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HomeMy WebLinkAbout12-14-09 (2)J 15056041114 REV-'I 5OO EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN PO 90X 280801 ~ I ~ ~ O a O ~ ` Hamsburg, PA 17128-0801 RESIDENT DECEDENT ( 1 ENTER DECEDENT INFORMATION BELOW ', Social Security Number Date of Death Date of Birth O `~` 198-20-6500 01182009 1261927 Decedent's last Name Suffix Decedent's First Name MI ROBBINS MARY LOUISE (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 VIIITH THE REGISTER OF WILLS FILL INAPPROPRIATE OVALS BELOW (fix 1.Original Retum 0 2. Supplemental Retum 0 3. Remainder Retum (date of death prior to 12-13-82) 0 4. Limited Estate 0 4a. Future Interest Compromise (date of 0 5. Federal Estate Tax Retum Required death after 12-12-82) 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 1 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 0 9. Lftigation Proceeds Received ~ 10. Spousal Poverty CredR (date of death ~ 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT- THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number ROBERT G. FREY 7172435838 Firm Name (If Applicable) REGISTER OF WILLS USE ONLY FREY & TILEY First line of address ^'~ 5 SOUTH HANOVER STREET n ~~ o ~ t Second line of address r ~ ~ te rn C') - ~~ 3? r -" Y i ~^ ~ ~ r ~y City or Post Office DATE ~. State ZIP Code ~' ~©~ ~ _ .~ .`. " CARLISLE PA 17 013 «~ r , ~ v --~ .rs- ~' ~ 1~ , Correspondent's e-mail address: RFREY@ FREYT ILEY . COM Under penalties o perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best o my knowledge and belie , it is true, con-ect and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has anv knowledge. SIG URE OF PERSO RESPOPLSIBLE FOR FILING RETURN DATE ~ `~- C~o1~:.~ s^,cec . 12/0'1 /09 ADDRESS 1005 SHEAFFER ROAD, ELIZABETHTOWN, PA 17022 DATE 12/07/09 5 SOUTH HANOVER STREET, C~ISLE, PA 17013 PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056041114 15056041114 J J 15056042115 REV-1500 EX Decedent's Social Security Number Decedent's Name: MARY LOUISE ROBBINS 198-20-6500 RECAPITULATION 1. Real estate (Schedule A) ........................................... 1. 14 2 0 0 0. 0 0 2. Stocks and Bonds (Schedule B) ...................................... 2. 17 7 713.0 0 3. Closely Held Corporation, Partnership or Sale-Proprietorship (Schedule C) ..... 3. NONE 4. Mortgages & Notes Receivable (Schedule D) ............................ 4. NONE 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ........ 5. 4 8 0 41.0 0 6. Jointly Owned Property (Schedule F) OSeparate Billing Requested ........ 6. NONE 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) Separate Billing Requested ........ 7 NONE 8. Total Gross Assets (total Lines 1-7) .................................. 8. 3 6 7 7 5 4. 0 0 9. Funeral Expenses & Administrative Costs (Schedule H) ................... 9. 4 6 5 9 9 . 0 0 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ............... 10. 2 2 4 3 6 . 0 0 11. Total Deductions (total Lines 9 & 10) ................................. 11. 6 9 O 3 5 . 0 0 12. Net Value of Estate (Line 8 minus Line 11) ............................. 12. 2 9 8 719.0 0 13. Charitable and Govemmentaf Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ....................... 13. 0 . 0 0 14. Net Value Subject to Tax (Line 12 minus Line 13) ....................... 14 2 9 8 719 0 0 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 19. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0 0 Y5. 0. 0 0 16. Amount of Line 14 taxable at linealratex.o 45 298719.00 16. 13442.00 17. Amount of Line 14 taxable at sibling rate X • 12 17. 0 , 0 0 18. Amount of Line 14 taxable at collateral rate X , 15 16. 0.0 0 19. TAxDUE ....................................................... 1s. 13442.00 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ~ -Side 2 L 15056042115 15056042115 J REV-1500 FJC Page 3 198-20-6500 Dec#edent's Complete Address: File Number 21-09-0071 DECEDENTS NAME DECEDENTS SOCIAL SECURITY NUMBER MA Y LOUISE ROBBINS 198-20-6500 ST 52 EET ADDRESS ST RIDGE STREET CI CAR ISLE STATE PA ZIP 17013 T 1. 2. 3. B. Prior Payments 12500.00 C. Discount 625.00 Payments and Credits: Tax Due (Page 2 Line 19) Credits/Payments A. Spousal Poverty Credit Interest/Penalty if applicable D. Interest E. Penalty (1) 13442.00 Total Credits (A + B + C) (2) 13125.00 Total Interest/Penalty (D + E) (3) 0.00 4. ~, If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. i Fill in oval on Page 2, Llne 20 to request a refund. (4) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 317.00 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56) 317.00 Make Check Payable to: REGISTER OF W1LLS, AGENT LEASE 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? .............................. ~ a .................. 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .. ~ ~X 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ...................................................... IF '~HE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Ford tes 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 u e of the surviving spouse is three (3) percent [72 P.S. §9116 (a) (1.1) (i)]. Ford tes 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 )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 requi ments for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. Ford tes of death on or after July 1, 2000: The t 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 u e 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 t 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) ercent, 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+ (11-08) Pennsylvania DEPARTMENT OF REVENUE INHERrrANCE TAX RETURN SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER ~1arv Louise Robbins _ 21-09-0071 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 Hulling buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real properly that is Jointly-owned with right of survivorship must be diaclosed on Schedule F. ITEM Attach a copy of the settlement sheet ff the property has been sold. i NUMBER Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE DESCRIPTION OF DEATH I I I 1. 52 East Ridge Street, Carlisle, Pennsylvania (See HUD-1 settlement statement). 142,000 TOTAL Also enter on Line 1, Reca itulation $ 142,000 If more space is needed, insert additional sheets of the same size. s~~ REV-1503 EX+ (6-96) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT EST TE OF FILE NUMBER Ma Louise Robbins 21-09-0071 All property Jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM ~ VALUE AT DATE UMBER DESCRIPTION OF DEATH 1. MFS Total Retum A, 1334.264 shares @ $11.04 14,730 2. MTB Money Market, 7452.12 shares @ $1.00 7,452 3. Alliant Energy Corp, 300 shares @27.87 8,361 4. Bon Ton Stores, 100 shares @ $1.41 141 5. FNB Corp PA, 527 shares @ $8.89 4,685 6. Fifth Third Bancorp, 266 shares @ $5.43 1,444 7. First Commonwealth Financial, 4943 shares @ $10.07 49,776 8. M&T Bank Corp, 398 shares @ $39.93 15,892 9. Mylan Inc., 2125 shares @ $11 23,375 10. US Gold Corp, 30 shares @ $1.13 g4 11. Anthracite Cap Inc., 355 shares @ $2.05 728 12. Vanguard 500 Index Fund, 105.216 shares @ $78.3 8,238 13. Anthracite Cap., Inc, 400 shares, @ $1.968 787 14. First Commonwealth, 2400 shares @ $9.8325 23,598 15. PPL Corp, 400 shares @ $32.005 12,802 16. Receivable Acquisition, 9 shares @$.03 0 17. Suburban Propane, 100 shares, @ $32.68575 3,269 18. FHLMC 114 H, 3000 shares; statement attached 95 I i 19. Series EE Bonds 2,305 TOTAL Also enter on line 2 Reca itulation $ 177 713 (If more space is needed, insert additional sheets of the same size) 217 REV-1508 Ex+ (6-96) SCHEDULE E CASH, BANK DEPOSITS, & MISC. COMMONWEALTH OF PENNSYLVANIA PERSONAL PROPERTY INHERITANCE TAX RETURN ESTATE OF FILE NUMBER Mary Louise Robbins 21-09-0071 Include the proceeds of litigation and the date the proceeds were received by the estate. All ro 'ointl -o n d ith ht f i h' b di I ITEM NUMBER w e w n o surv vors I must a sc osed on Schedule F. DESCRIPTION VALUE AT DATE OF DEATH 1 M&T Checking Account No. 976601 2,245 2 M8~T Checking Account No. 9845712869 3,732 3 M&T Savings Account No. 15004216209137 11,529 4 M&T Certificate of Deposit No. 31003915939424 7,579 5 Real Estate Tax proration from HUD-1 settlement statement 1,263 6 2005 Chevrolet Malibu 7,210 7 Sovereign Bank CD 12,289 8 Jewelry sold on consignment 400 9 Miscellaneous personal property sold at public sale 1,673 10 Capital One refund g 11 i it Income Tax refund, US Treasury 113 TOTAL (Also enter, on line 5, Recapitulation) $ 48,041 (If more space is needed, insert additional sheets of the same size) REV-1511 EX + (10-OB) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCETAxRETURN RESIDENT DECEDENT ADMINISTRATNE COSTS E TATS OF FILE NUMBER Ma Louise Robbins 21-09-0071 Debts of decedent must be re orted on Schedule I. ITEM UMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Carlisle Memorial Service, Grave Stone 395 ' 2. Ewing Brothers Funeral Home g,032 ~I 3. Steven Ewing, concrete slab for cemetary lot 250 4. Funeral reception 401 5. B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Gail L. Cohick Street Address 1005 Sheaffer Road city Elizabethtown State PA zip ~ Year(s) Commission Paid: 2009 14,000 ~ 2. Attorney Fees 14,000 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 426 5. Accountant's Fees 6. Tax Return Preparer's Fees 175 7. Expenses in connection with peal estate sold, see attached itemization 3,906 8. Executor expenses of travel, long distance, see attached itemization 973 9. Final medical expenses, see attached itemization 3,041 TOTAL Also enter on line 9, Reca itulation S 46,599 (If more space is needed, insert additional sheets of the same size) REV-1512 FJC+ (12-08) Pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN RESIDENT DECEDENT MORTGAGE LIABILITIES ~ LIEiVS STATE OF FILE NUMBER a Louise Robbins 21-09-0071 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 1 `'~ . Sallie.Mae Loan 1-~01 in name of Stephen W. Robbins, Mary Louise Robbins co-signer 9,949 ~~ I ~, 2. Sallie Mae Loan 1-~03 in name of Stephen W. Robbins, Mary Louise Robbins co-signer 12,487 TOTAL (Also enter on Line 10, Recapitulation) If more space is needed, insert additional sheets of the same size. 22,436 REV-1513 EX+ (11-OB) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ES ATE OF FILE NUMBER M Louise Robbins 21-09-0071 RELATIONSHIP TC DECEDENT AMOUNT OR SHARE N MBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Llat Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 2118 (a) (1.2).] 1. Gail L. Cohick, 1005 Sheaffer Road, Elizabethtown, PA Daughter 50% 2. William C. Robbins, 1055 Lincoln Heights Ave., Ephrata, PA Son 50% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THR OUGH 18 OF REV-1500 COVER S HEET, AS APPROPRIATE. II. NON-TAXABLE-DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 2113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARRABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500. COVER SHEET. S 0 If more space is needed, insert additional sheets of the same size. Executor Out-of-Pocket Expenses 2/6/09, cash for miscellaneous 200 Incidentals, cleaning supplies, office supplies, etc. 472 Telephone expenses 301 Mileage Expenses related to real estate sold: Settlement costs from HUD-1 settlement statement 2,350 Carlisle Borough, water and sewer bill 62 Edgar Poe, snow removal 25 S. W. Barrett, real estate appraisal 325 UGI 547 PPL 77 PPL 20 UGI 125 Embarq 2g UGI 313. Embarq 33 Total real estate expenses 3.906 HUD - 1 UNIFORM SETTLEMENT STATEMENT OMB Approval No. 2502-0265 A. U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SETTLEMENT STATEMENT B. TYPE GF LOAN 6. File Number: 7. Loan Number: FmHA FHA 2 1 2009-7 . . 3. Conv. Unins. 4. VA 5. Conv. Ins. 8. Mortgage Insurance 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 shoHm. Items marked "(p.o.c.)" we paid outside the closing; they are shown here for informational purposes and are not included in the totals. NOTE: TIN =Tax aver's Identification Number D. NAME AND ADDRESS OF BORROWER: E. NAME, ADDRESS AND TIN OF SELLER: F. NAME AND ADDRESS OF LENDER: Sc tt Hench Gail L. Cohick,Executrix for None Mary Louise Robbins Estate 25 1 Sheaffer Road 52 E. Ridge Street Ca lisle, Pa 17013 Carlisle, , PA 17013 G. PROPERTY LOCATION: H. SETTLEMENT AGENT NAME, ADDRESS AND TIN 52 E. Ridge Street Jaqueline M. Verney, Esquire Ca PA 17013 lisle 44 South Hancver Street Carlisle PA 17013 , PLACE OF SETTLEMENT I. SETTLEMENT DATE 44 South Hanover Street 03/19/2009 Carlisle Pa. 17013 J. SUMMARY OF BORROWER'S TRANSACTION K SUMMARY OF S LLER'S TRANSACTION 1 10 .GROSS AMOUNT DUE FROM BORROWER: . Contract sales rice 14 2 0 0 0. 0 0 400. GROSS AMOUNT DUE TO SELLER: 401. Contract sales rice 14 2 0 0 0. 0 0 ]0 . Personal ro 402. Personal ro e ] 0 . Settlement char es to borrower Line 1400 2 0 92.0 0 403. 1 404. 10 . 405. Ad'ustments for items aid seller in advance Ad'ustments for items aid by seller in advance 10 ]0 . Ci flown taxes . Coun taxes 03 19 2009-12 31 2009 693.46 406. Ci /town taxes 407. Coun taxes 03/19/2009-12/31 2009 693.48 10 . Assessments 408. Assessments 10 . 409. lt .School Tax. 03/19/09-06 30 09 569.67 410. School Tax 03/19/09-06 30/09 569.67 11 411. 11 412. 12 .GROSS AMOUNT DUE FROM BORROWER 14 5 355.15 420. GROSS AMOUNT DUE TO SELLER 14 3 2 63.15 20 . AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER: 20 . De sit or earnest mon 1 ~ 0 0 . U 0 501. Excess de osit 20 . Princi I amount of new loans 502. Settlement chazees to seller ine 1400 2 3 5 0 . 3 7 20 . Existin loans taken subject to 503. Existin loans taken subject to 2 504. Pavoff of first mortQ a loan 20 SOS. Pavoff of second mortsa¢e loan 20 . 506. 20 . 507. 20 . 508. 20 . 509. Ad'ustments for items un aid b seller Ad'ustments for items un aid b seller 21 . Ci hown taxes 510. Ci /town taxes 21 .Coun taxes 511. Coun taxes 21 .Assessments 512. Assessments 21 513. 21 514. 21 515. 21 516. 21 517. 21 518. 21 519. 22 . TOTAL PAID BY/FOR BORROWER 1 0 0 0. 0 0 520. TOTAL REDUCTION AMOUNT DUE SELLER 2 3 5 0. 3 7 3 .CASH AT SETTLEMENT FROMfI'O BORROWER 600. CASH AT SETTLEMENT FROMlI'O S LLER 30 . Gross amount due from borrower Line 120 14 5 3 5 5 . ? 5 601. Gross amount due to seller Line 420 14 3 2 6 3.15 30 . Less amount id by/for borrower Line 220 1 0 0 0. 0 0 602. Less reduction in amount due seller Line 520 2 3 5 0.3 7 30 .CASH FROM BORROWER 144 355.15 603. CASH TO SELLER 140 912.78 SELLER'S STATEMENT information contained in Blocks E, G, H, and I and on line 401 (or, if line 401 is asterisked, line 403 and 404) is important tax information and is being furnished to the In rnal Revenuc Service (sce Seller Certification). If you are required to file a return, a negligence penalty or other sanction will be imposed on you if this item is required to reported and the IRS determines that it has not been reported. You are required to provide the Settlement Agent with your correct taxpayer identification number. If you do not provide the Settlement Agent with your correct taxpayer identification number, you may be subject to civil or criminal penalties imposed bylaw. Under penalties of pe 'ury, I certify that the number shown on this statement is my correct taxpayer identifibation number. Signature) Gail L. ck,Executrix for (Seller's Signature) Mary Louise Robbins Estate ®EASY SOFT, Inc. 2001 Previous editions aze obsolete Page 1 form HUD-1 (3/86) ref Handbook 4305.2 r L. SETTLEMENT CHARGES 700 TOTAL SALES/BROKER'S COMMISSION based on rice $ 142 000.00 @ PAID FROM PA]D FROM Divis~on of Commission (line 700) as follows: BORROWER'S SELLER'S 701 $ FUNDS AT FUNDS AT 702' $ SETTLEMENT SETTLEMENT 703' Commission aid at Settlement 704 800 ITEMS PAYABLE IN CONNECTION WITH L0.4N SO] Loan Ori ination Fee 802 Loan Discount S03 A sisal Fee to 804 Credit re rt to 805 Lender's Ins ection Fee 806 807 808 809 810 811 81 813 . 90 ITEMS RE UIRED BY LENDER TO BE PAID IN ADVANCE 901 . Interest from 90 . Mort aee Insurance Premium for 90 . Hazard insurance Premium'for 90 . 90 . ]0 .RESERVES DEPOSITED WITH LENDER 10 1. Hazard insurance ] 0 2. Mortease insurance 10 3.Ci Pro a Taxes 10 4. Coun Pro a Taxes 10 5. Annual assessments 10 6. 10 7. 10 8. A eeate Accountine Ad'ustment 11 0. TITLE CHARGES 11 1. Settlement orclosinefeeto Jac ueline M. Verne ES uire 500.00 11 2. Abstract or title search to Coon & Com an 123.50 11 3. Title Examination to 11 .Title insurance binder to 11 5. Document re ration to 11 6. No fees to t 1 7. Attorn 's fees to Robert Fre Es uire POC /includes line numbers: Deed & Estate Documents 1 ] 8. Title Insurance to 1 includes line numbers: 11 9. Lender's coveraee $ 11 O.Owner's coveraee $ 14 2 0 0 0. 0 0 11 L I 1 2. 11 3. 12 0. GOVERNMENT RECORDING AND TRANSFER CHARGES 12 1. Recordin fees: Deed $ 4 8. 5 0 Mort a e $ Release $ 4 8 . 5 0 12 2. Ci /cn taxlstam s: Deed $ 1 4 2 0. 0 0 Mortease W 4 2 0. 0 0 12 3. State tax/stam s: Deed $ 1 4 2 0. 0 0 Mortease $ 1 4 2 0. 0 0 12 12 5. 13 0. ADDITIONAL SETTLEMENT CHARGES 13 1. Surve to 13 2. Pest ins ection to 13 3. 13 13 5. Carlisle Boro Final water sewer Acct 11533 - 48.42 13 .Carlisle Boro 2009 CO Tw taxes ! 881.95 14 0. TOTAL SETTLEMENT CHARGES enter on lines 103 Section J and 502, Section K ./.% 2 . ~0 0 2 3 5 0. 3 7 ON: I have carefully reviewed the HUll-1 Settlement Statement ana to me oesr or my rnow~eage ana ~~h n is a uuc anu~wa,c a,a,cmcm ~, au ,cw,Fna auu made on m~y `ac(counJt~or b(y m~e~in this transaction. I further certify that I received a copy of the fLBettlement Stateme~it. 7 zC -°~';~'-' Gail L. Cohick Borrows Scow :Wench ller Mary Louise Robbins Estate Borrower HUD-1 Settlement Statement which I have prepared is a true and accurate account of the funds disbursed or to be disbursed by the undersigned as part of the settlement of transaction. 03/19/2009 ttlem pAgent Jacqueline M. Ver y, Esquire Date ~J : It is a crime to laowingiy make false statements to the United States on this or any other similar form. Penalties upon conviction can include a fine and it-yprisonment. For details see: Title 1S U.S. Code Section 1001 and Section 1010. m EASY SOFT, Inc. 2001 Previous editions are obsolete Page 2 form HUD-I (3/S6) ref Handbook 4305.2 I L R ~'f~ LE~ 499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12 Frey & Tiley Attorneys At Law 9 South Hanover Street Carlisle, Pennsylvania 17013 Re: Estate of May Louise Robbins Social Security: 198-20-6500 Date of Death: January 18, 2009 r Phone (888)502-4349 Fax (302) 934-2955 February 13, 2009 Dear Sir or Madam: Per your inquiry dated February 9, 2009, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: 1. Type of Account CheckingAccount Account Number 976601 Ownership (Names o~ Mary L Robbins Opening Date 12/7/81 Closed 1/22/09 Balance on Date of Death $ 2,24.1.37 Accrued Interest $ 0.03 Total $ 2,245.40 2. Type ofAccount CheckingAccount Account Number 9845712869 Ownership (Names o~ MaryL Robbins* Opening Date 12/24/08 Closed 1/23/09 Balance on Date of Death $ 3, 732.20 Accrued Interest $ 0.12 Total $ 3.732.32 -------------------------------------------- 3. TypeofAccount Savings Account Account Number 15004216209137 Ownership (Names o~ Mary L Robbins* Opening Date 8/20/08 Closed 1/22/09 Balance on Date of Death $11,524.53 Accrued Interest $ 4.93 Total $11,529.46 4. Type of Account Cert~cate ofDeposit Account Number 31003915939424 Ownership (Names o~ Mary L Robbins* Opening Date 9/6/05 Closed 1/22/09 Balance on Date of Death $ 7,512.55 Accrued Interest $ 66.89 Total _-_----__-_----------------------~---------- $ 7,579.44 --------~-- Please be advised, there was no safe deposit box found for the above decedent * 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. For any additional information on the above accounts, including ownership and any changes, closures and/or reimbursement of funds, etc., please contact our Spring Garden Office # 717-24(W525. Sincerely, Q ~~ ~ ~N 1..5!.._ Tracie Hare Adjustment Services 2005 Chevrolet Malibu -Private Party Pricing Report -Official Kelley Blue Book Site ~~~ ~~ue Bad THE TRIITTEI3 RESO[JRCE _~.._...... -_ _ Eitit.ca~ .... advertisement 005 ~hevr©Bet t~a6ibu Sedec>I 4D ~1.C1E ~COK~ PRI1dA~E PARiY VAI~lE ~OPIC~1$1011 G©©d (Selected) ehicle Highlights ileage: 17,000 ngine: 4-Cyl. 2.2 Liter ransmission: Automatic rivetrain: FWD elected Eciu~pment. tandard it Conditioning Power Door Locks ower Steering Tilt Wheel ower Windows AM/FM Stereo Single Compact- Disc Dual Front Air Bags Power Seat Brae avvrc rr~vc~~e rar>:y vaoeae ivate Party Value is what a buyer can expect to pay when buying a used car from private party. The Private Party Value assumes the vehicle is sold "As Is" and rries no warranty (other than the continuing factory warranty). The final sale ice may vary depending on the vehicle's actual condition and local market nditions. This value may also be used to derive Fair Market Value for insurance ~d vehicle donation purposes. µ_ :hicle Condition Ratings .., .__ _. _..__._...._..____..__...,....._._._.~....~„-._-,__.___.._~_.._ ExceLle~rot r......-.,.,. _~ a...~:~~.;..:~ $7,70 • Looks new, is in excellent mechanical condition and needs no reconditioning. 1/29/09 5:14 PM it-s Send to Printer advertisement f Inge 1A/;nrln... http://uvww.kbb.com/KBB/UsedCars/PricingReport.aspx?Yearld=2005&Mi...tionHistory=256%7c29905%7c17013%7c0%7c0%7c&Action=&Printable=true Page 1 of 2 M&T Securities, Inc. 285 Delaware Avenue, Suite 2000, Buffalo, NY 14202-1885 February 3, 2009 Date of death valuation For Mary Lou Robbins Account # AZD304475 Date of death 1/18/09 Description of Security Shares Valuation date 1/16/09 Price per share MTB Money Market 7452.12 $1.00 Alliant Energy Corp 300 $27.87 Bon Ton Stores Inc 100 $1.41 FNB Corp PA Com 527. $8.89 Fifth Third Bancorp 266 $5:43 . First Commonwealth Financial Corp 4943 ~ $10.07 M&T' Bank Corp 398 $39.93 Mylan Inc Corp 2125 $11.00 US Gold Corp New 30 $1.13 Anthracite Cap Inc Com 355 $2.05 Van d 500 Index Fund Investor 105.216 $78.30 We have received the information presented above from sources, which we believe to be accurate. However, we do not guarantee their accuracy. The price per share an valuation date is the closing price on that date. , Please contact Client Solutions with any further questions, or if we may be of further assistance to you at 1-800-724-7788, Option #l. Thank you. Sincerely, ~~ ~~ Robin Brown Brokerage Investment Specialist M&T Securities, Inc. - Investment and Insurance Products: • Are NOT Deposits • Are NOT FDIC-Insured • Are NOT Insured By Any Federal Government Agency • Have NO Bank Guarantee • May Go Down In Value M&T Irnestment.Group•• is a-service mark of M&T Bank Corporation and consists of M&T Securities, Inc., the investment-related areas of M&T Bank and investment advisory firms MTB Investment Advisors, Inc., and Zirkin-Cutler Investments, Inc. Brokerage services and insurance products are offered by M&T Securities, Inc. (member FINRAlSIPCI, not by M&T Bank. M&T Securities, Inc. is licensed as an insurence agent and acts as agent for insurers. Insurance policies are obligations of the insurers that issue the policies. Insurance products may not be available in all states. M~'~' ~~~r~s~~~~.~ ~~GUp M&T Securities, Inc. 285 Delaware Avenue, Suite 2000, Buffalo, NY 14202-1685 February 3, 2009 Date of death valuation For Mary Lou Robbins Account # AZD304475 Date of death 1/18/09 Description of Security Shares ~ Valuation date 1/16/09 Price per share MTB Money Market 7452.12 $1.00 Alliant Energy Corp 300 $27.87 Bon Ton Stores Inc 100 $1.41 FNB Corp PA Com 527. $8.89 Fifth Third Bancorp ~ 266 $5.43. ~. First Commonwealth Financial Corp 4943 $10.07 M&T Bank Corp 398 $39.93 Mylan Inc Corp 2125 $11.00 US Gold Corp New 30 $1.13 Anthracite Cap Inc Com 355 $2.05 Van d 500 Index Fund Investor 105.216 $78.30 We have received the information presented above from sources, which we believe to be accurate. However, we do not guarantee their accuracy. The price per share on valuation date is the closing price on that date. Please contact Client Solutions with any further questions, or if we may be of further assistance to you at 1-800-724-7788, Option #1. Thank you. Sincerely, L~ ~~ Robin Brown Brokerage Investment Specialist M&T Securities, Inc. Investment and Insurance Products: • Are NOT Deposfts • Are NOT FDIC-Insured • Are NOT Insured By Any Federal Government Agency • Have NO Bank Guarantee • May Go Down In Value I~&T Investment Group" is a service mark of M&T Bank Corporation and consists of MixT Securities, Inc., the investment-related areas of M&T Bank and • . investment advisory firms MTB Investment Advisors, Inc., and Zirlcin-Cutler Investments, Inc. Brokerage services and insurance products are offered by M&T Securities, Inc. (member FINRA/SIPCj, not by M&T Bank. M&T Securfties, Inc. is licensed as an insurance ayent and acts as agent for insurers. insurance policies are obligations of the insurers that issue the policies. Insurance products may not be available in all states. l~~:T ~~~r~s~~~~ ~~~ M&T Securities, Inc. 285 Delaware Avenue, Suite 2000, Buffalo, NY 14202-1885 February 3, 2009 Date of death valuation For Mary Lou Robbins Account # AZE015930 Date of death 1/18/09 Description of Security Shares Valuation date U16/09 Price per share . MFS Total Return A 1334.264 ~' $11.04 We have received the information presented above from sources, which we believe to be accurate. However, we do not guarantee their accuracy. The price per share on valuation date is the closing price on that date. Please contact Client Solutions with any further questions, or if we may be of further assistance to you at 1-800-724-7788, Option #1. Thank you. Sincerely, /~. Robin Brown Brokerage Investment Specialist M&T Securities, Inc. Investment and Insurance Products: • Are NOT Deposits • Are NOT FDIC-Insured • Are NOT Insured By Any Federal Government Agency • Have NO Bank Guarantee • May Go Down In Value M&T Investment Group"' is a service mark of M&T Bank Corporation and consists of M8T Securities, Inc., the investment-related areas of M&T Bank and investment advisory firms MTB Investment Advisors, Inc., and Zirkin-Cutler Investments, Inc. Brokerage services and insurance products are offered by M&T Securities, Inc. (member FINRA/SIPC), not by M&T Bank. M&T Securities, Inc. is licensed as an insurance agent and acts as agent for insurers. Insurance policies are obligations of the insurers that issue the policies. Insurance products may not be available in all states. 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Gyrgf:7;?~ry . _.. ffaL~ a C.;.r rryoq;9 Billing summary > Billing arouo 1-Ui > Loan number 1-G1 > 10 day oavaff to day a~yo~: ~.~~~ ~-tai Page 1 of I FFQ j res:em=-sir ; ": ~ r_ ~~<y con`ar_t !n`ermation i ! _ :.~~ nnn r~a~?f Q+Sfiry:~~ ?negr~n~o C_ y}~_nrc ~~ Logs dhdte5or upromt~~~,~n LlnksK- Loan Repayment service UPromise~Rj is helping borrowers with sallk Mae- serviced loans pay down tfieir student loans! Leam more and;~oin todavl . Your I~St.paY.menx was .: ,, .:... ..: _ „~ :~ +`. i ~„ ,.. . pasted on 11/17/2009. . _ a ,: _ .. _ . • May r~ dift~culty a in4~ ~: US'~aR't C92!.a/TrgPnF q}!~n .'1.Q CI3li nav~€~ - Pay a little now, cave a Your current payment plan is: Standard/Level F~ayo?P amour 9,949.46 ~ [alert View d>~.e.~~axm_er~;;~h~~e~ Payo4F due dam: 1216/2009 If You Choose to make payments on your loan Account number. 98361fi6177 : before Your repayment period begins, you tan decrease the amount you'll PaY over the Ilfe of your' loan. Vtsit the 'Make a _ Payment' tab to make a payment todayt 6 -- i 1.~+err~. f. L+p.~. _.. ._.. ...... ,, Yor(Sign \ Snrsred 1 Prlvacv oo lcv ~ Disdalm~r ~ Terms of services ... ~ ~ Q~2~5 _20Q~Salli Mae Afl rights re~nigd. About SSL Certificates SLWI Corporation and iLS subsidiarks are not'sponsored by or apenaes of the United Staf$s of America. hags://Rrww.maIIageya~Ic><a.~.s.ec~r~/1`vfYI, 12/6/2009 ~.'" >~ _ _ _ _. ~a_tt~e t~2ae t~~a~age Your Moans - 1(? day g~.yof~ ~-~- ~~~~ .. '~° ~~s ~ ~ ~ ~ _ , ~ 'r r ~ ,„7~ ~ ' a - ` 1 J f { d J C l f f - . . , .~ AcCpll(tt S!~Ri n^,.r n; Fif (i:eC 51~!'1'I Rt&R ffi~I:F p Gnurytpnt Fiilinn cumm~ru ~ Rillinn nrnun ~_f11 ~ Inan numhar 7-f1~ ~. 7n riav navn`'F f0 day ~ay~€f: l.aan 1-~3 I Fage 1 of 1. ,•i~~ :ortacL Ii tiO~f@LIOn ; L~~ :ut ~ Ran~vresar•;f ',}^74i(~nC Fng+nnnF P •=~:cnte Loam f~CYi~~r ® ~loromise Limn Link- Loan Repayfnllnt Ser~Ace llpromise(R) is helping borrowers with Sallie Mae- servioed bans pay down their student loans! Learn ri1,QC2~n join today! _ - Your last. payment was p w ~~~ ~ Fes,: ~ i' t~ f e ~ ~ ~- ~ posted On 33,/17/2009. ~ • liaeina digf~Utty_p~yfnSbZ ~~srrez?` n=umen$ *~ian 341 d2Y *sea~`f Pay s I3tIHe now, save a Your current payment plan is: Standard/~~" Payo4E am©unt: 12,487.14 ~ ~~ View detailed Rayment schedule. PayofF due date: i2Ji6/2009 +} If you choose to make ~rn~ on your ban Account numiber: 9836166177 `~- before year repayment . "• period begins, you can •- decrease the amount you'll pay Over the I1t1C iJf your loan. Visit the 'Make a Payment' tab to make a . paymerrt today! 'a :. ~~~_ 1 ~x ,- ~` YvrlSign ~I 9scbrnd~~ Priv~c~r Qol~ ~ DI£daimer (Terms of service _. ~ coo - X009 Sallie Mae Ail rights reserved. About SSL ^arttr,.~+e~ SLAM Corporation and its subsidiaries are not sponsored by or agencies of the United States of America. hags://.ma~ageyat>:ridaas.rc~~/h~'L 1 X6/2009 ~~f ~ '