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HomeMy WebLinkAbout07-29-10~ fyO,105.71 DECEDENT'S ESTATE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION ESTATE OF Catherine E Cooney No. 21 - 09 - OOdd~ PETITION FOR ADJUDICATION / STATEMENT OF PROPOSED DISTRIBUTION PURSUANT TO Pa. O.C. RULE 6.9 N Q r c ~9 -r~ : J ,~ : _~ ~ -r~ ._-r r .. :~ C~ ~- r._= ~ : a - , f J.i ~ _ -~ "-'! --- :, r~~~ .,~, c-_.~ - - Cis , This form maybe used in all cases involving the Audit of the Account of a Decedent's Estate. If space is insufficient, riders maybe attached. Attach the spouse's election, if any; the papers required under items 8-19 inclusive; and any instrument pertinent to the adjudication. INCLUDE ATTACHMENTS AT THE BACK OF TH/S FORM. Name of Counsel: Robert P Kline Supreme Court I.D. No.: 58798 Name of Law Firm: Kline Law Office Address: 714 Bridge Street New Cumberland, PA 17070 Telephone: 717/770-2540 Fax: 717/770-2553 E-mail: Form OC-0~ Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. ,DECEASED Page 1 of 10 ( r Estate of Catherine F rnnno.. 1. Name(s) and address(es) of Petitioner(s): IVame~ Mary Anne Cooney Deceased Address: 9f24f1 1Ah...a....~...u n_~ . -...... Hunstville, AL 35803 Identify any executors or administrators who have not joined in the Petition for Adjudication and Statement of Proposed Distribution and Account and state reason: Is this the first accounting by this fiduciary? If not, identify prior accountings, the accounting periods covered, and the date of adjudication of the prior accounting. 2. Decedent died on 10/18/2008 ^X Letters Testamentary or 5/12/2009 Yes ~ No ^ Letters of Administration were granted to Petitioner(s) on Date of Will (if applicable): 6/21/2005 Date(s) of Codicil(s) (if applicable): Date of probate (if different from date Letters granted): Was a bond required? ~ Yes 0 No If yes, state amount: Are proofs of advertising of the grant of Letters attached? ............................. Yes ~ No Dates of advertising of the grant of Letters: 7/10/2009 7/17/2009 7/24/2009 7/12/2009 7/19/2009 7/26/2009 Form ~C-U1 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 2 of 10 Estate of Catherine E Cooney 3. Was decedent survived by a spouse? If yes, name of the surviving spouse: 4. Has the surviving spouse filed to take an elective share? ......................... (See Section 2201 et s_q. of the Probate, Estates and Fiduciaries Code) If yes, date of election: 5. In the case of an intestacy, state the names of the decedent's surviving children or surviving issue of deceased children (if none, so state): 6. Did the decedent marry after execution of Will or Codicil(s)? Were any children born to decedent after execution of Will or Codicil(s)? ..................................... If yes, give names and dates of birth: Name: 7. If required by the Medical Assistance Estate Recovery Act, 62 P.S. §1412, was a request for a statement of claim sent to the Department of Public Welfare? ................................ Deceased Yes ~ No Yes ~ No Yes ~ No Yes ~ No Date of Birth: Yes ~ No Form oC-Q1 Rev 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 3 Of 1 ~ Estate of Catherine E Cooney Deceased 8. Written notice of the Audit as required by Pa. O.C. Rules 6.3, 6.7 and 6.8 has been or will be given to all parties in interest listed in item 9 below, all unpaid creditors and all claimants listed in item 10 below. In addition, notice of any questions requiring Adjudication as discussed in item 14 below has been or will be given to all persons affected thereby. A. If Notice has been given, attach a copy of the Notice as well as a list of the names and addresses of the parties receiving such Notice. B. If Notice is yet to be given, a copy of the Notice as well as a list of the names and addresses of the parties receiving such Notice shall be submitted at the Audit together with a statement executed by a Petitioner or counsel certifying that such notice has been given. C. If any person entitled to Notice is not sui juris (e.g., minors or incapacitated persons), Notice of the Audit has been or will be given to the appropriate representative on such party's behalf as required by Pa. O.C. Rule 5.2. D. If any charitable interest is involved, Notice of the Audit has been or will also be given to the Attorney General as required under Pa. O.C. Rufe 5.5. In addition, the Attorney General's clearance certificate (or proof of service of Notice and a copy of such Notice) must be submitted herewith or at the Audit. 9. List all parties (charitable and non-charitable) of whom Petitioner(s) has/have notice or knowledge, having or claiming any interest in the estate as beneficiaries under the Will or Codicil(s) or as intestate heirs if there is a complete or partial intestacy: A. State each party's relationship to the decedent and the nature of each party's interest(s): Name and Address of Each Party in Mary Anne Cooney Daughter 2850 Wynterhall Road, Apt 102 Hunstville, AL 35803 -- Interest Form OC-0'l Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 4 Of 10 Estate of Catherine E Cooney Deceased B. Identify each party who is not sui juris (e.g., minors or incapacitated persons). For each such party, give date of birth, the name of each Guardian and how each Guardian was appointed. If no Guardian has been appointed, identify the next of kin of such party, giving the name, address and relationship of each. None C. State why a Petition for Guardian/Trustee Ad Litem has or has not been filed for this Audit (see PA. O.C. Rule 12.4). N/A D. If distribution is to be made to the personal representative of a deceased party, state date of death, date and place of grant of Letters and type of Letters granted. N/A Form OC-0'l Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. P89e 5 Of 1 ~ Estate of Catherine E Cooney Deceased 10. Other than the claim for the family exemption, list the names of all known claimants and the amount of their claims and state whether each claim is admitted. If the estate is insolvent, attach a schedule setting forth the order of preference under 20 Pa.C.S. § 3392 and the proposed payments. 11. Was family exemption claimed? .......................................................................................... Yes ~ No Was family exemption allowed? ........................................................................................... Yes ~ No Family exemption claimant's name and relationship: Name: Relationship: Form ()C-U1 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 6 Of ~ o Attachment 27,329.77 Total 27,329.77 Claims (continuation of Question # 10) Estate of Catherine E Cooney ,Deceased Name and Address of Each C/aimant Amount of Claim Claim Will Claim Admitted? Be Paid in Wells Fargo Financial Fuu? 4830 Carlisle Pike, E3 266.00 ~ Yes ~ Yes Mechanicsburg, PA 17050-7707 ^ No 0 No Citibank c/o Phillips & Cohen Assoc, Ltd 3,399.60 ~ Yes 1002 Justison Street ^ Yes Wlmington, DE 19801 ~ Wo 0 No Citibank c/o Phillips ~ Cohen Assoc, Ltd 1002 Justison Street 1,161.69 XC~ Yes ~ Yes Wlmington, DE 19801 ~ No ~ No Chase Bank USA, N.A. c/o West Asset Management 7171 Mercy Road 1,181.60 ~ Yes ^ Yes Omaha, NE 68106 ~ No 0 No Chase Bank USA, N.A. c/o West Asset Management 7171 Mercy Road 2,850.83 ~ Yes ^ Yes Omaha, NE 68106 ~ No 0 No FIA Card Services, N.A. ATTN: Estate Dept 1000 Samoset Drive 11,086.32 ~ Yes Yes Wilmingtn, DE 19844 ~ No ~ No FIA Card Services, N.A. ATTN: Estate Dept 1000 Samoset Drive 1,984.47 ~ Yes ^ Yes Wilmingtn, DE 19844 ^ No 0 No World Financial Network c/o DCM Services LLC 4150 Ol M 368.29 ~ Yes ^ son emorial Hwy, Suite 200 Yes Minneapolis, MN 55422.4811 ^ No 0 No World Financial Network c/o DCM Services LLC 4150 Ol M 348.47 X^ Yes ~ son emorial H wy, Suite 200 Yes Minneapolis, MN 55422.4811 ^ No 0 No World Financial Network c/o DCM Services LLC 4150 Olson Memorial Hwy, Suite 200 228.63 ~ Yes ^ Yes Minneapolis, MN 55422.4811 ^ No Q No World Financial Network c/o DCM Services LLC 4150 Olson Memorial H wy, Suite 200 456.35 ~ Yes [I Yes Minneapolis, MN 55422.4811 ^ No 0 Wo Claims (continuation of Question # 10) Estate of Catherine E Cooney Name and Address of Each C/aimant Boscov's c/o Estate Recoveries, Inc. PO Box 15380 Baltimore, MD 21220 Chase Bank USA, N.A. c/o Phillips & Cohen Assoc. PO Box 48458 Oak Park, MI 48237 ,Deceased Amount of Claim Claim Will Claim Admitted? Be Paid in Full? 2,106.46 Q Yes ~ Yes ~No ~No 1,891.06 ~ Yes ~ Yes ~No ~No Estate of Catherine E Cooney Deceased 12. The amount of Pennsylvania Transfer Inheritance Tax and additional Pennsylvania Estate Tax paid, the date(s) of payment(s), and the interest(s) upon which paid, are as follows: Date Payment Interest 12/28/2009 0.00 0.00 13. On the date of death, was the decedent a fiduciary (personal representative, trustee, guardian, agent under power of attorney) or surety on the bond of a fiduciary? ................................................................. Yes ~ No If yes, provide the name of the estate, indicate whether an account has been filed and confirmed absolutely and all awards performed, or, in the alternative, how the decedent's estate will be discharged for the decedent's fiduciary administration of the estate. 14. A. Describe in detail any questions requiring adjudication and state the position of the Petitioner(s) as to each question: B. Has notice of the question requiring adjudication been given to the parties identified in Paragraph 9 above? ............................................................. Yes ~ No 15. If Petitioner(s) has/have knowledge that a share has been assigned, renounced, disclaimed or attached, provide a copy of the assignment, renunciation, disclaimer or attachment, together with any relevant supporting documentation. Form OC-U1 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 7 Of ~ ~ Estate of Catherine E Cooney Deceased 16. Had the decedent been adjudicated an incapacitated person? If yes, attach a copy of the Order if available; otherwise state Court, term, number, date, and name of Hearing Judge. 17. A. List or attach a separate list of additional receipts and disbursements since the closing date of the Account. Date Description B. Has notice of the additional receipts and disbursements been given to the parties identified in Paragraph 9 above? .............. 18. If a reserve is requested, state amount and purpose. Amount Purpose: If a reserve is requested for counsel fees, has notice of the amount of fees to be paid from the reserve been given to the parties in interest?....... _ If so, attach a copy of the notice. 19. fs the Court being asked to direct the filing of a Schedule of Distribution? ..................................................... As to real estate only? ............................................................................... Form OC-O1 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Yes ~ No Amount . ~ Yes ~ No Yes ~ No Yes ~ No Yes ~ No Page 8 of 10 Estate of Catherine E Cooney Deceased Wherefore, your Petitioner(s) ask(s) that distribution be awarded to the parties entitled and suggest(s) that the distributive shares of income and principal (residuary shares being stated in proportions, not amounts) are as follows: A. Income: Proposed Distnbutee(5J Mary Anne Cooney B. Principal: Proposed Distributee(s) Mary Anne Cooney Amount Proportion Amount Proportion Submitted By: (All petitioners must sign. Add additional lines if necessary): Name f eti ner: Mary Ann oney Name of Petitioner: Name of Petitioner: Form OGO~ Rev. f0-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 9 Of 1 ~ Estate of Catherine E Cooney Verification of Petitioner (Verification must be by at least one petitioner.) The undersigned hereby verifies * [that ne~sne is rive of the above-named name o/corporation Deceased forth in the foregoing Petition for F,djudication /Statement of Proposed D strdibutiontwhich greet within the personal knowledge of the Petitioner are true, and as to facts based on the information of others, the Petitioner, after diligent inquiry, believes them to be true; and that any false statements herein are made subject to the penalties of 18 Pa. C.S. §4904 (relating to unsworn falsification to authorities). (~'b Signature f titioner Mary Anne ney _ ~...- signature of Net)tioner signature of Netit)oner * Corporate pefifioners must complete bracketed information. Certification of Counsel The undersigned counsel hereby certifies that the foregoing Petition for Adjudication/ Statement of Proposed Distribution is a true and accurate reproduction of the form Petition authorized by the Supreme Court, and that no changes to the form have been made beyond the responses herein. 1 Signature of Counsel for Petitioner Robert P Kline Form OC-0~ Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page ~ o Of ~ ~ PROOF OF PUBLICATION OF NOTICE IN CUMBERLAND LAW JOURNAL (Under Act No. 587, approved May 16, 1929), P. L.1784 COMMONWEALTH OF PENNSYLVANIA : COUNTY OF CUMBERLAND ss. Lisa Marie Coyne, Esquire, Editor of the Cumberland Law Journal, of the County and. State aforesaid, being duly sworn, according to law, deposes and says that the Cumberland Law Journal, a legal periodical published in the Borough of Carlisle in the County and State aforesaid, was established January 2, 1952, and designated by the local courts as the official legal periodical for the publication of all legal .notices, and has, since January 2, 1952, been regularly issued weekly in the said County, and that the printed notice or publication attached hereto is exactly the same as was printed in the regular editions and issues of the said Cumberland Law Journal. on the following dates, vlz: Jul 10 Jul 17 and Jul 24 2009 Affiant further deposes that he is authorized to verify this statement by the Cumberland Law Journal, a legal periodical of general circulation, and that he is not interested in the subject matter of the aforesaid notice or advertisement, and that all allegations in the foregoing statements as to time, place and character of publication are true. L sa Marie Coyne, E 'tor SWO O AND SUBSCRIBED before me this Q Cooney, Cathereine E., deed. Late of Lower Allen Township. Executrix: Mary Anne A. Cooney c/o Robert P. Kline, Esquire, Kline Law Office, P.O. Box 461, New Cumberland, PA 17070-0461. Attorneys: Robert P. Kline, Es- quire, Kline Law Office, P.O. Box 461, New Cumberland, PA 17070- 0461. Notary NO1Ak'IAL SEAL GEBURAH A COLLINS Notary Put,lic CARLISLE BORO, CUMBERLP.ND COUNTY My Commission Expires Apr 28, 2010 PROOF OF PUBLICATION State of Pennsylvania, County of Cumberland Erica Peterson, Classified Manager of The Sentinel, of the County and State aforesaid, being duly sworn, deposes and says that THE SENTINEL, a newspaper of general circulation in the Borough of Carlisle, County and State aforesaid, was established December 13th, 1881, since which date THE SENTINEL has been regularly issued in said County, and that the printed notice or publication attached hereto is exactly the same as was printed and published in the regular editions and issues of THE SENTINEL on the following day(s): Tuly 12, 2009, Tuly 19, 2009 and Tuly 26 2009 COPY OF NOTICE OF PUBLICATION NOTICE Lettershavebeen granted on the Estate of CATHEREINE E. GOONEY, late of Lower-Allen Township, Cumberland County, Pennsylvania, to Mary Anne A. ` Cooney, Executrix, c/o Robert P. Kline, Esquire, Kline Law Office, P.O. Box 461, New Cumberland, PA 17070-0461. , All persons havirig claims against the Estate are requested to present them in writing and all persons indebted to the Estate to make payment to it in care of the attorney noted above. Affiant further deposes that he/she is not interested in the subject matter of the aforesaid notice or advertisement, and that all allegations in the foregoing statement as to time, place and character of publication are true. ,~ Sworn to and subscribed before me this a~~~ Notary Public My commission expires: cor~Mgs~w~~~,~T.~ ~r : ~~~. ~~~~:w:~.~ i Nora~la~ sEa~ ~~ ~ -,~aP~~! AiU~I HECKENDORN, Notary Pu~Jic Camp Hlil Borc Cumberland Gounty E b1y Corrm~,q ~~ ~~~~ss~s January 27, 2~1t? y COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE BUREAU OF FINANCIAL OPERATIONS DIVISION OF THIRD PARTY LIABILITY ESTATE RECOVERY PROGRAM PO BOX 8486 HARRISBURG, PA 17105-8466 November 25, 2009 KLINE LAW OFFICE ROBERT P KLINE ESQUIRE 714 BRIDGE ST PO BOX 461 NEW CUMBERLAND PA 17070 Re: CATHERINE E GOONEY SSN: 057-12-7944 Dear Attorney Kline: Pursuant to your letter dated November 19, 2009, the Depart_~aent of Public Welfare (DPW), Estate Recovery Program, has reviewed the ~-nformation you provided regarding the above-referenced individual. It has been determined that this individual did not receive any type of assistance during the questioned period. Therefore, according to the information you provided, the Df=~partmer.t's Estate Recovery Program will not seek any recovery from this estate. If your client applied for Medical Assistance and had an application and:%or hearing pending at the time of death, please advise us and provide any additional. information that may affect a recovery by our Department. If you have any questions, please feel free to contact me< Sincerely, ,~ ,~ ~~~ rarn~le A. Procope Recovery Section Manager (717)772-6604 NOTICE OF INHERITANCE TAX Pennsylvania ~- BUREAU OF INDIVIDUAL raxES APPRAISEMENT, ALLOWANCE OR DISALLOWANCE INHERITANCE TAX DIVISION OF DEDUCTIONS AND ASSESSMENT OF TAX DEPARTMENT OF REVENUE PO BOX 280601 HARRISBURG PA 17128-0601 REV-1547 EX AFP (12-09) DATE 05-17-2010 ESTATE OF GOONEY DAT CATHERINE E ROBERT P KLINE KLINE BRIDGE ST PO BOX 461 NEW CUMBERLAND PA 17070 E OF DEATH 10-18-2008 FILE NUMBER 21 09-0445 COUNTY CUMBERLAND ACN 101 APPEAL DATE: 07-16-2010 (See reverse side under Objections) ~.«„~ MAKE CHECK PAYABLE AND REMIT PAYMENT TD: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT-ALONG THIS LINE ~ --R_ETA_IN-LOWER POR_TION_ - - ---------- REV-1547 EX AFP C12-09~ FOR YOUR RECORDS 4~ NOTICE OF INHERITANCE TAX ISALLOWANCE OF -------------- APPRAISEMENT, ALLOWANCE O DEDUCTIONS ESTATE OF: GOONEY AND ASSESSMENT OF TAX R CATHERINE EFILE N0.:21 09-0445 ACN TAX RETURN WAS: CX) ACCEPTED AS FILED : 101 DATE: 05-17-2010 C ) APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN CHANGED 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) C1) 139, 900.00 NOTE: To ensure proper 3. Closely Held Stock/Partnership Interest (Sched l C2) •00 credit to your account, u e C) 4. Mortgages/Notes Receivable (Schedule D) C3) .00 submit the upper portion f 5. Cash/Bank Deposits/Misc. Personal Propert (S C4) •00 o this form with your tax payment. y chedule E) 6. Jointly Owned Property [Schedule F) Cg) 205.71 7. Transfers (Schedule G) C6) .00 c7) .00 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: cB) 140 105.71 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) C9) 7$ 6 19 clo) 147,383 10 11. Total Deductions 12• Net Value of Tax Return C11) 175,74$,29 13. Charitable/Governmental Bequests; Non-elected 9113 Trust C12) 35,64 2.5 8- 14. Net Value of Estate Subject s to Tax (Schedule J) C13) .00 NOTE: If an assessment was issued reviousl P l C14) 35,642.58- reflect figures that Y, ines include the tot l 14, 15 and/or 16, 17, 18 and 19 will ASSESSMENT OF TAX: a of ALL returns assessed to date. 15. Amount of Line 14 at Spousal rate 16. Amount of Line 14 taxable at Lineal/Class A rate CIS) '00 X DO = .00 17. Amount of Line 14 at Sibling rate C16) ~0 x 045 = . 00 18. Amount of Line 14 taxable at cl7) Collateral/Class B n0 X 12 = .00 19. Principal Tax Due rate Clg) • 00 X 15 = TAX CREDITS: c19)= . 00 .00 PAYMENT RECEIPT DISCOUNT C+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID * IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. TOTAL TAX PAYMENT BALANCE OF TAX DUE 00 .00 INTEREST AND PEN.' .00 TOTAL DUE .00 IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FnR iAlcT eiirT ... .... $ ~~o,~u~• 71 ESTATE OF CATHERINE E. GOONEY, DECEASED LATE OF LOWER ALLEN TOWNSHIP, CUMBERLAND COUNTY, PA FIRST AND FINAL ACCOUNT OF MARY ANNE A. GOONEY, EXECUTRIX Date of Death: October 18, 2008 Date Letters Testamentary Issued: May 12, 2009 n Accounts Dated to July 1, 2010 c ~ ~-- _ ' _ ~ ~ ~ ., :; , ~;` ~ . r ~ ~ ~.. ~ Receipts 6/30/2009 National City Mortgage Escrow 105.57 "~ '; J~ , ~_-, Refund ~ cr`'r~ 11/23/2009 Proceeds from sale of 102 4,794.41 Manchester Road, Lower Allen Township, Cumberland County (settlement statement attached) 12/29/2009 PNC Mortgage Interest Refund 143.78 5,043.76 5,043.76 Disbursements 5/20/2009 Register of Wills 310.00 6/30/2009 Cumberland Law Journal 75.00 7/30/2009 The Carlisle Sentinel 113.20 12/23/2009 Register of Wills 30.00 Register of Wills 180.00 698.20 Proposed Administrative Expense: Attorneys Fees -Kline Law Office 2,500.00 2,500.00 Total Expenses (3,198.20) Net Remaining for Pro Rata Distribution to 1,845.56 Creditors Proposed Pro Rata Distribution to Amount of Pro Rata Remaining Creditors Claim Payment Wells Fargo Financial, Acct. #23655355 266.00 17.96 Citibank, Acct. #6035320160790463 3,399.60 229.57 Citibank, Acct. #6035320679306058 1,161.79 78.45 Chase Bank USA, Acct. #4266841041377381 1,181.60 79.79 Chase Bank USA, Acct. #5149231820037929 2,850.83 192.52 FIA Card Services Acct. #5490999018935055 11,086.32 748.65 FIA Card Services Acct. #4264298926160410 1,984.47 134.01 World Financial Network, Acct. #*****9633 368.29 24.87 World Financial Network, Acct. #*****2794 348.47 23.53 World Financial Network, Acct. #* * * * * 0644 228.63 15.44 World Financial Network, Acct. #*****2853 456.35 30.82 Boscov's, Acct. #9249842 Chase Bank USA, Acct. #*******6255 Total Pro Rata Disbursements 2,106.46 142.25 1,891.06 127.70 (1,845.56) Remaining Funds After Distribution $ 0.00 . ,..,..,,...,.,.,,,, «. vwv,er. rwm nUU~t (:uea) m neraooox aaw.z A. Settlement Statement U.S. Department of Housing and Urban Development B, Tvae of Loan ~...~ wN~ war lvD. tout-ucoo texplres ~ 7/302009) 1. gIFHA 2. OFmHA 3. ~Conv. Unins. 6. File Number 7 Loan Numbe . r 8. Mortgage Insurance Case Number 4. VA 5. Conv. ns. 2009110A8 217996003 PA4419565081703 C. Note: n«ns marked •(p.c.e.)• were peed outride the aosMO• that are snown Iwre rot mr«meaon purpessa .ne an not lna~dsd m ab tot.k. TitleExpress Settlement System WARNING A k a afore ro knowingy make rake statements to the Unaed Stales on Mk ar an o0rer tkntlar form p la , ena es u n conNCaon an Inaude a floe and.impdeanmenL For detaae sse: Tae to U. S. Code Sedron 1001 and Sedkm 1010. ~ Printed 11/2312009 at 15:02 CEC D. NAME OF BORROWER: Matthew B. Gliman and Michele L. Carr ADDRESS: E. NAME OF SELLER: Catherine E. Cooney ADDRESS: F. NAME OF LENDER: Bank of America, N.A. ADDRESS: 6400 L Drive Plano TX 75024 G. PROPERTY ADDRESS: 102 Manchester Road, Camp HIII, PA 17011 Lower Allen Townshi H. SETTLEMENT AGENT: Absolute Abstract, LLC, Telephone: 717-432-7102 Fax: 717.432-1535 PLACE OF SETTLEMENT: 125 West Harrlsbu Street Dillsbur PA 17019 L SETTLEMENT DATE: 1112312009 U M B RO S CT .:: K. SUMMARY OF SELLER'S T N ACTION: 100. GROSS AMOUNT DUE FROM BORROWER 400. GROSS AMOUNT DUE TO SELLER 101. Contract sales rice 139 900.00 401. Contract sales rice 139 900 00 . 102. Personal Pro rt 402. Personal Pro d 103. Settlement cha es to borrower line 1400 7 735.30 403. 104. 404. 105. 405. Adjustments for items paid by seller In advance Adjustments for items paid by seller in advance 106. Ci! Rown taxes 406. Cit Mown taxes 107. Count taxes 11123109 to 12/31/09 64.23 407. Count taxes 11!23109 to 12/31109 64 23 108. School taxes 11123-09to06130110 671.63 408. School taxes 11123109 to06130H0 . 671 63 109, Sewer - 4th Qtr. 11/23109 to 12131/09 16.10 409. Sewer - 4th Otr. 11123109 to 12131109 . 16 10 110. Trash - 4th Qtr. 11123109 to 12/31109 24.58 .410. Trash - 4th Otr. 11123!09 to 12131/09 . 24 58 111. 411. . 112. 412 120. GROSS AMOUNT DUE FROM BORROWER 148 411.84 . 420. GROSS AMOUNT DUE TO SELLER 140 676 54 200. AMOUNTS PAID BY OR ON BEHALF OF BOR ROWER . 500. REDUCTIONS IN AMOUNT DUE TO SELLER 201. De sit or earnest mone 1 000.00 501. Excess De sit see instructions 202. Princi al amount of new bans ' 137 365.00 502. Settlement char es to seller line 1400 10 697 00 203. Existin loan s taken sub ect to . 503. Exist/ loan s taken sub'ect to 2~' 504. Pa off:0003944450 120 053.33 PNC Mort a e Co ration 205. 505, ZO6. 506. 207, Seller Assist 4 911.00 507. Seller Assist ~8' 4 911.00 508, 209. 509. Ad ustmertts for items un id b seller Adjustments for tams un aid b seller 210. Cit (town taxes 510. Cit Mown taxes 211. Count taxes 511. Count taxes 212, School taxes 512. School taxes 213' 513. 214. 514. 215' 216 515. Final SewedTrash 220.60 . 516. 217 ' 517. 218 . 518. 219. 519 220. TOTAL PAID BYIFOR BORROWER 143 276.00 . 520. TOTAL REDUCTION AMOUNT DUE SELLER 300. CASH AT SETTLEMENT FROM OR TO BORROWER 135 862.13 600. CASH AT SETTLEMENT TO OR FROM SELLER 301. Gross amount due from borrower line 120 148 411.84 601. Gross amount due to seller line 420 140 676 54 302. Less amounts aid b/for borrower line 220 143 276.00 . 602. Less reduction amount due seller line 520 135 682 13 . 303. CASH FROM BORROWER 5135.84 603 CASH TO SELLER ~ . 4,794.41 SUBSTfTUTE FORM 1090 SELLER STATEMENT; TM k~ a to tyona~ load hereto k hnportant 1az inromwtbn and Is being tuMshed to the Internal Revenue Service. N you are raqu:red W ale a return, jk °eq~0lpsen~ ~°y~U++~ G~rwi R sds~W Ihh ~>acOOn required W ba reported and Ob IRS determines That N has not been repoAed. The ContreU Sales Puce desa~bed on Yoo ere YW may bs subfeUpra dvp ~ pl,nyry nt e0ent (Fsd. Tex ~ No: 71-0911067) wIN your rwrreU Wxpeyer identlfisatlon number. a yoo do not provide your oortaU kxpayer Idenllficalion number, penaaks Imposed by kw, Under panalaas of MrJury, I prtiry That the number shown on thk sWtemenl k my oorreU taxpayer IWntiMaaon number. T91. r SELLER(S)SIGNA7URE(S): SELLER(S) NEW MAILING ADDRESS: SELLER(S) PHONE NUMBERS; roan nutrl I;tnwl rer nano PAGE 2L U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT File Number: 2009110AB SETTLEMENT STATFAAFNT ...., ~_- ,.... . _ _ . _ ._ - - - coo ~mucmcnt a stem L SETTLEMENT CHARGES rnmeD I lIG3IGlA1J a l I D:UL lal; . PAID FROM PAID FROM 700. TOTAL SALESJBROKER'S COMMISSION based on price $139 900.00 6.000 = 8 394.00 BORROWER'S SELLER'S Division of commission line 700 aS fDlbws: FUNDS AT FUNDS AT 701. 4222.00 to M.C. Walker Real SETTLEMENT SETTLEMENT 702. 4172.00 to REIMAXA•1 Rea Inc. 703. Commission aid al Settlement 8 394.00 704. TransacBonFee to REIMAXA•1 Rea Inc. 195,00 800. ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan Ori ination Fee %Bank of America N.A. LR 654.00 802. Loan Discount % 803. A sisal Fee to LandSafe A sisal LR 460.00 804. Credit Re rt to LandSafe Cred Inc. LR 35.00 805. Lenders Ins 'on Fee 806. Mort a e A lication Fee 807. Tax Service Fee to BAC Tax Service LR 89.00 808. Flood Check Fee to LandSafe Flood LR 26.00 809. 810. 811. 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest From 11123/2009 to 12/0112009 18.3500 /da 8 Da s LR 146.80 902. Mort a Insurance Premium for to Federal Housin Admin LR 2 362.55 903. Hazard Insurance Premium for to State Auto 422.00 904. 905. 1000. RESERVES DEPOSITED WITH LENDER FOR 1001. Hazard Insurance 3 mo. 35.17 Imo LR 105.51 1002. Mori a Insurance mo. 196.68 !mo 1003. Ctt Pro rt Tax mo. Imo 1004. Count Pro a Tax 10 mo. 50.10 !mo LR 501.t1p 1005. School taxes 6 mo. 92.86 Imo LR 557.16 1009. A r ate Anal sis Ad'ustment LR -517.10 0 00 . 1100. TITLE CHARGES 1101. Settlement or closi tee 1102. Abstract lx ti0e search 1103. Tdle examination 1104. Title insurance binder 1105, Document Pre oration 1106. Note Fees to Carrie E. Cook 25.00 20 00 1107. Attome s fees . includes above items No: 1108. Title Insurance to Absolute Abstract LLC includes above items No: 952.88 1109. Lender's Polic 137 365.00 - 1110. Owner's Polic 139 900.00 •952.88 1111. 100 No Viol 300 Surve 900E to Absolute Abstra LLC 1112. 150.00 1113. Closin Svcltr to Absolute Abstract LLC 75.00 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Record'm Fees Deed 48.50 • Morl 66.50 • Release ' 115 00 1202. C (Count tax/stam Deed 1 399.00 • Mort a e . 1 399 00 1203. State Tax/stam Deed 1 399.00 • Mort a e . 1204, Re istralion Fee Deed • Mort a e • Release 1 399.00 1205. 1300. ADDITIONAL SETTLEMENT CHARGES 1301. Roof Cert. to TDHI Services 1302. Transaction Fee to M.C. Walker Real 60.00 1303. Wire Transfer Fee to Absolute Abstract LLC 195.00 1304. Ovem' ht Mail to Absolute Abstro LLC 20.00 25.00 1305. Doc. Delive Fee to Absolute Atlstra LLC 15.50 1306. Tax Cert. Fee to Absolute Abstract LLC 35.00 1307. Tax Cert. -Reimburse to Mike Bennett 10.00 1306. Home Warrant to American Home Shield 10.00 495.00 1400. TOTAL SETTLEMENT CHARGES enter on lines 103 Section J and 502 Section 7 735.30 10 697.00 I haw caMuay ravlewad Ilro HU0.1 SabNmanl Stalamenl and to IM beet o! my lurewtedge and be0el, It b a`We a amen or all receipts and disbunemenls made on my account or by me br ihh aaneadion. I hutlrer oadNy I I haw raeeh~d a copy o1 iM HU0.1 SetYemenl Statement. J lnmmrelae y//~~ l/~+ ~"'""""'_`_ ~j~~-3 ~ O °t //' . 11-a3-G~ WARNING fr ISACRMIE TO IP70WMGLY ANIO=FALSESTATEMENTS TO THE The HU0.l Settlement Stale enl I tj L~ UNITED STATES ON THIS OR ANY SIMILAR FORM. PENALTIES UPON CONVICTION Vsnsee0on. I have caused vAll u nCa po be dabursed in aceordalnee w~llf~~ls t ' and /Ul CAN INCLUDE A FINE AND IMPRISONMENT. FOR DETAILS SEE Tn1E 1S: U.S. CODE SECTON 1001 AND SECTION 1010. SETTLEMENT AGENT: DATE: