Loading...
HomeMy WebLinkAbout09-16-10' 15D5610140 REV-1500 EX ~°'-'°' OFFICIAL USE ONLY PA Department of Revenue Bureau of individual Taxes County Code Year File Number Po Box 2sosol INHERITANCE TAX RETURN 2 1 0 9 1 0 8 6 _ Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 2 0 0 2 2 ? 4 2 6 0 8 2 6 2 0 0 9 0 7 2 2 1 9 2 7 Decedent's last Name P E T E R S Suffix Decedent's First Name B E T T Y (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Sufhx Spouse's First Name MI F MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW a 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required death after 12-12-82) 0 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE uIREG I itv I U: Name Daytime Telephone Number G E R A L D J S H E K L E T S K I E S Q ? 1? ? 4 ?~ 3 5 REGISTER ~ ~.~ USE Y - ~~~ <~~ I ~ ~ m ~.... r ~°, ~' First line of address ~ . ~_r ~~ ~ ~ ~~~~ '~ 4 1 4 B R I D G E S T j ~ ~~ ~'' -1 E ~; -~- ~ ~~= Second line of address f --,~ ~ .. ~~-- -~; .~ .~ P 0 B 0 X E ~ irv i~ City or Post Office State ZIP Code DATE FILED N E W C U M B E R L A N D P A 1 7 0 7 0 Correspondent's a-mail address: g s h e k l e t s k i a s t o n e l a w• n e t Under penalties of perjury, I declare that t have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. DeGaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATU ERSO~ E'~I'~FOR FILING RETURN ©~ ` 16DAT ~V KENNETH A• SHOLLEY 639 GETTYSBURG PIKE, MECHANICSBURG PA 1?055 SIGNAT ~PREP~R OT~~THAN~GE1'RESE,~IT/jji+tlE _ ~ ,, DATE ADDRESS ~/ GERALD J• SHEKLETSKI, ESQ• 414 BRIDGEST•,NEW CUMBERLAND PA 1707D PLEASE USE ORIGINAL FORM ONLY Side 1 1505610140 1505610140 J J 1505610240 REV-1500 EX Decedent's Social Security Number oecedenes Name: B E T T Y F• PETERS 2 0 0 2 2 7 4 2 6 RECAPITULATION 1 5 0 0 0 0 0 0 1. Real Estate (Schedule A) ........................................... 1. . 2. Stocks and Bonds (Schedule B) .... . ................................. 2• • 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 4. Mortgages and Notes Receivable (Schedule D) .......................... 4. • 3 4 8 1. ? 9 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)....... 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... 6. • 7. Inter-Vivos Transfers 8 Miscellaneous N Probate Property uested Billin Re t ~] S 7 • ....... g q epara e (Schedule G) . 8. Total Gross Assets (total Lines 1 through 7) ........................... 8. 1 5 3 4 8 1. ? 9 9. p ( ) .................. Funeral Ex enses and Administrative Costs Schedule H 9. 5 4 1 6 8 . 2 0 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) .... ......... 10. 6 6 ? 9 9 . 0 3 11. Total Deductions (total Lines 9 and 10) ...................... ......... 11. 1 2 0 9 6 7. 2 3 12. Net Value of Estate (Line 8 minus Line 11) ................... ......... 12• 3 2 5 1 4 . 5 6 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. 3 2 5 1 4 • S 6 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 0 0 0 15 0 0 0 (a)(1.2} x .0 . . 16. Amount of Line 14 taxable at lineal rate x .045 3 2 5 1 4. 5 6 1s. ], 4 6 3. 1 6 17. Amount of Line 14 taxable 0 0 0 17 0. 0 0 at sibling rate X .12 . 18. Amount of Line 14 taxable 0 0 0 0 0 0 at collateral rate X .15 18, . 19. TAX DUE ............................................. ......... 19. 1 4 6 3• 1 6 20. FILL 1N THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ^ Side 2 1505610240 1505610240 J REV-1500 EX Page 3 Decedent's Complete Address: Tax Payments and Credits: ~ • Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 3. interest 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fi{I in oval on Page 2, Line 20 to request a refund. 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. File Number 21 D9 1086 1,463.16 Total Credits (A + B) (2) 0 • 0 0 (3) 19.6 4 (4) 0.0 0 (5) 1, 482.80 Make check payable to: REGISTER OF WILLS, AGENT 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 : ................................................................. i ..... ^ ^ ncome; .......................... b. retain the right to designate who shall use the property transferred or its ..... ^ 0 c. retain a reversionary interest; or ........................................................................................... ..... ^ d. receive the promise for life of either payments, benefits or care? .................................................. ..... 2. If death occurred after December 12,1982, did decedent transfer property within one year of death ^ without receiving adequate consideration? .................................................................................. " " ..... ^ 0 orpayable-upon-death bank account or security at his or her death? .... in trust for 3. Did decedent own an ..... 4. Did decedent own an individual retirement account, annuity or other non-probate property, which contains a beneficiary designation? ............................................................................................. ..... ^ 0 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FI LE 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 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)j. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements 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)j. • 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, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)j. • 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)J. Asibling is defined, undE Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1502 EX+ (01-10) pennsylvania SCHEDULE A DEPARTMENT OF REVENUE REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: BETTY F• PETERS 21 09 1086 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. Rest property that iajointly-owned with right of survivorship must be disclosed on Schedule F. Attach a copy of the settlement sheet if the property has been sold. ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE NUMBER OF DEATH DESCRIPTION 1• ALL THAT CERTAIN TRACT OF LAND WITH IMPROVEMENTS 150,000.00 THEREON SITUATE IN THE TOWNSHIP OF UPPER ALLEN, COUNTY OF CUMBERLAND AND COMMONWEALTH OF PENNSYLVANIA KNOWN AS 639 GETTYSBURG PIKE, MECHANICSBURG, PA 17055• BEING THE SAME PREMISES WHICH THOMAS J• PETERS AND BETTY F• PETERS, BY THEIR DEED DATED JULY 24, 1979 AND RECORDED JULY 26, 1979 IN THE OFFICE OF THE RECORDER OF DEEDS FOR THE COUNTY OF CUMBERLAND, PENNSYLVANIA, IN DEED BOOK 0-28, PAGE 210, GRANTED AND CONVEYED TO BETTY F. PETERS, THE DECEDENT. THE PROPERTY WAS SOLD ON SEPTEMBER 14, 2010, TO NEILL MUMMAU• TOTAL (Also enter on Line 1, Recapitulation.) ~ ~ 15 0 , 0 0 0.0 0 If more space is needed, use additional sheets of paper of the same size. REV-15o8 EX + (6-98) SCHED ~JLE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER BETTY F• PETERS 21 09 1086 __ __ _ __ Include the proceeds of liiygatlon 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 DESCRIPTIQN OF DEATH ~, CITIZENS BANK CHECKING ACCOUNT NUMBER 6100702871 2,243.96 2• PERSONAL PROPERTY AUCTION SALE PROCEEDS 1,028.83 3• UNITED STATES TREASURY REFUND CHECK - 2009 FORM 1040 85.00 4• PA FORM 40 INCOME TAX REFUND CHECK 124.00 TOTAL (Also enter on line 5, Recapitulation) ~ ~ 3 , 4 81 • ? 9 (If more space is needed, insert additional sheets of the same size) REV-1511 EX+ (10-09) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER BETTY F• PETERS 21 09 1086 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. PARTHEMORE FUNERAL HOME AND CREMATION SERVICES, INC• 9,674.07 B. ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) KENNETH A• S H O L L E Y Street Address 639 GETTYSBURG PIKE C;ty MECHANICSBURG state PA zIP 17055 Year(s) Commission Paid: 2 010 2. 3. AttomeyFees: GERALD J • SHEKLETSKI, ESQ • Family Exemption: (If decedents address is not the same as claimants, attach explanation.) Claimant Street Address City Relationship of Claimant to Decedent 4. I Probate Fees: LETTERS OF ADMINISTRATION 5,000.00 7,674.00 287.00 5 Accountant Fees: 6. TaxRetumPreparerFees: ELLIS LEE HOSTETTER 8 CO • PC 90.00 PREPARE IRS FORM 1040 AND PA FORM 40 ~. LEGAL ADVERTISING - CUMBERLAND LAW JOURNAL 75.00 8• LEGAL ADVERTISING - THE CARLISLE SENTINEL 187.54 9• MARK HECKMAN - REAL ESTATE APPRAISAL 400.00 10• SAC INC• HEATING OIL 519.00 11• HEART HEATING PROS - FURNACE REPLACEMENT 9,950.00 12• WEST SHORE TAX BUREAU - LOCAL TAX 10.00 13• 2010 COUNTY/LOCAL REAL ESTATE TAX 1/1/10 TO 9/14/10 659.28 14• SAC INC• HEATING OIL 449.00 15• PNC BANK, N•A• - CHECK PRINTING FEE 32.99 16• LIBERTY MUTUAL - HOMEOWNERS INSURANCE 1,68.40 17• PIG PEN HAULING-HOUSE CLEANING-TRASH/DEBRIS REMOVAL 2,860.80 18• WEST SHORE AMBULANCE 50.36 TOTAL (Also enter on Line 9, Recapitulation) S 5 4 ,16 8.2 0 If more space is needed, use additional sheets of paper of the same size. State ZIP Continuation of REV-1500 Inheritance Tax Return Resident Decedent BETTY F. PETERS Decedent's Name Page 1 21 09 1086 File Number Schedule H -Funeral Expenses & Administrative Costs - B7. ITEM NUMBER DESCRIPTION AMOUNT 19• 201,0-2011 SCHOOL TAX - 7/1/10 TO 9114/10 611.66 20• LIBERTY MUTUAL - HOMEOWNER'S INSURANCE 172.40 21• SAC, INC•-HEATING OIL 249.50 22• EARTH RAIN AND SUN LAWN MAINTENANCE 129.58 23• OFFICE OF CATHOLIC CHARITIES - INTERMENT ?5D•DO 24• ASSOCIATED CARDIOLOGISTS 170.38 25• CITIZENS BANKS LOAN ACCOUNT 6007996895 1,364.86 MONTHLY PAYMENTS PAID SEPTEMBER, 2009 TO AUGUST, 2010 26• DEATH CERTIFICATES 49.50 27• 2009-2010 SCHOOL TAX 3,102.69 28• LIBERTY MUTUAL - HOMEOWNER'S INSURANCE 715.70 29• SAC, INC• - HEATING OIL 400.00 30• FILING FEES - INHERITANCE TAX RETURN AND INVENTORY 30.00 31• SETTLEMENT CHARGES ON SALE OF REAL ESTATE• $10,800.00 8,034.49 (LINE 502) LESS $2,765.51 (LINES 406 AND 408) _ $8,034.49 (COPY OF SETTLEMENT SHEET ATTACHED). 32• RESERVE FOR CLOSING EXPENSES 300.00 SUBTOTAL SCHEDULE H-B7 I 16 , 0 8 0. 7 6 REV-1512 EX+ (12-OS) pennsytvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER A~'TTY F . PETERS __ 21 09 1086 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medics{ expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH ~, CITIZENS BANK MORTGAGE LOAN ACCOUNT NO. 6007996895 52,800.25 2• ~BNY MELLON MORTGAGE LOAN ACCOUNT M40700848 I 13,998.78 TOTAL (Also enter on Line 10, Recapitulation) I ~ 6 6 , 7 9 9 • D 3 If more space is needed, insert additional sheets of the same site. REV-1513 EX+ (01-10) pennsytvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT OECEOENT ESTATE OF: FILE NUMBER: CCTTY F _ Dp'Tp'RC 21 09 1086 v ~ ~ ~ ~ ~ RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not list Truatee~a) OF ESTATE I TAXABLE DISTRIBUTIONS (Include outn' ht spousal distributions and transfers under Sec. 91 ~6 (a) (1.2).j 1. LAUREN A • SERRA, FORMERLY KNOWN AS Lineal 1/2 of Residue LAUREN A• PIERCE ?32 TRAILS LANE, NEWPORT NEW, VA 23608 2. SCOTT PIERCE Lineal 112 of Residue 11 HOLT ST• PITTSBURGH, PA 1,5203 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN A80VE ON LINES 15 T HROUGH 18 OF REV-1500 COVER S HEET, AS APPROPRIATE. II. NON-TAXABLE DISTRIBUTIONS: 1. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: TOTAL OF PART tI -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. S If mare space is needed, use additional sheets of paper of the same size. ~ZMENr~ q~~ ~a`~ f~ ~ *~~ A. Settlement Statement HUD-1 ~R ~, ~ ~tp opJ~~ B. Type of Loan OMB Approval No. 2502-0265 1. Q FHA 2. ~ RHS 3. Q Conv. Unins. 4. Q VA 5. ~ Conv. Ins. 6. File Number. MUMMAU 7. Loan Number: 6800363510 8. Mortgage Insurance Case Number: C. Note: This form is famished b give you a statement of actual settlement costs. Amounts paid b and by the settlement agent are shown. /tams marked "(p.o.c.)"were paid outside the cbsing; they are shown here for iv>*f+onmatbna/purposes and are not inducted in the btals. D. Name and Address of Borrower: NEIL M MUMMAU E. Name and Address of Seller. ESTATE OF BETTY F PETERS F. Name and Address of Lender: MEMBERS 1ST FEDERAL CREDIT UNION G. Property Location: 639 GETTYSBURG ROAD MECHANICSBURG, PA 17055 H. Settlement Agent: Seasons Settlements, Inc. WEICHERT RALTORS UNGLESTOWN RD HBG PA Ph. (717)558-0005 I. Settlement Date: September 14, 2010 Place of Settlement: WEICHERT RALTORS LINGLESTOWN RD HBG PA J. Summary of Borrower's transactlon K. Summary of Sailers transaction 100. Gross Amount Due from Borrower: 400. Grass Amount Due to Seller. 101. Contract sales rice 150 000.00 401. Contract sales rice 150 000.00 102. PersonaAl r 402. Personal ro 103. Settlement Char es to Borrower Une 1400 5,654.92 403. 104. 404. 105. 405. A ustmerrts for items id b Seller in advance A ustmertts for items id b Seller in advance 106. Ci !Town Taxes 09/15/10 to 12/31/10 274.48 406. Ci !Town Taxes 09/15/10 to 12/31/10 274.48 107. Coun Taxes to 407. Coun Taxes to 108. Assessments 09/15/10 to 07/01/11 2 491.03 408. Assessments 09/15/10 to 07/01/11 2,491.03 109. 409. 110. 410. 111. 411. 112. 412. 120. Gross Amount Due from Borrower 158,420.43 420. Gross Amount Due m Seller 152,765.51 200. Amou Paid b or in Behalf of Borrower 500. Reductlons in Amount Due Seller: 201. De sit oreamest more 1000.00 501. Excess d sit see ktstructions 202. Prins I amount of new bans 142 500.00 502. Settlement cha es to Seller Line 1400 10 800.00 203. Exist' loan s taken sub' d to 503. Exist' bans taken sub' d to 204. CREDIT FOR AMOUNT PAID 375.00 504. Payoff First Mortgage to CITIZENS BANK 52,800.25 205. 505. Pao Second Mort a e to NY MELLON 13,998.78 206. 506. 207. 507. De osit disb. as rooeeds 208. 508. 209. 509. A ustmertts for items un aid Sellsr A 'ustments for items un aid Seller 210. Ci /Town Taxes to 510. Ci /Town Taxes to 211. Coun Taxes to 511. Coun Taxes to 212. Assessments to 512. Assessments to 213. 513. 214. 514. 215. 515. 216. 516. 217. 517. 218. 518. 219. 519. 220. Total Paid b /for Borrower 143,875.00 520. Total Reduction Amount Due Seller 77,599.03 300. Cash at Settlsmentfrom/to Borrower 600. Cash at settlement tolfrom Seller 301. Gross amount due from Borrower line 120 158 420.43 601. Grass amount due to Seller line 420 152,765.51 302. Less amount aid b/for Borrower line 220) ( 143,875.00) 602. Less reductions due Seller (line 520) ( 77,599.03 303. Cash ~ From ~ To Borrower 14,545.43 603. Cash X~ To ~ From Seller 75,166.48 ~~ vim. ~ ti The Pudic Reporting Burden brttis colectbn of irtarmetlon is estlmated at 35 minutes par response for odlectlng, review(rg, and reportng the data. This agency may not cdlecx this hbrtnatcrl and you are not required to conpk0e this form uriesa it dispaya a errantly valid OMB control number. No canlidentisBty b assured; this dscbsrre 's rnaMabrx THa la designed to provide the parties b a RESPA covered transaction w~h information durinng lM settlement process. Page 1 of 3 HUD-1 (MUMMAU.PFD/MUMMAU/18) L. Settlement Char es 700. Total Real Estate Broker Fees $ 9,250.00 Paid From Paid From Division of commissan line 700) as folVows: 8ormwers Seders 701. 4 750.00 to REMAX REALTY ASSOCIATES Fu'ids at Finds at 702. 4 500.00 to WEICHERT REALTORS FIRST CHOICE semement Semement 703. Commission aid at settlement 9 250.00 704. BROKER FEE to WEICHERT REALTORS FIRST CHOICE 250.00 705. 800. Items Pa able in Connection with Loan 801.Our on ination char a Indudes ination Point $ 830.00 $ 830.00 ftom GFE #1 ; ~ "'~~; 802. Your credd or charge (points) for the specific interest rate chosen $ (from GFE #2) 803. Your adjusted origination charges ftom GFE #A 830.00 804. sisal fee to ftom GFE #3 805. Credit Re rt to from GFE #3 806. Tax service to from GFE ) 807. Flood certification to from GFE ) 808. (from GFE #3) 809. (from G #3) 810. from GFE #3) 8 1. ftom G FE #3) 900. Items R aired Lender >n Be Paid in Advance 901. Daily interest charges from 09/14/10 to 10/01/10 17 ~ $16.592500/day (ftom GFE #10) 282.07 ~ ,~;" 902. Mort a e insurance remium for months to from GFE #3 903. Homeowner's insurance for 1.0 ors to from GFE #11 POC:648.10 904. from G FE #11 905. (from GFE #11) 1000. Reserves l~ osilosd with Lender 1001. Initial deposit for your escrow account (ftom GFE #9) 1,181.97 omeowne s insurance mont s per mon 1003. ort a insurance months $ r month $ 1004. Property taxes $ City/Town Taxes months @ $ per month Asse ments months $ r month 1005. $ 1006. CO TWP TAX 8.000 months ~ $ 77.81 per month $ 622.48 1007. SCHOOL TAX 4.000 months ~ $ 262.18 per month $ 1,048.72 1008. AGGREGATE ADJUSTMENT $ -651.26 ~' ~~''-`~'i 1009. $ 1100. Title Char s 1101. Tile services and lender's tale insurance from #4) 1,387.88 1102. Settlement or dosin fee $ 1103. Owne title insurance to from GFE #5 1104. Lender's tale insurance to 150.0 ~ sr,;,:r 1105. Lender's tale lic limit $ 142,500.00 1106. Owners tRle lic Umit $ 150 000.00 1107. ent's rtion of the total title insurance remium $ 1108. Underwriter's rtan of the total title insurance remium $ 1109. Seasons Settlements, Inc. 1110. 111 1112. 1113. 1114. TAX CERT to Seasons Settlements, Inc. 10.00 111 VERMIGHT PAYOFFS to Seasons Settlements, Inc. 40.00 1116. 1117. Seasons Settlements, Inc. 1118. 1200. Government Recording and Transfer Charges 1201. Government reoordin cha es to Recorder's Office from GFE #7 223.00 ' 1202. Deed ~ 63.00 Mortgage $ 160.00 Releases $ Other $ 1203. Tra nsfe r taxes (from G FE #8) 1204. Ci /County tax/stamps $ $ 1,500.00 1205. State tax/stam s $ $ 1206. TRAN FER TAX to Recorder's Office 1500.00 1207. 1300. Additbnai Settlement Char s 1301. R used services that u can sh for from GFE #6 ~~ 1302. 130 3. 1304. 1305. 1400. Total Settlement Charges (enter on lines 103, Section J and 502, Section K) 5,654.92. _ - 10 800.00 Seasons Settlements, Inc., Settlelrhent Anent Page 2 of 3 HUD-1 (MUMMAU.PFD/MUMMAU/18) Comparison of Good Faith Estimate (GFE) and HUD-1 Charges Good Faith Estimate HUD-1 Cha es That Carrot Increase HUD-1 Line Number Our origination charge # 801 830.00 830.00 Your credo or charge (points) for the specific interest rate chosen # 802 Your adjusted origination charges # 803 830.00 830.00 Tra nsfe r taxes #1203 1,500.00 1,500.00 Cha es That in Total Cannot increase More than 10% Good Faith Estimate HUD-1 Government recording charges #1201 238.00 223.00 Title services and len er's title insurance #1101 1,858.75 1,387.88 Total 2,096.75 1,610.88 Increase between GFE and HUD-1 Charges $ -485.87 or -23.17°/ Charges That Ca n Change Good Faith Estimate HUD-1 Initial deposit for your escrow account #1001 666.64 1,181.97 Daily interest charges # 901 $ 16.592500/day 282.07 282.07 Homeowner's insurance #903 648.10 648.10 Loan Terms Your initlal loan amount is $ 142,500.00 Your loan term is 30 years Your initial interest rate is 4.2500 Your initlal monthly amount owed for principal, interest and $ 701.01 inductee any mortgage insurance is 0 Prindpal Q Interest ^ Mortgage Insurance Can your interest rate rise? ^X No ^ Yes, it can rise to a maximum of °k. The first change wiu be on and can change again every _ months after . Every change date, your interest rate can inkxease or decrease by %. Over the life of the loan, your interest rate is guaranteed to never be lower than °~ or higher than ~%. Even if you make payments on tlme, can your loan balance rise? ^X No ^ Yes, it can rise to a maximum of $ Even if you make payments on tlme, can your monthly ^X No ^ Yes, the first inkxease can be on and the monthly amount owed for principal, in>erest, and mortgage Insurance rise? amount owed can rise to $ The maximum it can ever rise to is $ Does your loan have a prepayment penalty? ^X No ^ Yes, yourmaximum prepayment penalty is $ Does your loan have a balloon payment? ^X No ^ Yes, you have a balbon payment of $ due in _ years on Total monthlyamount owed including escrowaccount payments ^ You do not have a monthy escrow payment for items, such as property taxes and homeowner's insurance. You must pay these dems directly yourself. X^ You have an additional monthly escrow payment of $394.00 that resuRs in a total initial monthy amount owed of $1,095.01. This inductee principal, interest, any mortgage insurance and any items checked below: ^X Property taxes ^X Homeowner's insurance ^ Fbod insurance ^X SCHOOL TAX ^ ^ Note: If you have any questions about the Settlement Charges and Loan Terms listed on this form, please contact your lender. Page 3 of 3 HUD-1 (MUMMAU.PFD/MUMMAU/18) HUD-1 Attachment Borrower(s): NEIL M MUMMAU Seller(s): ESTATE OF BETTY F PETERS lender: MEMBERS 1ST FEDERAL CREDIT UNION Settlement Agent: Seasons Settlements, Inc. (717)558-0005 Place of Settlement: WEICHERT RALTORS LINGLESTOWN RD HBG PA Settlement Date: September 14, 2010 Property Location: 639 GETTYSBURG ROAD MECHANICSBURG, PA 17055 Seller Loan Payoff Details Payoff First Mortgage Loan Payoff Total Additional Interest Total Loan Payoff to CITIZENS BANK As of days @ Per Diem 52,800.25 Payoff Second Mortgage to BNY MELLON Loan Payoff As of Total Additional Interest days @ Per Diem Total Loan Payoff 13,998.78 Adjusted Origination Charge Details Origination Charge to MEMBERS 1ST FEDERAL CREDIT UNION Origination Credit/Charge (points) for the specific interest rate chosen 830.00 Total $ 830.00 Total $ Adjusted Origination Charges $ 830.00 Reserves Deposited with Lender Homeowner's Insurance 162.03 3.000 at 54.01 per month CO TWP TAX 622,48 8.000 at 77.81 per month SCHOOL TAX 1, 048.72 4.000 at262.18 per month AGGREGATE ADJUSTMENT -651.26 at per month Total $ 1,181.97 Title Services and Lender's Title Insurance Details BORROWER SELLER TITLE-$997.88 to Seasons Settlements, Inc. 848.20 WARNING: It is a crime to knowingly make false statements to the United States on this or any similar form. Penalties upon conviction can include a fine and imprisonment For details see: Title 18 U.S. Code Section 1001 and Section 1010. (MUMMAU.PFD/MUMMAU/18) HUD-1 Attachment - Continued UNDERWRITER PORTION 149.68 to Stewart Title Insurance Company CPL 75.00 to Stewart Title Insurance Company NOTARY 40.00 to Seasons Settlements, Inc. DOCDOWNLOAD, COPIES, WIRE FED 125.00 to Seasons Settlements, Inc. Lender's title insurance 150.00 to Total $ 1,387.88 $ 0.00 Lender's Title Insurance BORROWER SELLER 'fees also shown above in Title Services and Lender's Title Insurance Details Lender's Endorsement Charges 150.00 Endorsement Endorsement Charge ALTA Endorsement Form 300 (Survey Endorsement) 50.00 ALTA Endorsement Form 8.1 (Environmental Protection Lien) 50.00 ALTA Endorsement Form 9 (Restrictions, Encroachments, Min.) 50.00 Total $ 150.00 $ 0.00 WARNING: It is a crime fp knowingly make false statements to the United States on this or any similar form. Penalties upon conviction can include a fine and irrp~risonment For dstalls see: Title 18 U.S. Cods Section 1001 and Section 1010. (MUMMAU.PFD/MUMMAU/18) re\ded\peterebettyest Real Estate Tax Parcel: 42-29-2458-001 DEED ,~ ~'N THIS INDENTURE made the day of SEPTEMBER in the year 2010, between KENNETH A. SHOLLEY, individually and as Administrator of the Estate of BETTY F. PETERS, late of Upper Allen Township, County of Cumberland, and Commonwealth of Pennsylvania, of the first part, hereinafter called the Grantor, AND - NEILL MUMMAU, single person, of the second part, hereinafter called the Grantee; WHEREAS, the said BETTY F. PETERS became in her lifetime seised, as of fee, of and in to a certain tract of land, together with the improvements thereon erected, situate in Upper Allen Township, County of Cumberland, and Commonwealth of Pennsylvania, and more particularly described hereinafter; and being so thereof seised, died on August 26, 2009, having not made a Last Will and Testament in writing; and WHEREAS, Letters of Administration were upon her estate duly issued by the Register of Wills of Cumberland County on November 23, 2009, to said KENNETH A. SHOLLEY (File No. 21-09-1086). -1- NOW THIS INDENTURE WITNESSETH, that the said Grantor, for and in consideration of the sum of One Hundred Fifty Thousand and NO/100 ($150,000.00) Dollars, which has been paid to him by the said Grantee at or before the sealing and delivery hereof, receipt whereof is hereby acknowledged, has granted, bargained, sold, aliened, released and confirmed, and by these presents does grant, bargain, sell, alien, release and confirm unto the said Grantee, ALL THAT CERTAIN tract of land situate in the Township of Upper Allen, County of Cumberland and State of Pennsylvania, bounded and described as follows, to wit: BEGINNING at a point on the southern right-of-way line of the old Harrisburg-Gettysburg Pike (formerly U.S. Route 15), now known as Legislative Route 123 at the point of intersection of the eastern right-of-way line of a Township Road referred to as No. T-610; THENCE along the southern right-of-way line of the old Harrisburg-Gettysburg Pike North thirty-seven (37) degrees eighteen (18) minutes East one hundred thirty (130) feet to a point; THENCE along the line of other land now or late of Abner E. Rider, South fifty-two (52) degrees forty-two (42) minutes East two hundred forty-two and forty-eight hundredths (242.48) feet to a point on the northern right-of-way line of the new Harrisburg-Gettysburg Highway, known as U. S. Route 15; THENCE along the northern right-of-way line of said U. S. Route 15, South thirty-eight (38) degrees five (5) minutes West seventy-six and thirty-seven hundredths (76.37) feet; THENCE continuing along the same South thirty-six (36) degrees fifty-eight (58) minutes West one hundred (100) feet; THENCE continuing along the same South thirty-nine (39) degrees twenty nine (29) minutes West fifty-three and six hun- dredths (53.06) feet to a point on the eastern right-of-way line of the Township Road referred to as No. T-610 first mentioned above; THENCE along the eastern right-of-way line of said Township Road North thirty (30) degrees twenty-six (26) minutes West two hundred sixty-two and thirty-four hundredths (262.34) feet to a point on the southern right-of-way line of the old Harrisburg-Gettysburg Pike, the Place of BEGINNING. HAVING THEREON ERECTED a stone frame dwelling house. -2- BEING THE SAME PREMISES WHICH Thomas J. Peters and Betty F. Peters, his wife by their Deed dated July 24, 1979 and recorded July 26, 1979 in the Office of the Recorder of Deeds in and for the County of Cumberland, Pennsylvania, in Deed Book 028, page 210, granted and conveyed unto Betty F. Peters, Decedent herein. TO HAVE AND TO HOLD the said lot or piece of ground above described, with the buildings and improvements thereon erected, hereditaments and premises hereby granted or mentioned, and intended so to be, with the appurtenances unto the said Grantee, to and for the only proper use and behoof of the said Grantee, forever. And the said Grantor, for himself and his respective heirs, executors and administrators, does covenant, promise and agree to and with the said Grantee, his heirs and assigns, that he, the said Grantor, has not heretofore done or committed any act, matter or thing whatsoever whereby the premises hereby granted, or any part thereof, is, are, shall or may be impeached, charged, or encumbered in title, charge, estate or otherwise howsoever. IN WITNESS WHEREOF, the said Grantor has hereunto set his/her hand and seal the day and year first above written. Witness SEAL KENNETH A. SHOLLEY, individually and as Administrator of the Estate of Betty F. Peters -3- COMMONWEALTH OF PENNSYLVANIA: ``, SS: COUNTY OF ~~\`~" this the~~~ On , day of ~- 2010, before me a Notary Public, the undersigned officer, personally appeared KENNETH A. SHOLLEY, individually and as Administrator of the Estate of BETTY F. PETERS, known to me or satisfactorily proven to be the person whose name is subscribed to the within instrument, and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereto set my hand and notarial seal. ,`\ \ COMMONWEALTH ~F PENNSYtVANiA Notary Public NO?ARIAL SE.~a- Public CAR0L.1. NOXELL, Notary Cumberland Co• New Cumberland Bo%s Dec.,2T,..2013 Commission ~ I hereby certify that the precise address of the Grantee is: Attorney for -4- ~~ Citizens Bank JANUARY 19, 2010 STONE LAFAVER & SHEKLESKI 414 BRIDGE STREET POST OFFICE BOX E NEW CUMBERLAND PA 17070 Estate of BETTY F PETERS Date of Death: Aug 26, 2009 SSN: 200-22-7426 Dear Sir/Madam: 525 William Penn Place Suite 153-2618 Pittsburgh, PA 15219 In accordance with your request, the attached information sheet has been provided in the above decedent's name as of his/her date of death. For IL or LC accounts, contact our Loan Department at 1-800-708-6680. For all other inquiries, please call 1-888-999-6884 Sincere , __.._ f C 1 El-Walker Operations Services a~ CitizensBank Account Number 6100702871 Account Title BETTY F FETERS Date O ened 12/ 18/ 1978 Account T e Checkin Princi al Balance as of DOD $2243.96 Interest from Last Postin to DOD $ .00 Account Balance as of DOD $2243.96 YTD Interest to DOD $4.80 S*.c~r ROWE'S AUCTION SERVICE HRH ~9~, Bill Rowe (AU 1538L) 2506 Ritner Highway Carlisle, PA 17015 Dave Rowe (AU 2295L) 249-1978 697-4?94 249-2677 Auction Is Action Call ``Rowe" For Satisfaction ~ ,~~ ~'c~-S~ DATE ~' t 7 ~ e~ SELLERS NAME ~-S '~-'LT'~- c~ +t ~Qf'f'["T``y ADDRESS ~ ~' °r ~ Z T•s.. !~; ~- ~% ~~~!~ PHONE ~ Sl 7 - ~ ~ 1 'Z OTHER ~~-e-~C'~ ,~ 1 Z O ~" S~ AUCTIONEER % ~ ~" AUCTION DATE/LOCATION l ~~ CLERK % ~ _ ~ ,~ ~,,,._ DESCRIPTION OF MERCHANDISE «~-~`~~ ~- ...t....C~~ ,II,,~L`.~ /1~1.trD •J S K.'~4.~C.` ~°!.Z S i ~. i '-1 1 "1 '~. "~, ~ -- Z ~Q' ! '2 c~ `Z ~ I Commission the Auctioneers to sell the merchandise to the highest bidder by Public Auction. Merchandise to be sold as is & grouped as necessary to obtain bids. I certify that I am the owner or authorized represen- tative of the merchandise, goods and or property and have good title and the right to sell and that they are free from all incumbrances. I agree to accept all responsibility for providing merchantable title and for delivery of title to the purchaser. I agree to hold harmless the Auctioneers against a y claims of the nature referred to in this agreement. _,.__--- AUCTION SIGNATURE SELLERS SIGNATURE s~ Total Sales (Clerking Tickets Attached} ~ ~ ~ Qi J "'-- Less Sale Expense: ~ 1 % Commission Auctioneer $ ~,Q Z ~v % Commission Clerks $ r~ V OTHER: C~e..t„~,~t~--- j 3 S ~- k, t ~ Z TOTAL SALE EXPENSE DEDUCTED ~ - SELLERS NET ~ ~ ~ ~~ 8= nA 1 ...~,,_.w ... r`_ }}~~ ' ~~ ~~ part' S. Penn ~523~~atber~ne ~t - Penne # rnn Bas-ros earresburg, ~a ~x~oa date: -~ % ~ - ~ pustomsr Qame: ~ k~ - x~ A ~- ~ y . ~iddress: 3 ~ ~-s- n/1 Ask - _ . C,g fli / l ~9. i 70 ~ l auaE and d~spesal afi debr4s a~: ~~~ S ~. ~ P~ k ~ ~r ~e~ pasposa~ ~eigb~: _ p~sp~rsa~ fee: _ 7,r~.. ~~ ~a~nr Fee: ______ ~ ~` a ° . "~fi~.~l~ ~c~t~ #a~r patran~t3ne~ P~ Peet ~c~ud~r~. ~~~ar; ~~`~' ~r~ ~au~ p~eo+se colt. ~1 ~_ PK~ PEWN NAULIMG Oary S. Ponn X523 ~a~herine ~t Ph~~o # ~?t1~ 805-106 ~iarr~sb~urg, PA ~?i04 ~ate:.,..,do ._ e ~ ._ r d customer name:. ~ ~ R~ ~ ~ s' s r r -T Phone #: _. 9~~~a~rtat and ~f~~osaf of de~a~s at: ~~~ ~ )1.E ~~. /YlC cu ~I~~pl~~al 1~ll~~t~~: ~ 4 ti~3 _ D~sposa~ fee: _ ~ D. ~a~or Fne: ~~~~~ I~na~'~e: / 4 . `~~~s.~k ~A~ far p~trar~~~ ~ ~c~ud~g. ~ f~~~ ~ ~a~~~ pf~a~ cc~tt. ~* r ~ ~:. 5"'~ ~ ~1-Y F;' a' 3 _ fir. ~Y k~ ~ ~ ~ ~"~t „ < ~ ~~!~ ~ ~' ~ y ~, : ~Lr, ~ '~ ~.~.w+,.~4..,ski~_.~a~«~:...4~.:.:its<~~:~~+t..~„iac.#~~.~a. •x,~y,., ~t, .:,1 s;. ~.~, s .:ire""~~.~:::~. Date 1-19-2010 . Customer info ~~ f `~-t7 5 S Remove Old boiler and replace with new cast iron boiler with coil for domestic hot water Furnish with new smoke pipe and emergency shut off Redo piping from old boiler to suit new, including replacing any leaks or pipe corrosion. Replace all leaking valves in entire basement. Replace any leaking or potential leaking copper pipes in basement Fix upstairs leaks on kitchen faucet. Signature Deposit due on signing $2,500 Balance due on completion , TAL $6,200 Date THANK YOU FOR YOUR BUSINESS. We work hard to keep out customers satisfied Tony 8~ Brandon @ Heart Heating Pro's There will be a $65.00 fee for any bounced checks and cash will then need to be given at that time . :~, '~ ~,.~ ""~ ~`` PA041920 15 N. High Street Shiremanstown PA i 701 1 Tony car Brandon 717--307-751 1 Date 1-27-2010 6 3Ken Sho ley ~~ ~` ~ ~U ~S` Replace zone valve motor Remove 2 thermostats and replace with New standard thermostats Remove thermostat in foyer area of house (lowest tevel)t-stat wire no good. Run New T- stat wire to new location and set install new T-stat on wall going up to kitchen area. Snake out main Drain of house.... May need roto rooter. (no guarentee on this ) Remove old rotted sink and faucett and install New Double sided sink and standard faucett with spray. Remove Copper waste line approx 10 inches from where it connects to cast iron piping and run New PVC piping for Kitchen area. Replace one rotted piece of wood inside kitchen cabinet under sink. . -,-.: _,~..~ r ~-'~ ~ i Total Pric~"ts $1,500 plus Ms pacman and shooting arcade ames.. ~~ aid By Signature THANK YOU FOR YOUR PAYMENT Rep signature Date Tony @ Heart Heating Pro's TOTA ~ 1,5 LTG Date There wilt be a $65.00 fee for any bounced checks and cash will then need to be given at that time . t ». { ~; >:5 ~~; k ~, r~ -; ~, 7`:~rY 3 ~_ ~„ Y e t ~~w._ Customer Info: Mr Sholley Gettysburg Pike Mechanicsburg, Pa Work Performed Replace oil tank in garage with new oil tank and oil line .... Also replace 2 motorized zone valves AND low voltage wiring from junction box to zone valves and burner .... Run and test all ok .......... Signature TOTA $2,250.00 Date : 3-5-2010 Tony @ Heart Heating Pro's .. ,~ ~~ `~ There will be a $65.00 fee for any bounced checks and cash will then need to be given at that time . ~~G ~~ ?,~,. PA047920 Date : 3-5-2010 15 N. High Street Shiremanstown PA 1701 1 Tony 717-307-751 1 or Brandon 717-557-2138