HomeMy WebLinkAbout11-03-10 (2)J 15D5610143
~_~ ~~O EX (01-10)
PA De artment of Revenue OFFICIAL USE ONLY
p psnnsylvania l;ourky cone near File Number
Bureau of Individual Taxes ~~^~*°~^
PO Box.2806ot INHERITANCE TAX RETURN 21 07 ~, 1054
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
cn ~ cn vcvcvc~~ ~ mrv~mn ~ w~~ vcw~~ ~.,
Soaai Security Number Date of Death Date of Birth
162 22 6269 11 14 2007 12 13 1927 ~~
Decedent's Last Name Suffix Decedents First Name MI
NEUMAYER BELEN C
(If Appilcable) Enter Surviving Spouse's Information Bslow
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE H THE
REGISTER OF 1NILLS
FILL IN APPROPRIATE OVALS BELOW
^ 1. Original Return ~ 2. Supplemental Return 3. Remainder Retu
^ (date of death
pnort0 12-13-82
^ 4. Limited Estate ^ 4a. Future Interest Compromise
(date of death after 12-12-t12) 5. Federal Estate
^ ax Return Required
g. Decedent Died Teatime ~ Ma' rxd a Living TNSt
(Attach Copy of vuilp ^ At- taPY a Tom) 8. Total Number Safe D@ t Boxes
~
^ 9. Litigation Proceeds Received ^ 10. ~tvr a 1i7~'1 w~id ~_~ dpt h ^ 11. ( r Sec. 9113(A)
Attach Sch. O)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATIOI I SHOULD BE DIRECTED TO:
Name Daytime Telephor a Number
AMY M MOYA 717 652 323
REGISTE LLS U~iONLY
m ~,
First Iine of address
~ ~' ~ ,
,p
~.-, -
5011 LOCUST LANE fir' ~-~
r-r .i;,~
~ w h
Second line of address ~ '
~
'~ t7
3 r~
City or Poet Office State ZIP Code L:
~
~
HARRISBURG PA 17109 -~
correspondent's e-mail addross: AmY~Ledert3rlaW.COm
K Is~true~ca react ~d~~.o~mp p~ar~a~ ~ gamin ~~is~retu~meinduding aa:ompanYing schedules and statements, and to the best
personal representative is based on all information of which pre f myr knowledge and belief,
hash arty knowledge.
SIG RE OF PERS SPONSIBLE FOR F ING URN DATE
Cl Linda Susan T bar Gt7 ~l
ss
2 AsClford Road Enola PA 17025
S TORE PAR R OTHER THAN REPRESENTATNE TE
Amy M. Moya / ~
ADDR
5011 Locust Lane, Harrisburg, PA 17109
Side 1 ~!
15D5610143 15056101 3
REV-1500 EX
°e0s~^~'s "tee Neumayer ,Helen C.
Decedent's Social Security Number
162 22 16269
RECAPITULATION ii
140,000.00
1. Real Estate (Schedule A) ....................................................................................... 1.
2. Stocks and Bonds (Schedule B) ............................................................................. 2.
I
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)......... 3.
4. Mortgages & Notes Receivable (Schedule D} ........................................................ 4.
5• Cash, Bank Deposits 8~ Miscellaneous Personal Property (Schedule E) ............... 5.
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6.
7. Inter-Vivos Transfers 8 Miscellaneous -Probate Property
(Schedule G) ~ Separate Billing Requested............ 7,
8. Total Gross Asseta (total Lines 1-7) ..................................................................... g, ~14 0 , 0 0 0.0 0
9. Funeral Expenses 8 Administrative Costs (Schedule H) ....................................... 9.
10,711.50
10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I) .............................. 10. i
11. Total Deductions (total Lines 9 & 10) ................................................................... 11, 10 , 711.50
12. Net Value of Estate (Line 8 minus Line 11) .......................................................... 1P, 2 9 , 2 8 8 . 5 0
13. Charitable and Govemmentai 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, 2 9 , 2 8 8 . 5 0
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 12 9 288.50
~ 11i.
17. Amount of Line 14 taxable
at sibling rate X .12 0 . 0 0 17.
18. Amount of Line 14 taxable
at collateral rate X .15 0 . 0 0 18.
19. Tax Due ............................................................... .................................................. . 19.
20. FILL iN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
Side 2 11
L 15D5610243 15D5610243
1505610243
0.00
5,81T.98
0.00
0.00
5,817.98
J
REV-1500 EX Page 3
rlaneelae~+: (_nmrfiafre Llddress'
File Number 21-07-1054
..............~.~ __- -r------------
DECEDENTSNAME
Neumayer , He{en C.
STREET ADDRESS
731 Tower Road
CITY STATE I P
Enola PA 17025
Tax Payments and Credits:
1. Tax Due {Page 2, Line 19)
2. CreditsiPayments
A. Prior Payments
B. Discwunt
Total Credits (A + B)
3. Interest
4, If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box 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.
5,817.98
5,817.98
Make Check Pa~able to REGISTER OF WILLS, AGENT.
. 1;= ~ f,~,tS;<r~;"° r !?T a{ ,- ~ , L~ _ ~~~" ~"~"~~ n .,.~~ 'f~;'~x .~ 2~ •+ _ a g~ rf ~/"; r T' c~7. Y `f-_ ~ ',~ f ~ ; ,;> _- '~~- 'fir. ,:: ~ _
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROP~t1ATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred :............................................................................... ^
b. retain the rght to designate who shall use the property transferred or its income :............................... {.. x
c. retain a reversionary interest; or .............................................................................................................. x
d. receive the promise for life of either payments, benefits or care? ........................................................... x
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death wfth ut
receiving adequate consideration? .................................................................................................................... ^
3. Did decedent own an "in trust fob' or payable upan death bank account or security at his or her death?...... ^ ^x
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which ^ ^
contains a benefiaary designation? ................................................................................................................. x
IF THE ANSYVER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT PART OF THE RETURN.
tcf'~.::t~~ 'q., ~r 7 I ~l; ~'t~ r'7:, .y; . ~ u ~I` L a .. .. -. ~ ~ t .. - ~+ ~. ... 1
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 fo the use of the surviving
spouse is 3 percent [72 P.S. §9116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the survi ing, 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 require nts for disGosure of
assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. i
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 4.5 percent, ex~ept 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)j. A
sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
Rw-1602 D(* Itt-06)
SCHEDULE A
REAL ESTATE
coutr~or+vl~urrt of I~swwANIA
IteiERITANCE TAX RETURN
RESIDENT OECEl7EP(r
ESTATE OF FILE NU ER
Neuma er Helen C. 2~.p~-~ 54
All reel property owrad solely or as a tenant in corrallon must lIe reported at fair market valor. Faa market value is defined as the price ~ which would be
exchanged betwreen a wilting buyer and a wiNing seibr, raNtllsr bsip compelled to buy or seB, botlt rq reasonable la~owledge of the
Real propsAy whkh fs )ointlyownsd wk11 right of survivorship must M disclosed on schedule F. t
Attach a copy of the settlement sheet N tF» property has been seid
Include • copy of the deed showing decedent's Interest If owned as tenant in common.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Real estate located at 731 Tower Road, Enola, Pennsylvania, Parcel No. 09-11-3008-009, ti e ~'~ 140,000.00
to Frank X. Netunayer (deceased 10/23/1990) and Helen C. Neumayer (sale price - setd t
sheet attached)
I
TOTAL (Also enter on tine 1. Recapitulation) 140.000.00
(If more space is needed, additional pages of the same size)
Copyright (c) 2009 form software only The Lackner Group, Inc.
Form PA-1 Schedule A (Rev. 11-08)
REV-1157 EX+ (10-06)
SCHEDULE H
FUNERAL EXPENSES ~
ADMINISTRATIVE COSTS
ESTATE OF FILE NUM ER
Neuma er ,Helen C. 21-07-1 54
Debts of decedent must be reported on Schedule 1. '~
ITEM DESCRIPTION AMOUNT
p, FUNERAL EXPENSES:
B. AOMINISTRATtVE COSTS:
1. Personal Representative'sCpmmissions
Name of Personal Representative(s)
Street Address
Ctty State Zio
Yearts) Commission paid
2. Attomev's Fees
3, Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
Cry State Zio
Relationship of Claimant to Decedent
4. Probate Fees
5. Accountant's Fees
6. Tax Retum Preparer's Fees
7. Other Administrative Costs 10,711.50
See continuation scheduie(sj attached
TOTAL (Also enter on line 9, Recapitulation) 10,711.50
Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1 Schedule H (Rev. 10-06)
ESTATE OF
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATfVE COSTS
continued
Helen C.
FILE Nl
21-07
ITEM
NUMBER DESCRIPTION AMOUNT
1 Other Admin~trative Costs
Real Estate expenses (Items 2-7) (from settlement sheet)
2 Prudential Homesale Services (commission) 4,770.00
3 House 4 U Real Estate (commission) 4,175.00
4 City/County tax/stamps 1,400.00
5 East Pennsboro Township (SewerlTrash for April, May, June) 126.50
6 Law Offices of Susan E. Lederer (Deed preparation) ~ 200.00
7 Debbie Lupold, Treasurer (Tax Certification Fee) ' 10.00
8 Cumberland County Register of ~Ils (filing fee - Supplemental Return and Inventory) I 30.00
H-B7 ~ 10,711.50
Copyright (c) 2002 form software only The Lackner Group, Inc.
I
i
Form PA-1 I Schedule H (Rev. 6-98)
~ __ i
REV-1513 DN /N-051 ~
SCHEDULE J
coM~~~°~~~~""'" BENEFICIARIES
ESTATE OF FILE N ER
Neuma er ,Helen C. 21-07-1 54
NUMBER
NAME AND ADDRESS OF
PERSON(Sl RECEIVING PROPERTY RELATIONSHIP TO
DECEDENT
SHARE OF ESTATE
MOUNT OF ESTATE
(Words) ($$$)
I
' TAXABLE DISTRIBUTIONS [include outright spousal
d~stnbutions, and transfers
under Sec. 9118 a 1.2
1 David J. Neumayer Son 117 of residue 18,469.78
7 Beaver Avenue
Enola, PA 17025
2 Donald F. Neumayer Son 117 of residue 18,469.78
306 Montebello Farm Road
Duncannon, PA 17020
3 Edward T. Neumayer Son 117 of residui~ 18,469.78
54S Magaro Rosd
Enola, PA 17025
4 Frank X. Neumayer Son 117 of residue 18,469.79
85 Wise Lane
Boiling Springs, PA 17007
5 Kenneth E. Neumayer Son 1/7 of residue 18,469.79
2375 State Route 17
Liverpool, PA 17045
See continuation schedule attached Continuation 36,939.58
Total 129,288.50
Eller dollar amounts for distributions shown above on lines 1 5 throw h 18 on Rev 150 0 cover sheet as riete.
II NON-TAXABLE DISTRIBUTIONS:
. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAK N
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
I
I
I
I
TOTAL OF PART 11-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHE
~.vpyrgn[ ~c~ cvvy rvrm somrere orny 1 ne ~aacner group, mc• Form PA-1 Schedule J (Rev. 11-08)
SCHEDULE J
BENEFICIARIES
(Part I, Taxable Distributions)
ESTATE OF: ',
Helen C. Neumayer 11/14/2007 162-22-6269 'i
Item Name and Address of Person(s) Share of Estate Amount of Estate
Number Receiving Property Relationship ('Words) (;;;)
6 Lisa M. Neumayer Daughter
1428 Timber Brook Lane
Mechanicsburg, PA 17050
Linda S. Tyber
92 Ashford Road
Enola, PA 17025
Daughter
117 of residue 18.489.79
117 of residue I 18,469.79
T~tal 36.939.58
.. ,
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Mris dM 'thirty-Mroe ', dy e[ ~ .1h1~ is dr.
- ... i.r...d.is. 7r.rded eed .i:er-e,A. (lam)
.~ Da~wsa Rl3'~lI1Di i. DOIILED, widew, e! ehe lbaaship et Dusgoehaaoa, Cous
• ~ Daephlnr and Ca~oneealth e! Paaisylvaaia, Osaaterr ,
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.. rnArr[ x. 116v11.TER sad HELEN C. MRUMUT6R, hit Trite, e! the leaaship e! Eae~
Peansbora. County ut CnrbsrleaM. and Clsr~emnalth of Pennsrlrania, Cexneeer.
wiuwwrir, d+a is erasldeodM of three ~Thoneaad Hve Hundred (~f,500.00)
. it head peY. 16r salpr .ha"ef is i,.re6t erlesewlsdad, dr wld Qraaese ds ee
. sip Rsat .wd easy a dw wid Ges.as r
. ALL shoe oereain pieos or paroel of lard aitusb in r,..e peaasboro ?own
Cnsiberlaad County. pera-syltn-nia. boarded and deeoribed as tolloas+ to-witT
,~fE.
~:~~' ~ D-E-O-IrD-H-I-1-0 at a spike in the western line er tM Tower Roads TH
':a• alan6 laado now or late of ~aaee L. Reed north twaty ea (22) de6rps tenty
~: ~•°`' srinubs thirty (30) seeords Tress three hmalred eweney ao* and thirteen-one
(321.13} feet to an iron piel !t~lC6 alen6 land. raw of late e! Harry Bowles
' thirty rin (35) de6rees thirty three (3;) .arr~e.e ehisty (30) eeoonds east
.. '. buadrod twsath two and twaty rite ens-hr~adredehs (122.25) fees to as iron pdn
.' T8i1Ci alan6 loads sow or late of Harry Bewlea'aanth_twenty one (21) dear.ee
• riT~ (55) daubs east ere huadred aiaeteen and nia~sty oae-huaaredth. (119.91)
lees eo a tree/ 11C: aloaR Lands sew or late of Harry Dewles soath sixey t
(63) de`r.ee ei~~imte. ease ei6hty and tlrteen.o~haadredehs (80.15) r..e t
eree~ TlRROE al lands new or lab of Harry Danes sough serenty sine (79)
• dep~ees senNeen~17) sdaatee ease tosey rite end aip6ty aias-as~e hnadredehe
(1iS.8g) feet io s spike in the seater of said Toaer llaad aed.urees Mid Tower
Road alonE lands sow or Lab of L. atrailey soaeh Wino- (93' di~eie •ewrrty six 1
dbnba thirty (j0) oeoaads Tnse•tao huadred eiHh1 aTd toareson-aaa !>rmdredtba
• (2m.11~) tNe eo sn lrea pins 'II~ICE al°°~ loads now er lags et D. Derailey s~
ais17 live degrees (55) de6rwe twsl~e (+~~ ninnteo Tleee ei~ ehree sad eoTro~
ewe-are heardsedths (83.72) feet b • epib in tla wesessa line et Nye Tower Ha
elre ~ pLee or DEOIIIDI>ifi.
~`' ` ~:' ~' ' ~ ' Cantlr<iaiz~ oa. and rive-one lwad»dehe (1.05) sore..
...;,:•..Havin~ ehsrsan greeted a oas story trews dwelling.
...~:;; '~~.,.,.~.~ 'leiTt~ tM seas prenises.Tdrieh Henry Dewln by hio deco heed Juno 12. 1q,
.. (- aid .recorded in the Ottiee for Reoordla6 e! Deedo. is sad !or the Ceaae~ at
• ,Oab•lland in Deed Doan "D". •oi. il~. Aa6e 188. 6rarreed sad eaaTtiyed !a !ee cL
' wree Heart' Db~rrlcc,aad iatherinc E, Dawles. his wise. HeaTi- Sowisc departed tlr
•.lilc January 91r 1953r n!rerel7 Bela eo the above dcoesibd prerdsec is vesbd
ecley L XatMriae !. Daaics by virtue of Mr cnrvlvorship, Hraaeor hereeo.
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o ~ III p ~~GV OMB Approval No. 2502-0285
~;* I~II~~~ *~}~~ a Settlement Statement (HUD-1)
7',N OEVfi~d`
8. Type of Lan
i4. p FvFA1A . - S. O Corn. Ine3. p Corn. UrrMs. B. F9s•Number. 91 3596 6. ~ Insunnp Cuss Number... . ,
'- •--• -
C. Noh: This loan b tUmishsd to yhis you a etatamerrt of ecWN aeeNrrrent costs. Amounts paid to snd by fhs saeke+tertt apsnt ~ Items marked
~ "(p.o.a)' wars pakl oublds the dosMp; they ors sttorm pent for intormetlonN purposes sad are not Mcruded M the totab.
..._-.
rD. Name bAddress dBorrorrar: ----- E. Nems 6 Address of SstNr: ---- F. Name E Address of er.
i Sco<t D. King and tYeeitNs L King F_ehte of Frank and tNbn Neumsysr ~ 1deV0 Bank ',
24 SMnrood Ckcb 3001 Paxton Street
~4Erals, PA 17025 __ HerdebuN, PA 17111
{ G. Properly Locatlon: ~ - H. Sew Pgsnt: 1. SeltNnant lMe: 04/ N10 ~
1731 Tower,Road Wpgm C. KDAee Place Of Settlement: --
~ Enola, PA 17025 1104 Fsmwood Avranus
L-. _._.......... _----. ..---. Camp Niq, PA 17011
J. Summery d Borfower's TrargacHat K SurreMry d SNNr's Tnrrwetlon -~
- - --- •---- -----1
i 100. Grog Amount Dire fiorrt Borrowwr 4e0. Oros Amount Oua b 8allar ;
1D1. Contrsa ww prbs i14D,00D.00 4D1. commit sew pkx si4o,oo0.00!
102. Pegatel PropsAy __ _ __ _ 4e2. PartonN Properly - ---... _-. {
i 103. SMdsrnxtt eharpss to bortowsr (Nne 1400) • - ---- 54,350.75 403. - - --..---•- - ---------i
104. 404. i
105. __...-_ 405. - ---- - -- -•-
for Manta peW try se1Nr hr edvarrce ~ - AdJtrebnenb for Ihrw paid by seder M edvatcs ~ - - --- _ .~
_106. Cihrltown taxes __ to ---- 408. CNyAorwt tatrss to _ _
I107.CouNytaxw 4/14/10 to 12/31H0 ~---_•-•1329.59 407.Courrlytsxes U14/10 to 12131/70 _5329._
106. Sewer/frnh 4114!10 to 8/30/10 X8.57 408. t3srrsr/1'rsah 4114110 to 8/30110 598.57
109. School 4114/10 l0 6130110 5309.40 409. sdwol 4/14/10 l0 8130!10 5309.40
110.•--- --- ---f- 410. _....-- --- ---- .~
1111:-- -- _..-__. _ ___ 4,,. --- -----.
112. 412.
• 113. --- - _~-- -~ 413.
;120. Grow Amount Dire tram Borrower _ -- 1145,086.31 429. Grose Amount Dus to Osller 1140,737.56
•200. Antoretb tMd try rK in tlehelf d Borrower: w0. Reduetlone M Amount Dw 1o BNNr:
-~ -
201. Deposlls ar sernwt matsy_. - - .. it`000;00 501. Fxass dpwk (ant wbudlons) .- --..`- --° ---1
--. _ ----
202. Prbelpel amount d new !Dart(s) 1140,000.00 102. SetlNnwd durpes to ssesr (time 1400) S7D,681.50
i 2os _ExkNno ban(s) tek.n subJset co 503. Exhtkp keM.) tNcen wDjea to i
.._.-
204. 104. Payoff dflret morlpaps bsn ,
1205 --. 605. PeyoB of ssoorrd moAp~s ken ---_ -_~
208. _ 508_-_. _.____-i
E~=------- --- -- - -~ 507. _ ... - ---- i
-I
Ad)twtritNrb for Ilerrta urlptld by ea11N
-
- At~YellrNnle for Itarlle urtpeid by esihr
-
.210. Cayltown loxes --- to _ --
_
--_ 810. CNyltown fixes - ~ -to
- -__
211. County tetrw
to _
_ _ 511. County ttsw to _
• - -- ~
_
_
1212. Assewnlsrds ~ - to .-__
_. , 512. AseeestrrNrrts to I
.-
__
'213 .. ._-. ~ _
_
513:
to
._-
-
~
214. -
--------- -- -
514. -
215. 515. -
~216. 518.
---- ----
I
__
1217. ~ --
5t7 .-.__... _..._,
i-••-- - ----•-
218. -... _. --
516.
219. 519.
i
`220. Total PaW hyllor eortorrer
5141,000.00
ti20. Tolai tteducltsn Amowtt lws SMNr
510,681.50
l 300. Cash at BeMismerrt trarrtRo Borrower 800. Cash et lalUsrrrwrt iolhorn Seller _
301. Gross amount dus firm borrower (IMS 120) _ _
1145,088.31 801. (crow smourd due b asesr (tMs 420) 5140,737.56
302. Lass rnwrtls pekl byllor botroerar (Ihts 220) 5141,OOO.OD 802. Lea reducilons b rrrorrtrt due selbr (Nrre 520) _•_ 110.681.50
303. Cash ufFom ~toBorrowar 54.088.31 603.Cwh ~to ~iromeellar 5130.056.06
The Phtbllc RepaOrg Btrrdet for title cotlsetbn of MfamNbn a estknated at 35 mMuw per rwponw for 9, rsviswktp, and
apenq may not ooeeet tltb Miorrrta0on, end you ors not roquksd to oompbte ihls form, wliwe if dkpkrye a wrtarrty vsAd OMB
conltdeMhAly b sesreed; tllla dttdOSYle b nrerxlelory. Thb is deelpned to provide the parties b a RESPA t~Wred lraMatXlOn with Into
seekntent process. ~ n9 the data. This
trol number. No
adon during the
,.w.. ,..,~fi:.,.,. ,
.- _ _ _ _ _ _ ~_ r
- -
•. ~. ~emsmern 4narges
,.......,... Rai, csiace aroaar raw .p.
-- ------ -- ----_ --- - -.. _ _. -..-- --..-..-----.-
Division of Commb~ion Ikta 700 as follows:
----•---- - ---° -i----~------ .. ...........° --.. _-_-.-.---._._ ..-..
701. 54,770.00 to PrudenWl Flornesab Services
702. ~ 54,175.00 to House 4 U Real Eslata
~ 703. Commission paid at Settlement
~__...._._.--- ---------- ---...-_.--_.__
'704
-•-- P _-
b F
a rom
l3orrowar's
Funds at
Sekbment
- --- --
- -•--- _ -._- _ _
Peid From
Selbra
Funds at
Sekbment !
--- ,--- • _ .. --_
58,845.001
-....-__-
.
-
--- . _.--
----- ---
-___--_.
BOO. Items Payable in ConMalion with Loan -- ~-----••-
801. our origination charge (DOkrts)
__
1102. Your credit w charge (point) for ttN specific frrMrest rate chosen ---- -
--
-- ---
803. Yaur aJusted orightatlon dnrpw _
---- -- - --
___
804. Commitrnan_t Fee to: Msfro Bank --. .-- - ~
805
-. 51,000.00 - -.~ _
~
. Document P~Fea to_Matro Badt -_
tia6. Tax / J ment Sauch to: Metro Bank -- - --
- -..-.-
1------~-_-----•-. --._------.._._.___. _
' 807. Flood eerkflcation to: Metro Back 5275.00
166.00
~ _
-
-.. .~
-
:808.
809 -_..._. ~
- ~ ..-.---, i
:
.
' ----
810.
• 811.
-- --- - - ..._--.--
----- -~
812. --- ----
814. -- ~ - -- --
900. Name -- - red Lander to Ba Paid M Advance
'901.Dail~iMerastchary~fiom-•_-- ._.. ._ _. ~°. --•-- Q-----.._-..._._~!Y_----
~
902._Mo bsuranoe -
r~e•-____---p!errMian for martl»to
r "- --- ---•-- -•--- ------• ~- ----.-
903 Horneownsr's inswance for
M
~- - = - - ... . --- - ----~--- Ya
-_.---- - --- - --
---
1904.
1
. _..-. - -.
----~
905.
----- •-
---
i
1000. Ruarvas wMh Lar-dar _-.. - --
1001. InWal k for asaow acaourN
-~---.Lro!!r . --^- __
--
_
I1,002. Homeowners inaaarea monlM ®5 _,-pr monM
50.00
l~t~~-M-°-~°-i"-°O-ranC°-_. moMta~i- ..-_-- ._. Per!!bMh 50.00 _
~
1004- PrOiMfty faxes months ~ 5 - _ -~ rn011ttt •. 50.00
~1005.- -_.--__.-__. montlrs S __ .._ --.~ermonth SO.DO
~
- - ---. _.__
-.._
•1006.. .. - ---_._.- ._-._ mo^tM-~s...___-..-. permonM 50.00 _
-. _..-------
1007.
;1008. Aggrogate~rrsfinent artar as a rrepatlve - -
- -- --- -.... j
• 1100. nn. ll _. - ------...--___....- - --- ------ ----
t1101:TRb serykaa to Abstract and Property Services, neT from GFE 8 4 OD
- ---
50.00
1102_Seltbment of dosh-g tee to: '_ _.. _..--y
1103. l)wnera tltle kraaanoe .- _ _ _ (from GFE A 5 I
1104 Leralers tike krsunna_ ~: Stewart Tilb Guaranty
.-._- _ __
51 058.75 -'- - --i
~1105. Undars tkN policy Itmk
11 106.Ormara fide~i~y Anna --- - ------- -
1107_A~ent's !?~n_of the !oW tltle krsurarrce prankan _
_--- ..
11108. Undsnrtitx'sEortlon of Ura total ttke irrwranoapnmkm~ ._' _....• ----------
1109. Endorsement 100, 300, 8.1 -- _. ..__.
r- - ------_ _ ___... __...._ .. - -
--j
-- 5750.00
-
_ -i
---1
--- j
-- - _ y
41110-
-
1111.
f----• ---_ ...---- -•---. .._-.._ .--.- -._ --
----
- ` `
,1112.
_-. ..._. .___-. - 1
_~1
. _ ---..__r...
._--.-_I
X1200, QOyerraMrll Ra00fdl and Trarsla- -__.- C4. -_ _-__
1201.Ooranmant reoordlrg ehrrpss to: _ fhxn GFE ~
-
-- 5148.00 ~
1202:
Deed 58
4.00 Mortpsge
:82.00 }tebsaes 00
50
.
_
1203. Transfer tsxss to: -_- _ -- ---• --_ (fran GFE #r W __
51,400~00~
_
-•--- ..__ -
1204. Cky/Coarty ladatarrrps Deed _- _Moi(paQe. -
1205. Slate tax/strrtps Deed - MoRyags
~12oe. ___-.. _._..
•- -•-•----_. ~_ _.... ----- ---• ---- -•---- ~ --•----•
-
-----~-.-
i 51!400_00'
1
_• 50.00_
,1207. --- _-
~
---
;1206. _ - ...... --•--
---. -_.- -- - -
-----
--- L ----
-._- -.-..~
1300. Ad~tlonM 3atgarrant C
- - - - -- -
t 301. Ra4ukai savloss tlnlt you ran shop
flmm GFE i 8)
_ _ _ _-
1302. SawadTraah (/lprs, May, huffy tp East Psmaboro Township 1" Q penally 511.50
-
- __
______5128.50
-
-
i 1303. Deed to The Law Ofllce of Strsar E. t.eda~
..- .- _. -. 5200.00
1304. Tax Ceron Faa to Dsbbb l.upold, Treasurer
.. _
_
310.00
1305- --- --
-- - __------..._. ._. --•- ••- -
1306.
-.-...-- - ----
1307. - -
11308_. _ __.._'_.._ -_--
- - --- -
_
1400. Total Sattlantarrt Clw~as tirrlar on Nna 10a, Saeaon J ad 602, SaWoer K~ - ~ - - _
- 54,350.75 --_ -
510,881.
c:eR r rrrcr-r non
I have t2> fetrleMfed the HUDa St~lelneN Stelefnent aftd to the best of my knowkdpe and beNef, R b a t-ue and aaaaate statement aN ftxeipts
and dbburaartsrds made en my socouM or try ms b thb traneadbn. l firthat tertky eve raaehrad a os of the HUD-1 Sa ferment
SsNer __ _ !'lo r
'fstts Fn SLolt .1 rq 0 Nadtalb King
To the beat of my fafowledge fhe HUD-1 SetlbmsM Statement whMJr 1 have prspaad N true and aeeurele account M the ~wsre received and
have bean or vvie~~~~~ by undarslgned w part of the wkbrnad of tlNa trarwaetlon. I/
- --- ~ C. KOltae~ -•- -._.... SeklsmaM Agent ---...__~~( T~~~ _... -_. Date
WARPpNG: k is a crime to Imowingyr mske (else statement t the Unlbd States on thb or any otFrar sknAar form. Penaltlss upon convidt n can include a
floe and imprfsorvrrsr~t. For dstNa see: Title 1e U.S. Code SeQbn 1001 and Section 1010.