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HomeMy WebLinkAbout07-09-10 15056051047 -'' REV-1500 ~ (~, ~ ~ ReVerMlB OFFICUIL USE ONLY ` PoeOx 28061 T INHERITANCE TAX RETURN Code Y~r Fie ~~ tietiear~. g- u~2e-Deal _ RESIDENT DECEDENT 2_ 9 1 3 9 Oahe of Biritt r ~ ~ ~ Y X Y ~ Decedent's First Nam MI >r E L I a° ° `'O°"'df"° StANX SpOUSe's First Name MI e 's Socaai Security Number THIS RETURN MUST BE FILED IN DUPLICATE WI'frHl THE REGISTER OF WILLS FILL tN APPRQPR!ATE O~lA!_S BE! OW 1. Original Retum O 2. Supplemental Retum O 3. Remainden R~etum (date of death prior to 12-h3-82) O 4. Limited Estate O 4a- Future Interest Compromise (date of O 5. Federal Estate Tax Retum Required death aRer 12-12-82} ~ 6. Decedent Died Testate O 7. Decedent Mairdained a Living Trust ~ 8. Total Number of Safe Deposit Boxes (ANach SPY ~ ~+) (Atf~h Copy of Trust) O g_ L%t yatien Pr!Meeds Rived O tn_ Spous2! povert;~ r~-,t (~~ ~ dAa~ O 11. Election to ~at< under Sec. 9113(A) ket`~veen 12-31-91 and 1-1-95) (Attach Se.'. C~) CORRESPONDENT -TENS SECTION IIU.R'f SE COMPLETED. ALL CORRESPONDENCE AND CONFN)ENTiAL TAX INFORMIATION BE DIRECTED T0: Name Daytime Tale Number ~M. R~ I R M c A L B B :~ _~n, .~ ~ ~~ .. ~ ;,~, ' 1 ,~ 9'~ 1 7 7 7 0 Firm Name (if Appli~le) ~ . ,; ~ -~fl~ ~~; -~ ~~~~ ~: ~ ~:=~..~ RE ~~ INLLL.S iI~ILY ^ ;- © -. '. ,, .. - . ~ s--.- ~ . ~ „ - _ i _ - fir- .` .. .. F'rtst Nne of address M~A I N S T.cE,E .T ~ ~~ uD ter... = n ~ second tine of address ~ _ C~ ~' 'P~O~ B ..O;X ~ 2z3 0~ - ~ ~ ~ ~ ~~~ , , 'Jf,, as K:^ - ~, ..-,I4 F ~ ., .. N`I Or P03t ~ff1Ce .. ~ :. .+a.-max. ,,. n FY Frf ...~ •. stare zlP cone sod -_...,: ~ ... .~ - .....~ ! ~,. -. .~.: B .~, M EC li~,A.N~ I Cog, t ,: ... .. ~.. ~ U:II 'G~ ~P A• ~1 ~ 0 5~5 ~~ Correspondent's a-ttraA address: Under penalties of perjury, t declare that t stave examined this realm, irxAbirg aocompanykg sdredules and statements, and b the of my knowledge and belief, it is true. correct and canplete. Dedaratbrr of preparer other tt~t the personal represer~tive is based on ap irNom~ation d which tree any knowledge SI OF PERSON RE~~~t3LE FOR FILING RETURN ' DATE ~~ ~ '-~'~- --^~ Executor ~ ~, S' ~ AtjDRESS Donald C. flumes 18b Rgnhau$ Rg~d, Mechanicsburg, FA 17050 ADt~tr~SS ' /~ '~ .~ Mar in R. Iic a eb 2I9 East: Maud Street F.O. Box 230 Mechani~sbur FA 17055 PLEA'3E U3E ORfGlNAL FORM ONLY Side 1 r 1505605104? 1505605110!47 J _.._ 1505b052048 REV 1500 EX Decedent's ISocial Secxuity Number t~eoederrt's Name: Pear 1 I . Hines 1 7 1 "~ ~ 8 ~ ©` 9 6N 7 RECAPITULATION .,,. k ~ ~ ~ 1. Real estate (Schedule A) ............................................. 1 S S ~ 0' 0 , 0~` 0 ~ , . 2. Stocks and Borrds {Schedule B) ....................................... 2. ,~ r ~ ~ 0~ 0 3. CloseiY Held Corporation. Partnership or Sole-Proprietorship (Schedule C) ..... 3 ') ~ } 4. Mortgages 8~ Notes Receivable (Schedule D) ............................. 4. ;; __ ~ ~ s. 0~ 0 A 5. Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E} ........ 5 ! 3 .i ~ 1 ~ 6 5` 2 :, 6. Jo~tly Owned Properly (Schedule F O ~~ f Separate Bring Requested ....... 6. ~ ,~ ~ ~,~ -,;' 0 0 ~~ .< .,a 7. Inter-Vrvos Transfers $ Misc~ilaneous iV~-f'robete Property ~~" ~ . (Schedule G) O Separate B~Bng Requested........ 7 t `' 0~ 0 ~~-~ .~r:,~:.y~~~ri; .~.~a ~-~:~ ~, ~ , . g_~ 1 8~8-1 .6 5~2 B. Total Gross Assets (total lames 1-7} ................................... r 9. Funeral ~ ~ r ~ trative Costs Schedule H ..... . 10. Debts of Decedent, ( ) ~9 , Mortgage LrabiGties, & Liens Schedule 1 ................ 10. ~ a . 2 ' ~. ` 11. Total Deductions (total Lines 9 8 10} ....... . ........................... 11. ~ 3 2 .a ~ _o..,. 12. Net Value of Estate Line S minus Line 11 ........... .. 1 ............ 12. 13. Charitable and Governmental BequestslSec 9113 Trusts for which ~ s an election b tax has not been made (Schedule J) ........................ 13. ~ ~ air ' ' , 14. Net Value Subject to Tax {Line 12 minus Line 13} ................. ....... 14. TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLiCAt3LE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a}(1.2) X .0 0 15. 16. Amount of Line 14 tap~bie at Nneai rate X .0 ,_ 16. 17. Amount of Line 14 taxable at sling rate X .12 17, 18. Amount of Line 14 taxable at copateral rate X .15 1 g, 19. TAX DUE .........................................................19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 25056052048 150560$2048 .~ REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 -O9-01039 DECEDENTS NAME Pearl I. Humes STREET ADDRESS 1119 Baldwin Street CITY Mechanicsburg STATE PA ziP 17055 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 6,987.60 Total Credits (A + B + C) (2) 0.00 3. InteresUPenalty if applicable D: Interest E. Penalty Total InteresUPenalty (D + E ) 4. If Lined is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. 5. If Line 1 + Line 3 is greater than Line 2, enter the d'rfference. This is the TAX DUE. A. Enter the interest on the tax due. (3) 0.00 (4) I' 0.00 (5) 6 , 987.60 (5A) 0.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56) 6 , 987.60 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE. FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPR~J~RIATE BLOCKS 1. Did decedent make a transfer and: "fes 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 reversions interest: or ...................................................................................... ry .... ^ d. receive the romise for life of either payments, benefits or care? ............................................................... P ....... '^ ~] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................................... ....... 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 beneficary designation? .................................................................................................................. ...... ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND 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 is three (3) percent [72 P.S. §9116 (a) (1.1) (i)]. the use of the surviving spouse For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 P.S. §9116 (a) (1.1) (ii)). The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirjerhents 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 o~ flor 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-h$If (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. §911j6~a)(1.3)]: A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. ~ AS PART OF THE RETURN. REV-1502 EX + (1-9~ OF PENNSYLVANIA SCHEDULE A REAL ESTATE Pearl I. Humes SS~~ 171-28-0967 10/15/2009 21-09-01039 Ali 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 knowled of the relevant facts. Real property which is ointly-owned with ri ht of survivorship must be disclos n Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 House and lot,.- numbered as 1119 Baldwin Street, Borough of ' 155,000.00 Mechanicsburg, Cumberland County, PA. Value based on Agreemeni~ of Sale dated 10/05/2009 with Donald L. Lauver and Joanne P. Lauver, his wife. TOTAL (Also enter on line 1, Recapitulation); ~: 155 , 000.00 (If more space is needed, insert additional sheets of the same size) CopyNght (c)1996 form software only CPSystems, loc. ', Form RIrV-1502 ~ {Rev. 1-97) ---- -- _ _ _ --- _ ~ i REV-1506IX+(1-9'n SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Pearl I. Humes SS~~ 171-28-0967 10/15/2009 21-09-01039 Include the roceeds of litigation and the date the proceeds were received by the estate. All properly jointly-own4d'' with the right of survivorsh~ must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Citizens Bank, checking Acct. ~~6222611285, - principal balance as 1,189.02 of D.O.D.: $1,189.02 (no interest accrued to D.O.D.). 2 Citizens Bank, Checking Acct. ~~6213377941, - principal balance a of D.O.D.: $2,225.26 (no interest accrued to D.O.D.). 3 Citizens Bank, Checking Acct. ~~6100700178, - principal balance''I of D.O.D.: $19,857.85 (no interest accrued to D.O.D.). 4 Malpezzi Funeral Home, - pre-need funeral agreement. 5 Bankers Fidelity Life Ins. Co., - refund of unused insurance premium. 6 Donegal Insurance Group, - refund of homeowners insurance premium. 7 Lauver, Donald L. and Joanne P., - Co/Boro real estate tax pro-ration as of date of settlement. 8 Lauver, Donald L. and Joanne P., - School Dist. real estate tart pro-ration as of date of settlement. TOTAL (Also enter on line 5, F (If mare space is needed, insert additional sheets of the same size) Copyright (c)1996 form software only CPSystems, Inc. 2,225.26 19,857.85 8,523.30 108.35 190.00 79.44 996.30 ~) li 33 ,169.52 Form REV-1508 EX (Rev. t-9~ ~ ~_., REV-1511 EX+(1-9'n SCHEDULE H FUNERAL EXPENSES ~ ADMINISTRATIVE COSTS Pearl I. Humes SS~~ 171-28-0967 10/15/2009 21-09-01039 Debts of decedent must be reported on Schedule 1. ITEM NUMBER DESCRIPTION ' AMOUNT A. FUNERAL EXPENSES: 1 Gingrich Memorials, - inscribing gravemarker. 135.00 2 Hoss's Steak House, - funeral luncheon. 141.06 3 Malpezzi Funeral Home, - funeral service and burial. _.8,731.20 B. ADMINISTRATIVE COSTS: 1. Personal Represertative's Commissions ', 9 , 200.00 Name of Personal RepreseMative(s) Donald C. Humes Social Security Number(s) / EIN Number of Personal Representative(s) 204 - 26 - 9733 Stroet Address 186 Konhaus Road City Mechanicsburg State PA Zip 17050 Year(s) Commission Paid: 2. Attorney's Fees Law Offices-Marlin R. McCaleb 9.,300.00 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 Register of Wills ', 330.00 5. Accountant's Fees 6. Tax Retum Preparer's Fees 7. Other Administrative Costs 1 Citizens Bank, - service charge. 30.80 2 Clarke American, - printing checks. 43.95 3 Cumberland Law Journal, - advertising Letters. 75.00 4 Recorder of Deeds, - Realty Transfer Tax. on sale of house. ', 1,550.00 5 Register of Wills, - filing Inventory and Appraisement. 30.00 6 Robert Haring, - trash removal to clean house in preparation fdr 160.00 sale. Total of Continuation Schedule(s) 193.17 TOTAL (Also enter on line 9, Recapitul~ltior~ ~= 29, 920.18 (If more space is needed, insert additional sheets of the same size) i Copyright (c)1996 form software only CPSystams, Inc. I Form REV-1511 t:X (Rev. 1-97) __ - __ _... _T ~.... Estate of: Pearl I. Humes Soc Sec ~~: 171-28-0967 Date of Death: 10/15/2009 Continuation of Schedule H-B7 (Other Administrative Costs) Item Description ', Amount ~~ 7 The Patriot-News, - advertising Letters. 148.17 8 Vital Statistics, - certified copies of death certificates for 45.00 Francis Humes (Decedent's husband, who died on 07/15/06). 193.17 REV-1512 t7C s (1-9~ SCHEDULEI DEBTS OF DECE[~ENT, TGAGE LIABILITIES. AND LIENS Pearl I. Humes SS~~ 171-28-0967 10/15/2009 21-09-01039 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION ' AMOUNT 1 Alert Pharmacy Services, Inc., - account payable, medicines. ' 81.84 2 Chuck Bricker, - account payable, auctioneer's commission on public sale of personalty. 3 The Woods at Cedar Run, - account payable, room and lodging fort October 1-15, 2009. ' 4 United Water, - account payable, water service. 1,300.00 1,573.20 14.28 TOTAL (Also enter on line 10, Recapitulatia~n~ (t 2 , 969.32 (If more space is needed, insert additional sheets of the same size) Copyright (c)1996 form software ony CPSystems, Inc. Dorm REV-1512 EX (Rev. 1-97) --- I REV-1513 EX+(9-00) SCHEDULE) BENEFICIARIES ESTATE OF FILE NUMBER Pearl I. Humes SS~~ 171-28-0967 10/15/2009 21-09-01039 CATIONS O C AMO 0 SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEMNG PROPERTY Do Not List Trustees ' OF ESTATE I. TAXABLE DISTRIBUTIONS (irKhrde auMght spousal dlstributtons, and tnunfers under See. 9116(ax1.2)) 1 Shirley M. Edris Daughter ', 31.,056.00 16 Makenzee Drive Carlisle, PA 17015 2 Nancy I. Jones Daughter ' 31,056.00 417 Alison Avenue Mechanicsburg, PA 17055 3 Donald C. Humes Son 31,056.00 186 Konhaus Road Mechanicsburg, PA 17050 4 Richard E. .Humes Son 31,056.00 156 Texaco Road Mechanicsburg, PA 17050 5 Ronald A. Humes Grandson 10,352.01 412 Sharon Avenue Mechanicsburg, PA 17055 See attached Schedule J, continued ' ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18 AS APPROPRIATE' 0 EV 1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MAf)'E' 8. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHE ' S 0 .00 (If more space is needed, insert additional sheets of the same size) Copyright (e) 2000 form software only Tha Lackner Group, Inc. ~a~ REV-1513 EX (Rev. s-oo) ~_ ~ I Pearl I. Humes, Deceased Inheritance Tax Return Rev-1500 SCHEDULE J - continued I. Taxable Distributions Name• 6. Bradley Humes 14 Oakwood Avenue Mechanicsburg, PA 17055 7. Keith Humes 204 West Elmwood Avenue Mechanicsburg, PA 17055 Relationship: Grandson Grandson 'IAimt . or Share of Estate X10,352.01 ',10,352.00 ~~_ LAST WILL AND TESTAMENT OF PEARL I. HUMES I, PEARL I. HUMES, of the Borough of Mechanicsburg, County of Cumberland and State of Pennsylvania, being~lof sound and disposing mind, memory and understanding, do makel, publish and declare this my Last Wi11 and Testament. 1. I direct the payment of all my dust debts and funeral expenses as soon after my decease as the same can be '~,donveniently done . '~ 2. I give, devise and bequeath all the rest, reside and remainder of my estate, real, personal and mixed, whatsoever and wheresoever the same may be situated, to my husband,~~'rancis L. Humes, absolutely and unconditionally. 3• In the event that my husband, Francis L. Humes,!, should predecease me, or should he die at about the same ti~n~ as I do, such as in an accident common to both of us, then in'~~uch event, I give and bequeath my entire estate, of whatsoever ~~-ture and wheresoever the same may be situated, to my children, to wit, Shirley M. Edris, Donald C. Humes, Ronald L. Humes,~',N~ancy I. Jones and Richard E. Humes, share and share alike. 4• Should my said husband predecease me, or should he die at about the same time as I do, such as in a common disaste,r~,then, for the purpose of facilitating the settlement and distribut~~on of my estate, I authoriz®, empower and direct my Executrices, her~i~nafter named, to sell any and all real estate which I may own at tthe time of my decease, at either public."or priavate.sale or sales', as they at their sole discre~.ton may determine. LASTLY, I nominate, constitut® and appoint my ~u~aband, Francis L. Humes, Executor of (this my Last Will and Testame~ht,'end in the event that my said husband should predeQease me, or'~hould he be unable or unwihing to serve in such capacity for any reason, then in such event, I nominate, constitute and appoint'm~r two daughters, Shirley M. Edris and Nancy I. Jones, Co-executrices'of this my Last Will and Testament, in has place and stead. IN WITNESS WHEREOF, I have hereunto set my hand and seal this~~ day of December, A. D., 1975. ~'`.CA~iQ ~ ~' ~iu~rrR.~ ( SEAS, ) Pearl I. Humes Signed, sealed, published and declared by the wave named, Pearl I. Humes, as and for her Last Will and Testame#~t, in the presence of us, who have subscribed our names heretolas witnesses, at the request of said testatrix, in her presence and in the presence of each othe~ -~~ C O D I C I L I, PEARL I, HUMES, of the Borough of P~Iechanicsburg, County of Cumberland and State of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this the First Codicil to my Last Wi11 and Testament dated December 16, 1975• 1. I hereby amend the paragraph in my Last Will and ~eatament pertaining to the appointment of my personal representative, to read as .follows, to wit, "LASTLY, I nominate, constitute and appoint my husband, FRANCIS L. I3UMES, Executor of thisi my Last Will and Testament end in the event that my said husband should predecease me, or should he be unable or unwilling to serve in such capacity for any reason, then in such event, T nominate, constitute and appoint my son, DONALD C. HUMES and my daughter, NANCY I. J©NES, Co-Executors of this my Last Wi11 and testament, in his place and stead, and in all instant®s, I direct that my said personal representatives be excused from posting bond or other security for the faithful performanc® of their duties in any ~urisdietion." 2. T hereby ratify and confirm my Last Will and Testament -1- dated December 16, 1975 in all other respects avid to all intents and purposes not inconsistent herewith. ', TN WITNE I' SS WHEREOF, I have hereunto set my ha~id and seal this sS._(~__.. day of May, A. D., 1898. II' ~-~~ z of -yn,ca s EAL) Pearl I. Humes ~~ Signed, sealed, published and declared by thel,above named, PEARL I. HUMES, as and for the First Codicil to her Last Will and Testament, dated December 16, 197,5, in tY~e~ presence of us, who have subscribed our names hereto as witnesses, at the request of said testatrix, in her presence and in lithe presence of each other. -2- AaRl3E'MENT OF SALE THIS AGREEMENT is entered into this 5th day 2009, by and between PEARL I. HUMES, by and throi: Donald C. Humes, pursuant to Power of Attorney d 3, 2003, and recorded in the Office of the Record Cumberland County, Pennsylvania, on September 23, Instrument No. 200932964, hereinafter called SELI sin lar or plural) and 1~1,~'.t~.4G~ ~, G~u~-.4 7~ ~~l/1~6~ hereinafter cal (whether singular or plural). October, her Agent, d November of Deeds of 009, as (whether IT IS MUTUALLY AGREED AS FOLLOWS: 1. The SELLER agrees to sell, grant and co~v~e'y to the PURCHASER, and the PURCHASER agree to purchase a#~d~~accept the conveyance of the following described real estate: ALL .that certain tract of land with ig~r~pvements thereon erected, situate in the Borou ~~f Mechanicsburg, Cumberland County, Penn>'~ylvania, being known and numbered as 1119 Baldwin Str~e ', as more particularly shown in the Legal Descrig~tlion attached hereto. LAW OFFICES MARLIN R. McCALE6 2 . The PURCHASER agrees to pay the sum of ' ~~'S;'c~p o vd to the SELLER as the full purchase price and con>~i~le a ion for said premises, payable. as follows: $ /Q~do-yf4c~ '~, upon the execution and delivery of this Agreement, the re-~e~'-t of which is hereby acknowledged, which amount will be held ,in escrow in a noninterest-bearing IOLTA account by the SELLER'S attorney, Marlin R. McCaleb, Esquire, pending final settlerhe~it; and $ ~'P~laDo• 60 the balance of the purchase p~ce, in cash at settlement of this transaction as scheduled a~d'~,provided hereinbelow. 3. This sale includes the following items: 11 drapes, curtains and curtain rods; the electric range, mic~owave and ceiling fan in the kitchen; and the attic fan. 4. Final settlement of this transaction shall be made at the Law Offices of Marlin R. McCaleb, Esquire, 2L9 fast Main Street, Mechanicsburg, Pennsylvania and shall be m~~e on or before December 1, 2009, time being of the essendelhereof. At final settlement, SELLER shall tender to PURCHASER ~ properly drawn and executed deed of special warranty convdy ~g to the PURCHASER a good and marketable title in fee simpl ~ clear of all encumbrances except easements or building and ~i~e restrictions, visible on the ground or of prior re~drd. 5. All real estate taxes for the current y~a~ shall be SCHEDULE A.1 i i__ prorated .between the parties as of the date of final settlement (County and Borough or Township taxes on a Januaryr 1st to December 31st basis, and School District taxes on ~ July 1st to June 30th basis). Pennsylvania Realty Transfer T~ac and any other sale or transfer taxes shall be paid equalllylby SELLER and PURCHASER. 6. SELLER shall deliver possession of the skid premises to PURCHASER at the time of final settlement. 7. SELLER assumes the risk of loss by fire ~~ other casualty until transfer of title and agrees that lie property shall remain in substantially its present conditi~r~ until the date of settlement, reasonable wear and tear exc,eptzed, and if it is not, PURCHASER may rescind this Agreement. ' 8. The property is being sold "as is" and ~SE~I~LER makes no ,representation or warranty, express or implied, a ',to the condition or fitness of any structure or part thie Hof, nor as to the condition, fitness or operability of the ~ ~mbing, heating, electrical, water supply and sewage dispd~al systems. 9. .Should PURCHASER fail to make settlement!i~s herein provided, then the amount paid down as hand money,!,',as set forth in Paragraph 2, above, may, at SELLER'S option, b~,',retained by SELLER as liquidated .damages or applied by Seller 'ia~gainst actual loss. Should SELLER fail or refuse to conviefy as herein provided, then the hand money paid as set forth in, Paragraph 2, above, shall be returned to PURCHASER. '' LAW OFFICES MARLIN R. McCALE6 FOR the performance of this Agreement and i~t~~iding to be legally bound hereby, the parties bind themselve~,,their heirs, personal representatives, successors and assigns, ~~ their hands and seals the day and year first written abolv~. Witnessed by: _(/~ (SEAL ) Pearl umes~; Seller ~,1 . ! .CycaOJ~f . L~/,,.~ ( SEAL ) Donald C . Hu~~e~k~ Agent , pursuant to Pow r of Attorney dated ~ovember 3, 2003, and reco fed in the Office of the corder of Deeds of Cumbe 7~and County, Pennsylvania, ~~ September 23, 2009, as Ir~~trument No. 200932964. -2- SCHEDULE .A.1 (SEAL) Purchaser SEAL ) Purchaser (SEAL) Purchaser ~,, ' (SEAL). Purchaser LAW OFFICES MARLIN R. McCALEB -3- SCHEDULE A.1 LEGAL DESCRIPTION LAW OFFICES MARLIN R. McCALE6 ALL that certain tract or lot of land situat in the Borough of Mechanicsburg, ,Cumberland County, Peran~~rlvania, more particularly bounded and described as follows, to ~lvit: BEGINNING at a point on the north side of Ba at the dividing line between lots Nos. 34 and 35 lots referred to hereinafter and which said point is also referenced South 66 degrees 43 minutes We of four hundred twenty-three and seventy-five hwn (423.75) feet measured along the north side of Ba from its intersection with the west side of Apple along the north side of Baldwin Street South 66 d~ minutes West, a distance of seventy-five (75) fe~e~ thence along the dividing line between Lots Nos.'.: said plan, North 21 degrees 13 minutes West, a di; hundred forty (140) feet to a point; thence along now or formerly or Orchard Crest, Inc., North 66''~c minutes East, a distance of seventy-five (75) feet thence along the dividing line between Lots Nos. said plan South 21 degrees 13 minutes East, a diet hundred forty (140) feet to a point, the place o c~win Street the plan of df beginning ~, a distance ~tedths c~win Street grive; thence gees 43 to a point; 3' and 3 4 on t!ance of one either lands ~'grees 43 'to a point; ~~ and 35 on ~~ce of one 3~GINNING. BEING Lot No. 34 on the Plan of Section 102 0~ Orchard Crest, Inc., said plan being recorded in the Cumbe Viand County Recorder's office in Plan Book 15, Page 10. ' HAVING THEREON ERECTED a one-story brick ramc type dwelling house with attached carport, being~knowM and numbered as 1119 Baldwin Street. BEING the same premises which Melvin C. Chron~~ster and Ethel L. Chronister, his wife, by their deed dated Larch 11, 1966, and recorded in the Office of the Recorder'o~ Deeds of Cumberland County, Pennsylvania, in Deed Book "X'",I~iolume 21, Page 1165, granted and conveyed unto Francis L. I#u es and Pearl I. Humes, his wife. The said Francis L. Humes dive on July 15, 2006, survived by his wife, the said Pearl I. Humje ,, the SELLER herein, in whom title to the said premises vested k}solutely and in fee simple as surviving tenant by the entixe~t~ies. UNDER and SUBJECT to building and use restri~ci~!ions required in Miscellaneous Book 166, Page 948, Cumberland County records. -4- SCHEDULE A.i . ' ~I#i~~ns B~nk~ November 30, 2009 MARLIN R MCCALEB FRANKEBERGER PLACE 219 EAST-MAIN STREET MECHANICSBURG PA 17055-3935 Estate of PEARL I HUMES Date of Death: Oct 15, 2009 SSN: 171-28=0967 Dear Sir/Madam: 525 William Penn Place Suite 153-2618 Pittsburgh, PA 15219 In accordance with your request, the attached information sheet has been provided in the move decedent's name as of his/her date of death. For IL or LC accoucrts, contact our Loan Department at 1-800-708-6680. For all other inquiries, please call T-888-999-6884 Sincerely, Ann Rhodes Operations Services SCHEDULE 'E.1,2&3 Citi~+~~s ~artk. Account Number 6222611285 Account Title PEARL I HUMES Date ~ 8/29/2008 Account T Checkin Princi al Balance as of DOD $1189:02 Interest from Last Postin to DOD $ ,00 Account Balance as of _DOD $1189.02 YTD Interest to DOD $24.43 SCHEDULE ~E.1,2&3 I - ~ i ; ~_ Citi~e~s Bank- Account Number 6213377941 Account Title PEARL I HiJMES i Date ~ 2/2/2006 Account T Chec . Princi ai Balance as of DOD $2225.26 Interest from Last Po to DOD $ .00 Account Balance:as of DOA $2225.26 YTD Interest to DOD $2.87 SCHEDULE E.1,2&3 ~it~ens ~ank- Account Number. 61'00700178 ' Account Title ~ FRANCIS L HLTMES OR PEARL I' S Date ned 6/6/1966 Account T Checlcin ' Princi al Balance as of DOD $19857.85 Interest from Last Postin to DOD $ .00 Account Balance as of DOD $19857.85 ' YT`D Interest to DOD $35.09 SCHEDULE~E.1,2&3 T Malpe.ZZi Funeral Home November 12, 2009 ~ + Donald C. Humes ~ '~ 186 Konhaus Road - ~~ ~;~ Mechanicsburg, PA 17050 X ~~ The Funeral Service for Pearl Irene Humes We sincerely appreciate the confidence you have placed in us and will continue to assist you in ~le~rery way we can. Please feel free to contact us if you have any questions in regard to this statement. ', THE FOLLOWING IS AN ITEMIZED STATEMENT OF THE SERVICES, FACILITIES, AUTOMOTIVE EQUIP~NT, AND MERCHANDISE THAT YOU SELECTED WHEN MAKING THE FUNERAL ARRANGEMENTS. 1. PROFESSIONAL SERVICES Services of Funeral Director/Staff . 54275.00 ~ FUNERAL HOME SERVICE CHARGES 54275.00 SELECTED MERCHANDISE: 18 Gauge Stcel Caskct 52395.00 Sentinel Vault. 51335.00 ~, Register Package . 585.00 ' THE COST OF OUR SERVICES, EQUIPMENT, AND MERCHANDLSE ', THAT YOU HAVE SELECTED ... .. 58090.00 AT THE TIME FUNERAL ARRANGEMENTS WERE MADE, WE AI?VANCED CERTAIN PAYIVIENTS TO OTHERS AS AN ACCOMMODATION. THE FOLLOWING IS AN ACCOUNTING FOR THOSE CHARGES. CASH ADVANCES . Opening Gravq 5750.00 Cemetery Equipment . 5160.00 ',, Certified Death Certificates . .. '. 5120.00 Newspaper Notices -Patriot. . 5189.67 C1wgy/Mass Offering '6125.00 Flowers. 5159.00 TOTAL CASH ADVANCES AND SPECIAL CHARGES . S1503.67 CONTRACT PRICE 59593.67 ~ HISTORY 10/16/2009 Pre Need Guararrtce -TRADITIONAL SERVICE 5-862.4"1 ', 10/19/2009 Homesteaders 5-8523.30 TOTAL AMOUNT DUE 5207.910 __ _ _ __ ~ _ • A. Settlement Statement t'J.S. Department of Housing and Urban Development OMB No. 2502-0265 8. Type of Loan 1. Q FHA 2.OFmHA 3. ~Conv. Unins. •. t e um er an um r ocit ge na, ae um r 4. Q VA 5. ~Conv. Ins. AVER ' C. This form is fumiahed as a statement of actual settlement costa. Amounts paid to and by the settlement agent are shown. Ikefns marked (p.o.c) were paid outside the closing; they are shown for informational purposes and are not included in totals. ame an ress o rrowet ame an teas o er ame an r o er Donald L. Lauver Donald C. Humes, Executor Cash 3oanne P. Lauver of the Estate of Peal I. Humes, - 59 Park Street a/k/a Pearl Irene Humes Harrisburg, PA 17105 1119 Baldwin Street Mechanicsburg, PA 17055 . Property don et ement gent Mi 11 er Li psi tt , LLC 1119 Baldwin Street, Mechanicsburg Cumberland County, Pennsylvania ace o et ement emtnt ate 765 Poplar Church Road 11/20/2009 Camp Hill PA 17011 <. 101 ~ Contract sales price 155, 000.00 401: Contract sales price ~ ' 155, 000.00 102. Personal property _ 402. Personal property 103; Settlement charges to bortower(Ihte 1400) 2,198.50 403. 104. 404. 105. 405. Adjustments for items paid by seller in advance Adjustments for items paidby aelle ' ' advance 106., City/town taxes to 406. City/town fazes to 107: County taxes 11/20/20(1® 01/01/2010 79.44 407. County fazes ~ 11/20/20.Ofh Ql/ 1 2010 79.44 108.iAssessments 11/20/200Eb .07/01/2010 996.30 408. Assessments 11/20/200 07/ 1 2010 996.30 109! 4th Qtr Sewer 11/20/2009 to 1/1/2010 32.22. 409. 4th Qtr Sewer ll/20/2009 to 1/1/ 0 0 32.22 110. 4th Qtr Refuse 11/20/2009 to 7/1/2010 19.94 410. 4th Qtr Refuse 11/20/2009 to 7/1 2 10 19.94 111.' 411. 112 412 .:•ti:rit,t};.a't:{''•:ia'•: v+.v;}{'tayn• ••%#•• :av''. ..},4Y:{{' H } ~y~~ v: • :'::i0'{~~c• . .t } :{'tn. ~}} } ~ $ a::H:k n•{:'• ~:Y.••.v`~,:•'•:,at,::a: •,:l},.~::.+~t}r,...•/yY g:'. t~, {..;a,t ~[. {} .n : 1 '<M$:. . .}. t :.7i ••'f J' v ~C • +:;> ~:~/. ~:f' a.: :l . Y : :i; y:: J i.t:a „y :lt::: : ; '`'1 158 326.40 , ~ , 4• ; v .v . . , '.;~• '~;: ' "' :}'.• •''v ' •` , ` ~ a 156.127.90 . ,,, , . ::. t . ., . a, u w;: .... ~ • .. , t ~''}:f?."t~, •rc ,:.,. .t }' :.::~t:•'.:5:;y`,:c;.te'~~rg::•:s`••`•:: 201.,Deposit or earnest money 10,000.00 501. Excess deposit(sce Instructions) ' 10.,000.00 202.!Pcincipal amount of new loan(s) 502. Settlement charges to seller(line 1400) ' 1, 550.00 203.'Existing loan(s) taken subject to 503. Existing loans}taken subject to 204. 504: Payoff of first mortgage loan 205.: 505. Payoff of second mortgage loan 206.' 506. 207.. 507. 208. 508. 209. , 509. Adjustments for items unpaid by seller Adjustments for items unpaid by se ldr 210.:City/town taxes to 510. Cityltown taxes to ' '~ 211.:County taxes to 511. County taxes to 212.'Assessments to 512. Assessments to 213.. 513. 214. ' 514. 215.' 515. 216. • 516: 217.• 517. 218. 518. 219. 519. ..........:.:•:.: 2.}.:J:.:...... ;>:•`.:.;•.>.;, ... ,..a..; ,..;.t•:~:{ t:t•: ...}}.:{ttt: •:•. .. {:¢'dx'.??S).'t;ct•$:}x,u,:L:,`.•:}.. .•L:`•>,~,C,:>:,~•,:t~a:,,~• . k~3?.•~ar,, 'a:. ~{ic,?y:.• ••~.~`.: t ~ } k: t :^„ ,{..,•. }.a>+~~w+~.'h . •{ '•. : . •Y:Q:: { { ~: ~ + ~ n' {a}:•:{;'r,:+y}.••}•:t::::.y:~::•.:t:.::{t''t:;xt:{.;:•:.:{•:::{::::5;>,:.:{>'•:c:{'•5`:yrtt:,.: •ic}• x:;: {!~: .c+•:r•#.~~{}'4:,~t^{St,rt:}•~:{yD.S», :#^#•~• ~.tY! }, :;a t, ,,}..K <•3. ~'. }•~'t•''.,,:+::35. t .t ~''"•.`•" •>L x~.. 6 a. 3 d ~ a •LS .t t .5, f .yam},\.l ai?Y ~ . ~ ~ fit'/.: 'h i S {i ~ 'r'' r'}: +S• ' a ~' ~: { ':: }~ . tK n$ \ tK }. k : y~•.Y*•;~,,Y. . ; ' '>:<: • >~ '` 10 000 00 i . • • . •: :.: iti~ :. . , 1. S , : : , \ } ~ t:~{' ' ;:. ~<:• ~ >~~''• ` 11 00 550 . . • • . ::<~~ . ` . , . :: . , :{:; t k : ~ . y"~e~,c~~,j ~::: r}:.•.w: :'.v .~,• x::r::., :• ,...:•.:: .v •, •, -vT.v • •. • ' ' ' ::.. .e}. •>::~2. ~h'.' ' ~)~;;y>,?~:'.`'•{?}y} v vSCa}: n •.} :ta a.,'•h+$:.a. : t4a : ~:it} a•. TSh"::: •.:.N''•}. • : •• .: ~ ,~~ •~9F's%: t: k~,. •ty,} v .•:.`•:OY.•:a'k..v>+iY'`..M•~'''.. 301. oss amount due from borrowerpine 120) 158.326.40 .601. Groaa amount due to seller(line 420) 156,127•.90 302. ~ amount paid by/for borrower(tine 220) 10 , 000.00 } 602. Leas reduction amount due aeller(line 5 0) ( 11, 550.00 ) .:............: ::.}•..v:::::::: •.v..; ......; ... •.v:::: {:: •Y . v^}} va'ti' \+'a;•:t{ .'r'. \ t, ...:: a: .......... ...... .. ...% Y.. . L.. Y ....~, k 1:,: }. ':}:{%•. $:.. :}:x;•'.c::::::{:.:,{.:.C$:i."•;?,.. R. +y... •l•• .9:. ~.}{. ..:.yJ.• ;:3•.}.}Y.; v.:e . ~:>; :•.+c .}•:•t{ ...:..: tia:. >> :it~. •n••#:'t', ~::: a;.;:•..}.,i},\.}: k':'•~a,},T : $ C1~v : :>~v . , :}},n:+~0}t ~.{,y: ::..}v:. :.: ., ti,.+, n ..t:. i'.. ; ~.~i...... yt.n .: :.::::..: . v... .... • :' }}•.:{.}•.}; •., .^i.:.. : • •.:$~ : i l:.~y {:'6:;.'•'y{l:''i•:',tltl.} : ay~,v v~Y' : iC:':{ : ~{'%{ . :.''r` •ry:•,~3}~~,~ :.,:,..a}. :..a. ..t ,~.:$ :<`'::{:y'.'..K +::a't~t .kk'>:`:: t::a• : ••:.>,;).. Xat'ba• .. ~ },2oW,,:•::.x .vi.• •: ':: fJ. v?.~$}•. .: t':}::::},y:}.{ y::: <.a.Yi .i:.v ~'~: \+ ,} ~••{Y... :.;~ +yF •\ : t:k;{:tx.;•}.. r J::.. ~ ~~ y~y „ '~ ;>:. >:~ ?~0~. 148 326 40 3 y < €t '•~ ..'. r~~:°x: <~ : :y'~ ~ 144.577.90 : : . . . . : . SUBSTITUTE FORM 1099 SBLLER STATEMENT: The information contained in Blocks B, G, H and I and on line 401 or, if ~ir+e 401 is asterisked, lines 403 and 404 is important taz information and is being furnished to the Internal Revenue Service. If you are required to file ~ return, a negligence penalty nor other sanction will lie imposed on' you if this item is required to be reported and the IRS determines that it has not beer reported. •. You are required by law to provide [ace box H] with your correct taxpayer identification number. If you do not provide [see box III with your correct taxpayer identification number, you may be subjxt to civil or criminal penalties imposed by law, and under penalties of perjury, I certify kh$t the number shown on this statement is my correct taxpayer identification number. Seller's Signature HUD-1 SETTLEMENT STATEMENT A Brainstorm Software 1-54a-6165-0800 SCHEDULE- H.B.7.4 _ _ _ _ _ _ , -T . ,. . WARNING: It is a cricnt to knowingly make false statements to the United States on this or any other similar form. Penalties uppoon conviction can includt a fine and imprisonment. For details see: Title 18 U.S. Code Section 1001 & 1010. SETTLEMENT STATEMENT PAGg 2 :.,.: - -?: ...: ::: - •: ; ~ - ?,; ; `„>;t> ;' -~ ~~ : ~~. ~'~~:s~~r~xy~x~>.~ •:~s:~~z~•-.~:>•~',' •,z':,~.'••:• ...`~..~:.:^ ~'".'.~~.:~;~;' ' ~``.: 700. TOTAL SALES/BROKER'S COMMISSION based on price S ~ 9G m S Division of commission (line 700) as follows: PAID', OM BORI~tOWER'S FUNDS•AT PAID FROM SELLBR'S FUNDS AT 701. S to SETTLEMENT SETTLEMENT 702. S to ~ 703. Commission paid at Settlement 704. .} ~p,y .R.}i:L'• :.C••~ ~ '::':#tv ~:?' •:.r:.: ffi;2•'.: 'wY::"ti,y..y ~{ ~j ,..,::aa. ...w. ..•... :.•.. `:v: .w;.,~`n•.; .v; v::v.v: •.v:n ;.,.::,.,...:{v.•.Av:+.v'.'w::.••.}i••}~::::'{'•:. ;•..:}Yv •}n} vJ: ;}. }.. ,}:'•.~:.. :!,i2,~Y!•.,.;• 801 Loa O i i i F ,:.?,y:.. .. } ;~•. •. r:: ;}:{. :\k.Cvv~.\,>r,.^,y :;'.}ti~{n.;.?:{I.<::•i?;)^}? •:,#::{}:};: . p r g nat on ee % 802. Loan Discount % 803. Appraisai Fee to _ 804. Credit Report to 805. Lender's Inspection Fet 806. Mortgage Insurance Application Fee to 807. Assumption Fee 808. 809. 810. 811. ~NI' :.. .,r .. .: :: : rxx: •.v,• ;. ' .. ! ' r '•.•.~.v ~.v''~ :''J'A:S•~::.•::,s`,"`n ..A'}\vk.}X.:~?>'4.6.~v:'+'X):; :Y. `•{:k#f:{{?{.:v:•:'Cv}:•:':i:ii:yl•$:~~,•.~:KS? 901 Interest fr m ',{~f,1 '~d•,4,•}:}• ik+' . .i2{}}C'{..:} ?Tr~: yp$ Pr}::ipW}';}i>r,:?;• .i•,+};v.;?: 4• : ;:::::: ;. r'•i+ti:~~r~'~v:,~: 'r:'tii:: $:: ...... .: :..:.::::::::. . o ~ ~ /day 902. Mortgage Insurance Premium for months to 903. Hazard Insurance Premium for years to 904. 905. ..... :..v . . ..~•:: ...c:::.::.,;•.vi:::, •:•• •~.+. •5. ~. .:'k ....N..... .,},,,~i;{.. :':}f:: .?.: ~.}s,..,n, #• :w?,••y.' ..::,.:•F:.or•..;,.:::a~i; . ...., {... ......:.~''i$$ 3' . ;; .. , ., ..r:#:....: ,:• , t :y< ., . Y,;..p..; . }. ;} :,M.s .r m,,:w:vvn:..Lv .vv.:n...v. v.:.: v...•.v:x:.v:. unwn .v: i<+':•y}:E•:•:.;S.vfn rv:nV}• :?'::: i':::.h.T?i•$} {:.{.;}O }:M%:•} .. '{a}?.:.; §}Y .iy.::.IJ{ {.S. ,v,{;+.; n ;..::.,,;.•,v{ ::: ., ....:~xs~a.....:....:4>::::::c:::r•::~<:::.•,:?.:z,~.~::.:~:.:: 1001 H :.o:>:..•.>::: :r .?:.:}::<:..:.r .; ..# •:: •.:: ..: v C:r y:i ;i {.:•.,v.a•.,•.{•:::•.'s~'''~~'.::.>~:s..: ::: •. •. ..:•xo::.}:: :•:: .•, x:R.,}, ?t:;,2•,:v:.. ..:.4.i>. }:rr' ::.; :.}. ix _::•,:~sf<s:~:>a~~sv;:~{~~<x: . azard insurance months ~ S per month 1002. Mortgage insurance months ®S per month 1003. City Property taxes months ~ S per month 1004. County property fazes months ®S 57.69 per month 1005. Annual assessments months ®S 136.27 pet month 1006. months (~ S per month 1007. months ~ S per month 1008. .... . . } {~g :;;:a::•txakt::F;.?.,;{•:'.'Q::•:;::r '4:v r: •: {;yGa,:•v{. r... .;. ;:.x :.. •.; :::... ......... ., .. '• y,?a•{......: •. ...,:::.~:.~. ` ~'.•':•' .:..,+.::. ., ..x..i: ... :,r.•:i.::'• .~~}~... r .:::. L ;• :rri•:R?' k;{; ss:, •. ,•1 r .~t~•:k. o .. .. . S. ..}; : x... ... :.... ,..... ,... .. .. \.... :::. x.. .:>. ., •'•: }S;??}. :>., #Ao},. ..} ~3.. :.:.t>..::{•{:.:,•..?f•.F.}, •%~.%{?.:. f^,#: }:•}s:a??;tY:;~3,..r. 1101. Settlement or closing fee to Mi 11 er Li psi tt, LLC ,~: .;y:' ' :4R?•. •., ~'::•':„#: ;:;ti??{. '•:i2i•:,:" •r••r•••: }:,••:•:5>}•:., :••: •: e,;n.'•t;..v ,,...;t:'t.2:•:.•:$:'.:t titi:;;•;; 1102. Abstract or tint search to Ace Abstract 1 0.00 1103. Title ezat;tination to Mi 11 er Li psi tt, LLC 1104. Title insurance binder to 1105. Document preparation to Mi 11 er Li psi tt ,LLC 1106. Notary fees to 1107. Attorney's fees to Miller Lipsitt,LLC (includes above items Numbers: ) 4 .00 1108. Title insurance ~ to (includes above items Numbers: ) 1109. Lender's coverage S 1110. Owner's coverage S 1111. 1112. 1~1{{ 1((1y~3~~. :.? .: .: .; ?.: .. ~ : ,y; ~.} ~Si~1}V:i.;9.;':. %•;.v..3 '•<~: '+:':rb,. •.Yr'':?': 5{v:S;Y '•.%;}:;} 7'•v '.v. ;:}h.}.' : viY }i.. ; .:. .. .:.: •: %... .....:.:: :...•'. +"~~y,' v{r• ..;/,. :vin'•f'.%.{>::tii.';:h. .. ,J,•;, d 3'. :..}, :. < ..:.....•#.:..:.... .... .~::?•:.:•:: ~..., .,~ 1201 Recordin fees• D S 38 50 : ..~:. .:K.}}%:i:}: ti,:{?Y,.;:• •'i i;,}.v $: K •~.. ~ ~ :s::•#.:::::>}:.. .;c:'s>:`~ :v{Gy k}:vti:•:+?'n:, •, :,,,, ... :;?<.::•.:; ;v.;<.<;;::;:<:::,::<: . ee . 8 ;Mortgage S ;Releases S 8 50 1202. City/county tax/stamps: Deed S 1, 550.00 ;Mortgage S 1203. State tax stamps: Deed S 1, 550.00 ;Mortgage S 1204. UPI Cert to Recorder of Deeds . 1 5 0.00 10.00 1, 550.00 1205. t ,. :. , } ....}. •:• ?`Ai7~i2$::Ytilofi' ?:vY.•t;}2}T:{k:; •• ,•:;;i,.•??;r`y y5::•: •. .:?t", :::.:.........:.., ......... :. ......:.... ..:......... ... :.2:..{'.Y... _. ..2..,. r•, :. .; v},,: :.S: CY. .'Y}. •. r.•~~}•.•'' +::$? .. $. .r•+.; ...... ... .... ,.; v.;,. ~ .... y;t •:.. ..• :, ;; }•}. \; :.; ' ~ u:{•.::.., .; {;: •:. Y,.•6 •?:.{~:'! Y . .....,. F. > :::.Y •: t. .}.;:y ..; :~.::: •v:{:. .:,:4.{ .S: •.:. r1'•5 •~:,{:{ .. •?#^:{•:,fafi 130 ;},' {; {} .: ?S;}}::c.? : '. :'A~.c:ti?r.:•:':: {.: :.{7:~'•.r,.r.,'•f : •tk:f: }:•:::{x•},~ i•::b:{•::?.: •:•.+'??::?:.:•`..:'J. '{ .... ..r?Y: { ;...: }::.n {kx};;#:•}}:: { ., #'x'::'; :~.s:::>••>• 1. Survey to 1302. Pest inspection to 1303. 1304. 1305. .... -..::.. : r .... • .......' .....: ''• - ~t'::~~:~..rr. ~'~.....~1~:.¢ ..:~~:.•i ``:" ...R"F..: ~•`<~::.>.~:;::' ;~::.;:,..:~s<,~>: 2'x.1 98.50 ! 1, 550.00 CERTIFICATION I have.carefu reviewed the HUD-I Se t Statement and to the best of my knowledge and belief, it is a true and accurate s t ment of all receipts and disbursemen ma a vn t b in this transactio I further certify that I hav eived a copy of the HU 1 Settlem~n~ Statement. . a auv r ~ ~~ c -~ umes, zeL~ r 7- orrowers oanne auve a ers o e s ate o ea umes, The HUD-1 Settlement Statement which I have prepared is a true and accurate account of this transaction. I have caused or will csuhe the funds to be disbursed in accordance with this statement. _..- er t.ips~~; Novembdr 20, 2009 ate SCHEDULE H.B.7.4