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HomeMy WebLinkAbout06-10-11 (3)J 1505610140 REV-1500 EX (°'-'°, PA Department of Revenue OFFICIAL USE ONLY Bureau of Individual Taxes INHERITANCE TAX RETURN PO BOX 280601 County Code Year File Number Harrisbur PA 17128-0601 RESIDENT DECEDENT 2 1 1 0 1 0 2 5 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYW Date of Birth MMDDYYW 1 9 1 4 6 2 5 2 9 0 8 2 9 2 0 1 0 0 6 1 3 1 9 1 8 Decedent's Last Name Suffix Decedent's First Name M Y E R S MI L A U R A E (If Applicable) Enter Surviving Spouse's Information Belo w Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW Q 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) QX 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 DIRECTED T0: Name Daytime Telephone Number R O G E R B I R W I N E S Q U I R E 7 1 7 2 4 9 2 3 5 3 First line of address 6 0 W E S T Second line of address City or Post Office C A R L I S L E Correspondent's a-mail address: State ZIP Code na REGIST _ ~ ILLS USF-ONLY _" ~~' -~ ~i.7 =~) ~ A z- ~ r-- x~y r' ~. --: _ ~ _r. r r-T~ _ ~ ~,~ C ~ `~` -~,. _:r ~Ts -~'UATE FILED _._ C7 P A 1 7 0 1 3 Under penalties of perjury, I declare that I have examined this return, including accompanying 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 representative is based on all information of which preparer has any knowledge. IGNATURE OF PERSON RESPpp~~SIBLE FOR FILING RETURN DATE annRGCC e 81 WO SIGNATUF IDGE= RO/~D P O M F R E T S T R E E T OCHER T N REPRESENTATIVE 60 WEST F~FRET STR 1505610140 LIS CARLISL PLEASE USE ORIGINAL FORM ONLY Side 1 A 17013 TE iv ~, A 17013 1505610140 r ,~ \~, 1505610240 REV-1500 EX Decedent's Social Security Number 1 9 1 4 6 2 5 2 9 decedent's Name: LAURA E- M Y E R S RECAPITULATION 3 7 5 D 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• 8 7 6 2 3. 9 7 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 & Miscellaneous N~PSeparaterBill'ng Requested .. G U ..... 7. ) (Schedule 8 4 6 2 6 2 3.9 7 8. Total Gross Assets (total Lines 1 through 7) .............. . 9 4 2 3 1 6. 4 3 9. Funeral Expenses and Administrative Costs (Schedule H) .... . . 5 0 4 1. 6 0 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ....... 10. ..... . 11 4 7 3 5 8. 0 3 11. Total Deductions (total Lines 9 and 10) ......................... . ...... 12 4 1 5 2 6 5. 9 4 12. Net Value of Estate (Line 8 minus Line 11) .............. . . 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which 13 an election to tax has not been made (Schedule J) ................ . ..... . .-.•.. 14. Net Value Subject to Tax (Line 12 minus Line 13) ......... . ......14. 4 1 5 2 6 5. 9 4 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 O. D D 15• D. D D (a)(1.2) X •0 16. Amount of Line 14 taxable 4 1 5 2 6 5. 9 4 1s. 1 8 6 8 6. 9 7 at lineal rate X .045 .. 17. Amount of Line 14 taxable D ~ D D 17. 0 ' D D at sibling rate X .12 18. Amount of Line 14 taxable D . D D 18. D ' D D at collateral rate X .15 19 .. 1 8 6 8 6. 9 7 19. TAX DUE ............................................... ..... 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ^ Side 2 1505610240 1505610240 J Continuation of REV-1500 Inheritance Tax Return Resident Decedent LAURA E. MYERS Decedent's Name 21 10 1025 Page 1 File Number Correspondents Name R O G E R B I R W I N Daytime Telephone Number 7 1 7 2 4 9 2 3 5 3 First line of address 6 0 W E S T Second line of address City or Post Office C A R L I S L E P O M F R E T S T R E E T State ZIP Code P A 1 7 0 1 3 Correspondent's a-mail address: Under penalties of perjury, I dedare that I have examined this return, including accompanying 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 representative is based on all information of which pn:parer has any knowledge. SIGN~URE QF PE~2SON RISPONSIBLE FOR FILING R~ TURN ~ ,DATE ADDRESS 119 HILL DRIVE CARLISLE P 17013 REV-1500 EX Page 3 Decedent's Complete Address File Number 21 1n 1roR DECEDENT'S NAME LAURA E. MYERS STREET ADDRESS 255 WOLFS BRIDGE ROAD CITY CARLISLE STATE Zlp PA 17013 Tax Payments and Credits: ~. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments 7.000.00 B. Discount 368.41 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. (1 } 18,686.97 Total Credits (A + B) (2} 7, 368.41 (3) (4) 0.00 (5) 11,318.56 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 : ................................................. ^ Q ....................: b. retain the right to designate who shall use the property transferred or its income; .............................. ^ Q 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? ....................................................................................... ^ X^ 3. Did decedent own an "in trust for" or payable-upon-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 beneficiary designation? .................................................................................................. ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN For dates of death on or after July 1,1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse 3 percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after Jan.1,1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory 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)]. • 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)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, 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 INHERITANCE TAX RETURN REAL ESTATE RESIDENT DECEDENT ESTATE OF: FILE NUMBER: LAURA E. MYERS 21 10 1025 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property that is jointly-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. 255 WOLFS BRIDGE ROAD, CARLISLE, PENNSYLVANIA 375,000.00 SOLD -SETTLEMENT SHEET ATTACHED TOTAL (Also enter on Line 1, Recapitulation.) I $ 375.000.00 If more space is needed, use additional sheets of paper of the same size. REV-1508 EX + (B-98) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. IN RES DENT DECEDENT N PERSONAL PROPERTY ESTATE OF FILE NUMBER LAURA E. MYERS 21 10 1025 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. VEHICLE - 1966 CHEVROLET C10 300.00 2. IM&T BANK -CHECKING ACCOUNT #430161 3. ~M&T BANK -CHECKING ACCOUNT #9850787848 8,718.06 31, 532.66 4. (PERSONAL PROPERTY -SETTLEMENT STATEMENTS ATTACHED I 47,073.25 TOTAL (Also enter on line 5, Recapitulation) I $ 87 (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 LAURA E. MYERS 21 10 1025 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION A. FUNERAL EXPENSES: 1. EWING BROTHERS FUNERAL HOME B. State ZIP AMOUNT 5,160.26 Year(s) Commission Paid: 2, AttomeyFees: IRWIN & McKNIGHT, P.C. 17,650.00 3. Family Exemption: (If decedents address is not the same as claimants, attach explanation.) Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4• Probate Fees: REGISTER OF WILLS 457.50 5 Accountant Fees: GROUP'S TAX & PAYROLL SERVICE 50.00 6. TaxRetumPreparerFees: PATRICIAA. ROSENDALE, CPA 375.00 7. REGISTER OF WILLS -FILING FEE 30 00 8. CLOSING COSTS ON SALE OF REAL ESTATE . 3 777.00 9. CUMBERLAND LAW JOURNAL -ESTATE NOTICE , 75 00 10. THE SENTINEL -ESTATE NOTICE . 198 16 11. JONES & MARTIN AUCTIONEERS -PUBLIC SALE COMMISSION . 4 591.25 12. JONES & MARTIN AUCTIONEERS -REAL ESTATE SALE COMMISSION , 9 602.26 13. DIVERSIFIED APPRAISAL SERVICES -APPRAISAL ON REAL ESTATE , 350.00 TOTAL (Also enter on Line 9, Recapitulation) $ 42 316.43 If more space is needed, use additional sheets of paper of the same size. ADMINISTRATIVE COSTS: Personal Representative Commissions: Name(s) of Personal Representative(s) Street Address City REV-1512 EX+ (12-08) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER LAURA E. MYERS 21 10 1025 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. PP&L -ELECTRIC 2. ASOCIAL SECURITY ADMINISTRATION -REIMBURSEMENT 3. IAERO ENERGY -FUEL 4. ICENTURYLINK -TELEPHONE 5. ~EVERETT CASH MUTUAL INSURANCE COMPANY -HOMEOWNERS INSURANCE 6. (FARRELL VETERINARY ASSOCIATES, INC. -OUTSTANDING INVOICE 7. (FRANK ROBERTO, TAX COLLECTOR -REAL ESTATE TAXES TOTAL (Also enter on Line 10, Recapitulation) I $ If more space is needed, insert additional sheets of the same size. 467.15 1,089.00 2,073.75 36.27 824.00 88.00 463.43 REV-1513 EX+ (Ot-10) Pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF: FILE NUMBER: LAURA E. MYERS ~~ ~n ~n~~ 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 outrightspousaldistributions and transfers under Sec. 9116 (a) (1.2).] 1. MARY A. JAYNE Lineal 207,632.97 81 WOLFS BRIDGE ROAD 1/2 REMAINDER CARLISLE, PA 17013 2. ETHEL M. MURTOFF Lineal 207,632.97 119 HILL DRIVE 1/2 REMAINDER CARLISLE, PA 17013 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER S HEET, AS APPROPRIATE. II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ If more space is needed, use additional sheets of paper of the same size. E. LAST WILL AND TESTAMENT I, LAURA E. 1VlYERS, of Middlesex Township, Cumberland County, Pennsylvania, declare this instrument to be my Last Will and Testament, hereby expressly revoking all Wills and Codicils heretofore made by me. 1. I direct my executrices to pay all of my debts, funeral and administrative expenses as soon as maybe done conveniently after my decease. 2. I authorize and empower my executrices to sell any realty owned by me at my death and not specifically devised herein, at either public or private sale, and to give good and sufficient deeds therefor, in fee simple, as I could do if living. 3. I give, devise and bequeath all of my estate of every nature and wherever situate to my two daughters, Mary A. Jayne and Ethel M. Murtoff, share and share alike, the child or children of any deceased child taking the share their parent would have taken if living. 4. I nominate and appoint Mary A. Jayne and Ethel M. Murtoff to be the executrices of this my Last Will and Testament; they are to serve as such without bond. 5. I hereby suggest that my personal representative retain the services of Irwin, McKnight & Hughes, as attorneys in the settlement of my estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this day of October, 1996. (SEAL) LAURA E. MYE Signed, sealed, published and declared by LAURA E. MYERS, the testatrix above named, as and for her Last Will and Testament, in the presence of us, who at her request, in her presence and in the presence of each other have subscribed our names as witnesses hereto. 2 ACKNOWLEDGM~~VT,AND AFFIDAVIT WE, LAURA E. MYERS, MARTHA L. NOEL and CHERYL L. CLELAND, the testatrix and witnesses respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testatrix signed and executed the instrument as her Last Will and that she had signed willingly, and that she executed it as her free and voluntary act for the purpose herein expressed, and that each of the witnesses, in the presence and hearing of the testatrix, signed the Will as a witness and that to the best of their knowledge the testatrix was, at that time, eighteen years of age or older, of sound mind and under no constraint or undue influence. p~GZ~l.U+-~ LAURA E. ,. ,. ~.. L. NOEL HERYL L. CLELAND COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS: Subscribed, sworn to and acknowledged before me by LAURA E. MYERS, the testatrix herein and subscribed and sworn to before me by MARTHA L. NOEL and CHERYL L. CLELAND, witnesses, this 4TH day of October, 1996. ~. Public Rogger BNlrwinaNotary Public ~rlisle Boro, Cumberland County Commission Expires Oct. 3, 2000 per, P9nntylvgnia Association of Notari~ OMB Approval No. 2502-0265 • 6 A. Settlement Statement (HUD-1) a 1. ~ FHA 2. Q RHS 3. X^ Conv. Unins. 6. Ffle Number: 7. Loan Number: 8. Mortgage Insurance Case Number: MANTAJ411 5701194550 4. ^ VA 5. ^Conv. Ins. C. Note: This forth is famished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agents are shown. Items marked "(p.o.c)" were paid outside the dosing; they are shown here for informational purposes and are not inducted in the totals. D. Name 8 Address of Borrower: E. Name & Address of Seller: F. Name & Address of Lender: JOHN S MANTA, JULIE TREGO MANTA LAURA E. MYERS ESTATE FULTON BANK, N.A. 122 SUNSET DRIVE, MOUNT HOLLY SPRINGS, 255 WOLFS BRIDGE ROAD, CARLISLE, PA 17013 ONE PENN SQUARE, LANCASTER, PA PA 17065 17602 G. Property Location: H. Settlement Agent: I. Settlement Date: 05/23/2011 255 WOLFS BRIDGE ROAD I&M REAL ESTATE SERVICES, LLC Disbursement Date: 05/23/2011 Carlisle, PA 17013 Telephone: 717-249-2353 Fax: 717-249.6354 Middlesex Townshi p Place of Settlement: TitleExpress West Pomfret Professional Btdg, 60 West Pomfret Street, Printed 05/23!2011 at 11:53 am Carlisle, PA 17013 by JMR Previous editions are obsolete Page 1 of 4 HUo-l J. Summary of Borrower's Transaction K. Sumrnary of Seller's Transaction ;~.. 'tom ~ ` 1 t'~1~F1_ f ~ r~ ~ 701 $0.00 tof~ 702 $0 00 ~~;,~ ~~. at ~'~ ~ ~' ~tgF`~S . . to 703. Commission paid at settlement a , . s ";EHement °;; °,; - . _. ~.,:., ~~ f'` 801. Our nagon ch argi arge (Includes Origination Pant % or $0.00) $69500 (from GFE #1) 802. Yarr cxedit or charge (pants) for the spedfic interest rate chosen $1,250.00 (from GFE #2) 803. Your adjusted origination charges (from GFE A) 1 945 00 , . 804' Apprasal tee to CENTRAL PENN APPRAISALS (from GFE #3) 375.00 805. Credit report to CREDSTAR Gran GFE #3) 12.24 806 Tax service . to fran GFE #3 807. Flood certrficahon to CORERLOGIC FLOOD SERVICES (fran GFE #3) 11 50 , 808. ~ 901. Daly interest charges from from05/2312011 to O6I0f12011 Co3 $36.8151/daY (from GFE #10) 331 34 . 902. Mortgage Ins. Premium fa months to (fran GFE #3) ' 903. Homeowner s insurance for 12 months to FOREMOST INSURANCE $1,850.00 P.O.C. B' (from GFE #11) ~• months to from GFE #11 / 1001. Initial deposit for your escrow account (from GFE #9) 1 397 00 1002• Homeowners insurance 3 months $ 154.17/month $462.51 , . 1003. Matgage Insurance months $ 0.00/month $0.00 1004. City Property Tax months $ O.OOlmonth $0.00 1005. County Property Tax 4 months $ 38.62/month $154.46 1006. Schad Taxes 12 months $ 116.421month $1,397.04 1007. Aggregate Adjustment $-617.03 .= 1101. Title services and lenders title insurance (from GFE #4) 1 976.75 , 1102. Settlement or dosing tee to $ 1103. Owners title insurance (from GFE #5) 625 00 1104. Lenders title insurance $1,883.75 . 1105. Lenders title paicy limit$250,000.00 Lenders Poky 1106. Owners title paicy limit $375,000.00 Owners Policy 1107. Agent's potion of the btal title insurance premium $2,Ogg,gg 1108. Underwriters portion of the teal 8tle insurance premium $440,06 1109. ENDORSEMENTS 300,100, 900, 7~ $ ` . 1201. GaremmeM recording charges (from GFE #7) 254 50 1202. peed $62.00 Mat $104.00 Release $0.00 . 1203. Transfer taxes (from GFE #8) 3 750.00 1204. City/Countytax/stamps Deed $3,750.00 Mort $0.00 , 1205. State Taxlstamps Deed $3,750.00 Mat a $0.00 3 750 00 1206' Deed $0.00 Mort $0.00 , . 1207. Clean & Green Transfer $ gg,50 1208. Clean & Green Transfer .. . ? , `' ; , I _ 1301. Required services that you can shop for ~) ~ , (from GFE 1302. Surrey ~ $ 1303. to 1304• to $ 1305. to '' ~ r 10,678.33 3,777.00 "Paid outside of dosing by (B)orrower, (S)eller, (L)ender, (I)nvestor, Bro(IC)er. Previous editions are obsolete Page 2 of 4 HUD-1 III ~ ~ .~~ .. Af°.€.~i.~1... 695.00 695.00 1,250.00 1,250.00 1,945.00 1,845.00 7,500.00 3,750.00 130.00 _.._.. 254.50 450.00 375.00 40.00 12.24 11.50 11.50 631.50 653.24 $ 21.74 or 3.4426% ~ 2,244.75 .' ~:1y 1,397.00 331.34 331.34 600.00 1,850.00 10,000.00 1,976.75 10,000.00 625.00 o.oo o.oo Loan Terms $250,000.00 30. years 5.3750% $1,399.93 includes 0 Pdncipal ^X Interest ^ Modgage Insurance ^ No. 0 Yes, it can dse to a maximum of 10.3750%. The first change will be on 06/01/2016 and can change again every 120 Months after 06/0112016. Every change your interest rate can increase or decease by 2.0000%. Over fhe I'de of the loan, your interest r guaranteed to never be louver than 3.0000% or higher than 10.3750%. X^ No. ^ Yes, it can dse to a maximum of $ ^ No. ^X Yes, the first increase can be on 07/01/2016 and the monthly amount owed can dse to $2,158.28. The maximum it can ever dse to is $2,158.28. ^X No. ^ Yes, your maximum prepayment penalty is $ ^X No. ^ Yes, you have a balloon payment of $ due in years on I I ^ You do not have a nanthly escrow payment for items, such as property taxes and homeowners insurance. You must pay these items direc0y yourself. ^X You have an additional monthly escrow payment of $309.21 that results in a total inifial monthly amount owed of $1,709.14. This indudes pdndpat interest, mortgage insurance and any items checked below: ^X Property taxes ^ Homeowner's insurance ^ Flood insurance ^X HOMEOWNERS INSURANCE SCHOOL TAXES n Hake: it you nave any quesoons aoout the settlement charges and Loan Terms listed on this form, please contact your lender. Previous editions are obsolete Page 3 of 4 HUD-1 HUD CERTIFICA170N OF BUYER AND SELLER I have carefully reviewed the HUD~1 Settlement Statement and to the best of my knowledge and belief, d is a true and accurate statement of all receipts and disbursements made on my acwunt or by me in this transaction I further certify that I have received a copy of the HUD-1 Settlement Statement ~~ JOHN ANTA E TREGO MANTA `~r.^~ ~ ~, ~. LAURA E. MYERS ESTATE The HUdt SetNemerd Statement which 1 have prepared is a true and accurate account disbursed in accordance with this statement transaction 1 have caused or will cause the funds to be SETTLEMENT AGENT c~/o~3 ~G1 DATE-~ 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. Previous editions are obsolete Page 4 of 4 HUD-1. ,. .. ~/ ~/ ~ tlr4~ N / - Y N ~ / /I • / /MV / IV / •M// J~..~/ 544 Mohawk Road Newaille~ PA 17241 SALE Dawn yl I1~V A~~tin Newvfile, pA 5hippen~burg, i'A Y.101 NAME• ~~''a°.'~K1~~~~~~ DATB OF SAf.Si ~~ f ADVERTISING BXPENSES: Lancaster F e ~~ ~ The Guide Valley Times News 'ck Other ~ ~ Ocher Sete Flyer! Copies Type Total Adverr3sing Cost Total #~ of Bidder Numbers '-~-. .___ Total #~ sale Sheets Cash Amount I~,_____~~ Total ~ of CheckB Total #~ ell Sale Sheete~=~~ ~ W .~,..,- Advertising Cast Aucdoneer's 96 ~ - _ Misc Charge Misc. Charge ~.~.J~C-ti ~ ll.¢~+r 3 -~ ~;1~ ~..yCo 7Zraot~r 1hr the ayq~pru~tftp by ~ with you andJ~ AunilJr, ~. ~~N,~S ~ ~~~~TIN r~ClCTIVNS, LLC,~ ~~~ vlohawk .Road Newville, PA 17241 l7arryl Jones Neil Martin Newvil(e,1~A ~I~ippen~~urc.j, i~A SETTLEMENT STATEMENT SALE NAME: ~ ~ ~) ;/ ~ ~ , r DATE OF SALE ~ .C. ~ °~,, ~ -~ ~ _ ~, f ,. .ADVERTISING EXPENSES: Lancaster Farmer ~ ~ ~ ~ (~~ The Guide U~o (,,~ Valley Times. News Chronicle _ ~,~ . ~~~ Other `~ ~~-E; ~~~ ,~.t~~ e ~ Sale Flyers Copies ~' ~ . ~ ;~ Type Setting Total Advertising Cost ~ ,~ ~~' rj'C~ Total # of Bidder Numbers IS Total # Sale Sheets Cash Amount In Total $ of Checks 'T'otal # all Sale Sheets_ ICS, (p~~ ~ + Advertising Cost_j,L'~.='~'O - ~Luctioneer's °io_~(~~~ ~ ~~. _ V[isc. Charge- ~` s _ < <~,~ _ _ tilisc. Charge ~`,~ -~~_1._~_ ~ - ~~•._ `~_ --- ~~Iet ~~ale (after expenses) ,~_~~ (~~~~ ~ "<,3if,~- ; {~r< iUr t%le ~)~J~)U!'C111.11/err) ;v~c~t'~ ;vr'c`h ,;.~~i ~.r~d your ,arn_-ly. ~~ ~~ ~~~' ~~l JONES & I~I~T1N ~lllClI0N5, LLC 544 Mohawk Road Newville, PA 17241 C~arryl Jones Nei! Martin Newville, f A Shippen5burg, ~'A SETTLEMENT STATEMENT SALE NAME: ~ . ' ~ a ! ~ ` -e ~,~ ~~1~~ DATE OF SALE ~I I ~ I ,-~~ i ~ ADVERTISING EXPENSES: Lancaster Farmer ~,~ ~ , ' ~ (~ The Guide~C9 ~ ~ C~~ Valley Times News C nicle - • C~~ Other , .:~ ~ ~ - (~ ~ . Other ` ~ . Sale Flyers Copies ~ ~ 1. C..~ y Type Setting Total Advertising Cost~~. ~ . ~_ Total # of Bidder Numbers ;-~. 0 Total # Sale Sheets Cash Amount In Total $ of Checks Total # all Sale Sheets ~,~~ ~t'~"I . ~ + Advertising Cost l ~ ~~ .~ _ Auctioneer's %~-~~ ~ - ~ o~ • '~~ _ Misc. Charge ', . ~ _ Misc. Charge ~ JS (YZ I S ~ 1 -~-- . ~ ~t-e,~-~ s Net Sale (aher expenses) .~ r ~ j (~ ~1 Thank you for the opportunity to work with you and your family. ~;' ~ ~- ~. e What ~+ ~ Y used Cars, tnc `~/es and Se~~e 2/14/2011 1130 Harrisburg Pike Carlisle, PA 17013 Phone: 245-2322 b-. _ __ . To whom it may concern; ~°~~~',~~ ~ , i!~' '~ .., Reference 1966 Chevrolet C10 - ' ~ ~ -~ I have appraised the 1966 Chevrolet C10 serial number C1546B146574. To the best of my knowledge the vehicle would have a cash value of Three Hundred dollars. (+ or-) . The said vehicle would either need to be crushed and sold for scrap, or complete restoration. Daryl Heiges president © .~~1~1~1 ~~E~:~Id1111 499 Mitchell Street, Millsboro, DE 19966 September 16, 2010 ` '°' °"'° s ° ~~ ~~~~~ Law Offices Irwin & McKnight, P.C. '~ j~~° ~ ~ ~~~~ West Pomfret Professional Building 60 West Pomfret Street ~RWIN & NIcKNIGH~r Carlisle, PA 17013-3222 I,AW pFfICES. RE: Estate of Laura Myers Date of Death: August 29, 2010 Social Security Number: 191-46-2529 Dear Mr. Irwin: In response to your request, please be advised that at the time of death,. the above- named decedent had on deposit with this bank the following accounts. 1. Account Tijpe ........................... Checlflng Account Account Number ....................... 430161 Ownership (Names off .............. Laura Myers Opening Date ...........................09/O1 /67 Balance on Date of Death.........$8,718.06 Accnied Interest $ 0.00 Total ....................................... $8, 718.06 2. Account T jpe ........................... Checl~ng Account Account Number ....................... 9850787848 Ownership (Names off .............. Ethel Murtoff, Laura Myers Opening Date ...........................06/28/ 10 Balance on Date of Death..........$31,532.48 Accrued Interest $ 0.18 Total ...................................... $31, 532.66 'The above named decedent did not have a safe deposit box. • Page 2 September 16, 2010 * If upon reviewing the information above, you believe there aze additional accounts not referenced, please provide us with an account number and/or the name of any possible joint account holder. For any additional information on the above accounts, including ownership and any changes, closures and/or reimbursement of funds, please contact our High Street Cazlisle branch at 1 West High Street, Carlisle, PA 17013 or # 717-240- 4536. Sincerely, r Charlene Warrington, Adjustment Services 1-888-502-4349 Ewing Brothers Funeral Home, Inc. 630 South Hanover Street Carlisle, PA 17013- (717)243-2421 September 7, 2010 Ethel M. Murtoff 119 Hill Drive . Carlisle, PA 17013 The Funeral Service for Laura E. Myers We sincerely appreciate the confidence you have placed in us and will continue to assist you in every way we can feel free to contact us if you have an Please uesti i y q ons n regard to this statement. . THE FOLLOWING IS AN ITEMIZED STATEMENT OF THE SERVICES, FACILITIES, AUTOMOTIVE EQUIPMENT, AND MERCHANDISE THAT YOU SELECTED WHEN M AKING THE FUNERAL ARRANG EMENTS I. PROFESSIONAL SERVICES . Services of Funeral Director/Staff , Embalming, $ 1840.00 Dressing, Casketing, Cosmo etc. $875.00 2. FACILITIES AND SERVICES ~ ~ $290.00 Complete facility Usage , 3. AUTOMOTIVE EQUIPMENT ~ ~ ' $890.00 Vehicle to transfer remains to Funeral Home , Hearse (Casket Coach) $275.00 Lead car/Clergy $250.00 Utility Vehicle for DC retrieval/filing $125.00 , FUNERAL HOME SERVICE CHARGES ' $125.00 SELECTED MERCHANDISE: $4670.00 Acknowledgement cards , Register Book(s) $10.00 Memorial folders $40.00 , THE COST OF OUR SERVICES, EQUIPMENT, AND MERCHANDISE $75.00 THAT YOU HAVE SELECTED $4795.00 Cash Advances Clergy/Mass Offering, $100.00 Certified Copies of the Death Certificate , $60.00 The Sentinel Obit no photo, $143.49 Short Obit with patriot $61.77 TOTAL CASH ADVANCES AND SPECIAL CHARGES . $365.26 Total Total Cost . . . . . . . . . . . . . . . . $5160.26