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HomeMy WebLinkAbout06-23-11J 1505610143 REV-1500 Ex(°'-'°' PA Department of Revenue OFFICIAL USE ONLY pennsylvania County Code Year File Number Bureau of Individual Taxes DEPARTIr~NT OF REVENUE Po Box.2soso~ INHERITANCE TAX RETURN 21 11 0321 Harrisburg, PA 17128-0601 RESIDENT DECEDENT tlv I tK DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 166 12 6697 02 20 2011 11 10 1915 Decedent's Last Name Suffix Decedent's First Name KUNT Z AT.Nrn (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name 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 5. Federal Estate Tax Return Re uired (date of death after 12-12-82) ~^ 4 8 Decedent Died Testate (Attach Copy of Will) ^ ~ Decedent Maintained a Living Trust 8. Total Number of Safe De OSIt BOXeS (Attach Copy of Trust) p 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death r~ 11. Election to tax under Sec. 9113 A between 12-31 ~J1 and T-1-95) u ( ) (Attach SCh. O) MI L MI CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number JOHN E FEATHER JR 717 867 1200 First line of address 22 W MAIN STREET Second line of address City or Post Office State ZIP Code ANNVILLE PA 17003 Correspondent's a-mail address: )ef@featherlaw.COm REGISTER OF WILLS USE QN,LY ~ -- ._: ~, -~ -- • AJ :.."../ C C..~ . ~~; ? c7 ~-.... __ ~- ~ • f '1 f ~-- ~ '~'1 T-t ~ i L .1 - DAF~~ rED ~~ - .. f.. ;~~ r +;.T.? ;- !~- ~7 1 ~.~~_t t~~ :as- -• ,- L'e'i ~'~ "TZ t 'a unaer penattles or pequry, 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 persona-I representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE ,~/i~L b . O .-~ '~ Cx•r c William O Kuntz III ~ ~ z~ ~!I ~~~o 3 Hlprl,~ygo falls CQur'1t, Perry Hall, MD 21128 SIGN OF ~A R O REPRESENTATIVE John E. Feather Jr. u~l ~~ 22 ~1~-Main Street, Annvl~N~, PA Side 1 L 1505610143 1505610143 J 1505610243 REV-1500 EX Decedent's Social Security Number Decedent's Name: KU n1;Z~ Alma L. 16 6 12 6 6 9 7 RE CAPITULATION 1. Real Estate (Schedule A) ....................................................................................... 1. 10 3, 4 4 9. 0 4 2. Stocks and Bonds (Schedule B) ............................................................................. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C)......... 3. 4. Mortgages 8 Notes Receivable (Schedule D) ........................................................ 4. 5• Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ............... 5. 2 7 9 . 5 5 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6. 2 3 , 18 7.41 7. Inter-Vivos Transfers & Miscellaneous fyoq Probate Property (Schedule G) Se t Billi R (~ para e ng equested............ 7, 8. Total Gross Assets (total Lines 1-7) ..................................................................... g. 12 6 , 916.00 9. Funeral Expenses & Administrative Costs (Schedule H) ....................................... 9. 2 $ , 411.97 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............................. 10. 1 , 0 9 6 . 8 4 11. Total Deductions (total Lines 9 8 10) ................................................................... 11 2 6 , 5 0 $ . 81 12. Net Value of Estate (Line 8 minus Line 11) .......................................................... 12• 10 0 , 4 0 7.19 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, 10 0 , 4 0 7.19 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. 0.00 16. Amount of Line 14 taxable at lineal rate X .045 9 9, 4 0 7.19 16. 4, 4 7 3. 3 2 17. Amount of Line 14 taxable at sibling rate X .12 0. 0 0 17. 0. 0 0 18. Amount of Line 14 taxable at collateral rate X .15 1, 0 0 0. 0 0 18. 15 0. 0 0 19. Tax Due .................................................................................................................. 19. 4 , 623.32 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ^ Side 2 1505610243 1505610243 J REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-11-0321 DECEDENT'S NAME Kuntz, Alma L. STREET ADDRESS 502 South 20th Street CITY STATE ZIP Camp Hill PA 17011 Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. Credits/Payments A. Prior Payments B. Discount 3. Interest 4,000.00 210.53 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. (1) Total Credits (A + B) (2) (3) (4) (5) 4,623.32 4,210.53 412.79 Nlake 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 :............................................................................... ^ 0 b. retain the right to designate who shall use the property transferred or its income :.................................. c. retain a reversionary interest; or ............................................................................................................... ^ 0 d. receive the promise for life of either payments, benefits or care? ........................................................... ^ 0 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .................................................................................................................... 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?....... ^ 0 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 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 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)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. Rev-1502 EX+~11-08) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER 21-11-0321 exchariged between a willing buyer and a willing seller, neither being compelled to buy or sell, both hae ng reasonable knowledgefof theyrelevant facts would be Real property which 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 Include a 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 -situate 502 S. 20th Street, Camp Hill, Cumberland County, PA 103,000.00 (see attached settlement statement) 2 Real Estate -credit for proration of real estate taxes and sewer charges (per attached 449.04 settlement statement) TOTAL (Also enter on Line 1, Recapitulation) I 103,449.04 (If more space is needed, additional pages of the same size) Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule A (Rev. 11-08) Rev-1508 EX+ (6-98) ,. COMMONWEALTH OF PENNSYLVANIA. INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. FILE NUMBER 21-11-0321 (Ir more space Is neeaea, aaaitlonal pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98) Rev-1509 EX+ (6-98) ,. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF Kuntz, Alma L. FILE NUMBER 21-11-0321 A. William O. Kuntz III B. C. 3 Honeygo Falls Court Grandson Perry Hall, MD 21128 JOINTLY OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY ITEM NUMBER FOR JOIN T MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER ATTACH DEED FOR DATE OF DEATH % OF DECD'S DATE OF DEATH VALUE OF ' TENANT JOINT . JOINTLY-HELD REAL ESTATE. VALUE OF ASSE INTEREST DECEDENT S INTEREST 1 Citizens Bank -account no. 6100682072 15.981.34 50.000% 7.990.67 2 Citizens Bank -account no. 6100768287 30,393.47 50.000% 15,196.74 TOTAL (Also enter on Line 6, Recapitulation) I 23,187.41 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule F (Rev. 6-98) r'f an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT REV-1151 EX+ (10-06) ,. COMMONWEALT OF PENNSYLVANIA INHEI~ITAN~E TALC RETI~,RN REJJIDEN DEII;;EDEEN SCHEDULE H FUNERAL EXPENSES & -DMINISTRATIVE COSTS ESTATE OF FILE NUMBER Kuntz, Alma L. 21-11-0321 Debts of decedent must be reported on Schedule I. ITEM N MBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: See continuation schedule(s) attached I 2,840.09 B. 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zip Yearls) Commission paid 2. Attorney's Fees Feather and Feather, PC 6,108.64 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zin Relationshio of Claimant to Decedent 4. Probate Fees 330.50 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 16,132.74 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 25,411.97 Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 10-06) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Kuntz, Alma L. 21-11-0321 ITEM NUMBER DESCRIPTION AMOUNT Funeral Ex enses 1 Auer Cremation Services of Pennsylvania, Inc. -funeral services 1,895.09 2 Rolling Green Cemetery Co. -interment expenses 945.00 H-A Other Administrative Costs 3 Bonnie K. Miller, Treasurer - 2011 county 8~ municipal real estate taxes 4 Cumberland County Register of Wills -two short certificates 5 Cumberland Law Journal -estate notice 6 Feather and Feather, P.C. -reimbursement for present owner search 8~ UPS charges 7 Karla Snyder -reimbursement for house cleaning 8 Lower Allen Township -sewer/refuse 4/1-6/30/11 9 Peggy S. Clements -notary fee 10 Pennsylvania American Water -water 2/2-3/7/11 11 Pennsylvania American Water -water 3/7-4/5/11 12 Pennsylvania American Water-final water 13 PPL -electric 2/15-3/17/11 14 PPL -electric 3/17-4/15/11 2,840.09 575.00 8.00 75.00 91.59 50.00 103.95 10.00 33.07 31.72 39.60 16.00 10.86 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Kuntz, Alma L. 21-11-0321 ITEM NUMBER DESCRIPTION AMOUNT 15 Real Estate -expense -seller paid prepaids (per attached settlement statement) 1,672.77 16 Real Estate -expense -seller closing cost assist (per attached settlement statement) 4,327.63 17 Real Estate -expense -real estate commission per attached settlement statement 5,809.20 18 Real Estate -expense -notary fee per attached settlement statement 10.00 19 Real Estate -expense -reimbursement for tax certification per attached settlement statement 10.00 20 Real Estate -expense -1% transfer tax per attached settlement statement 1,030.00 21 Real Estate -expense -repairs per attached settlement statement 1,775.00 22 The Sentinel -estate notice 176.92 23 UGI -gas bill 92.14 24 UGI -gas - 3/28-4/27/11 91.00 25 UGI -gas 93.29 H-B7 16,132.74 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1512 EX+(12-08) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF Kuntz, Alma L. FILE NUMBER 21-11-0321 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 AT&T -final telephone 51.23 2 Quantum Imaging -medical bill 14.00 3 Quest Diagnostics -medical bill 53.07 4 Snoke Family Practice -medical bill 98.00 5 Snoke Family Practice -medical bill 10.00 6 Spirit Physicians Services -inpatient consultation 24.93 7 State Employees Retirement System -reimbursement for 2/11 and 3/11 overpayments 845.61 TOTAL (Also enter on Line 10, Recapitulation) I 1,096.84 (If more space is needed, additional pages of the same size) Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 12-08) REV-1513 EX+(11-08) COMMONWEALTH [)F PFNNCVi vnwn SCHEDULE J Kuntz, Alma L. NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 a 1.2 Judith Imler 8 Cornell Drive Camp Hill, PA 17011 Kristin K. Kuntr 425 North Front Street Columbus, OH 43215 William O. Kuntr III 3 Honeygo Falls Court Perry Hall, MD 21128 FILE NUMBER 21-11-0321 RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE DECEDENT (Words) ($$$) 0 of i t T stee Friend I I 1,000.00 Granddaughter I I 49,703.60 Grandson I ~ 49,703.60 ~ ~ Total ~ 100,407.20 Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 1500 cover sheet, as a ro riate. NON-TAXABLE DISTRIBUTIONS: II. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET Copyright (c) 2009 form software only The Lackner Group, Inc. -Form PA-1500 Schedule J (Rev. 11-08) ?ASM¢Nr~'~S' o"~ °~,~ ~ x ~ * ~ OMB Approval No. 2502-0265 =a ~ ~= A. Settleme ° ` nt Statement (HUD-1) gBRN oN~roQ B. Type of Loan 6 F 1. ©FHA 2. [~ RHS 3. Q Conv. Unins. . ile Number. KUJ70-11 7. Loan Number: 8. Mortgage Insurance Case Number. 4. Q VA 5. ~ Conv: Ins. 91000037 446-0773705-703 C. Note; This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked "(p.o.c.)" were paid outside the closin the h D. Name and Address of Borrower: g; y are s own here for lnfom-ational pu rposes and are not included in the totals. E. Name and Address of Seller. F. Name and Address of Lender. CRAIG A. KUJAWA and JENNIFER L KUJAWA ESTATE OF ALMA L. KUNTZ FAIRWAY INDEPENDENT MORTGAGE . 1008 VINTAGE COURT APT. A 502 SOUTH 20TH STREET CAMP HILL PA 17011 CORP. HARRISBURG, PA 17109 , 4720 CARLISLE PIKE, SUITE 300 MECHANICSBURG, PA 17050 G. Property Location: 502 SOUTH 20TH STREET H. Settlement Agent: 25-1619811 TRI-COUNTY ABSTRACT SERVICE I• Settlement Date: CAMP HILL, PA 17011 48 CENTRAL BLVD CUMBERLAND County, Pennsylvania . CAMP HILL PA 17011 June 2, 2011 , Place of Settlement: Ph. (717)761-8870 48 CENTRAL BLVD. CAMP HILL, PA 17011 from 1 ~r in adva 1 to 01 to 1 to 07 111. 112. 120. Gross Amount Due from Borrower 200. Amounts Paid b or in Behalf of B~ 201. Deposit or earnest money 400. Gross Amount Due to 404. nu usirnems Tor 1[ems aiq Seller in advance X42.02 406. C' /Town Taxes 06/02/11 to 01/01/12 407. Coun 'Taxes 342.C to 73.89 408. SCHOOL TAXES 06/02!11 to 07/01/11 73.8 33.13 409. SEWER/TRASH 06/02/11 to 07/01/11 33.1 wwn 412. 110,079.43 420. Gross Amount Due to Seller 103,449.04 to Ad ustments for items un aid Seller 210. Ci /Town Taxes t 4,327.63 509. SELLER CLOSING COST ASSIST Ad'ustments for items un aid b Seller ~ ~v~ 4,327.63 o 211. Coun Taxes t 510. Ci /Town Taxes to o 212. SCHOOL TAXES t 511. Coun Taxes to o 213 512. SCHOOL TAXES to X214. 513. 215 514. 216. 515. 217. 516. 218. 517. 219. 518. 519. 220. Total Pald b /for Borrower 300. Cash at SetNement from/to Borrower 301 G 106,888.40 b20. Total Reduction Amount Due Seller 600. Cash at settlement to/from S II 14,634.60 ross amount due from Borrower line 120 a er 110,079.43 601. Gross amount due to Seller line 420 103 449.04 302. Less amount aid b/for Borrower line 220) ( 106,888.40} 602. Less reductions due Seller (line 520 ( 14,634.60 303. Cash X~ From ~ To Borrower 3,191.03 603. Cash Q To ~ From Seller 88,814.44 The undersigned hereby ac ledge receipt of a completed copy of this statement & any attachments referred to herein Borrower Seller ESTATE OF ALMA L. KUNTZ . KUJ WA' TO THE BEST OF MY KE WLEDG ,THE HUD 1 SETT MENT STATEMENT WHICH I HAVE PREPARED IS T UE AND ACCURATE ACCOUNT OF T .FU ~ D WHICH WERE RECEIVED AND HAVE BEEN OR WILL BE DISBURSED BY THE UNDERSIGNED AS PART O SETTLEME F THIS i i i SETTLEMENT AGENT, Settlement Agent WARNING: IT IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE UNITED STATES ON THIS OR ANY SIMILAR FORM. PENALTIES UPON C TION CAN INCLUDE A FINE AND IMPRISONMENT. FOR DETAILS SEE: TITLE 18 U.S. CODE SECTION 1001 & SECTION 1010. TcompleteitlUs formnunles~a Ilndl ~a cWlectbn of iMormetlon Is eaUmeted at 36 minutes per response /or colleging. reviewing. and reporting the date. This agency may not tolled Wa {nionnatlon. end you yre rqt required to during the settlement process. splays a wrrently valid OMB conVol number. No cordfdentlelity k assured; This dlaeloaure Is m~datory. This is designed to provkle the parties to a RESPA covered hanaactlon wlUr IMormetlon Page 1 of 3 HUC)-1 (KUJ70-11. PFD/KUJ70-11 /17) L. Settlement Charges 700: Total Real Estate Broker Fees $ 5,809.20 DiWsion of comm/ssion (line 700) as fellows: 701. 2 904.60 to CENTURY 21 PISCIONERI 702. 2904.60 to EXIT PLATINUM PLUS REALTY 703. Commission aid at settlement 704. 705. BROKERS FEE to EXIT PLATINUM PLUS REALTY 800. Items Pa able in Connection with Loan 801. Our on ination cha e $ 1,166.00 802. Your credft or charge (points) for the specific interest rate chosen $ 03. Your adjusted origination charges 804. A sisal fee to FAIRWAY MORTGAGE FOR FAIRWAY APf 805. Credit Re ort to FAIRWAY MORTGAGE FOR KROLL DATA o c r_.. ___.:__ __ ~~ ,.a~.~~~~ar~~~~ to rHircwAY MORTGAGE FOR CORELOGIC (from GFE #3) 808. 809. (from GFE #3) 8 0. (from GFE #3) 811. (from GFE #3) from GFE #3) 900. Items Re wired b Lender to Be Paid in Advance 901. Deily interest charges from 06/02/11 to 07/01/11 29 @ $13.064200/day (from-GFE #10) 902. Mort a e insurance remium for months to HUD from GFE #3 903. Homeowner's insurance for ears to THE METZ AGENCY from GFE #11 POC 3fi 904. 905. (from GFE #11) (from GFE #11) 1000. Reserves De osited with Lender 1001. Initial deposit for your escrow account (from GFE #9) omeowne s insurance mon s per mon 1003. Mort a e insurance 0.000 months $ 94.59 r month $ 1004. Property taxes $ City/Town Taxes months (a3 $ per month Assessments months @ $ per month 1005. 1006. COUNTYliWP TAXES 5.000 months Q $ 48.84 per month $ 244.20 1007. SCHOOL TAXES 12.000 months @ $ 77.50 per month $ 930 00 . 1008. 1009. AGGREGATE ESCROW ADJUSTMEI $ -335.24 1100. Title Cha es 1101. Title services and lender's title insurance from GFE #4) 1102. Settlement or ciosin fee $ 1103. Owner's title insurance to FIRST AMERICAN TITLE INSURANCE CO . from GFE #5 1104. Lenders ftie Insurance to FIRST AMERICAN TITLE INSURANCE CO . $ 927.38 100 300 1105. Lenders title oli limft $ 100 388 00 . 5011342-00252' 1106. Owners title oli Ilmit $ 103 000 00 . 5011442-00178 1107. A set's ortion of the total title insurance remium to TRI-COUNTY ABSTRACT SERVICE $ 7g ; 1108. Underwriters ortion of the total tftle Insurance remium to FIRST AMERICAN TITLE INSURANCE ( $ 14( 1109. NOTARY FEE to CASH 1110. RE-IMBURSEMENT FOR TAX CERT to TRI-COUNTY ABSTRACT SERVI E 1111. 1112. 1113. 1200. Government Recording and Transfer Charges 1201. Government recordin cha es to RECORDER OF DEEDS from GFE #7 1202. Deed $ 62.00 Mortgage $ 74.00 Releases $ Other $ 1203. Transfer taxes to RECORDER OF DEEDS (from GFE #8) 1204. City/County tax/stamps $ 1,030.00 $ 1205. State tax/stam s $ 1,030.00 $ 1206. 1207. 1300. Additional Settlement Char es 1301. R wired services that ou can sho for from GFE #6 1302. REPAIRS to MIKE SHEELY HOME INSPECTIONS 1303. 1 304. 1 305. 1 400. Total Settlement Char es enter on lines 103, Section J and 502, Section ay signing Page 1 al this statement, the slgnatorfes acknowledge receipt of a completed copy o/ page 2 3 3 or this tli a statement. SETITLEMENT AGENT, Settlement Agent CERTIFIED, TRUE AND CORRECT Paid From Paid From Borrowers Beliefs Funds al Funds st Setllement Settlement 5 808 195.00 ', '' 1.166.00 378.86 993.95 929.95 1,056.88 10.00 1 1,0 1 Page 2 of 3 HUD-1.. (KUJ70-11.PFD/KUJ70-11/17) Good Faith Estimate HUD-1 200.00 136.00 500.00 500.00 25.00 25.00 9.75 9.75 993.95 993:95 --~--'-' --r __.. .... ~..... ., oa.wu~Il #1001 Daily interest charges # 901 Homeowner's insurance # 903 Title services and lender's title insurance #1101 Owner's title insurance to FIRST AMERICAN TITLE INSURANCE #1103 Loan Terms Your initial loan amou t i $ 13.064200/day Good Faith Estimate HUD-1 1,086.67 929.95 378.86 378.86 480.00 1,158.75 1,056.88 10.00 9.00 n s $ 100,388.00 Your loan term is 30 years Your initial interest rate is 4.7500 Your initial monthy amount owed for principal, Interest and $ 618 26 includes any mortgage insurance is . ^X Principal 0 Interest ^X Mortgage Insurance Can your interest rate rise? ^X No ^ Yes, it can rise to a maximum of %. The first change will be on and can change again every _ months after . Every change date, your interest rate can increase or decrease by °h. 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 time, can your Moan balance rise? , ^X No ^ Yes, it can rise to a maximum of $ Even if you make payments on time, can your monthly amount owed for principal interest and mort a e i 0 No ^ Yes, the first increase can be on and the monthly , , g g nsurance rise? amount owed can rise to $ The maximum it can ever rise to Is $ Does your loan have a prepayment penalty? ^X No ^ Yes, your maximum prepayment penalty is $ Doe l s your oan have a balloon payment? 0 No ^ Yes, you have a balloon payment of $ due in _ years on T t l o a monthly amount owed including escrow account payments ^ You do not have a monthly escrow payment for item h s, suc as property taxes and homeowner's insurance. You must pay these items directly yourself. X^ You have an additional monthly escrow payment of $156.67 that results in a total initial monthly amount owed of $774.93. This Includes principal, interest, any mortgage insurance and any items checked below: ^X Property taxes X^ Homeowner's insurance ^ Flood insurance XO COUNTY TAXES N ote: If ou h ^X SCHOOL TAXES ^ y ave any questions about the Settlement Charges and Loan Term s listed on this form, please contact your lender. Page 3 of 3 _ HUD-1 (KUJ70-11. PFD/KUJ70-11 /17) Comparison of Good Fafth Estimate (GFE) and HUD-1 Charges Good Fafth Estimate HUD-1 Charges That Cannot increase HUD-1 Line Number Our origination charge # 801 1,166.00 1,166.00 Your credit or charge (points) for the specific interest rate chosen # 802 Your adjusted origination charges # 803 1,166.00 1,166.00 Transfer taxes #1203 1,030.00 1,030.00 HUD-1 Attachment Borrower(s): CRAIG A. KUJAWA and JENNIFER L. Seller(s): ESTATE OF ALMA L. KUNTZ KUJAWA 1008 VINTAGE COURT APT. A 502 SOUTH 20TH STREET HARRISBURG, PA 17109 CAMP HILL, PA 17011 Lender: FAIRWAY INDEPENDENT MORTGAGE CORP. Settlement Agent: TRI-COUNTY ABSTRACT SERVICE (717)761-8870 Place of Settlement: 48 CENTRAL BLVD. CAMP HILL, PA 17011 Settlement Date: June 2, 2011 Property Location: 502 SOUTH 20TH STREET CAMP HILL, PA 17011 CUMBERLAND County, Pennsylvania Additional Adjustments For Items Paid By Seller In Advance (Borrower Debit) Description Amount From/Throuph Prorated Amount SEWER/TRASH 103.95 04/01/11 through 06/30/11 33.13 Total Line 1091409 33.13 Adjusted Origination Charge Details Origination Charge AUTOMATED UNDERWRITING FEE to FAIRWAY INDEPENDENT MORTGAGE CORP. DOCUMENT PREPARATION FEE to SCHWARTZ & ASSOCIATES FRAUD DETECTION SERVICES to FAIRWAY INDEPENDENT MORTGAGE CORP. PROCESSING FEE to FAIRWAY INDEPENDENT MORTGAGE CORP. UNDERWRITING FEE to FAIRWAY INDEPENDENT MORTGAGE CORP. Origination Credit/Charge (points) for the specific interest rate chosen 15.00 INVOICE #E4636844 115.00 36.00 400.00 600.00 Total $_ 1,166.00 Total $ Adjusted Origination Charges $ 1,166.00 Reserves Deposited with Lender Homeowner's Insurance 3.000 at 30.33 per month COUNTY/TWP TAXES 5.000 at 48.84 per month SCHOOL TAXES 12.000 at 77.50 per month AGGREGATE ESCROW ADJUSTMENT month 90.99 244.20 930.00 -335.24 Total $ 929.95 Title Services and Lender's Title Insurance Details INSURED CLOSING LETTER to FIRST AMERICAN TITLE INSURANCE BORROWER SELLER 75.00 WARNING: It Is a crime to knowingly make false statements to the Unlted States on this or any similar form. Penalties upon convection can include a fine and imprisonment. For details see: Title 18 U.S. Code Sectlon 1001 and Section 1010. (KUJ70-11. PFD/KUJ70-11 /17) HUD-1 Attachment - Continued ELECTRONIC DOCUMENT DELIVERY 25.00 to TRI-COUNTY ABSTRACT SERVICE OVERNIGHT FEES to TRI-COUNTY ABSTRACT SERVICE 14.50 NOTARY FEES to CASH 15.00 Lender's title insurance 100 300 8.1 927,gg to FIRST AMERICAN TITLE INSURANCE CO. Total $ 1,056.88 $ 0.00 Owner's Title Insurance BORROWER SELLER Owner's Policy Premium 9.00 to FIRST AMERICAN TITLE INSURANCE CO, Total $ 9.00 $ 0.00 Lender's Title Insurance "fees also shown above in Title Services and Lender's Title Insurance Details BORROWER SELLER Lender's Policy Premium to FIRST AMERICAN TITLE INSURANCE CO. 777.38 Lender's Endorsement Charges Endorsement 150.00 ALTA Endorsement Form 8.1 (Environmental Protection Lien) orsem50 OOharge ALTA Endorsement Form 9 (Restrictions, Encroachments, Min.) 50.00 PA ENDORSEMENT 300 MTG. SURVEY EXCEPTION 50.00 Total s 4~~ z~ ~ ., ...: 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. (KUJ70-11. PFD/KUJ70-11 /17) Citizens Bank° April 11, 2011 Feather and Feather P.C. Attorneys At Law 22 West Main Street Annville PA 17003 Estate of Alma L Kuntz Date of Death: Feb 20, 2011 SSN: 166-12-6697 Dear Sir/Madam: One Citizens Dnve ROP 112 Riverside, RI 02915 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 Installment Loans or Line of Credit accounts, contact our Loan Department at 1-800-708-6680. For all other inquiries, please call 1-877-579-2667 Sincerely, nnifer Co Decedent Account Processing REF#: 489547 Schedule "F" Citizens Bank° Account Number 6100682072 Account Title Alma LKuntz/William Kuntz III Date Opened 6/6/1966 Account Type Checkin Princi al Balance as of DOD $15981.12 Interest from Last Postin to DOD $ .22 Account Balance as of DOD $1.5981.34 YTD Interest to DOD $2 32 *** Accounts were acquired through MELLON conversion on 4/20/2002 and have been titled like this since that time. Citizens Bank° Account Number Account Title Date Opened Account Type Principal Balance as of DOD Interest from Last Posting to DOD Account Balance as of DOD YTD Interest to DOD 6100768287 Alma LKuntz/William Kuntz III 12/17/1982 ~, , . $30390.56 $2.91 $30393.47 $23.10 * * * Accounts were acquired through MELLON conversion on 4/20/2002 and have been titled like this since that time. rr.r~i rir.tc t~tv L 1'I/A1 H1~;K, Y. C. ATTORNEYS AT LAW 22 WEST MAfN STREET ANNVILLE, PENNSYLVANIA.17003 ~ 7v~ as7-i2oo F/JC l 717) 867-5074 ~' LAST WILL AND TESTAMENT ALMA L. KUNTZ I, Alma L. Kuntz (Social Security Number 166-12-6697) of Cumberland County, Pennsylvania, do hereby make, publish and declare the following as and for my last Will and Testament, hereb revokin and Y g making null and void any and all former Wills and codicils heretofore made by me. FIRST. I hereby nominate and appoint my grandson, William O. Kuntz III, as Personal Representative of this my last Will and Testament. In the event he is unable or unwilling to serve, then I appoint my granddaughter, Kristin K. Kuntz. , SECOND. I hereby direct that no Personal Representative shall be required to give any bond in any jurisdiction and that if, notwithstanding this direction, any bond is required by any Law, Statute, or Rule of Court, no sureties shall. be required thereon. THIRD. I direct that all of my funeral expenses including my grave marker shall be paid from my residuary estate as soon. as practicable after my decease as a part of the expense of the administration of m Y estate. FOURTH. I direct that all taxes that may be assessed in consequence of my death on any property passing under this my Last Will and Testament, of whatever nature and by' whatever jurisdiction imposed, shall be paid from my residuary estate as part of the expense of the administration of my estate. FIFTH. I make the following specific bequests: A) $1,000.00 to my dear friend, Judith Imler of Camp Hill, PA. SIXTH. I give, devise and bequeath all the rest of my estate, excluding the property described in Paragraph Fifth, unto my grandchildren, William O. Kuntz III and Kristin K. Kuntz my in equal shares. ~°~ Page 1 of 4 In the event any of my grandchildren should predecease me and leave issue surviving, I give and bequeath the share of said predeceased grandchild to the issue of the predeceased grandchild. In the event any ofmy grandchildren should predecease me and leave no issue surviving, I give and bequeath that share to my surviving grandchild. IN WITNESS WI-IEREOF, I have hereunto set my hand and seal to this, my last Will and Testament, consisting of this and three (3) other pages, this ~ day of 200-1. ~~"~ `~ (SEAL) ALMA L. KUNTZ Signed, sealed, published and declared by the Testatrix above named, as and for her last Will and Testamen in our resence, who in her presence, and at her request, and in the presence of each other, have here t~ subs dour names s attesting witnesses. unto \' Address ~ } ~~ D~ Addres / ~ J Page 2 of 4 COMMONWEALTH OF PENNSYLVANIA ) COUNTY OF LEBANON ) I, Alma L. Kuntz;, whose name is signed to the attached or foregoing instrument, havin been dul qualified according to law, do hereby acknowled e that I si g Y Will; that I signed it willingly, and that I signed g as m fregened and executed the instrument as my Last expressed. Y and voluntary act for the purposes therein G~~~ az° Alma L. Kuntz, Testa ON THIS, the/7~ti day of ~~.-; / , 2001, before me, Carol M. Dau he officer, personally appeared John E. Feather, Jr., Esq., (known to me or satisfactoril ~ the undersigned y proven) to be a member of the bar of the highest court ofPennsylvania and subscribing witness to the foregoin instrument and certified that he was personally present when Alma L. Kuntz, whose name is subscribed to the fore o' instrument executed the instrument, and that as the si ato g u1g gn ry, she acknowledged that she executed the instrument for the purposes contained in it. IN WITNESS WH-EREOF, I have hereunto set my hand and notarial seal. ~ ~'Y~. Notary Public - ~~~~ , ti , NOTARIAL SEAL ~ ' CAROL M. DAU6HfRTY, NOTARYPUBUC ~ c_, r~~ _ ANNVILLE TWP., LEBANON CO., PA. ~ t :4 ; 7 ,. 'y. MY COMMISSION EXPIRES JULY 5, 2001 ~ '; .~ f ..;;' , . ' ai „\ ,. ,;;~~ Page 3 of 4 COMMONWEALTH OF PENNSYLVANIA ) COUNTY OF LEBANON ) We, John E. Feather, Jr., and /.~o ~,,,~ ,~ j~u,~ ~ ,the witnesses whose names are si ed to the attached or foregoing instrument, being duly qualified according to law, do depose and sa that~we (I) were present and saw the testatrix sign and execute the instrument as her Last Will; that th testa ' signed willingly and executed it as her free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the testatrix signed the will as a witness; and that to the be of our (my) knowledge the testatrix was at that ti 8 or more years of age, of sound mind and under st constraint or undue influence. n~ no Sworn to or affirmed and subscribed before me by John E. Feather, Jr., witness,. this /7f~ da o - /~} ~ ~ ~ ! 2001. y f -ate. Notary Public COMMONWEALTH OF PENNSYLVANIA COUNTY OF LEBANON ) NOTARIAL SEAL CAROL M. DAUGHERTY, NOTARY PUBLIC ) SS ANNVILLE TWP., LEBANON CO., PA. MY COh4MISSION IXPIRES JULY 5 2001 ON THIS, the /7~~ day of _ ~,or; / , 2001, before me, Carol M. Daugherty, the undersi ~'/~, officer, personally appeared John E. Feather, Jr., Esq., (known to me or satisfactoril roven to fined member of the bar of the highest court of Pennsylvania and subscribing witness to the fore op n ) be a and certified that he was ersonall g g instrument, p y present when ~o-„~,<< ,D, ,~u~, f2 ,whose name is subscribed to the foregoing instrument as witness, executed the instrument, and he acknowledgedthat he/she exe the instrument for the purposes contained in it. cuted IN WITNESS WHEREOF, I have hereunto set my hand and notarial seal. ~~ ~~~jc.c~.~ Notary Public NOTARIAL SEAL CAROL M. DAUGHERTY, NOTARY PUBLIC ANNVILLE TWP., LEBANON CO., PA. Page 4 of 4 MY COMMiSS10N EXPIRES JULY 5, 2001