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HomeMy WebLinkAbout07-08-101505610101 ~ REV' i ~oo EX(oi-io) OFF{CIAL USE ONLY PA Department of Revenue Pennsylvania Bureau of Individual Taxes DEPApTMENTOFREVENUE County Code .Year File Number PO BOX 28o6oi INHERITANCE TAX RETURN Harrisburg, PA 1128-o6oi RESIDENT DECEDENT 21 10 0085 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 196-14-2215 01 /17/2010 06/10/1925 Decedent's Last Name Suffix Decedent's First Name MI WATKINS MARGARET ' M (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name_ _ MI Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW ~ 1. Original Return O 4. Limited Estate ~ 6. Decedent Died Testate (Attach Copy of Will) O 9. Litigation Proceeds Received THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS O 2. Supplemental Return O 4a. Future Interest Compromise (date of death after 12-12-82) O 7. Decedent Maintained a Living Trust (Attach Copy of Trust) O 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) O 3. Remainder Return (date of death prior to 12-13-82) O 5. Federal Estate Tax Return Required 0 8. Total Number of Safe Deposit Boxes O 11. Election to ta;c under Sec. 9113(A) (Attach Sch. O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number Keith O. Brenneman, Esq (717) 697-8528 ,~,_ First line of address........... 44 West Main Street Second line of address City or Post Office State ZIP Code REGISl OF WILLS t ONLY "~ -, .y L.-. ; ~.;; ---;~ r~'l ~ C"" ~ "; i ~ CIS ` J f L..1 r ~ :; . t ~ t ~ { ~ F i ~ ""~I • • r. " ~ ~~pp 3aAT1E FILE D C~ -~ ~ a Mechanicsburg PA 17055 Correspondent's a-mail address: Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best or my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. IATURE OF PERSON RESPONSIB,L~E~FOR FILING RETURN DATE iv-r~ ! ~-/~.G~~c.7~?1 o n~.-__~ Executrix '^7 -r~'_r h ADDRESS ~J 230 Easy Road, Carlisle, PA 17013 SIC,~~~/y~ OF PREPARER OTHER THAN REPRESENTATIVE DA~T~E~~ 11 w-~-~'--° ADDRESS 44 West Main Street, Mechanicsburg, PA 17055 PLEASE USE ORIGINAL FORM ONLY Side 1 1505610101 1,5056101,0], r~ - J 150561,0105 REV-1500 EX Decedent's Social Security Number DeceaenYs Name: Margaret M. Watkins 196-14-2215 RECAPITULATION _. 1. Real Estate (Schedule A) ............................................. 1. 107,500.00 2. Stocks and Bonds (Schedule B) ....................................... 2. ' 14, 505.04 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 4. Mortgages and Notes Receivable (Schedule D) ........................... 4. 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)....... 5. 195,681.98 _. 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ....... 6. ! 423.55 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested........ 7. 8. Total Gross Assets (total Lines 1 through 7) ............................. 8. 318,110.57 9. Funeral Expenses and Administrative Costs (Schedule H) ................... 9. 23,576.17 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) .............. 10. 1,443.55 11. Total Deductions (total Lines 9 and 10) ................................. 11. 25,019.72 12. Net Value of Estate (Line 8 minus Line 11) .............................. 12. 293,090.85 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ........................ 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ........................ 14. l 293,090.85 ``. TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0~ 15. 'i 16. Amount of Line 14 taxable at lineal rate X .0 _ 16. 17. Amount of Line 14 taxable at sibling rate X .12 17. _ _ _. 18. Amount of Line 14 taxable 293 090 85 43 963.63 . at collateral rate X .15 ~ 18. 19. TAX DUE ......................................................... 19.' 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT C~ Side 2 150561015 1505610105 REV-1500 EX Page 3 Decedent's Comalete Address: File Number 21-10-0085 DECEDENT'S NAME Margaret M. Watkins -------- -- ---- STREET ADDRESS ------------ - ----------- 168 Crain Drive - --- -- -- ---- CITY ~---~---~___~..__.__.__ - -~_~ Carlisle STATEPA ZIP17015 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments _.__ B. Discount 3. Interest 2,198.18 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. Total Credits (A + B) (2) (3) (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) Make check payable to: REGISTER OF WILLS, AGENT. 43, 963.63 47, 873.18 3,909.55 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No .................... a. retain the use or income of the property transferred :................................................................ ...... ^ x b. retain the right to designate who shall use the property transferred or its income : ...................................... ...... ^ c. retain a reversionary interest; or .................................................................................................................... ...... ^ 0 d. receive the promise for life of either payments, benefits or care? ................................................................ ...... ^ 0 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? x 3. Did decedent own an "in trust for" or payable-upon-death bank account or security at his or her death? ........ ...... ^ 4. Did decedent own an individual retirement account, annuity or other non-probate property, which contains a beneficiary designation? .................................................................................................................. ...... ~ ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 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 requiremE;nts 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 21 years of age or younger at death to or for the use of a natural parent, an adoptive parent or a stepparent of the child is 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 4.~i 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 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. 45,675.00 REV-1502 EXt (11-0$) ~ pennsylvania SCHEDULE A DEPARTMENT OF REVENUE INHERITANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT ESTATE OF FILE NUMIBER Margaret M. Watkins 21-10-0085 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property that is iointly-owned with right of survivorship must be disclosed on Schedule F. If more space is needed, insert additional sheets of the same size. REV-1503 EX+ (6-98) SCHEDULE 6 COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Margaret M. Watkins ~! 1-10-0085 All property jointly-owned with right of survivorship must be disclosed on Schedule F. (If more space is needed, insert additional sheets of the same size) REV-1508 EX+ (6-98) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Margaret M. Watkins 21-10-0085 include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Orrstown Bank Accounts No. 143000227 (checking): $74,245.97 No. 143000410 (money market): 25,557.46 No. 4000014505 (Cert. of Deposit) 54,026.01 Total: 151,829.44 2. ~ Miscellaneous personal property, furniture, furnishings, household effects, including 1995 Buick station wagon 9,728.00 3. MST checking account No . 2675036830 32,677.02 4. Refund, United Telephone of PA 14.68 5. Cumberland County Veterans Benefit 100.00 6. Refund, The Sentinel newspaper subscription 4.84 7. Two cemetery lots, Cumberland Valley Memorial Gardens 250.00 8. United States Treasury, 2009 income tax refund 906.00 9. The Hartford, refund of homeowners insurance 172.00 TOTAL (Also enter on line 5, Recapitulation) $ I 195,681.98 (If more space is needed, insert additional sheets of the same size) REV-i5og EX+ (oi-io) ~ pennsylvania DEPARTMENT OFREVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF: FILE NUMBER: Margaret M. Watkins 21-10-0085 JOINTLY OWNED PROPERTY: ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY INCLUDE NAME OF FINANCIAL INSTTfUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECEDENT'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST i. A. 05/22/02 Orrstown Bank checking account No. 106002588 847.10 50% 423.55 TOTAL (Also enter on Line 6, Recapitulation} I $ 423.55 If more space is needed, use additional sheets of paper of the same size. If an asset became iointly owned within one year of the decedent's date of death, it must be reported ion Schedule G. REV-1510 EX+ (08-09) enns lvania SCHEDULE G P Y DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND rnHERITANCE TAx RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Margaret M. Watkins 21-10-0085 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. If more space is needed, use additional sheets of paper of the same size. REV-1511 EX+ (10-09) ~ pennsy~vania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Margaret M. Watkins 21-10-0085 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Hoffman -Roth Funeral Home $8,680.87 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s) of Personal Representative(s) R~ i n ~hPrman-jell thPxow -- Street Address 230 Easy Road City _______Sa r 1 i ~ 1 P State ___~ ZIP l~n ~ ~ Year(s) Commission Paid: __ - 2. Attorney Fees: Snelbaker & Brenneman , P . C . 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: Initial fee ($202.50) and additional fee ($175.00) 5. Accountant Fees: , miscellaneous fling f es , reserve 6. Tax Return Preparer Fees: Wagner's Tax and Accounting Services 7. Bob Sholly, Auctioneer, auctioneer's fee 8. Bob Sholly, Auctioneer, commission from auction of real estate 9. Advertise grant of Letters: a. Cumberland Law Journal: $75.00 b, The Sentinel: 219.40 Total: 3,500.00 3,500.00 377.50 1,000.00 80.00 2,918.40 3,225.00 294.40 TOTAL (Also enter on Line 9, Recapitulation) $ 23,576.17 If more space is needed, use additional sheets of paper of the same size. REV-1512 EX+ (12-08) ~~ pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Margaret M. Watkins 21-10-0085 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. If more space is needed, insert additional sheets of the same size. REV-1513 EX+ (01-10) ~ Pennsylvania SCHEDULE J DEPARTMENT OF REVENUE - - - BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Margaret M. Watkins 21-10-0085 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under Sec. 9116 (a) (1.2).] 1' Donald W. Watkins Stepson 1960 Country Road 130 P. 0. Box 125 Bellefontaine, OH 43311 2. Brett A. Sherman Great Nephew 20 Tiffany Drive Carlisle, PA 17013 3. Connie L. Sherman Niece 230 East Road Carlisle, PA 17013 4. Robin N. Sherman-Witherow Great Niece 230 Easy Road Carlisle, PA 17013 10~ of Estate 30~ of Estate 30~ of Estate 30~ of Estate ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. I $ If more space is needed, use additional sheets of paper of the same size. `~ '~ H ~' `~- ~ ~ - _ ~ ~ - . .... ` ,...o..,. ~ ~ ~ ~ ' ~ h z -~ ~' ~, o ~ ~. ~ ~ ~ ~ ~ ~~ :<_ : _ ~, t y M ~+.~~++ ~. .... ..~ }} 1 1 ~..+~~.. .~ T~" . 1 }}y .LLWr .,? t~~,l ~' .. l ~~ i f ~ X'.,,.-. r--, ..,..:. ~t ~,~C~ ~~.~t JF t~llARGAR~T ~Vt.1tVA i Kll~S i !-, ~argaret~lVl. Watkins of Cumberland ~c~un~jr, ~ennsylvani~, being .of ~ounc~ memo and understanding, do hereby make, ~publisl~ and declare this as and far mind, ry my Last Will and ~"estament, hereby .revoking al! other v~ills and codicils heretofore made by rne. l~'1=p~! ~~;~: !direct the payfrnent of my debts and the expenses of my Oast illness and funeral fror~n my estate as span after my death as conveniently may be done. if there be no cemetery lot available foamy interment, ©wned by me at the ~.ir~ne of m}~ death, f autfi~c~rize my perscanai representative tG purchase such cemetery lot with a co~~tract fcsr perpe'cual care, u:~ing therefore funds from my estate, and ! authcri~e my ersonal rep~rese~:~ati~e ~o cause title tc~ ®r ownership of such lot sa purui~ased t.o he p vested in such person as my personal representative shall designate. Further, in this c©nnection, i authorize my personal representative to upend funds from my estate, in such amount as my personal representative shalt consider essa and desirable, for the purchase, erection and inscription of a suitable marker nec ry for my Qrave. ..~ ...+.--~~v.^.;-Yr-.^fi r. ,.y....._. .. «.r.~nrv~7.. ..ye.f-•.. .~ n.y.:.*.. ,..- ^7;-..- -n.,..... 2~..--mar. -.+.n~rvre+.p ...n1r ...,.+. ^T.+;mt' ,. ,. ,,. y ~, r: ~ 1TEtVl TWCJ: I, give, devise and bequeath my estate to each of the fallowing ' - . provided they survive me by thirty days: Ten percent to my stepson Donald W. Watkins; Thirty percent to my niece, Connie Sherman, Thirty percent to my great-nephetinr, Brett A. Sherman; and, Thirty percent to my great-niece., Robin N. Sherman-Witherow. iTEM THREE: l direct that no Executrix or other fiduciary named, nominated, or appointed by this my Last 1Nili and Testament shall b~1 required to post any band or give any security of any type for any purpose whatsoever, any law or rule of the court of the Gornmonweaith of l'ennsyivania flr any other jurisdiction to the contrary notwithstanding. 1 direct that the lava of the Gorrtmonwealth of P~ennsyivan'sa shall apply ' to any interpretation or application of the validity of this instrument. lT~~!i FCDtJR: Any and a{S payment car payments of any sum or sums, wheti~er in ~~ cash or in kind and whether for principa{ or income, payable to an heir, ar any ~-r them, ~ shall be made upon fhe sole receipt of the respective individual to whom the payment is ~„ madA, and free from anticipation, alienation, assignment, attachment, and pledge, and free from control by the creditors of any such beneF~ciary. (TEtJI ~i~E: (confer upon my i=xecutrix the right tc~ sell or otherv,~ise canve~ any rea! or personal property at public or private sale, at such time ar time, in such nnanner, and for such price or prices, and on such terra: and Gondi~:ions as my executor ~ahall {~etG~rrr~lrl~, ~r'td to G~eGS.~z~ end d~11Ver gC:Q~ end suffiCl~n~ conveyances, assignrneitt~ and transfers of the pr©perty, without iiabiiit}1 of any' purchaser for the appiicatiar~ of any consideration; to borrow money and to secure its payment by mortgage of real or personal pr©perty, pledge of investments, or otherwise, without liability on the part of the lenders to see to the application thereof; to retain any investments at discretion; to .... ..~lln• .... _..;, ~i.. enK _ _ _ _ .•~ -ter r h~'e+ "'^r'c . ~~ir,~ . .n .Ywivr •ow ........~ .-r--+a.~.l.~~..n ~-...7..rwrm. '~I}i:r -eqp~ ..1'M/.fkPq.X~nR~~.:• M1yT /y~.KK'M 'CI"~EW~~ f.'.~ ~~ ~/:. f ~ t: invest and reinvest at discretion, without restriction to so-called "[ega! investments"; to rna~ke distribution in cash or in kind; to allocate and distribute different kinds or disproportionate shares of property or undivided interests in property among beneficiaries, in case or in kind, or partly in each; and to do all other acts and things necessary or appropriate in the management, administration and distribution of my estate. ITEM S1X: 1 appoint my great-niece,~~ Robin N. Sherman-Witherow, Executrix a-f this my Last Will and Testament. Should my said Executrix fail to survive me odor any reason fail to qualify as Executrix, l then appoint my niece, Connie Sherman, Executrix of this my Last Will and Yestament. 11V WITPVESS WHEREOF, l have hereunto set my hand and seat to this, my L~sfi Will and Testament, consisting of three (3} typewritten pages, the first firvo (2} of vrhich bear my signature in the margin far the purpose of identiTSCa#ian, this 27th day ®f ~Jul}~, 2Da9. ~'~'~ . ~ ~ S E_A~. ( ) argaret M. V1}'atkins ,.~ . - _, .. ...., ~~ j .„ ,., . _ _ _ ~ ;. - .. . A. Settlelnent Statement U.S. Department of Housing and Urban Development B. T~-fie of Loan nnnR 4r,nrn„nl nl„ ~~no_no~ti 1. ~ FfiA 2. ~F111HA 3. ~Conv. Unins. 4. RYA ~_~Conv. L1s. 6. File Number 2010-086 7. Loan Number 8. Mortgage hlsunnce Case NuulUer This form is furnished to give you a statement of actual settlement casts. Amounts paid to and bythe settlement agent are shown. C. Note: Items marked "(p.o.c.)" were paid outside the clos(ng; they are shown here for information purposes and are not included in the totals. WARNING: 1t is a crime to knowingly make false statements to the United Stales on this or any other similar form. Penalties upon nment. For details~er~ Title 18 U S Code SPCtion 1001 and lion 1010 -` TitleF~cpresS Settlement System j D. NAME OF BORROWER: Ralph L. Deitch and Linda K. Deitch ADDRESS: E. NAME OF SELLER: The Estate of Margaret M. Watkins F. NAME OF LENDER: N/A G. PROPERTY ADDRESS: 168 Crain Drive, Carlisle, PA 17013 North Middleton Townshi H. SETTLEMENT AGENT: PA Real Estate Settlement Services LLC, Telephone: 717-249-6333 rax: 717-249-7334 n F 3S4 Alexander S rin>~ Road. Carlisle, PA 17015 I. 05/25/2010 J. SUMMARY OF BORROWER'S TRANSACTION: K. SUMMARY OF S1=LLER'S TRANSACTION: 10 GRC S M U F M R W R 40 N E 1 1 ~ I r" 107 500.00 4 l _ 107 500.00 nal Property 1 I 2 035.75 _ 1 Ad' ent f i m i se I i n ad a c Ad's f r' ~ mS~aid b II v nc~ 1 i w ~x 406 ~i{y/jgwn taxes _ 1 s 05 25 10 12 31/10 208.50 47 fl5/25 10 12 31 10 _ 208.50 QL~axes 05/25 10 06 30 10 130.90 05 25 10~ 06 30 10 130.90 1 4 1 - 410. V 11~ 4 ' ` 1.12. '__12 GR S5 AMO NT DUE FROM ORROW R 109 875 . 15 _ j 420 GROSS AMOUNT DUE TOLE LER 107 839.40 200. AMO~INTS PAID BY OR ON BEHALF OF BORROWER 0 D T10NS IN AMOUNT DUE TO S~ R 10 , 750__00_ 2 1. DQOOSit or earnest money --- € cess De osit ($ee instructions) X41, 10, 750.00 ~ ~2~_Pri cipal amount of new loans ~ _____ _ q? Settlement charges to seller {lne 1400) 1 085.00 203. Existina loan(s) taken subject to _ Existing loan{s) taken subject to ~' 2 04 Payoff of First Mortgage Loan - __ _ __ 2 r 2 I ~ 207. 2~_- _ ' 507 I _ A 'u n f' em n id b t er m n f it rrls unpaid I r 1 Q`..G1 211 __~ountytaxes _ I- I s 1 1 i X14, b14. ~~1~.- ~ 15 ------- 2 217 ---, __ - 1 ~_21$.~- _ $.-_ ~ ~_- x_220 T~ZAL PAID BY/FOR BO ER _ 10 750.00 _ 520. TOTAL RF,~UCTION AMOUNT U SEL R 11 835.00 ,_ 300 CASH AT SETTLEMENT FROM OR TO BORR W R ,_W_____ ~QO CASH AT SETTLEM_ENT~ OIL FROM S E R _ 301 of r w r i ~ 109 875.15 r 4 ~_ _ 107,839.40 ;302. Less amounts oard by f/ or ba w r Iine~~20 10 750.00 ~ r m ~ I I' le 52D) 11 $35 00 _~p3.._C!_1SH FROM BORROWER _ __~ _ 991125.15 603 ASH TO SELLER _ _ 96 r_004 . 40 SUBSTITUTE FORM 1099 SELLER STATEMENT: The information comained herein is important tax information and is being furnished to the Internal Revenue Service. If you are required to file a return, a negligence penalty or other sanction will be imposed on you if this item is required to be reported and the 1RS determines that it has not been reported. The Contract Sales Price described on line 401 above constitutes the Gross Proceeds of this transaction. You are required bylaw to provide the settlement agent (fed. Tax ID No: )with your correct taxpayer identification number. If you do not provide your correct taxpayer identification number, you may be subject to civil or criminal penalties imposed by taw. Hoer penalties o perjury, I certify that the number shown on this statement rs my correct taxpayer identification number. TIN: - / - SELLER(S) SIGNATURE(S): SELLER(S) NEW MAILING ADDRESS: SELLER(S) PHONE NUMBERS: (H) U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT File Number: 2010-03G ~~TT{ 4=MFNT ~TATI=MFNT r;}tec...,,o~~ corno.,.o„r c„ate.,, o~;..re.a nrioennin ~r ~o~~n n rn L S^TTLEMEIdT CHARGES PAID FROM PAID FROM 79~ TOTAL SALESIBROk~CR'S COMfy11SSION based on price $107 , 500 . 00 = _ BORROWER'S SELLER'S i commission (line 7001 as follp~v s: FUNDS AT FUNDS AT 7 1. to SETTLEMENT SETTLEMENT 7 ~, $ to mmission paid at SeUhment . ITEMS PAYABL IN ONNECTI N WITH AN n Sion Fee % - ._ 4? Loan Discount °/ ptai~al Fee 4 Credit ReRprt _ ~. Lender's Insoecfion Fee M ppli anon Fee .~ sumotQ Fee 900. ITEM5 REQUIRED BY LENDER TO BE PAID IN ADVANCE Can$ !da}(_ 02 M~gage Insurance Premium far to ~H~zard Insurance Premium for to 4. 05 OQ. RESERVES DEPOSITED WITH LENDER FOR _ X01 Hazard Insurance mo LaP ~ Imo » 1002 Mortgagor surance mo Cad ~ (mo _ .._ 1 9~~1Y-_P[Qgerty Tax ma (a~ $ /mo ;_'LQQ4 County Prop~y Tax rho ~1a ~ /mo 1005. SchooLtaxes mo ~a ~ /mo _ ~1QIl,L_BggreaateAnaJysis~A-Ijustment _ 0.00 0.00 110 TITLE N GES _ - -{~ 11Q1~m0LlLflt G1o;iirig~8e Q_2_ A~ta~.L~t-.titJgsearch ___ _ 11Q~_ Ti_;I~_examination __ i 11Q4._Title insurance binder __. ___ 1Q~.pocument Preparation ~ __ ` 110@,._ Notary Fees to Notary Clerk _ 10 . QO ~. 11QZ~/ ~orneys fees I_ __ _(incfudes above items No: ) _ _ ~ ^~ 11 I I surance to Stewart Title Guaranty/PA RE SS 898.75 _jir1clS~des above items No; l ~~1 r @~er's Polity 1110 0wners_Policy 107 , 500 . 00 - 898 .75 1 ?1. 1112. _. i~1~ 1_~~. ~ -~ 12Q0, GOVERNMENT RE. ORDING~ND TRANSFER CHARGES __, _ ~7Q1 RP4Qr in Fees Deed ~ 52.00 • Mot]gagt' $ _ Release $ _ 52.00 _ 1202 qty/Cou~ySax(_sta[nR~ Deed $1, 075.00 ; Morty,~q~~ _ 1 075.00 ~, 1203 State Taxlsiamvs Deed $J 075 , 00 ; Mortyage ~ 1 075.00 ~12Q4_. P~1JD E~~ __. tp Recorder of Deeds _ 1 0~~ _- - --- 10.00 ~ 1 00. ADDITIONAL SETTLEMENT CH~GES ~. 130~.Fjl_7a1 Wtr/Swr to North Middleton Authority j 1302 Pes I~s,~ection _ I _ I I 140(). TOTAL SETTLEMENT~HA~C~ES (enter on lines 103. ~eclp~rd 5D2 ~~lion L() _ 2 035.75 _l 085.00 HUD CERTIFICATION OF BUYER AND SELLER I have carefully reviewed the HUD-1 Settlement Statement and to the best of my knowledge and belief, it is a true and accurate statement of all receipts and disbursements made on my account or by men in this transa ~ ion. 1 further certify at I ve received a co y of the HUD-1 Settlement Statement. \ ~f Ralph L. f enc V Linda K. Oeilch The Estate of Margaret M. Watkins y: Robin ShLrrf~an-Witherow WARNING' IT IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE The HUD-1 Settlement Slalement which I have prepared is a true and accurate account of This transaction. UNITED STATES ON THIS OR ANY SIMILAR FORM. PENALTIES UPON CDNVICTION I have caused wi(1 cause the funds to be disbursed in accordance with this statement. CAN INCLUDE A FINE AND IMPRISONMENT. FOR DETAILS SEE TITLE 18: ~ ~/~~~~ U.S. CODE SECTION 1001 AND SECTION 1010. 0y: A ~;aiculatea value of Your Yaper savings Bond(sl Page 1 of 3 Calculated Value of Your Paper Savings Bond(s) Calculator Results for Redemption Date 01/2010 3,075.00 $14,505.04 $11,430.04 $40.04 Bands: 1-123 of 123~~ L206517463EE: EE . $50; 06/1985;. 0.6/201.0 06/2015.,..__, $25.00.;,.,,_ $67.74„; 4,.00°/a $92.74 L207117423EE _ EE . $50 07/1985 07/2010: 07/20,1;5.._ _ $25.00 _ ..,.$67.74:._. 4.00% $92.74 .......................... . L206517254EE EE $50 06/1985 06/2010 06/2015_,..._ $25.00 _ $67.74 '_ 4.00% $92.74 _ L206517041EE _ EE . $50: 05/1985: 05/2010 05/2015 $25.00 ` $67.74 4.00% $92.74 L206516856EE EE $50 05/1985 05/2010 05/2015 $25.00 $67.74 4.00% $92.74 L201678050EE EE $50. 04/1985 04/2010 04/2015 $25.00 $67.74. 4.(JO% $92.74 L201677846EE EE $50 04/1985. 04/201.0, 04/2015. $25..00 $67.74 4.00% $92.74 L201677639EE . EE $50 03/1985 , 03/2010 03/2015 $25.00 $67.74 4.00% $92.74 L200070593EE EE $50 03/1985 03/2010 03/2015: $25.00 $67.74 , 4.00% $92.74 L200070386EE EE $50 03/1985 03/2010 03/2015 $25.00 $67.74 4.00% $92.74 L200070200EE EE $50 02/1985 02/2010 02/2015 $25.00 $67.74 4.00°10 $92.74 L189851041EE EE $50, 02/1985 02/2010 02/2015 $25.00 $67.74 4.00% $92,74 L189850855EE EE $50 01/1985. 07/2010 01/2015 $25.00 $69.60 4.00% $94.60 L189850648EE EE $50 01/1985 07/2010 01/2015 $25..00 $69.60 4.00% $94,60 L189850452EE EE $50. 12/1984 06/2010 12/2014_ $25.00 $69.60 4.00% $94.60 L184892977EE EE $50 12/1984 06/2010; 12/2014 $25.00 $69.60 4.C)0% $94.60. L184892775EE EE $50 11/1984 05/2010 11/2014 $25.00 $69.60 4.C10% $94.60 L184892559EE EE $50 11/1984 05/2010 11/2014 $25.00: $69.60 4.00% $94.60 L184892368EE EE $50! 10/1984 .04/2010. 10/2014 $25.00 $69.60 4.00% $94,60 L184555519EE EE $50 10/1984 04/2010 10/2014 $25.00 $69.60 4.00% $94.60 L184555323EE EE $50 09/1984 03/2010. 09/2014. $25.00 $.69.60 4.00% $94.60 L184555097EE EE $50 09/1984 03/2010. 09/2014 $25.00 $69.60 4.00% $94.60 L172543093EE EE $50 09/1984 03/201.0 09/2014 $25.00 $69.60 4.00% $94.60 L172542883EE EE $50 :08/1984. 02/2010 08/2014 $25.00 $69.60 4.00% $94.60 L167908416EE EE $50 08/1984 02/2010 08/2014 $25.00; $69.60. 4.00% $94.60 L167908199EE EE $50 07/1984 07/2010 07/2014 $25.00'. $71.50 4.00% $96.50 L167174155EE EE $50 07/1984 07/201.0 07/2014. $25.00 $71.50. 4.00% $96.50 L167132133EE EE $50 06/1984 06/2010 06/2014, $25.00 $71.50 4.00% $96.50 L167132074EE EE $50 06/1984 06/2010 06/2014 $25.00 $71.50 4.00% $96.50 L167077286EE EE $5.0 :05/19,8.4 05/20.10 05/2014 $25.0.0 $71.50- 4.00% $96.50. L167077112EE EE $50 ..05/1984 05/2010 05/2014. $25.00 $71.50 4.00% $96.50 L167076926EE EE $50 04/1984 04/2010 04/2014. $25.00, $72.30 ` 4.00% $97.30'. L167062422EE EE $50 04/1984 04/2010 . 04/2014 $25.00 $72.30 4.00% o $97.30 i L167062250EE EE $50 03/1984 03/2010 03/2014 $25.00 $72.30 4.00°l0 $97,30 L157678497EE EE $50 .03/1984 03/2010 ; 03/2014 $25.00 $72.30 4.00% $97.30 L157678317EE EE $50 03/1984 03/2010 03/2014. $25.00 $72.30 4.00% $97.30 L156943433EE EE $50 02/1984 02/2010 :02/2014 $,25.00,, $72.30 4.00% $97.30 L156943254EE EE $50 .02/1984 02/2010 02/2014 $25.00. $72.30 4.00% $97.30 ............ ... L156102717EE EE $50 01/1984,.07/2010 01/2014 $25.00 $73.42' 4.00%; $98.42 L156102535EE EE $50 01/1984:.07/2010 01/2014 $25.00' $73.42 4.00% $98.42 L155644671EE EE $50 12/1983 06/2010 12/2013 $25.00 $73.42 4.OC)% $98.42 http://www.treasurydirect.gov/BC/SBCPrice 2/?!?010 calculated value of Your Yaper Savings Bond(s) Page 2 of 3 L155644476EE EE $50 12/1983 06/2010 12/2013 $25.00 $73.42 4,00% $98.42 L152171001EE EE $50 11/1983 05/2010, 11/2013 $25.00 $73.42 4.00% $98.42 L151161856EE EE $50 11/1983 0.5/2010 11/2013 $2.5.00 $73.42 4.00% $98.42 L151161693EE EE $50 10/1983 04/2010 10/2013 $25.00. $76.44 1.78% $101.44 L151161542EE EE $50. 10/1983 04/2010 10/2013 $25.00 $76.44. 1„78% $101.44 L115200980EE EE $50 10/1983: 04/2010 10/2013 $25..00 $76.44 1.78%; $101.44 L115200815EE EE $50 09/19$3: 03/2010 09/2013 $25.00 $76.44 1.78% $101,44 L115200660EE EE $50 09/1983: 03/2010: 09/2013 $25.00:. $76.44 1.78% $101.44 L115200519EE ` EE $50 08/1983 02/2010 08/2013 $25.00: $76.44. 1.78% $101.44 L115200364EE EE $50 08/1983 02/2010: 08/2013 $25.00 $76.44 1.78% $101.44 _1152001785EE EE $50 _:. 07/1983. 07/2010 07/2013 $25.00. $77.3.6 1.64% $102.36 L115173365EE EE $50 07/1983 07/2010 07/2013 $25.00 $77.36 1.64% $102.36 L115173216EE EE $50 06/1983: 06/2010 06/2013 $25.00 $77.36 1,64% $102.36 L115173062EE EE $50 06/1983 06/2010: 06/2013 $25.00 $77.36:, 1.64% $102.36 L76079909EE . EE $50 ; 05/1983 05/2010 05/2013 _ $25.00 $77.36 1.64% $102.36 _ ._ L76079768EE EE $50 05/1983 05/2010: 05/2013 $25.00 $77.36 1.64% $102.36. ._ L76079656EE EE $50 04/19$,3.:,, 04/2010 04/20,13 $25.,00 $82,22 1.29% $107.22 L76079523EE EE $50 04/1983: 04/201,0 04/2013 $25.00 $82.22 1.29% $107.22. L76079389EE EE $50'. 04/1983: 04/2010 04/2013 $25.00. $82.22 1.29% $107.22 L76078744EE EE $50 01/1983. 07/2010 01jZ013 $25.00 $99.46. 4.O0% $124.46 L76078621EE EE $50 01/1983 07/2010 01/2013 $25.00 $99.46 4.t)0% $124.46 L76078473EE EE $50 12/1982 06/2010 12/2012 $25,00 $99.46 4.00% $124.46 L76078337EE EE $50 12/1982 06/2010 12/2012 $25.00 $99..46 4.C)0% $124.46 L76078201EE EE $50 11/1982 05/2010 11/2012 $25.00 $99.46 4.00% $124.46 L76078085EE EE $50 11/1982 05/2010. 11/2012 $25.00. $99.46 4.00% $124.46 L76077949EE EE $50 10/1982 04/2010 10/2012 $25.00: $105.4.4 4.C)0% $130.44 L76077807EE EE $50 10/1982 04/2010 10/2012 $25.00 $105.44 4.00% $130.44 L76077677EE EE $50 ;10/1982 04/2010 10/2012 $25.00 $105.44 4.00% $130.44 L76077562EE EE $50 09/1982 03/2010 09/2012 $25.00 $105.44 4.G0% $130.44 L76077429EE EE $50 09/1982 03/2010 09/2012 $25.00 $105.44 4.00% $130.44 L76077304EE EE $50 08/1982 .02/2010 08/2012 $25.00 $105.44 4.00% $130.44. L76077166EE EE $50 08/1982 02/2010 08/2012 $25.00 $105.44 4.00% $130.44 L76077050EE EE $50 .07/1982 07/2010 07/2012 $25.00 $108.04. 4.00% $133.04 L76076917EE EE $50 07/1982 07/2010 07/2012 $25.00 $108.04 4.00% $133.04 L76076788EE EE $50 06/1982 06/2010 06/2012 $25.00 $108.04. 4.00% $133.04 L76076672EE' EE $50 06/1982 , 06/2010. 06/2012 $25.00: $108.04 4.00% $133.04 L76076570EE EE $50 .05/1982 05/2010 05/2012 $25.00 $10$.04 4.00% $133.04 L76076450EE EE $50 05/1982 .05/2010 05/2012 $25.00 $108.04 4.00% $133.04 L76076333EE EE $50 05/1982 05/2010 05/2012 $25.00 $108.04 4.00% $133.04 L76076228EE EE $50 .04/1982 04/2010 04/2012. $25.00 $108.04 4.00% $133.04 L76076129EE EE $50 04/1982 04/2010 04/2012 $25.00 $108.04 4.00% $133.04 L76076009EE EE $50 .03/1982 03/2010 03/2012. $25.00 $108.04. 4.0t)% $133.04 L76075894EE EE $50 03/1982 __ 03/2010 03/2012 $2.5.00 $108.04 4.00% $133.04 L76075770EE EE $50 02/1982 02/2010 02/2012 $25.00 $108.04 4.0O% $133.04 L76075662EE EE $50 02/1982 ; 02/2010 02/2012 $25.00 $108.04 4.00% $133.04 L76075531EE EE $50 . 01/1982 07/2010 . 01/2012 $25.00 $110.70 4.00%' $135.70 __ L76075401EE EE $50 01/1982 07/2010 01/2012 $25.00 $110.70 4.00% $135,70 L76075288EE EE $50 12/1981 06/2010 12/2011, $25.00 $110.70 4.00% $135.70 ' L7607516$EE EE $50 12/1981 06/2010 , 12/2011 $25.00 $110.70, 4.OC)% $135.70 L76075042EE EE $50 11/19$1 .05/2010 11/2011 $25.0.0 , $110.70: 4.00%' $135.70 L6832466EE EE $50 11/19$1 ; 05/2010 11/2011 $25.00 $110.70: 4.00% $135.70 L6832339EE EE $50 10/1981 , 04/2010 10/2011_.: $25.00 $110.70 , 4.OC)% $135.70 L6831956EE EE $50 09/1981.03/2010 09/2011 $25.,00 $110.70 4.00% $135.70 L6832072EE EE $50 10/1981:04/2010 : 10/2011 $25..00: $110.70 4.00% $135.70 L6832306EE EE $50 10/1981 04/2010 .10/2011: $25.00 $110.70 4.00% $135.70 L6831700EE EE $50 09/1981, 03/2010 09J2011 $25.00 $110.70 . 4.00% $135.70 L6831599EE EE $50 08/1981.02/2010: 08/2011: $25.00 $110.70 ' 4.00% $135J0 http:llwww.treasurydirect.govlBC/SBCPrice 2/2/20 l 0 Calculated Value of Your Paper Savings Bond(s) Page 3 of 3 L6831462EE EE $50. 08/1981 02/2010 08/2011: $25.00 $110.70 4.00% $135.70. L6831438EE' EE $50 07/1981 07/2010 07/2011 $25.00 $113.42 4.00% $138.42 L6831217EE EE $50: 07/1981' 07/2010. 07/20.11 $25.00 $1.13.42 4.00% $138.42. L6831124EE EE $50 06/1981 06/2010 06/2011 $25.00, $113.42: 4.00% $138.42 L6831017EE EE $50: 06/1981; 06/2010 06/2011 $25.00 , $113.42. 4.00% $138.42 L6830894EE EE $50 05/1981 _ 05/2010 05/2011: $25.00: $113.42 4.00% $138.42 L6830795EE EE $50 _ 05/1981 05/2010 05/2011 $25.00' $113.42. 4.00% $138.42 L6830696EE; EE $50 05/1981 05/2010; 05/2011 $25.00 $113.42 4.00% $138.42 L6$30571EE EE $50 04/1981 04/2010' 04/2011 $25.00 $119.58 4.00% $144.58 L6830464EE EE $50 04/1981 ' 04/2010 04/2011 $25.00: $119.58 4.00% $144.58 L6830366EE EE $50 03/1981 03/2010 03/2011 $25.00 $119.58 4.00% $144.58 L6830257EE EE $50 03/1981 03/2010 03/2011 $25.00: $119.58 4.00% $144.58.,- L6830147EE EE $50; . 2/1981: 0 02/2010. 02/2011 $25.00 $119.58 4..00% $144.58: L6830023EE EE $50' . 02/1981'. 02/2010 02/2011 $ 25.00 $119.58: 4..00% $144.58 L6829931EE EE $50 01/1981 ; 07/2010: 01/2011; $25.00 $122.48 4.00% $147.48 - ___ __ L6829835EE _ EE $50 01/1981 07/2010: 01/2011 _ $25.00 $122.48 4.00% $147.48 __ L6829728EE EE $50 12/1980 06/2010__ 12/20.10, $25.00 $122.48', .4.00% $147,.48 L6829600EE EE $50 . 12/1980 06/2010 12/2010, $25.00: $122.48 4.00% $147.48 L6829506EE EE _ $50 :..11/1980 05/2010 11/2010 $25.00: $122.48 4.00% $1.47.48 L6829407EE EE $50 11/1980 05/,2010 11/2010 $25.00, $122_.4$ 4.00% $147.48 ......... . . L6829299EE EE $50 11/1980 05/2010 11/2010 $25.00. $122.48 4.00% $147.48 L6829171EE EE $50 10/1980 ..04/2010 10/2010 $25.00 $135.90 4.00% $160.90 L6829076EE EE $50 10/1980 04/2010 10/2010 $25.00 $135.90. 4.00% $160.90 L6$28966EE EE $50 09/1980 :03/2010 09/2010 $25.00 $135.90 4.00% $160.90 L6828852EE EE $50 09/1980 .03/2010 09/2010 $25.00 $135.90 4.00% $160.90 Tota{s for 123 Bonds $3,075.00 $11,430.04 $14,505.04 1 NI Not Issued NE Not eligible for payment P5 Includes 3 month interest penalty MA Matured and not earnin interest http:/iwww.treasuiydirect. gov/BC/SBCPrice ?/?/? G 10