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Home My WebLink About04-12-11 (2)15056 0140 REV-1500 EX (°'-'°' PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes INHERITANCE County Code Year File Number AX RETURN Po Box 280601 Harrisbur , PA 17128-0601 RESIDENT 2 1 1 0 1 1 3 5 ECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY 1 6 5 2 6 7 1 4 2 1 1 0 6 2 0 1 0 0 4 2 3 1 9 3 3 Decedent's Last Name Suffix Decedent's First Name MI S T O N E E S T H E R L (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN UST BE FILED IN DUPLICATE WITH THE RE ISTER 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 Compro ise (date of ~ 5. Federal Estate Tax Return Required death after 12-12-82) QX s. 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 CORRESPONDE CE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO Name Daytime Telephone Number W I L L I A M A D U N C A N 7 1 7 2 4 9 7 7 8 0 REGISTER OF WILLS USE ONLY -~~ First line of address .i 1T I-,~ '; 1 I R V I N E R O W ~' =a ;; -- , - I Second line of address `J' % } _~ ~~ =n -- -; City or Post Office State `DA~ FILED `" =' ~' ZIP Code ~ :~ ~: 7 ~' C A R L I S L E P A 1 7 0 1 3 ~- Correspondent's a-mail address: b i 11 d U n C a n a a• n e t Under penalties of perjury, I declare that I have examined this return, including accompan ing schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal represents ive is based on all information of which preparer has any knowledge. SIGNA E OF, E SO SPONSIB FOR FILING RETURN DATE 2 ADDRESS 353 CROSSROAD SCHOOL ROAD N WVILLE PA 17241 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL F RM ONLY Side 1 1505610140 1505610140 J J REV-1500 EX 1505614240 Decedent's Social Security Number Decedent's Name: E S T H E R L• STONE 1 6 5 2 6 7 1 4 2 RECAPITULATION 1. Real Estate (Schedule A) ................................... ...... .. 1. 7 3 2 1 8, 2 9 2. Stocks and Bonds (Schedule B) .............................. ...... .. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedul C) ... .. 3. 4. Mortgages and Notes Receivable (Schedule D) .................. ...... .. 4. 5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule )..... .. 5. 4 6 1 1 0 , 2 2 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requeste ..... .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ^ Separate Billing Requeste ..... .. 7. 8. Total Gross Assets (total Lines 1 through 7) ................... ...... .. 8. 1 1 9 3 2 8 . 5 1 9. Funeral Expenses and Administrative Costs (Schedule H) .......... .. ...... 9. 1 2 8 8 5 . 2 6 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ..... .. ...... 10. 9 6 7 3 . 3 8 11. Total Deductions (total Lines 9 and 10) ....................... .. ...... 11. 2 2 5 5 8 . 6 4 12. Net Value of Estate (Line 8 minus Line 11) .................... .. ...... 12. 9 6 7 6 9 . 8 7 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. 9 6 7 6 9 . 8 7 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0 _ 0 0 15. 16. Amount of Line 14 taxable at lineal rate X .045 9 6 7 6 9 7 16. 17. Amount of Line 14 taxable at sibling rate X .12 0 0 17. 18. Amount of Line 14 taxable at collateral rate X .15 0 0 18. 19. TAX DUE ................. .......................... ...... ..19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN O Side 2 1505610240 0. 0 0 4 3 5 4. 6 4 0. 0 0 0. 0 0 4 3 5 4. 6 4 a 1505610240 REV-1500 EX Page 3 Decedent's Complete Address: DECEDENT'S NAME ESTHER L• STONE STREET ADDRESS 1091 BELLAIRE PARK ROAD -- - CITY CARLISLE STATE PA Zip 17013 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. Fill 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 10 1135 (1) 4,354.64 Total Credits (A + B) (2) 0 • 0 0 (3) (4) 0.00 (5) 4,354.64 Make check payable to: REGISI~ER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PL~CING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred : ................... ............................................. ..... ^ ^X b. retain the right to designate who shall use the property transferred or is income; .......................... ..... ^ X^ c. retain a reversionary interest; or ............................................. ............................................. ..... ^ X^ d. receive the promise for life of either payments, benefits or care? .... ............................................. ..... ^ Q 2. If death occurred after December 12, 1982, did decedent transfer prope y within one year of death without receiving adequate consideration? .................................... . ............................................ ^ ..... 0 3. Did decedent own an "intrust for" orpayable-upon-death bank account r security at his or her death? .... ..... ^ X^ 4. Did decedent own an individual retirement account, annuity or other non- robate property, which contains a beneficiary designation? ............................................... ............................................. .... X ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST For dates of death on or after July 1, 1994, and before Jan. 1, 1995, the tax rate impc 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 ti [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spc filing a tax return are still applicable even if the surviving spouse is the only beneficiar 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 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 deceden 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 deceden Section 9102, as an individual who has at least one parent in common with the dei SCHEDULE G AND FILE IT AS PART OF THE RETURN. on the net value of transfers to or for the use of the surviving spouse is ors to or for the use of the surviving spouse is 0 percent from tax, and the statutory requirements for disclosure of assets and age or younger at death to or for the use of a natural parent, an lineal beneficiaries is 4.5 percent, except as noted in siblings is 12 percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under dent, whether by blood or adoption. REV-1502 EX+ (01-10) pennsylvania SCHEDUL A DEPARTMENT OF REVENUE REAL ESTAT INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: ESTHER L• STONE 21 10 1135 All real property owned solely or as a tenant in common must be reported at fair mark t 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 compel) d to buy or sell, both having reasonable knowledge of the relevant facts. Real property that is jointly-owned with right of survivo hip must be disclosed on Schedule F. Attach a copy of the settlement sheet if the pro erty 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• 1091 BELLAIRE PARK ROAD 72,900.00 CARLISLE, PA 17013 SEE HUD SHEET ATTACHED3 2• TAX PRORATION - (2010-11 SCHOOL TA ES) 318.29 ESEE HUD SHEET ATTACHED71 OTAL (Also enter on Line 1, Recapitulation.) $ 7 3 , 218.2 9 If more space is needed, use additional sheets of paper of the same size. Ktv-i Dues tx + lb-ats~ SCHEDUL E COMMONWEALTH OF PENNSYLVA CASH BANK DEPOSI S & MISC NIA , , . INHERITANCE TAX RETURN PERSONAL PRO ERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER ESTHER L• STONE 21 10 1135 Include the proceeds of litigation and the date the pro eds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH ~. MEMBERS FIRST SAVINGS ACCOUNT # 11 408-00 5.00 ESEE DATE OF DEATH LETTER ATTACHED 2• MEMBERS FIRST CHECKING ACCOUNT # 1 3408-11 7,594.76 ESEE DATE OF DEATH LETTER ATTACHED 3• MEMBERS FIRST SAVINGS ACCOUNT # 11 408-05 10,832.00 ESEE DATE OF DEATH LETTER ATTACHED 4• PROCEEDS FROM MONUMENTAL LIFE INSU ANCE POLICY 500.00 # 1009200303 5• PROCEEDS FROM MONUMENTAL LIFE INSU ANCE POOICY 400.00 # 10099372940 6• U•S• TREASURY CHECK FOR OCTOBER 20 0 977.00 7• MONUMENTAL CHECK 132.50 8• TRANSAMERICA INSURANCE COMPANY - R PLACEMENT CHECK 159.47 9• PRO-RATED SCHOOL TAXES 318.39 ESEE HUD SHEET ATTACHED71 10• LINCOLN FINANCIAL ANNUITY 21,361.30 ESEE DATE OF DEATH LETTER ATTACHED 11• MONUMENTAL LIFE INSURANCE ANNUITY 3,702.80 ESEE DATE OF DEATH LETTER ATTACHED 12• 2010 TAX REFUND 127.00 OTAL (Also enter on line 5, Recapitulation) S 4 6 ,110.2 2 (If more space is needed, insert additional Sheets of the same size) OC\/ ~G~~ CYO. i~l1 h0\ pennsylvania SCHEDUL H DEPARTMENT OF REVENUE FUNERAL EXPENS SAND INHERITANCE TAX RETURN RESIDENT DECEDENT ADMINISTRATIVE OSTS ESTATE OF FILE NUMBER ESTHER L• STONE 21 10 1135 Decedent's debts must be reported on Sc edule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. DEATH CERTIFICATES 100.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s) of Personal Representative(s) PAUL L S T O N 5, 9 6 6. 4 2 street Address 353 CROSSROAD SCHOOL OAD City NEWVILLE fate PA Zip 17241 Year(s) Commission Paid: 2. Attomeyl=ees: DUNCAN & HARTMAN, PC 5, 966 •42 3. Family Exemption: (If decedents address is not the same as claimant's, attach xplanation.) Claimant Street Address City fate ZIP Relationship of Claimant to Decedent 4. Probate Fees: REGISTER OF WILLS 285.50 5 Accountant Fees: 6. Tax Retum Preparer Fees: ~. CUMBERLAND LAW JOURNAL - LEGAL N TICE 75.00 8• THE SENTINEL - LEGAL AD 176.92 9• REGISTER OF WILLS - FILING FEE 15.00 10• HELD IN RESERVE 300.00 OTAL (Also enter on Line 9, Recapitulation) $ 12 , 8 8 5.2 6 If more space is needed, use additional sheets of paper of the same size. REV-1512 EX+ (~2-OS) pennsylvania SCHEDUL DEPARTMENT OF REVENUE DEBTS OF DECE ENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIE ~ LIENS RESIDENT DECEDENT , ESTATE OF FILE NUMBER ESTHER L• STONE 21 10 1135 Report debts incurred by the decedent prior to death that remained unpaid a the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. N• MIDDLETON WATER/SEWER BILL 79.50 2• PPL - ELECTRIC BILL 5.53 3• FOREST PARK HEALTH CENTER 1,011.50 4• GUARDIAN LONG TERM CARE PHARMACY 251.94 5• PPL - ELECTRIC BILL 7.29 6• N• MIDDLETON WATER/SEWER BILL 75.71 7• PPL - ELECTRIC BILL 15.50 8• SELLER ASSISTANCE - SALE OF PROPER Y 2,187.00 ESEE HUD SHEET ATTACHED71 9• HELD IN ESCROW - SALE OF PROPERTY 1,968.00 ESEE HUD SHEET ATTACHED3 10• REALTOR'S COMMISSION - SALE OF PRO ERTY 2,914.44 ESEE HUD SHEET ATTACHED3 11• NOTARY FEE 10.00 ESEE HUD SHEET ATTACHED71 12• REALTY TRANSFER TAX 729.00 ESEE HUD SHEET ATTACHED3 13• DEED PREPARATION 275.00 ESEE HUD SHEET ATTACHED71 14• TAX CERTIFICATION FEE 5.00 ESEE HUD SHEET ATTACHEDI 15• TAX PRORATION - 2010-11 COUNTY & L OCAL 17.97 ESEE HUD SHEET ATTACHED71 OTAL (Also enter on Line 10, Recapitulation) S 9 , 6 7 3. 3 8 If more space is needed, insert additional shee~ of the same size. Continuation of REV-1500 Inheritance T ESTHERL.STONE Decedent's Name Page 1 x Return Resident Decedent 21 10 1135 File Number Schedule I -Debts of Decedent, Mortgage Liabilities, 8 Liens ITEM NUMBER DESCRIPTION AMOUNT 16• 17• N• MIDDLETON WATER AUTHORITY CCSEE HUD SHEET ATTACHED71 WAGNERrS TAX SERVICE - TAX PREPARA ION 50.00 70.00 SUBTOTAL SCHEDULE I 12 0 • 0 0 GRAND TOTAL SCHEDULE I $ 9,673.38 REV-1513 EX+ (01-10) pennsylvania SCHEDUL J DEPARTMENT OF REVENUE BENEFICIARI S INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: ESTHER L- STONE 21 10 1135 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers unde Sec. 9116 (a) (1.2).] 1. WANDA CONLEY Lineal BOX 191 1/5 SHARE WELLSVILLE, PA 17365 2• SHARON SHELLENBERGER Lineal 851 E• LOUTHER STREET 1/5 SHARE CARLISLE, PA 17013 3• PAUL L• STONE Lineal 353 CROSSROAD SCHOOL ROAD 1/5 SHARE NEWVILLE, PA 17241 4• PAUL L• HALTER Lineal 305 BANANA CIRCLE 1/5 SHARE CARLISLE, PA 17015 5• CHRISTINA J• WICKARD Lineal 268 MC ALLISTER CHURCH ROAD 1/5 SHARE CARLISLE, PA 17015 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINE 15 THROUGH 18 OF REV-1500 COVER S HEET, AS APPROPRIATE. II. NON-TAXABLE DISTRIBUTIONS: 1. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELE ION TO TAXIS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON INE 13 OF REV-1500 COVER SHEET. $ It more space is needed, use additional s~eets of paper of the same size. LAST WIL TESTAMEN OF I, ESTHER L. STONE, of 1091 Bellaire ParkRoad, Carlisle, North Middleton Township, Cumberland County, Commonwealth of Pennsylvani memory and understanding, do hereby make, publish and Testament, hereby revoking any and all other wil FIRST. I direct that all my just debts and soon after my death as practically and conveniently SECOND. I direct that my remains be Stone in Westminster Cemetery within my family's wishes. being of sound and disposing mind, end declare this as and for my Last Will s and codicils heretofore made by me. 1 expenses be paid from my estate as be done. side-by-side to my husband Paul W al plot in accord with my expressed THIRD. I authorize my personal representati e to expend funds from my estate, in such amounts as my personal representative shall consider necessary and desirable for the purchase, erection and inscription of a suitable marker for my g ave. FOURTH. I give, devise and bequeath any a d all tangible personal property owned by me at the time of my death unto my children, WAND CONLEY, SHARON SHELLENBERGER, PAUL L. STONE, PAUL R. H LTER, CHRISTINA J. WICKARD, in equal shares, per stirpes. FIFTH. I give, devise and bequeath any and my death, unto my children, WANDA CONLEY, Sf STONE, PAUL R. HALTER, CHRISTINA J. WICK 1 real estate owned by me at the time of RON SHELLENBERGER, PAUL L. in equal shares, per stirpes. SIXTH. I give, devise and bequeath all the my children, WANDA CONLEY, SHARON SHEI HALTER, CHRISTINA J. WICKARD, in equal sh SEVENTH. I direct that any and all Inheri~ my estate passing under my will or otherwise, shall estate. EIGHTH. I hereby nominate, constitute and Executor of this my Last Will and Testament. In the >t, residue and remainder of my estate unto ?NBERGER, PAUL L. S"fONF., PAUL R. s, per stirpes. ;e, Estate and Transfer taxes imposed upon paid out of the principal of my residuary nt my son, PAUL L. STONE as of renunciation, death, resignation or inability to act for any reason whatsoever of PAUI. L STONE, I nominate, constitute and appoint SHARON SHELLENBERGER as Executor f this my Last Will and Testament. hereby relieve my Executor from the necessity ofpc as such, in any jurisdiction in which he may be calle do so. In addition to the powers conferred by law, I discretion, to retain in the form received, and to sell ring security in connection with his duties, upon to act insofar as I am able by law to uthorize my Executor, in his absolute ither at public or private sale any real or personal property owned by me at the time of my NINTH. I have made, or may from time to time make, a written memorandum expressing my desire to give certain items of perso al property to specific persons. I urge my Executor and beneficiaries to respect these wishes. S ch a memorandum, if made, shall be stored in conjunction with this Will. IN WITNESS WHEREOF, I have hereunto et my hand and seal to this, my Last Will and Testament, consisting of two typewritten pages this ~ /(~ day of 2008. t/ ` ~. THER L. STONE Signed, sealed, published and declared by the above named Testatrix ESTHER L. STONE as and for her Last Will and Testament, in the presence of us, who, at her request, in her sight and presence and in the sight and presence of each other, have here nto subscribed our~mes as witnesses. to COMMONWEAL TH OF PENNSYL VANIA COUNTY OF CUMBERLAND I, ESTHER L. STONE, Testatrix whose name is sil having been duly qualified according to law, do hereby instrument as my Last Will; that I signed it willingly; act for the purposes therein expressed. Sworn or affirmed to and acknowledged before me, by ESTHER L. STONE this Z ~~ of Ql/~~O~J~i~'" a, Nota Public COMMONWEALTH OF PENNSYL VANIA COUNTY OF CUMBERLAND We, w / /ilil ~..f/1 s~ . 17v.~(~G~ N ar the witnesses whose names are signed to the attached according to law, do depose and say that we were pr execute the instrument as her Last Will; that she sign and voluntary act for the purposes therein expressed; Testatrix signed the will as witnesses; and that to the >; time eighteen (18) or more years of age, of sound mir SS. ned to the attached or foregoing instrument, acknowledge that I signed and executed the end that I signed it as my free and voluntary THER L. STONE SS. COMMONV'VL•.ALTH OF PENNSYLVANIA NOTARIAL SEAL JOAN D. P.DAMS, Notary Public Carlisle Boro., Cumberland County My Commission Expires March 7, 2611 K,~-y~l Y L. ~ ~i~d ~il~,~-T foregoing instrument, being duly qualified nt and saw ESTHER L. STONE sign and willingly and that she executed as her free ~t each of us in the hearing and sight of the of our knowledge, the Testatrix was at that and undue influence. ~~~~ Sworn or affirmed to and subscribed before me by ~l1 /l WI ~~ iS . ~~~~ N and jc~-~-fJ y L- .i1/1 ~-~~~`~'~" witnesse< this ~~ day of OG~'D~"~~ , 2008 O, Not "Public CQMMONWEALTH OF PENNSYLVANIA NOTA.R!AL SEAL JOAN 0 ~",~-~;^-„4+S. "~G,~r~ Public, ~~ ,, -, -- ~~~^7,Z 11 `~•I~•~ A. Settlement Stateme t (HUD-1) ~a OMB Approval No. 2502-0265 1. ~ FHA 2. ~ RHS 3. XO Conv. Unins. 6. File N mbar: 7. Loan Number: 8. Mortgage Insurance Case Number: 4. a VA 5. ^Conv. Ins. 11-01 1012003902 C. Note: This form is fumiehed to give you a statement at actual aettleme " t costs. Amounts paid to and by the settlement agents are shown. Items marked (p.o.c)" ware paid outside the Goaing; they are shown here informational purposes and are not inUUded in the totals. D. Name & Address of Borrower: E. Nam 8 Address of Seller. F. Name 8 Address of Lender: Richard L. Gab The Esfat of Paul Warren Stone and EsOrer L. Stone Vision Mortgage Capital 620 West Germantown Pike, Suite 350, Plynauth Meeting, PA 19462 G. Property Location: H. Settl mentAgent: I. Settlement Date: 02/01/2011 1091 Bellaire Park Road P.R.O. S M Services Disbursement Date: 02/01/2011 Cartisle. PA 17013 Telepta :717-249-3785 Fax: 717-249-0344 NoM Middbtan T tu awrrs p Place o Settlement: T-itleExpress 424 West enn Sheet, CadLsle, PA 17013 100. Grow Amount Dw hom Borrower 100. Gross Amount Dw to Se1Nr 101. Contrad saba price 72,900.00 401. Contract sales price 72,900.00 102. Personal 402. Personal 103. SeMemeM charges ro tbrrower (line 1400) 4,670.42 403. 104. ~. 105. ~. Ad sbrtsms for 6erw b sNNr In advenu Ad Ms for items Id alNr in advanu 106. COyRown taxes to 406. CilyRown taxes to 107, County taxes ro 407. County taxes to 108. Scholl takes 0210112011 to 06/3012011 318.39 408. Scholl fazes 02A)112011 to O6I3012011 318.39 1 ~' 409. 110. 410. 111. 411. 112. 412. 1~• Grose Amount Dw from Borrovwr 77,888.81 120. Gross Amourd Dua to SeINr 73,218.39 200. AmatMS Paid a in Behep of eortowar 500. Redtrctlorts In Amount Dw to SNNr 201. Depoa4 a eartxsst ngrtey 1,000.00 501. Excess deposit (sae instnrctiona) 202. PAnclpal amount of rnw loan(s) 69,255.00 502. SeltlenieM charges ro seller (line 1400) 3,983.44 203. Ex' a taken su ' l0 503. Existr loa s taken suo ro 204_ 504. Payo0 of first mortgage loan 205. 505. Payo6 of second mortgage ban 206. ~ 2,187.00 506. SelbrAssbtarx:e 2,187.00 207. 507. Escrow for Inspectiore per Agreement 1,968.00 208. PHFA Fund 3.000.00 506. 209. ~ Ad Urrsrth la ibrrr un b eeWr Ad sUrrsMS for items un M se9er 210. CilyAawn taxes to 510. COyitown lazes to 211. County taxes O1N1I2011 to 02101/2011 17.97 511. County taxes 01/01/2011 to 07/0112011 17.97 212. Sctad taxes ro 512. Sclad taxes to 213. 513. 214' 514. 215. 515. 216. 518. 217. 517. 218. 518. 219. 519. ~• Tobl Paid Ifor Borrower 75,159.97 520. Total Reduction Amount Dw Seller 8,156.41 300. Cash et SNINmsrd 6ondto Borrower 600. Cash at SegNtnsrd tofhom 6e6er 301. Gross annrxd dw team harrower (line 120) 77,888.81 601. Gross amaart dua ro seller (line 420) 73,218.39 302. Less amounts paid bYna tarrower (line 220) 75,459.97 602. Less redud'ans in anaunt due seller (line 520) 303. Cash ~X From ~ To Borrower i 2,426.61 603. Cash ~ To ~ From SsINr 6,156.41 85,061.98 ~ Rpp-p btlw aMbm.Ypny w• Y MnY. r+~.~. p bn.uY-pJ•pF•. v,wY~W100YB m/dru~W.r NomM~rY~Nl~4~,..4bi b Mtlnp,r- daun4 -tl nowWptl llw4d.WM w C b .M nw pw'Ib IM VrM.•b REBPA rww.Obr.sbn irMn-m MWV~YMnN„1 Previous editions are obsolete Page 1 of 4 HUD-1 700. Tohl Rul Esuta BroMar Faaa 52,914.44 Pald F Divisbn of canxnissbn line 700 as follows; rom Bo ' Paid From ' 701. 51414.44 to Help-U-Sell DelwilerRealty rrower s F d Seller s 702. 51,500.00 ip Hdp-U-SeIl DelwierRealty un s at Funds at 703. Commission paid d selGernent Settlement Settlement 2,914.44 800. Ibma P able M Connaetlon wNh Lun 601, Orx argkralbn charge (Includes Origination Print % u 50.00) 5596.20 (from GFE #1) 802, Yaur credit or charge (poirda) for the specific interest rate chosen S (flan GFE #2) 803. Your adjusted onginatbn charges (from GFE A) 59620 801. Appraisal lea to P. Scott A ibald (from GFE #3) 400 00 805. Credd report to Krdl Fact Data (Iran GFE #3) . 21.93 806. Tax service to from GFE #3 807. Flood rerlt8cdlon ro KroN F Data (from GFE #3) g 00 808. Ellie Mae Closing Fee to Visbn Mo a Ca ' I (from GFE #3) . 100,00 900. Ibmt R uind lender to M Pak M Advanu 901. Daly interest charges trap hom 02101/2011 ro 0310112011 57.2141IdaY (fran GFE #101 201.99 902. Morglage Iris. Premium for rtantlrs ro (from GFE #3) 903. Haneowrrets irrsurarke for rtardhs to Nationxxide (from GFE #11) 561.00 ~ months to from GFE #11 1000. Reaerwa Da Mad with Ludar 1001. Initial depos8 for your escrow account (from GFE #9) 388.05 1002. Homeowxils inswarka 4 nrontlrs S 46.7 /month 5187.00 1003. MoAgage Insurance nronfhs S 32.3 h 50.00 1004. City PropeAy Tax months S 0.0 month 50.00 1005. County PropeAy Tax 2 nanths S 11.6 /month 535.22 1008. School taxes 9 months f 64.5 /month 5581.13 1007. AggrsgateAdJustrnanl 515.30 1100. TNM C 1101. Title services and lenders tittle irraurance (from GFE #4) 1 053.75 1102. Seltlenrent or dosing fee to S , 1103. Owners title insurance (fran GFE #5) 18.00 1104. Lendefs title insurance 5676.75 1105. Lendefs IiUe pdicy IimA 589,255.00 1106. Owner's title pdicy IimA 572,900.00 1107. Agent's por0on d the told title insurance premium 5571.33 1108. UrMerwrdels poAbn of the total title insurance premium 5125.42 1109. Notary Fee tc Cash 530.00 1110. Owanighl Fee to P.R.O. Settlement Services 520.00 10.00 1111. Document PrepaRipn Fee to P.R.O. Settlement Senices 5100.00 1112. 100 No Vid1100 to First American Title Ireura Can 550.00 1113. 300 Survey1300 ro First American Title Inwra Can 550.00 1114. 900 EPL-Res18.1 to First American Title Insu Com 550.00 1115. ClosingSvd.lrtCL to First American Title Insu Com 575.00 1200. fiovarnmant Record arW Transfer Cha ea 1201. Govermnent rawrding charges (from GFE #7) 217.50 1202. pud 552.00 a 578.00 elease 50.00 1203. Transfer fazes (from GFE #8) 729.00 1204. CitylCounry tax/alernps Deed 5729.00 a 50.00 1205. Stale Taxlstamps Deed 5729.00 a 50 00 1208. peed 50.00 . a 50.00 729.00 1207. UPI CerBficalion Fee 20.00 1208. Subordinate Morgage 27 00 1209. Assgmxmt of mortgage 50 1300. AddNlonal 8altlanraM Cha 1301. Required services ttrat you can shop for 1302. Survey (Irom GFE #6) 135.00 to 5 1303. Pest Iropadion to Gilbert's Professiond Pest rird 585.00 1301. Deed FheDanatron ro Duncan d Harhnan P C . . 1305. Home Irrspectbn to Troubnan's Home Ins 550.00 275.0 1308. Taz CertiBcatbn Fee to Hal U-SeN Delwier R 1307. Est. 2011 CoartyRwp. Taws to Robin SoBen er Tax 5.0 13011. Est. Wrier Bit ro N. Middleton A 240.00 50.0 r ' r ' 4,670.42 3,983.44 . , ~.,~~~ _~,.~~„~ a, ~ wwrcie Page 2 of 4 HUD-1 alOood FaNh UFE ind H1NL C That Cannot btaeud HU0.1 LNe Number OurorgNpdonchrgs N 801 You csedl or (PobN) br the ePsolAe ktlereq qda chaart g 802: YovadJubdodpYptloncharpee. d 809 Trarrlertaxes g 1103 C ThM Can C IMINI depoel loryoureacrow acaouM 0 1001 DaAy Ytlenal oherpee ban ~{ 907 ;7.2141 HamorMNh NNaatlort * ~ TIN eerrbea and lerrdefa tl8s Y1et-arrct i 1104 t3astere We bMUenoe tr 1103 Peet Mrpecllorl I1 1303 Home I d 1305 Lean Taemc Good FaMh Eatlntap HU0.1 596.20 596.20 0.00 0.00 596.20 596.20 729.00 729.00 Hood FaNh Egbnrts HU0.1 200.00 217.50 450.00 400.00 40.00 21.93 8.00 8.00 100.00 100.00 798.00 747.43 5-50.57 pr x.3311% Good FaNb Eetlmate HU0.1 1,175.64 388.05 7.21 201.99 380.00 561.00 1,112.08 1,053.75 0.00 18.00 75.00 85.00 0.00 50.00 Your Wtlel ban amoutl k ~ 369,255.00 Your ban tertrt N 30 yeah Your YdUel keaeet rap N 3.7500% You Ydtlal maMhly enlolart owed br prYlclpal, Ydereat, arld any 3320.73 includes kruarra 4 ^X Principal ^X Interest ~ ; ^ Mortgage Insurance ~ 1'ou YMerslt ~ ~? ~ ^X No. ~ Yes, R can rise to a maximum of %. The first charge I4 will be on 1 I and can change again every years after 1 1 .Every change date, your interest rate ran increase or decrease by %. Over the Ii1e of the loan, your interest rate is guaranteed to never be lovwr than % or hlyher than %. Even 8 you males paynrertla on dare. Gel you ben bdalcs tIN? ^X No. ~ Yes, I can rise to a maximum of 3 Evan Y you mYp paymerrp on dotes Cen youngMMy allorslt owed ~ ~X No. ~ Yes, the first increase can be on / ( and the monthly PMT. ir8ereal atld morgps kruarrct rles7 amount owed ran rise to 3 ~ The maxknum I can ever rise to a 3 Does you ban Aava a prspsylnent pattMy2 1 ~X No. ~ Yes, your maxkmxn prepayment penalty b 3 Does your ben tpYe a baboon paymart? 1 ~X No. ~ Yes, you have a balloon payment of S d i ue n years on / I Tapl maWy amount awed ylckdinp escrow aocatad paymatta ~ ~ You do not have a monthly escrow payment for items, such as property fazes and homeoMSrers insurance. You must pay these items directly yourseH. ^X You have an addlional nantNy escrow payment of 31fi1.25 that resWts in a total initial mondiy anwuM owed of 3481.98. This includes principal, interest, any mortgage insurarx:e and any items checked blow: ^X Property fazes ~X Homeowner's insurance Flood insurane HUD CER I have carefully reviewed the HUD-1 Stttbment Statement and to the bea disburaementa made on my account or by me in this transaction. I further FICATION OF BUYER AND SELLER of my knowledge and belief, it is a true and accurate statement of all receipts and rtiy that I have received a copy of the HUD-1 Settlement Statement. R' L. Geib The Estate of Paul Warren Stone and EstMr L. St The HUD-1 Settlement S4tement which I have prepared is a true and dlsburaed in accordance with this statement. rate account of this trenaaction. 1 have caused or will cause the funds to ba SETTLEMENT AGENT WARNING' IT IS A CRIME TO KNOVNNGLY MAKE FALSE STATEMENT CONVICTION CAN INCLUDE A FINE AND IMPRISONMENT FOR DETAI DATE TO THE UNITED STATES ON THIS OR ANY SIMILAR FORM PENALTIES UPON S SEE TITLE 1e: U.S. CODE SECTION 1001 AND SECTION 1010. Previous editions are obsolete Page 4 of 4 HUD-] MEMBERS 't FEDERALCREDTT UNI N REGULAR SAVINGS ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner CHECKING ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner INVESTMENT SAVINGS ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner Estate of: Esther L. Stone Date of Death: November 6, 2010 Social Security Number: 165-26-7142 St 1 3408-00 0 /26/1990 $ .00 $ .00 $ .00 N ne 1 3408-11 0 /28/1990 $ ,594.64 $. 2 $ ,594.76 1 3408-05 0 /19/2010 $ 0,831.41 $. 9 $ 0,832.00 M BERS 1ST FEDERAL CREDIT UNION i~Ai1'he Stallin s 9 ing Insurance Support Specialist ember 18, 2010 5000 Louise Drive P.O. Box 40 Mechanicsburg, Pennsylvania 17055 (800) 283-2328 wwwmemberslst.org i { 02f 16/2Q11 I~lONUMEN~'1lL LIFE IAI&UR,A-N C41lSPANY Deferred arx,~ty 060 Tax Qualif~atioR ~S 0006924.. ER L~ Amuitr~t Nom: STONE Poticyown~tak ~~ CHR !t STINA JOY STONE Payee Natna i s sincere condwiences o~ your r ~, P{ei~e acca~rt our c~±pany` . toss. Your request for a r r~edc is atty. Folbwin9 Y ~, ~ distcibu- from year` ~Ix . deferred amui fi- h~ ~ tslcsra from and t1~ is ir~~ r+i1 - ou ~ of ttus distr ,, Lass Fedsri~ irtcotne lax Withheld g~ Tax Withhskt 40 ` 4 $ ~ • ~~ : ~ 3 7 42.8U tVet d, 3 !f' ~ R ~ ~ taxably. #u~ distributia:~ 702.SQ~ i wig' be. rgpa+~ted to that ~~nd to yam, o~ ~ : tQg~--a .. .. _ .. ~ _. _ _ , . f~t~r+~~ air eurrA~~dso. W tl~ pdk~~ #~~ Yes sr~ h y ~ l - r~ ~ C ~~ ~S , ~, ~~ I L F} ..~ l , 4 ~ _ _ ~ ~anct I~fe` ihwf P!~ ~ ~ ~~ . d ~ ~~ t ~` ~ a~ ~~ Wa rwcxxnn~'~d" ~~~ ~ ~ ~ ~~' ~ f~ ` ~ c~ Rr~' r of `t~'111F1?~+~'tY irrtM~ in this #~ +4 ~s,~„~~ we~. nQt~i~ , ~ ~1t ~ tht~ no ~ ; ' ae` '` r A ~ +~ ~ Py" agrwe ~ , v te F Y, to ~ ~~ ~,.lrocn `tl~ e~'.'+Q thin tcar~sac~an` : t tf you Fi~lnt~ a'~y q±a P ~ ~ rapt ,. ~-, the ~ Dlstr~but ` ~ Team ~~-~pQ-553~59~i7'. Zp~'11t+ LIli I~ COlD?~E y.:~.~.A~ •~/ 6 2 - 3 5 4 3 3 3 EDOE'tii~D ROAD li . 8 . ~y MELIAN TRUST of o~+w~ 311 p .O. BOX 3183 CEDAR RAPIDS. IA 52406-3183 ~, nr.Li-w~-RE 19711 - ~ ~('~' tJF O~C~E ; ,..v~vO SSV~ HUNDRED S'~O DOLLARS laws ~~~ 02/16/2011 •••••:;,702.80 : _ __ PAY EXACTLY HIQ,$j~Y CE~l'S ~:. L 4 ,yy L111CU111 Financial Group~~ PQ B(rx iSbO Fort 1Vayue iN 4t~R01~788Q March 14, 21111 VlA FACS1NiCLE ~1~-2~-~-7soo 1Nilliatu A. U-urcan Attc~rncy rYf Law Une Irvine flow Carlisle, YA 17013 LZe: lsther L. Stone, ileceasetl Contract Number. Et75311328 C>eat Mr. ll~incan: 1Ve have received correspondence fiam you regarding t~~e above contr.ict. E3elow is the information requested: 1. 1RA 2. EQ531112$ 3. Otvn~r -- Estlti;r L. Stone; ~, Not a joint account 5. Value as of 11-Ci-(t1- ~21,361.3fl 1-li~pelitlly this infonr~c~tion will be helpful to y~n-. Sincerely, 'n-e~u~ Q~~ ~,Ca~.f Nara Anne Flowe Annuity Technical Specialist Atuntity Claims Dept.