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HomeMy WebLinkAbout08-04-10 (2)T -_~ REV-1500 ~`(°'-10' 1505610143 OFFICIAL USE ONLY PA Department of Revenue pennsylvania cw,nty code vex File Number Bureau. Of Individual Taxes DEFMTMENr OF REVENUE Po Boxzlioso~ INHERITANCE TAX RETURN 21 0 9 O 110 6 Harrisburg, PA ~~128-OSO~ RESIDENT DECEDENT sa r s:rc uca.cvsn r t~r•vrcww ~ tVn 61GLVW Social Security Number Date of Death 192 34 6099 11 O1 2009 Decedent's Last Name RICHTER (If Applicable) Enter Survivlrlp 8pouse's Information Below Spouse's Last Name Spouse's Social Security Number FILL IN APPROPRUITE OVALS BELOW ® 1. Original Return ^ 4. limited Estate ® g. Decedent Died Tegtate (Attach Copy of Wig) ^ 9. litigation Proceeds Received Date of Birth 08 13 1923 Suffix Decedent's First Name MI ELIZABETH ' C Suffix Spouse's First Name MI THIS RETURN MUST BE FILED IN DUPLICATE vInTH THE REGISTER OF WILLS ^ 2. Supplemental Return ^ 3, Remainder Re~~ut~t (date of death • prior to 12-13-a;'Z~ ^ qa. Future Interest Compromise ^ 5. Federal Estate T1ax Return Required (date w deem alter 12-f 2.92> ^ T. Decedent Maintained a Living Trust (Attach Copy of Trust) __.-- 8. Total Number pf Safe Deposit Boxes ^ 10. ?2-3f- i ~ ~-1~'-g5jf ^ 11.Election to tax ui{ Ider Sec. 9113(A) --_ (Attach Soh. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTULL TAX INI Name Daytime DEBRA R PALLET 717 First line of address 24 NORTH 32ND STREET Second line of address City or Post Office CAMP HILL State ZIP Code PA 17011 ~:~ DATE SHOULD BE DIRECTED TO: Ntmt~ USE ONLY x' ~,~' .F" .~-, ro -r, _ ~ Q Correspondent's e-mail address: w a l l st d e b a o 1. c o rn ~ ~ppe ~perj~, 1 declare that 1 have examined this return, inGuding accomparty(rtg schedules and statements, and to tlte'~bas« o my knowledge and belief, plate. Declaration of preparer other than the person representative I!S based Ori all information of which preps has any knowledge. SIB OF PERSON RESPONSIaI R FILING RETURN ~ I DATE Sandra Richter ADDRESS 10 Summer Drive, Dilisburg, PA 17019 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE 1~Qw~~K ~ra1- Debra K Wallet ~,_ 30e $tt i p ADDRESS 24 North 32nd Street, Camp Hill, PA 17011 Side 1 L 1505610143 15056101431, J REV-1500 EX 1505610243 osoedenrs Nana: RICHTER, ELIZABETH C RECAPRUtATION ---- ----- 1. Real Estate (Schedule A) .......................................................................................... 1. 2. Stocks and Bonds (Schedule B) ............................................................................... 2. 3. Glossy Heki Corporation, Partnership or Sole-Proprietorship. (Schedule C).......... 3. 4. Mortgages & Notes Receivable (Schedule D) .......................................................... 4. 5• Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ................ 5. 6. Jointy Owned Property (Schedule F) ^ Separate Billing Requested ............. 6. 7. Inter-Vnros Transfers & Miscellaneous Non-Probate Property (Schedule G) ^ Separate Billing Requested ............. 7. 8. Total Gross Assets (total Lines 1-7) ....................................................................... 8. 9. Funeral Expenses & Administrative Costs (Schedule H) ......................................... 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10. 11. Total Deductions (total Lines 9 & 10) ...................................................................... 11. 12. N~ Value of Estate (Line 8 minus Line 11) ............................................................. 12. 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ................................................. 13. 14. Net Value SubJsct to Tax (Line 12 minus Line 13) ............................................... .. T4. TAX COMPUTATION -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 .00 15. 16. Amount of Line 14 taxable at lineal rate x .045 2 0 0 , 121.9 7 16. 17. Amount of Line 14 taxable at sibling rate X ,12 17. 18. Amount of Line 14 taxable at collateral rate X .15 18. 19. Tax Due ................................................................................................................... .. 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Decedent's SoCiat Security Number 192 34',6099 14,523.56 $6,180.20 'i1,981.22 4,254.22 i 26,939.20 ----- _ -~~4,912.12 I~,1,905.11 16,817.23 20,121.97 2t~0,121.97 ------ I -- _ ---__ __ I 9,005.49 9,005.49 Side 2 L 1505610243 150561024031 REV-1500 EX Page 3 Decedent's Complete Address: FHe Number 21 - 09 - 01106 Richter, Elizabeth C __ ______ _ _ ___ ^_ __ STREET ADDRESS 6001 William Drive CITY - - - - ------ STATE - -~ ZIP - -- Mechanicsburg PA ~ 17050 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) (1) 9,005.49 2. Credits/Payments ', A. prior Payments 6,000.00 B. Discount 315.79 Total Credits (A + B) (2} 6,315.79 3. Interest I (3) 0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) _ ^ _ Check box on Pegs 2 Une 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 2 , s 8 9.7 ~ Make Check Payable to: REGISTER OF WILLS, AGENT. ~ F . _ . . r~ ~-~~, - PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APP-F~OPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred :.........................................................................'i......... ^ b. retain the right to designate who shall use the property transferred or its income :................................... ^ [l ................................................................ P P Ym .......................,; ....... ^ 0 c. retain a reversionary interest; or ................ ,n ne ear o deat ^ ^ d. receive the romise for life of edher a ents, benefits or care? .............:.........................f ....... h ..'.~...~~~~ x 2. If death occurred after December 12, 1982, dxi decedent transfer property wdh o y v4rithout reoeivin adequate consideration .................................... pays p b ~........ ^ ~~ 3. Did decedent own an "m trust for°'or bleu on death bank account or securi at his or her death? I 1 rX-` 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a benefiaary des' nation? .............................................................................................................~,........ ^ ~_ i rg - IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS t3 YES, YOU MUST COMPLETE SCHEDULE G AND FILE ~' AS PART OF THE RETURN. For dabs of death on or after Juy 1, 1994 and before Jan. 1,1995, the tax rate imposed on the net value of transfers to ok for the use of the surviving spouse is 3 percent [72 P.S. §91116 (a) (1.1) {I)]. For dabs of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of t p2 P.S. §9116 (a) (1.1) (u)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory easels 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 ars 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 p2 P.S. §9116 (a) (~2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent; e~ccept as noted in 72 P.S. §9116 1.2) p2 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. §§9!11 ((a) (1.3) . A sibling is defined under Section 9102, as an ind+viduat who has at least one parent in common with the decedent, wfiet r by bloo~ or adoption cowioHwEKni aF vENNSVwANu NNERfTANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE -- _-- _- ___ - _____ --1-FILE NUMBE - ESTATE OF Richter, Elizabeth C ~ 21 -09-01 O6 All real property owned solely or as a tenant In common must bs naorted at fair market vslw. Fair marks slue is defined as the price at which property would be exchanged between a wiNing buyer and a wfl ng seller, neither being compelled to bu r sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship st bs disclosed on schedule F. ~ Attach a copy of the settlement sheet if the property has been sold. Include a copy of the deed showing decedent's interest if owned as tenant in common. ,-- -- __ ITEM DESCRIPTION VALUE AT DATE OF NUMBER DEATH 1 6001 William Drive, Mechanicsburg, PA 17050 (Based on proceeds from sale -see attached 154,523.56 HUD-1. Sold with all furniture and appliances.) TOTAL (Also enter on L1ne 1, oowMOawFxni of Po+NSV~wwU WHEMANCE TA7f RETUIIN RE&DBrT DECED@1T SCH~CULE B STOCKS & BONDS ESTATE OF Richter Fli~ahpth f All property joirMly-0wned with right of survivorship must be disclosed on Schedule F ITEM DESCRIPTION NUMBER 1 71 Savings Bonds (see attached list) _ __ T-__-.___- ___. _. _ _. FILE NU~M~~R 21 -09-01'06 ----- - _ --- I ---- - _ UNIT VAL~JE VALUE AT DATE OF DEATH - --I----- --- -._ ~' 36,180.20 TOTAL (Also enter on line 2, Recapitulation) ~, 36,180.20 SCHEDULE E CASH, BANK DEPOSITS, & MISC. c~woNwEALTMOFro+NSV~vANw PERSONAL PROPERTY N!lIERITANDE TAX RE7VRN RESIDENT DECEDENT FILE NUMBI ESTATE OF Richter, Elizabeth C __ 21 - os - 01 Include the pproceeds of litigation and the date the proceeds were received by the estate. All property jointly-owl survivonthip must be disclosed on schedule F. with the right of ITEM DESCRIPTION ', VALUE AT DATE OF NUMBER ' DEATH 1 Citizens Bank Checking Account #610076-541-5 ', 860.22 2 Highmark Blue Shield refund ! 301.00 3 Mittel Steel death benefit ', 800.00 4 Cash in possession of Decedent ' 20.00 TOTAL (Also enter on Line 5, Recapitulation) 1,981.22 SCHEDULEF COMAAONNIEALTHOFPENNSYLVANIA JOINTLY-0WNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Richter, Elizabeth C I FILE NUMBgR 21 -091-01106 If an asset was made joint within one year of the decedent's date of death, R must be reported on schadulei, G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIf,~NSHIP TO DECEDENT James E. Richter, II 31 Autumn Drive Son q Dillsburg, PA 17019 Sandra Richter 10 Summer Drive Daughter~~ g Dillsburg, PA 17019 ~' JOINTLY OWNED PROPERTY: ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT Indude name o nan in a ban account number r similar iden n number. Attach deed for'ointi -held real ~ 9 I y estate. _ DATE OF DEATH VALUE OF ASSET _ OF D CD'S INT REST DATE OF DEATH VALUE OF DECEDENTS INTEREST 1 approx. Citizens Bank CD#6140-828279 (joint with funds 41,924.17 34% 14,254.22 2001 from a previous Members 1st CD) I i i TOTAL (Also enter on line 6, Recapitulation) ~ 14,254.22 I~ti ~T}I of v~NSnwwa WHERITANCE TAl( RETURN RE810ENT DECEDENT ESTATE OF Richter, Elizabeth C SCI'f~ULE H FLJI~?AL E~H~.SES ~ ADNNSTRATNE CO6'T5 FILE NUMBE~t 21 -09-01106 Debts of decedent must be reported on Schedule 1. ___~_ __ ___ __ _ ITEM AMOUNT NUMBER FUNERAL EXPENSES: DESCRIPTION ---+---- A. 1 Myers Funeral Home, Inc. 336.00 37 East Main St., Mechanicsburg, PA 17055 2 Cake for funeral luncheon 100.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zip Year(s) Commission paid 2. Attorney's Fees Debra K. Wallet, Esq. 3,500.00 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 a. Probate Fees ', 346.00 5. s. 7. 1 Aaountant's Fees Tax Return Prepan3r'a Fees H gc R BIOCk Other Administrative Costs Postage, photocopies, etc. 112.00 30.00 TOTAL (Also enter on Ilne 9, Recapitulation) 4,912.12 iii -T Sdted~,iieH ODMAAONMfEALTH OF PENNSYLVANIA INF~RITANCE TAX RETURN ~~~'~~ ~$ RESIDENT DECEDENT ESTATE OF Richter, Elizabeth C 2 Postage charges incurred by the Co-Executors 3 Terminex 4 Pennsylvania American Water Company 5 Hampden Township -sewer bill balance 6 PP&L 7 UPI - furnace repair 8 Clarke American -estate checks FILE NUMB~Ei 21 -09-011~~ ~~_~_. 60.00 98.05 37.04 12.49 43.63 200.79 36.12 ~'T Page 2 bfi Schedule H II' ~TM of Pe+NSVwnriw INM ANCE TIVf PIkTURN E81DBiT D~®ENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIAB{LITIES, & LIENS ESTATE OF Richter, Elizabeth C 1FILE NuMB~R - 21 -09-01h06 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreirrnb~rsed medical expenses. ITEM DESCRIPTION AMOUNT NUMBER 1 UIGI 133.31 2 P{~nnsylvania American Water Company 27.03 3 PpBL 28.71 4 A1f8~T Long Distance 30.43 5 Hampden Township (sewer & trash) ~ 94.40 6 L~wnscapes, lnc. (lawn maintenance, trimming & leaf cleanup) 311.64 7 Sate Farm Insurance Co. (homeowner's insurance quarterly payment) 82.74 8 1Mest Shore EMS 54.00 9 Country Meadows ~ 1,104.85 10 M~HS Camp Hiil (beautician) 38.00 l j TOTAL (Also enter on Line 10, RecapitulsWo~)!. ~ 1,905.11 .._. _ r- REV-1613 EXr (11-04) SCHEDULE) COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INH RITANCE TAX RETURN ESIDEN7 DECEpENT ESTATE OF ;Richter, Elizabeth C FlLE NUMig~R 21 -09-01106 RELATIONSHIP TO SHARE OF E- 51~ATE AMOUNT OF ESTATE NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT (Wordsa ', ($$$) RECEIVING PROPERTY s)o Not ua Tnna.(s) ~~ TP~XABLE DISTRIBUTIONS [include outright spousal distributions and transfers under Sec. X116 (a) (1.2)j 1 J mes E. Richter, II Son 1/2 of residuarjy 1 Autumn Drive Estate illsburg, PA 17019 2 ands Richter Daughter 1/2 of residu~r~r 1 Summer Drive Estate illsburg, PA 17019 I En r dollar amounts for distributions shown above on Imes 15 through 18 on Rev 1500 cover sheet, as appropria II. N N-TAXABLE DISTRIBUTIONS: ', A. POUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN I i i I 'I 1 B. (CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS AL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER ..... _. _r-r. LAST WILL AND TESTAMENT OF ELIZABETH C. RICHTER Introductory Clause. I, ELIZABETH C. RICHTER, a resident of and domiciled in the -ty of Cumberland and Commonwealth of Pennsylvania, do hereby make, pub~ish and ire this to be my Last Will and Testament, hereby revoking all Wills and Codic~ls at any , heretofore made by me. I have two living children: James E. Richter, II and Sandra Richter ARTICLE I Direction to Pav Debts. I direct that all my legally enforceable debts, secured and red, be paid as soon as practicable after my death. ARTICLE II any be is a I direct that; (1) Direction to Pay All Taxes from Residuary Estate. Except as provided in (2) all estate, inheritance, succession, death or similar. taxes (except generation-s pping taxes) assessed with respect to my estate herein disposed of, or any part th~r~of, or on west or devise contained in this my Last Will (which term wherever used. herein shall any Codicil hereto), be paid out of my residuary estate and shall not be char~ed to or any recipient, beneficiary, transferee or owner of any such property or interests in y included in my estate for such tax purposes. (2) Apportion Taxes on Nonprobate Property. All such taxes in respect to any y or interests in properly included in my estate for inheritance or estate tax purposes shall ged against and paid by the recipient or beneficiary of such property or interest in y or from the property or interest in the property, provided, however, there sh~.ll be no ~nment against any donee or recipient of any such property or interest in praperty which citable organization and the property or interest in property was allowed as a charitable on in calculating any inheritance or estate tax due. The amount of the tax td ~e charged such donee or recipient shall be determined by apportionment. -1- .ARTICLE III Ge al t o a so o d a i a r to e r I gi a and bequeath all my personal and household effects of every kind includng lti t not limited to 'tore, appliances, furnishings, pictures, silverware, china, glass, books, jew~l#~y, wearing ap arel, boats, automobiles, and other vehicles, and ail policies of fire, burglary, pr~perty age, and other insurance on or in connection with the use of this property, to m~ children s 'ving me in approximately equal shares. I request that my Executor abide by a m morandum by me directing the disposition of this property or any part thereof. s request is pr catory and not mandatory. ARTICLE ~V I give, or __ .. e and bequeath all the rest, residue and remainder of my property of every kirid iption (including lapsed legacies and devises) wherever situate and whether ac er the execution of this Will, absolutely in fee simple to my surviving children s. The living issue of a deceased child of mine shall have no right to inherit the t would have taken had he or she survived me. If neither of my children survi~ devise and bequeath all the rest, residue and remainder of my estate in equal ~t King charitable organizations: the Mechanicsburg Presbyterian Church, the CSI ion of the American Heart Association, Wormleysburg, PA and the Harrisburg ter of the Diabetes Foundation, Camp Hill, PA. ARTICLE V aired before n equal share their me, then I ores to the tal Region Namintt the Executor. Executor Succession. Executor's Fees and Other Mattelrs. The -~- pro 'sions for naming the Executor, Executor succession, Executor's fees and other utters are set rth below: (1) Namin~t Individuals as Executor. I hereby nominate, constitute and a point as Exe utors of this my Last Will and Testament James E. Richter, II and Sandra Iticht~r and direct that ey shall serve without bond. ', (2) I,~dividual Executors Succession. If any individual Executor should ~~i1 to qualify as E ecutor hereunder, or for any reason should cease to act in such capacity, the rem'~aining indi 'dual Executors shall continue to serve without a successor or substitute. ~,~,,, ~,/...~ c'. -2- ARTICLE VI Definition of Executor. Whenever the word "Executor" or any modifying ~# substituted noun therefor is used in this my Will, such words and respective pronouns shall include both singulaz and the plural, the masculine, feminine and neuter gender thereof, and' Shall apply pally to the Executor named herein and to any successor or substitute Executor ~gting eunder, and such successor or substitute Executor shall possess all the rights, p~~vers and ies, authority and responsibility conferred upon the Executor originally named herein. ARTICLE VII I give to any Executor named in this Will or any Codicil hereto or to any sLtc~Cessor or su 'tote Executor all of the powers enumerated in this Will and all of the powers applicable by la to fiduciaries in the Commonwealth of Pennsylvania and in particular through !tl~e Pe ylvania Probate, Estates and Fiduciaries Code, as effective and as in effect om }he date of my death, during the administration and until the completion of the distribution of icy estate. I ct that all such powers shall be construed in the broadest possible manner and u be exer- cis ble without court authorization. (1) My Executor is authorized and empowered to acquire and to retain, ether pe anently or for such period of time as my Executor may determine, any assets, ii~cluding the cap stock of any closely held corporation, whether such assets are or are not of tie character app ved or authorized by law for investment.by fiduciaries and whether such asse~sldo or do not rep sent an overconcentration in one investment. (2) My Executor is authorized and empowered to disclaim any interest, " whole or in p of which I, or my Executor, may be the beneficiary, devisee, or legatee, by exelc g an app priate instrument (in accordance with section 2518 of the Internal Revenue Cq a of 1986, as ended, or such similar section as may then be in effect). (3) My Executor is authorized and empowered to sell at public or private ale, or exc ge, and to encumber or lease, for any period of time, any real or personal prorty and to give options to buy or lease any such property. Additionally, my Executor is authorised and em- pow red to compromise claims, to borrow from anyone (including a fiduciary heredndder) and to ple a property as security therefor, to make loans to and to buy property from anyone (incl g a fiduciary or beneficiary hereunder); provided that any such loans shall be adequately sec d and at a fair interest rate. (4) My Executor is authorized and empowered to allocate property, char~es on ty, receipts and income among and between principal or income, or partly to arch, without to any law defining principal and income. ~. , ~.,k -3- ARTICLE VIII seficiary and I should die under such circumstances as would make it doubtful seficiary or I died first, then it shall be conclusively presumed for the purposes beneficiary predeceased me. If any ~eth~er the this Will that Testimonium Cl/ause. IN WITNESS WHEREOF, I have hereunto set my hind and my seal this ~ /1' day of ~ ~. C ,= ,r,, t ~ , 2000. {. ~~..~,G.+_,f/ C• - (SEAL) ELIZ ETH C. RICHTER Attestation Clause. The foregoing Will was this 14thday of Dece ' , ,signed, sealed, published and declared by the Testator as and for her Last Wil and ~ment in our presence, and we, at her request and in her presence, and in the presence of other, have hereunto subscribed our names as witnesses on the above date. ~~1- ~/r~`~.~~~~ of Harrisburg, Pennsylvanid of Mechanlcsbura, Pennsylvania of -4- ~ _ _ __ SELF-PROVINC3 AFFIDAVIT TH OF PENNSYLVANIA OF cUMBERLi4ND . SS. WE, and Bridget M. WHit~ey ~ Wayne M. Pecht ~ and ,the Testator and the witnesses, respectively, iwhose names signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to undersigned authority that the Testator signed and executed the instrument as l~~r Last Will that she had signed willingly (willingly directed another to sign for her), and that she cuted it as her free and voluntary act for the purposes therein expressed, and that'~~, each of the nesses, in the presence and hearing of the Testator, signed the Will as witness a~}i to the best us or her laiowledge the Testator was at that time eighteen (18) years of age or o~der, of sound ~d, and under no constraint or undue influence. e~ EL ETH C. RICHTER, ~'e{stator -t.c /~ ~ . Witness Witnes Witness to of :d, sworn to, and acknowledged before me by ,the Testator, and subscribed',and sworn me by Bridget M. Whitley ~ Wayne M. Pecht ~ and', ,witnesses, this ! ~ day -2000. ~~~ No Public NOTARIAL 5 l CYNTHIA J. RULE, No Public Catr~f tiiN Boro., Cum -5- ,2< _ _ __ _. __ ___ ~•°"~"'a OMB Approval No. 2502-0265 `* ~ A Settlement Statement (HUD-1) ~ ~~ nNS~ B. Type of Lwn B. FNs Number. 7. Loan Number. 8. Mortpape Msurance Case Number. 1. ~ FHA 2. Q RHS 3.OX Comr. Unins. CHADWICK 100308003 4. Q VA 5. Q Com. n s. C. Nob: 7hJs Ibrrn !s b pM you s shlerrrerd oI atlas! setdlenrsrd ooefa. Amarnb peJd b and 6y the aefWmsnt apsrrt aro shown. Ibr-rs rrrrksd .o.a)"wws pdd outside the cbskp: they ars shown here for krfornra0orrel pwposea end ane not brcludsd ki dre bts/a. D. Name and Address o/ o maver. E. Name and Addess of Ssber. F. Nems and Address of LsMer. ELAINE A. CHADWICK FIRST AMERICAN MORTGAGE. LLC 35 NATHAN DRNE JAMES E RICHTER,11, Co-Exec and 4188 MILL STREET ENOLA, PA 17025 SANDRA RICHTER, Co-Exsanw BRISTOL, PA 19007 of the Es1s~ of E9zabeth C. RkMsr G. Property L.oulbn: H. SettlameM Agent: 23-2402318 I. Sa/HsmeM Date: 6001 WILLIAM DRNE PURITY ABSTRACT COMPANY MECHANICSBURG, PA 17 3329 MAR10=T STREET March 11.2010 HANPOEN TWP, CLMI CO. CAMP HILL PA 17011 Ph. (717)937.8359 Plsoe of SelOsrnent: Century 21 Phdonad RsaKy 303. Cash U Frorn To Borrower 78,959.31 The undersigned hereby of • 0ompkbd of thb statement b any allachmsMs rotaned to hs Bonower se 1, a lile.~cur~ A. C K ~ ES E. RICHTER, 11, Co-Executor SANDRA RICHTER, o•6ceartor ~~~ nrv~e~er~as~ss.anbrar a~na~,rw,rwanrwrasmr.rsvr~ewbraweramw+ao~a~IY~pr,.mtw.sr.ym.rnormresrt+aoren.dr~••no~rai.ab m~rbna n+r.eeavae~• rseonemrad~~M.r.NomtlldNe~Yawurk/bdMew~.YmrWvY.ThYYAwb~7bpwk.MpelWb.REaPAmw.dY~wgknvAl~iib~myfon tluke ti Ml~rtpiaa~a Page 10}3 HUD-1 (C W 1D W VCK.PFDICHADW ICKI18) L. Settlement Cha 700. Total Real Eslats r Fesa S 10.080.00 wa crom Pre Fmm u 9onw,ra s.w. 701.5 5 480.00 m REALTYASSOCWTES ww r Fum r Nob: l.lne 701 7 1 ustrneM of 395.00 For Y 1 I TY IN aalNrnrt s.nwnwv 7 10 475.00 704. TRANSACTION FEE 708. DEED PREP b CENTURY 21 PlSCIONERI REALTY, INC to RF.M/JC REALTY ASSOCIATES 225.00 125.00 707. 708. 708. 710. 711. 712. 800.1brna M 801.Oiu wMh l.an PdM or 1882.10 /1 802. Your oro~t ar eharps our 804. Isal fss BOS. Credlt ax n 809. ) for tl1e apseMc IMsrsst rata chosen E -90T.10 b FAM LLC b CREDR PLUS CIO FAM to b (fiom G~FE>X2) GFE AA Iran GFE A POC 5400. GFE Ki 975.00 17.53 18. 81 . 81 m 900. Mains ref W Ba Paid in Advance 901. ills~est 902. Mo isurancs f 903. s canoe 904. 905• 03H 1M 0 Eo 04101 M 0 21 512,876700 ain for naMhs b 1. R b A (from GFE if10) GFE #Ci 1 from GFE aRt t (from GFE tf11) 270.41 351. 1000. RaaM'ras Msd Lander 1001. hdtlal daposk for your 1 canoe acoouM per nq mo r nanlh (hom GFE t9) 954.84 1004. Properlytaxas own axes months r 5 1005. Scfiool Tax AssasmeMS monfhe r 5 1006. COtAITYRWPTAX 2.000 montla ~ S 31.96 psr ngrdh S 83.92 1007. SCHOOL TAX 10.000 months @ S 107.89 per naMh S 1,078.90 1008. AGGREGJITE ADJ ENT S -278.22 1009. 5 1100. TMM Cha 1101. Tkle ssn4ass and Isnda 1102. SetllsrraM ar 1103. 11 s s t>Ile insurance f4 P.10-041 5 GFE SRS 107187557PA0 2.51 1,139.75 376.00 1105. Lsrabrs title tlmtl 1106. Owners title Nrrrit 1107. piths 1108. UrWsrvRilsrs of 1109. Fee S 94 000.00 166 OOD.00 Otleirrwranos um to PURITYABSTRACTCOMPANY S 1132. bbl ltlle fnsurarxx hxn to flRST AMERICAN TI71E INS. CO. S 215. to Note Clsrk 0.00 1110. ax es to 5.00 1111. 1 2. 1113. 1200. GovemmaM Recordlrrp nd Transfer Charges 1201. GowmmsM b RECORDER OF DEEDS hom GFE 146.00 1202. Deed S 82.00 S 84.00 Releases S Ofhsr S 1203. Tramdsr taxes to RECORDER OF DEEDS from GFE #8) 1,880.00 1204. bx/ab 1205. Stsb 1206. S 1,880.00 S 1 88D.00 S S 1,680.00 1207. 1300. AddMbrW tlatlfarrraM 1301. setvioss ihd can for m GFE 1302. M4HERTfId4CE TAX OW b PURITY ABSTRACT COMPANY 3000.00 130.7. TRASH 9M 0 - 3R1 b HAMPDEN TOWNSHIP 14 75 1304. RADON MITIGATION b MI SHEELY 795.00 1305. 201000UNTY/iWPT ESCROW b PURRYABSTRACTCOMPANY 425.00 1400. Total Seltlaaurrt C aMar on Wra 103 14aetlon J and 80 Ssdbrr 6 801.78 16090.00 ~r4~VP4~ar~~c~ ~oas~aP wapla~m~p~o mp/vp4 ean~s~o . SetlbmeM F~ent CertlBed b be s hue OOpy. Paps 2 of 3 HUD-i (C4M1ADW ICKPFOf CVIAAW f C W 19) _T _ __ _ _ Comparison of Good Fsifh (GFE) and HUD•1 Charpp Good Faith Estimate HUD-1 ThatCarsvot HUD-1 Una Number Our (nation #801 .1,882.10 7,882.10 Your credtl or (point) the apeoltk: krterest rate chosen #802 -907.10 -907.10 Your usted ch #803 975.00 975.00 Tromfer taxes #1203 1,680.00 1,080.00 l;ovemrnentrscordi #1201 170.00 148.00 Appraisal fee #804 400.00 400.00 Credit report #805 50.OD 77.53 Flood carti8eatlon #807 16.50 16.50 Titb asrvicas and IerMsrt k uuwnoe #1101 1,423.75 1,139.75 Owners tltle insurance to AAAERICAN TRLE INS. CO. #1103 376.00 Total 2,060.25 2,095.78 Inaasse batwesn GFE and HUM Charyas S 35.53 or 1.72 Charyq That Can Chant's Good Faith Estlmab HUD-1 Mtliai depwk for your saaow #1001 1,668.00 954.84 Dally kdersat charges #901 S 12.676700/day 261.11 270.41 Homeowners insuroncs #903 480.00 361.00 Loan Tenns Your inhtal town amount k S 94,000.00 Yow ban tans b 30 years Your InMtal Interest rest b 5.0000 % Your InIWI monthly arnornrt for principal, interest and S 504.61 Includes arty mor>oape haiuranee is © Prindpal ® lntersst ^ Maipape Inwrance Can your interest rats rise4 © No ^ Yas, tl can rhs to • nwdrrsrm of %. The first change will be on and an change apart ovary! months afler . Every cfianps date, your Interest rest an increaw or decrease by %. Over the Nfs of the loco. your kgsrsat rate b guaranteed torrovsrbsbwerthan %orhiphsrthan %. Even K you males payments time, pn your lasn tralanee rW? ® No ^ Yes, K can rte b a maximum of 5 Even N you mNrs paymarrts tttra, pn yorw morgldy ® No ^ Yes, tlro first Inassee pn bs on and the naMhty amount owed for prindpN, and mortpepe insrrrsnu rlwl amount awed pn rises bo i The maximum k can ever rise b k 5 doss your ban haw a penaMl/I ® No ^ Yss, your mardmum propaymsnt penalty b S Does yow loan have a paymsrtt'J ® No ^ Yss, you have a tattoo payment of 5 due In _ yearo on ToW monhy amorart owed escrow account payments ^ You do not have ^ mouthy asorow patmrsnt for Items, wch as property foxes and homeovmara inwronoe. You must pay 1Mae hems dirodly yourseM. © You have an addN(onal nanthty escrow payment of 5189.93 that roautle in a total Initlal monflrty arrwtrnt owed of 5674.54, Tttfs includes princpal, Interest, any mortgage insurance and any Items checked below: ® Propsrtyfaxas ® HomsovmersMsuronae ^ Fbod Inwrancs ^ ^ ^ loos: K you have arty qusstlorn the Settlement Charges and Loan Terms tlsted on thb form, Abase contact your bndsr. Ppe 3 of 3 HUD-1 (CHA(WJICKPFDICHADW ICK/19) HUD-1, Page 4 Borrower (s): L AINE A. CHADWICK seller(s): JAMES E. RICHTER, II, Co-Executor and 5 NATHAN DRIVE SANDRA RICHTER, Co-Executor N OLA, PA 17025 twnder. I RST AMERICAN MORTGAGE, LLC ~ ~~ U RITY ABSTRACT COMPANY 17)737-6359 Pans of ssttamenf: e ntury 21 Piscioneri Realty 3 15 Market St, Camp Hill, PA ssttk-merrt Date: rch 11, 2010 Properly Location: 0 01 WILLIAM DRIVE ECHANICSBURG, PA 17050 AMPDEN TWP, CUMBERLAND CO. Additional Adjus ents For Items Paid By Seller In Advance (Borrower Debit) Descri n Amount FromlThrou h Prorated Amount 1ST QTR SEWER 105.75 01/01/10 through 03!31/10 24.68 Total Line 109!409 24.68 Adjuabed Origins on Charge Details Origination Charge YSP 907.10 to FIRST ERICAN MORTGAGE. LLC PROCESSING FEE 325.00 to FIRST ERICAN MORTGAGE. LLC COMMITMENT FEE 650.00 to FIRST ERICAN MORTGAGE. LLC Total 1,882.10 Origination Credit/ rge (points) for the specific interest rate chosen CrediUCharge -907.10 to FIRST ERICAN MORTGAGE. LLC Total -907.10 Adjusted Origination Charges S 975.00 Title Services and enders Title Insurance Details BORROWER SELLEF CPL to First America Title In 75.00 First n Title Insurance Company Email Document Rem val 50.00 PURITY A TRACT COMPANY Notary Fee 30.00 Notary C Overnight FeelP a 12.00 PURITY STRACT COMPANY Total S 167.00 S Owners Title insu rice BORROWER SELLEF WARNINQ: k kt • crime tb make hlas siahnranb to 1M Unlad state on tMs or arty similar form. Penaltlss upon convkfion can krGude • lira and For deaRe see: TkN 7t U.e. Code eeWon 1007 and Ssetlon 7070. (CFWDWICKPFD/CHADWICKH 9) __ _ T _ _ __ ___ _ _ - __ _ HUD-1, Page 4 -Continued Owners Policy Pre ium 376.00 to FIRST ERICAN TITLE INS. CO. Total S 376.00 S Lenders Tttle tns fence BORROWER SELLER Lenders Policy Pre ium 822.75 to FIRST ERICAN TITLE INS. CO. Lender's Endorsem nt Charges 150.00 Endorsement Endorsement Charge END 100 50.00 END 300 50.00 END 900 50.00 Total S 872.75 S The undersigned he by acknowledge receipt of a completed copy of this statement & any attachments referred to herein ~~~~/~' u ~/~~ LAINE CHADWI K J ES E. RICHTER, II, Co-Executor SANDRA RICHTER, Co-Executor WARlkNG;: k b a GNne knowingly make faW sGEemMib to fire Unksd Sobs on tlds or arty simibr form. PenalWs upon convietlon can hdurb a floe and kn For dsbib see: TkN 10 US. Code Sectlon 1001 and Sedbn 1010. (CHADWICKPFDlCHADWICK/1 S) Calculated Value of Your Paper Savings Bond(s) Page 1 of 2 Caldulated Value of Your Paper Ravings Bond(s) lator Results for Redemption Date 01/2010 T tat Price 350.00 Totat Yalue J 6 180.20 Total Interest 27 830.20 YTD IntXerest 8~. 4 fond : 1-71 of 71 Serial eries Denom Issue Next Final Issue Interest Interest Value N # Date Accruat Maturity price Rate NA EE $200 11/1984 05/2010 11/2014 $100.00 $278.40 4.00/d $378.40 NA EE $200 12/1980 06/2010 12/2010 $100.00 $489.92 4.OOQ/a, $589.92 NA EE $200 11/1984 05/2010 11/2014 $100.00 $278.40 4,00°!a $378.40 NA EE $200 05/1985 05/2010 05/2015 $100.00 $270.96 4.p0~/o~ $370.96 NA EE $200 01/1984 07/2010 01/2014 $100.00 $293.68 4.00/0'' $393.68 NA EE $200 12/1984 06/2010 12/2014 $100.00 $278.40 4.00/0'' $378.40 NA EE $200 01/1985 07/2010 01/2015 $100.00 $278.40 4.00%' $378.40 NA EE $200 04/1985 04/2010 04/2015 $100.00 $270.96 4.OOWo' $370.96 NA EE $200 01/1985 07/2010 01/2015 $100.00 $278.40 4.00%' $378.40 NA EE $200 01/1985 07/2010 01/2015 $100.00 $278.40 4.009/0', $378.40 NA EE $200 10/1984 04/2010 10/2014 $100.00 $278.40 4.009/0', $378.40 NA EE $200 05/1984 05/2010 05/2014 $100.00 $286.00 4.00%', $386.00 NA EE $200 04/1984 04/2010 04/2014 $100.00 $289.20 4.00%% $389.20 NA EE $200 12/1984 06/2010 12/2014 $100.00 $278.40 4.00%~, $378.40 NA EE $200 03/1984 03/2010 03/2014 $100.00. $289.20 4.00°Xo'; $389.20 NA EE $200 03/1984 03/2010 03/2014 $100.00 $289.20 4.00°Xo', $389.20 NA EE $200 04/1984 04/2010 04/2014 $100.00 $289.20 4.00%', $389.20 NA EE $200 10/1984 04/2010 10/2014 $100.00 $278.40 4.0'0% ~', $378.40 NA EE $200 09/1984 03/2010 09/2014 $100.00 $278.40 4.00%' $378.40 NA EE $200 06/1984 06/2010 06/2014 $100.00 $286.00 4.00%', $386.00 NA EE $200 05/1984 05/2010 05/2014 $100.00 $286.00 4.00%' $386.00 NA EE $200 07/1984 07/2010 07/2014 $100.00 $286.00 4.00%' $386.00 NA EE $200 07/1984 07/2010 07/2014 $100.00 $286.00 4.00°/b ' $386.00 NA EE $200 06/1984 06/2010 06/2014 $100.00 $286.00 4.00°/6 , $386.00 NA EE $200 10/1983 04/2010 10/2013 $100.00 $305.76 1.78% ', $405.76 NA EE $200 08/1984 02/2010 08/2014 $100.00 $278.40 4.00% ~ $378.40 NA EE $200 08/1984 02/2010 08/2014 $100.00 $278.40 4.00% ', $378.40 NA EE $200 08/1984 02/2010 08/2014 $100.00 $278.40 4.00°/d ' $378.40 NA EE $200 09/1984 03/2010 09/2014 $100.00 $278.40 4.00°/q $378.40 NA EE $200 02/1983 02/2010 02/2013 $100.00 $388.08 4.00% ' $488.08 NA EE $200 03/1983 03/2010 03/2013 $100.00 $328.88 1.29% ' $428.88 NA EE $200 03/1983 03/2010 03/2013 $100.00 $328.88 1.29% ', $428.88 NA EE $200 04/1983 04/2010 04/2013 $100.00 $328.88 1.29°/q $428.88 NA EE $200 03/1983 .03/2010 03/2013 $100.00 $328.88 1.29°/d $428.88 NA EE $200 08/1983 02/2010 08/2013 $100.00 $305.76 1.7$°/d, $405.76 NA EE $200 08/1983 02/2010 08/2013 $100.00 $305.76 1.7$%% $405.76 NA EE $200 07/1983 07{2010 07/2013 $100.00 $309.44 1.64%j $409.44 NA EE $200 05/1983 05/2010 05/2013 $100.00 $309.44 1.64% $409.44 NA EE $200 05/1983 05/2010 05/2013 $100.00 $309.44 1.64%' $409.44 http://wv~w.treasurydirect.gov/BC/SBCPrice !, 1/8/20]0 _ __ _r - ~_ Calculated Value of Your Paper Savings Bond(s) Page 2 of 2 NA EE $200 12/1982 06/2010 12/2012 $100.00 $397.84 4.00% $497.84 NA EE $200 01/1983 07/2010 01/2013 $100.00 $397.84 4.00°rb $497.84 NA EE $200 04/1983 04/2010 04/2013 $100.00 $328.88 1.29°rb $428.88 NA EE $200 09/1983 03/2010 09/2013 $100.00 $305.76 1.78°/0 $405.76 NA EE $200 08/1983 02/2010 08/2013 $100.00 $305.76 1.78% $405.76 NA EE $200 09/1982 03/2010 09/2012 $100.00 $421.76 4.00°/n $521.76 NA EE $200 05j1982 05/2010 05J2012 $100.00 $432.16 4.00°/p $532.16 NA EE $200 05/1982 05/2010 05/2012 $100.00 $432.16 4.00% $532.16 NA EE $200 11/1982 05/2010 11J2012 $100.00 $397.84 4.00'0/m $497.84 NA EE $200 01/1982 07/2010 01/2012 $100.00 $442.80 4.00P/q $542.80 NA EE $200 08/1982 02/2010 08/2012 $100.00 $421.76 4.00% $521.76 NA EE $200 09/1982 03/2010 09/2012 $100.00 $421.76 4.00°/b $521.76 NA EE $200 09/1982 03/2010 09/2012 $100.00 $421.76 4.00°/~ $521.76 NA EE $200 04/1982 04/2010 04/2012 $100.00 $432.16 4.00°/q $532.16 NA EE $200 02/1982 02/2010 02/2012 $100.00 $432.16 4.00°/q $532.16 NA EE $200 03/1982 03/2010 03/2012 $100.00 $432.16 4.OOm/d $532.16 NA EE $200 09/1981 03/2010 09J2011 $100.00 $442.80 4.00°/q $542.80 NA EE $200 09J1981 03/2010 09J2011 $100.00 $442.80 4.00°/a, $542.80 NA EE $200 08/1981 02/2010 08/2011 $100.00 $442.80 4.00?/oi $542.80 NA EE $200 07/1981 07J2010 07J2011 $100.00 $453.68 4AOQIo $553.68 NA EE $200 07/1981 07/2010 07/2011 $100.00 $453.68 4.00%j $553.68 NA EE $200 05/1981 05/2010 05/2011 $100.00 $453.68 4.00% $553.68 NA EE $200 05/1981 05/2010 05/2011 $100.00 $453.68 4.00% $553.68 NA EE $200 06/1981 06/2010 06/2011 $100.00 $453.68 4.00% $553.68 NA EE $200 06/1981 06/2010 06/2011 $100.00 $453.68 4.00% $553.68 NA EE $200 04/1981 04/2010 04/2011 $100.00 $478.32 4.00%' $578.32 NA EE $1,000 04J1985 04j2010 04J2015 $500.00 $1,354.80 4.00%' $1,854.80 NA EE $200 12/1980 06/2010 12/2010 $100.00 $489.92 4.00%, $589.92 NA EE $1,000 04/1985 04/2010 04/2015 $500.00 $1,354.80 4.00%'; $1,854.$0 NA EE $500 04/1985 04/2010 04/2015 $250.00 $677.40 4.00%~I $927.40 NA EE $500 04/1985 04/2010 04/2015 $250.00 $677,40 4.00%0 ', $927.40 NA EE $500 04/1985 04/2010 04/2015 $250.00 $677.40 4.0'0°/O' $927.40 Totals for 71 Bonds 8 350.00 27 830.20 36 180.20 Notes Ni N t Issued NE N t eligible for payment P5 In ludes 3 month interest penalty MA M tured and not earning interest http://wv~{w.treasurydirect.gov/BC/SBCPrice 118/20] 0