HomeMy WebLinkAbout08-02-111505610143
EX (01-10)
REV-1500 OFFICIAL USE ONLY
PA Department of Revenue pennsylvania County Code Year File Number
Bureau of Individual Taxes DEPARTMENT OF REVENUE
PO 60X.280601 INHERITANCE TAX RETURN 2 ]. 10 12 63
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
210 26 5651 12 21 2010 04 12 1934
Decedent's Last Name Suffix Decedent's First Name MI
F'RIDINGER BETTY V
(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 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 Required
(date of death after 12-12-82)
6 Decedent Died Testate ~ 7• (Attach Copy~of Trust)a Living Trust 0 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will)
9. Liti ation Proceeds Received ~ 1 p, Spousal Povert Credit date of death ~ 11, Election to tax under Sec. 9113(A)
g between 12-31 ~J1 and -1-95) (Attach SCh. O)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
u[~RF.12T c sCHOLLAERT ESQ 717 2 64 194 __
First line of address
82 WEST QUEEN STREET
Second line of address
PO BOX 513
City or Post Office State 21P Code
CHAt~ERSBURG PA 17201
E
REGISTER OI~-~l p ~~ SSE Y
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DATE FILED
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Correspondent's a-mail address:
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.
SIGNA RE OF PERSON RESPONSIBLE FOR FILING RETURN DATE
v ,-~1 ~„ rI r~ ~C ~o ,~ ,13~ ~ Linda K. Keck ~( '7l~'l~' ! I
1137 Creek Road New Milford PA 18834
SI~URE OF PREPARE OTHER THAN EPRESENTATIVE DATE
rl / ~ /I ~ _. ~ ~ Robert C. Schollaert Esq. '7 ~j q ~, ~
82 West Queen Street, Chambersburg, PA 17201
Side 1
L 1505610143
1505610143
~~
J
REV-1500 EX
Decedents Name: FI'Idltlger, Beth/ ~/•
Decedent's Social Security Number
210 26 5651
RECAPITULATION
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 & Notes Receivable (Schedule D) ........................................................ 4.
5. Cash, Bank Deposits 8~ Miscellaneous Personal Property (Schedule E) ............... 5.
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested............ 6.
7. Inter-Vivos Transfers & Miscellaneous ~nq Probate Property
^ Separate Billing Requested............
7.
(Schedule G)
8. Total Gross Assets (total Lines 1-7) ...................................................................... 8.
9. Funeral Expenses 8~ Administrative Costs (Schedule H) ....................................... 9.
10. Debts of Decedent, Mortgage Liabilities, 8~ Liens (Schedule I) .............................. 10.
11. Total Deductions (total Lines 9 8 10) ................................................................... 11.
12. Net Value of Estate (Line 8 minus Line 11) ........................................................... 12.
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.
TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116 15.
(a)(1.2) X .00
16. Amount of Line 14 taxable 131 , 60 6.67 16.
at lineal rate X .045
17. Amount of Line 14 taxable 0 , 0 0 17.
at sibling rate X .12
18. Amount of Line 14 taxable 0 , 0 0 18.
at collateral rate X .15
19 . Tax Due ..................................................................................................................
19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
1505610243
150,000.00
13,014.85
3,786.42
166,801.27
34,274.39
920.21
35,194.60
131,606.67
131,606.67
0.00
5,922.30
0.00
0.00
5,922.30
Side 2
150561U243 1505610243
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19)
2. Credits/Payments
A. Prior Payments
B. Discount
3. Interest
0.00
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)
5,922.30
0.00
5,922.30
Make Check Pa able 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 ............................................................................................................... x
d. receive the promise for life of either payments, benefits or care? ............................................................ ^ ^x
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death 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?....... ^ ^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 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)]. 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-1500 EX Page 3 File Number 21-10-1263
Decedent's Complete Address:
Rev-1502 EX+ (11-08)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
ESTATE OF
Fridin
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.
VALUE AT DATE
ITEM DESCRIPTION OF DEATH
NUMBER
1 Real estate lying and being situate in Hopewell Township, Cumberland County, 150,000.00
Pennsylvania, having a street address of 989 Ridge Road, Shippensburg -sale price
TOTAL (Also enter on Line 1, Recapitulation} I 150,000.00
(If more space is needed, additional pages of the same size)
V.
FILE NUMBER
21-10-1263
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 wllling buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts.
Real property which is jointly-owned with right of survivorship must be disclosed on schedule F.
Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule A (Rev. 11-08)
Rev-1508 EX+ (6-98)
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Fridin er, Bet V. 21-10-1263
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.
ITEM DESCRIPTION
NUMBER
1 2005 Jeep Grand Cherokee -date of death value as per Kelley Blue Book
2 Personal property - as per attached appraisal
3 CenturyLink -refund
4 Erie Insurance Company -vehicle insurance refund
5 Erie Insurance Company -homeowner's insurance refund
6 Received from John C. Stouffer, Jr. - prorata 2010-2011 school real estate taxes
7 U S Treasury - 2010 income tax refund
TOTAL (Also enter on Line 5, Recapitulation)
(If more space is needed, additional pages of the same size)
VALUE AT DATE
OF DEATH
10,675.00
965.00
36.58
543.00
133.00
122.27
540.00
13,014.85
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98)
Rev-1509 EX+ (6-98)
I.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF FILE NUMBER
Fridin er, Bett V. 21-10-1263
If 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
A. Linda K. Keck 1137 Creek Road Daughter
New Milford, PA 18834
B.
C.
JOINTLY OWNED PROPERTY:
DESCRIPTION OF PROPERTY % OF DATE OF DEATH
LETTER DATE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT DATE OF DEATH DECD'S VALUE OF
DECEDENT'S INTEREST
ITEM FOR JOINT MADE NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR VALUE OF ASSE INTEREST
NUMBER TENANT JOINT JOINTLY-HELD REAL ESTATE.
1 A 10/7/2010 Patriot Federal Credit Union account 3,786.42 100.000% 3,786.42
#5000017994 held jointly with daughter, Linda
K. Keck -date of death value
TOTAL (Also enter on Line 6, Recapitulation) I 3,786.42
(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)
REV-1151 EXt(10-06) gCHEDULE H
,.
COMM WALT~E F P R T RI.NVANIA FUNERAL EXPENSES &
'"~~DENT~~`ED~N~ ADMINISTRATIVE COSTS
ESTATE OF
Fridinaer, Betty V.
ITEM
NUMBE
A.
FUNERAL EXPENSES:
Debts of decedent must be reported on Schedule I.
DESCRIPTION
FILE NUMBER
21-10-1263
AMOUNT
See continuation schedule(s) attached I 2,173.98
g, ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Linda K. Keck
Street Address 1137 Creek Road
City New Milford State PA zip 18834
Year(sl Commission paid 2011 7,422.05
2. Attorney's Fees Black and Davison 7,422.05
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 3,500.00
Claimant Linda K. Keck
Street Address 989 Ridge Road
city Shippensburg state PA zip 17257
Relationship of Claimant to Decedent Daughter
4. Probate Fees Cumberland County Register of Wills 65.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
13,691.31
7. Other Administrative Costs
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation) 34,274.39
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
Fridin er, Bett V. 21-10-1263
ITEM DESCRIPTION AMOUNT
NUMBER
Funeral Ex e~ rases
1 Dan Clark -memorial service 100.00
2 Dan Swank -organist for memorial service 25.00
3 Linda Keck -reimbursement for funeral expenses 2,048.98
H-A 2,173.98
4 Other Administrative Gosts
AAA -vehicle transfer fee
30.00
5 Black and Davison -reserve for closing costs 300.00
6 Black and Davison -administration expenses advanced 358.12
7 Carl Ocker Auctioneer -personal property appraisal fee 150.00
8 Commonwealth of Pennsylvania -vehicle transfer 58.50
9 Cumberland County Recorder of Deeds -seller's share of transfer tax on sale of real estate 1,500.00
10 Cumberland County Recorder of Deeds -satisfaction piece recording fee 50.50
11 Federal Express -shipment of items to decedent's son 123.56
12 Interstate Waste -trash removal 53.67
13 Jeremy Landi -snow removal at decedent's real estate 100.00
14 Jeremy Landi -lawn care 40.00
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
FILE NUMBER
ESTATE OF 21-10-1263
Fridin er, Bet V.
ITEM DESCRIPTION AMOUNT
NUMBER
1,530.00
15 Linda Keck -travel expenses
16 Linda Keck -reimbursement for salt for water softener at decedent's home 14.42
17 Re/Max Delta Group -commission on sale of real estate 4,500.00
18 Re/Max Delta Group -transaction fee on sale of real estate 195.00
19 Sailhamer Real Estate -commission on sale of real estate 4,500.00
20 The Sentinal -legal notice 187.54
H_B7 13,691.31
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98)
Rev-1512 EX+ (12-08)
SCHEDULE 1
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Fridin
V.
FILE NUMBER
21-10-1263
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses.
VALUE AT DATE
ITEM DESCRIPTION OF DEATH
NUMBER
1 Adams Electric -debt of decedent 83.41
2 Central Valley Veterinarian Hospital -care for decedent's pet 146.50
3 CenturyLink -debt of decedent 80'92
4 Elk Lake Vet -vet care for decedent's pet 115.00
5 Elk Lake Vet -vet care for decedent's pet 60.00
6 Interstate Waste -debt of decedent 52.14
7 Kough's Oil Service -debt of decedent 357.24
8 Lutheran Social Services Foundation -debt of decedent 25.00
TOTAL (Also enter on Line 10, Recapitulation) I 920.21
(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)
SCHEDULE J
COM IN(~I~N/EDENT ~ECEDN~N~RNANIA BENEFICIARIES
ESTATE OF
Fridin er, Be V.
NAME AND ADDRESS OF
NUMBER PERSONISI RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal
I. distributions, and transfers
under Sec. 9116 a 1.2
1 Sam Hawkins
6309 E. Redfield Road
Scottsdale, AZ 85254
2 Linda K. Keck
1137 Creek Road
New Milford, PA 18834
3 Chad Franklin Martin
51 Carbaugh Hollow Lane
Fayetteville, PA 17222
FILE NUMBER
21-10-1263
RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
DECEDENT (Words) ($$$)
Son 140% of residuary
estate
Daughter 160% of residuary
estate
Grandson 2005 Jeep valued
at $10,675.00
Total ~
Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 1500 cover sheet as a ro I
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 SHEETI
Copyright (c) 2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 11-08)
LAST WILL AND TESTAMENT
I, BETTY V. FRIDINGER, of 989 Ridge Road, Shippensburg, Cumberland
County, Pennsylvania, revoke all my prior Wills and declare this to be my Will.
1.
I direct the expenses of my last illness, funeral and burial shall be paid from my
estate as soon as practicable after my death.
L.
I give and bequeath my 2005 Jeep vehicle to my grandson, Chad Franklin
Martin.
3.
I give, devise and bequeath all the rest, residue and remainder of my estate, of
whatsoever kind and wheresoever situate, as follows:
A. Sixty (60%) percent to my daughter, Linda K. Keck; and
B. Forty (40%) percent to my son, Sam Hawkins.
In the event that any of my children shall predecease me, leaving lawful issue of
him or her surviving, whether the same be natural born or adopted, then, and in that
r: vC~i., ~ d;~ C~~ a !a< li .c .71 id! C vvl Ili..! i thc~'iai c! It ~ivvUlu ! IdvC tdl'~C; t, i! llvlt i~, be divldecl
among the lawful issue of the one or ones so dying, per stirpes and not per capita.
have made an unequal distribution of my estate to my children, not because I
love one more than the other, and I hereby affirm that I love both o~.~ny child~~n equal,
but in recognition of the considerable sacrifice and time devoted b~~uger, ~:~~~~,
tom care Burin m last illness. ~'?~ °° ~" `~;'
~ o -~, ~ . -~=1
cr, `'`~
-1-
4.
All death taxes payable because of my death, with respect to the property
forming my gross estate for tax purposes passing under this Will, including any interest
~r penalty imposed in connection with such tax, shall be considered a part of the
expense of the administration of my estate and shall be paid from my residuary estate
without apportionment or right of reimbursement.
,,.
I nominate, constitute and appoint my daughter, Linda K. Keck, as Executrix of
this, my Last Will and Testament. If she for any reason does not act or continue to act, I
appoint my son, Sam Hawkins, as Executor in her place with the same powers and
duties. I direct that no Executor or Executrix named, nominated or appointed hereunder
~ shall be required to post bond or give any security of any type for any purpose
whatsoever, any law or rule of court of the Commonwealth of Pennsylvania or any other
jurisdiction to the contrary notwithstanding.
IN WITNESS WHEREOF, I have hereunto set my hand and affixed my seal the
~~ ~.. ~-
day of ~= c~~~ 1~ ~~~ , 2010.
i
Betty V. F~idinger
-2-
Signed, sealed, published and declared as and for her Last Will and Testament
~ by Betty V. Fridinger, the above-named Testatrix, in the sight and presence of us, who
at her request and in the sight and presence of her and of each other, have hereunto
subscribed our names as witnesses on the day and year last above written.
1
1~
f
I ~ ,•' ~ ,.
-3-
COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF FRANKLIN
I, Betty V. Fridinger, the Testatrix whose name is signed to the attached or
foregoing instrument, having been duly qualified according to law, do hereby
acknowledge that I signed and executed the instrument as my Last Will; and that I
signed it willingly and as my free and voluntary act for the purposes therein expressed.
Sworn to or affirmed and acknowledged before me by Betty V. Fridinger, the
Testatrix, this ~ ..-tom.. day of ~~~ c '{-;-~ ~,~ r , 2010.
~r ti .-'~"
~''~~ L"
Testatrix
r'
~z...~.. f ~.:ia:i1 1 _..
N7 "4
.Y ~...W. ....:..... .. ___.. _.
.. ~' - .. -
COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF FRANKLIN
We, ~ ~ ~. ;~~: i~_ ~ ~~- -rr- and ~..~ ~~ f~~._ C.. ~ ~. ~ ~ ~ ~r r• ~~ the
witnesses whose names are signed to the attached or foregoing instrument, being duly
qualified according to law, do depose and say that we were present and saw the
Testatrix sign and execute the instrument as her Last Will; that the Testatrix 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 best of our knowledge the Testatrix was at
that time eighteen or more years of age, of sound mind and under no constraint or
undue influence.
Sworn to or affirmed and subscribed to
~ ~; ` ;~` ~~~ ~• ~- and ~ ~-. ~ ~-~ ~~ t: C' S <- h.~: I (~~~=,~ f:
i ~^ day of ~-~ ~ ~ ~,._ , 201
.~
~ ~ p ~
Notary 1
:
~ _ _ _
_ }, ,
~
i
• '?Y ~•:~ C ql. ...`fit ~~ ~:)'.~'~° a.. ~I It ^ i i... r".:c....
before me by
witnesses, this
OMB Approval No. 2502-0265
i~y~~~~~!!; A. Settlement Statement (HUD-1) FINAL
.- . ..
6. File Number: 7. Loan Number: 8. Mortgage Insurance Case Number:
~ , ^ FHA 2. ^ RHS 3. Q Conv. Unins. CTA1307 5200035327 ~
4. ^ VA 5. ^Conv. Ins.
C. Note: This form is furnished 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 closing; they are shown here for informational purposes and are not included in the totals.
E. Name & Address of Seller: F. Name & Address of Lender:
D. Name & Address of Borrower:
John C. Stouffer, Jr. Linda K. Keck, Executrix of the Estate of Betty V. Patriot Federal Credit Union
800 Wayne Avenue, Chambersburg, PA 17201
1489 Roxbury Road, Shippensburg, PA 17257 Fridinger
H. Settlement Agent: I. Settlement Date: 05/27/2011
G. Property Location:
989 Ridge Road Franklin RE Services and Abstracting Co. Disbursement Date: 05/27/2011
Shippensburg, PA 17257 273 Lincoln Way East, Chambersburg, PA 17201
Hopewell Township
Telephone:717-264-3290 Fax:717-264-1985
Place of Settlement: TitleExpress
273 Lincoln Way East, Chambersburg, PA 17201 by JLF 05/23/2011 at 9:34 am
. :. e
400. Gross Amount Due to Seller 150,000.00 +~
100. Gross Amount Due from Borrower 150,000.00 401. Contract sales price
~n~ rnntract sales price
102. Personal ro en 5,322.49
103. Settlement charges to borrower (line 1400)
104.
105.
Adjustments for items paid by seller in advance
106. Cityltown taxes to
107. County taxes to
108. Assessments to
27
122
109. School taxes 05127!2011 to 0613012011 .
110.
111.
112' 155,444.78
120. Gross Amount Due from Borrower
200. Amounts Paid b or in Behalf of Borrower 2,000.00
201. Deposit or earnest money 000.00
110
202. Principal amount of new loan(s) ,
203. Existin loa s taken sub'ect to
204.
205.
206.
207.
208.
209.
Ad'ustments for items un aid b seller
210. Cityltown taxes to
88
130
211. County taxes 0110112011 to 0512712011 .
212. Assessments to
213.
214.
215.
216.
217.
218.
219' 112,130.88
220. Total Paid b /for Borrower
Cash at Settlement fromlto Borrower
300
.
Gross amount due from borrower (line 120) 155,444.7
301.
302. Less amounts paid bylfor borrower (line 220) 112,130.8
^ To Borrower
303. Cash ^X From
43,313.8
e u ,c epo ing u en or is co c ion o m orma ton a es ima e a mtnu es per response or co ec ing, rewewrn
this form, unless it tlisplays a currently valid OMB control number. No confidentiality is assured. This disclosure is mantlalory
process.
402, Personal ro ert
403.
404.
405.
Ad'ustments for items aid b seller in advance
406. Cityltown taxes to
407. County taxes to
408. Assessments to
409. School taxes 0512712011 to 0613012011
410.
411.
412.
420. Gross Amount Due to Seller
500. Reductions In Amount Due to Seller
501. Excess deposit (see instructions)
502. Settlement charges to seller (line 1400)
503. Existin loa s taken sub'ect to
504. Payoff of first mortgage loan
505. Payoff of second mortgage loan
506.
507.
508.
509.
Ad'ustments for items un aid b seller
510. Cityltown taxes to
511. County taxes 01101!2011 to 05127!2011
512. Assessments to
513.
514.
515.
516.
517.
518.
519.
520. Total Reduction Amount Due Seller
800. Cash at Settlement tolfrom Seller
6 601. Gross amount due to seller (line 420)
8 602. Less reductions in amount due seller (line 520)
8 803. Cash ^X To ^ From Seller
9 This s designetl to provide the parries too a f7ESPA covered Itlransaclion wild nrormalon During Ine
122.27
150,122.27
10,745.50
130.88 ~ /
10,876.38
150,122.27
10,876.38
139,245.89
HUD-]
Page 1 of 4
Previous editions are obsolete
00
000
$ 9 Paid From Paid From
'
.
,
700. Total Real Estate Broker Fees Borrower's s
Seller
Division of commission line 700 as follows: to RelMax Celta Group i Funds at Funds at
701. $4,500.00 to Sailhamer Real Estate / Settlement Settlement
00 ~
000
9
702. $4,500.00
703. Commission paid at settlement .
,
195.00 ~
nsaction Fee to Re(Max Delta Group
T
04
ra
.
7
800. Items Pa able in Connection with Loan
ination charge (Includes Origination Point 0.000% or $0.00) $566.95
i
O
(from GFE #1)
g
ur or
801.
802. Your credit or charge (points) for the specific interest rate chosen $ from GFE #2)
(from GFE A)
566.95
803. Your adjusted origination charges
i from GFE #3
O
00 P
C. B ( )
$375
s
804. Appraisal fee to E er A raisa .
.
.
(from GFE #3) 19.40
to MDA Lendin Solutions
805. Credit report (from GFE #3) 85.00
806. Tax service to PHH Mort a e Services (from GFE #3) 19.50
807. Flood certification to PHH Mort a e Services
to
808.
900. Items Re uired b Lender to be Paid in Advance
m 05127!2011 to 06101/2011 @ $14.31511day
f from GFE #10
) 71.58
ro
901. Daily interest charges from (from GFE #3)
902. Mortgage Ins. Premium for months to from GFE #11
C. B ( )
O
00 P
$661
903. Homeowner's insurance for 1 ears to Nationwide .
.
.
from GFE #11
months to
904.
1000. Reserves De osited with Lender (from GFE #9) 1,301.11
1001. Initial deposit for your escrow account
1002. Homeowner's insurance 3 months $ 55.081month $165.24
1003. Mortgage Insurance months $ O.OOlmonth $
1004. School Property Tax 12 months $ 108.431month $1,301.16
1005. Couniy Property Tax 4 months $ 27.271month $109.08 I
Assessments months $ O.OOlmonth $
1006
.
1007. Aggregate Adjustment $-274.37
~/
1305. "'
~ ~ ~ ~ ~ 5,322.49 10,745.50
,i~ .. ~-
'Paid outside of closing by (B)orrower, (S)eller, (L)ender, (I)nvestor, Bro(K)er. "Credit by lender shown on page 1."'Credit by seller shown on page 1.
HUD-]
Page 2 of 4
Previous editions are obsolete
Good Faith Estimate 4UD•1
Com arison of Good Faith Estimate GFE and HUD-1 Char es
Char es That Cannot Increase HUD•1 Line Number
95
566 566.95
Our origination charge # 801 .
00
0 0.00
Your credit or charge (points) for the specific interest rate chosen # 802 .
95
566 566.95
Your adjusted origination charges # 803
1203 .
1,500.00
1,500.00
Transfer taxes
#
Char es That in Total Cannot Increase More Than 10°!°
Government recording charges # 1201
Appraisal fee # 804
Credit report # 805
# 806
Tax service
# 807
Flood certification
' 1101
s title insurance
Title services and lender
Owner's title insurance # 1103
Good Faith Estimate HUD-1
1,100.00 1,301.11
243.36 71.58
530.04 661.00
Loan Terms
Your initial loan amount is $110,000.00
Your loan term is 30. years
Your initial interest rate is 4.7500%
Your initial monthly amount owed for principal, interest, and any mortgage $573.81 includes
insurance is []X Principal
[]X Interest
Mortgage Insurance
Can your interest rate rise? ^X No. ^ Yes, it can rise to a maximum of %. The first change
will be on 1 1 and can change again every years after 1 / .Every change
date, your interest rate can increase or decrease by %. Over the life of the loan, your
interest rate is guaranteed to never be lower than % or higher than %•
Even if you make payments on time, can your loan balance rise? Q No• ^ Yes, it can rise to a maximum of $ •
Even if you make payments on time, can your monthly amount owed for 0 No• ^ Yes, the first increase can be on 1 1 and the monthly
principal, interest, and mortgage insurance rise? amount owed can rise to $
The maximum it can ever rise to is $
Does your loan have a prepayment penalty? ^X No. ^ Yes, your maximum prepayment penalty is $
^X No. ^ Yes, you have a balloon payment of $ due in
Does your loan have a balloon payment? years on 1 1
Total monthly amount owed including escrow account payments ^ You do not have a monthly escrow payment for items, such as property taxes
and homeowner's insurance. You must pay these items directly yourself.
^X You have an additional monthly escrow payment of $190.78
that results in a total initial monthly amount owed of $764.59. This includes principal, interest, any
mortgage insurance and any items checked belcw:
0 Property taxes 0 Homeowner's insurance
Flood insurance
Note: If you have any questions about the Settlement Charges and Loan Terms listed on Phis form, please contact your lender.
HUD-]
Page 3 of 4
Previous editions are obsolete
~.~~
HUD CERTIFICATION OF BUYER AND SELLER
I have carefully reviewed the HUD-1 Settlement Statement and to t urther certinythat I hav9e received a copy of the HUD-1cSettlement Statement receipts and
disbursements made on my account or by me in this transaction. I f fY
C~~~' ~--
n C. Stouffer, Jr.
i
~ ~ ~! ~a ~
s
Linda K. Keck, Execut ix of t e s of Betty V. Fridi r
The HUD-1 Settlement Statement which I have prepared is a true and accurate account of this transaction. I have caused or will cause the funds to be
disbursed in accordance with this statement.
~~
SETTLEMENT AGE
~/
DA
WARNING: IT IS A CRIME TO KNOWINGLYnMPRKSONMENT FOR DETAILS SEE T THE BDUSACODE SECTION 1001 ANDISECT ONN1 OPONALTIES UPON
CONVICTION CAN INCLUDE A FINE AND
HUD-]
Page 4 of 4
Previous editions are obsolete
•. ~ ~ • ~-
~ ~ ~
Name of Seller: File Number:
Name of Borrower: CTA1307
John C. Stouffer, Jr. Linda K. Keck, Executrix of the Estate of Betty V.
Fridinger
Prepared 05123/2011 at 9:34 am
Note: This page displays an itemization of the adjusted origination charges shown in section 800 of the HUD-1 Settlement Statemen
This page accompanies but is not a part of the HUD-1 Settlement Statement. If a discrepancy exists, the information on the HUD-1
Settlement Statement applies.
Borrower Seller
Your Loan Origination Charges
801. Our origination charge (Includes Origination Point 0.000% or $0.00) 200.00
Processing Fee to Patriot Federal Credit Union $ 360.00
Underwriting Fee to PHH Mort a e Services $ 6.95
MERS Fee to Patriot Federal Credit Union $
802. Your credit or charge (points) for the specific interest rate chosen $ 0.00
to 566.95 0.00
803. Your adjusted origination charges
. ~
r:l_ A1. ~... {...r•
HUD-l
Page 1 of 1
Previous editions are obsolete
I
V ,J
CARL E. OCKER
AUCTIONEER
4401 Philadelphia Avenue
Chambersburg, PA 17201
(717) 264-6578
Personal Property Appraisal for
Betty Fridinger Estate
989 Ridge Road
Shippensburg, PA 17257
LIVING ROOM
00
75
2 PC LIVING ROOM SET ....................................................................... .
..............................................
2 OAK END TABLES, COFFEE TABLE ................................................ .............................................. 75.00
PINE ROCKER ......................................................................................... .............................................. 20.00
PICTURES ............................................................................................... ................................................. 5.00
PAIR LAMPS .......................
................................................................... ................................................. 5.00
OAK CORNER TV CABINET ................................................................ ............................................... 25.00
TOSHIBA FLAT TV ............................................................................... ............................................. 125.00
RECLINER .............................................................................................. ............................................... 40.00
WALL CLOCK ........................................................................................ ............................................... 10.00
SMITH STAND ....................................................................................... ............................................... 20.00
GARAGE
00
50
CRAFTSMAN PUSH MOWER .............................................................. .
...............................................
PATIO 00
10
PATIO CHAIRS ...................................................................................... .
...............................................
KITCHEN
10
00
MICROWAVE AND STAND ................................................................ .
.................................................
SMALL APPLIANCES, DISHES .......................................................... ................................................ 20.00
ROUND OAK TABLE, 4 CHAIRS ........................................................ .............................................. 125.00
OAK 2 PC HUTCH ................................................................................. .............................................. 125.00
BEDROOM ONE
TREADMILL .......................................................................................... ................................................ 50.00
CEDAR CHEST ...................................................................................... ................................................ 20.00
SINGLE BED .......................................................................................... ................................................ 20.00
2 ROUND RUGS .................................................................................... ................................................ 10.00
2 STANDS, LAMPS ............................................................................... .................................................. 5.00
BEDROOM TWO
MAPLE BED ......................
................................................................... .................................................. 35.00
FLOOR LAMP ......................................................................................,. ................................................. 10.00
PICTURES . ................................................... 5.00
DRESSER .............................................................................................. ................................................... 5.00
RUGS ..................................................................................................... ................................................... 5.00
BEDROOM THREE 25.00
4 PC 1960'S BEDROOM SET ................................................................................................................
ROUND VICTORIAN STAND .............................................................................................................. 25.00
CHAIR ...................................................................................................................................................... 5.00
PICTURES, FIGURINE ................... 5.00
........................................................................................................
TOTAL ................................................................................................................................................ $965.00
I, DO HEREBY CERTIFY that I have examined the tangible personal property of
Betty Fridinger Estate, 989 Ridge Road, Shippensburg, PA 17257
And do value and appraise the same at $965.00 as being fair market
Value of said property on this date of January 15, 2011
Date ~ l.3 t 1 Carl E. Ocker
Appraiser
Linda K. Keck
1137 Creek Road
New Milford, PA 18834
July 18, 2011
Pennsylvania Department of Revenue
Bureau of Individual Taxes
P.O. Box 280601
Harrisburg, PA 17128-0601
Re: Estate of Betty V. Fridinger
Ladies and Gentlemen:
I write to you as the daughter of Betty V. Fridinger. Prior to my mother's illness, she
lived alone, and I lived two hundred miles away from her. In order for me to properly care for
my mother during her final illness, I chose to leave my job and my home and move in with my
mother. I lived with my mother for about three months before her death; therefore, I have
decided to claim the family exemption against her estate.
Yours very truly,
Linda K. Keck
BLACK AND DAVISON
Attorneys-at-Law
82 West Queen Street
Chambersburg, PA 17201
Robert C. Schollaert (717) 264-5194 Jan G. Sulcove
Elliott B. Sulcove Jerrold A. Sulcove
Estate of Betty V. Fridinger
RE : General
DATE EXPENSE
12/28/10 Cumberland County Register of Wills -probate fee
12/28/10 Cumberland County Law Journal -legal notice
12/29/10 Travel expense
O 1 /24/ 11 Postage
Total of New Expenses:
AMOUNT
273.50
75.00
4.08
5.54
358.12
ACCOUNT SUMMARY
PREVIOUS BALANCE: $0.00
NEW SERVICES: $0.00
NEW EXPENSES: $358.12
NEW PAYMENTS: $0.00
TOT. CURRENT PERIOD: $3 5 8.12
CURRENT BALANCE: $358.12
PAGE 1
BILLING DATE: 07/18/11
ACCT NO.: RCS-18637.01
Please write the above account number on your check
and make your check payable to Black and Davison
"THANK YOU"