additional sheets of the same size.
REV-1508 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
Dorris M. Ocker 21-09-00498
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.
(If more space is needed, insert additional sheets of the same size)
REV-1509 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF FILE NUMBER
Dorris M. Ocker 21-09-00498
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT
A. Fonda 0. Taylor 2200 West Coventry Lane Daughter
Enola, PA 17025
B. Steven D. Ocker 124 East Ridge Street Son
Carlisle, PA 17013
c
JOINTLY-OWNED PROPERTY:
ITEM
NUMBER LETTER
FOR JOINT
TENANT DATE
MADE
JOINT DESCRIPTION OF PROPERTY
INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR
IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY•HELD REAL ESTATE.
DATE. OF DEATH
VALU_ OF ASSET % OF
DECD'S
INTEREST DATE OF DEATH
VALUE OF
DECEDENT'S INTEREST
t. A., 7/28/ Citizens Bank checking account $502.08 33.3 $167.36
B. 2000 No. 6140272327
TOTAL (Also enter on line 6, Recapitulation) I S 167 .36
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX+ (10-06)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
DORRIS M. OCKER
FILE NUMBER
21-09-00498
Debts of decedent must be reported on Schedule I.
ITEM
IUMBER DESCRIPTION
A. FUNERAL EXPENSES:
1.
Hoffman-Roth Funeral Home & Crematory, Inc., balances due
for funeral services
2. Westminster Cemetery burial fee
3. Funeral luncheon and honorarium
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s) waived
Street Address
City State Zip
Year(s) Commission Paid:
2. AttomeyFees to Snelbaker & Brenneman, P.C.
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
4.
5.
6.
~.
8
Street Address
City State Zip
Relationship of Claimant to Decedent
Probate Fees to Register of Wills ($148.00) Additional F~robate
fee ($120.00)
Accountant's Fees and reserve for miscellaneous administrative
costs
Tax Return Preparer's Fees
Advertise Letters Testamentary:
a. The Sentinel: $219.40
b. Cumberland Law Journal: 75.00
Total:
Transfer tax upon sale of real estate
$ 464.77
260.00
215.00
3,000.00
268.00
750.00
250.00
294.40
861.00
TOTAL (Also enter on line 9, Recapitulation) ~ $
(If more space is needed, insert additional sheets of the same size)
RFV-'_SI2 S,K+ iii-:ib?
~ pennsylvarria
OERARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
ESTATE OF FILE NUMBER
Dorris M. Ocker _21-09-00498
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
i. Payment due Blue Cross for refund overpayment $ 71.82
2. PharMerica, balance due for prescriptions 313.01
3. Claremont Nursing Home, balance due on account 52,106.28
4. Stocker Opthalmology, balance due on account 20.00
5. Dr. Michael Gawlas, balance due on account of medical
services 95.78
6. PP&L, payment due for electrical service 54.71
7. Borough of Carlisle - sewer and water bill due on account 78.84
8. Cumberland County/Borough of Carlisle 2009 real estate
taxes due (net of refund upon settlement) 232.21
TOTAL (Also enter on Line 10, Recapitulation) I $52 , 972.65
If more space is needed, insert additional sheets of the same size.
REV-'_5,.3 EX+ (1:-0+3'
it pennsylvania SCHEDULE
~: DEPARTMENT OF REVENUE
INHERRANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE Of FILE NUMBER
Dorris M. Ocker 21-09-00498
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) (1.2).]
1, Fonda 0. Taylor Daughtel• 1/2 residue
2200 West Coventry Lane
Enola, PA 17025
2. Steven D. Ocker Son 1/2 residue
124 East Ridge Street
Carlisle, PA 17013
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, A S APPROPRIATE.
II NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $
If more space is needed, insert additional sheets of the same size.
LAST WILL AND TESTAMENT
OF. .
DORRIS'M: 'OCKE;R
I, DORRIS M. OCIIo-'~R, a legal resident of the Borough ,of Carlisle,
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 all other wills and codicils .heretofore made by
me.
FIRST: I direct that a1T my just debts and funeral expenses,
including my grave marker; shall be paid from tha assets of my estate as soon
as practicable after my decease.
SECOND: I devise and bequeath the .residue of my estate, of .every
nature and wherever situate; to my husband, Paul B, Ocker, Jr., providing he
shall survive ine by thirty (30) days: Should my .husband, Paul~B, Ocker, Jr.,
predecease me or die on or .before the thirtieth day following nry.death, I
devise and bequeath the .residue of my estate, of every nature and wherever sit-
uate, to my two children; Steven D, Ocker and Fonda L. Moyer, equally, provided
that the share of any child who predeceases me or dies on or before the thirti-'
eth day following my death shall be distributed to his ox .her issue, .per stixpes
living on the thirty-first day following my .death: and in default of any such
then living issue, such share shall be added ~to the share for my surviving chil
THIRD: I direct that all taxes that 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,
FOURTH: I nominate, constitute and appoint my daughter, Fonda L.
Moyer, Executrix of this my Last Will and Testament. In the event of the renun-
ciation, death; resignation or inability to act for any .reason whatsoever of my
said daughter; I nominate, constitute and appoint my son, Steven D, Ocker,
Executor of this my Last Will and Testament. I hereby relieve my Executrix or
Executor of the necessity of posting security in connection with her or his
duties as such in any jurisdiction in which she or .he may be called upon to act
uisofar as I am able by-law to do so,
IN WITNESS WHEREOF, I have hereunto set my hand and .seal to tl~a m}-
Last Will and Testament, consisting of one (I) typewritten page the~.gr y of
September, 1975.
i `
____~ ~7"7 C~~~ ~ (SEAT )
Dorris M. Ocker
_ LAW OFFICE6
'. LAN DIS & BLACK
' -WRLIe LE. PENNBYLYA NIA
Signed, sealed; published and declared by the-above-named Testator,
Dorris M. Ocker, 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 pres-
ence,of each other; have .hereunto .subscribed our names as witnesses.
A, V. LVVL-VLVV
B. TYPE OF LOAN:
U.S . DEPARTMENT OF HOUSING & URBAN DEVE LOPMENT 1.QFHA 2.~FmHA 3. QX CONV. UNINS. 4. ~VA 5, ~CONV. INS.
SETTLEMENT STATEMENT 6. FILE NUMBER:
1 7. LOAN NUMBER:
8. MORTGAGE INS CASE NUMBER:
C. NOTE: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown.
Items marked '(POCJ" were paid outside the closing; they are shown here for informational purposes and are not included in the totals.
1.0 3/98 (13239.1 MOYER/13239.1 MOYER/100)
D. NAME AND ADDRESS OF BORROWER:
Brandon D. Moyer
513 W. Louther Street
Carlisle, PA 17013 E. NAME AND ADDRESS OF SELLER:
Estate of Dorris M. Ocker
a/k/a Dorris I. Ocker F. NAME AND ADDRESS OF LENDER:
Comrnerce Bank/Harrisburg
T!D/E./A Metro Bank
3801 Paxton Street
Harrisburg, PA 17111
G. PROPERTY LOCATION:
513 W. Louther Street
Carlisle, PA 17013 H. SETTLEMENT AGENT:
Martson Deardorff Williams Otto Gilroy & Faller I . SETTLEMENT DATE:
J
ne 25
2009
Cumberland County, Pennsylvania PLACE OF SETTLEMENT
10 East High Street
Carlisle, PA 17013 u
,
J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRA NSACTION
O SELLER:
101. Contract Sales Price 86,100.00 401. Contract Sales Price 86,100.00
102. Personal Pro a 402. Personal Pro ert
103. Settlement Char es to Borrower (Line 1400) 4,598.56 403.
104. 404.
105. 405.
m n r em Pay B er 'n v n u r I i r n n
106. Coun /Tw .Taxes 06/26!09 to 01/01/10 249.37 406. Count !Tw .Taxes 06/26/09 to 01/01/1 0 249.37
107. School Taxes 06/26/09 to 07!01!09 13.96 407. School Taxes 06126!09 to 07/01/09 13.96
108. Assessments to 408. Assessments to
109. 409.
110. 410.
111. 411. !
112. ~ 412. I
120.
200. GROSS AMOUNT DUE FROM BORROWER 90,961.89
AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 420. GROSS AMOUNT DUE TO SELLER
500. REDUCTIONS IN AMOUNT DUE TO SELLER: 86,363.33
201. De osit or earnest mone 501. Excess De osit (See Instnactions)
202. Princi al Amount of New Loan(s) 73,185.00 502. Settlement Char es to Seller (Line 1400) 1 496.42
203. Existin loans taken sub ect to 503. Existin loans taken sub~ect to
204. 504. Payoff of first Mortgage
205. 505. Pa off of second Mort a e
206. 506.
207. 507.
208. 508.
209. 509.
A ustments For Items Un aid 8 eller Ad ustments or Iter7s Un aid ell
r
210. Count /Twp. Taxes to e
510. Count /Tw .Taxes to
211. School Taxes to 511. School Taxes to
212. Assessments to I 512. Assessments to
213. 513.
214. 514.
215. 515.
216. 516.
217. 517.
218. 518.
219. 519.
220. TOTAL PAID BY/FOR BORROWER ~ 73,185.00
300. CASH AT SETTLEMENT FROM/TO BORROWER:
301. Gross Amount Due From Borrower Line 120 90,961.89
302. Less Amount Paid By/For Borrower (Line 220) ( 73,185.00)
303. CASH(X FROM) ( TO) BORROWER 17,776.89
The undersinnerl hPrPhv arknn~edc.-Inc ~o,.e~.,+,.a., ...,.....~,..,.a ___.. _~ _____ . ~
, 520. TOTAL REDUCTION AMOUNT DUE SELLER
600. CASH AT SETTLEMENT TO/FROM SELLER:
601. Gross Amount Due To Seller (Line 420
602. Less Reductions Due Seller (Line 520) (
603. CASH(X TO) ( FROM) SELLER
_~.~_ 1,496.42
86,363.33
1,496.42
84,866.91
- - ~-- - --"~~'~---- --rJ "• r"te"" "^•- ~~ ~~~~.~ a~a~c~„c~il tX oily alt~l:111IIC11lS IClerrea ZO rlerein.
Borrower ~ n.~ ~ Seller ~~ ~ ~~C ~~~
f^~~
Brandon D. oyer Fonda O. Taylor, Executrix f the Estate
of Dorris M. Ocker a!k/a Dorris I. Ocker
HUD•1 (3-86) RESPA, HB4305.2
' '" L. SETTLEMENT CHARGES
700. TOTAL COMMISSION Based on Price $ (O7 % PAID FROM PAID FROM
Division of Commission line 700 aS FOIIOWS: BORROWER'S SELLER'S
701. $ t0 FUNDS A7 FUNDS AT
702. $ f0 SETTLEMENT SETTLEMENT
703. Commission Paid at Settlement
704. to
800. ITEMS PAYABLE IN CONNECTION WITH LOAN
801. Loan Ori ination Fee 1.0000 % to Metro Bank 731.85
802. Loan Discount % to
803. Appraisal Fee to Clauser Real Estate Appraisais 375.00
804. Credit Report to Equifax Mortgage Services PC)C:L$13.18
805. Underwriting Fee to Commerce Bank/Harrisburg T/D/B/A Metro Bank POC:L$397.00
806. Administration Fee to Metro Bank 325.00
807. Overnight Mail to Unishippers PC)C:L$16.00
808. Flood Cert Fee to Wolters Kluwer Financial Svcs. POC:L$6.00
8D9.
810.
811.
900. ITE RE IRE BY LENDER T BE AID IN DVANCE
901. Interest From 06/25/09 to 07!01/09 @ $ 13.214000/day ( 6 days %) 78,28
902. Mort a e Insurance Premium for months to
903. Hazard Insurance Premium for 1.0 ears to Met Life POC:B$486.00
904.
905.
1000. RESERVES DEPOSITED WITH LENDER
1001. Hazard Insurance 2.000 months $ 40.50 er month 81.00
1002. Mort a e Insurance months $ er month
1003. Count /Tw .Taxes 5.000 months $ 40.13 er month 200.65
1004. School Taxes 12.000 months $ 86.64 er month 1,039.68
1005. Assessments months @ $ per month
1006. months $ per month
1007. months $ er month
1008. A re ate Escrow Ad'ustment months $ er month -281.65
1100. TITLE CHARGES
1101. Settlement or Closin Fee to
1102. Abstract or Title Search to
1103. Title Examination to
1104. Title Insurance Binder to
1105. Document Pre aration to Martson Deardorff Williams Otto Gilro & Faller Deed 75.00
1106. Nota Fees to
1107. Attorney's Fees to
(includes above item numbers:
1108. Title Insurance to La ers Title Insurance Com an 780.75
includes above item numbers:
1109. Lender's Coverage $ 73,185.00
1110. Owner's Coverage $ 86,100.00 780.75
1111. Endorsements 100, 300 & 900 to Lawyers Title Insurance Company 150.00
1112. Closing Service Letter to Lawyers Title Insurance Company 35.00
1113. Electronic Document Production to Martson Deardorff Williams Otto Gilroy & Faller 50.D0
1200. GOVERNMENT RECORDING AND TRANSFER CHARGES
1201. Recording Fees: Deed $ 49.50; Mortgage $ 84.50; Releases $ 134
00
1202. Cit /Count Tax/Stamps: Deed 861.00: Mort a e .
861.00
1203. State Tax/Stamps: Deed 861,00; Mort a e
1204. 861.00
1205. 2008 School Taxes to Cumberland County Recorder of Deeds POC:S1018.91
1300. ADDITIONAL SETTLEMENT CHARGES
1301. Surve to
1302. Pest Ins ection to
1303. Overni ht Mail Fee & Wire Fee to Martson Deardorff Williams Otto Gilro & Faller 37.00
1304. Final Water/Sewer Bill to Borou h of Carlisle Acct. Igo. 008315
1305. 2009 Township & County Taxes to Carlisle Borough Tax Account 05-20-1796-173 78.$4
481.58
1400. TOTAL SETTLEMENT CHARGES (Enter on Lines 103, Section J and 502, Section K)
Rv cinninn n~nc 1 of fhio c. i..1.~........a a~... ..:...._a__:__ __'._'...~_~__ __ .. . 4,598.56 1,496.42
_ _ . _ __ _, _.._ _ ~__~_ .-- --.........,...y„ ,.,....,N.... ~ ,,,,,~~r~c~c~ wNy v~ Nayc ~ vi un~ ~wU page statement.
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Certified to be a true copy. Martson Deardorff Williams C)tto Gilroy & Faller
Settlement Agent
( 13239.1 MOYER ! 13239.1 MOYER 1100 )
Citlx+~ns Ban~Cry
Account Number 6140272327
Account Title DORRIS M OCKER STEVEN D COCKER FONDA O
TAYLOR
Date O ened 7/28/2000
Account T e Savin s
Princi al Balance as of DOD $502.08
Interest from Last Postin to DOD $ .00
Account Balance as of DOD $502.08
YTD Interest to DOD $ .00