HomeMy WebLinkAbout09-01-09 (5)a. Sett{ement Statement U.S. Department of Housing
and Urban Development
~r
OMB Approval No. 2502-0265
B. T e of Loan
1. ^ FHA 2. ^ FmHA 3. ^Conv. Unins. s. Fna Numtx+r 7. Loan Number 9. Monpage Insurance Cace Number
4. ^ VA .5. ^Conv. Ins. 09-228
C. Note: This forth is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are
shown. Items marked "(p.o.c.)" were paid outside Dosing; they are shown here for informational purposes and not
inGuded in the totals. F 10ti B ja se5. I~ ol1v.
D. Name ant Addess of 9ortower E Name and Address of Geller >~ ~~ ~Nj~~~a~ F. Name and Atltlross of Lender
Kirby J. Baer Barbara B. Taylor, Co-Executrix Provident Funding Group, Inc.
Karalee B. Ameel, Co-Executrix ISAOA ATIMA
101 Sunset Drive 219 Haldeman Avenue 350 Sentry Parkway, Ste. 220, Bldg. 610
Carlisle PA 17013 New Cumberland PA 17070 Blue Bell PA 19422
c. Fropeny Loo9on _ N. setuemeM A9eM Melanie Walz Scaringi,
219 Haldeman Avenue Scarin i & Scarin i, P.C.
place of Setdemerd 1. Setdemem Dale
New Cumberland PA 17070 2000 Linglestown Road, Suite 106 8/28/2009
Harrisburg PA 17110 Disbursement Date
Loc abd< 8/28/2009
J. Summary of Borrower's Transaction ~ K. Summary of Seller's Transaction
__.._ .._ ..._ ., ann r....aa em~~~ar nna Tn saner
101. Contract sales price 234 000.00 401. Contract sales Rce 234, 000.00
102 Personal 402. Personal ro
103. Settlement cha es to bortower line 1400 1 D 906.78 403.
1oa. A raisalCC Fee to PFG Inc 4.5DPOC aoa.
105. 405.
Ad'ustments for Items aid seller in advance Ad'ustments for kerns aid b seller in advance
106. Ci flown taxes to 406. C /town taxes to
to7. Coun taxes 8/28/2001 12/31/2009 285.20 407. Coun taxes 8/28/200tsb 12/31/2009 285.20
109. Assessments to 406. Assessments to
109. to 409. to
110 }0 41 D. to
111. to 411. to
11 z. to a1 z to
113. to 413. to
114 to 414. to
115. to 415. to
120. Gross Amount Due From Borrower 245,191.98 420. Gross Amount Due To Seller 234,285.20
.. ....,.,.. 5nn Reduetinns In Amount Due To Seller
201. De sit or earnest mone 2,500, 00 501. Excess de it see instructions
202. Pdnd al amount of new loans 502. Settlement ch es to seller line 1400 2 840.00
203. Exisfin loans taken sub'ed to 503. ExisSn loan s taken su to
zoa. Provident Fundin Grou ,Inc. 174 000.00 soa. Pa ftof first mo a e loan
205. 505. P ft of second mo a e loan
206. ~6•
207. 507.
206. 506.
209. 509.
Ad'ustments for Items un aid seller Ad ustmettts for items un aid seller
21 D. C flown taxes to 510. C /town taxes to
to
211. Coun taxes
511. Coun taxes tO
to
212. Assessments
512. Assessments to
z13. School Tax 7/1/2009 ~ 8/28/2009 258.31 s13. School Tax 7/1/2009 tD 8/28/2009 258.31
z1a. Sewer 1!1/2009 to 8/28/2009 154.82 s14. Sewer 1/1/2009 to 8/28/2009 154.82
21 s. Trash 4/1/2009+0 8/2812009 69.37 s1s. Trash 4/1/20098/28/2009 69.37
to
216.
516. ~
to
217.
517. to
to
21 B.
516. to
to
219.
519. to
220. Total Paid BylFor Bortower 176,982.50 520. Total Reduction Amount Dua Seller 3,322.50
.. • C.Ml.msni Tnn%rAro Caliw~
Sot. Gross Amount due from bomwaer line 120 245 191.98 601. Gross amount due to seller Ina 420 234 285.20
302. Less amount id /for bonower ine 220 176 982.50 602 Less reductions in amt due seller line 520 3,322.50
303. Cash 0 From ^ To Borrower g$~20g,Q$ 603. Cash ®To ^ From Seller 230~gg2,7D
SUBSTITUTE FORM 1099 SELLER STATEMENT
The irlfonna0on contained in Blocks E, G, H, and I and on line 401 (or, line 403 and 404) is impoRam tax irlforma0on antl is being furnished to the Internal Revenue
Service. If you are required to file a return, a negligence penalty or other sanction will be imposed on you H this item is required to be rcpoRad and the IRS determines
that 6 has not been reported. If this real estate is your pdndpai residence, file Forth 2119, Sale or Exchange of Principal Residence, for arty gain, with your in~me tax
return; for other transardions, complete the applicable paRS of Form 4797, Form 6232 and/or Schedule D, Form 1040). You are required to provide the Settlement Agent
(named above) with your coned taxpayer identification number. If you do not provide the Settlement Agent with your sorted taxpayer identificd0on number, you may be
subject to civil or criminal penahies imposed by law. Under penaltles of perjury, I certify that the number shown on this statement is my coned taxpayer ide~ number.
(Seller's Signature)
700. Total SalesBrokers Commission based on price S Z34,DDO.DO %= 0.00 paid From Paid From
Division of Commission line 700 as follows: Bonower's Sellefs
701 5 to Funds At Funds At
Settlement Settlement
702. S to
Inc.
B00. ttems Payable In Connection With Loan
801. Loan Ori inaeon Fee % to LeTort Mt G .Inc. 2 587.50
602 Loan DISWUM 96
603. A praisal Fee to Provident Fundin Grou Inc. $150 POC
804. CredttReport to LeTort Mort a e Grou Inc. $25 POC
BDS. Lenders Ins 'on Fee
BOS. Mortgage Insurance Appliceeon Fee to
607. Assum eon Fee
eoe. Tax Service Fee to Provident Fundin Grou Inc. 60.00
Bog. Wire Fee to Provident Fundin Grou Inc. 17.00
e1D. Processin Fee to LeTort Mort a e Grou Inc. 750.00
att. Administration fee to Provident Fundin Grou Inc. 795.00
etz. Administration Fee to LeTort Mort a e Grou ,Inc. 20.00
eta. MERS Fee to Provident Fundin Grou Inc. 6.95
900. Items Required By Lender To Be Paid to Advance F~cdude last day in cake -line 901
sot Interest from 8/28/2009 to 8/31/2009 E 24.17 / d 96.68
902. Mort a e Insurance Premium for months to
903. Hazard Insurance Premium for rs b
904. rs 10
sos. Hazard Insurance Premium for 1 ear to Gunn Mowe $396.00 POC
1000. Reserves Deposited With Lender
1001. Hazard insurance 3 month § 33.00 r month 99.00
1002. Mortga a insurance 1 month S r month
1003. C roe taxes 1 month § month
toD4. coup o taxes 7 nwnel S 35.55 r month 248.85
1005. Annual assessments 1 months S r month
tool. School Tax 3 mone,s § 138.23 r monm 414.69
1007. 1 months S r month
1008. A r ate Accounen Ad"ustment -142.20
1100. Title Charges
1101. Settlement Or dO61n fee to
1102. Absbadortitlesearch to Harve P. Murra Jr. 143.00
1103. Tdle examination to
1104. TNIe insurance binder to
1105. Document re ration to
11oe. Nota teas to Cash 10.00 5.00
1107. Attome sfees to Scarin i 8r Scarin i P.C. A roved Attorne s 647.75
Indudes above items numbers: for First American Title Insurance Com an
11oe. tee insurance for owner and lender to John R. Lhota P.C. A ent for First American 746.00
Includes above Hems numbers: Title Insurance Com an
t 1 D9. Lender's covers S
1110. Ownefs covers e 8
1111. Brin down and Record fee to Harve P. Murra Jr. 20.00
1112. Endorsements 100 300 900 8~ 710 to John R. Lhota P.C. A ent for First American 200.00
1113. Closin Services Letter to First American Title Insurance Com an 35.00
1200. GovemmeM Reeordin and Transfer Cha es
1201. Recording fees: Dead S 44.50 Mo a E 64:50 ;Releases § 109.00
1202. C' /coun tax/stam :Deed E 2,340.00 ; Mo a e S 2340,00
1203. State tax/stam s: Deed § 2340.00 ; a e § 2340.00
tzoa. UPI Certification Fee to Cumberland Co. Rec. of Deeds- $10 er recorded document 20.00
1zos.
1300. Additional Settlement Charges
1301. Su to
1302. Pest ins 'on remed io Know Swett Termite Pest Services $1 272 POC b Selle
t3o3. Tax Certification Fee to Robin Gas eretti Tax Collector 10.00
1304.2009/2010 School Real Estate Taxes to Robin Gas eretti Tax Collector 1 625.56
,3os. American Home Shield - 1 ear -Contract No. 91539072 495.00
13os. Ovemi ht fee to Scarin i & Scarin i P.C. 35.00
t3o7. Flood Fee to to Provident Fundin Grou Inc. 12.00
13oe. A raisal Technolo & Mana ement Fee to ProvidentFundin Grou Inc. $50 POC
1400. Total Settlement Charges (enter on lines 703, section J and 502, SeeUon IQ 1 9 6.78 2 840.00
CERTIFICATION
I have cerefully reviewetl the HU0.1 Settlement Statement and to the best of rtry knowledge and belief, tt b a true and c ate s tSteme II receipts and disbursemems
on my account or by me m this y, nsaction. I further certify that i have received a copy of ttre HU0.1 Settlement S t en
r(/J~ Seller Bortower
Barbara B. Ta lot, Co- ecutrix I y , g
Seller Borrower
aralee B. Ameel, Co-Executrix
To the b t of my knowledge the HUD-1 Settlement Statement which I have preparetl is a true and acwrete account of the funds whkh were received antl have been or will
be disbr ea~ by the utdersig e s art o e settlergent of this bansaceon. ~ ~ ~ ~~
Settlement Agent Date
Melan a Walz Scaringi, tfic~ingi & Scaring .C.
WARNING: It is a crime to knowingly make false statements to the Uniled States on this or any other similar form. Penalties upon eonvidion ran include a One and
imprisonment For details see: Title 16 U.S. Code Sedion 1001 and Sedion 1010.
US OOr61NIENr PRIeI1Mn OFFIGs: 1Mr 0.r11.]LS